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Board of Health Meeting Items


Item 4.1





























Midland Office – 865 Hugel Avenue, Unit B (Midland Secondary School), Midland, ON

See attached map for directions

May 18, 2011, 9:00 am – 12:00 pm


Barry Ward (Chair), Scott Warnock (Vice Chair), Sandy Cairns, Mike Kennedy, Gord, McKay, Linda Murray, Cal Patterson, Ben Rattelade, Alicia Savage, Doug Skeaff, Dr. Charles Gardner, Medical Officer of Health, Sandra Horney, Director, Corporate Service.


John Brassard, Fred Hamelink, Gail Mullen, Margaretta Papp-Belayneh


Marlene Klanert









New Board of Health Member Orientation

Health Protection Service T. Devine presented.



Call To Order

The meeting was called to order at 9:32 a.m.



Approval of the Agenda

The agenda was approved as presented.


THAT the Board of Health approves the agenda as presented.




Declaration of Conflict of Interest

There was no conflict of interest declared.




Minutes of Previous Meeting




Approval of minutes from April 20, 2011.

The minutes of April 20, 2011 were approved as presented.



THAT the Board of Health approves the minutes from the April 20, 2011 Board of Health meeting as presented.




New Business



2010 Audit Report.  Report.  Mike Laycock of BDO Dunwoody presented.


THAT the Board of Health accepts the draft 2010 Audit Report.



2011 Infrastructure Projected Expenditures.  Briefing Note.  S. Horney presented.


THAT the Board of Health endorses moving forward on the renovations of the Barrie Office and move to the Orillia office and the use of the capital reserve to cover the costs of the renovations if required.



Barrie Server Room Contract Award.  Briefing Note.  S. Horney presented.


THAT the Board of Health awards the contract for Server Room Infrastructure to Axisource based on the proposal submitted April 21, 2011 and the quoted price of $55,384 plus tax and freight.



Bed Bug Support Fund.  Briefing Note.  T. Devine, M. Whelan and Dr. R. Sommers presented.


THAT the Board of Health receives the Health Unit Role in Responding to Bed Bug Complaints briefing note as information.



Progress on Trans Fat Reduction in Simcoe Muskoka.  Briefing Note.  C. Bushey and R. Gaudet presented.


THAT the Board of Health receives the Status Report on Implementing the Recommendations in the SMDHU Board of Health Trans Fat Motion 07-06 as information regarding the progress that has occurred in response to Board of Health resolution 07-06 (Appendix A).



Healthy Communities Partnership Needs Assessment.  Briefing Note.  C. Bushey, L. Zinkan-McKee and V. Shewfelt presented.


THAT the Board of Health receives the Healthy Communities Community Picture report for information.




Advocacy Items




alPHa Resolutions.  Resolution Package.  C. Gardner presented.


THAT the Board of Health receives the alPHa resolutions for information and provides direction to staff and Board members attending the alPHa conference.




Educational Item


alPHa Conference June 12 to 14, 2011 at Toronto Marriott Bloor Yorkville, 90 Bloor Street East, Toronto, ON.


Staff Education Days, May 24 & 25, 2011, Geneva Park, Orillia, ON







Presentation to Anita Dubeau for her years of dedication to the Board of Health.




Items of Information



Letter from Janet Nyhof, Deputy Clerk, City of Orillia to Dr. Charles Gardner, Medical Officer of Health, Simcoe Muskoka District Health Unit re Healthy Community Design Resource.



Letter from Janet Nyhof, Deputy Clerk, City of Orillia to Barry Ward, Chair, Simcoe Muskoka District Health Board of Health re Board of Health 2011 Funding Notice



Copy of letter from Amanda Rayburn, Chair, Board of Health, Wellington-Dufferin-Guelph Public Health to The Honourable Deborah Matthews, Minister, Ministry of Health and Long-Term Care re HPV Publicly Funded Vaccine – Grade 8 Eligibility.



Copy of letter from Amanda Rayburn, Chair, Board of Health, Wellington-Dufferin-Guelph Public Health to The Honourable Deborah Matthews, Minister, Ministry of Health and Long-Term Care re HPV Publicly Funded Vaccine – Male Eligibility.



Copy of letter and attachments from Hazel Lynn, Medical Officer of Health, Grey Bruce Health Unit to Mr. Gary Bettman and the NHL Board of Governors re Violence in Hockey.



Letter from Stacey Weber, Manager, Early Years Program Unit, Ministry of Children and Youth Services to Dr. Charles Gardner, Medical Officer of Health, Simcoe Muskoka District Health Unit re the 2011 allocation for the healthy Babies Healthy Children (HBHC) program of $2,419,133.



Letter from Margarett Best, Minister, Ministry of Health Promotion and Sport to Dr. Charles Gardner, Medical Officer of Health, Simcoe Muskoka District Health Unit re renewed commitment to building a Smoke-Free Ontario.



Copy of letter and attachments from Mr. Jack Butt, Chair, Leeds, Grenville & Lanark District health Unit to The Honourable Laurel Broten, Minister of Children and Youth Services re Increased funding for Preschool Speech and Language Program.



Copy of letter from Penny Sutcliffe, Medical Officer of Health, Sudbury & District Health Unit to Mayors/Reeves, Constituent Municipalities within the Sudbury & District Health Unit Catchment Area re Sustainable Mobility.



NEWS from the Ministry of Health and Long-Term Care re Ontario’s Immunization Program Getting A Boost



Copy of letter from C. Davidovits, Secretary, City of Toronto Board of Health to Medical Officer of Health re Communicable Disease Control Programs 100% Funded by the Ministry of Health and Long-Term Care.



Copy of memo from Dr. Arlene King, Chief Medical Officer of Health, Ministry of Health and Long-Term Care to Medical Officers of Health re Changes to Improve Public Health Coordination, Leadership and Service Delivery-Staffing Announcement.



Letter from Sylvia Shedden, A/Assistant Deputy Minister, Ministry of Health and Long-Term Care to Dr. Charles Gardner, Medical Officer of Health, Simcoe Muskoka District Health Unit re response to letter dated April 5, 2011 regarding provincial public health funding.



Letter from Allison J. Stuart, Assistant Deputy Minister, Ministry of Health and Long-Term Care to Dr. Charles Gardner, Medical Officer of Health, Simcoe Muskoka District Health unit re base funding of $170,040 for two new full time equivalent public health nursing positions.



Ministry of Health and Long-Term Care Press release re More Public Health Nurses Delivering Care To Ontarians.



Thank you from The Gideons for donation on behalf of the Galloway Family.



Letter from Janet Nyhof, Deputy Clerk, City of Orillia to Dr. Charles Gardner, Medical Officer of Health, Simcoe Muskoka District Health Unit re Healthy Community Design Resource.



Date and Time of Next Meeting:



Next Board of Health meetings


Wednesday, June 15, 2011, 9:15 a.m. to 12:00 noon, Barrie Office.


Wednesday, September 21, 2011, 9:15 a.m. to 12:00 noon, Barrie Office



The meeting was adjourned at 12:08 p.m.


Original signed by                                                         Original signed by


Barry Ward,                                                                     Dr. Charles Gardner,

Chair, Board of Health                                                    Medical Officer of Health

Item 6.1

Addressing Time-Sensitive Issues Between Board of Health Meetings



Update:  New                                                                         Date: June 15, 2011





The Board of Health does not hold regular meetings in the months of July and August.  It is anticipated that authorization for significant purchases requiring Board of Health approval may arise as a result of the planned renovations.  It is also possible that other public health or governance issues could arise through this period. 




That the Board of Health receives the Addressing Time-Sensitive Issues Between Board of Health Meetings briefing note for information.


Current Facts:


Policy  FI0107 Health Unit Purchasing and Contracting Services stipulates that agency purchase of goods and services of $50,000.00 or more can only be authorized following a formal request for tender and awarded by the Board of Health; however the Board may delegate this authority to the Medical Officer of Health as it deems necessary.   At its meeting on May 18, 2011 the Board of Health endorsed moving forward with renovations to the Barrie Office beginning the summer of 2011.  An investment in upgrades and reconfiguration of the current space is necessary to maximize the use of space and reduce the required square footage.  We anticipate the need to tender for several products and services as part of the planned renovations including, but not limited to, cabling, flooring and moveable walls.  Our practice for requesting Board approval in the absence of a scheduled meeting has been to:

  • share information by email with clear recommendations and rationale with a follow up phone call indicating information of a time sensitive nature has been forwarded,
  • provide an opportunity for Board of Health members to seek clarification,
  • request Board members to email their approval/non approval by a set date and time,
  • confirm outcome of email response and next steps.



Through the summer months, it has also been the practice of the Medical Officer of Health to provide the Board of Health with updates regarding urgent or emerging issues via email through July and August regarding key and emerging issues.


If an issue arises through the summer months the Board of Health Chairperson may summon a special meeting of the Board on forty-eight (48) hours notice to the Members of the Board, or, upon receipt of the petition of the majority of the members of the Board, the Medical Officer of Health shall summon a special meeting for the purpose and at the time mentioned in the petition. The only business to be dealt with at a special meeting is that which is listed in the notice of the meeting. (Bylaw 2007-01 section 6.1)








Charles Gardner, Medical Officer of Health and CEO                                       Ext. 7219

Item 6.2

Expenditures for the Period Ending April 30, 2011


Report: #1                                                          Date: June 15, 2011


Integral to the governance role in superintending the activities of the health unit is financial accountability.


That the Board of Health receives the expenditure report, for the period ending April 30, 2011, for information.

Current Facts:

The expenditures for the period ending April 30, 2011 are provided in Appendix A.  Benefits, although over spent, are in line with expenditures for this period in 2011 and are projected to be on budget as the full effect of the capped maximums for CPP, EI, and WSIB take effect.


Expenditures related to the Children in Need of Treatment Program (CINOT) are in line with expenditures for this period in 2011 for children under 14.  In 2010, expenditures in this program spiked in the second quarter of the year and at year-end expenditures exceeded the budget by approximately $170,000.  The budget for 2011 was increased by $50,000 in response to need and the program is monitoring expenditures closely and is prepared to implement cost control measures if necessary to remain within budget.


Expenditures related to CINOT for the 14 to 18 age group (CINOT Ext.) are low when compared to year-to-date budget projections but expenditures are approximately 45 per cent higher than for the same period in 2010.  This pattern of expenditures is consistent with the anticipated growth and uptake of a relatively new program.


Expenditures in the Transportation line are slightly over budget and are being monitored closely.  Management continues to encourage careful consideration of the need to travel and the use of alternatives such as teleconferencing and video conferencing, car pooling, public transportation and active transportation.


Year-to-date expenditures in the Occupancy Budget line exceed budget due to the requirement to provide matching funding at 25 per cent for one-time expenditures incurred in the first quarter of 2011 for renovations to the Midland and Barrie Offices. The Board of Health has approved the allocation of funds from the capital reserve to cover these costs if required.


All other budget lines are within acceptable variances at this time.  Funding announcements in relation to cost-shared program grants from the province are anticipated in early July.


As was the case in 2009, and 2010 the health unit has implemented a gapping strategy due to the uncertainty of the funding approvals from the Ministry of Health and Long-Term Care for 2011.   Health unit staff will monitor closely the expenditures to ensure that appropriate gapping is maintained to avoid a deficit at year end.


See attached Expenditures for the Period Ending March 31, 2011 (Appendix A).


Sandra Horney, Director, Corporate Service                                                Ext 7256

Simcoe Muskoka District Health Unit - Board Financial Report

 Appendix A

Expenditures for the Period Ending April 30, 2011



YTD Actual

YTD Budget

YTD Variance

2010 Budget



 $     5,648,174

 $       6,078,379

 $       430,205

 $      18,592,688



 $     1,646,053

 $       1,458,811

 $      (187,242)

 $        4,462,245


Total Salaries and Benefits

 $     7,294,227

 $       7,537,190

 $       242,963

 $      23,054,933


Direct Program Costs






Dental Treatment Fees

 $        206,234

 $          200,245

 $          (5,989)

 $          600,736


Contracted Medical & Resource Fees STD/AIDs

 $           8,752

 $            10,000

 $           1,248

 $            30,000


Total Direct Program Costs

 $        214,986

 $          210,245

 $          (4,741)

 $          630,736


Operating Expenditures






Staff Development

 $         31,109

 $            40,000

 $           8,891

 $          120,000


Board Expenses

 $           6,438

 $            11,667

 $           5,229

 $            35,000



 $        139,568

 $          135,000

 $          (4,568)

 $          405,000


Occupancy cost

 $        639,184

 $          510,853

 $      (128,331)

 $        1,532,560


Office Supplies

 $         21,710

 $            25,000

 $           3,290

 $            75,000



 $         20,212

 $            20,000

 $            (212)

 $            40,000



 $         16,217

 $            15,667

 $            (550)

 $            47,000



 $         27,826

 $            30,667

 $           2,841

 $            92,000



 $         15,302

 $            23,333

 $           8,031

 $            70,000


P.H. Practice Resource

 $         28,175

 $            20,000

 $          (8,175)

 $            40,000


Program Supplies

 $         32,196

 $            54,000

 $         21,804

 $          162,000


Clinic Supplies

 $           8,009

 $            15,333

 $           7,324

 $            46,000



 $         12,907

 $            21,500

 $           8,593

 $            64,500


Consulting (Contracted Services)

 $         29,247

 $            56,333

 $         27,086

 $          169,000



 $         14,861

 $            19,000

 $           4,139

 $            38,000


Bank Charges & Payroll Admin

 $           6,319

 $             5,333

 $            (986)

 $            16,000



 $              150

 $             3,333

 $           3,183

 $            10,000


Telephone Long Distance

 $           2,294

 $             3,333

 $           1,039

 $            10,000



 $         86,465

 $          101,667

 $         15,202

 $          305,000


Health & Safety

 $           1,055

 $             2,500

 $           1,445

 $              7,500



 $         10,084

 $             3,456

 $          (6,628)

 $            10,369



 $        116,938

 $          192,000

 $         75,062

 $          576,000


Authorized Unbudgeted

 $                78

 $                  -  

 $              (78)

 $                   -  


Aids Bureau

 $         18,459

 $                  -  

 $        (18,459)

 $                   -  


Total Operating Expenditures

 $     1,284,803

 $       1,309,976

 $         25,173

 $        3,870,929



Item 7.1

Children, Youth and Energy Drinks


Update: 1                                                            Date: June 15, 2011


Energy drinks are available throughout our communities in corner stores, grocery stores, gas stations and bars. We know these products, despite clear warnings on the label advising against their use by children, are marketed towards children and youth and that sales continue to grow across Canada.


In addition to concerns with the nutritional components of energy drinks outlined in the attached background document, there are concerns when mixed with alcohol and the availability of premixed energy drinks with alcohol products in LCBO outlets in Ontario.  Research shows there are significant health risks associated with combined energy drinks with alcohol including reduced perception of the influence of alcohol, increased alcohol consumption, increased risk of driving while impaired, experiencing or committing sexual assault, riding with an intoxicated driver, having an alcohol-related incident, or requiring medical treatment (Science Daily, 2010).


There are significant health risks associated with energy drinks and the availability of energy drinks premixed with alcohol.


That the Simcoe Muskoka District Health Unit (SMDHU) Board of Health endorses the recommendation of the Peterborough County-City Health Unit (attached) urging the Federal and Provincial Ministers of Health to:


1. Restrict the advertising and sale of energy drinks to children and youth; and,


2. Eliminate the sale of premixed alcohol and energy drinks in liquor outlets.


And further that the SMDHU Board of Health send letters indicating support of this recommendation to the Federal Minister of Health, the Ontario Minister of Health Promotion and Sport and the Ontario Minister of Health with a copy to all health units in Ontario, alPHa, Ontario Public Health Association, the Ontario Chief Medical Officer of Health, the North Simcoe Muskoka and Central LHINs and Simcoe Muskoka MP’s and MPP’s.


Current Facts and Background:

See attached background report and letter of advocacy prepared by Peterborough County-City Health Unit for more information.



Joyce Fox, Director Healthy Living Service                                                                Ext. 7210

Janice Greco, Program Manager Injury & Substance Misuse Prevention           Ext. 2788




Science Daily.  “Caffeinated Alcoholic Beverages: A Growing Public Health Problem?”  (November 30, 2010) (accessed on February 23, 2011)


Staff Report


Energy Drinks


Date:   January 19, 2011

To:       Board of Health

From:  Dr. Rosana Pellizzari, Medical Officer of Health


Original signed by                               Original signed by

___________________________      ______________________________

Rosana Pellizzari, M.D.                      Larry Stinson, Acting Director, Public Health Programs




This report provides the Board of Health with background information regarding energy drinks.


Decision History

This staff report on energy drinks was prepared based on a request of a Board of Health

member at the November 2010 Board of Health Meeting.


Financial Implications and Impact




That the Board of Health for the Peterborough County-City Health Unit:


  1. Send a letter to Minister Leona Aglukkaq, Federal Minister of Health, Minister Margarett Best, Ontario Minister of Health Promotion and Sport, and Minister Deb Matthews, Ontario Minister of Health requesting that:
  • Advertising and sale of energy drinks to children and youth be restricted.
  • Pre-mixed alcohol and energy drinks not be sold in liquor outlets.


  1. Direct staff to create a link to Health Canada’s “Safe Use of Energy Drinks” on the Peterborough County-City Health Unit website. (



The term energy drink refers to a unique category of beverages that claim to stimulate and energize the user. Energy drinks are commonly available in corner stores, grocery stores (including the check-out area), gas stations and bars, often displayed alongside soft drinks, juices and sports drinks. Some examples include:

  • Red Bull Energy Drink®
  • SoBe Adrenaline Rush®
  • Rock Star Energy Drink®
  • Hype Energy Drink®
  • Red Dragon Energy Drink®
  • YJ Stinger®

Many energy drink companies make claims that their drinks give the user energy to perform and help keep the user alert when tired. They often have large amounts of caffeine and combinations of herbal ingredients. Energy drinks can be expensive and can cost up to three times more than other less caffeinated drinks like soft drinks and coffee.


Energy drinks have normally been targeted at young men but are becoming more popular with the general population. According to a report from the Marin Institute (2007), teenagers and young adults are the core consumer group for energy drinks; thirty-one percent of 12 to 17 year olds and 34 percent of 18 to 24 year olds report regular consumption of energy drinks.


Nonalcoholic energy drink producers promote youth consumption using “grassroots” level marketing strategies, as opposed to traditional channels (such as television, radio, magazine and outdoor advertising). Companies look for “one-on-one relationships” gained through events, extreme sports sponsorships, internet interactions, text messaging, and communication among users on internet sites such as Facebook.


The market for energy drinks in Canada is growing quickly. In 2006, the market was valued at $287.2 million and is expected to reach $375.2 million by 2011. New brands are being introduced all the time. In 2008, it was estimated that there were over 300 brands of energy drinks in North America.


In Canada, energy drinks are not regulated as a food product, so they are not required to have a Nutrition Facts table. Instead, energy drinks are considered supplements and are therefore reviewed under Natural Health Products (NHP) Regulations. Under the NHP Regulations, the label of an energy drink must list all ingredients, both medicinal and non-medicinal, and the recommended use of the product. Not all energy drinks currently sold in Canada have been evaluated under the NHP Regulations. Only energy drinks with an 8-digit code with the letters “NPN” (Natural Health Product Number) on the can have been evaluated.


Certain warnings must also appear on the labels of energy drinks. These warnings state that energy drinks should not be:

  • used by children;
  • used by women who are pregnant or breastfeeding;
  • mixed with alcohol; or,
  • consumed at more than 500 mL/day.


Currently there are no regulations prohibiting the sale of energy drinks to children.


Health Canada is investigating some serious medical reactions linked with energy drinks including dizziness, nausea and vomiting, stomach pain, electrolyte imbalances and heart irregularities. These effects have been reported after too many energy drinks were consumed or when mixed with alcohol.


What is in Energy Drinks and Why?

Ingredients may be slightly different between brands, but most have the same two main ingredients: sugar and caffeine. Aside from the sugar-free versions, energy drinks have about the same amount of sugar as regular pop (i.e., approximately 26 grams in 240 mL) but they usually have more caffeine. For example, one 250 mL can of Red Bull® contains almost 7 teaspoons of sugar, 110 calories and 80 mg of caffeine.

Caffeine: Caffeine is a stimulant. When caffeine is added to products, such as cola, it must be listed in the ingredient list. Ingredients such as guarana and yerba mate, commonly found in energy drinks also contain caffeine. It is mandatory that these be listed as ingredients however, it is not currently mandatory that the amount of caffeine from these natural sources be listed on the label. Caffeine content of teas, coffee and cocoa beans, guarana and yerba mate plants all also vary by growing conditions, harvesting, plant genetics soil quality, serving size and preparation method, making accurate labelling difficult.


Most energy drinks have 80 mg caffeine per 250 mL can (though some have more). This is double the amount of caffeine found in soft drinks. The amount of caffeine in most energy drinks exceeds recommendations for children. Health Canada suggests no more than 45 mg/day for children 4-6 years, 62.5 mg/day for 7-9 years and 85 mg/day for children 10-12 years. Caffeine can cause nervousness, anxiety, jitteriness, stomach/intestinal upset, rapid heart rate and trouble sleeping in some individuals. Withdrawal symptoms can include headache, fatigue, irritability and poor concentration for those who consume caffeine regularly.


Children are more sensitive to caffeine than adults. They can become restless, irritable and have problems sleeping if they have too much caffeine. Drinking too much caffeine can cause calcium to be lost from the body; therefore calcium is not available to build strong bones and teeth. Also, if energy drinks replace calcium-rich drinks, such as milk, growing bodies and bones suffer even more.


Energy drinks are consumed cold and can be easy for youth to consume quickly. The caffeine available in energy drinks is in a more purified form so the consumer often feels the “hit” sooner.


Sugar: Sugar provides energy in the form of calories. A small can (250 mL) is likely to have at least 100-130 calories. However, many energy drinks are sold in larger can sizes so contribute more unneeded, liquid calories to one’s diet.


Medicinal Herbs: Many energy drinks contain the herbs Gingko biloba and ginseng. There is no scientific evidence to support claims on energy drink labels that the herbs improve sports performance. Some herbs can interact with drugs/medications such as warfarin and affect blood clotting. People taking medication should discuss energy drink use with their physician.


Taurine: Taurine is an amino acid-like compound and is found in the diet in meat and dairy products. It is not an essential nutrient nor is it involved in protein synthesis. Some energy drinks claim that taurine makes you more alert but research is not conclusive. It has been estimated that the average diet contains 40-400 mg/day of taurine. Most energy drinks have 1 gram of taurine per 250 mL can, therefore consuming one or more energy drinks can far exceed the amount of taurine found in a typical diet. The safety of large doses of taurine, or its long term health effects, are not known.


Energy Drinks and Exercise

Energy drinks can dehydrate. The caffeine in energy drinks has a diuretic effect, which causes you to urinate more often and may cause your body to lose too much water. The high sugar content and carbonation of energy drinks make them harder to absorb and drink during exercise and can cause stomach upset. For this reason, energy drinks should not be used during or after exercise when hydration is critical. Water is the best choice to drink during most types of activity.
Alcohol and Energy Drinks

Despite the clear warning that alcohol should not be mixed with energy drinks, doing so has become a common trend, especially among young adults. Drinks featuring energy drinks mixed with alcohol are available at bars and pre-mixed alcoholic energy drinks are sold at Liquor Control Board of Ontario (LCBO) outlets (e.g., Rock Star® pre-mixed with vodka).


Research has determined that the ingestion of an energy drink with alcohol reduced the drinker’s perception of the influence of the alcohol, while the energy drink did not in fact significantly reduce the deficits caused by alcohol on objective motor coordination and visual reaction time (Ferreira, 2006). In other words, people who combine alcohol and energy drinks are definitely drunk and their faculties are impaired, but they don’t feel the effects of intoxication.


Thus, people may not realize their inability to perform tasks that require alertness, such as driving a car.


If drinkers don’t feel the effects of the alcohol, the self-regulating mechanisms associated with being drunk fail to function. Indeed, the scientific literature suggests that individuals drinking such beverages may consume more alcohol per drinking occasion (Thombs, 2010), a situation that is particularly dangerous for inexperienced drinkers.


There is research suggesting that mixing alcohol with energy drinks is related to increased rates of injury. A study of 4,271 American college students (McCoy, 2007) found that, compared to students who drank alcohol by itself, those who drank it in combination with an energy drink were twice as likely to:

  • hurt themselves or be injured;
  • require medical attention;
  • get into a vehicle with a drunk driver;
  • assault someone sexually;
  • be sexually abused.


The Ministry of Education’s School Food and Beverage Policy, Policy/Program Memorandum 150 (2010), has classified energy drinks as a “not permitted for sale” beverage. As of September 2011, these beverages will no longer be allowed for sale in elementary or secondary schools.


Although not available at school, elementary and secondary school students will still have ample opportunity to purchase energy drinks at local convenience stores, gas stations and grocery stores.


Health Canada issued a media advisory in March of this year stating that it has not approved the sale of any pre-mixed alcoholic energy drinks for sale and that “An energy drink containing alcohol would be subject to different regulations under the Food and Drugs Act, and would be evaluated differently -as a food, and not as a natural health product…Health Canada will be following up with liquor boards and other relevant bodies to ensure that the regulations and their implications for energy drinks containing alcohol are appropriately understood… Health Canada continues to advise consumers not to mix energy drinks with alcohol.” Meanwhile, a call to a Peterborough LCBO store confirmed that pre-mixed alcohol and energy drinks are still being sold to consumers. (December 22, 2010).

In December 2010, an Edmonton newspaper reported that the federal government is still waiting for two expert panel reports that will recommend new rules in regards to pre-mixed alcohol and energy drinks.


The first one focuses on the safety of energy drinks without alcohol. Those are considered to be natural health products and have different rules than food products. The second report looks at caffeine in all foods, including drinks that mix caffeine with alcohol. The results of both reports are expected to be released in the next few months (Cummings, 2010).


Calls to both the Canadian Food Inspection Agency and Health Canada could not confirm this information.


It remains a concern that alcoholic beverages are being mixed with energy drinks at licensed establishments and parties.



The labels of energy drinks state that these drinks should not be consumed by children or mixed with alcohol. However marketing and availability clearly targets young people. Mixing of energy drinks with alcohol is increasingly common and pre-mixed alcohol and energy drinks are being sold in Peterborough LCBO outlets. There are significant health risks associated with these practices.


Strategic Direction

Board of Health advocacy on the topic of energy drinks supports the 2008-2012 Strategic Directions, Build on Our Leadership Role and Continue to Meet Our Mandate.






Carolyn Doris, RD

Public Health Nutritionist

(705)743-1000, ext. 251


Suzanne Galloway

Health Promoter, Substance Misuse Prevention

(705)743-1000, ext. 223


Cummings, Jeff “Alcoholic energy drinks targeted.” Edmonton Sun. (December 8, 2010) EatRight Ontario, Energy Drink FAQ,

(Accessed November 24, 2010)


Ferreira, S.E. et al, “Effects of Energy Drink Ingestion on Alcohol”, Alcoholism, Clinical and Experimental Research, 2006 Apr;30 (4):598-605.


Health Canada, Alcoholic Energy Drinks NOT Approved by Health Canada 2010-83 May 21, 2010

(Accessed on Dec. 14, 2010)


Health Canada, It’s your Health: Caffeine (2007)


Marin Institute, Alcohol, Energy Drinks and Youth:A Dangerous Mix (2007)


McCoy, Thomas et al. “Energy Drink ‘Cocktails’ Lead to Injury Risk, Study Shows.” Science Daily, Nov. 6, 2007.


Practice Based Evidence in Nutrition (PEN): Caffeine Backgrounder The Global Resource for

Nutrition Practice

(Accessed on December 8, 2010) Thombs DL, O’Mara RJ, Tsukamoto M, Rossheim Me, Weiler RM, Merves ML, Goldberger BA.


Event-level analyses of energy drink consumption and alcohol intoxication in bar patrons.

Addictive Behaviors 2010;35;325-330.


Windsor Essex County Health Unit, The Buzz on Energy Drinks, August 2010

Item 7.2

Public Advocacy during the Fall Provincial Election


Update: New                                                      Date: June 15, 2011



Ontario provincial elections will take place October 6, 2011. This event provides an opportunity for Simcoe Muskoka District Health Unit (SMDHU) to:

  1. Educate the public and provincial candidates about specific public health issues relevant to the local population;
  2. Advocate for specific public health initiatives, actions or policies that are related to and/or influenced by provincial government. 


This report provides the Board of Health with an overview on the topics of advocacy being raised by SMDHU during the fall provincial election.



That the Board of Health receives the Public Advocacy during the Fall Provincial Election briefing note for information.


Current Facts:


Advocacy and public education and awareness-raising on public health issues are important public health functions. Such activities can be both challenging and opportune during elections. The provincial election is a time in which candidates and the public will be focused on key areas of leadership for the province. As such the public health community would want the public discussion to include topics of concern for the improvement of the health of the population.

In order to raise such topics in an effective and respectful manner, planning and early communication with stakeholders is required, including with the Board of Health. In order to achieve this, descriptions are appended of the key messages being developed to be communicated to candidates during the election are appended.



The Board of Health has supported developing communication packages for provincial candidates during the provincial election in 2007.


The past experience was very positive, therefore it is recommended that SMDHU develop key public health messages for the 2011 provincial election.




Dr. C. Gardner, Medical Officer of Health and CEO                                  Ext. 7219

Appendix A

Healthy Living Service


Chronic Disease Prevention (CDP) – Healthy Living

Built environment to support active transportation in particular, childhood obesity, and food security.


CDP - Tobacco

1) Renewal of the Ontario Tobacco Strategy (as supported by alPHa, OPHA AND OCDPA) - although the Ministry of Health Promotion and Sport (MHPS) states that the Tobacco Strategy is being renewed - we have yet to receive any details (do not know how many of the TSAG report recommendations have been adopted)

  • Recommendations in the TSAG report should be fully adopted
  • Provision of free smoking cessation medications for individuals under the Ontario Drug Benefit Plan
  • Taking action on the supply and sale of contraband tobacco products

2)     Smoke free public housing

  • Pass legislation to protect people living in social housing by moving towards smoke free complexes giving people the option to choose a smoke free building to live and raise their children.

3) Smoke Free Movies

  • Remove tobacco and smoking from youth-rated movies (G, PG, 14A) by including tobacco use/exposure as a ratings indicator;
  • Require strong anti-tobacco advertisements before all movies depicting tobacco use or exposure in all distribution channels, regardless of rating, in Ontario at the distributor expense.


Injury and Substance Misuse Prevention

Advocacy for a complete review of the economic and health implications of alcohol with a view to creation of a provincial alcohol strategy and no further changes to the Liquor Licence Act until such a strategy is created.


Clinical Service


Oral Health

Looking ahead, the goal of the Simcoe Muskoka District Health Unit is to promote community water fluoridation to communities through Simcoe and Muskoka, thus increasing the oral health benefits to the population served by the health unit.  The provincial government can play an effective supportive role through legislation, finance and the provision of expertise.


Family Health Service


The Child Youth and Family Services Coalition of Simcoe County created the Advocacy Task Group to help meet its vision of maximizing the capacity, effectiveness, and cultural uniqueness of the child, youth, and family services system through collective efforts.  Advocacy is one of the goals for the Coalition’s Strategic Plan for 2011-2013. A Board-to-Board Forum was held on May 17, 2011 to create an opportunity for Board members of the member organizations of the Child, Youth and Family Services Coalition of Simcoe County to get to know each other and to have input into the preparation of a Simcoe County advocacy strategy that includes key messages for the provincial government. One of the next steps prior to the Fall election is hosting an “All Candidates Meeting” for early September 2011 to highlight service delivery challenges all agencies are experiencing related to child, youth and families and bring the candidates of all parties together to discuss children and youth issues in the County.  The approach is that we are “Better Together” – joint advocacy is better than going at it on our own. SMDHU is a member organization of the Coalition.


Margaretta Papp-Belayneh was the Board of Health representative at the Child, Youth and Family Services Coalition of Simcoe County Board-to-Board forum held on May 17, 2010 and will be supporting further advocacy work focusing on the funding challenges regarding the Healthy Babies Healthy Children program.   


Health Protection Service


Outdoor Air Quality

Advocate for healthy provincial policy initiatives to improve outdoor air quality such as incentives that facilitate energy conservation; replacement of fossil fuel power plants with renewable sources of energy, including wind, solar power, biomass and hydro; and provincial rollout of the Air Quality Health Index to protect and promote the health of all Ontarians.



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