There have been a lot of enquiries since my last Presidential message and I am very pleased it has aroused great interest amongst Fellows and Members. Let me stress again if you have intermediate qualification from Category II Conjoint Examination or from overseas training, you may benefit from our revised Exit Examination Guidelines and Training Requirements. The time limit for attempting and passing the Exit Examination is removed. Your previous hard work and extra future training may bear the fruit of FHKAM (Family Medicine). Please contact the College Secretariat for further information.

The lead-in-water contamination problem has a snow ball effect. A number of public housing estates in Hong Kong found themselves at the centre of a tainted water scandal after tests in June 2015 showed samples taken from tap water in Kai Ching Estate in Kowloon City contained lead exceeding WHO standards. Subsequent tests showed water samples from at least two other public estates in Kwai Chung and Sha Tin also contained excessive lead. Prince Philip Dental Hospital, University residency and some schools are also involved.

Government officials have made a U-turn and announced they would conduct tests on lead levels in water at kindergartens and new schools as pupils returned for the new academic year. Water will be tested at public hospitals as well. Kindergartens and schools are racing to installwater filters amid lead scare.

I have joined the Ad Hoc Commit tee on Toxic Ef fec ts of Lead Contaminated Water organized by HKMA. There are colleagues from Poison Treatment Centre, Poison Information Centre, Toxicology Reference Laboratory, Occupational and Environmental Health, Paediatrician, Obstetrician, Community Physician and of course Family Physician. The Committee was set up to formulate advices to members and the general public. So far, nobody has the blood level reached the “toxic” level that requires chelating therapy. I do hope this public health issue will soon solve on its own course.

What is the apocalypse?

In June and July 2015, the public hospitals have limited resources to cope with the large number of blood lead level testings. The general public turns to private laboratories for blood and water testing. My patients and colleagues keep asking me which are the reputable and reliable laboratories other than the public laboratories based at HA hospitals. In fact, nobody knows how many medical laboratories are there in Hong Kong! Some have NATA (National Association of Testing Authorities, Australia). NATA provides assessment, accreditation and training services to laboratories and technical facilities throughout Australia and internationally. Some have HOKLAS (The Hong Kong Laboratory Accreditation Scheme). HOKLAS is an accreditation scheme opens to voluntary participation by any Hong Kong laboratory that performs objective testing and calibration, provides proficiency test and produces reference material falling within the scope of the Scheme and meets the HOKLAS criteria of competence.

A medical laboratory is usually divided into 4 segments, i.e. Biochemistry, Immunology, Haematology and Microbiology. A laboratory can be proficient at only one segment and try to get the accreditation. My previous experience is not to look at the NATA or HOKLAS label-responsible doctor should go to the laboratory site, speak to the technicians, look at the laboratory information system, check out its machines and calibration methods and make sure no food is in the refrigerator. It sounds like the Practice Assessment of our Exit Examination! Don’t look at the price, be vigilant at the standard. We owe it to our patients to send their samples to the best available laboratories.

We are all good at bloodletting with adults but certainly less confident with babies and young children. I was told a large clinic could not cope with the high number of blood sample taking as it only had one technician for venepuncture. Why not train up all the nurses in your clinic! They are capable hands in dealing with emergencies and disasters.Interestingly, doctors know much about Legionnaires' Disease but few know the clinical effects of heavy metal poisoning like lead, cadmium, chromium, nickel and mercury. I was lucky to have attended the diploma course in Occupational Medicine at The Chinese University, Hong Kong. Prof TW Wong and Prof Ignatius Yu were extremely good teachers. Our ex-President, Dr John Chung was my course mate and he was one of the top students. I have never thought this course being useful fourteen years later. Prepare yourself, we Family Physicians love to know and learn everything on the horizon.

Dr. Angus M W CHAN
President