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Environmental health research in Canada

Petition: No. 201

Issue(s): Air quality, human health/environmental health, pesticides, and toxic substances

Petitioner(s): David R. Boyd

Date Received: 4 May 2007

Status: Completed

Summary: This petition concerns the state of comprehensive environmental health research and policy in Canada. It requests information on federal funding for environmental health research; the existence of a national environmental health strategy; national “environmental burden of disease” statistics (such as the number of Canadians who become ill or die annually as a result of exposure to various environmental hazards); and the extent to which geographically concentrated '”toxic hotspots” have been identified in Canada.

Federal Departments Responsible for Reply: Environment Canada, Health Canada

Petition

April 30, 2007

Ron Thompson
Interim Commissioner of the Environment and Sustainable Development
Office of the Auditor General
240 Sparks Street
Ottawa, Ontario
K1A 0G6

Re: Petition on Environmental Health in Canada

Dear Sir:

As you are well aware, Canadians are gravely concerned by contemporary environmental problems. Although climate change is receiving the lion's share of attention today, evidence suggests that Canadians are acutely interested in the adverse effects of environmental hazards upon their health and the health of their families, a broad issue which this petition refers to as environmental health.

I believe that the majority of the following questions fall within the responsibilities of the Minister of Health and to a lesser extent, the Minister of Environment:

Funding for environmental health research

1. What is the federal budget for environmental health research? Please provide year-by-year figures from 2000 to 2007 for the amount of federal funding invested in environmental health research at various institutions (e.g. Canadian Institutes for Health Research, Social Sciences and Humanities Research Council, Health Canada, Environment Canada, Natural Science and Engineering Research Council, the National Collaborating Centre on Environmental Health, etc.)?

2. Given the prominence of environmental health concerns, why is there no Canadian equivalent of the US National Institute of Environmental Health Science or the US National Centre for Environmental health? Why is there no Environmental Health Institute at the Canadian Institutes for Health Research?

3. The U.S. National Children's Study is the world's largest longitudinal birth cohort study on children's health and the environment, following 100,000 children from the womb to adulthood. The study is expected to provide an extraordinary wealth of information about environmental impacts on children's health that will save lives, reduce illness, and generate immense social and economic dividends. Given the prominence of environmental health concerns, particularly with respect to children, why has Canada rejected repeated invitations from the U.S. to participate in the National Children's Study?

4. It is widely recognized that children are particularly vulnerable to the adverse health effects of environmental hazards. In light of this fact, why are children under the age of six excluded from Canada's national Health Measures Survey (i.e. the new national bio-monitoring program)? Why is Canada excluding children when other nations such as the U.S. include children in similar studies (e.g. the US Centers for Disease Control bio-monitoring program)?

National Environmental Health Strategy

Most industrialized nations, including the U.S., Australia, and many Western European nations, are implementing comprehensive national environmental health strategies or action plans to address the full suite of threats to citizens' environmental health. Despite repeated promises over a period of years, Canada has no environmental health strategy. In 1999, the federal Cabinet gave approval in principle for a health and environment strategy to be developed and implemented by Health Canada and Environment Canada, with a promised budget of $600 million over a period of five years. The strategy was never developed, and funds were never allocated to ensure either its development or its implementation.

Please note that I am well aware of the Government of Canada's various chemical management and clean air initiatives. However, the efficacy of these policies and programs is undermined by the ad hoc and piecemeal approach. The numerous weaknesses and gaps in research, surveillance, tracking, public education, and policy underscore the importance of a comprehensive national strategy or action plan, as nations with superior environmental records to Canada have recognized.

5. Is the Government of Canada currently developing a comprehensive national environmental health strategy or action plan, including targets, timelines, new funding, research initiatives, improved surveillance and tracking, enhanced efforts at public education, and stronger laws, regulations, and policies?

6. If the answer to Question #5 is negative, then when will Canada establish and implement a comprehensive national environmental health strategy or action plan, including targets, timelines, new funding, research initiatives, improved surveillance and tracking, enhanced efforts at public education, and stronger laws, regulations, and policies?

7. If the answer to Questions #5 and #6 are both negative, then why is Canada refusing to develop a comprehensive national environmental health strategy or action plan?

The Environmental Burden of Disease in Canada

Environmental burden of disease studies estimate the magnitude of mortality and morbidity caused by exposure to environmental hazards. Canada has not conducted a comprehensive environmental burden of disease study. Environmental health specialists across Canada recently identified this gap as a research priority of "high importance" to policymakers1.

8. How many Canadians become ill or die annually because of exposure to environmental hazards:

(a) Overall?
(b) From outdoor air pollution? Does the Government of Canada agree with the estimates published by the Ontario Medical Association?
(c) From indoor air pollution?
(d) From contaminated drinking water?
(e) From contaminated food?
(f) From acute exposures to pesticides?
(g) From acute exposures to toxic substances in household cleaning products?
(h) From acute exposures to toxic substances in cosmetic products?
(i) From chronic exposures to toxic substances in consumer products?
(j) Because of ozone depletion?

9. How many Canadian children have blood lead levels that affect their health or development? When was the last national survey of blood lead levels in Canadian children? When is the next national survey planned? How does this frequency of testing compare to other nations, such as the U.S.?

Environmental Justice in Canada

Environmental justice refers to the principle that "all peoples and communities are entitled to equal protection of environmental and public health laws and regulations2." The Government of Canada has acknowledged that "we know that some segments of our population are exposed to unacceptably high levels of environmental pollutants3."

10. What segments of the Canadian population is the Government of Canada referring to? What are the pollutants? What are the unacceptably high levels? What evidence does the Government of Canada have to support this assertion?

11. Has the government of Canada analyzed the national Pollutants Release Inventory spatially to determine if there are toxic hotspots (i.e. geographic areas subject to a disproportionate share of pollution)? If so, please provide this information. If not, why not?

12. Has the government of Canada analyzed the national Contaminated Sites Inventory spatially to determine if there are toxic hotspots (i.e. geographic areas subject to a disproportionate share of pollution)? If so, please provide this information. If not, why not?

I look forward to receiving the Government of Canada's response to these questions. However I would also like to request, for reasons of fiscal prudence and environmental conservation, that no correspondence associated with this petition be sent using courier services. Canada Post's regular mail is preferable.

Thank you for your prompt attention to this matter.

Respectfully,

[Original signed by David R. Boyd]

David R. Boyd
Trudeau Scholar, University of British Columbia
1321 MacKinnon Road, RR1
Pender Island, British Columbia V0N 2M1
Tel: 250-629-9984
Email: davidrichardboyd@yahoo.com


1 C. Chociolko, R. Copes, and J. Rekart. 2006. Needs, Gaps, and Opportunities Assessment for the National Collaborating Centre for Environmental Health, p. 37.

2 R.D. Bullard. 1990. Dumping in Dixie. Boulder, CO: Westview Press.

3 Government of Canada. 2005. Children's Health and the Environment in North America: A First Report on Available Indicators and Measures. Country Report: Canada. Gaineau, QC: Environment Canada, p. 58.

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Joint Response: Environment Canada, Health Canada


Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6


14 September 2007

Mr. David R. Boyd
Trudeau Scholar
University of British Columbia
1321 MacKinnon Road
Pender Island, British Columbia
V0N 2M1

Dear Mr. Boyd,

This is in response to your environmental petition no. 201 of April 30, 2007, addressed to the Interim Commissioner of the Environment and Sustainable Development.

In your petition, you requested information from Health Canada and Environment Canada regarding the effects of the environment on the health of Canadians.

Due to the nature of the issues being raised in the petition, I am pleased to provide you with a joint Government of Canada response prepared in collaboration with my colleague, the Minister of the Environment.

I appreciate your interest in this important matter, and I hope you will find the information useful.

Yours sincerely,

[Original signed by Tony Clement, Minister of Health and
the Minister for the Economic Development Initiative for Northern Ontario]

Tony Clement

Enclosure

c.c.

Mr. Ronald C. Thompson, Interim CESD
The Honourable John Baird, P.C., M. P.


Response to
Environmental Petition 201:
Environmental Health in Canada

Filed by David R. Boyd
Under Section 22 of the
Auditor General Act
Received May 4, 2007

September, 2007

Minister of Health
Minister of the Environment

Table of Contents

Funding for environmental health research

 

Question 1

3

Question 2

3

Question 3

4

Question 4

5

National environmental health strategy

 

Question 5

6

Question 6

6

Question 7

7

The environmental burden of disease in Canada

 

Question 8

10

Question 9

14

Environmental justice in Canada

 

Question 10

15

Question 11

17

Question 12

18

Funding for environmental health research

Question 1

What is the federal budget for environmental health research? Please provide year-by-year figures for 2000 to 2007 for the amount of federal funding invested in environmental health research at various institutions (e.g., Canadian Institute for Health Research, Social Sciences and Humanities Research Council, Health Canada, Environment Canada, Natural Environment and Engineering Research Council, National Collaborating Centre on Environmental Health, etc.).

Response:

Table 1 (attached) outlines investments in environmental health research based on available information from organizations within the mandates of the Minister of the Environment (Environment Canada) and the Minister of Health (Health Canada, Public Health Agency of Canada, Canadian Institutes of Health Research, and the Pest Management Regulatory Agency).

Financial information for 2007 is incomplete since finalized financial data for the financial year 2007-2008, starting on April 1, 2007, is unavailable. Health Canada information is not available for 2000-2001 owing to organizational and financial reporting systems changes that year.

Question 2

Given the prominence of environmental health concerns, why is there no Canadian equivalent of the US National Institute of Environmental Health Science or the US National Centre for Environmental health? Why is there no Environmental Health Institute at the Canadian Institutes for Health Research?

Response:

Creation of the Canadian Institutes of Health Research

The Canadian Institutes of Health Research Act specifies that the Governing Council of the Canadian Institutes of Health Research (CIHR) is responsible for creating, reviewing and terminating CIHR's Health Research Institutes.

Leading up to CIHR's creation, an Interim Governing Council led an open process on Institute designation. It received over 150 submissions. In July 2000, CIHR's Governing Council selected 13 Institutes based on advice from Interim Governing Council Reports on Institute Design and Institute Creation. The selection was supported by strong consensus among CIHR's partners in the research community, the voluntary sector, universities, governments and the private sector.

The Governing Council reviews each Institute's mandate and performance at least every five years. As required under the CIHR Act, the Governing Council convened an international team of leading health research experts in February 2006 to conduct CIHR's five-year review. The International Review Panel released its report in June 2006 and observed that the number and mandate of the Institutes are appropriate at this time.

CIHR Approach to Environment and Health Issues

All Institutes address environmental health issues, which are multidisciplinary in nature and cut across disease specific boundaries. In 2001, CIHR designated "environmental influences on health" as a multi-Institute priority championed by the Institute of Human Development, Child, Youth and Health (IHDCYH). Since 2001, CIHR has led several partnered research strategies in areas such as food and water safety, and childhood asthma and indoor air quality. To date, eleven of its thirteen Institutes have participated in environment and health research strategies. Researchers continue to apply for CIHR funding through open operating grants competitions.

Health Canada's Safe Environments Programme

Health Canada's Safe Environments Programme (SEP) is committed to science and research excellence to support its role in identifying, assessing, managing and communicating health risks in the environment. Science provides the foundation for sound environmental health policy (e.g. legislation, regulations, standards, guidelines, etc.), delivery of health promotion and protection activities, and achieving positive health outcomes.

SEP's Environmental Health Science and Research Bureau is a primary source of research to support SEP activities related to water, air, climate change, radiation, contaminated sites and vulnerable populations. It undertakes research/science on toxic metals, air and water contaminants, dermal exposure, biomonitoring, reproduction, neurotoxicology, biochemical toxicology, cardiopulmonary effects, moulds and allergens, genetic toxicology, genomics, proteomics, epidemiology and biostatistics, as well as potential emerging environmental health concerns related to biotechnology and nanotechnology.

SEP's science foundation is based on a continuum of research domains covering exposure assessment, hazard identification, mechanistic studies and population studies. Scientific knowledge is generated both "in-house" and through a collaborative science research networks.

Question 3

The US National Children's Study is the world's largest longitudinal birth cohort study on children's health and the environment, following 100,000 children from the womb to adulthood. The study is expected to provide an extraordinary wealth of information about environmental impacts on children's health that will save lives, reduce illness and generate immense social and economic dividends. Give the prominence of environmental health concerns, particularly with respect to children, why has Canada rejected repeated invitations from the U.S. to participate in the National Children's Study?

Response:

Health Canada agrees with the need to better understand the relationship between the environment and child health, and that longitudinal cohort studies of Canadian children, and other research designs, can help address this knowledge gap. Health Canada has closely followed developments in the U.S Study and has met Study officials to discuss Canadian participation. Health Canada scientists have in fact been involved in the U.S. study's design.

Health Canada is exploring ways to benefit from the work underway on the National Children's Study, whether through direct participation or through a complementary Canadian study.

Health Canada, the Canadian Institutes of Health Research and the Ontario Ministry of the Environment are partnering to support clinical researchers across Canada to implement a national longitudinal pregnancy cohort study (MIREC: Maternal-Infant Research on Environmental Chemicals) that will measure prenatal and lactational exposure to environmental contaminants. While smaller in scale and scope than the U.S. National Children's Study, this study is expected to contribute significantly to our understanding of potential health effects of environmental chemicals to which Canadians are exposed in early life.

Question 4

It is widely recognized that children are particularly vulnerable to the adverse health effects of environmental hazards. In light of this fact, why are children under the age of six excluded from Canada's national Health Measures Survey (i.e. the new biomonitoring program)? Why is Canada excluding children when other nations such as the U.S. include children in similar studies (e.g. the US Centers for Disease Control biomonitoring program)?

Response:

Health Canada and the Public Health Agency of Canada helped in the design of Statistic Canada's Canadian Health Measures Survey (CHMS). While including all children in the CHMS was recognized as ideal, there were operational constraints to doing so:

  • Public consultations during the planning phase (early 2004) revealed that parents of pre-schoolers were generally reluctant to consent to blood draws from their children. Obtaining urine samples from this age group is also often difficult. Even the National Health and Nutrition Examination Survey, the base survey for the U.S. Center for Disease Control and Prevention biomonitoring program, only requests urine from age 6 and above. In the absence of blood and urine, the only other data collected from these children would have been height and weight.
  • The survey operations could only handle a sample of size of about 5,000 people over two years. Excluding children under the age of 6 permitted increasing sample size for other age groups and provided more reliable results for measures taken in these age groups.
  • Development and testing time was relatively short for developing special protocols and materials for pre-school children.

Given these issues, Statistics Canada and its partners decided to restrict the targeted ages to 6 to 79 years. However, now that the infrastructure is in place, the possibility of expanding the age ranges for future CHMS cycles will be considered.

The MIREC study outlined in Answer 3 will also generate important new biomonitoring and exposure measurements of chemicals in vulnerable populations such as pregnant women and their infants.

National environmental health strategy

Most industrialized nations, including the U.S., Australia, and many Western European nations, are implementing comprehensive national environmental health strategies or action plans to address the full suite of threats to citizens' environmental health. Despite repeated promises over a period of years, Canada has no environmental health strategy. In 1999, the federal Cabinet gave approval in principle for a health and environment strategy to be developed and implemented by Health Canada and Environment Canada, with a promised budget of $600 million over a period of five years. The strategy was never developed, and funds were never allocated to ensure either its development or its implementation.

Please note I am well aware of the Government of Canada's various chemical management and clean air initiatives. However, the efficacy of these policies and programs is undermined by the ad hoc and piecemeal approach. The numerous weaknesses and gaps in research, surveillance, tracking, public education, and policy underscore the importance of a comprehensive national strategy or action plan, as nations with superior environmental records to Canada have recognized.

Question 5

Is the Government of Canada currently developing a comprehensive national environmental health strategy or action plan, including targets, timelines, new funding, research initiatives, improved surveillance and tracking, enhanced efforts at public education, and stronger laws, regulations, and policies?

Question 6

If the answer to Question #5 is negative, then when will Canada establish and implement a comprehensive national environmental health strategy or action plan, including targets, timelines, new funding, research initiatives, improved surveillance and tracking, enhanced efforts at public education, and stronger laws, regulations, and policies?

Question 7

If the answer to Questions #5 and #6 are both negative, then why is Canada refusing to develop a comprehensive national environmental health strategy or action plan?

Response:

Canada's new government has made the promotion and protection of Canadians' health a hallmark of its Environmental Agenda and its approach to preserving our environmental heritage. It is actively fulfilling the federal health and environment role of setting national regulations, guidelines and standards, conducting science to guide interventions and track progress, informing the public on how to protect their health from environmental risks, and collaborating closely with partners. Its approach to health and environment addresses the range of risks to Canadians' health, and comprises all of the key elements listed in the question above.

Action on health and the environment

The Environmental Agenda is founded on an approach to address health and environment issues in an integrated way. Canada's new government has been explicit in its intention to develop programs and measures aimed to deliver tangible benefits for the health of Canadians and their environment - evident through the many initiatives announced as part of the ecoAction program, the Notice of Intent1 to regulate air emissions, and through the investment of $4.5 billion of new funds as part of Budget 2007.

Turning the Corner: An Action Plan to Reduce Greenhouse Gases and Air Pollution2 is a key advancement from historical approaches which relied on a variety of non-compulsory measures to reduce air emissions. The Regulatory Framework for Air Emissions includes mandatory and enforceable reductions in air emissions from all major industrial sources, as well as from transportation, consumer and commercial products and sources which affect indoor air. For the first time, both greenhouse gases and air pollutants will be addressed in an integrated, nationally consistent approach which takes into account their common sources. The Government of Canada continues to develop and implement the necessary policy, programs and infrastructure to support this agenda. Collectively, these initiatives are designed to take advantage of a variety of opportunities to achieve significant reductions nationally, thereby improving the quality of the air and the health of Canadians.

Further, under the Canadian Environmental Protection Act, 1999 (CEPA 1999), the Government of Canada controls chemical substances to protect human health and the environment using a variety of tools. Canada's Chemicals Management Plan3 (CMP) will improve the degree of protection against hazardous chemicals. It includes a number of new, proactive measures to make sure that chemical substances are managed properly. The CMP is a forward-looking approach to protecting human health and the environment; taking action now will significantly reduce future costs. It will improve Canadians' quality of life, and better protect our environment.

Additionally, Health Canada will work with Environment Canada, the Canadian Institutes of Health Research, and the research granting councils, to explore opportunities to further promote scientific study and understanding of the impacts of environmental contaminants and factors on human health.

Timelines and targets

Under the Turning the Corner Action Plan, Canada will have one of the most stringent industrial regulatory systems in the world. This will have positive health outcomes for Canadians. The air pollutant targets are based on the toughest standards in leading jurisdictions around the world, and the greenhouse gases targets are among the toughest in the world. Consultations with stakeholders are ongoing on the Regulatory Framework for Air Emissions, with the intention of finalizing the Framework, including targets, by fall 2007, beginning publication of draft regulations by spring 2008, and publishing final regulations by 2010. As well, the Government of Canada has made a commitment to use National Air Quality Objectives to restrict the use of trading for compliance with regulations in areas of particularly poor air quality.

The Chemicals Management Plan Implementation Timetable4 describes a timeline of specific government action on chemicals, under various relevant regulatory regimes.

Enhanced efforts at public education

Public awareness and education is a cornerstone of the Government's approach to health and environment issues.

Under the Turning the Corner plan, individual Canadians can share in the responsibility of achieving emissions reductions, through a number of programs, such as the ecoEnergy Retrofit Grant and the ecoAuto Program. As these and other programs continue to be developed, there will be enhanced opportunities and efforts to ensure public engagement and participation.

The Government of Canada's publicly-accessible website on chemicals management, http://www.chemicalsubstanceschimiques.gc.ca, provides Canadians with comprehensive and regularly updated information on the government's activities aimed at protecting Canadians from chemical substances that could affect human health and/or the environment.

In July 2007, Canada's new government announced an investment of $30 million to establish the world's first National Air Quality Health Index. This personal health protection tool will provide Canadians, including those most at risk from air pollution, with current and forecasted local air quality information they can use to take actions to reduce risks posed by air pollution.

Improved surveillance and tracking

The federal government is actively implementing surveillance and tracking mechanisms to support its policies and programming on environmental health. For instance:

  • Reporting and monitoring requirements are being developed under the Turning the Corner plan, to ensure accurate reporting of emissions, and greenhouse gases and nitrous oxide (NOx) and sulphur oxides (SOx) emissions trading systems are being designed.
  • The risk-based approach to chemical substances in Canada applies strong science, assessment and monitoring, combined with a variety of tools for protection.
  • The Government of Canada is in the process of developing a set of environmental health indicators and will be reporting on the set following extensive consultations with relevant stakeholders.
  • As mentioned above, The Canadian Health Measures Survey will collect information from Canadians about their health. The study, which will be carried out from 2007 to 2009, will include a biomonitoring component to measure human levels of environmental chemicals in a sample that represents the overall Canadian population. There will also be a questionnaire about risk factors related to exposure to these substances. This first-ever national survey will establish a representative baseline of the concentrations of environmental chemical substances that end up finding their way into the bodies of Canadians. It will help determine future trends and allow comparisons to other countries.
  • Under the CMP, enhanced monitoring and surveillance activities are being undertaken, including implementation of a national health and environment monitoring and surveillance program.

Federal-provincial-territorial collaboration on health and environment

In addition to the activities described above, the Federal-Provincial-Territorial (FPT) Committee on Health and the Environment (CHE) takes a national approach to health and the environment. CHE is a liaising body of the Pan-Canadian Public Health Network Council (PHN) and reports to the Canadian Council of Ministers of the Environment (CCME). The Committee is the principal FPT forum for advice and joint action on health and environment issues of pan-Canadian interest to all FPT governments. The Committee is responsible for addressing issues related to the relationship between the environment and health in the areas of greatest risk, through the application of a population health-based approach, and for facilitating the integration of decision-making related to health and environment issues at the pan-Canadian level. The committee is supported by four task groups, which focus on four priorities areas: children's health; water quality; air quality; and environmental health tracking and surveillance.

The Committee advances integrated strategies on health and the environment beyond the mandates of the individual Committee members. The Committee is currently undergoing a strategic planning process to better link health and environment issues to ensure that its objectives are aligned with those of the environment and health sectors. This outcome-based approach will align priorities and health and environment outcomes with those of the environment and health sectors by identifying some common outcomes that would serve as a basis for future planning. This approach will also demonstrate how the CHE can contribute to the priorities and agendas of the federal government, and, specifically, of the FPT Environment Protection and Planning Committee (EPPC) of the CCME, and the PHN.

The environmental burden of disease in Canada

Environmental burden of disease studies estimate the magnitude of mortality and morbidity caused by exposure to environmental hazards. Canada has not conducted a comprehensive environmental burden of disease study. Environmental health specialists across Canada recently identified this gap as a research priority of "high importance" to policymakers.

Question 8

How many Canadians become ill or die annually because of exposure to environmental hazards?

8a. Overall, how many Canadians become ill or die annually from exposure to environmental hazards?

Response:

According to World Health Organization (WHO) estimates5 for developed countries of the Americas (comprising Canada, the United States and Cuba), 15 percent of deaths and 14 percent of the burden of disease (as measured by Disability Adjusted Life Years) are potentially due to environmental factors. These estimates comprise a narrow, albeit global range of environmental risk factors including air pollution, lead, water, sanitation and climate change.

It is difficult to estimate more precisely the overall environmental burden of disease for Canada. However, Health Canada is working with academic groups to develop a proposal for a Canadian Environmental Burden of Disease initiative. As an initial step to obtain information and advice, Health Canada and the University of Ottawa's McLaughlin Centre for Population Health Risk Assessment jointly hosted the Workshop on Environmental Burden of Disease, February 12, 2007. A summary of this workshop is available on the McLaughlin Centre website (http://www.mclaughlincentre.ca/).

8b. How many Canadians become ill or die annually from exposure to environmental hazards from outdoor air pollution? Does the Government of Canada agree with the estimates published by the Ontario Medical Association?

Response:

The Ontario Medical Association's Air Quality Benefits Assessment Tool (AQBAT) uses complex statistical models to estimate the number of deaths which could be prevented annually if air pollution from human sources in North America were eliminated.

Using the simulation model, Health Canada estimates that, in eight Canadian communities, outdoor pollution contributes to more than 5,900 deaths per year from stroke, cardiac and lung disease. This represents 8 percent of deaths from all causes with a 95 percent confidence interval of between 5 and 11 percent (3700-8100 deaths). This analysis only examines mortality impacts in selected cities, and does not take into consideration either mortality impacts in other cities, or morbidity impacts, both of which could be significant.

The Ontario Medical Association (OMA) has estimated the impacts for the entire population of Ontario. Health Canada and OMA estimates are consistent in terms of the percentage contribution of air pollution to mortality. Health Canada is working with the Canadian Medical Association to apply the OMA methodology nationally.

8c. How many Canadians become ill or die annually from exposure to environmental hazards from indoor air pollution?

Response:

It is not possible to estimate the health impacts of indoor air pollution for the country. There is a national indoor air estimate for exposure to radon of 1,900 deaths per year. There are some provincial numbers for deaths due to carbon monoxide poisoning for some provinces, but this information has not been compiled nationally.

8d. How many Canadians become ill or die annually from exposure to environmental hazards from contaminated drinking water?

Response:

Drinking water in Canada is among the safest in the world. Since the incidents of Walkerton and North Battleford, all jurisdictions have taken regulatory and non-regulatory action to better ensure the safety of drinking water from source to tap. Since 2001, there have been no confirmed outbreaks of waterborne illness reported in Canada. While drinking water may have caused gastro-intestinal illnesses, these have been isolated and have not resulted in outbreaks.

Historically, data show that from 1974 to 2001, there were 288 drinking water outbreaks from microbiological contaminants, 99 of which were in public sources, 138 in semi-public, and 51 in private systems, with more than 8000 confirmed cases linked to these outbreaks.

Two cases of waterborne outbreaks in Canada have been well documented. The outbreak in Walkerton, Ontario, in 2000 is the last Canadian outbreak with confirmed deaths. There were 2,300 cases of gastro-intestinal illness, 65 hospitalizations and 7 deaths. The 2001 outbreak in North Battleford, Saskatchewan, resulted in 5,800-7,100 gastro-intestinal illnesses, though only 275 of these cases were confirmed and no deaths were reported. Recent action taken by jurisdictions in the wake of these incidents appears to have resulted in a decrease in the number and severity of waterborne illnesses.

Health effects from exposure to most chemical and radiological contaminants generally take years to appear. In most cases, there are many different sources of such contaminants which may play a role. It cannot be determined if a health effect such as cancer is due to an environmental exposure, genetic factors, or a combination of factors.

There are several initiatives underway to better address disease surveillance and source attribution through the Public Health Agency of Canada. One of these is the C-Enternet sentinel site, in which a team is working to better capture infectious disease incidence and attribute it to sources (e.g., food, water).

8e. How many Canadians become ill or die annually from contaminated food?

Response:

Environmental hazards associated with food borne illnesses are wide ranging, requiring complex tracking systems for sound attribution. The scope of environmental hazards that is factored will influence the burden estimate. However, based on studies and administrative databases, the estimated rate of microbial foodborne illness in Canada is at 0.35 cases per person-year (or approximately 11 million cases in Canada per year). From 2000 to 2003, an average of 68 deaths per year was attributed to infectious enteric infections of which foodborne agents are partly responsible. Canadian estimates are comparable to those from similar studies conducted in Australia, United States, the United Kingdom, Sweden, and New Zealand. Current available knowledge does not allow estimation of yearly illnesses or deaths from exposure to foodborne environmental chemical hazards.

8f. How many Canadians become ill or die annually from acute exposures to pesticides?

Response:

No deaths in Canada attributed to acute pesticide exposure have been reported to Health Canada. Current information does not permit estimating illnesses or deaths attributed to pesticide exposures.

The Health Canada Pest Management Regulatory Agency (PMRA) is responsible for the administration of the new Pest Control Products Act (PCPA). Under Section 13 of the PCPA, registrants (companies to whom the registration is issued), as well as applicants for the registration of a pesticide, are required to report information about incidents related to pesticides. The Pest Control Products Incident Reporting Regulations, which came into force on April 26, 2007, prescribe the information to be reported by registrants and applicants for registration. Incident reports are compiled into a publicly accessible database on the PMRA's website. There is as of yet no annual data available on incidents from the database.

The medical and research community, government and non-governmental organizations, and individuals can also directly report incidents on a voluntary basis to PMRA. The voluntary reporting system currently in place will be soon modified to be more consistent with the mandatory reporting system. The information received through the improved voluntary reporting system will be included in the incident reporting database.

Further information on pesticide incident reporting can be found at: http://www.pmra-arla.gc.ca/english/legis/aer-e.html.

8g. How many Canadians become ill or die annually from acute exposures to toxic substances in household cleaning products?

Response:

Current information does not permit estimating illnesses or deaths attributed to acute exposures to household cleaning products. According to the Regulatory Impact Analysis Statement (RIAS) for the Consumer Chemicals and Container Regulations (CCCR) 2001, there are an estimated 50,000 incidents in Canada each year involving consumer chemical products resulting in injury or illness requiring medical attention, or in property damage of $50 or more. It estimates 20 deaths a year related to unintentional incidents involving consumer chemical products.

According to analysis by the Canadian Institute for Health Information6, 94 cases of poisoning injury hospitalizations (0.3 percent of total poisoning injury hospitalizations) were classified as due to "unintentional poisoning by cleaning and polishing agents, paints" in Canada in 1999-2000.

8h. How many Canadians become ill or die annually from acute exposures to toxic substances in cosmetic products?

Response:

No deaths in Canada attributed to cosmetics exposure have been reported to Health Canada.

It is estimated that between 2-5 percent of the adult population may experience mild reactions to chemicals in cosmetics, most frequently in the form of a skin rash called "contact dermatitis." The condition usually resolves itself when the product is no longer used. However, more serious reactions, for which the potential hazard is more significant, occur in about 10 percent of these cases.

About 50 user cases are reported annually to Health Canada. The cosmetics industry, as a whole, receives more. It is estimated that reported incidents represent only a fraction of actual incidents that occur.

8i. How many Canadians become ill or die annually from chronic exposures to toxic substances in consumer products?

Response:

Current available knowledge does not allow estimation of illnesses or deaths attributed to chronic exposure to consumer products. Attribution of health outcomes such as death or morbidity from chronic exposure to consumer chemicals is complex in large part due to the wide scope of consumer products and their ingredients.

8j. How many Canadians become ill or die annually because of ozone depletion?

Response:

Health Canada is unaware of an accurate assessment of the burden of disease from fluctuations in stratospheric ozone levels. While some researchers have linked skin cancer to stratospheric ozone depletion, the specific population attribution risk (adjusting for behaviour) is unknown. According to the National Cancer Institute of Canada (NCIC), surveillance of skin cancer (other than melanoma) is difficult because it is often treated successfully without hospitalization. The NCIC estimates (extrapolating data from only British Columbia, Manitoba and New Brunswick) 69,000 cases of non-melanoma (basal cell and squamous cell) skin cancer for Canada in 2007.

Question 9

How many Canadian children have blood lead levels that affect their health or development? When was the last national survey of blood lead levels in Canadian children? When is the next national survey planned? How does this frequency of testing compare to other nations, such as the U.S.?

Response:

Health Canada's current intervention level for blood lead is 10 micrograms per decilitre (g/dL) and is intended to flag situations where potential risk of exposure to lead should be investigated in individual cases, and within sub-populations. Health Canada is currently reviewing recent scientific literature regarding possible adverse health effects at levels below 10 g/dL.

The current average blood lead level of Canadian children is not known, but based on similarities in environments, lifestyle and food supply, they are thought to be similar to those in the United States. Using National Health and Nutrition Examination Survey (NHANES) 1999-2002 data, the U.S. Centers for Disease Control (CDC) reports the average blood lead level for children 1-5 years as 1.9 g/dL. CDC also estimates that 1.6 percent of American children have blood lead levels equal to or exceeding 10 g/dL, which is also the CDC level of concern for the U.S. population.

Historically, blood lead levels in Canada and the U.S. have declined since both countries implemented measures to reduce lead exposure risk, such as greatly reducing leaded gasoline and reducing leaded solder used in canned food production. The Canada Health Survey of 1978-1979, Canada's last national survey that included blood lead measurements in children, estimated that 12.1 percent of children aged 3-5 years had blood lead levels equal to or greater than 10 g/dL. NHANES data for 1976-1980 estimated that 88.6 percent of American children aged 1-5 years had blood lead levels equal to or greater than 10 g/dL. Since that time, screenings and surveys carried out in Ontario (1983-1992) showed a steady decline of blood lead levels in children, so that by 1992 the average blood level of Ontario children screened or surveyed had decreased to approximately 3 g/dL. This average level is very similar to NHANES data reported for American children during the same time period.

The Canadian Health Measures Survey currently being conducted by Statistics Canada includes a survey of blood lead levels in children and youth ages 6-19 years. However, since 1978-79, targeted blood lead surveys have been conducted to evaluate the exposure of children at risk due to point sources of lead pollution, such as smelters. While these surveys do not represent the average blood lead level of Canadian children, they do indicate that markedly elevated blood lead levels in children living near such sources have declined over time, indicating that measures taken have resulted in reduced blood lead levels.

As outlined in the response to Question 4, Statistics Canada and its partners will explore the possibility of expanding age ranges in future cycles of the CHMS. Health Canada is also continuing to investigate possible alternative survey mechanisms to obtain nationally representative biomonitoring measurements for children below the age of 6.

The U.S. NHANES survey started testing for blood lead in Americans in the late 1970s (NHANES II, 1976-1980) and since 2000 reports every two years. Germany established a national biomonitoring survey known as the German Environmental Survey (GES) in 1985 that reports about every five years. Its 2003-2006 survey focussed on children (0-17 years of age) with a sample size of 18,000. In previous GES studies slightly different age groups were evaluated: 1990-92 (ages 6-14, sample size: 700 children) and 2003-2006 (ages 3-14, sample size: 1,800 children). Human biomonitoring blood sampling in these studies has included lead.

Environmental justice in Canada

Environmental justice refers to the principle that "all peoples and communities are entitled to equal protection of environmental and public health laws and regulations". The Government of Canada has acknowledged that "we know that some segments of our population are exposed to unacceptably high levels of environmental pollutants"7.

Question 10

What segments of the Canadian population is the Government of Canada referring to? What are the pollutants? What are the unacceptably high levels? What evidence does the Government of Canada have to support this assertion?

Response:

The quotation above is from a Government of Canada report prepared in the context of its work with the Commission for Environmental Cooperation. The assertion was substantiated by the following case examples, as described in the report:

    "... the Northern Contaminants Program has found that some Inuit women from the North who eat traditional/country foods have levels of certain persistent organic pollutants and mercury in their bodies that are above Health Canada's guidelines. Their infants may experience subtle neurodevelopmental effects as a result of exposures to these toxic substances in utero. Canada is working with the international community to decrease the levels of persistent organic pollutants and mercury in the environment. Although the consumption of traditional/country foods containing contaminants may be associated with greater exposures and health risks, it is important to recognize that diets containing these foods confer substantial nutritional benefits and are the foundation of the social, cultural and spiritual way of life for Canada's Aboriginal peoples." (p. v)

    "CASE STUDY—Northern Aboriginal people in Canada

    The Northern Contaminants Program was established in Canada in 1991 in response to concerns about human exposure to elevated levels of contaminants in fish and wildlife species that are important to the traditional diets of northern Aboriginal people in Canada. The primary contaminants of concern in the context of traditional/country food consumption in Arctic Canada are the persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs), chlordane and toxaphene, the toxic metal mercury and naturally occurring radionuclides. The Northern Contaminants Program found that Inuit mothers had oxychlordane and trans-nonachlor levels in maternal/cord blood that are 6–12 times higher than levels in Caucasians, Dene and Métis, or other mothers. Similar patterns were observed for PCBs, HCB, mirex and toxaphene. Recent research has also revealed significantly higher levels of mercury in maternal blood of Inuit women, when compared with other mothers." (p. 39)

Further information about the Northern Contaminants Program (NCP) may be found at: http://www.ainc-inac.gc.ca/ncp/pub/ncppub/index_e.html.

Another example of populations at risk of high exposure to certain environmental pollutants relates to exposure to lead shot, described in the report as follows:

    "Umbilical cord blood lead levels and source assessment among the Inuit in northern Quebec. A study on Inuit newborns from northern Quebec showed that about 7 percent of 475 Inuit newborns had a cord blood lead concentration equal to or greater than 0.48 micromoles per litre, an intervention level adopted by many governmental agencies. A comparison between the cord blood lead isotope ratios of Inuit and southern Quebec newborns showed that lead sources for these populations were different. The study suggests that lead shot used for game hunting was an important source of lead exposure in the Inuit population. A cohort study conducted in three Inuit communities shows a significant decrease of cord blood lead concentrations after a public health intervention to reduce the use of lead shot. Lead shot ammunition can be a major and preventable source of human exposure to lead. Source: Lévesque et al. (2003)" (p. 20)

Further details about this study are available in the related scientific journal article: Lévesque, B., Duchesne, J.F., Gariepy, C., Rhainds, M., Dumas, P., Scheuhammer, A.M., Proulx, J.F., Dery, S., Muckle, G., Dallaire, F. and Dewailly, E. (2003) Monitoring of umbilical cord blood lead levels and sources assessment among the Inuit. Occup. Environ. Med., 60(9): 693–695. Additional information about blood lead levels is provided in the response to question 9.

According to data in the Government of Canada's five-year progress report on the Canada-wide standards (CWS) for particulate matter and ozone8, between 2003 and 2005, at least 30 percent of Canadians lived in communities with fine particulate matter (PM2.5) levels above the ambient CWS target, and at least 40 percent of the population lived in communities with ozone above the ambient CWS target. Additional efforts are required to improve air quality and reduce the risks posed by poor air quality to our environment and to the health of Canadians. To this end, the Government of Canada is undertaking an ambitious agenda to reduce air emissions in Canada as part of the Environmental Agenda and ecoAction programs.

Question 11

Has the Government of Canada analyzed the National Pollutant Release Inventory spatially to determine if there are toxic hotspots (i.e. geographic areas subject to a disproportionate share of pollution)? If so, please provide this information. If not, why not?

Response:

The Government of Canada (GoC) has analysed the National Pollutant Release Inventory (NPRI) data spatially in several instances.

Environment Canada and the Canadian Institute for Environmental Law and Policy have collaborated to develop maps showing the largest NPRI releases of various toxic substances across Canada. These maps are included for your information.

NPRI includes information on releases from industrial and commercial facilities in Canada that meet specified thresholds. However, for some pollutants, industrial sources do not represent the majority of releases in Canada. Environment Canada also develops comprehensive emissions inventories for the air pollutants that contribute to smog and acid rain, and selected heavy metals and persistent organic pollutants. These comprehensive inventories include releases from all sources, including small and large industry, transportation, residential heating, use of products and natural sources, and are based on data from the NPRI and other sources such as statistical and fuel use data. These inventories can also be mapped to show areas where higher and lower releases occur. Examples of maps produced by Environment Canada, for emissions of fine particulate matter (PM2.5) and lead (PB), are included in Figures 1 and 2 (attached).

In addition, Health Canada has contracted Dalhousie University to undertake analytical work on mapping both NPRI and comprehensive emissions inventory data for Nova Scotia. Interpretation of the data is underway and may help to identify potential areas of concern for poor air quality.

Although the NPRI and comprehensive inventories provide information on the sources of pollutant releases, they do not provide information on the actual levels of pollutants in the ambient air and water at a particular location. Environment Canada collects information on ambient levels of pollution in air, for example, through the joint federal-provincial National Air Pollution Surveillance (NAPS) Network (www.etc-cte.ec.gc.ca/NAPS/index_e.html). Information on water quality at specific locations is also available, for example through the following report for Pacific and Yukon Region: (waterquality.ec.gc.ca/web/Environment~Canada/Water~Quality~Web/
assets/PDFs/BCYTWQReport.pdf
).

Question 12

Has the government of Canada analyzed the Contaminated Sites Inventory spatially to determine if there are toxic hot spots (i.e.: geographic areas subject to a disproportionate share of pollution)? If so, please provide this information. If not, why not?

Response:

In 2003-04 Health Canada commissioned Statistics Canada to generate maps, based on information from the Federal Contaminated Sites Inventory, of the distribution of federal contaminated sites across Canada, with specific reference to sites with population centres within close proximity. These maps are appended as Figures 3 – 6 (available with French language legends only). Health Canada has concluded from these maps that, as with most sites deemed 'contaminated' in Canada, they are generally concentrated in the industrialized, more densely populated areas of southern Canada. Federal sites are ranked for their relative potential for human and/or ecological exposure to contaminants and for posing risks to human health and the environment, and the Federal Contaminated Sites Action Plan (FCSAP) generally awards funding firstly to sites presenting the greatest potential for human health and/or environmental risk. Given that risk is partially determined by the ease of access by, and proximity to, residential communities, the FCSAP is effectively ensuring that those sites with the greater potential for human contact are given top priority for assessment and remediation.

Table 1:

Investment in Environmental Health Research, 2000 - 2007 in thousands of dollars (historical dollars)

HC

CIHR

PHAC

EC

TOTALS

2000-2001

N/A

993

--

29001

29994

2001-2002

6382.3

1503

--

33769.9

41655.2

2002-2003

7775.6

2837

--

29552.3

40164.9

2003-2004

6124

4220

--

34996.6

45340.6

2004-2005

7741.9

5133

--

34731.6

47606.5

2005-2006

8046.7

5751

375

37309.3

51482

2006-2007

10816.4

7567

1267.3

46415.2

66065.9

TOTALS

46886.9

28004

1642.3

245775.9

322309.1

Acronyms

HC

Health Canada

 

CIHR

Canadian Institutes of Health Research

PHAC

Public Health Agency of Canada

EC

Environment Canada

 

To attain these dollar figures, Health Canada (HC) and the Public Health Agency of Canada (PHAC) have included intramural and extramural research funding, according to the definitions as provided in the Federal Science Expenditures and Personnel survey from Statistics Canada. [Intramural includes costs incurred for scientific activities carried out by in-house personnel of units assigned to the program, the related acquisition of land, buildings, machinery and equipment for scientific activities; the administration of scientific activities by program employees and the purchase of goods and services to support in-house scientific activities. Extramural performers are groups being funded for S&T activities by the Federal government sector. They include business enterprise, higher education, Canadian non-profit institutions, and Canadian provincial and municipal governments.

HC's figures do not include research that falls under the Statistics Canada definition of Related Scientific Activities (RSA) [i.e., activities concerned with the gathering, dissemination and application of scientific and technical knowledge. RSA also includes information services, special services and studies including testing and standardization, and education support].

The Canadian Institutes of Health Research (CIHR) funds research through the allocation of funding for grants and awards.

Environment Canada's budget for environmental health research was used in numerous research areas, including:

  • the development of analytical and regulatory reference methods;
  • measuring a variety of organic and inorganic compounds in diverse sample matrices, principally from air pollution-related sources but also from contaminated soils, hazardous wastes, and other residues;
  • performing legal analyses of pollution samples;
  • forecasting the need for new environmental toxicology testing methods;
  • developing single-species and microbial functional assays for the assessment of the impact of contaminants on natural soil systems;
  • developing techniques for measuring contamination in air, water, and soil at spill sites and for airborne remote sensing of spills;
  • measurement and characterization of emissions such as greenhouse gases, organics and metals from municipal and industrial sources such as landfills, incinerators, boilers, kilns and smelters, and the evaluation of process control technologies;
  • the development of new sampling methodologies and level of quantification for substances of concern;
  • the characterization of emissions from sources such as marine vessels, off-road vehicles, and utility vehicles;
  • the evaluation of alternative and reformulated fuels for light-duty passenger cars and trucks;
  • air quality monitoring and modeling.

Figures 1 and 2

Figure 3

Distribution of federal contaminated sites in relation to the ecumene

  • "sites not within 1.0 km of populated areas
  • "sites within 1.0 km of populated areas

Figure 4

Distribution of federal contaminated sites in relation to the ecumene

  • "sites not within 2.0 km of populated areas
  • "sites within 2.0 km of populated areas

Figure 5

Distribution of federal contaminated sites in relation to the ecumene

  • "sites not within 0.5 km of populated areas
  • "sites within 0.5 km of populated areas

Figure 6

Distribution of federal contaminated sites in relation to the ecumene

  • "sites not within 0.5 km of populated areas
  • "sites within 0.5 km of populated areas

1 Notice of intent to develop and implement regulations and other measures to reduce air emissions (October 21, 2006) http://canadagazette.gc.ca/partI/2006/20061021/html/notice-e.html#i3

2 Turning the Corner: An action plan to reduce greenhouse gases and air pollution http://www.ecoaction.gc.ca/turning-virage/index-eng.cfm

3 See http://www.chemicalsubstanceschimiques.gc.ca/plan/index_e.html

4 Available at http://www.chemicalsubstanceschimiques.gc.ca/plan/table-tableau_e.html

5 Pruss-Ustun, A and Corvalan, C. Preventing Disease Through Healthy Environments: Towards an estimate of the environmental disease. WHO 2006. (http://www.who.int/quantifying_ehimpacts/publications/
preventingdisease/en/index.html)

6 Canadian Institute for Health Information (CIHI). National Trauma Registry Bulletin: Poisoning Injury Hospitalizations in Canada, 1999/2000. Toronto (ON): CIHI, 2002.

7 Government of Canada. 2005. Children's Health and the Environment in North America: A First Report on Available Indicators and Measures. Country Report: Canada. Gatineau, QC. Environment Canada, p. 58.

8 Government of Canada five-year progress report: Canada-wide standards for particulate matter and ozone (http://www.ec.gc.ca/cleanair-airpur/278E367A-B4E0-4342-9AC8-A2C2AD926488/Federal_CWS_Report_Jan_31_EN.pdf)