1. 1 Environmental Epidemiology of the Great Lakes Basin Industrial Pollution and Human Health August 1999

2. 2 Overview 1. Pollutants 2. Local examples, reaction of public health officials 3. Medical literature: health effects 4. Economics and politics

3. 3 1968 University of Waterloo Dr.Bryce Kendrick, Professor of Botany University of Toronto Dr. Don Chant, Professor of Zoology Pollution Probe

4. 4 1989 Dr. Paul Connett, Professor of Chemistry St. Lawrence University, New York State dioxin chemist Work on Waste USA

5. 5 500 articles on Environmental toxics, 1992 - 1998 Canadian Medical Association Journal JAMA New England Journal of Medicine British Medical Journal The Lancet (others)

6. 6 500 Journal articles on Toxics 1992 - 1998

7. 7 Medline computer search: dioxins and human health 1995 -Dec 1998 217 articles in many other journals: e.g. J. Epidemiology and Community Health Early Human Development Environmental Health Perspectives Chemosphere Am J of Epidemiology

8. 8 Robert Fletcher, M.D. internist, clinical epidemiologist Prof, Harvard Medical School Founding editor, Journal of General Internal Medicine Editor, Annals of Internal Medicine author, Clinical Epidemiology

9. 9 Robert Fletcher, II What is your greatest concern? “Destruction of the good earth by toxins or nuclear waste.” (or simply too many people) The Lancet, Lifeline, Jan 2, l999

10. 10 “Toxics” I. Any industrial pollutants II. Chlorinated Organic chemicals, COC’s

11. 11 Environmental Epidemiology of the Great Lakes Human Health Effects of Industrial Pollutants, Effluents and Toxics November 1998 presentation, Oakville Ontario, to:

12. 12 Canadian Association of Physicians for the Environment C.A.P.E.

13. 13 Health Canada, l997 “State of Knowledge Report on Environmental Contaminants and Human Health in the Great Lakes Basin” 300 pages

14. 14 Arctic Pollution Issues Arctic Pollution Issues, A State of the Arctic Environment Report, Arctic Monitoring and Assessment Program, Oslo, l997 Highlights of the Canadian Arctic Contaminants Assessment Report, a community reference manual, Northern Contaminants Program, Ottawa, l997

15. 15 Where do contaminants go in North America? Great Lakes Basin St. Lawrence River Rocky Mountains Arctic

16. 16 Cdn J of Public Health Supplement, May/June l998 What on Earth? A National Symposium on Environmental Contaminants and the Implications for Child Health (selected papers) Canadian Institute of Child Health May l997, Ottawa

17. 17 What are the causes of illnesses? 1. Genes 2. Environmental factors

18. 18 McGinnis & Foege, DHSS JAMA, Nov 10, l993 “Actual Causes of Death in U.S.” 2 components to the cause of illness: 1. Genes 2. Environmental factors

19. 19 Genetic factors in illness Genetic resistance/susceptibility some individuals more susceptible than others e. g. cancer: tumor suppressor genes cancer families

20. 20 Environmental factors in illness (McGinnis, JAMA, 1993) 1. Smoking 2. Animal fat 3. Alcohol 4.infectious disease 5. TOXICS exposure 6. Automobiles 7. Firearms 8.drugs

21. 21 Toxics exposure in the Great Lakes Basin? How many people? 36 million

22. 22 How many chemicals are in the Great Lakes? 800 sources: agricultural industrial municipal

23. 23 How many chemicals 100,000 3,000 in high volume use 95% have incomplete health data 43% have no health data ( Bev Thorpe,1999) present in: dirty dozen: Epstein

24. 24 What chemicals?? What pollutants?? 1. Organic chemicals: a. non chlorinated: methanol, ammonia toluene, benzene, methyl ethyl ketone, ethylene glycol

25. 25 2. Chlorinated/brominated organic chemicals, COC’s “Persistent toxic substances” “Persistent organic pollutants, POPs” e.g. pcb’s, dioxins, furans

26. 26 Dioxins

27. 27 Barry Commoner 2nd Citizens Conference on Dioxin, St. Louis, Missouri, July, l994 “Dioxin and dioxin-like substances represent the most perilous chemical threat to the health and biological integrity of human beings and the environment.”

28. 28 WHO Tolerable Daily Intake Dioxin, Sept l998 1990: 10 picogram/kg for 2378 tet dioxin new epidemiologic data on effects on nervous and endocrine systems new TDI, tolerable daily intake 1 to 4 pg/kg Medical Post,Sept 22, l998

29. 29 Source of Daily Intake Food 90%

30. 30 Dioxin intake: Breast feeding “In the Great Lakes Basin exposure to TCDD during Breast feeding exceeds the established TDI for this contaminant.” Cdn J of Public Health, May/June l997, from Haines et al, Environ Res, 1998

31. 31 Canadian Breast milk survey Twenty five Years of Surveillance for Contaminants in Human Breast Milk A. G Craan, D. A. Haines, Great Lakes Health Effects Program, Health Canada, Archives of Environ Contam and Toxicology. 35, 702 - 710 (1998)

32. 32 Misleading? “There are indications that dioxin and furan levels in breast milk are decreasing (see Table 4 of the Craan and Haines article.) Further monitoring over the next ten years will be needed to confirm this trend.” D. Haines, personal communication, January 29, 1999

33. 33 Daily Intake of Dioxin/furan from Breast milk ( pg/kg bw/day)

34. 34 Concentrations of dioxins and furans in Canadian human milk pg/Kg Whole milk

35. 35 1992 estimated daily intake of dioxin from breast milk/formula pg TEQ/Kg body wgt/day

36. 36 WHO TDI Dioxin 1998 1 - 4 (2.5) pg/kg body wgt/day 5 - 6 month Canadian infant taking in 750 ml milk daily: Breast milk: 25 times TDI formula: 5 times

37. 37 Misleading? “Table 6-5 shows that the mean levels ofd total PCDDs/PCDFs in adipose tissue of Canadians are comparable to those reported for other countries.” Page 65, State of Knowledge Report on Environmental Contaminants and Human Health in the Great Lakes Basin, Health Canada, 1997

38. 38 Table 6-5 Ryan, 1985, Canadian samples collected in 1976 throughout Canada, post mortem. U.S. samples collected l983-84,NY state Schecter, 1986, Vietnam. Southern areas were sprayed with Agent Orange while northern areas were not. 1029, 985, 1577, 147 respectively. (see also Sweden, Japan, East Germany,

39. 39 Mean levels of PCDDs and PCDFs in Human Adipose Tissue

40. 40 countries Sweden, 1986, Dsgren (some exposed) New York State, USA, Ryan, 1983 (MVA) Canada, Ryan, 1976, &Teschke, 1992 ( “ ) Japan, 1986, Ono North Vietnam, Schecter, 1986 (no AO) South Vietnam, “ (Agent Orange) Fed Rep Germany, Rappe, 1987 (exposed)

41. 41 “comparable” Levels in Canadians/ NY State residents sampled from accidental death (“unexposed”) victims comparable to: countries where residents were exposed to dioxins

42. 42 What pollutants? II 2. Heavy Metals: Mercury, lead, arsenic, cadmium Copper, zinc (No discussion of health effects)

43. 43 What pollutants? III 3. Classic Air Pollutants Particulates (PM 10, PM 50) Ozone Acid Gases (Sox, Nox, HCl) CO

44. 44 What pollutants? IV 4. CO2 Global Warming

45. 45 Sources Industrial processes, e.g. petrochemical industry e.g. PVC coal fired power plants automobile engines, (gas, diesel) pulp and paper industry waste incineration (3) cement kilns hazardous waste landfilling, dumping

46. 46 Municipal Solid Waste: backyard barrel burning PVC plastic significant source of dioxin

47. 47 Incineration of Medical Waste, I U. S. E. P. A. 3rd largest source of Dioxin major source of Mercury North American environment

48. 48 Incineration of hospital/medical waste, II Lynn R. Goldman, MD, JAMA, Aug 12,98 EPA: assistant administrator for toxic substances 2% of hospital waste needs incineration 75% -100% actual

49. 49 What is the Current toxic load entering the Great Lakes Basin? Canadian NPRI, (1993) U. S. EPA TRI, (l990) 1000 tonnes per week US GAO: 5% of total: 20,000 tonnes per week

50. 50 What is the Current toxic load entering the Great Lakes Basin? Great Lakes United, 1997 2500 tonnes per week (100 truck loads)

51. 51 Provincial Auditor of Ontario 1996 1200 tonnes in Province of Ontario /week (1000 tonnes into the air)

52. 52 NAFTA: CEC Toxic Load in North America 1998 1 million tonnes per year

53. 53

54. 54 What are (or could be) the Human Health Effects of Toxics? 1. Proven 2. Speculative/unproven

55. 55 Public health Officials Concerned citizens ask questions about hazardous chemicals in their communities

56. 56 Public health officials offer Reassurance The following are some local, provincial, national and international examples

57. 57 Bay of Quinte Hazardous Waste Sites 1. Trenton Norampac: Dombind 2. Aikens Road landfill 3. Zwick’s Island Park landfill 4. Meyer’s Pier coal gasification site, pah’s 5. Bakelite plant, phenols 6. Deloro mines: arsenic/radioactivity 7. Rednersville Road, TCE 8. Richmond municipal landfill site, Napanee

58. 58 Other Hazardous Waste Sites West Lincoln, Ontario (incinerator) East Liverpool, Ohio ( “ ) Times Beach, Missouri (dioxin in waste oil dust suppressant) Sydney Mines, Cape Breton Island (PAH’s)

59. 59 #1 Rednersville, Ontario

60. 60 Rednersville, Ontario, 1990 Illegal hazardous waste site 200 barrels of VOC’s: TCE, benzene 1973-1988: 15 years 16 (25) families: contaminated water compare Woburn, Mass case MoH Health Study

61. 61 Woburn, Massachusetts 1970 - 1990 Drinking water contamination with TCE 2 local plants: W.R.Grace, Beatrice Foods 12 children died of leukemia (‘70’s) civil action by citizens, EPA action, 1990 $70,000,000 liability, cleanup operation Civil Action, Jonathan Harr,

62. 62 Rednersville Health Study, 1990 “no evidence of human health effects”.

63. 63 #2 Zwick’s Island landfill, Meier’s Pier Belleville, Ontario

64. 64 Zwick’s Island Park, Meyers Pier Belleville, l998 Municipal/hazardous waste landfill Creasy engineering Report leaking : PAH’s (benzo (a) pyrene), VOC’s (chloroform) compare NY State and Eurohazcon studies Municipal Health study: risk assessment shows elevated cancer risk at Meier’s Pier

65. 65 NY State ATSDR June l998: cancer Eurohazcon study, Dolk,1998: congenital defects (The Lancet)

66. 66 Zwick’s Island/Meyer’s Pier Creasy (Engineering), 1998 Belleville City Council says reports show the following compounds in the landfill sites: sodium chloride, “table salt” (Belleville Intelligencer) “ammonia” (smelling salts) (Community Press, Dec.24, 98)

67. 67 Zwick’s Island/Meyer’s Pier Health Study, 1998 “These places are not unsafe for people.” City Administrator, Belleville Intelligencer, Nov.3,98

68. 68 #3 Dombind, Eastern Ontario

69. 69 Dombind, 1993 - 98 Hastings/Northumberland/Peterborough Trent River-Moira watershed Dust suppressant in 90 townships Domtar spent black liquor 50 million litres/yr (6100 tanker trucks) Dioxins, furans, metals, phenols compare Times Beach, Missouri MoH Health Study (Hukowich):

70. 70 1994, Times Beach, Missouri 2nd Citizen’s Conference on Dioxin St. Louis/Times Beach 1970’s dioxin-contaminated waste oil as dust suppressant on roads

71. 71 Dombind Health Study, 1998 “On the very narrow issue of whether the use of Dombind constitutes a health hazard within the Health Protection and Promotion Act, I have concluded that it does not.” Alex Hukowich, MOH, Peterborough Belleville Intelligencer, Oct 21, l998

72. 72 Norampac Inc, Trenton Dombind disposal problem consideration underway (1999) for hazardous waste incinerator construction as an alternative to Dombind method of disposal of pulp liquor

73. 73 #4 Richmond landfill site, Napanee, Ont

74. 74 Richmond (Napanee) landfill site 2 million tonnes existing Canadian Waste Services application for 750,000 more annual tonnes leachate flow into:Marysville,Sucker Creek thence into Bay of Quinte Committee of Concerned Residents Paul Finkle, Stephen Geneja, Residents community press, April 2, 1999

75. 75 #5 Kingston landfill site

76. 76 Kingston landfill case, 1999 Janet Fletcher private prosecution, federal Fisheries Act joined eventually by MoE who initially declined the opportunity guilty fine see 1999 press file

77. 77 #6 Arsenic leakage into Moira River Deloro, Ontario

78. 78 Deloro, Ontario Arsenic leakage into river at Deloro 100,000 tonnes of arsenic tailings 10 tonnes per yr leak into Moira R Deloro human health Risk study,1999: no human health effects Moira River Impact study, 1999, screening human health risk assessment under way

79. 79 Deloro hazardous waste site Spring, 1999 MoE health study urine samples control urines: ?neighbouring community number of people: ?200 MoE toxicologist: likelihood of stat sign findings: low “crackerjack teams of experts in Toronto”

80. 80 #7 Peterborough,Ontario

81. 81 Peterborough, Ontario Feasibility hearings for municipal incinerator construction, April 1999

82. 82 #8 Cornwall, Ontario Material resources recovery unit

83. 83 Cornwall, Ontario material resources recovery unit Public hearings, attended by Ellen and Paul Connett, August 1999 application for permit to burn 30,000 ppm PCB’s, current permitted for 50 ppm Cornwall/Massena area already heavily contaminated with PCB’s

84. 84 Cornwall hazardous waste incinerator October 1998, began operation PCB’s from fluorescent light ballast In the new permit they also want to burn: pharmaceuticals, chloroflurocarbons, electrical equipment, poisonous and reactive gasses, “controlled substances” and waste oils.

85. 85 Response of Medical Officer of Health Dr. Bourdeau: 5 county Eastern Ontario Health Unit, quoted the: 1996 Harvard Report on Cancer Prevention (R. Clapp) to explain cancers: 30% from smoking, 30% from obesity and fat and lack of exercise and 2% from environmental sources. (noted lower male:female birth ratio in Cornwall in passing)

86. 86 #9 West Lincoln, Ontario failed proposal of 1980’s

87. 87 OWMC hazardous waste facility West Lincoln, Ontario, 1980’s Hazardous waste incinerator 60,000 tonnes per year Joint Board Hearings, Oakville Ontario 1991 - 1993 Health Risk Assessment

88. 88 West Lincoln Risk Assessment Negligible Cancer risks No Non Cancer health effects “No evidence of significant health effects”

89. 89 Examples from elsewhere in Canada and United States

90. 90 # 1 Sydney Tar Ponds, Nova Scotia

91. 91 Sydney Mines, Cape Breton, NS Tar ponds, 1995 CMAJ, March l5, l995 cokes ovens, steel plants PAH’s in tar ponds (700,000 tonnes sediment) Cancer mortality: 25% higher in women, 49% higher in men than provincial average Provincial Epidemiologist:

92. 92 Sydney tar ponds Lifestyle factors, namely smoking and poor diet, were said to be responsible by public health officials

93. 93 #2 East Liverpool, Ohio hazardous waste incinerator

94. 94 WTI hazardous waste incinerator East Liverpool, Ohio, 1997 Hazardous waste incinerator 200 miles south of Oakville 60,000 to 170,000 tonnes per year EPA hearings, East Liverpool, 1997 Dioxin output ?????? (UNKNOWN) Health Risk Assessment, 3500 pages

95. 95 East Liverpool Risk Assessment Negligible Cancer risk No additional Non Cancer health effects “No evidence of significant health effects”

96. 96 Citizens ask questions about toxic substances in their communities Public health officials 1. Epidemiology 2. Risk Assessment

97. 97 “No evidence of human health risk.”

98. 98 Hamilton, March 1999 EverydayCarcinogens conference Dr. Richard Schabas head, cancer prevention, CCO keynote speaker did not address the issue of environmental carcinogens citizen delegation to CCO, July 1999, presentation made to Dr. Ken Shumak

99. 99 Reassurance Pattern of Denial ? by public health authorities

100. 100 Denial by developers Royal Group Technologies, Woodbridge “plastic houses” PVC interlocking panels for wall construction filled with cement since 1996

101. 101 Denial by developers, II Charlie Cray, Greenpeace, Chicago “PVC emits dioxin when it burns. It’s very toxic”

102. 102 Denial by developers, III Gwain Cornish, senior VP and chemist Royal Group Technologies “The amount of dioxin emitted by burning PVC is negligible. Even mashed potatoes give off more toxins than PVC.” Globe and Mail, Jan 23, l999

103. 103 Medical literature 1992 - 1998

104. 104 Non reassuring medical literature 1. Limitations of Epidemiology and Risk Assessment 2. Reports: changes in disease patterns strong hints: industrial chemicals are implicated

105. 105 “More controversy, little clarification”… “The impact of low-level exposures on human health has proved difficult to investigate but refined environmental epidemiological methods and mechanistic studies are providing new insights…..Although environmental health risks are of low magnitude and difficult to prove, they may still pose …..

106. 106 ……….The Lancet End of Year Review, Dec 1998 ….an important public health problem if large numbers of people are exposed, and if certain populations are disproportionately exposed…..The need for better risk assessment and better education of the public regarding environmental risks is being recognized.” Carrie Redlich, MD, Yale University

107. 107 I. Cancer

108. 108 Dr. Bernard Dixon, editor BMJ, June 11, l995 “Cancer is essentially a disease of genes which are triggered into mischief by external carcinogens such as chemicals and radiation.”

109. 109 Epidemiology (has a problem) Do industrial effluents cause cancer?

110. 110 Dr. Anthony Miller, U of T Epidemiology JAMA Feb 9, l994 “We must remember the long natural history of cancer, and that the full effect of exposures to carcinogens in early life may not be seen until those exposed reach advanced age.”

111. 111 Dr. David Kessler U. S. FDA, Joint Report of Pesticide Use, June l993 “We know that children are overexposed, and we know that the chemicals are toxic. But when cancer or chronic neurological, immune or reproductive problems show up years later there will be no footprints left.”

112. 112 CLASSIFICATION OF CANCER by Age 1. Childhood Cancer, < age l7, 19 2. Adult cancer

113. 113 Childhood Cancer Dr. Anthony Miller CMAJ Dec l5, l994 1969 - 1988 overall incidence: rose from 13 to 17 per 100,000 20% increase in 20 years

114. 114 Canadian Childhood Cancer Control Program, I Gibbons, Mao, Levy, Miller, CMAJ, Dec l5, l994

115. 115 Canadian Childhood Cancer Control Program II, Gibbons, Mao, Levy, Miller, CMAJ, Dec l5, l994

116. 116 Childhood ALL Landrigan and Pui NEJM Nov 9, l995 SEER data from l973 to l991 increased from 2.7 to 3.3 cases per 100,000 children 20% increase in 20 years causes: unknown, ? Environmental toxins

117. 117 Childhood Brain Tumors Dr. Rutka, Neurosurgeon, HSC Medical Post, September l5, l998 1990: 60 1997: 100 Dr. John McLaughlan,U of T Epidemiology “There is strong evidence that children who live in close proximity to hydro transformers, nuclear power plants and industrial toxins are at greater risk of brain tumors.”

118. 118 Parliamentary Assistant to the federal Minister of the Environment Paddy Torsney AAUW/CFWW Cross Border Conference October l998 male: “25% increase” female: “42% increase” in rates of Childhood Cancer ? Reference/source

119. 119 “Childhood Cancer and Environmental Contaminants” Cdn J Public Health, June 1998 Mary Mcbride, B.C. Cancer Control Agency 185 references

120. 120 Adult Cancer

121. 121 Adult Cancers Common, increasing: lung, (bowel), breast, prostate. Uncommon, increasing: 1. NHL 2. Brain tumors 3. Melanoma 4. Testicular cancer

122. 122 Common Cancers

123. 123 Lung Cancer Genes

124. 124 Tumor suppressor genes Control cell reproduction Individuals/families who are: genetically RESISTANT “ SUSCEPTIBLE to cancer

125. 125 Tumour suppressor genes: Normal vs. Mutations

126. 126 Lung Cancer Tang, (Smithville, USA) Lancet Oct 26, l996 4000 chemicals in Cigarette smoke Benzo (a) pyrene DNA damage to p53 tumor suppressor gene

127. 127 Tang (one) mechanism by which Toxics cause cancer

128. 128 Benzo (a) pyrene in the Great Lakes Basin PAH (polyaromatic hydrocarbon) by product of petrochemical processes IJC, International Joint Commission 11 critical contaminants: pcb, dioxin, furan, ddt, toxaphene, mirex, dieldrin, hcb, methyl mercury, alkylated lead, benzo(a)pyrene

129. 129 Bowel cancer: Chlorine and drinking water (I) Will King, OCTRF/Queen’s University Dec 6, l995 chlorinated water 10% increase in bowel (and bladder) cancer ?Trihalomethanes

130. 130 Bowel cancer: chlorinated drinking water (II) Doyle, Univ of Minnesota Lancet, Aug 23, l997 28,000 post menopausal women in Iowa chlorinated drinking water increased colon cancer

131. 131 Breast Cancer & industrial chemicals Dr. Devra Davis World Resources Institute JAMA, Feb 9, l994 1973 - 1987 19 % increase ? Environmental xenoestrogens

132. 132 CCO graph Breast cancer incidence Rising on display at Everyday Carcinogens conf March 1999

133. 133 Devra Davis: (cont’d) “There are critical periods in development, e.g. the first trimester of pregnancy and adolescence, when sensitivity to carcinogenesis is high. Timing of exposure to chemicals and radiation can be more important than dose.”

134. 134 Breast cancer and chemicals:CON Stephen Safe, Ph.D, Texas A&M University editorial, NEJM, Oct 30, l997 “chemophobia, the unreasonable fear of chemicals” “paparazzi science” 2 problems ??

135. 135 Safe’s editorial Hunter ? Doubtful conclusions ?undeclared interests (CMA)

136. 136 Breast Cancer and chemicals : CON Hunter, Organochlorines and the risk of breast cancer, NEJM, Oct 30, l997 240 women, case control study pcb, dde levels No difference on organochlorine levels (? Breast cancer group genetically susceptible)

137. 137 Breast cancer & Breast feeding Moysich, Vena, SUNY Buffalo, l997 women from Love Canal area, western NY organochlorine exposure breast feeding was a protective factor vs breast cancer: lower blood levels of DDE “The chief mechanism for eliminating organochlorides from the breast is lactation, which flushes them from the system.”

138. 138...Recipient of this toxic flush …... Newborn breast feeding infant

139. 139 Prostate Cancer Morrison, LCDC Cdn Journal of Public Health, July/Aug ‘96 predicted tripling in rates over next 20 yrs “part of the increase may be due to chemicals in the environment ” ???? no evidence

140. 140 Prostate cancer, II Gallagher, Fleshner CMAJ, October 6, l998 strong relationship to Dietary Fat intake

141. 141 Uncommon Cancers (that are increasing) * 1. NHL 2. Brain tumors 3. Melanoma * 4. Testicular cancer

142. 142 Non Hodgkin’s Lymphomas, I Adami et al, Sweden BMJ, June 10, l995 2 - 4% annual increase in a number of countries ?role of u/v exposure

143. 143 Non-Hodgkin’s Lymphomas, II Freedman BMJ May 17, l997 mortality NOT associated with u/v exposure ? Unsuspected environmental agents

144. 144 Non-Hodgkin’s Lymphomas, III Rothman, Cantor Lancet, July 26, l997 occurrence of NHL related to PCB levels ?immunosuppression, with EBV susceptibility

145. 145 Non Hodgkin’s Lymphomas 2 - 4 % annual increase Rothman, Cantor Lancet, July 26, l997 occurrence of NHL related to PCB levels

146. 146 Testicular cancer, I 2 - 4 % annual increase for last 25 years Scandinavia, Europe, North America Danish EPA, l995 Canada, 2% annual increase, over 30 yrs,Weir, Jan 26,1999,CMAJ

147. 147 Testicular cancer, II “It is a reasonable hypothesis that toxins acting during the early fetal development of the gonads are involved in the ….increase in the incidence of testicular germ cell cancer…..The likely culprits include DDT, PCBs, nonylphenol, bisphenols and vinclozolin.” L. Klotz, MD, CMAJ, Jan 26, 1999

148. 148 Testicular cancer, III “Changes in male genitalia, such as the increasing incidence of testicular cancer in the U. S., could be like a canary in a mine shaft.” Harry Fisch, director, Male Reproductive Centre, Columbia Presbyterian Medical Centre, New York Globe and Mail, Jan 26, l999

149. 149 Adult Brain Cancer Workshop Group on Brain cancer CMAJ, March l5, l992 DOUBLING of rate, 1969 - 1985 age > 65 occupational and non-occupational exposure to chemicals

150. 150 Melanoma BMJ Jan 20, l996 DOUBLING of rate in Southern Hemisphere chlorofluorocarbon release: ozone loss, increased u/v exposure

151. 151 II. Non Cancer illnesses

152. 152 Non-cancer illnesses 1. CardioRespiratory 2. Reproductive and Developmental 3. Neuropsychological 4. Endocrine 5. Immunological

153. 153 1. CardioRespiratory Asthma Chronic lung disease Myocardial infarction 1800 deaths annually in Ontario from cardio-respiratory disease related to air pollutants (Eva Ligeti, Ontario government Environment commissioner, 1998 )

154. 154 Classic Air Pollutants: Particulates (PM 10, PM 50) Ozone Acid Gases (Sox, Nox, HCl) CO

155. 155 2. Reproduction and Development

156. 156 Environmental Estrogens “Xenoestrogens” 1. Chlorinated organic chemicals 2. APE’s (alpha phenyl ethoxylates), surfactants, detergents 3. Bisphenols (polycarbonate subunit) 4. phthalates (plasticizers)

157. 157 2.Reproduction & Development a. (Canadian) MEN 1. declining sperm counts 2. declining male:female birth ratio 3. Increasing abnormalities of male sex organs (hypospadias) 4. Shrinking testicle size(Klotz, CMAJ,Jan99) 5. Increasing testicular cancer

158. 158 Declining Sperm Counts, I Carlsen, Skakkebakk (Copenhagen) BMJ, l992 metanalysis of 61 studies: 50 years, 1940 - 1990 40% reduction in sperm count coincidental introduction of COC’s into industrial production in 1940

159. 159 Declining Sperm Counts, II French (Thibeault, Bujan British (Irvine, Sharp) American (Fisch) Scandinavian (Pajarinen)

160. 160 Declining Sperm Counts, III Canadian study: Feb l998 Health Canada/McMaster University 49,000 Canadian men 1984 - 1996, 11 centers 1.4 % reduction per year

161. 161 Declining Sperm Counts, IV Swan (California) Lancet Nov 29, l997 reanalysis of Carlsen’s meta analysis, l992 USA: 1.5% reduction annually, 1938 - 90 Europe: 3.1% reduction annually,l971- 90

162. 162 ?Declining Sperm Counts NIH ACDCP started study Nov l997

163. 163 Male genital malformations: Hypospadias Paulozzi, (Pediatrics, 100, l997) Atlanta, l968 - 1992 DOUBLING to 30 per 10,000 births similar increases documented in: US wide Birth defects monitoring program European/Scandinavian studies of l980’s

164. 164 Declining male:female birth ratio I Usual ratio: 51.5% are male 106: 100 declines documented in: Davis & Gottlieb, JAMA April 1, l998 (European countries) Patterson, Lancet Aug 10, l996 (Seveso) Williams, Int’ J Epidem, l992 (incinerators)

165. 165 Declining male:female birth ratio II Allan, Jarrell et al CMAJ Jan 1, l997 Canada, 1930 - 1990 after l970: 2.2 less male births/1000/year ovulation inductions drugs could NOT account for all of the reduction

166. 166 2.Reproduction & Development b. WOMEN 1. Shorter menstrual cycles 2. Threatened miscarriage 3. Endometriosis 4. Premature ovarian failure

167. 167 Delay in Conception? Mendola, Buck Am J Epidemiology, Dec 2, l998 New York State residents eating Lake Ontario fish for 7 yrs No significant delay in conception Menstrual cycle was 1.1 days shorter

168. 168 Premature ovarian failure/menopause Cowan & Seifer Clinical Reproductive Medicine, 1997 7 causes of premature menopause “environmental dioxin”

169. 169 2.Reproduction & Development c. EMBRYO, FETUS AND NEONATE : Birth cycle: 1. Ovary contamination 2. IUGR 3. Congenital birth defects 4. Increased gonadal intersex 5. Breast milk contamination

170. 170 Soderstrom, Michigan State Medical Society CMAJ, Oct 1, l998 “The development of embryos of different species is a very similar thing, especially in the first few weeks. Whether it’s a human, a fish or a bird, it goes through much the same process. So if there’s an extensive problem for ( wildlife such as) fish and birds, and there certainly has been, there is no reason to think that there cannot be effects on humans.”

171. 171 Preconceptual environment Jarrell CMAJ, April l5, l993 ? 6 Canadian cities fluid in human ovarian follicles measurable levels of 5 organochlorines: dde, pcb, hexachlorobenzene, chlordane, heptachlor

172. 172 Fetal development Vivyan Howard University of Liverpool Fetal toxicopathology group 2nd Citizens Conference on Dioxin, l994 IUGR as a conseqence of toxics exposure

173. 173 Congenital Birth Defects I Lie, NEJM July 7, l994: cause of 2/3 of birth defects is unknown Rodgers, University of Kentucky, 1994: increased birth defects in Times Beach, Missouri after dioxin contamination U. S. IOM, Lancet June 8, l996: Agent Orange ( dioxin ) and Spina Bifida in children of Vietnam veterans

174. 174 Congenital Birth Defects II Helen Dolk, London School of Hygiene Lancet, August 8, l998 Eurohazcon study (hazardous waste sites) residents within 3 km of landfill 1.33 Odds Ratio : congenital anomalies NTD’s, cardiac septal defects, transposition of great arteries and veins statistically significant

175. 175 Breast feeding, I Frank, Newman CMAJ, July 1993 pcb’s and other toxics in breast milk “good evidence of subtle fetal and infant health effects resulting from prenatal (intrauterine) exposure”

176. 176 Breast feeding, II WHO committee Lancet, BMJ, May l997 2 month old breast fed infant receives 17 times the TDI of pcb’s and dioxins from breast milk (50 times) breast feeding a “significant risk” ??

177. 177 Breast feeding, III Craan & Haines, GHEP, Canada Arch Environ Contam Toxicol, l998. 35, 702-10 Twenty five years of Surveillance for Contaminants in Human Breast Milk Canada: 6 surveys of human breast milk. 1967, 1970, 1975, 1982, 1986, 1992

178. 178 Canadian Breast milk studies Summary: Persistent Environmental Contaminants and the Great Lakes Basin Population: An Exposure Assessment Health Canada, 1998 Douglas Haines, GLHEP

179. 179 Canadian Breast milk A B C D E 1982: 889 95 1986: 562 60 1992: 522 56 12 2.5 25/5 A. pg TEQ D+F/kg whole milk B/C Pg Teq D+F/kg body wgt/day daily intake, Breast milk/formula C. WHO TDI, l998 D. factor over WHO

180. 180 3. Brain PCB’s and brain injury in: babies/children of fish-eating residents of: Lake Michigan (Jacobson) Lake Ontario (Daley) adults St. Lawrence River (Mergler)

181. 181 Human brain development: Lancet Oct 11, l997 20th week of gestation. number of new synapses (nerve cells and connections) being formed per second: 40,000 Can toxic exposures interfere?

182. 182 Neuropsychological, I Jacobson & Jacobson NEJM Sept 12, l996 followup of original cohort, now age 11 pcb’s in utero from contaminated Lake Michigan fish eaten during pregnancy abnormal body wgt/head circ at birth 6 point IQ reduction at age 11

183. 183 Neuropsychological II Helen Daly SUNY Oswego NY mothers ate pcb-contaminated Lake Ontario fish during pregnancy newborn babies “abnormal psychological reactions” (No abnormal body weights/head circ)

184. 184 Neuropsychological, III Kosatsky, Mergler 1997 Gt. Lakes/St. Lawrence Health Conference Lac St. Louis, Lac St. Francois deficits in attention, concentration and cognitive intellectual function in fish eaters pcb levels in fish eaters were “well within Health Canada guidelines”

185. 185 4. Immunologic Effects

186. 186 Immunologic Effects, I McConnachie, Illinois, 1994 2nd Citizen’s Conference on Dioxin Times Beach, Missouri, dioxin exposure children lymphocyte dysfunction

187. 187 Immunologic Effects, II Repetto, World Resources Institute JAMA March 27, l996 Pesticides and the Immune System immune system dysfunction in children

188. 188 5. Endocrine Effects

189. 189 Endocrine Effects Koppe, Netherlands Lancet Feb 3, l996 thyroid neonatal dysfunction after dioxin exposure structural similarilty between dioxin and thyroxine molecules

190. 190 Conclusions Environmental Economics

191. 191 Comparison: Intel Corporation (and the Silicon Chip) New York Times, December 3, l995 Semiconductor manufacturing plant New Mexico environment is “thousands of times cleaner than an operating room” Price: $ 1 Billion

192. 192 Government of Ontario, I (and the human brain) Ministry of Environment Operating Budget l993/94 $ 390 million 1994/95, 95/96 240 “ 1996/97 150 “

193. 193 Government of Ontario II (and the human brain)

194. 194 Government of Ontario, III 1995 - 1998: MoE: number of pollution investigators: fell 28% total staffing: fell 32%

195. 195 Government of Ontario, IV “We truly believe that this government has done more than any previous government to aid the environment. ” Norman Sterling June 22, l998 Minister of Environment

196. 196 Provincial Auditor of Ontario,1996 226 air-pollutant standards required reassessment (1992 MoE study) substantial reductions needed in releases of air pollutants:“aggressive 3 year MoE plan”

197. 197 Provincial Auditor, 1998 Erik Peters followup November 4,1998 “not a single one of the 226 air pollutant standards has been updated”

198. 198 Minister of Environment, 1998 Norman Sterling, Nov 4, l998 “When you are striking scientific-based standards, it does take a bit of time.”

199. 199 Waste water standards, l996 MoE enforcement 1000 violations sewage, pulp & paper, mining,chemical, etc 3 fines: Malette, Domtar, Russell FoI Act: Sierra Legal Defense Fund $20,000 charge levied 1 1/2 year process Privacy commissioner settled eventually

200. 200 MoE, 1996, II Karen Vaux, spokeswoman: “Our priority is to get them to fix it and ensure that these type of occurrences don’t happen again.”

201. 201 500 Journal articles on Toxics 1992 - 1998

202. 202 Government of Ontario II

203. 203 Linkage Government funding for environmental work environmental research

204. 204 Montreal Biosphere 1999 Multimedia presentation: Mission Bios H20 but: “in the last 15 years the situation has greatly improved” (How would you know?)

205. 205 Dr. Pierre Beland former commissioner, IJC 1998 GLU Citizen’s Hearings “Governments are becoming more and more uninterested in the environment….. Knowledge of the health of the Beluga in the St. Lawrence River is now uncertain. There is no 1998 data because there is no money to analyze and research.”

206. 206 Eva Ligeti Environmental commission, Ont State of Environment report 1998 released 1999 Ligeti met with new Minister of Environment August 1999, Tony Clement who said he “could do business with her” Ligeti fired the next day by the government Globe and Mail, week of August 16, 1999

207. 207 International Joint Commission of the Great Lakes, 9th Biennial Report “The evidence is overwhelming: certain persistent toxic substances impair human intellectual capacity, change behaviour, damage the immune system and compromise reproductive capacity. The people most at risk are children, pregnant women, women of child bearing age and people who rely on fish and wildlife…….

208. 208 IJC, 9th Biennial Report, II …as a major part of their diet. Particularly at risk are developing embryos and nursing infants.” July l998

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