Community liaison forums

Health studies the focus of presentation and workshop at second Community Liaison Forum in Port Hope

June 19, 2006 — Issues related to the health studies done over the last approximately 20 years involving Port Hope generated lots of questions and vigorous, passionate discussion at the second community liaison forum held June 19th at the Port Hope Lions Recreation Centre.

The session, sponsored by Cameco, was a follow up to the forum held May 15th at the Port Hope High School during which participants were asked to help set the priorities for future forums.  Health was selected as a priority issue and during the workshop portion of the evening, participants recognized the importance of receiving an expert overview on health studies that had been done in the past in order to put those studies in context and to provide a common understanding to help set the stage for future forums on health.

Based on the feedback from the May 15th forum, Cameco engaged Dr. Lesbia Smith, a physician and expert on environmental epidemiology, to do a presentation at the June 19th forum on what constitutes a health study, the various sources that are used to collect the data for studies, the ways in which the results of studies are interpreted, and a general overview of past health studies that were either specific to the Port Hope area or included Port Hope as part of broader  research,in an effort to bring all interested members of the community to a common level of understanding regarding health issues.

Dr. Smith has been involved in environmental issues in Ontario for over 30 years and is a highly respected expert in community health studies.  She teaches environmental epidemiology and health issues at the University of Toronto and her extensive background includes work with all levels of government, communities, families and industry on health studies done in a number of communities.

Using real examples to illustrate her points, Dr. Smith provided attendees with information about the methodology, research and findings associated with nuclear industry related health studies that had been carried out in Canada and the United Kingdom. Her goal was to use the background information on those studies as a context for her overview of the past studies that had been carried out involving the Port Hope area.  She described the role of epidemiology, the different types of epidemiological studies, and the kind of information that is already available to researchers to use in order to carry out studies in Ontario, such as disease registries (e.g. cancer) and vital statistics (births and deaths).  She explained that health studies try to answer the question why some people get sick and others do not and how studies look at the risk factors for why.

Dr. Smith explained that when health studies are done, the results generally fall into three categories:   “positive” results, which mean they show elevated risks or associations with exposures, “negative” results which do not show elevated risks or associations, and studies where the results are “inconclusive”.  She pointed out that an inconclusive result in a health study sometimes directs us to look at the relationship between exposure and health risk differently.

Dr. Smith then provided the audience with a general overview of several of the studies that been carried out that were directly related to Port Hope and the conclusions reported by the studies’ authors.  She made it clear to the forum that she was not there to present critical analyses of the findings, but only to provide an overview of the history of the studies, the methodologies used and the conclusions reported by the authors.  The study examples she discussed included the “Study of Health Effects of Low Level Exposure to Environmental Radiation Contamination in Port Hope, June 1984 (Lees R.E., Steele R., Roberts, J.H.).  She also talked about the studies done by Health Canada (Cancer Incidence in Port Hope:  1956 – 1997) in which the authors concluded that the “cancer mortality rates in Port Hope are similar to the rest of Ontario.”  She outlined the mortality studies of uranium workers (R.C. Nair, J.D. Abbatt, G. R. Howe, H. B. Newcombe, and S.E. Frost) that examined mortality of 18,424 employees of Eldorado.  It reported that “Port Hope refinery workers did not experience elevated mortality from lung cancer.  Uranium miners did show an increase mortality rate from lung cancer.”

Dr. Smith provided a brief description of the three volume report on health studies prepared in 1994 for The Siting Task Force for Low Level Radioactive Waste Management (LLRWM), established by the federal government to study the type, the location, and the amount of waste materials in the Port Hope area.  The first volume reviewed the types of contaminants; the second reviewed the various health studies and volume three dealt with ongoing studies and suggested potential future ones.  This included updating the administrative databases (i.e. cancer, birth defects and any other health information). 

Dr. Smith’s presentation to the forum was interrupted several times by questions and comments by a few members of the audience.  It was an indication of the strong opinions that exist about the results of the previous studies that have been conducted, the interpretation of the data contained in the studies and the analysis reported by the studies’ authors.  Later in the evening when the results of the workshop portion of the forum were presented there were several calls from participants for more civility at these community meetings in order that those who came to learn could do so effectively.

Following Dr. Smith’s presentation the 80 people attending the forum, already sitting at eight break-out tables with facilitators, were asked to workshop two questions.  The first was designed to collect feedback on what they heard in the presentation, including whether or not it was detailed enough, if it was understandable, and if it led to any opinions regarding the need for further health studies.  This question was the subject of substantial debate at each table and resulted in a lot of comments and opinions.  While some participants felt the presentation should have been a critical analysis of previous health studies and not just a description, there were others who expressed satisfaction with the overview and appreciated the information on study methodology.   Some attendees questioned the validity of the data in the studies that were covered in the presentation and others felt they needed an even more detailed review of the data.  Some workshop participants felt strongly that more health studies are definitely required and a few expressed the belief that a new study is needed in order to take advantage of the advances in science and technology.

It was indicated to forum attendees that Cameco was making efforts to ensure that the health studies about Port Hope are available at the Port Hope Library for those interested in reviewing the full documents.

The second question asked workshop participants to express their views on what they would like to see as the topic at a future community liaison forum on health.  They were encouraged to recommend as many ideas as possible and were given three suggestions to discuss:

• Presentation of more detailed information on how health studies are conducted – the different types of health studies, their strengths, weaknesses and limitations.  And how these studies have been or may be applied in Port Hope.
• A panel of experts to provide a variety of views on cancer, health and radiation exposure.  Panellists could include both national and international perspectives.
• A presentation by the Canadian Nuclear Safety Commission (CNSC) on the relationship between environmental emission standards and health.

When the representatives of each table reported the findings of their group to the entire forum it was obvious that a future forum on the issues around health and health studies was an ongoing interest to the workshop participants.  The majority of tables were in agreement with the suggestion that the next forum should feature a panel of experts, but there was a variety of opinions on who should be invited to be on the panel, how the participants should be selected, and what specific topics the panel should handle.

On the subject of panel composition, forum moderator John Armstrong indicated that Dr. Eric Mintz, a critic of studies done by Health Canada, had already been invited to address a forum as part of a panel of experts that was being planned for the fall.

 Bob Steane, vice-president of Cameco’s fuel services division, wrapped up the evening by thanking everyone for taking the time to attend and reiterating Cameco’s commitment to the community forum process to share information and deal with community issues and concerns.

“It’s quite clear from both our first forum in May and from this one that information and dialogue about health related issues and the health studies that have been done are important, so we will continue to respond to that through the community liaison forum process,” said Steane.  “Based on the feedback we have received we will begin planning future forums related to health issues.”

Although an overview and workshop on previous health studies was the key theme of the evening, Bob Steane opened the forum with information on the upcoming licence renewal process for both Cameco’s conversion facility and for Zircatec Precision Industries.   

Forum Workshop
Here are some of the comments and suggestions made by participants during the workshop about future forums on health issues.

• Expanded information on the previous health studies and some detailed conclusions is required
• There are still questions about past health studies that need to be answered at a forum
• If there is a panel at a future forum, the discussion will need to be well managed in order to balance the experts on the panel with the questions that people will have
• We need a balanced panel of experts in order to get to the truth about health and health studies
• We need to somehow unify all of the conflicting interpretations of the results of the studies
• We need a forum with adequate time to discuss the principles and the issues of another health study
• A discussion on what would constitute the right questions to study should a study be done
• We need information on where Canada stands in comparison to European and U.S. standards
• There should be a presentation from the Canadian Nuclear Safety Commission (CNSC)