Dr. Nelson Ames, former Medical Health Officer for the Kootenays (retired) answers common community questions in this interview.. Dr. Ames has been involved with lead health issues in Trail since 1988.
1. How long have you been involved with the lead health issues in Trail? What has your role been?
A: I have been involved for over 20 years, since 1988. Initially I was
part of the UBC research team asked by the Ministry of Health to
investigate child lead exposure concerns that had been identified by the
local Medical Health Officer. Subsequent to the initial ‘Lead Study’ I
was pleased to be offered the Kootenay Boundary Medical Health Officer
position that I occupied until June 2009. I was a founding member of the
Trail Community Lead Task Force and, subsequently, the Trail Area
Health and Environment Committee (THEC).
2. What role does Interior Health play? What about the BC Ministry of Health? Health Canada?
A: Public Health has been an active participant and funding partner
since the inception of Task Force in 1990. Initially, the BC Ministry of
Health provided public health services. In 1997, this role transferred
to the Kootenay Boundary Community Health Services Society and, in 2001,
to Interior Health. In 1988, the BC Ministry of Health allocated an
annual amount of funding to Public Health to provide lead health
services in Trail on an ongoing basis. This has covered core staffing
and program expenses for the public health nurse responsible for lead
health services. The regional Medical Health Officer has provided
service as part of regular medical health officer duties. The Provincial
Health Officer has maintained an active interest and professional
supervisory role to the Medical Health Officer. The Federal Government,
through its health and environment departments, provides guidance
documents on acceptable exposures and measurable levels of contaminants.
3.
What are the health risks from metals in the environment in Trail? Who
is most at risk from a community health standpoint? Children? Elderly?
A: In Trail, the most important health risks come from exposure to
lead, arsenic and cadmium. Children are most at risk from lead exposure
and the population at large is at risk from life long exposure to
arsenic and cadmium.
Each of the three metals of concern can have
theoretical health impacts on an exposed population. These health
impacts have been actively looked for in the Trail population and have
not been detected. Lead is a neurotoxin for developing brains and
nervous systems. Arsenic and cadmium can cause lung cancer and arsenic
can also cause skin cancer. Cadmium can also cause chronic kidney
disease. For more information, please refer to the Family Health Fact Sheet and General FAQ questions on health risks from metals.
4.
New scientific knowledge shows that low levels of lead may pose health
risks. How confident are you that low levels of lead won’t affect
children’s health in Trail? A: The Trail Area Health and
Environment Committee continues to monitor the world literature on lead
exposure. THEC accepts the scientific evidence that, at current levels
of exposure, lead is having a health impact on the population of
children living in Trail. However, the current exposure is so low that
the impact is not detectable in individual children. We have never been
able to attribute the health issues of a particular child to lead
exposure. The main objective of the Trail Area Health & Environment
Program is to lower lead exposure as much as possible. For more information, please refer to the Family Health Fact Sheet and General FAQ questions on health risks from lead.
5. Is it safe to raise children in the Trail area? Would you raise your children in Trail if your employment brought you here?
A: Knowing what I know about the Trail community I would not hesitate
to live and raise my children in Trail. Acceptability of a health risk
is a personal or family assessment and decision. Families assess and
make decisions about potential health risks every day.
6.
Has the Trail Area Health & Environment Program been effective?
What has been done well and what improvements should be made?
A: The Trail Area Health and Environment Committee is a unique
partnership of key players. I am impressed that, after 20 years, it
still collaborates diligently on the common purpose to reduce the
exposure of the Trail population to heavy metals. I hope the citizens of
Trail continue to volunteer to participate in this important work. As
long as there is an operating smelter this issue will remain an
important focus.
7. How has community health improved
over the past 20 years? Are people generally healthy or are there still
smelter-related health issues? If people are generally healthy, why do
we need the health & environment program? A: The general
measures of community health have not really changed relative to
provincial measurements in the last 20 years. Without getting into
specific measures, overall community health status in Trail is
comparable to the BC average. Using current measures of the health of a
population, BC is one of the healthiest places in the world. No smelter
related health issues have been detected in the general population in
Trail. Exposures to the contaminants of concern have dramatically
reduced in the last 20 years.
8. What order of priority do you place on components of the health & environment program?
Blood lead monitoring for children? Dust control? New initiatives? A:
For me, reducing the source of exposure to heavy metals is the most
important component. However, I think all the components are important.
They work together like the strands of a web to create a strong response
to the known health risks. The whole program is stronger than the sum
of its parts.
9. Do blood lead levels continue to be an issue? What was the situation 20 years ago compared to today?
A: Yes, blood lead levels continue to be a concern. There have been
significant reductions in environmental exposures mostly as a result of
improvements at the smelter. Blood lead levels have fallen dramatically.
In 1989, fewer than 20% of Trail area pre-school children had blood
lead levels below 10 µg/dL (micrograms per deciliter). Now around 90% of
Trail pre-school children have blood leads below 10 µg/dL.
The accumulating scientific evidence for health effects at lower levels
of exposure is constantly being updated. I predict that as long as
there is an operating smelter in Trail, people will be addressing this
concern.
10. Why do children under the age of three still have to
be tested and monitored for blood lead levels if these levels have
generally gone down over the past years? A: Even though the
blood levels in Trail children have fallen dramatically, they are still
higher than the average for Canadian children. Internationally, the
blood lead targets have recently gone even lower so we can’t be
complacent. Measuring blood lead levels is the best way of measuring our
progress and success.
11. What do you think about the new health goal of having
an average blood lead level of 4 µg/dL, bringing 95% of young children
under 10 (µg/dL)? A: Given that the international blood lead
target has been lowered, I think the new goal is ambitious but
necessary. The community should expect the Trail Area Health and
Environment Committee to do everything it can to reduce child lead
exposure in Trail. Even though the health impact of environmental lead
exposure is not detectable in individual children living in Trail, we
need to address the health impacts on the population at large. This
means further reducing lead exposure. The main way that people are
exposed to lead is from fine dust in the emissions that settle on
surfaces indoors and outdoors. The main way children are exposed to lead
is from putting dirty ‘contaminated’ hands in their mouths.
12. What are the other health risks from smelter emissions? How has air quality improved?
A: In the last 15 years, along with the reduction in lead emissions,
smelter emissions of other heavy metals have also been dramatically
reduced. Even at these lower levels there are still theoretical, or
statistical, health risks. Inhaling arsenic and cadmium for a lifetime
at the levels found in Trail results in a small increase in calculated
risks for lung cancer. A lifetime of inadvertently ingesting arsenic
found in surface dust slightly increases the risk of a
non-life-threatening skin cancer. A lifetime of ingesting cadmium in
surface dust is associated with chronic renal disease. No detected
increases in any of these cancers or kidney diseases have been observed
in Trail.
13. Recently, arsenic levels in air increased.
Since arsenic is a known carcinogen, shouldn’t THE Program be doing more
about it? A: Yes. This is a technical challenge for Teck to
apply the best available technology to minimize arsenic emissions.
Ongoing air quality monitoring and reporting is key to evaluating
success.
14. How do you rate the health and environment performance of Teck Metals?
A: Very good. Despite changes in personnel and ownership they have been concerned and active participants since the beginning.
15.
You have indicated some concern that not all contractors or homeowners
doing renovations use the Home Renovation Support Program. Why is this
program important? What can be done to make all contractors use it?
A: I am very concerned that not all contractors or homeowners are aware
of and/or using this service. We have evidence that the release of
historically accumulated contaminated dust during construction and
renovation has been a significant route of exposure for some children. I
don’t have the whole answer for better awareness and participation but
suggest the home building and renovation community must be engaged to
make sure this happens.
16. What are the health risks
from soil? Why does THE Program offer soil replacement? Who should get
their soil replaced? Does soil replacement make a difference?
A: The health risks from exposure to contaminated soil depend on
exposure. If the contaminated soil is covered with vegetation or
pavement, the risk is minimal. Soil exposure can be a concern for
certain cases where there is uncovered soil. THE Program offers clean
sand for sand boxes and new soil or sod coverage for barren areas that
are frequented by young children. Replacing all the soil in Trail is
unlikely to significantly reduce the population impact of heavy metals. For more information about health risks from soil, please refer to the Home & Garden Fact Sheet and General FAQ questions on soil.
17. What advice do you have to the people of Trail?
A:
I hope residents in Trail have real opportunities to increase their
understanding of the environmental health issues in Trail and will
continue to express their opinions on those issues and also on the
program.
