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Kelley Bush
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Kelley Bush
2015-06-18 16:07
Good afternoon. My name is Kelley Bush, and I am the head of radon education and awareness under Health Canada's national radon program.
Thank you, Mr. Chair and members of the committee, for inviting me to be here today to discuss radon as a cause of lung cancer and to highlight the work of the Canadian – National Radon Proficiency Program.
Through the ongoing activities of this program, Health Canada is committed to informing Canadians about the health risk of radon, better understanding the methods and technologies available for reducing radon exposure, and giving Canadians the tools to take action to reduce their exposure.
Radon is a colourless, odourless radioactive gas that is formed naturally in the environment. It comes from the breakdown of uranium in soil and rock. When radon is released from the ground in outdoor air, it gets diluted and is not a concern. However, when radon enters an indoor space, such as a home, it can accumulate to high levels and become a serious health risk. Radon naturally breaks down into other radioactive substances called progeny. Radon gas and radon progeny in the air can be breathed into the lungs, where they break down further and emit alpha particles. These alpha particles release small bursts of energy, which are absorbed by the nearby lung tissue and lead to lung cell death or damage. When lung cells are damaged, they have the potential to result in cancer when they reproduce.
The lung cancer risk associated with radon is well recognized internationally. As noted by the World Health Organization, a recent study on indoor radon and lung cancer in North America, Europe, and Asia provided strong evidence that radon causes a substantial number of lung cancers in the general population. It's recognized around the world that radon is the second leading cause of lung cancer after smoking, and that smokers also exposed to high levels of radon have a significantly increased risk of developing lung cancer.
Based on the latest data from Health Canada, 16% of lung cancers are radon-induced, resulting in more than 3,200 deaths in Canada each year. To manage these risks, in 2007 the federal government in collaboration with provinces and territories lowered the federal guideline from 800 to 200 becquerels per cubic metre. Our guideline of 200 becquerels per cubic metre is amongst the lowest radon action levels internationally, and aligns with the World Health Organization's recommended range of 100 to 300 becquerels per cubic metre.
All homes and buildings have some level of radon. It's not a question of “if” you have radon in your house; you do. The only question is how much, and the only way to know is to test. Health Canada recommends that all homeowners test their home and that if the levels are high, above our Canadian guideline, you take action to reduce.
The national radon program was launched in 2007 to support the implementation of the new federal guideline. Funding for this program is provided under the Government of Canada's clean air regulatory agenda. Our national radon program budget is $30.5 million over five years.
Since its creation, the program has had direct and measurable impacts on increasing public awareness, increasing radon testing in homes and public buildings, and reducing radon exposure. This has been accomplished through research to characterize the radon problem in Canada, as well as through measures to protect Canadians by increasing their awareness and giving them tools to take action on radon.
The national radon program includes important research to characterize radon risk in Canada. Two large-scale, cross-Canada residential surveys have been completed, using long-term radon test kits in over 17,000 homes. The surveys have provided us with a much better understanding of radon levels across the country. This data is used by Health Canada and our stakeholder partners to further define radon risk, to effectively target radon outreach, to raise awareness, and to promote action. For example, Public Health Ontario used this data in its radon burden of illness study. The Province of British Columbia used the data to inform its 2014 changes to their provincial building codes, which made radon reduction codes more stringent in radon-prone areas based on the results of our cross-Canada surveys. The CBC used the data to develop a special health investigative report and interactive radon map.
The national radon program also conducts research on radon mitigation, including evaluating the effectiveness of mitigation methods, conducting mitigation action follow-up studies, and analyzing the effects of energy retrofits on radon levels in buildings. For example, in partnership with the National Research Council, the national radon program conducted research on the efficacy of common radon mitigation systems in our beautiful Canadian climatic conditions. It is also working with the Toronto Atmospheric Fund to incorporate radon testing in a study they're doing that looks at community housing retrofits and the impacts on indoor air quality.
This work supports the development of national codes and standards on radon mitigation. The national radon program led changes to the 2010 national building codes. We are currently working on the development of two national mitigation standards, one for existing homes and one for new construction.
The program has developed an extensive outreach program to inform Canadians about the risk from radon and encourage action to reduce exposure. This outreach is conducted through multiple platforms targeting the general public, key stakeholder groups, as well as populations most at risk such as smokers and communities known to have high radon.
Many of the successes we've achieved so far under this program have been accomplished as a result of collaboration and partnership with a broad range of stakeholder partners. Our partners include provincial and municipal governments, non-governmental organizations, health professional organizations, the building industry, the real estate industry, and many more. By working with these stakeholders, the program is able to strengthen the credibility of the messages we're sending out and extend the reach and impact of our outreach efforts. We are very grateful for their ongoing engagement and support.
In November 2013 the New Brunswick Lung Association, the Ontario Lung Association, Summerhill Impact, and Health Canada launched the very first national radon action month. This annual national campaign is promoted through outreach events, website content, social media, public service announcements, and media exposure. It raises awareness about radon and encourages Canadians to take action. In 2014 the campaign grew in the number of stakeholders and organizations that participate in raising awareness. It also included the release of a public service announcement with television personality Mike Holmes, who encouraged all Canadians to test their home for radon.
To give Canadians access to the tools to take action, extensive guidance documents have been developed on radon measurement and mitigation. Heath Canada also supported the development of a Canadian national radon proficiency program, which is a certification program designed to establish guidelines for training professionals in radon services. This program ensures that quality measurement and mitigation services are available to Canadians.
The Ontario College of Family Physicians as well as McMaster University, with the support of Health Canada, have developed an accredited continuing medical education course on radon. This course is designed to help health professionals—a key stakeholder group—answer patients' questions about the health risks of radon and the need to test their homes and reduce their families' exposure.
The national radon program also includes outreach targeted to at-risk populations. For example, Erica already mentioned the three-point home safety checklist that we've supported in partnership with CPCHE. As well, to reach smokers, we have a fact sheet entitled “Radon—Another Reason to Quit”. This is sent out to doctors' offices across Canada to be distributed to patients. Since the distribution of those fact sheets began, the requests from doctors offices have increased quite significantly. It began with about 5,000 fact sheets ordered a month, and we're up to about 30,000 fact sheets ordered a month and delivered across Canada.
In recognition of the significant health risk posed by radon, Health Canada's national radon program continues to undertake a range of activities to increase public awareness of the risk from radon and to provide Canadians with the tools they need to take action. We are pleased to conduct this work in collaboration with many partners across the country.
Thank you for your attention. I look forward to any questions the committee members might have.
Donald MacPherson
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Donald MacPherson
2013-12-04 15:42
On the issue of displacement in the U.S., using the combined data from the 2002, 2004, 2008 to 2010 national survey on drug use and health, a recent study has shown that 77% of those reporting both non-medical prescription pain relievers and heroin use in the past year were found to have initiated non-medical use of pain relievers prior to initiating heroin use. Although the discontinuation of one drug cannot account for all transition from non-medical pain relief to heroin use, it may be a significant role.
I'll close by saying what we believe. We will submit a more comprehensive brief in the coming months. It is being translated at the moment.
We feel it's a component of a comprehensive overdose strategy around both illegal opioids and prescription opioids. This is an overlapping public health problem that we have and people move back and forth between both of those markets, and then there are accidental overdose deaths when people are attempting to take medication as prescribed.
We recommend that the federal government adopt a comprehensive approach to overdose prevention and response that includes six key components.
One would be to make naloxone more readily available and cost effective by including it in provincial drug plans and making it available over the counter.
Two would be to scale up community-based and institutional overdose programs training on how to prevent, recognize, and respond to overdose. I just took one of those at the Canadian Students for Sensible Drug Policy conference. It takes about an hour.
Three, would be to scale up overdose training programs for first responders.
Four would be to reduce the barriers to calling 911 during a drug overdose event so that people do not fear police arriving and arresting them for some other drug charge during an overdose event. The Vancouver Police Department has a policy of not routinely responding to overdose calls unless they're asked to by ambulance attendants. This could be expanded to other departments.
Five would be to implement appropriate guidelines for opioid prescription that do not limit access to needed pain medication or result in further discrimination against people who use drugs.
Six would be to increase the timely collection, analysis, and dissemination of data on drug overdose events.
This is probably one of the more important recommendations, because in the literature that I've read, Canada really does need to get much better at monitoring and collecting data so that we can come up with some sound policy decisions based on some sound evidence.
Thank you very much .
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