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Sony Perron
View Sony Perron Profile
Sony Perron
2015-06-01 15:39
I would like to thank the committee chair and the rest of the committee members for the invitation to appear here today.
I, and other officials at Health Canada, have reviewed the Auditor General's 2015 Report, and we have paid a great deal of attention to his recommendations. We take the findings seriously and are addressing each of them through an action plan. This plan will continue to be refined and defined in collaboration with first nations. Indeed, as you know, we work in cooperation with first nations. This plan can therefore only be completed with an additional commitment by our first nations partners.
The health care system serving first nations is highly complex. Provincial health systems do not directly extend to first nations reserves. To support first nations, Health Canada provides the delivery of a range of effective, sustainable and culturally appropriate programs and services. We work with first nations to increase their control of health services and collaborate with provinces to increase access and promote system integration.
We also support programs that address first nations health priorities in the areas of mental health, chronic disease, maternal and child health, and health benefits providing coverage for prescription drugs, dental care, vision care, mental crisis intervention, and medical supplies and equipment.
Most of the community-based programs have been transferred in varying degrees to over 400 first nation communities. This number does not include British Columbia, where in 2013 Health Canada transferred its role in the design, management, and delivery of first nations health programming in British Columbia to the new First Nations Health Authority.
Health Canada provides funding to first nations to deliver clinical care in 27 remote and isolated communities, again, outside British Columbia. In an additional 53 remote and isolated first nation communities, Health Canada continues to deliver clinical care. The delivery model varies based on the specifics of each province and geographic conditions. The clinical care teams are located in nursing stations, along with community health workers delivering other programs.
Because of the importance of these services, it is imperative that Health Canada ensure that remote communities have access to clinical and client care, that nursing stations are staffed with registered nurses, and that nurses work in a safe environment, have access to physicians to support them, and have access to tools.
Registered nurses and nurse practitioners are predominantly the first point of contact in isolated communities and are highly educated and qualified individuals. To ensure that our nurses are prepared for the unique demands of working in remote stations, a mandatory training requirement has been defined and is now part of the national education policy.
I can report that we currently have an 88% compliance rate on Health Canada's nursing education model for controlled substances in first nations health facilities, while advanced cardiac life support is at 63%, trauma support is at 59%, pediatric advanced life support is at 64%, and immunization is at 61%. The overall compliance rate is at 46% as of the end of April 2015. We still have work to do, and we are doing it while ensuring that we have resources in place to backfill these important positions while incumbents are in training.
Health Canada is committed to ensuring that nurses working in remote first nations communities meet established public service requirements on top of these workers' already robust credentials.
Remote and isolated practice environments sometimes require nurses to respond immediately to life-threatening or emergency situations. Nurses therefore need appropriate mechanisms to perform these important duties.
Clinical practice guidelines assist nurses to address clinical care situations and provide instruction on whether and when consultation with a physician or a nurse practitioner is required. There are arrangements in place for all nursing stations to access physicians when physicians are not located in the community. We also continue to collaborate on region-specific solutions with provinces to advance access to health services and with regulatory bodies to support nurses practising within their scope of practice.
A key challenge is the need for more nurses. Health Canada has implemented a nurse recruitment and retention strategy, which involves a number of initiatives: a nursing recruitment marketing plan, a nursing development program, a student outreach program, and an onboarding program.
Since its February launch, we have received over 500 nursing applications, with 200 of these moving to the next level of screening. As well, the strategy aims to increase the number of nurse practitioners, which will provide greater stability in the clinical teams, assist in meeting training objectives, and enhance the level of services available at the community level.
Nurses and other community health professionals require facilities to conduct their work. Currently, we invest approximately $30 million annually for repairs, renovation, and construction of health facilities, plus an additional $44 million for maintenance and operations. The nursing stations are owned by first nations communities, and we collaborate with them to support their operation.
We work with first nations communities to ensure buildings are inspected and deficiencies are addressed. In response to the audit, we are implementing a more robust tracking system to capture this work. We will also enhance our process in order to use facility condition reports as a tool to better plan maintenance and renovation work with the owners.
In addition, to ensure new nursing stations are built to code, we have updated our requirements for attestations and have communicated the change to facility management staff. The audit rightly noted that the requirements, such as the station as defined currently, did not provide the necessary level of assurance.
Another area reported on was the management of medical transportation; medical transportation that provides coverage to support access to insured health services. Health Canada spends over $300 million on medical transportation per year, and approximately 60% of that is in remote and isolated communities. The main reasons for transportation are emergencies, at 24%, hospital services, at 10%, appointments with general practitioners, at 7%, and dental services, at 5%.
The program provides coverage for transportation to the nearest appropriate professional or facility that takes place when the needed service is not locally available. Our goal is to provide timely coverage for medical transportation to avoid an undue burden for clients and health care professionals. Decisions are based on a national program framework and are made with a solid understanding of the health services available and the transportation options at the regional level.
In response to the audit observations, the program has already modified and disseminated guidelines to resolve discrepancies observed between our practices and the medical transportation framework in terms of the level of documentation required.
Regarding the transportation of children who are not registered, Health Canada has a long practice of allowing coverage for a child up to one year of age to be covered for medical transportation under the registration number of their parents. Health Canada will continue its efforts with partners to inform parents and make available registration material in nursing stations and health centres.
Health Canada and the Assembly of First Nations are undertaking a joint review of the non-insured health benefits program, of which medical transportation is a component, and I am pleased to report that the work is well under way. It will identify strengths, weaknesses, including inefficiencies in administration, and recommendations for action.
Given that the geographic location, the size of the community, and the need to ensure cultural safety influence the range of programs and services funded or provided by Health Canada, comparing one community to the other is not always possible or the best approach. Community health planning, investing in the integration of services with provincial systems, and the development of community programs and capacity have proven to be more effective and more responsive to community needs over time.
As indicated earlier, Health Canada funds a number of community programs aimed at addressing specific needs and working as a complement to the clinical and client care program. These programs are funded to support community health needs and mostly managed by the communities themselves. In response to the audit, we will improve our support to community health planning to enhance integration of the community-based programs and clinical services where these services are delivered by Health Canada. We will also engage with the communities to review the current service delivery model and clinical care resource allocations.
The last area I would like to discuss is coordination among health system jurisdictions.
We work closely with partners to build health service delivery models that take into account community needs.
We have made significant progress with health service integration over the last 10 years. We see examples in various regions where there are more physicians' visits, provincial services are being extended on reserve, and there are more collaborative arrangements between community health services and regional health authorities. Co-management and trilateral tables exist in most regions to formally engage with provincial and first nations partners to advance common practices and resolve systemic issues. We will formally engage these tables in order to make progress on the important issues raised in the report.
Health Canada will continue to collaborate with our partners to develop and implement other models of first nations-led health systems across the country, as we have celebrated in B.C. We have presented an overview of our action plan, which requires further engagement and collaboration with first nation partners. We believe the next update will be more comprehensive as it will benefit from our partners' input.
In closing, we are working on a number of actions in response to the audit, and we will continue to do so.
I would note that I am accompanied today by three senior officials from Health Canada's first nations and Inuit health branch: Valerie Gideon, assistant deputy minister, regional operations; Robin Buckland, executive director, office of primary health care; and Scott Doidge, acting director general, non-insured health benefits.
We would be pleased to answer your questions. Thank you.
View Rona Ambrose Profile
CPC (AB)
Thank you very much, Mr. Chair, and thank you to the committee. I want to thank all of you for the work you do on the health committee. I know many of you are passionate about the issues of health, and I thank you for your commitment to that.
I'm joined by Simon Kennedy, Health Canada's new deputy minister; Krista Outhwaite, our newly appointed president of the Public Health Agency of Canada; and Dr. Gregory Taylor, whom you've met before, Canada's chief public health officer. I know he'll be here for the second half. You might want to ask him about his trip to Guinea and Sierra Leone to visit our troops and others who are working on the front dealing with Ebola. I'm sure he'll have some great things to share with you.
Michel Perron is here on behalf of the Canadian Institutes of Health Research. He's also new. Last time I know you met Dr. Alain Beaudet.
We also have Dr. Bruce Archibald, who's the president of the Canadian Food Inspection Agency. I think you've met Bruce as well.
Mr. Chair, I'd like to start by sharing an update on some of the key issues that we've been working on recently. I'll begin by talking about Canada's health care system, the pressures it's facing, and the opportunities for improvement through innovation. I will then highlight some recent activities on priority issues such as family violence and the safety of drugs in food.
According to the Canadian Institute for Health Information, Canada spent around $215 billion on health care just in 2014. Provinces and territories, which are responsible for the delivery of health care to Canadians, are working very hard to ensure their systems continue to meet the needs of Canadians, but with an aging population, chronic disease, and economic uncertainty, the job of financing and delivering quality care is not getting easier.
Our government continues to be a strong partner for the provinces and territories when it comes to record transfer dollars. Since 2006, federal health transfers have increased by almost 70% and are on track to increase from $34 billion this year to more than $40 billion annually by the end of the decade—an all-time high.
This ongoing federal investment in healthcare is providing provinces and territories with the financial predictability and flexibility they need to respond to the priorities and pressures within their jurisdictions.
In addition of course, federal support for health research through the CIHR as well as targeted investments in areas such as mental health, cancer prevention, and patient safety are helping to improve the accessibility and quality of health care for Canadians.
But to build on the record transfers and the targeted investments I just mentioned, we're also taking a number of other measures to improve the health of Canadians and reduce pressure on the health care system. To date we've leveraged over $27 million in private sector investments to advance healthy living partnerships. I'm very pleased with the momentum we've seen across Canada.
Last year we launched the play exchange, in collaboration with Canadian Tire, LIFT Philanthropy Partners, and the CBC, to find the best ideas that would encourage Canadians to live healthier and active lives. We announced the winning idea in January: the Canadian Cancer Society of Quebec and their idea called “trottibus”, which is a walking school bus. This is an innovative program that gives elementary schoolchildren a safe and fun way to get to school while being active. Trottibus is going to receive $1 million in funding from the federal government to launch their great idea across the country.
Other social innovation projects are encouraging all children to get active early in life so that we can make some real headway in terms of preventing chronic diseases, obesity, and other health issues. We're also supporting health care innovation through investments from the Canadian Institutes of Health Research. In fact our government now is the single-largest contributor to health research in Canada, investing roughly $1 billion every year.
Since its launch in 2011, the strategy for patient-oriented research has been working to bring improvements from the latest research straight to the bedsides of patients. I was pleased to see that budget 2015 provided additional funds so that we can build on this success, including an important partnership with the Canadian Foundation for Healthcare Improvement.
Canadians benefit from a health system that provides access to high-quality care and supports good health outcomes, but we can't afford to be complacent in the face of an aging society, changing technology, and new economic and fiscal realities. That is why we have been committed to supporting innovation that improves the quality and affordability of health care.
As you know, the advisory panel on health care innovation that I launched last June has spent the last 10 months exploring the top areas of innovation in Canada and abroad with the goal of identifying how the federal government can support those ideas that hold the greatest promise. The panel has now met with more than 500 individuals including patients, families, business leaders, economists, and researchers. As we speak, the panel is busy analyzing what they've heard, and I look forward to receiving their final report in June.
I'd also like to talk about another issue. It's one that does not receive the attention that it deserves as a pressing public health concern, and that's family violence. Family violence has undeniable impacts on the health of the women, children, and even men, who are victimized. There are also very significant impacts on our health care and justice systems.
Family violence can lead to chronic pain and disease, substance abuse, depression, anxiety, self-harm, and many other serious and lifelong afflictions for its victims. That's why this past winter I was pleased to announce a federal investment of $100 million over 10 years to help address family violence and support the health of victims of violence. This investment will support health professionals and community organizations in improving the physical and mental health of victims of violence, and help stop intergenerational cycles of violence.
In addition to our efforts to address family violence and support innovation to improve the sustainability of the health care system, we have made significant progress on a number of key drug safety issues. Canadians want and deserve to depend on and trust the care they receive. To that end, I'd like to thank the committee for its thoughtful study of our government's signature patient safety legislation, Vanessa's Law. Building on the consultations that we held with Canadians prior to its introduction, this committee's careful review of Vanessa's Law, including the helpful amendments that were brought forward by MP Young, served to strengthen the bill and will improve the transparency that Canadians expect.
Vanessa's Law, as you know, introduces the most significant improvements to drug safety in Canada in more than 50 years. It allows me, as minister, to recall unsafe drugs and to impose tough new penalties, including jail time and fines up to $5 million per day, instead of what is the current $5,000 a day. It also compels drug companies to do further testing and revise labels in plain language to clearly reflect health risk information, including updates for health warnings for children. It will also enhance surveillance by requiring mandatory adverse drug reaction reporting by health care institutions, and requires new transparency for Health Canada's regulatory decisions about drug approvals.
To ensure the new transparency powers are providing the kind of information that Canadian families and researchers are looking for, we've also just launched further consultations asking about the types of information that are most useful to improve drug safety. Beyond the improvements in Vanessa's Law, we're making great progress and increasing transparency through Health Canada's regulatory transparency and openness framework. In addition to posting summaries of drug safety reviews that patients and medical professionals can use to make informed decisions, we are now also publishing more detailed inspection information on companies and facilities that make drugs. This includes inspection dates, licence status, types of risks observed, and measures that are taken by Health Canada. Patients can also check Health Canada's clinical trials database to determine if a trial they are interested in has met regulatory requirements.
Another priority of mine is tackling the issue of drug abuse and addiction in Canada. There's no question that addiction to dangerous drugs has a devastating and widespread impact on Canadian families and communities. In line with recommendations from this committee, I am pleased that the marketing campaign launched last fall by Health Canada is helping parents talk with their teenagers about the dangers of smoking marijuana and prescription drug abuse. The campaign addresses both of those things, because too many of our young people are abusing drugs that are meant to heal them.
Our government also recognizes that those struggling with drug addictions need help to recover a drug-free life. From a federal perspective, of course, we provide assistance for prevention and treatment projects under our national anti-drug strategy. We've now committed over $44 million to expand the strategy to include prescription drug abuse and are continuing to work with the provinces to improve drug treatment.
I've now met and will continue to meet with physicians, pharmacists, first nations, law enforcement, addictions specialists, medical experts, and of course parents to discuss how we can collectively tackle prescription drug abuse.
Finally, our government continues to make very real investments to strengthen our food safety system. As only the latest example, I recently announced a five-year investment of more than $30 million in the CFIA's new food safety information network. Through this modern network, food safety experts will be better connected, and laboratories will be able to share urgently needed surveillance information and food safety data, using a secure web platform. This will put us in an even better position to protect Canadians from food safety risk by improving our ability to actually anticipate, detect, and then effectively deal with food safety issues. This investment will continue to build on the record levels of funding we've already provided, as well as the improved powers such as tougher penalties, enhanced controls on E. coli, new meat labelling requirements, and improved inspection oversight.
In conclusion, those are just some of the priorities that will be supported through the funding our government has allocated to the Health portfolio. This year's main estimates, notably, include investments for first nations health, for our ongoing contribution to the international response to the Ebola outbreak in West Africa, and the key research and food safety investments that I have already mentioned.
I'll leave it at that. If committee members have any questions, my officials and I would be very pleased to answer them. Thank you.
Frank Clegg
View Frank Clegg Profile
Frank Clegg
2015-04-23 15:45
Mr. Chair and committee members, I'd like to thank you for the invitation to speak with you this afternoon and for deciding to invest committee time on Safety Code 6.
When I ran the Canadian operations for Microsoft, I learned that it is critical to focus on process. Today, as a board member for Indigo Books and Music, my role has shifted more towards governance and oversight. In both roles, process is critical to success. Government is the largest corporation of all, so process is of paramount importance. As someone who regularly examines success and failure, I believe I can explain why the Safety Code 6 process is a failure by all metrics and has left Canadians unprotected.
There is a book written by Nassim Taleb called The Black Swan, a focus on very low-probability, high-impact events that aren't supposed to happen. Oil spills, train derailments, and airplane crashes are some of the events in this category. Taleb calls these “black swan” events.
If one decides that all swans are white and refuses evidence of black swans, then one will conclude that all swans are white. Black swans are rare, but they do exist. Unfortunately, experts convinced themselves that these events had zero probability. They did not plan appropriately and people died.
The American Academy of Environmental Medicine is an international organization of physicians and scientists that has predicted, among other things, the rise in multiple chemical sensitivity, which is now protected in many public policies. Regarding the unprecedented increase in wireless devices, the academy forecasts “a widespread public health hazard that the medical system is not yet prepared to address”.
I believe Health Canada's analysis focuses on identifying and counting white swans, while ignoring black swan evidence. Health Canada's representative informed this committee on March 24:
...some of these studies report biological or adverse health effects of RF fields at levels below the limits in Safety Code 6, I want to emphasize that these studies are in the minority and they do not represent the prevailing line of scientific evidence in this area.
In other words, black swans exist.
In your handout—I don't know if you have it, as we put it in for translation—is a document entitled “Analysis of 140 Studies Submitted by Canadians for Safe Technology (C4ST) During the Public Comment Period on Safety Code 6”. A chart in that document shows that Health Canada accepts that there are in fact 36 studies all passing Health Canada's quality criteria showing harm at levels below Safety Code 6.
As a Canadian, I find this confusing. As an executive, I find it inexcusable.
Of the 36 studies Health Canada deemed satisfactory, cancer is linked in six of them. In 13 of them, the brain and/or nervous system is disrupted. In 16 studies, Health Canada admits that biochemical disruption occurs. Finally, seven high-level scientific studies indicate an effect on intellectual development and/or learning behaviour. All of these studies show impacts with radiation below Safety Code 6 limits. How was this black swan evidence evaluated?
In our two-year investigation, C4ST has determined that Health Canada doesn't even have the proper software required to access, summarize, and analyze the large number of relevant studies. If our group of learned and qualified volunteers can uncover 140 studies, how many more are being missed or ignored?
Health Canada references its weight-of-evidence approach. It is unclear how many studies you need to outweigh 36 studies that show harm, especially to children. I just can't fathom why Health Canada is not highlighting these studies and prioritizing their implications. Despite requests to publish the weight-of-evidence criteria as per international standards, Health Canada refuses to do so. Even the recent 2015 rationale document does not provide this critical information.
Health Canada dismisses scientific evidence unless it shows harm where the microwave levels are strong enough to heat your skin. The notion that microwaves are not harmful unless they heat your skin is decades out of date. The core premise of this white swan dates back to Einstein's theory that non-ionizing radiation cannot cause harm, or if it does, it must heat tissue to do that. Albert Einstein passed away the same year Steve Jobs was born. To think that science has not evolved since then is classic white swan thinking. It's part of a process predetermined to fail.
Health Canada says on its website today that there is no chance that Wi-Fi or cellphones can harm you because it has studied all the science, but when pressed under oath, Health Canada officials give a more fulsome answer. In Quebec Superior Court in September 2013, Health Canada senior scientist James McNamee admitted that Health Canada only assesses risk based on the thermal effect, i.e., the heating of tissue.
Unfortunately, Canada has not invested the necessary time nor had the balanced opinion of experts necessary to undertake a proper review. Our research has uncovered that the Health Canada author of Safety Code 6 has published papers demonstrating his bias towards this topic.
In a few hours over three days, this health committee has spent more time speaking with scientific experts who believe there is harm from wireless radiation below Safety Code 6 than all of Health Canada combined. You can't find black swans when you don't talk to the experts who've identified them.
There is a fundamental business rule: you can't manage what you don't measure. It is clear that Health Canada not only doesn't follow that rule but even resists it. A memo obtained under access to information to the Minister of Health in March of 2012 revealed that Health Canada “does not support the recommendation to establish an adverse reaction reporting process specifically for RF exposures”. The memo goes on to state that “consumer complaints...may be directed to...the web-based system...under the...Canada Consumer Product Safety Act”. This is an inadequate solution and, I believe, a missed opportunity.
I refer you to the C4ST fact sheet. I think you have it. I'd like to highlight three examples from that fact sheet: Health Canada's Safety Code 6 is among the countries with the worst guidelines in the world; Canada has fallen behind countries such as France, Taiwan, and Belgium in protecting Canadians; and finally, Health Canada wasted over $100,000 of taxpayers' money, as the Royal Society report is not an independent review.
Health Canada also states that Safety Code 6 is a guideline and that other organizations at the provincial and local levels of government are free to implement lower levels as they see fit; however, that's not the reality of what happens. We have witnessed school boards, power and water utilities, Industry Canada, and manufacturers depending on Health Canada's analysis, and frankly, abdicating to it. They don't perform their own analysis.
Safer solutions exist. There are several situations in Canada regarding cell towers where the proponents have voluntarily offered to restrict radiation exposure, in some cases to thousands of times less than Safety Code 6. There is a solution in Iowa for smart meters that use a wired meter that provides a safer, more secure solution at a lower cost.
Given that our track record in North America is not successful regarding such products as tobacco, asbestos, BPA, thalidomide, DDT, urea-formaldahyde insulation, and many others, use of the precautionary principle of prudent avoidance should be recommended until the science proves beyond reasonable doubt that there is no potential for harm.
For the last three years, science has published a new study every month that shows irreparable harm at levels below Safety Code 6. That is why we're asking the committee to take three decisive steps.
First, conduct a national campaign to educate Canadians about methods to minimize exposure to RF radiation, ban Wi-Fi in day care centres and preschools, and ban the marketing of wireless devices to children.
Second, protect individuals who are sensitive to RF radiation by accommodating them with safer levels of wireless exposure in federal workplaces and federal areas of responsibility.
Third, and finally, create an adverse reporting system for Canadians and a publicly available database to collect improved data regarding potential links between health effects and exposure to RF radiation.
Parallel to the above, recommend that Health Canada conduct a comprehensive systematic review, subject to international standards, regarding the potential harmfulness of RF radiation to human health, with a scientific review panel that is balanced in opinion. It was a textbook case of black swan thinking that has led to this failure of Safety Code 6.
In conclusion, C4ST volunteers found 36 black swans that Health Canada agrees are high quality. How many would be available if Health Canada sincerely looked? Better yet, how many black swans will it take before Health Canada takes serious actions? Thank you very much.
Andrew Adams
View Andrew Adams Profile
Andrew Adams
2015-03-24 15:32
Thank you very much. I have some opening remarks to make.
Chairman and members of the committee, it is my pleasure to be here today to speak on Health Canada Safety Code 6. My name is Andrew Adams, and I am the director of the environmental and radiation health sciences directorate in the healthy environments and consumer safety branch of Health Canada. I am joined today by Dr. James McNamee, the chief of the health effects and assessments division in the consumer and clinical radiation protection bureau and the lead author of Safety Code 6.
Safety Code 6 is Health Canada's guideline for exposure to radio frequency, or RF, electromagnetic energy, the kind of energy given off by cellphones and Wi-Fi, as well as broadcasting and cellphone towers. Safety Code 6 provides human exposure limits in the 3 kilohertz to 300 gigahertz frequency range, and we have provided chart A of the electromagnetic spectrum, just so committee members can situate the frequency range we're talking about.
But Safety Code 6 does not cover exposure to electromagnetic energy in the optical or ionizing radiation portions of the electromagnetic spectrum. Safety Code 6 establishes limits for safe human exposure to RF energy. These limits incorporate large safety margins to protect the health and safety of all Canadians, including those who work near RF sources.
While Safety Code 6 recommends limits for safe human exposure, Health Canada does not regulate the general public's exposure to electromagnetic RF energy.
Industry Canada is the regulator of radiocommunication and broadcasting installations and apparatus in Canada. To ensure that public exposures fall within acceptable guidelines, Industry Canada has developed regulatory standards that require compliance with the human exposure limits outlined in Safety Code 6.
I'd like to talk a little bit about the approach for updates to Safety Code 6. Safety Code 6 is reviewed on a regular basis to verify that the guideline provides protection against all known potentially harmful health effects and that it takes into account recent scientific data from studies carried out worldwide. The most recent update to Safety Code 6 was completed earlier this month. I will describe the process used for that update later in my remarks.
When developing the exposure limits in the revised Safety Code 6, departmental scientists considered all peer-reviewed scientific studies, including those pertaining to both thermal and non-thermal, and employed a weight-of-evidence approach when evaluating possible health risks from exposure to RF energy.
The weight-of-evidence approach takes into account both the quantity of studies on a particular end point and the quality of those studies. Poorly conducted studies receive relatively little weight, while properly conducted studies receive more weight.
Now I'll focus on the recent update of Safety Code 6.
The most recent update to Safety Code 6 was initiated in 2012, with the goal of ensuring that the most up-to-date and credible scientific studies on the potential effects of RF energy on human health were reflected in the code.
Health Canada proposed changes to Safety Code 6 that were based on the latest available scientific evidence, including improved modelling of the interaction of RF fields with the human body, and alignment with exposure limits specified by the International Commission on Non-Ionizing Radiation Protection. These changes were proposed to ensure that wide safety margins were maintained to protect the health and safety of all Canadians, including infants and children.
Some of you may recall that this committee previously conducted a study on the potential health impacts of RF electromagnetic radiation. Among the recommendations included in the committee's December 2010 report was a recommendation that:
Health Canada request that the Council of Canadian Academies or another appropriate independent institution conduct an assessment of the Canadian and international scientific literature regarding the potential health impacts of short and long-term exposure to radiofrequency electromagnetic radiation....
ln response to this recommendation, in 2013, Health Canada contracted the Royal Society of Canada to review the results of emerging research relating to the safety of RF energy on human health, to ensure it was appropriately reflected in the revised Safety Code, through a formalized expert panel process.
I'm sure you know that today we're joined by the chair of the expert panel and one of the members of the expert panel.
The Expert Panel of the Royal Society released their review in March 2014, concluding that in the view of the panel there are no established adverse health effects at exposure levels below the proposed limits.
Among the recommendations made by the expert panel was the suggestion that the proposed reference levels in the draft Safety Code 6 be made slightly more restrictive in some frequency ranges to ensure larger safety margins for all Canadians, including newborn infants and children.
ln the interest of openness and transparency, Health Canada also undertook a 60-day public consultation period for the proposed revisions to Safety Code 6 between May and July 2014. The department invited feedback from interested Canadians and stakeholders.
Comments related to the scientific and technical aspects of Safety Code 6 received by Health Canada during the public consultation period, as well as the recommendations provided by the Royal Society Expert Panel, were taken into consideration when finalizing the revised guideline.
The final version of Safety Code 6 was published on March 13, 2015. Health Canada also published a summary of the feedback received during the public consultation period. Given the scientific basis of the guideline, only feedback of a technical or scientific nature could be considered in the finalization of Safety Code 6; however, the summary of consultation feedback responds to both technical and non-technical comments received from Canadians.
With the recent update, Canadians should be confident that the radiofrequency exposure limits in Safety Code 6 are now among the most stringent science-based limits in the world.
To shift a little bit and talk about the scientific methodology that underlies the revision of Safety Code 6, a large number of submissions received during the public consultation period raised concerns that Health Canada had not considered all of the relevant scientific literature when updating Safety Code 6. ln particular, it has been stated that 140 studies were ignored. I would like to address that criticism here today.
ln updating Safety Code 6, Health Canada made use of existing internationally recognized reviews of the literature along with its own expert review of the relevant scientific literature. Numerous reviews on this issue have been written in recent years by international organizations such as the World Health Organization, the European Commission's Scientific Committee on Emerging Newly identified Health Risks, and ICNIRP. I believe we have provided links to some of these reports for the committee's interest.
While Safety Code 6 references these international reviews, the code is an exposure guideline, not a scientific review article. Accordingly, most individual scientific studies are not referenced in the code. However, this does not mean that Health Canada did not consider all relevant scientific information when deriving the science-based exposure limits in the code. I can assure you we did.
lt should be noted that studies with inappropriate study design or methodology can lead to erroneous results that are scientifically meaningless.
Studies were considered not to be of sufficient quality to inform the recent update if it was not possible to determine the dosage studied, if the study lacked an appropriate control, if experiments within the study were not repeated a sufficient number of times, if no statistical analysis of the results was conducted, or if other improper scientific techniques were used. Of the 140 studies that have been cited, a large number fall into this category.
Other studies were not considered to be within scope. For example, some of these studies looked at exposures to a frequency range outside of the frequency range covered by Safety Code 6 and were therefore not considered relevant.
However, Health Canada did consider all studies that were considered to be both in scope and of sufficient quality for inclusion in our risk assessment. While it is true that some of these studies report biological or adverse health effects of RF fields at levels below the limits in Safety Code 6, I want to emphasize that these studies are in the minority and they do not represent the prevailing line of scientific evidence in this area.
The conclusions reached by Health Canada are consistent with reviews of the scientific evidence by national and international health authorities. Of note, the European Commission's Scientific Committee on Emerging and Newly Identified Health Risks earlier this month released its final opinion on the potential health effects of electromagnetic fields. SCENIHR concluded that there are no evident adverse health effects, provided exposure levels remain below levels recommended by European Union legislation.
Now I'd like to talk a little bit about an international comparison. Members of the committee may be wondering how the limits in Safety Code 6 compare with limits in other parts of the world. I refer you to the chart of radio frequency exposure limits for the general public in different countries. Internationally, a few jurisdictions have applied more restrictive limits for RF field exposures from cell towers; however, there is no scientific evidence to support the need for such restrictive limits. Canada's limits are consistent with, if not more stringent than, the science-based limits used in such other jurisdictions as the European Union, the United States, Japan, Australia, and New Zealand.
In conclusion, the health of Canadians is protected form radio frequency electromagnetic energy when the human exposure limits recommended in Safety Code 6 are respected. Safety Code 6 has always established and maintained a human exposure limit that is far below the threshold for potentially adverse health effects. The health of Canadians was protected under the previous version of Safety Code 6, and recent revisions to the code ensure even greater protection.
Health Canada will continue to monitor the scientific literature on this issue on an ongoing basis. Should new evidence arise that indicates a risk to Canadians at levels below the limits in Safety Code 6, the department would take appropriate action.
Thank you for your time.
View Hedy Fry Profile
Lib. (BC)
If there is no database that looks at clusters of new diseases, new cancers, etc., in people who have had extensive cellphone usage, and that is age-related and based on frequency of use, and of course the cumulative effect.... Especially in children, how do you gauge the cumulative effect when it is only in the last three or four years that we have seen people exposing their kids as young as two or three years old to cellphone use, etc. Now, there is obviously no study done on the longitudinal effects of cumulative use, etc., because these kids are still little.
Do you not feel that it is important to have some kind of database that looks at clusters, that is reporting clusters, or that physicians may be asked to look at any kind of possible cause and effect on new cancers among people based on the frequency of their cellphone use, the cumulative effect, and age-related use? Has that been done? Has Health Canada tried to set up such a database or reporting system of some kind?
View Terence Young Profile
CPC (ON)
View Terence Young Profile
2014-06-05 10:09
Ms. Lamar, could you please describe how Vanessa's law will make drugs safer for children in Canada?
David Lee
View David Lee Profile
David Lee
2014-06-05 10:10
This is where a number of clauses in the bill can really work together very valuably.
You can start with approval. There is a section in the proposals that would allow us to put conditions on authorizations, so to plan out what to look for as a drug goes out. If it's not approved for kids initially, we can put in some measures that we want to see if we think it's going to be used in that population.
If we start to see something, we will also be able to ask for further tests and studies, which could include monitoring who's being prescribed the drugs. It would be a utilization study. Again, if we see anything of concern, we can ask for signals to be confirmed. They can come in and do a reassessment—
David Lee
View David Lee Profile
David Lee
2014-06-05 10:11
Oh, sorry.
If we start to see adverse events occurring and we see that kids are being harmed, then we can pick that up and try to understand it and figure out if it's the drug and if we need to do something, and we can use these powers to very immediately get at that analysis and do a reassessment. Then we can either go to suspension or indicate to the community of practice not to use it in that community, which we call a contraindication, and we can really make sure that message gets out there to change prescribing behaviour.
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