Interventions in Committee
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Kelley Bush
View Kelley Bush Profile
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.
View Rona Ambrose Profile
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.
View Murray Rankin Profile
View Murray Rankin Profile
2015-05-07 15:46
I appreciate that.
As you speak of transparency, that takes me to Vanessa's Law, to which you made reference earlier.
Toronto doctor, Nav Persaud, made an information request to Health Canada to get clinical trials on a pregnancy drug, an anti-nausea drug called Diclectin. He tried that three and a half years ago. He finally got 359 pages, 212 of which were completely redacted or censored.
In March, after Vanessa's Law came in, he resubmitted the request for all of the 359 pages, and so far has been given nothing. I got that as recently as two days ago in a letter. The clinical trial data was something that was to be made available, as I understood it, under Vanessa's Law. His experience has been entirely frustrating.
View Rona Ambrose Profile
I sympathize with his experience.
Under Vanessa's Law, the intention is to make clinical trial information available, but still to some extent—and for legal reasons obviously—protect confidential business information. Our intention under Vanessa's Law—and it's my belief—is that we should be sharing as much as we possibly can.
On that specific one, I think that's still under way, but I know Simon is working on that.
Simon Kennedy
View Simon Kennedy Profile
Simon Kennedy
2015-05-07 15:48
Thanks, Minister.
On this particular case, the original submission was made under the access to information rules. The ministry is obliged to apply the access law, which does require a number of exemptions for business information and so on.
With new authorities under Vanessa's Law, there is this other avenue we can use to make information available where there is a health or safety threat. We've spoken to the researcher in question, and we sent him a fairly detailed letter to explain the process to make an application under Vanessa's Law. That conversation is going on and our hope would be to be able to move through that avenue to deal with the issue.
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.
View Hedy Fry Profile
Lib. (BC)
This is like déjà vu. I think you asked a very important question, Dr. Havas. I don't understand. Inherent, for instance, in the medical ethos is to first do no harm, so the primary thing for a physician is the precautionary principle unless you see that the benefits outweigh the risks and you are prepared to do some harm in order to divert worse harm.
I've been listening to this so I called up my son and my daughter-in-law and I said, “Hey, you guys have a wireless baby monitor on my granddaughter's crib. I'm hearing this stuff and I think maybe you should take precautions and get a plug-in monitor or find a way to turn it on only when you need to”.
They said to me, “Oh, for God's sake, that is such a bunch of hokey stuff. The guidelines are clear, blah, blah, blah”, and of course I was almost accused of crying wolf.
If I couldn't convince my children that this is not reasonable and fair.... I think you said that it was 50 years before we got anybody to understand, in spite of evidence, that cigarettes caused cancer; and in the case of acid rain, it was 20 years. Surely to goodness we have learned by now that we shouldn't be taking that long. We need to see the harm that not acting on evidence sooner does.
Given that those blocking this the most are in industry themselves, and the fact that, let's be honest, governments have to balance economic growth and development and progress against harm to the greater good, and given that there is almost this conflict of interest between how governments currently operate and how governments could operate to protect people, how can we convince the public, which is completely addicted to Wi-Fi and to wireless devices, when they don't know anything else?
I'm addicted. I can't put away my stupid BlackBerry, so how do we convince people, because public awareness, obviously, as Frank said, must be a part of the recommendations? How do you put forward a public awareness program that will actually reach people and sink in without people saying, “Oh my God, everybody is being so hysterical about this”?
Frank Clegg
View Frank Clegg Profile
Frank Clegg
2015-04-23 16:25
I would make two comments, Dr. Fry.
I would say that people are smart, and when they have the right information, they act appropriately and they act responsibly, particularly parents with newborns.
What I've heard though, hundreds of times now, is that it must be okay if Health Canada says it's safe. They don't understand that it takes time for this information to be digested. As Dr. Miller said, we are befuddled as to why Health Canada isn't being more active. If the health authority in Canada, which is Health Canada, came out with very clear statements that said there is proof that there could be harm, so we should be careful and take a precautionary approach, I think you would see the majority of Canadians change what they do.
You also made a comment about industry. I have spent my life in industry. We go out and work hard to provide technology that is cheaper, faster, better. That's the way we work.
View Christine Moore Profile
Thank you, Mr. Chair.
In December 2010, the Standing Committee on Health published a report entitled “An Examination of the Potential Health Impacts of Radiofrequency Electromagnetic Radiation”. Allow me to summarize the five recommendations I'm interested in.
The first recommendation was to provide funding to the Canadian Institutes of Health Research for studies into this matter.
The second was to conduct an assessment of scientific literature.
The third called for a comprehensive risk awareness program for exposure to electromagnetic radiation.
The fourth involved providing information, including awareness sessions.
The fifth recommendation was to implement a process to receive reports of adverse reactions.
As we know, the government did not respond to that report because of the 2011 federal election. I would like to know which of those five recommendations submitted by the committee over four years ago have been followed, why some of them may not have been implemented, and to what extent certain recommendations were followed.
I would also like to know what the next steps are.
Andrew Adams
View Andrew Adams Profile
Andrew Adams
2015-03-24 16:08
Thank you.
Health Canada did receive the committee's recommendations in 2010. I can give you an overview of what we have done in response to the recommendations.
It could take some time, as there are five recommendations.
The Health Canada website provides some information on the effects of electromagnetic fields and on what Canadians can do to protect themselves. We have information on cellphones and on how Canadians can reduce their exposure to those devices. We also have information on Safety Code 6, as well as on its development and measures to protect the health of Canadians.
I think we have submitted to the committee a list of documents available on the Health Canada website. I should have a copy of it. Perhaps I should be asking you whether you have received the list. I think we have given you documents from the Health Canada website.
View Christine Moore Profile
If I understand correctly, only people who look for the information on your website will be educated. There are no awareness programs for the general population—for instance, warning young people against carrying their cellphones in their pockets, directly against their skin.
View Carolyn Bennett Profile
Lib. (ON)
Thank you for coming, Minister.
I have three questions. The first is with regard to the issue you raised around prevention. When we did the post-market surveillance study at this committee, it was very clear that in future, with personalized medicine, we can sort out that certain people have genetic predispositions to a certain drug interaction or to an adverse reaction. In the science around the definition of serious risk or injury or harm, how will the department determine whether it's a number of people with a serious predisposition to a problem or whether it's a general problem for which the drug must be recalled for the public good?
Second, as my colleague was asking, could you explain your thinking on why toilet bowl cleaners are included in this because it's a disinfectant, but natural health products are not?
Third, I think we know, whether it's trying to talk to physicians about SARS or whether it's trying to talk to physicians about recalls, that the time that elapses before Health Canada makes a decision and it actually gets out to the doctors is.... From the time when you make your decision, I may have in my office been prescribing this drug for three weeks before I get the letter from Health Canada. In 2014 do you think Health Canada has the resources or the systems in place to actually communicate with the front-line providers to tell them they have to stop prescribing this today, and not when...?
I can remember one situation when I was up all night delivering a baby, and it was on the news that a drug had been recalled. One of my patients, who'd been watching the news, came in and asked me the next morning what I thought about that drug being removed from the market. I wouldn't have known about it if my astute patient hadn't filled me in.
Those are the three things that I would like to know about in terms of whether those are areas for amendments.
View David Wilks Profile
Thank you very much, Mr. Chair.
Before I ask my question, I've heard from time to time that sometimes those of us in the back seats of the House of Commons can't make a difference. I believe my colleague, Mr. Young, has proven that wrong, and that he will make a significant difference in the lives of millions of Canadians in years to come. So thank you for that.
Minister, I appreciate your being here today.
You made mention of the competence and transparency in regard to the health care system. Can you provide the committee with some additional details on what Health Canada is doing to provide Canadians with the information they need to make informed health decisions? How will Vanessa's law give Canadians the information they need to make informed decisions about the use of therapeutic drugs and medical devices? Would you be able to provide the committee with some examples of these transparent measures?
View Rona Ambrose Profile
Sure. Thanks so much.
The fact is that Canadians do expect more information from Health Canada when it comes to patient safety issues. This legislation is incredibly important, but the current legal framework that we have is outdated. Just like every Canadian, I expect more. We expect to have that kind of information at our fingertips, and we expect the regulator to be able to make decisions when they're confronted with clear information that a drug is negatively impacting Canadians.
We know that 83% of Canadians are online now. They expect access to accurate information. They want it quickly and they want it easily. This is especially true when it comes to health and safety information. In most cases we will purchase over-the-counter medications or pay a visit to the doctor to receive prescribed medication. Along the way, we will read the label or receive information from a pharmacist about the proper dosage, when to take the medicine, and how to take it. We may also read or receive information about any side effects or other health warnings of which we should be aware. But the reality is that we sometimes do not get all of the information that we should, and the information can be confusing for people to follow.
Last year, as you know, we took important steps to help Canadians better understand medicine. As a result, our plain language labelling initiative is set to make prescription and over-the-counter labels and safety information easier to read and understand. Through the introduction of a standardized format for information on drug labels, this includes what's called a drug facts table.
In addition, the plain language labelling regulations will advance key safeguards, such as requiring labels to be in plain language, requiring that companies include contact information on labels so that users can report problems and adverse drug reactions, requirements for manufacturers to provide mock-ups of labels and packages for our review, and requirements for manufacturers to provide evidence that drug names will not be confused with other authorized products.
Canadians are already familiar with the nutrition facts table on food. Many report using this information to make informed decisions when choosing healthier foods. It makes sense then that we would have a similar tool to help Canadians make equally informed decisions when it comes to choosing the right medications and over-the-counter drugs.
Vanessa's law will build on the successes of the plain language labelling initiative by enabling new ways for our government to collect more information to provide to Canadians.
First, it will require a mandatory reporting of serious adverse drug reactions and medical device incidents by health care institutions. The knowledge gained by Health Canada through this reporting will help us to inform Canadian patients about any safety concerns or risks more quickly and more transparently.
Second, it will authorize Health Canada to compel manufacturers to make a label or packaging change when it's needed to alert patients and prescribers about a potential side effect or other health risk that only becomes known after the product is on the market. This will also expedite the communication of important safety information by Health Canada to prevent harm to Canadians who rely on these products.
Third, Vanessa's law will authorize Health Canada to compel manufacturers, when necessary, to provide more post-market information about their products. Companies may be required to gather ongoing evidence of the product's benefits and risks, to conduct new tests and studies, perhaps on specific populations, or to undergo a product reassessment. For example, as I mentioned, I would be able to compel further studies on a drug for adults that was routinely causing side effects in children.
Of course, information is power, and we are committed to gathering the information that Health Canada needs to ensure that Canadian patients and caregivers are empowered to make the most informed choices about their drug and medical device decisions. The measures in Vanessa's law will build on other efforts that we've undertaken to make more data and information available to Canadians than ever before.
For example, the department's Healthy Canadians website and social media channels give Canadians important up-to-date health and safety information, written in plain language. More than five million Canadians have visited these online sources. Canadians also have access to Health Canada's online databases, including a drug product database that provides information about all approved drugs. Our recalls and safety alerts database is another critical resource to learn more about the possible risks associated with health, consumer, and food products. Vanessa's law will help us to add valuable information to these trusted sources.
Canadians also need to understand that when they are using therapeutic drugs and medical devices, they need to know how to use them. They need clear, plain language information on the drug label to make the right choices for themselves and their families, and they need access to it transparently and in a timely way. They also need assurance that the regulator of therapeutic products has the ability to gather information throughout the life cycle of these products.
The plain language labelling initiative and our commitment to regulatory transparency and openness are important steps forward to meet the information expectations of Canadians. Vanessa's law will provide the necessary legal authorities for us to ensure that labels and information contain the most accurate information for Canadians to use to make informed decisions for themselves and their families.
View Rona Ambrose Profile
Let's remember that Health Canada is doing a lot of this work today in terms of assessing the safety of drugs, going through the drug approval process. We have many hundreds of experts, researchers, physicians, who work on our staff, who are doing these assessments. What we're talking about in terms of the drug approval process is making those assessments more transparent, easier to understand, more available to Canadians. Obviously, that takes some resources, but it's about doing our work differently.
In terms of collecting the information from institutions and then ensuring that we can assess that information, again, we do those assessments on an ongoing basis.
I don't know, Dr. Sharma, but maybe you want to explain how it is we do a drug safety assessment. We do these things today. What we want is more information—
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