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Remington Park Cancer Cluster Investigation
TOWN HALL MEETING
Wednesday, April 29, 2015 at 7 p.m.
Optimist Community Centre
1075 Ypres Ave, Windsor, ON N8W 1S1

Summary/Main Points

Introductions

Dr. Gary Kirk, Medical Officer of Health for Windsor-Essex and CEO of the Windsor-Essex County Health Unit (The Health Unit) welcomed and thanked everyone for attending. There were approximately 75 individuals present.

The Town Hall was hosted by the Windsor-Essex County Health Unit.  Staff  present included: Dr. Wajid Ahmed, Associate Medical Officer of Health (Acting); Julie Fraser, Director, Knowledge Management; Mike Janisse, Manager, Communications; Rosanne St. Denis, Executive Assistant and Recorder; Konrad Farrugia, Executive Assistant; Erica Colovic, Communications Coordinator; Mark Tortola, Communications Coordinator; and Thelma Maxwell, Public Health Nurse. Also in attendance was Mr. Paul Borrelli, Ward 10 City Councillor representing the Remington Park area.

The main points regarding the investigation were captured in a PowerPoint presentation by the Health Unit. The PowerPoint presentation can be found on the Health Unit’s website; however, anyone who provided an email address for updates regarding the Remington Park investigation will automatically be emailed a copy.  Highlights of the presentation were as follows:

A.         Cancer Cluster Information

A cancer cluster is an increased number of cancer cases that occur within a specific period of time and/or geographical area. Cancer can have a number of causes, including environment, hereditary and lifestyle factors (e.g., exposure to radon, smoking, genetics, etc.).  Cancer can also occur due to random variation.

Cancer clusters are difficult to investigate for many reasons: cancer has multiple causes, the number of cases in a cluster are often small, and the time between an exposure and the development of cancer (the latency period) can be lengthy. Lung cancer in particular has a long latency period. It is believed to take 20 to 30 years for lung cancer to develop depending on exposure. Cluster investigations are also difficult because association or correlation doesn’t mean causation. In other words, just because two things happen together, doesn’t mean one caused the other.

B.         General Cancer Information

Cancer can be caused by many different factors, often interacting together. The most important causes of cancer are smoking, alcohol use, overweight and obesity. Family history and genetics (especially for breast cancer) account for a significant number of cancer cases. Other cancer causes include environmental exposures. However, environmental exposures account for only a small percentage of cancer cases. Lung cancer is an exception in that environmental exposures – cigarette smoke, radon, asbestos and others – are known to be very signification in their causation.

Some cancers can also be caused by infectious triggers, for example the HPV virus which causes cervical cancer. Age is also a factor. The older you get, the greater your chances of developing cancer. According to the Canadian Cancer Society, two out of five Canadians will develop cancer in their lifetime. Cancer is responsible for almost 30% of deaths in Canada.

C.         Lung Cancer Information

Lung cancer is the most commonly diagnosed cancer in Canada other than skin cancer (not including melanoma).

Dr. Kirk reviewed lung cancer projections for 2014 from the Canadian Cancer Society. Approximately 26,100 Canadians will be diagnosed with lung cancer, representing 14% of all new cancer cases in 2014. It is estimated that 20,500 Canadians will die from lung cancer, representing 27% of all cancer deaths in 2014. It was noted that men have a higher incidence of and mortality rate from lung cancer. The five year relative survival rate for lung cancer for 2006 to 2008 is estimated to be 14% for men and 20% for women.

Dr. Kirk spoke about risk factors for lung cancer provided by the Canadian Cancer Society. The primary cause of lung cancer is cigarette smoking which causes 85% to 90% of all lung cancers. It was noted that an individual who smokes one-pack per day over 40 years is 20 times more likely to develop lung cancer than someone who has never smoked.

Dr. Kirk also referred to the International Agency for Research on Cancer’s (IARC) listings of carcinogens and cancer causing/probable cancer causing agents in humans as a source of additional information. IARC is a specialized cancer research organization.

D.         Remington Park Data

Dr. Kirk reviewed the ‘Selected Data Provided by Cancer Care Ontario on Lung Cancer Incidence’ table. This table lists 2000-2009 lung cancer incidence rates. Cancer Care Ontario analyzed the age-standardized rate of cancer for four dissemination areas within Remington Park against Windsor-Essex County, Lambton County, and Ontario rates.

‘Dissemination area’ is a census term. Each dissemination area consists of 400-700 people. Statistics Canada began using dissemination areas for the census in 2001. The four dissemination areas chosen and mapped by Cancer Care and were based on the first data the Health Unit received when the concern was brought forward. The rates for Remington Park are per 100,000 persons and standardized to the age distribution of the 1991 Canadian population.

The table also provides a 95% confidence limit (CL). This is used to determine whether rates of cancer incidence are significantly different from one another. When two sets of confidence levels do not overlap, then the rates associated with those confidence levels are believed to be significantly different from one another.

Cancer Care Ontario found the lung cancer incidence rate in the Remington Park dissemination areas to be more than two times higher than the Ontario rate. Looking at the 95% confidence limits for these two areas, we know these data are significant because the confidence limits do not overlap. The rates in the Remington Park dissemination areas are also significantly higher than the rates of lung cancer for the Erie St. Clair LHIN and Windsor-Essex County.

A second slide containing data provided by Cancer Care Ontario in 2014 entitled ‘Indirect Standardization and Standardized Incidence Ratio for Remington Park compared to Ontario, 2000-2009’, was also explained by Dr. Kirk.

The table lists various cancers and the number of cases observed in the Remington Park dissemination areas between 2000-2009 compared to the rest of Ontario.

The observed number is the actual number of cancer cases reported. The expected number is the number of cancer cases that would be seen under normal circumstances. The Standardized Incidence Ratio (SIR) is used to tell us whether the amount of cancer in a small area is high or low. Because cancer rates go up with age, the SIR takes into account the age of those in the area. The SIR is calculated by dividing the observed number of cases by the expected number of cases. A SIR value greater than 1.0 means that the actual number of cases is higher than what would be expected, although it may not be significantly higher.

The 95% Confidence Limit is used to determine whether the rate of cancer is significantly higher than what would be expected.  It includes both a lower value and an upper value. If the number 1.0 falls between the upper and lower values, it means that the increase or decrease in the SIR could be due to chance alone.

This table compares the rates for the four most common kinds of cancer – breast, colorectal, lung, and prostate. Also included is a single combined rate for the next six most common kinds of cancer – Non-Hodgkin lymphoma, melanoma, leukemia, thyroid, bladder, and body of uterus. Finally, included were all other cancers. The data show that the only type of cancer, of those analyzed above, that is significantly higher than what would be expected is lung cancer.  While colorectal and the two combined groupings have rates that are higher than would be expected, these rates are not significant, which means they may have occurred by chance.

E.         Remington Park Dissemination Areas in Investigation

Dr. Kirk provided a diagram of the Remington Park dissemination area that was investigated by Cancer Care Ontario. The Remington Park dissemination areas that are the focus of the investigation are within the borders of the Canadian Pacific Railway, Howard Avenue, Parent Avenue, and Grand Marais East.

F.         Investigation and Next Steps

The Health Unit is working with a number of partners with the intent to finalize a detailed questionnaire to be completed for the 24 individuals diagnosed with lung cancer between 2000 and 2009 in the four Remington Park dissemination areas or their next of kin. This will direct the next steps of the investigation. Regardless of where the data leads, the Health Unit has committed to:

  1. Keep the public informed of the outcome of this investigation, as well as subsequent parts.
  2. Continue to invite the public to share their concerns.
  3. Continue to monitor the lung cancer rates in the four Remington Park dissemination areas.
  4. Promote the Ontario Health Study.
  5. Create and share a final report at the conclusion of the investigation.

G.         Acknowledgement of Partners

Dr. Kirk thanked Cancer Care Ontario for providing the data, and Public Health Ontario for their expert consultation and ongoing work finding out the history of the area. The Erie-St. Clair Regional Cancer Program was also acknowledged. It is hoped that through the Regional Cancer Program the 24 individuals and their next of kin will be contacted.

H.         How to Contact Us

Dr. Kirk provided contact information for forwarding concerns:

Social media: Facebook or Twitter via private messaging.

I.          Questions

Audience members were given the chance to address the group once the presentation was complete. Questions from residents, concerned citizens and representatives from organizations and various advocacy groups were voiced.

Questions and issues raised are presented in the table that follows. The following disclaimers should be noted regarding the information in this table:

Every effort was made to document the main issues identified in each question/issue along with the Health Unit’s response, if solicited. For ease of reading, questions with similar responses are grouped together and as such, may not appear in the precise order in which they were asked at the meeting.

The questions or issues raised are taken directly from community members who spoke. The Health Unit does not vouch for the accuracy of the opinions or information presented by community members.

Q and A

Question/Issue Raised

Health Unit Response

Was the plotting of addresses included in the investigation?

The initial complainant mapped out the specific area of concern based on addresses.

Strong paint odour in the Remington Park area believed to cause breathing problems—resident now using inhalers-puffers.

 

 

Will the Health Unit be providing the 91-day Health Canada certified radon test kits at cost to Remington Park residents?

The Health Unit is seriously looking at the distribution of 91-day radon test kits given higher rates of radon identified in Windsor-Essex. The Health Unit will have a response about the kits in the next several months. Dr. Kirk described the cause of radon gas, how it enters the home, damage to the lungs, and the compounding effect of cigarette smoking and radon on health.

Is anyone looking at the effects of chemtrails here? The fallout from the nuclear plants in Michigan? Is there a reason we are looking at one area rather than all of Windsor-Essex County?

An investigation has to start somewhere and the Health Unit is investigating this particular cancer cluster. It began with a concerned citizen who identified a number of individuals with cancer in a certain area. The results of this investigation will tell what the next steps are.

 

An individual with a rare blood disorder asked at what point is a rare cancer reported, who investigates it, and when will a cause be identified?

 

Cancer Care Ontario collects the data on these. When cases are very rare, it may be impossible to do reliable statistical analysis.

The effects of GeoEngineering should be considered (a flyer was distributed to those interested).

 

A Remington resident with a rare blood cell disorder believes environmental factors are an issue.

 

She brought attention to Fighting Island that was used as a dumping ground for large piles of substances between 1920 and 1982. It is still not cleaned up as discovered at a recent school trip. As a huge industrial area, concern was expressed about environmental waste from across the river, nearby factories, etc.

 

The Ministry of Environment conducted an analysis in 1988 but the report was never released.

 

Concern expressed re: dirty electricity (electrical pollution) as a carcinogen and its downstream effects. A Remington Park resident raised concern about a sudden spike in electricity readings that occurs in the area that he believes are way beyond the safe limit.

The Health Unit was not aware of the term ‘dirty electricity’ and agreed to receive information from the resident after the meeting.

Is the Health Unit aware of a cancer cluster investigation that discovered a cause and was able to stop the cancer?

Cancer cluster investigations are infrequent. Dr. Ray Copes of Public Health Ontario indicated that it is rare to find a cause of cancer in these cases. Dr. Kirk was not aware of any cancer clusters that were investigated in Windsor-Essex. He was aware of a non-Hodgkins lymphoma investigation in Perth County but it did not lead to the discovery of a cause.

Nine of fifteen children in a family living on Charlotte Street have cancer. Will there be an investigation into some of these companies/possible causes?  A number of concerns were identified, including: railway tracks in the area and rail cars that went through carrying coal; an old battery company whose overflow was draining into the south end of Remington Park (Grand Marais creek); Zalev’s; a former slaughter house where everything drained down the road into the gutters. With all these things is there going to be any kind of research into the environmental effects from these companies? Are we going to get that information? Is there going to be some investigation into air quality?

Dr. Kirk highlighted the difference between the environment 20-30 years ago and now.

Because cluster investigations are looking at conditions many years ago, not as they currently are, it is difficult to find a cause. Fortunately, environmental protection legislation and regulations to improve business practices mean environmental conditions have improved.

 

The job at the Health Unit is to talk about the concerns and acquire the data. The Health Unit’s role is not to litigate the matter. We are working with Public Health Ontario, who has looked at the data from 20-30 years ago and advised that air quality in the Remington Park area has gotten better since that time.

There was sentiment expressed that because the Health Unit is a government organization that nothing will be done.

 

The presentation is 100% based on stats. Twenty or thirty years ago there was a local presentation noting 1 of 4 individuals will encounter cancer in their lifetime and near Zug Island it is 1 of 3. Now Remington Park is 1 of 2.

Dr. Kirk explained that this was not a correct interpretation of the Indirect Standardization and Standardized Incidence Ratio data for Remington Park compared to Ontario, 2000-2009. Dr. Kirk added that 2 out of 5 individuals in Canada will get cancer in their lifetime.

Concern was voiced about high voltage lines running through Remington Park and WiFi radiation. It was reported that Remington Park has 30-40 cell towers in the area that emit microwave radiation and that meters on houses emit microwave radiation, in addition to exposure to everyday electronics. This resident suggested people take their own measurements of the cell towers. The individual offered to help support the search for the cause.

 

Need to continue investigating beyond this meeting, beyond the geographical borders of Remington Park. The sentiment is that there is no imaginary wall and investigation needs to expand beyond the borders into other areas of the City. Need to leave this planet a lot better for future generations.  A study the University is doing was noted. A statement was made that Windsor has been acknowledged as the number 1 city for cancer in the world.

 

 

 

 

 

 

 

Zalev’s is a big issue. Is there data about testing that has been done on Zalev Brothers?

Dr. Kirk believes environmental testing for the area has been done and the results are obtainable.

A representative from Windsor-Essex Community Right to Know Association advised that he was willing to collect concerns.

 

I live a block away from Remington Park, do you want our input?

Remington Park is a starting point. We would be happy to receive information from other residents on their cancers and possible causes.

A resident referred to the blue chart hung on the back wall of the Optimist Centre gymnasium that she created listing residents who lived in the Remington Park area from 1970, all having had cancer with some having passed away. There are over 100 people on the list. She lived there all her life. Concern was raised whether they are next? With this being exposed, who is going to buy our houses? The consensus was that residents should not have to live like this. She just wants an answer as to why cancer rates are so high. Other individuals expressed concern that they have children and families and will they too die of cancer? She offered the chart to the Health Unit for further investigation.

 

An individual who lived in the area for 52 years expressed frustration that Zalev’s has not been acknowledged as a contributor. She cited a situation where Zalev’s polluted the area, then when it was time for an audit, the City had the streets cleaned. She also advised that when she goes out on her deck, she has to wash it off before sitting and routinely washes her window sills to get rid of a rusty colour sediment she attributes to Zalev’s. The light standards in the area have had to be replaced for corrosion; guard rails near Zalev’s also corroded. It has been brought to City Council and the individual claimed she was told it would take 50 million to remove Zalev’s . A statement was directed to City Councillor Borelli that it is a lot of money but aren’t our lives worth it?

Dr. Kirk advised that although there are known carcinogens used in the metal recycling business, the Health Unit must conduct an unbiased investigation. We can’t jump to conclusions until we have the evidence.

What is the data you have?

Cancer Care Ontario has the cancer data, which they have shared with the Health Unit.  The Health Unit, in turn, has shared these data with the public through our webpage dedicated to the issue.

Do we have information back to the 1970s? It was suggested that the Health Unit focus on the list of people who died because of cancer.

Combining data from before 2000 with data collected later is difficult because Census Canada changed the geographical boundaries of the areas at that time.

 

Is the Ministry of Environment going to go into Remington Park to do soil testing?

The Health Unit and Public Health Ontario are working with the Ministry of Environment.

Re: metal recycling plants, is ‘hexavalent chromium’ on the list of cancer causing agents?

These compounds will be included on the questionnaire the Health Unit intends to administer to the individuals (or their next of kin) who were diagnosed with lung cancer in the Remington Park area between 2000-2009.

An individual who identified himself as a certified radon professional suggested everyone’s houses be tested for radon and offered to assist the Health Unit with streamlining the process.

 

A Remington Park resident advised of her intent to display white cloths on her premise to catch pollutants and ultimately have them analyzed.

 

Dr. Kirk advised the group that any individuals with questions that have not been answered by meeting close could submit them by way of the comment cards that were distributed upon entering the meeting or they could be submitted online through the Health Unit website.

The meeting concluded at 8:30 p.m.