Health

Air emission and effluent from pulp and paper mills have known short and long term toxicological effects (Soskolne and Sieswerda, 2010) and prior to revisions to the Canadian Environmental Protection Act, irreversible toxic effects from pulp mill effluents were observed (Canadian Environmental Protection Act Priority Substances List). Two recent documents that overview the incidence of various health concerns in Pictou County are the Statistics Canada Health Profile, January 2013 and the Pictou County Health Authority 2008 Health Status Profile. These reports identify a number of health conditions in Pictou County have elevated incidence rates compared to the rest of Canada and/or Nova Scotia. Of particular concern are incidences of cancer and respiratory disease. While the group appreciates that linking these health conditions directly to one facility is often not possible especially given confounding variables, the incidences of these particular diseases do raise questions as to their source and as no comprehensive study has been undertaken, suspicions remain strong (Gorman, 2011). Some local doctors have speculated that there may be an association between diseases common in the area and the mill (Reid, 1989; “Laid to Waste”, 2009) and another study identified that healthy shellfish contracted leukemia after just six months in Pictou Harbour where they were exposed to mill effluent and sewage (St. Jean et al, 2005).

CANCER
Of great concern is the incidence of cancer in the area. Pictou County has the highest rate of cancer incidence in Nova Scotia and Nova Scotia has the highest incidence rate in Canada’s ten provinces (Table 3.1.1). Further, the cancer incidence rate is higher than the national average.

Table 3.1.1. Cancer Health Profile of PCHA compared with Nova Scotia and Canadian rates

Health Condition PCHA NS Canada

(per 100,000 population)

Cancer incidence 486.9 456.3 404.9
Lung cancer incidence 78.6 68.8 56.9
Breast Cancer incidence 116.8 101.9 98.4
Prostate cancer incidence 154.2 148.3 124.3
Total cancer deaths 190.4 188.6 166.4

Source: Statistics Canada Health Profile, January 2013 from Statistics Canada, Canadian Cancer Registry (CCR) Database and Demography Division (population estimates) 2007/2009. CANSIM table no.: 103-0404 Accessed from http://www12.statcan.gc.ca/health-sante/82-228/details/page.cfm?Lang=E&Tab=1&Geo1=HR&Code1=1246&Geo2=PR&Code2=12&Data=Rate&SearchText=Pictou%20County%20Health%20Authority&SearchType=Contains&SearchPR=01&B1=All&Custom= . and

http://www12.statcan.gc.ca/health-sante/82-228/details/page.cfm?Lang=E&Tab=1&Geo1=PR&Code1=01&Geo2=PR&Code2=01&Data=Rate&SearchText=Canada&SearchType=Contains&SearchPR=01&B1=All&Custom [Accessed August 8, 2013]
RESPIRATORY DISEASE
While Statistics Canada does not report incidence rates of COPD or asthma for Pictou County, deaths from respiratory diseases in Pictou County are higher than the Canadian rate (Table 3.1.2) and there is reason to believe that respiratory diseases are of special concern in the area. For example, the Pictou County Health Authority’s 2008 Health Status Profile states that, “[i]t is expected that respiratory rates are even higher than illustrated as data is not available for pneumonia, bronchiolitis, and other respiratory illnesses” (PCHA 2008 Health Status Report, p.16). Two of the top 10 causes of death in 2006 in PCHA were chronic respiratory disease (43.92/100,000) and other respiratory diseases (12.78/100,000) and these were the highest in Nova Scotia. Further, there have been academic connections drawn between impaired lung function and occupational exposures in the pulp and paper industry (Torén, Hagberg and Westberg, 1996) and Dr. Dan Reid (1989) concluded a local link as well.

Table 3.1.2. Respiratory Disease Health Profile of PCHA compared with Nova Scotia and Canadian rates

Health Condition PCHA NS Canada
% % %
COPD Not applicable 6.3% 4.3% Source : Canadian Community Health Survey, Statistics Canada, 2009/2010. CANSIM table no.: 105-0502, 105-0592
Asthma Not applicable 9.3% 8.3% Source : Canadian Community Health Survey, Statistics Canada, 2009/2010. CANSIM table no.: 105-0502, 105-0592
Deaths from respiratory diseases (per 100,000 pop) 50.9 54.0 45.0 Source : Statistics Canada, Canadian Vital Statistics, Death Database and Demography Division (population estimates), 2005/2007; CANSIM table no.: 102-4309

Source: Statistics Canada. 2013. Health Profile. Statistics Canada Catalogue No. 82-228-XWE. Ottawa. Released April 15, 2013. http://www12.statcan.gc.ca/health-sante/82-228/index.cfm?Lang=E Accessed from: http://www12.statcan.gc.ca/health-sante/82-228/details/page.cfm?Lang=E&Tab=1&Geo1=PR&Code1=01&Geo2=PR&Code2=01&Data=Rate&SearchText=Canada&SearchType=Contains&SearchPR=01&B1=All&Custom= [Accessed August 8, 2013]

CARDIOVASCULAR DISEASE
In addition, the incidence of cardiovascular disease in Pictou County is higher than the provincial incidence rate (Table 3.1.3). Due to connections made between cardiovascular conditions and the pulp industry, this statistic is also of concern. Specifically, cardiovascular mortality has been linked to pulp mill chemical exposures among pulp mill employees (Jäppinen and Tola, 1990). Table 3.1.3. Cardiovascular Disease 2002-2005

PCHA

NS

Per 100,000

Acute Coronary Syndrome 704 555
Coronary Heart Failure 373 324

Source: PCHA 2008 Health Status Report. Original source identified as: Saulnier, Katherine. 2008. Cardiovascular Health in Pictou County, pg 4; Data from Cardiovascular Health Nova Scotia, Indicators Format 2008 Finally, the Pictou County Health Authority 2008 Health Status Profile points to two other statistics of interest:

1. STILLBIRTH: The report identifies that the “The rate of stillbirths and infant deaths (less than 1 year age) are significantly higher in Pictou County than in the rest of Nova Scotia” (Pictou County Health Authority 2008 Health Status Profile, p.9). Specifically, the rate of still births in PCHA is 11.8/1000 compared to 9/1000 for the province as a whole and the rate of infant deaths is almost double for PCHA compared with the provincial rate (7.1/1000 in PCHA versus 3.8/1000 in Nova Scotia). Despite confounding variables and no appreciable evidence uncovered as yet to link stillbirths with mill effluent and air emissions specifically, we do have questions about whether the harmful health effects of pulp mills might also extend to affect the most vulnerable and be affecting the rate of pre-natal and infant mortality. Particularly in light of the recognition that many emissions reported by Northern Pulp to the National Pollutant Release Inventory including formaldehyde, ammonia, chloromethane, hydrogen sulfide, carbon monoxide, nitrogen oxide, volatile organic compounds and particulate matter 2.5 are suspected reproductive toxicants (http://scorecard.goodguide.com/health-effects/chemicals-2.tcl?short_hazard_name=repro&all_p=t), we feel this is a legitimate question. And, Northern Pulp emits considerable quantities of some of these substances, particularly PM 2.5. For instance, in 2012, the mill reported emissions of PM 2.5 in excess of 1000 tonnes and similar quantities in previous years. Given that facilities are required to report PM 2.5 emissions if they exceed 0.3 tonnes in a calendar year, this is a noteworthy association.

2. GENDER DISTRIBUTION: The report also identifies the gender distribution of births in Pictou County compared with the provincial rate. PCHA has an appreciable higher rate of male births compared with the province. Specifically, there are 1.26 boys born for every girl in PCHA compared with the 1.06 boy:girl ratio for the province as whole (Pictou County Health Authority 2008 Health Status Profile, p.9). According to the World Fact Book Human Sex Ratio (https://www.cia.gov/library/publications/the-world-factbook/fields/2018.html) the worldwide sex ratio is on average 1.05 male:female ratio. In Canada, the ratio is 1.06 male:female. Countries with somewhat asynchronous ratios include Albania (1.11 male:female ratio), China, India and Vietnam (each with a 1.12 male:female ratio) and Nauru (0.83 male:female ratio). Given these distributions, the sex ratio realized in Pictou County appears entirely anomalous. Pulp mill effluent had long been noted to have reproductive effects on fish. Specifically, Hewitt et al (2008) noted that:

“For more than 25 years, there have been reports that effluents from pulp and paper mills affect fish reproduction. Studies involving wild fish, in situ experiments, and laboratory in vivo tests conducted in Sweden, Canada, Finland, the United States, and New Zealand have documented reductions in sex steroid hormone levels, gonad size and fecundity, alterations in secondary sex characteristics, and delayed sexual maturity associated with exposure to mill effluents.” (p.682).

While no scientific evidence has been found that links human reproduction or human sexual characteristics with pulp mill effluent or emissions, the scientific links established among aquatic organisms and pulp mill effluent combined with the unusual sex ratio in Pictou County certainly raises the question whether such a link might exist.