Treating the climate with coal phase-out

*Reprinted with the permission of National Observer

Op-Ed By Dr. Courtney Howard, President, CAPE December 3, 2017

Canada, the UK and partners announced a global alliance to phase-out coal power at COP23 in Bonn, Germany. It was an honour to speak on behalf of the health community at the launch, as coal-power phase-out is a key recommendation of the 2017 Lancet Countdown Report and the Countdown’s associated UK brief, as well as the Canadian Brief which I co-authored on behalf of the Canadian Public Health Association.

The Lancet tells us that climate change is the biggest global health threat of the 21st century…and that tackling climate change could be the greatest global health opportunity of the 21st century.

Phasing out coal is about reducing the 44 per cent of global carbon dioxide emissions due to coal—and the trauma, displacement and heat-related deaths associated with severe weather events due to climate change. It’s about a future with less burns and cough-inducing smoke clouds from wildfires, less conflict and migration, and less undernourished children.

Phasing out coal is also about seeing less kids with asthma puffers from air pollution—less costly ER visits for asthma, less time off school and work. It’s about less morbidity and deaths from the long-term health impacts of coal-related air pollution—cancer, cardiovascular disease, stroke, lower respiratory infection. It’s about less neurodevelopmental problems from mercury, and less polluted water and habitat loss from coal extraction.

Health professionals worldwide are beginning to treat climate change with coal phase-out.In Canada, organizations such as the Canadian Association of Physicians for the Environment and the Canadian Public Health Association have been key contributors to coal phase-out commitments in Ontario, Alberta and Canada-wide.

Earlier at COP23, the World Health Organization Director General, Dr Tedros Adhanom, repeated his commitments to make action for a healthy climate one of the four priorities of his presidency, and met with myself and other members of the Global Climate and Health Alliance to discuss collaboration on both adaptation and mitigation work in service of health.

 

At the Global Climate and Health Alliance Summit, held in association with the World Health Organization, we spoke with health professionals from across the world, including medical students, to teach them what advocacy techniques work and who they need to partner with in order to support coal phase-out in their home countries. With income being a major social determinant of health, health professionals believe that active support of workers is key to a just and healthy transition.

The health professions are late to the climate fight, but we learn fast, we don’t need a lot of sleep and we’re used to dealing with crisis.

As we move forwards towards actioning the coal phase-out in Canada and beyond, health professionals will be looking to see as much coal as possible replaced with renewables as opposed to natural gas. An increasing proportion of natural gas in Canada is being produced via hydraulic fracturing—for which increasing studies are demonstrating negative impacts. One assessment of the peer-reviewed literature on the impacts of hydraulic fracturing found that 84 per cent of studies on public health, 69 per cent of studies on water and 85 per cent of studies on air pollution found concerning findings. A direct transition to healthy, low-carbon energy should be our goal.

As an Emergency doctor I know what it’s like to act too slowly and to have patients die. The first time a child died under my care was on a pediatric malnutrition project in the Horn of Africa. It was one of the worst moments of my life. I also know what it’s like to act quickly, to do the right thing, and to pull someone from the spiral back to where we can thrive.

The health professionals of the world are applying the skills they’ve learned from treating people—to work to resuscitating the planet.

COP23 has seen new initiatives, new alliances, and new skills created. In partnership with the global health community and our decision-makers, I’m looking forward to treating the climate with coal phase-out and moving forward to a healthier planet.

Related Links:

Ontario’s Nuclear Emergency Response Plan Is Far from Adequate

Above: Darlington Nuclear Station on the shore of Lake Ontario, via Óðinn

Nuclear energy provides as much as fifty percent of Ontario’s electricity. It is extremely expensive, produces radioactive waste for which there is no safe disposal or storage, and carries the risk of catastrophic accident (far more serious in Ontario than anywhere else in the world due to our reactors’ proximity to a large population and source of drinking water). Ontario’s nuclear emergency plan is outdated and inadequate.

This summer, the Ontario Ministry of Community Safety and Correctional Services will be hearing the public’s comments on proposed changes to the province’s Nuclear Emergency Response Plan. This is an excellent opportunity for health professionals to voice concerns about the safety of the nuclear industry in Ontario, and its emergency response plan in particular.

Pickering Nuclear Station, via ilker

Prepared by Dr. Cathy Vakil, Board Member, CAPE, June 2017

Historically, there has been a major nuclear accident every decade since the 1970s. The most recent one occurred in Fukushima, Japan in 2011 when 400,000 residents living 50 kilometres from the Fukushima reactors were evacuated. Half of Ontarians, and one in six Canadians, live within 60 kilometres of Darlington and Pickering nuclear stations, which is why Ontario needs a robust and detailed emergency response plan.

The tragic disaster in Fukushima demonstrated the critical importance of a strong nuclear emergency plan, the value in having clear measures in place to deal with immediate mass health issues among workers and citizens, and the importance of monitoring to prevent long term health effects. International reports and Japanese officials have stated that none of these conditions were adequately in place in Japan prior to the Fukushima accident. Japanese authorities increased permissible dose limits so that workers’ and citizens’ doses would remain in the “acceptable” range. Many important issues had not been addressed as part of an emergency plan, such as knowledge of emergency responders of decontamination methods, adequate transportation of contaminated patients to hospitals, capacity of local hospitals to deal with incoming patients from hospitals within the primary zone that had to be evacuated, malfunctioning of water and electricity supplies in these hospitals, emergency lodging facilities, and secure food supplies.

In Ontario, we believe the current nuclear emergency plan should be designed to respond to a nuclear accident of the same severity as Fukushima. Instead, the Plan is designed for an accident several times less severe. It does not address the needs of vulnerable populations such as the elderly, hospital patients, and children. Nor are there measures in place for training health professionals to deal with large numbers of contaminated patients who would arrive at clinics and hospitals.

Ontario’s nuclear reactors, which are some of the oldest in the world, are all adjacent to the Great Lakes, the source of drinking water for tens of millions of Canadians and Americans. Large quantities of radionuclides would flow into the Great Lakes in the case of a catastrophic accident, and despite the large volume of water, this could affect safety of the drinking water of millions of residents. An adequate emergency plan must include the provision of clean drinking water for the tens of millions of people presently reliant on the Great Lakes.

Aerial view of Pickering Nuclear Station on the shore of Lake Ontario, via Joe Mabel

Public awareness needs to be improved regarding instructions to follow in the case of a nuclear accident as well. For example, iodine pills, which should be ingested within four hours of radiation exposure and preferably before exposure if possible, are needed to prevent thyroid cancer. In Ontario, they are pre-distributed to residents living within a 10 kilometre radius of the reactors. The pills are available to people living within a 50 kilometre radius but most people are unaware of this important preventative measure. Ontario should consider pre-distribution of pills to all residents living within at least 20 kilometers of a nuclear reactor, in keeping with international best practices, as is the case in New Brunswick for the Point Lepreau nuclear reactor.

In order for Ontario to be ready for a major nuclear disaster, an emergency plan should be implemented that is based on a Fukushima-level accident, that includes training and preparation of emergency responders and health professionals, clear communication with the public on an ongoing basis, adequate pre-distribution of iodine pills, and a plan to provide sufficient clean drinking water to the tens of millions of residents reliant on the Great Lakes for their water.

CAPE urges the Ontario government to create a detailed, comprehensive, and transparent emergency plan to protect the health of Ontarians in the case of a catastrophic Fukushima-level nuclear accident.

Chalk River: Un Projet Très Inquiétant / A Project of Great Concern

A PROJECT OF GREAT CONCERN: CHALK RIVER’S PROPOSED NUCLEAR WASTE SITE

PHOTO Credit: Chalk River CNL, seen from the Ottawa River. Photo courtesy of Padraic Ryan via Wikimedia Commons.

Prepared by Dr. Éric Notebaert, Board Member, CAPE (French version below)

Canadian Nuclear Laboratories (CNL) recently proposed to the Federal Government, Ontario, and the Canadian Nuclear Safety Commission (CNSC) that it would build a giant nuclear waste site in Chalk River, Ontario. We strongly believe that this proposal must be opposed. Here’s why.

This radioactive waste site would be the largest ever built in the world. It would have an area of ​​11 hectares and be 25 meters in height. It would be build to contain one million cubic meters of low- and intermediate-level radioactive waste. If approved, this site would be built on the banks of the Ottawa River at the Chalk River CNL, 100 km upstream from Ottawa.

The proposed site is located in a swamp that flows to many municipalities in Quebec and Ontario. Leaks from this facility could significantly contaminate drinking water downstream. The surface of the site would be constantly exposed to rain and snow until 2070, the date of the planned closure. It is expected that the water would be partially recovered, and returned to the dump, but the tritium would be released into the river. It is pertinent to point out that all landfill projects of this type are currently planned for desert areas and designed with concrete enclosures around the waste. This is not the case at Chalk River.

The Chalk River site is located in the seismic zone of western Quebec. According to Natural Resources Canada, a small earthquake occurs, on average, every five days in this area. The largest of these earthquakes can have a magnitude of 6 on the Richter scale. In the 1990s, elected officials from 50 municipalities in Quebec and Ontario adopted resolutions opposing a radioactive waste storage project in Chalk River because of these characteristics.

In addition to the waste accumulated over more than 50 years of operation of the Chalk River CNL such as demolition debris and contaminated soil, radioactive waste could be transported from across Canada to this site. Mixed waste, which may include PCBs, arsenic and mercury, could also be stored in this facility.

Radioactive waste would be stored over two plastic liners such as those used in municipal dumps. These “geomembranes” are not waterproof. The causes of leakage could be numerous and related to incorrect installation, physical deterioration, perforations by sharp or heavy objects, chemical deterioration, seismic activity, flooding or sabotage. Moreover, the storage is so superficial that one can access the waste by means of a simple shovel (see image below).

The proposed dump has a planned life time of 50 years, while radioactive waste of medium activity remains radioactive for tens of thousands of years. During the 50+ years, the waste would be exposed to rain and snow. Failure of the proposed waste site would result in rapid contamination of the Ottawa River. This waste site is scheduled to be used until 2070, but it is also stated that any monitoring activity will cease in 2100, which makes no sense when it is known that the radioactivity at this site will last for thousands of years. It should be emphasized here that the CNL has arrived at the current solution because it believed that all other safer solutions would be tens or even hundreds of times more expensive.

WHY IT IS IMPORTANT TO ACT NOW

The non-elected CNSC is solely responsible for approving such projects. The CNSC has demonstrated in the past a tendency to favor the interests of the nuclear industry over public safety. Following a request from several citizens and groups, the CNSC has finally agreed to receive public comments until August 16, 2017. We encourage you to offer your comments on their website or by email to Nicole Frigault, Environmental Assessment Officer, at cnsc.ea-ee.ccsn@canada.ca

In summary, CAPE is calling for the cancellation of this proposed project. We believe that the CNL must totally rethink its concept of nuclear waste management. We believe that it is better to store the waste temporarily, rather than creating the illusion of burying them safely for centuries to come. We recently wrote to the Minister of the Environment asking her to intervene. We are currently working with several other Canadian organizations and First Nations groups to try to stop this project from proceeding.

FRENCH VERSION

UN PROJET TRÈS INQUIÉTANT: LE PROJET DE DÉPOTOIR DE DÉCHETS NUCLÉAIRES DE CHALK RIVER

Ci-dessus: Chalk River LNC, vu de la rivière des Outaouais. Photo grâce à Padraic Ryan via Wikimedia Commons.

Préparé par Dr Éric Notebaert, membre du conseil d’administration de l’ACME

Les Laboratoires Nucléaires Canadiens (LNC) ont proposé récemment aux gouvernements du Canada, de l’Ontario, et à la Commission Canadienne de Sécurité Nucléaire (CCSN) de construire un gigantesque dépotoir de déchets nucléaires à Chalk River en Ontario. Nous croyons qu’il faut absolument s’opposer à ce projet. Voici pourquoi.

Ce dépotoir de déchets radioactifs serait le plus grand jamais construit au monde. Il aurait une superficie de 11 hectares et 25 mètres de hauteur. Il contiendrait un million de mètres cubes de déchets radioactifs de faible et moyenne activité. S’il est approuvé, ce dépotoir serait créé sur les berges de la rivière des Outaouais aux Laboratoires Nucléaires Canadiens de Chalk River, à 100 Km en amont de Ottawa.

Le site proposé, pratiquement entouré d’eau, se trouve dans un marécage qui s’écoule vers de nombreuses municipalités du Québec et de l’Ontario. Les fuites provenant de cette installation pourraient contaminer de façon importante l’eau potable en aval. D’ailleurs dans le projet proposé, la surface du site sera constamment exposée à la pluie et à la neige jusqu’en 2070, date de la fermeture prévue. On prévoit que l’eau qui y en ruissellera sera partiellement récupérée et renvoyée dans le dépotoir, mais le tritium sera libéré dans la rivière. Il est pertinent de souligner que tous les projets d’enfouissement de tels déchets actuellement sont conçus dans des régions désertiques, avec sarcophage de béton autour des déchets. C’est évidemment loin d’être le cas à Chalk River.

Le site de Chalk River est situé dans la zone sismique de l’ouest du Québec. Selon Ressources naturelles Canada, un petit tremblement de terre survient à tous les cinq jours en moyenne dans cette zone. Le plus grand de ces séismes peut avoir une magnitude de 6 sur l’échelle de Richter. Dans les années 90, les élus de 50 municipalités québécoises et ontariennes avaient adopté des résolutions contre un projet de stockage des déchets radioactifs à Chalk River en raison de ces caractéristiques.

En plus des déchets accumulés pendant plus de 50 ans d’exploitation des laboratoires nucléaires de Chalk River (débris de démolition, sols contaminés, déchets entreposés), des déchets radioactifs pourraient être transportés de partout à travers le Canada vers ce site. Les déchets dits «mixtes» (qui peuvent inclure des BPC, de l’arsenic et du mercure) pourraient également être stockés dans cette installation. 

Les déchets radioactifs seraient entreposés au-dessus de deux revêtements en plastique comme ceux utilisés dans les dépotoirs municipaux. Ces «géomembranes», ne sont pas étanches. Les causes de fuites pourraient être nombreuses et liées à une installation incorrecte, une détérioration physique, des perforations par des objets tranchants ou lourds, une détérioration chimique, l’activité sismique, les inondations ou le sabotage. D’ailleurs l’entreposage est si superficiel que l’on pourra avoir accès aux déchets au moyen d’une simple pelle (voir graphique ci-dessous).

Le dépotoir proposé à une durée de vie de 50 ans, tandis que les déchets radioactifs de moyenne activité restent radioactifs pour des dizaines de milliers d’années. Durant la période de 50 ans et plus, les déchets seraient donc exposés à la pluie et la neige. L’échec ou un bris de fonctionnement de la station d’épuration proposée pourrait entraîner une contamination rapide de la rivière des Outaouais. On prévoit remplir ce dépotoir jusqu’en 2070, mais on précise aussi que toute activité de surveillance cessera dès 2100, ce qui est un non-sens lorsque l’on sait que la radioactivité sur ce site durera pendant des milliers d’années. Il faut souligner ici que le consortium est arrivé à la solution actuelle car il estimait que toutes les autres solutions plus sécuritaires coûteraient des dizaines voire des centaines de fois plus cher.

POURQUOI IL EST IMPORTANT D’AGIR MAINTENANT

La CCSN, organisme non élu, est seule responsable de l’approbation des projets. La commission a démontré une incapacité à protéger l’environnement et une tendance à favoriser les intérêts de l’industrie nucléaire par rapport à la sécurité publique. À la suite d’une demande de plusieurs citoyens et groupes, la CCSN a finalement permis au public de commenter l’évaluation environnementale du IGDPS jusqu’au 16 août 2017. Nous vous encourageons à offrir vos commentaires sur leur site web ou par courriel à Nicole Frigault, Agente de l’évaluation environnementale, cnsc.ea-ee.ccsn@canada.ca

Nous demandons l’annulation pure et simple du projet et croyons que le consortium doit repenser de fond en comble son concept de gestion des déchets. Il est certainement préférable de les stocker de façon temporaire que d’avoir l’illusion de les enfouir de façon sécuritaire pour les siècles à venir. Nous avons écrit récemment à la Ministre de l’Environnement, Mme McKenna afin qu’elle se saisisse de cette question. Nous en sommes actuellement à définir la meilleure stratégie afin de bloquer ce projet, avec plusieurs autres organismes canadiens, et groupes des Premières Nations.

 

 

 

CAPE Calls for Moratorium on Fracking in B.C.

Prepared by Dr. Courtney Howard, Board Member, CAPE, and Dr. Larry Barzelai, Chair, B.C. CAPE Committee, April 18, 2017

Liquefied Natural Gas (LNG) has been a hot topic of conversation in British Columbia for several years now, but many people still don’t realize that the vast majority of LNG will be coming from hydraulic fracturing (fracking) projects. Because of that, it is important to take a look at the emerging research around fracking as we debate LNG.

Technological developments in the fracking industry have outpaced health and environmental research. We are only now starting to get studies that tell us about the health impacts associated with fracking. The information is still preliminary, but overwhelmingly raises red flags for health. One study, which looked at all the health-oriented research on fracking, found that 80% of all studies had been done between 2013 and 2015. Of the ones that looked at public health outcomes, 84% identified potential problems.

Preliminary studies on the human health effects of fracking have identified concerns with the hormone-disrupting properties of fracking fluids and their potential for reproductive and developmental toxicity, increased asthma rates, and congenital heart disease with greater proximity to natural gas development.

Development can bring new jobs to a community, but it can also bring an influx of male workers. A recent report has shown that this may increase violence against Indigenous women and girls in northeastern B.C.

Very few studies have examined longer-term health outcomes with longer latency periods such as cancer or developmental outcomes. To quote a review of the literature: “This is a clear gap in the scientific knowledge that requires urgent attention.”

Additionally, even the single Pacific Northwest LNG project and the greenhouse gas emissions associated with it will make it virtually impossible for B.C. to meet its 2050 greenhouse gas emissions targets. Given that the World Health Organization has identified climate change as the greatest health threat of the 21st century, failure to meet greenhouse gas targets must be viewed as a risk to human health.

In the face of incomplete information, the best approach is to act in accordance with the precautionary principle. As stated by the World Health Organization: “in the case of serious or irreversible threats to the health of humans or the ecosystem, acknowledged scientific uncertainty should not be used as a reason to postpone preventive measures.” CAPE Doctors in B.C. believe that this approach should be applied to fracking in B.C.

Both the New Brunswick and Newfoundland/Labrador chapters of the College of Family Physicians of Canada have urged fracking moratoria in those provinces in the interest of public health. Over 180 physicians and health professionals recently signed a letter asking that no new projects which increase the level of hydraulic fracturing in British Columbia, or in Canada as a whole, go ahead until the health risks are understood, communicated to communities, and mitigated.

Let the candidates in your riding know that you are concerned about the health impacts associated with fracking and LNG in B.C.: http://www.cbc.ca/news/canada/british-columbia/who-s-running-in-the-2017-british-columbia-election-1.3786771

If you would like to see public health protected by a moratorium on further fracking projects in B.C., please click here to add your name to our petition.

NOTICE: Join us in Vancouver on Friday April 28th for a discussion panel about the health impacts of fracking featuring environmental scientist Judi Krzyzanowski, PhD, Dene environmental activist and lawyer Caleb Behn, and CAPE board members Dr. Courtney Howard and Dr. Warren Bell.
Click here for more information and free registration.

The Fight for a Bike and Pedestrian Highway Overpass in Montreal

[version français ici]

Above: Félix Gravel, Sylvie Bernier, and Dr. Eric Notebaert at a rally in support of the Turcot Dalle-Parc project in June 2017.

Prepared by Dr Éric Notebaert, Board Member, CAPE, March 21, 2017

This spring, the Canadian Association of Physicians for the Environment is partnering with the Conseil Régional de l’Environnement de Montréal and several environmental groups in a major campaign to promote active transportation: the Return of the Turcot Dalle-Parc project.

Dr Éric Notebaert, CAPE board member, speaking at the campaign’s launch event.

The Turcot Interchange, a major highway interchange in southwest Montreal, is currently under renovation. This is a major infrastructure project—costing more than $4 billion—which originally included a large, green overpass connecting two zones of Montreal in the plans. This overpass, the “Dalle-Parc”, is a project that connects the upper part of the city (Notre-Dame-de-Grâce–Westmount) and the lower part (Verdun–Pointe-Saint-Charles). This slab that passes over the highway and the railway is a structure that can allow pedestrians and cyclists to cross this area in a safe way. It is a great project that greatly benefitspedestrians and cyclists, and is also connected to a rail shuttle service to the Montreal airport in Dorval.

Dalle-Parc Turcot
Image of the planned overpass for pedestrians and cyclists from the 2010 project plan.

This Dalle-Parc project not only greatly favours active transportation, but it will give people in many neighbourhoods easier and safer access to hospitals and other employment and development centers. If it is not implemented, cyclists will have to make a 10km detour to traverse a distance of barely 1km. The Dalle-Parc project will also significantly reduce pollution and greenhouse gases emitted by the city.

In the initial project to renovate the Turcot Interchange in 2010, this Dalle-Parc was the only truly interesting environmental aspect of this huge construction site. The Dalle-Parc therefore had the support of all the environmental groups and citizens of the city. However, in the latest version from the Quebec Ministry of Transport (MTQ) in 2015, the Dalle-Parc was simply gone. No one at the MTQ seems to be able to explain this decision. It is important to note that the cost of the Dalle-Parc is estimated at $40 million, or 1-2% of the total cost of refurbishing of the interchange.

Left: 2010 project plan, including the Dalle-Parc. Right: 2015 project plan, the Dalle-Parc has disappeared.

We are asking the MTQ for the reinstatement of the Dalle-Parc. The current campaign has several components: meeting with municipal, provincial and federal politicians; social, festive, cultural, and sporting events; meeting with local groups; meeting with the media; etc.

This campaign will certainly last several months. But it will last as long as it takes. We are absolutely determined to win this battle for the health of the population… and the planet.

 

Retour de la Dalle-Parc Turcot

[English version here]

UN ENJEU MAJEUR DE SANTÉ PUBLIQUE ET D’ENVIRONNEMENT POUR MONTRÉAL : LE RETOUR DE LA ‘DALLE-PARC’ DANS L’ÉCHANGEUR TURCOT

Ci-dessus: Félix Gravel, Sylvie Bernier, et Dr. Eric Notebaert lors d’un rassemblement à l’appui du Dalle-Parc Turcot en juin 2017.

Dr Éric Notebaert, membre du conseil d’administration de l’ACME, June 2017

Ce printemps, l’Association Canadienne des Médecins pour l’Environnement s’associe au Conseil Régional de l’Environnement de Montréal et à plusieurs groupes environnementaux dans une importante campagne de promotion du transport actif.  Il s’agit du projet Retour de la Dalle-Parc Turcot.

Dr Éric Notebaert, membre du conseil d’administration de l’ACME, en parlant à l’événement de lancement de la campagne.

Le grand échangeur routier du sud-ouest de Montréal, l’échangeur Turcot est actuellement en réfection. Il s’agit d’un projet majeur de plus de 4 milliards de dollars, dans lequel une grande plate forme verte entre 2 zones de Montréal était initialement prévue dans les plans. Cette plate forme, la Dalle-Parc est un projet qui permet de relier la partie haute de la ville : Notre Dame de Grâce-Westmount et la partie basse : Verdun-Pointe St-Charles. Cette dalle qui passe au dessus de l’autoroute et de la voie ferrée est un ouvrage qui peut permettre aux piétons et cyclistes de traverser cette zone de façon sécuritaire. Il s’agit d’un beau projet qui favorise grandement les piétons et cyclistes, et qui est, de plus, en lien avec une navette ferroviaire dans l’axe Montréal-Aéroport de Dorval.

Dalle-Parc Turcot
Image du Dalle-Parc Turcot prévu tiré du plan de projet de 2010.

Ce projet de Dalle-Parc permet non seulement de favoriser grandement le transport actif, mais grâce à lui, les citoyens et citoyennes de plusieurs quartiers ont plus facilement accès aux centres hospitaliers et autres pôles d’emplois et de développement, et ce, de façon très sécuritaire. S’il n’est pas réalisé, les cyclistes auront à faire un grand détour de 10 Km pour parcourir une distance d’à peine 1Km. Le projet de la Dalle-Parc permet en outre de diminuer de façon substantielle la pollution et les Gaz à Effet de Serre émis par la ville.

Dans le projet initial de réfection de l’échangeur Turcot en 2010, cette Dalle-Parc était le seul aspect véritablement intéressant au niveau environnemental de ce gigantesque chantier. La Dalle-Parc avait donc le soutien de tous les groupes environnementaux et des citoyens et citoyennes de la ville. Or dans la dernière version du Ministère des Transports du Québec (MTQ) en 2015, la Dalle-Parc était tout simplement disparue. Personne au MTQ ne semble pouvoir expliquer cette décision. Il est important de souligner que le coût de la Dalle-Parc est estimé à 40 millions de dollars, soit 1-2% du budget total de réfection de l’échangeur.

À gauche: projet présenté en 2010, avec la Dalle-Parc. À droite: projet présenté en 2015, la Dalle-Parc a disparu.

Nous demandons dont au MTQ la réinsertion de la Dalle-Parc. La campagne actuelle a plusieurs volets : rencontre avec les politiciens municipaux, provinciaux et fédéraux; rencontre avec les groupes locaux, événements sociaux, festifs, sportifs, culturels, rencontre avec les médias, etc…

Cette campagne durera certainement plusieurs mois. Mais elle durera le temps qu’il faudra. Nous sommes absolument déterminés à gagner cette bataille. Il en va de la santé de la population…et de la planète.

 

Prescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals

As health professionals, we know how important it is for our patients to be physically active. After all, physical activity is known to reduce the risk of chronic diseases such heart disease and diabetes. It also improves mental health and provides some relief from arthritis. But we also know that many people have difficulty finding the time to get the levels of physically activity needed to maintain good health. Studies bear this out; the number one barrier to physical activity is time. This is particularly true for women with young children. This is where active modes of transportation (such as walking and cycling) and transit use come in. Research has demonstrated that many people can fold physical activity into their lives if they combine it with other activities such as errands, commuting to work, or taking the kids to school.

As health professionals, we are well positioned to encourage our patients to think about active transportation as a way to get the physical activity they need to stay healthy. When we use the phrase “active transportation”, we mean any activity used to get people from one destination to another that involves physical activity. It can include skate boarding or in-line skating, but usually involves walking or cycling. When we use the phrase “active travel”, we are referring to transit use as well as active transportation because many trips on transit begin or end with walking or cycling.

Unfortunately, many communities across Canada have not been designed to encourage and foster active modes of transportation or transit. Many were built during a time when it was considered wise to separate homes and schools from workplaces and amenities. This led to communities designed around cars; sprawling neighbourhoods with winding roads and cul-de-sacs separated from shopping malls that grouped all amenities into one place. Experience and research has demonstrated the problem with this thinking. We now understand the need for compact neighbourhoods that have enough people in them to support efficient transit service and attract restaurants, stores, and other services. We know that streets built on a grid encourage people to walk and cycle to nearby amenities. We know that streets lined with sidewalks encourage walking by making it safer and easier to do. And we know that busy streets with separated bike lanes are safer for cyclists and encourage more people to ride their bicycles.

But changing the design of communities and streets can be difficult. Resistance can come from a number of different sources. As health professionals, we can play an important role in community decisions. We can help educate the public and decision-makers about the many health benefits of community and street designs that support and foster a healthy lifestyle.

CAPE has produced a new toolkitPrescribing Active Travel for Healthy People and a Healthy Planet: A Toolkit for Health Professionals—to help health professionals become advocates of active transportation and transit with their patients and in their communities. The toolkit is designed with five stand-alone modules so people can focus on the ones of most interest to them. Module 1 describes the health, environmental and social benefits of active travel. Module 2 provides strategies to motivate patients to use active travel. Module 3 explains the links between active transportation and community design. Module 4, designed for health professionals in southern Ontario, focuses on Ontario’s Growth Plan and how it impacts active travel. Module 5 provides strategies for promoting change in one’s community. The toolkit also includes two factsheets and brochures that health professionals can give to their patients, two backgrounders that can be used in meetings with the public or decision-makers, and a series of memes that can be used on Twitter or Facebook to make people think about the many benefits of walking, cycling, and transit for society as a whole.

The toolkit and its various supporting documents can be found at https://cape.ca/active-travel-toolkit/

Prepared by Kim Perrotta, Executive Director, CAPE, March 20, 2017

Ontario’s Coal Plant Phase-out Produced Many Health and Environmental Benefits

On January 17, 2017, industry think-tank the Fraser Institute released a new report, Did the Coal Phase-out Reduce Ontario Air Pollution? which suggests that coal plants across Canada should not be phased out based on its assertion that Ontario’s phase-out did not significantly reduce air pollution (Fraser Institute, 2017). This report includes a number of statements about pollution, health care benefits, and coal plants that are incorrect or misleading.

The Fraser report focuses on the air pollution benefits of the Ontario coal plant phase-out while ignoring the many co-benefits associated with this action. In 2002, the five coal-fired power plants in Ontario were responsible for

  • nearly one quarter (23%) of the sulphur dioxide (SO2) emissions and one seventh (14%) of the nitrogen oxide (NOx) emissions in Ontario that contributed to air pollution and acid rain,
  • nearly one quarter (23%) of the airborne mercury emissions which contributed to the contamination of fish with a persistent toxic that is harmful to the brains of humans, and
  • one fifth (20%) of Ontario’s greenhouse gases emissions that were contributing to climate change (OPHA, 2002).
Figure 1: Annual SO2 Emissons by Sector, Ontario (OMOECC)
Figure 1: Annual Emissions of Sulphur Dioxide, Different Sectors, Ontario, 2003-2012 (OMOECC, 2014)

Over the last 20 years, the public health sector, the Ontario Medical Association, environmental organizations, cottagers’ associations, and labour organizations have been outspoken advocates for the phase-out of coal plants in Ontario. All of these groups shared the common view that many health and environmental benefits could be gained simultaneously by closing Ontario’s coal plants.

While there were technologies that could be applied to reduce emissions of sulphur dioxide, nitrogen oxides, and mercury from these plants, there was no technology at that time that could eliminate emissions of greenhouse gases. Given the age of Ontario’s coal plants, the availability of combined cycle natural gas plants, the promise of energy efficiency, and renewable technologies, it made more sense economically to accelerate the closure of coal plants than to re-invest in them.

Figure 2: annual air levels of sulfur dioxide in Ontario, 2004-2013
Figure 2: Annual Air Levels of Sulphur Dioxide, Selected Sites, Ontario, 2004-2013 (OMOECC, 2014)

The Fraser report and press release suggest that coal plants are not a major contributor of fine particulate matter (PM2.5)—the air pollutant that has been mostly clearly linked to chronic health impacts such as heart disease and lung cancer, and one of two air pollutants responsible for most of the smog alerts that used to be common in Ontario. This is simply not true.

Coal plants emit significant quantities of SO2 and substantial quantities of NOx. Both are gaseous air pollutants that can harm human health directly. When they enter the atmosphere, they can be transformed into sulphates and nitrates—acid particles that contribute to air levels of PM2.5. In fact, this secondary PM2.5 is the major culprit behind high levels of PM2.5 measured in many airsheds and is often more hazardous for human health than other forms of PM2.5 (RIAS, 2011). This PM2.5 does not, however, show up in emission inventories for PM2.5.

The Fraser Institute suggests that Ontario’s coal phase-out had little impact on emissions and air quality. This is misleading. Between 2003 and 2012, SO2 emissions from coal plants were reduced by about 140,000 tonnes (see Figure 1). During that same period, annual air levels of SO2 across Ontario declined by nearly 50% (see Figure 2) and annual air levels of PM2.5 declined by about 25% (see Figure 3) (OMOECC, 2014). While the improvements in air levels of SO2 and PM2.5 cannot be attributed solely to the closure of coal plants, their closure was an important contributor to reductions in air levels.

Figure 3: annual air levels of fine particulate matter in Ontario, 2004-2013
Figure 3: Annual Air Levels of Fine Particulate Matter, Selected Sites, Ontario 2004-2013 (OMOECC, 2014)

Air quality is impacted by multiple sources of pollution. The actions to reduce air pollution are intentionally broad-based because the improvements are cumulative. Coal plants are an efficient target for emission reductions because they are stationary sources that emit large volumes of air pollutants. They are also a significant source of air toxics such as mercury and greenhouse gases.

Air pollution is also a transboundary issue. Emissions of SO2 and NOx from coal plants in the U.S. have a significant impact on Ontario’s air quality, while emissions from Ontario’s coal plants have a substantial impact on air quality in Quebec, Vermont and New York (Yap et al., 2005). In recognition of this reality, Canada and the United States committed in 1991 to take action on both sides of the border with the Canada-US Air Quality Agreement. This agreement has proven very successful. Emissions and air quality on both sides of the border have improved because of cooperation between the two countries (Canada-US, 2014).

In 2005, Ontario estimated the contribution of coal plants to air pollution across Ontario and the adverse health impacts associated with that contribution. Because coal plants release air pollutants so high in the air, the pollutants are dispersed over long distances. The impact, therefore, on any one airshed is relatively small, but the impact overall on human health can be significant because so many people can be affected. Using methodologies that were well-accepted in other jurisdictions, Ontario estimated that air pollution from its  coal plants were responsible for over 600 premature deaths, 900 hospital admissions, and 1000 emergency room visits, each year, in Ontario. These health impacts were valued at $3 billion per year (OMOE, 2005).

The Fraser report suggests that the $3 billion in health benefits estimated cannot be accurate because it represents too great a percentage of Ontario’s health care budget. This statement reflects a misunderstanding about the health benefits estimated in 2005. The $3 billion per year in health benefits reflect the value of the many lives that are shortened by air pollution, as well as health care costs. They do not reflect health care costs alone. The 2005 report is clear about this point.

 An independent assessment conducted by Toronto Public Health in 2014 suggests that improvements in Ontario’s air quality have translated into significant health benefits for Ontario residents. Toronto Public Health found that improvements in Toronto’s air quality from 2000 to 2011 have reduced air pollution-related premature deaths by 23% (from 1,700 to 1,300 per year) and hospital admissions by 41% (from 6,000 to 3,550 per year) in Toronto alone.  It attributes the improvements in air quality to a variety of policies implemented by different levels of government including the phase-out of coal plants by Ontario (TPH, 2014).

With the evidence of catastrophic climate change mounting daily, the need to modernize Canada’s electricity sector has never been more clear. With the costs of renewable technologies dropping, the opportunity to transform our economy has never been greater. CAPE stands by its position. We believe that the phase-out of coal plants in Alberta and across Canada is an economically prudent decision that will improve the health of Canadians while taking the steps needed to address climate change.

Prepared by Kim Perrotta, MHSc, Executive Director, CAPE

References:

  • Canada-US, 2014. Canada-U.S. Air Quality Agreement Progress
  • Fraser Institute.  (2017). Did the Coal Phase-out Reduce Ontario Air Pollution? Prepared by Ross McKitrick and Elmira Aliakbari.
  • Ontario Ministry of Energy (OMOE).  2005. Cost Benefit Analysis: Replacing Ontario’s Coal-Fired Electricity Generation. Prepared by DSS Management Consultants Inc. RWDI Air Inc. April, 2005
  • Ontario Ministry of the Environment and Climate Change (OMOECC). 2014. Air Quality in Ontario 2013 Report.
  • Ontario Public Health Association (OPHA). 2002. Beyond Coal: Power, Public Health and the Environment
  • Regulatory Impact Assessment Study (RIAS). 2011.  Reduction of Carbon Dioxide Emissions from Coal-Fired Generation of Electricity Regulations.
  • Toronto Public Health (TPH). 2014. Path to Healthier Air: Toronto Air Pollution Burden of Illness Update. Technical Report.
  • World Health Organization (WHO). 2013. Review of evidence on health aspects of air pollution – REVIHAAP Project.
  • Yap, David, Neville Reid, Gary De Brou, and Robert Bloxam. 2005. Transboundary Air Pollution in Ontario 2005. Queen’s Printer.

Health and the Environment Belong in the Same Box: Why Health Impact Assessments Belong in Environmental Assessments

Perhaps because we mostly work inside boxes—hospitals, clinics, universities, and office buildings—it has taken the world’s health community far too long to realize that human health belongs in the same box as what we call “the environment.”

These ideas have been part of other thought systems, including Aboriginal concepts of wellness, for generations—but until recently they have been largely neglected within Western medical thought, other than in the realm of public health and environmental medicine.

As health professionals, it is not actually easy to admit that what happens outside our clinics and hospitals has a greater impact on overall health status than what happens inside them. We have put a lot of time and effort into learning what to do in our boxes. But as professionals who have committed a lifetime to the pursuit of optimal health for the people and populations we serve, we recognize that when the evidence demands it, we must peek over the edges of our boxes, open the windows, and let in new ideas and collaborations.

As with many diagnoses, however, the connection between health and the environment is becoming more obvious as ecological decline gets worse. Happily, the narrow perspective of health professionals is beginning to change. The past 5 years have seen the World Health Organization call climate change the “greatest threat to global health in the 21st century,” and the Canadian Public Health Association (CPHA) tell us that “the ultimate determinant of human health (and that of all other species) is the health of the Earth’s life-supporting systems.” Also last year the prestigious medical journal The Lancet published the report of its Commission on Planetary Health, defining planetary health as “the health of human civilization and the state of the natural systems on which it depends.”

In response, a Planetary Health Alliance has been launched out of Harvard, funded by the Rockefeller Foundation, the world’s first Chair in Planetary Health has been established at the University of Sydney, and health professionals are mobilizing worldwide to ensure that our growing understanding of the linkage between human health and the natural environment is integrated into policy.

Here in Canada, the Minister of Environment and Climate Change Canada has established an Expert Panel Review of Environmental Assessment (EA) Processes that is soliciting submissions and touring Canada to hear from community members about how the EA process can better function. This is a critical opportunity to connect the health box and the environmental box. We urge the Federal Government to do so by integrating health impact assessments into its environmental assessment processes.

To that end, the Canadian Association of Physicians for the Environment (CAPE), the CPHA, key academics, other health organizations, and individual health professionals and advocates have submitted a letter asking that comprehensive human health impact assessments be integrated into the Federal Environmental Assessment process.

This idea is now well-accepted in Canadian medical circles. In 2012 the Canadian Medical Association General Council passed a motion supporting a comprehensive federal environmental review process, including health impact studies, for all industrial projects and the CPHA proposed in 2015 applying “comprehensive impact assessments that address the ecological, social, health and economic impacts of all major public policies and private sector developments.”

Comprehensive human health impact assessments include an assessment of the impact of a project on the social determinants of health such as housing and income, as well as the ecological determinants of health including greenhouse gas emissions. This will allow health authorities to recognize and consider potential positive and negative health impacts of projects on their communities, to plan and fund healthcare provision services to address those impacts, and, to suggest modifications to plans in order to mitigate negative health impacts.

This integration has the potential to save not only lives but also money as it is well-recognized that preventative medicine is cheaper than acute care.

Prepared by Dr. Courtney Howard, Dr. Trevor Hancock, and Robert Rattle

The full letter to the MoECC calling for the integration of health impact assessments into federal environmental impact assessment processes and a list of signatories can be found here.

Some Good News for People and the Planet

It has been a good week for people and the planet. Last Monday, November 21st, 2016, the federal government announced that it will take steps to phase out pollution from coal-fired power plants across the country by 2030. And on Thursday, November 24th, the Government of Alberta announced that it has signed an agreement with three major power generators to ensure a phase-out of coal plants in Alberta by 2030.

There will be time in the coming days to examine and critique the details surrounding these two new announcements but today we want to acknowledge what they can mean for human health in Alberta, across Canada, and around the world.

A new report endorsed by 15 health and environmental organizations—including the Canadian Association of Physicians for the Environment, the Asthma Society of Canada, and the Lung Association—estimates that a Canada-wide phase-out of coal power by 2030 would prevent more than 1000 premature deaths, 900 hospital admissions or emergency room visits and nearly $5 billion in health care costs by improving local air quality. In fact, most of these national health benefits will be realized in the Prairies—about $3 billion in Alberta and up to $1.3 billion in Saskatchewan. While the lion’s share of the benefits will happen in the Prairies, there will still be important benefits realized in the Atlantic provinces and in central Canada, making a Canada-wide coal-phase out truly in the country’s national interest.

The 2030 phase-out will also significantly reduce mercury emissions. Mercury is the reason that pregnant women are warned not to eat certain types of fish during pregnancy. It is a persistent substance that accumulates in the aquatic food chain that can harm the brains of children exposed during pregnancy. Reducing this pollution will mean that these harmful effects can be minimized; that we can reclaim fish as a healthy protein source for all.

In addition, the 2030 phase-out will help Canada’s fight against climate change. Renowned medical journal The Lancet estimates that climate change is already responsible for approximately 150,000 deaths each year. People are dying from malnutrition, malaria, infectious disease and extreme heat; conditions made worse by a climate characterized by more frequent and more intense storms, heat waves, and droughts. People in countries that are already struggling to feed their people will experience many of these health impacts, but Canada will not be immune. Over the last 10 years, Canada has experienced an increase in droughts, wildfires, extreme rain and ice storms, floods and extreme heat. We have seen the spread of insect- and tick-borne diseases such as West Nile virus and Lyme disease. And we have seen permafrost and ice roads melting in the far north. Canadians are already being affected by climate change, both in economic and health terms.

By accelerating the closure of coal plants across the country, we will cut Canada’s greenhouse gas emissions by about 8%. This will help Canada to meet its commitments under the Paris Agreement on Climate Change and put us in a stronger position to ask the same of other countries. But more importantly, we will be acting decisively to improve the health of Albertans, Canadians and other people around the world from the ravages of uncontrolled climate change.

We congratulate the governments of Alberta and Canada in their decisions to phase out coal-fired power, and to reap the important health benefits for Albertans and all Canadians. Now the hard work begins: designing plans to ensure this transition happens quickly, in partnership and collaboration with communities most impacted. We look forward to working with all levels of governments throughout this process.

Prepared by Kim Perrotta, MHSc, Executive Director of Canadian Association of Physicians for the Environment (CAPE), on November 25, 2016