Sludge Watch ==> Ontario - Adverse Health Impact from Sludge

[maureen.reilly at sympatico.ca]

Sludgewatch Admin

Since the EPA and industry touts love to say that there has never been a 
documented adverse health impact from sludge, I thought I should post one.  
Here is the report from the Medical Officer of Health for a region in 
Southern Ontario, Canada.  Under the Health Protection and Promotion act a 
Medical Officer of Health is obligated to investigate and report in writing 
to a formal complaint about an environmental health situation.

The EPA, WERF, WEF, CWWA, all of them have failed to investigate even a 
single complaint related to sludge and health (please..if I missed something 
let me know!)  So when they say there isn't a single documented case, its 
because they refuse to investigate!

Now of course, the sludge industry has paid out hush money to sludge 
victims....that is a documented fact.   I guess the industry wants us to 
think they give away money to people whose life or health was NOT impacted 
by sludge.

We call this 'doing the duct tape'.  You have a sludge victim...you give 
them money and close their mouth and the file forever as though with duct 
tape.

For more info on sludge victims visit

Sludge Victims
http://www.sludgevictims.net/

Cornell Investigations of Sludge Victims
http://cwmi.css.cornell.edu/Sludge/Newsolutions.pdf


...........................................................................................


Health Unit


Your Health Partner for Life!
Haliburton, Kawartha, Pine Ridge District




A. Hukowich, M.D., C.C.F.P., D.P.H. · Medical Officer of Health · Executive 
Officer, Board of Health


March 12, 2002


Mrs. Enid Lipsett
R.R. 1
Warkworth ON K0K 3K0


Dear Mrs. Lipsett


Enclosed is a copy of my report relating to your complaint concerning 
illness in your granddaughter Madison. I have concluded that your 
granddaughter did suffer from an adverse health effect as a result from the 
storage of sewage sludge from the Ashbridges plant of the City of Toronto on 
a neighbouring property. The standard that I have used in reaching this 
conclusion is the civil standard of a balance of probabilities, in that I 
have concluded that it is more likely than not that she suffered an episode 
of respiratory distress and that this was a result of the highly offensive 
odour from the sewage sludge. However, I do not believe that I can come to a 
conclusion that the storage of the sewage sludge was a health hazard as 
defined within the meaning of the Health Protection and Promotion Act as I 
believe that I would require a higher standard of objective evidence to 
conclude that a legally sanctioned activity was indeed a health hazard.


While I have discussed your complaint in general terms with representatives 
of the Ministry of the Environment as I am required to do under Section 11 
of the Health Protection and Promotion Act, I have not provided my specific 
findings or any of the information contained in the report I have provided 
to you. With your permission, I would of course be pleased to supply a copy 
of this report to the Ministry of the Environment.


Since it is my understanding that the neighbouring property no longer has a 
Certificate of Approval for further deposition of sewage sludge, there 
should not be a repeat of the circumstances of this past summer. However, in 
my discussions with representatives of the Ministry of the Environment I 
have advised them that given the specific circumstances of the strength of 
odour from the sewage sludge produced by the Ashbridges plant in the City of 
Toronto, that should the Health Unit receive further complaints of illness 
attributable to storage or spreading of this particular material, the Health 
Unit will investigate, and if it is able to find any objective evidence of 
human illness, I would be prepared to conclude that there was a health 
hazard within the meaning of the Health Protection and Promotion Act and 
issue appropriate orders to reduce or eliminate such hazard. As well, the 
Health Unit would attempt to evaluate the degree of material discomfort 
suffered by a panel of persons, including myself, so that I might be in a 
position to conclude that the material was resulting in an adverse health 
effect. In such a case I would strongly recommend to the Ministry of the 
Environment that they make appropriate use of their legislative authority to 
suspend those activities resulting in such an adverse health effect.


Should you require any additional information or interpretation of my report 
or conclusions, I would be most pleased to discuss this matter with you.


Sincerely,


C.C.F.P., D.P.H. Medical Officer of Health


enc.




REPORT RE LIPSETT COMPLAINT


Background


Mr. and Mrs. Lipsett have owned the property described as Lot 3 Concession 4 
Percy Township located on the east side of Stone Road for approximately 
three years and spend most weekends at this property. They state that they 
have considerable experience living in a rural area and are familiar with 
periodic odours from manure which they accept and which do not bother them.


Madison, their granddaughter, was bom in November 2000, and along with her 
parents was a regular visitor to the Stone Road property, having been 
present on at least 15 occasions up until July 2001. These visits were 
generally of a two-day duration, although over the Christmas season of 
December 2000 and January 2001, she was in attendance for approximately 10 
days. While initially breastfed, by the summer of 2000, she was being bottle 
fed with formula being prepared with bottled water and not the well water of 
the property. By that summer she was also eating commercial baby food. 
During these visits she did not develop any illnesses, in particular had no 
history of respiratory difficulties or diarrhea. She was noted to have an 
allergy to their dog, in particular that she would develop a rash on her 
face if licked by the dog.


On the weekend of July 13 - 15, on their arrival, they noted that material 
which they subsequently learned was sewage sludge from the Ashbridges plant 
of the City of Toronto, was being stockpiled on the west side of Stone Road 
on the property described as Lots 5, 6,7,8 Concession 4 Percy Township. The 
presence of this material was resulting in a strong odour which they 
describe as an overpowering putrid stench to be present on their property 
when the wind direction was from the west. They found the odour resulted in 
some nasal irritation and feelings of nausea. Since their property does not 
have central air conditioning, they had to leave windows open and this 
resulted in their inability to enjoy their property both inside and outside 
because of the odour.


Madison visited during one weekend in August, arriving on Saturday morning 
and leaving on Sunday afternoon. During this visit she developed diarrhea.


She again visited on the weekend of September 8 and 9, arriving the morning 
of September 8. The Lipsetts were not present but had a telephone 
conversation with their daughter during the afternoon of September 8. She 
indicated that Madison was developing some difficulty breathing and 
diarrhea. They remained at the residence until Sunday afternoon, when they 
took Madison to the Markham-Stouffville Hospital on their way home. They 
arrived at approximately 6 pm and left the hospital at 9 pm. Madison was 
assessed by the hospital nurse and physician. The history as obtained by the 
parents was noted of shortness of breath, wheezing and cough. No history of 
diarrhea was noted. Notations available from the medical record were brief 
and some illegible. However, the record disclosed a history of allergy to 
dogs, that the child was not the child was in no respiratory distress, there 
was no indrawing and that the chest was clear to oscilltation. Vital signs 
were recorded as a temperature of 35.7, pulse rate of 118, respiratory read 
of 20 and an oxygen saturation of 99%. The infant was treated with Ventalin, 
a bronchodialator, and the parents taught the use of an aero chamber for 
further administration of Venatalin.


Spreading of the sewage sludge occurred on September 21 and 22.


Madison was again in attendance at the property on the weekend of September 
29 and 30. She arrived on Saturday, September 29 and left early on Sunday, 
September 30, again because of some symptoms of diarrhea.


Legislative framework


Section 11 under the Health Protection and Promotion Act requires that 
"where a complaint is made to a Board of Health or Medical Officer of Health 
that a health hazard related to occupational or environmental health exists 
in the health unit served by the Board of Health or the Medical Officer of 
Health, the Medical Officer of Health shall notify the Ministry of the 
Government of Ontario that has primary responsibility in the matter and in 
consultation with the Ministry, the Medical Officer of Health shah 
investigate the complaint to determine whether the health hazard exists or 
does not exist." Further subsection 2 states that "the Medical Officer of 
Health shall report the results of the investigation to the complainant, but 
shall not include in the report medical information in respect of other than 
the complainant without the consent of the person or in the case of a child, 
of a parent or other person who has lawful custody of the child."


The Ministry of the Environment is aware of the complaint by Mrs. Lipsett. 
An investigation at the time by staff of the Ministry of the Environment 
determined that activities relating to the initial stockpiling of sewage 
sludge and its eventual spreading and its incorporation into the soil was in 
accordance with the Certificate of Approval issued by that Ministry.


In addition, Section 12, (1) of the Act requires that "every Medical Officer 
of Health shall keep himself or herself informed respective to matters 
related to occupational and environmental health."


I believe that these sections were included in the Health Protection and 
Promotion Act not for some academic purpose, but so as to allow members of 
the public to have an independent evaluation of cases of illness suspected 
of being caused by environmental matters.


Section 13 provides for extensive authority for a Medical Officer "by a 
written order" to "require a person to take or to refrain from taking any 
action that is specified in the order in respect of a health hazard" in 
order to "decrease the effect of or to eliminate the health hazard." The 
determination of existence of a health hazard requires the Medical Officer 
of Health to come to "the opinion, upon reasonable and probably grounds that 
a health hazard exists in the health unit served by him or her." While 
Section 13 is permissive and does not require that a Medical Officer of 
Health issue an order, it does seem open to making Section 11 of the Act 
rather inconsequential.


Historically, Boards of Health and Medical Officers of Health had broader 
authorities and investigative powers under the Public Health Act which 
existed in Ontario prior to 1983. This Act allowed for the investigation of 
complaints regarding "nuisance" and to take all necessary steps as "provided 
by this Act or provided by the Regulations to abate or remedy the same." No 
definition of nuisance was provided in the legislation. When the Public 
Health Act was replaced by the Health Protection and Promotion Act in 1983, 
no authority for dealing with a nuisance was retained in the legislation. 
Rather authority was provided to issue orders concerning "maintenance of 
sanitary conditions and the prevention or elimination of health hazards." A

health hazard is defined in the Act as: a) a condition of a premises b) a 
substance, thing, plant or animal other than man c) a solid, liquid, gas or 
combination of any them that has or that is likely to have an adverse effect 
on the health of any person.


No definition of adverse effect is provided in the legislation. To date 
there has been only a single court interpretation related to the definition 
of health hazard. In the 1994 case of Bracy v.s. Kendal et al, the judge 
found that the definition of health hazard was capable of various meanings 
and is ambiguous. The judge went on to say that "the meaning in a given 
statute depends upon the context and subject matter of the statute and that 
it is clear from Section 2 that the purpose and intent of the Act is to 
ensure community health protection of the people of Ontario and is not 
directed to the health issues peculiar to an individual that should be 
addressed by an individual's physician."


The authority of the Ministry of the Environment under its legislation 
appears to be much broader. Section 1 of the Environmental Protection Act 
defines adverse effect as including "impairment of the quality of the 
natural environment, harm or material discomfort of any person rendering any 
property, plant or animal life unfit for human use, loss of enjoyment of 
normal use of property and interference with the normal conduct of 
business." Section 14 (1) prohibits the "discharge of a contaminant that 
causes or is likely to cause an adverse effect." The only limitation in the 
section comes in (2) which exempts animal waste when disposed of in 
accordance with normal farming practice. Section 14 of the Act allows a 
director under the Environmental Protection Act to issue orders to repair 
injury/damage and to prevent injury/damage resulting from the discharge of a 
contaminant. Contaminants are also defined under subsection (1) as including 
"odour resulting from human activities that may cause an adverse effect." 
While the definition is somewhat circular, it is clear that the legislation 
intended that the authority under the Environmental Protection Act be much 
broader in relation to adverse effects than the authority under the Health 
Protection and Promotion Act where no such broad definitions of inclusion of 
odour or issues of material discomfort were included in the definition. 
Ontario Regulation 346 section 6 under the Environmental Protection Act 
states that "no person shall cause or permit to be caused the emission of an 
air contaminant to such an extent or degree as to a) cause material 
discomfort to persons, b) cause loss of enjoyment of normal property use." 
While the authority within the Ministry of the Environment appears much 
greater, the Ministry of the Environment does not have medical personnel and 
is therefore dependent upon the finding by a local Medical Officer of Health 
that an activity is producing or has produced "an adverse health effect."


Air-borne Contaminants and Health


There is a substantial body of scientific evidence relating to human illness 
which can be caused by a wide variety of air-borne contaminants. The 
mechanisms for such human illness can be briefly described as relating to 
either an infectious agent, a toxin or poison, an irritant or an odour 
causing agent. Irritants may somewhat overlap with toxins but may also 
include materials such as dust which produce a directly irritating effect 
and pollens which can produce an allergic reaction. Infection, poisoning, 
irritation and allergy are often the most readily demonstrable human effects 
and have the potential for being objectively verified through various 
independent observations and testing procedures on a human being. However, 
identification of a causative or causative substances in air is difficult 
because of the need to carry out sampling at the time of contamination and 
because of a lack of a clear objective standard for most substances to allow 
for the interpretation of air quality test results. On the other hand, the 
adverse health effect of odours are often the least capable of being 
verified by independent test evaluation, either within a human being or in 
air and similarly there is usually no independent air quality standard that 
can be used to interpret an air quality result for odour even if an 
objective test method were available. This latter issue does not apply to a 
small number of toxic materials including hydrogen sulphide, which do have a 
specified concentration in air which is considered to be harmful to human 
health. Unfortunately, for many such substances, the odour threshold, i.e., 
the concentration at which the substance can be detected by its odour, is 
well below the concentration at which the substance would be considered 
harmful to human health such that detection of the odour of the substance 
provides no evidence that a harmful concentration of the substance is 
present.


Despite the lack of any clear objective standards relating to most odours, 
there is in my view sufficient scientific support, as well as personal 
understanding, that offensive odours can result in both personal discomfort 
and such health effects as loss of appetite, nausea, vomiting, loss of 
well-being and perhaps headache, loss of concentration, feeling unwell or 
other such non­specific and general symptoms.


Conclusion

Based on my consideration of all the foregoing material, I believe that the 
Lipsett's granddaughter Madison, did suffer from an adverse health effect on 
the weekend of July 13 - 15 resulting from the storage of sewage sludge from 
the Ashbridges plant of the City of Toronto being stockpiled on the west 
side of Stone Road on lots 5, 6, 7, 8 of Concession 4 Percy Township. While 
there is no objective evidence of Madison suffering from any infection or 
exposure to a poison, allergen or irritant material, I believe it is 
reasonable to conclude that exposure that weekend to an odour that is 
described as "highly offensive" and as "an over powering putrid stench," 
could and did result in the triggering of respiratory distress in this 10 
month old child. Unfortunately, apart from the nature of the treatment 
prescribed by the physician who saw Madison, there was no documentation 
relating to any objective evidence to substantiate an asthmatic attack or 
any effect beyond some transient respiratory distress. It can however be 
argued that such objective evidence cleared between the time Madison was 
removed from exposure to the offensive odour and the time she was assessed 
by the physician. It is also possible, although I have no specific proof 
that Madison suffered from some temporary respiratory distress due to the 
concentration of some irritant material present in the sewage sludge in a 
concentration sufficient to affect her but not adults present. Infants and 
young children do have a normally higher respiratory rate and do inhale 
larger volumes of air for their body sizes as compared to adults. An infant 
such as Madison would reasonably be considered as being more susceptible to 
the presence of any air-borne irritant contaminant. However, even a 
prolonged period of crying as occasioned by an offensive odour or other 
discomfort could equally result in some temporary period of respiratory 
distress.



A. Hukowich, M.D., C.C.F.P., D.P.H.

Medical Officer of Health


March 12, 2002