Health Committee on Nov. 30th, 2010

[Pamela Fuselli]

I think we have seen successful initiatives in and around some of those leading causes of death. There is always more to be done. In the case of booster seats, three provinces still don't have booster seat legislation. We're now seeing some evaluation from the provinces that do have legislation that has been in place for a couple of years as to the difference in the injury rates for that population.

We know when we address in a strategic way environmental initiatives, education, and enforcement, if it is by legislation or standard, those are the types of areas where we see injuries starting to be reduced. When there is that attention, the priority, the funding and resources put to it, we start to see the numbers decrease.

We also have to be careful with pedestrian injuries. We see the numbers going down, but we know that may also be an exposure difference. If people aren't walking as much, we are then seeing pedestrian injuries reduced but not for a good reason. That's why injury needs to be linked to a number of different health issues. It needs to be seen in the overall child health picture as an indicator of health. The link of injuries to environmental and mental health, obesity, and nutrition is quite close. Safe Kids Canada has been forging links with organizations like Active & Safe Routes to School, and ParticipACTION, to integrate our messaging with healthy, safe activity. For example, issues like falls still need to be addressed. Falls are the leading cause of hospitalization.

Falls in the home and falls in playgrounds result in an enormous number of injuries. It's a little less concrete, so we need to turn our attention to--

[The Chair, Conservative, Joy Smith]

I'm sorry, Ms. Davidson.

We'll now go to Mr. Dufour.

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you, Madam Chair.

Before I begin, I would like to thank Mr. Segard for acknowledging the role of Quebec and other provinces in this matter. This can sometimes be forgotten by some of our colleagues.

Ms. Billings, I would like to continue the discussion on the Northern community. If we did not consider the Northern community in these calculations, where would Canada be on an international scale? Do you have any numbers that would indicate this?

[Sylvain Segard]

We do not have this data on us at the moment. It is surely possible to try and tell the difference.

One of the main factors distinguishing the Great North is the nature of the activities that people engage in there. Many are related to the work of extracting primary resources. Incidents are linked to these types of activities rather than to ones that occur in urban settings. There will be a notable difference in this respect.

If the committee is interested, we can return with this information at a later time.

[Nicolas Dufour, Bloc, Repentigny, QC]

Yes, precisely.

From our discussion, I understand that the problematics exist primarily in the Great North. Therefore, if we are to make a move, if the committee produces a report, it would be very important to note that the actions we take target the Canadian North.

[Jane Billings]

I think what we indicated was that the rate of injury was higher in the north, and particularly the rate of suicide. Of course, the population is much smaller, so the absolute number of injuries is higher in the south than it is in the north.

It's the rate that's different. Taking those out still isn't enough to move us right up to the top of the pack, but we would certainly move up somewhat.

[Nicolas Dufour, Bloc, Repentigny, QC]

My next question is for the representatives of Health Canada.

Ms. Mentzelopoulos, you mentioned earlier that you have safety officers for the purpose of monitoring products. How many safety officers do you have altogether?

[Athana Mentzelopoulos]

I believe I talked about this when we appeared before you on the Canada Consumer Product Safety Act.

Currently, we have 46 inspectors, to which we are adding 26 new inspectors thanks to funding from the

food and consumer safety action plan. We are in the middle of the implementation of that plan. At the end of it, we will have doubled the number of inspectors across the country to 90.

[Nicolas Dufour, Bloc, Repentigny, QC]

I remember very well having discussed this in past committee hearings. That being said, you will understand that, for me, this is important. If we enact a law to ensure that products meet certain standards, we must see to it that officers on the ground make sure that this law is respected. I think that goes without saying.

Do you think that the number of officers we give you is sufficient?

[Athana Mentzelopoulos]

Yes.

[Nicolas Dufour, Bloc, Repentigny, QC]

To give us an idea, how many visits or inspections can you give in a year? You can give us a range.

[Athana Mentzelopoulos]

I would appreciate the opportunity to provide that information to the committee afterwards. I didn't come with that information. My apologies.

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you very much.

As did my colleague, Ms. McLeod, a little earlier, I will talk about your "aggressive" plan.

You said earlier that you have "a significant body of regulations and prohibitions" at your disposal, and you added that you have "an aggressive work agenda for modernizing some of those regulations and for developing new ones."

Can you give us an overview of the new regulations you would like to create?

[Athana Mentzelopoulos]

May I just clarify? Are you speaking in the context of the Canada consumer safety action plan?

[Nicolas Dufour, Bloc, Repentigny, QC]

Yes.

[Athana Mentzelopoulos]

With the new legislation, we will have a suite of new tools that we don't currently have with the Hazardous Products Act. They include mandatory recall, which we don't currently have. They include the ability for us to demand tests and studies from industry at the highest levels of trade. We will have a general prohibition that states that industry cannot sell products that pose a hazard. For me, personally, the element that I think holds the most possibility in this context is mandatory reporting of incidents related to consumer products. That will give us intelligence about issues, injuries, and incidents that are happening with products early--soon--before we start to see a larger number of such incidents. And it will give us the information we need to respond quickly.

We are currently working on the implementation plan for the legislation. One of the things we have to consider is the balance between what the general prohibition can do and the extent to which we will continue to generate--and we do generate very vigorously--new regulations and prohibitions. The consideration there is that consumer products is an area where there is rapid change and where we see, frequently, an emerging hazard that sometimes in your wildest imagination you couldn't have anticipated. That's the beauty, in my view, of the general prohibition, and that will be where we put a lot of our work.

But we still plan to develop regulations. We've just yesterday done a first tranche of regulations for lead, and that's part of a four-phase lead reduction strategy.

[The Chair, Conservative, Joy Smith]

Thank you.

We'll go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

I'm finding this very interesting. In my life before becoming a politician, I was a chiropractor, and I used to see a number of injuries. It would be every year, whether they were from being out boarding or skiing. I've seen trampoline.... I've seen all kinds of falls on the ice. And I've come to the conclusion that living can be incredibly dangerous to your health.

I was wondering what you have seen. You put forward some numbers. Drowning is at 15%. Motor vehicle accidents are at 14%. I was surprised to hear you say that there are three provinces that don't have regulations for car seats. Suffocation is at 13%.

What have you seen as some of the very successful injury prevention initiatives and programs that have been out there, not only in Canada but around the world?

[Pamela Fuselli]

There are a number of successes, and I think it starts with a strategy. When we look at the EU countries, the ones that have been most successful in reducing their injury rates are the ones that have a plan, a plan with priorities, with resources, and with measurements. So generally, that's what I would say.

When we look at things like drowning, we look internationally at New Zealand, which implemented the four-sided pool fencing and saw its deaths due to drowning in young children reduced to virtually zero. So there are different strategies for different injuries, and that's where we rely on the surveillance data.

But we also rely on the data collection systems, like the CHIRPP data and the Canadian agricultural injury report, which provide us with contextual information. As injury prevention people, we need to know more than only the absolute numbers. We need to know what's happening around those issues. Around drowning, we needed to know that it was children accessing pools when they weren't meant to be swimming, so we could then look at what's effective in terms of strategies for implementation.

There isn't sort of one-size-fits-all. It depends on the injury issue that you're talking about.

Ms. Billings talked about the good practice guide that we're interested in, Canadianizing it from the European Child Safety Alliance. Basically, that goes through leading causes of death and looks at what evidence there is for effective interventions and then provides some case studies. My vision for Canada would be to have a document like this so that people working in injury prevention, in public health, in policy, will have some type of standardized information so that they can make good decisions, whether it's on education, whether it's on policy, or whether it's on environmental change.

[Colin Carrie, Conservative, Oshawa, ON]

It sounds like it's really a coordinated effort.

I have a question for the public health agency. We heard about the pools. I remember when I had my pool, we had all four...and that made a lot of sense to me. Why wouldn't municipalities have that as a mandatory thing? Obviously, you're partnering with Safe Kids Canada, but who else are you partnering with? Are you partnering with the provinces, the territories, the municipalities, to get this information disseminated? Some of it sounds like a lot of common sense that simply isn't getting out there.

[Jane Billings]

We're partnering at many different levels. One element of the partnership that has been crucially important to us across a number of different public health issues has been the Public Health Network expert group that panellists sit on. That's an area where we pull together experts from the associations, from academia, from the provinces and territories, to work on injury prevention and chronic disease prevention in a very orderly fashion in terms of setting a work plan, getting the agenda, gathering the evidence, making recommendations for interventions, and learning more about best practices. That serves to bring the jurisdictions onto a common page and acts as input to many of the strategies where we're working far better together with the provinces and territories. As a result, when the ministries of health announced this past fall, their declaration on health promotion, injury prevention, and prevention with an emphasis on obesity and injury prevention...the action plans being developed under those will be common across many of the provinces and territories and will rest on a lot of the work that the expert group does.

In addition, we have cross-department initiatives in the federal government on family violence, for example, where we're working with a number of departments on the federal family violence initiative. We also work with Transport Canada on helmet and road safety. We use their numbers, for example, on a lot of the traffic accident information. So we have networks that go across the federal family, so to speak, to try to get the various partners in.

Increasingly, we are working with the Federation of Canadian Municipalities on obesity prevention, healthy cities, and of course injury prevention, and what they can do in terms of standards.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Billings.

We'll now go to Dr. Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you to you all.

I don't know if this is correct, but I'm able to check stats here. This is 2007 data. It notes that since Nunavut was first formed in 1999, 233 in the territory have taken their own life, of a population of 30,000. If that's correct, that is absolutely devastating. That's about 0.8%. I just think we need to really focus on making real change here.

I'm going to ask about brain injuries now. Nationwide, there are about 34,000 brain injuries that lead to hospitalizations here in Canada; 6,000 will be permanently disabled as a result. We know for older children and adolescents that many injuries are related to recreational activities and sports. We know the young brain is more vulnerable.

I'll start with Ms. Fuselli. What would be your recommendations to this committee, a new federal action that we could take to perhaps reduce concussions in youth because of that vulnerability, and also because of new data looking at concussions and what it potentially can mean long term?

[Pamela Fuselli]

With my colleagues at ThinkFirst Canada and the Brain Injury Association of Canada, there has been an explosion of new information around concussions and sports injuries in particular.

For me--I'm not an expert in brain injury--the continued focus in terms of the cross-sectoral engagement is essential: the researchers, the physicians who are seeing the trauma, the rehab, and those living with brain injuries. But as with any other injury, the research is the most important, and the data, because that's what informs what we do that is effective going forward.

So a focus on an injury like a brain injury, which is lifelong, has a huge impact--and we are just learning the extent of these injuries. We continue to support the work of those experts in the area to find out more about what is most effective and to support that on a national basis.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Where are the gaps in data collection? For example, if you don't go to the emergency and you go to your physician the next day, that data is not captured. So where are the gaps, please?