Thank you very much, Mr. Chairman and members of the panel. I'm very grateful for this opportunity today.
I apologize for not providing bilingual materials, but I received my invitation just a week ago, so the timing didn't work out to take advantage of your translation services.
My name is Margaret Sears. I am here as someone with some knowledge on the subject matter—a very limited knowledge on the subject matter—but more importantly, as a scientist interested in environmental health as well as methodology in this field.
I am inspired by working with Dr. David Moher's research group here in Ottawa at the Ottawa Hospital. He is among the world's premier methodologists in clinical epidemiology, a highly respected and influential scientist. I also work in environmental health, was funded as a principal investigator for a Canadian Institutes of Health Research project. I'm associated with research institutes at both CHEO and the Ottawa Hospital, and have worked with Canadian medical specialists in environmental health preparing reports for the Canadian Human Rights Commission, the Canadian Transportation Authority, the Alberta Energy Regulator, and others. I have been a guest editor for peer-reviewed medical journals and have co-authored several systematic reviews. That's enough about me.
Regarding Safety Code 6, I made submissions to the Royal Society of Canada and to Health Canada, and Dr. Moher and I also attended a meeting on September 19 with Mr. Adams, Dr. McNamee, and Ms. Bellier.
I also recently responded to the World Health Organization during consultations on their review of health effects of radio frequency radiation. I'll briefly answer one of the questions about that. That consultation document is only partially done. There were no conclusions associated with it, and according to the method section, the literature search ended in 2011, so it's far from complete. So it is nothing that we could be basing anything on at this stage. And it also had no tables of evidence or anything like that in it.
In short, I see major problems with the reporting of these studies, which should reflect on the execution of these reviews. If a review is not well conducted, it is subject to bias and incorrect conclusions.
Last year, the prominent medical journal, The Lancet, published a series of articles on waste in research that was not adequately conducted or reported. It is a big problem, wasting a lot of money on badly conducted and badly reported research.
You have been provided a paper by Rooney et al describing the most recent methodology for systematic reviews in environmental health. The reviews of health and frequencies covered by Safety Code 6 that I have examined, including many of the authoritative reviews relied upon by Health Canada, are lacking salient features of systematic reviews, as summarized in the chart you have been provided. They have also captured but a fraction of the literature, according to what's referenced, with organizations referring to the validity of one another's reviews.
On the other hand, I have a sample of one of the systematic reviews that I co-authored. It's on the relatively narrow topic of dietary supplements and cardiovascular drugs. This is a concern for a much smaller segment of the population than radio frequency radiation that we're all exposed to, but we started from scratch because there was no good review to base it upon, and initially we screened over 33,000 records. There are methods and software established to handle this kind of volume of literature. In a 2012 presentation, it was stated by Pascale Bellier that Health Canada has reviewed 50 years of research. Canadians are waiting to see this evidence because it is not evident to date.
Systematic reviews address specific questions, not really general questions so much, so you have to parse your question to be able to tackle it with really good methodology. They are collaborative. They're transparent. Certainly these processes with Health Canada leave a lot to be desired. Systematic reviews address ingrained biases.
You can only build upon previous reviews that are of high quality. Without previous high-quality reviews to build upon, we have to go back to that 50 years of data. What we have currently is a bit like that telephone game in which messages get mixed up as they're half-heard while they are whispered to one another around the table.
I also believe that there's good reason for concern in this field. Safety Code 6 is said to protect against “established” health effects. What does it take to establish a health effect? Sometimes that hurdle is very high, and there's a somewhat arbitrary bar, because people are.... We'll talk about that in a minute, but keep in mind that every time you hear “established health effects”, there is the question, what does it take to establish a health effect?
I'll give you a couple of examples of research. In the slides that were distributed to you, there is a table with cancer studies. The clearest research originates from Hardell's group in Sweden, comparing phone use between people who had brain tumours and healthy individuals; this is called a case-control study. In Sweden, the background rate of glioma is, I believe, lower than in Canada. We do not properly capture details of brain tumour incidence in Canada, although a database is being set up.
Higher risks, up to fourfold increases, were seen in Sweden with use of wireless phones, both cellphones and cordless phones. The risk of a tumour on the side of the head the phone was held against increases when use begins earlier in life, so children and adolescents are at greater risk, with longer cumulative time on the phone and more years of use. But only part of this information was referenced by the Royal Society of Canada.
The Interphone Study was referenced. This was an enormous study extending over 13 countries, and the diversity of health status and co-exposures really muddied the waters in this study. For example, in some countries, having a phone was a symbol of wealth and was associated with a healthier diet and a cleaner environment. Initial analyses showed that cellphones protect you from cancer, which even the author said was a completely implausible effect, and it was because of this confounding. Further analysis did show higher tumour incidence with phone use.
These two human studies were key in the IARC determination that cellphones possibly cause cancer. But since then, the French CERENAT study was published in 2014. It was not referenced in any of the documents from Health Canada or the Royal Society. It is similar to the Hardell studies. When the analyses were performed in the same manner, the results were basically replicated. So now we have that replication, and such replication is key to becoming an established health effect.
Another concern relating to cancer is women who carry their phones in their bras. Phones are sending signals constantly to keep in touch with a network, even when you're not talking. The first case was reported in 2009, in a keen cell phone user who stored her phone in her bra for 10 years. Cases are piling up of characteristic tumours in young women with no known genetic predisposition. This information also was not taken into account, as far as we know. Maybe it was, but it was certainly not documented that it was taken into account.
Now, if women carry phones in their bras, men carry a lot of phones in their pockets. In Canada, we have some problem with infertility. This is one of many studies showing effects on sperm—there is a graph in your handout. When exposed to typical radiation from phones in pockets, sperm stop swimming, their DNA is damaged, and they die.
What we see in people is backed up by much other research into cells and animals. A lot of the recent research demonstrating potential harm was omitted from reports that supported Safety Code 6, as was discussed previously.
I should say that in the comments regarding the ability to assign a dose to an exposure, what happens in this research is that, if animals are merely exposed to a phone.... With a phone, it's hard to say that the exposure is precisely such and such a number, but it's status quo. But these status quo phone exposure studies are discarded. There's a huge body of evidence that is discarded just because they used a phone instead of something that was more “scientific”.
In summary, I'd offer three recommendations.
First, Health Canada must systematically access, assess, and act upon all the science from scratch. It needs specific tools as well as methodological and library expertise to accomplish this.
Second, we have to open our eyes and collect this environmental health data, both exposures and health outcomes. On that, I would note that the regular compliance data that Industry Canada is accumulating should be made public, so that if a doctor is concerned, he has that data to connect the dots.
We also have to be collecting really good, detailed cancer incidence data. We used to collect that, but it's not available any more. The Public Health Agency of Canada has some data on their website. It used to be reported in small areas, but now it's only reported at the provincial level.