Health Committee on June 18th, 2015

[Mike Sullivan, NDP, York South—Weston, ON]

You mentioned that only less than 10% have tested their homes and Manitoba is the only place where there is some kind of government position, through Manitoba Hydro, or aggressive position, I guess, on this whole notion of testing and remediation.

Are you recommending that the federal government also enter the fray and start to provide funding? I can think of many in my riding who couldn't even afford the test, let alone remediation. Is there something the panel is suggesting as something we ought to be doing nationally?

[Prof. Anne-Marie Nicol]

Kathleen Cooper's work has suggested a tax credit and there also are tax credits or different kinds of financial incentives that can be done through loans for renovation. Quebec does have a loan renovation program for which one can apply. They've just added radon to that as well, so if you have up to $3,000 of renovation costs and over, you can apply for radon remediation within that work.

There are different models for doing it, but I do believe that financial incentives are what get people to change. I changed my hot water heater because I got a financial incentive to do it. Otherwise, I don't think I would have done that. If we think about it, if we're offered just a little bit, all of us might take that extra step, plus it shows a leadership role.

[Mike Sullivan, NDP, York South—Weston, ON]

Thank you.

[Dr. Tom Kosatsky]

Also, we all agree that radon should be built out in the first place. That is the most important thing to do. Test and remediate should also be directed to priority areas. If you're living in interior B.C., your risk of having a higher level of radon in your house, never mind whether you test or not, is definitely higher. The chance if you live in Victoria or Vancouver is low. You might possibly have a slightly higher level, but the risk of that, based on tons of evidence, tons of tests that have been done so far, is very low.

Really, if we want to get a message across to Canadians about testing and remediation, it should really be directed to those areas where it's highest. But we'd all be protected if we built it out in the first place.

[The Chair, Conservative, Ben Lobb]

Mr. Lizon.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you very much, Mr. Chair, and thank you to all the witnesses for being here.

First of all, I would like to thank the committee for agreeing to this study. It is my passion and I will be working on it because I truly believe that we should really address what is one of the major health issues that we have in this country.

To start, I have just a few basic questions for Mr. Kosatsky.

You mentioned in your presentation that lung cancer is actually different in smokers, in non-smokers.... Did you mention three types?

[Dr. Tom Kosatsky]

No. There are many types of lung cancer but the basic groupings of lung cancer tend to be different in non-smokers and in smokers so that if you looked at autopsy evidence, you would have a very strong chance of knowing whether the lung cancer you were looking at was occurring in a smoker versus a non-smoker without knowing the status of the deceased.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

If you look at a smoker who also is exposed to radon and at people who are exposed to radon only, how do those types of cancer compare? Or do they compare at all?

[Dr. Tom Kosatsky]

It's a good question. Nobody has done a study like that. One could do it. That would be something that the CIHR, the Instituts de recherche en santé du Canada, should get into, because it's worth it.

You can almost pick them out. Typically, a non-smoker radon-exposed person would have a typical non-smoking cancer. They would have an adenocarcinoma with an early presentation at a late stage that was very sensitive to treatment. They would more likely be a woman. If they're also a smoker, on the other hand, they would tend to approach a smoker's type of cancer, which is a squamous cell cancer, more likely small cell, more likely less advanced at time of diagnosis, presenting based on an X-ray, not on symptoms, and not very responsive to treatment.

If you smoke, it pushes it towards the smoking zone.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

This is probably a very basic technical question. Is the unit that's referred to a becquerel?

[Dr. Tom Kosatsky]

Yes, a becquerel.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

I understand—and I don't know, so correct me if I'm wrong—that the radon gas we get at home would probably have different levels of radioactivity. How does this unit refer to the level of radioactivity in a gas? As I understand it, it's not only the level of the gas itself, but there's also the time of exposure. I would assume that the level of radioactivity plays a very important role here as well.

[Dr. Tom Kosatsky]

It's slightly complicated, but I'll get onto one of my other hobby horses, for what it's worth. It's not the radon itself that causes the lung cancer; it's the so-called degradation products of the radon. Radon is an inert gas, so it doesn't attach itself to lung linings. It's when radon transforms itself by atomic degradation into a radioactive metal that the problem occurs, because that attaches to your lungs. That attaches to dust, so more dust in your house is a bad thing if you also have radon. That's really what causes the damage.

A becquerel is a unit of disintegration. One becquerel per metre cubed is one disintegration per cubic metre of space, so that 750 becquerels per metre cubed is 750 disintegrations per cubic metre of space.

[Dr. Sarah Henderson]

That's disintegrations per second.

[Dr. Tom Kosatsky]

Yes, per second per cubic metre. Pardon me.

Each one of those alpha particles that either the radon itself or the metals it produces or releases causes a packet of energy to get into any cell it's next to. Radon gas itself, because it doesn't react—it's inert chemically—tends to be farther away. The radon-related metals that it produces tend to be very close to the cell linings. When they also release these alpha particles, it's the alpha particles themselves that wreck the nucleus of the cell and that ultimately cause lung cancer.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Just one last, maybe—

[The Chair, Conservative, Ben Lobb]

A short comment, please, Mr. Lizon.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Yes, very short, Mr. Chair, because we were talking about an awareness campaign. Speaking for my constituents, the majority of them have no idea that we have radon and no idea about statistics.

When I go to a doctor's office, I see brochures about doing the PSA test or about checking my heart. I've never seen a brochure about checking my home for radon. Do you have any comments on that?

[Dr. Tom Kosatsky]

Both Health Canada and the BCCDC have encouraged doctors—those of us in British Columbia and Health Canada across the country—and have had awareness campaigns for physicians. We have issued pamphlets to physicians and have put it in the medical literature. Doctors can help with this, especially if their patients are smokers or live in high radon areas. They can do a lot to encourage people to do something to protect themselves from lung cancer. We could all do more, but we wouldn't need to do more if we'd build it out in the first place.

[The Chair, Conservative, Ben Lobb]

Thank you.

Mr. Hsu, go ahead, sir.

[Ted Hsu, Liberal, Kingston and the Islands, ON]

Thank you.

My first question is just to satisfy my curiosity a little bit. I'm trying to interpret one of the graphs that Ms. Henderson produced. It's the one where at the top of the page there are different numbers corresponding to becquerels. There's a jump in the graph for women for higher radon areas, from between 400 and 300. Is that just statistics?

[Dr. Sarah Henderson]

Yes, it will be statistics. Basically, we're taking the province of British Columbia and we're saying, okay, if we draw the line in the sand at 300, these areas are higher-radon and those areas are lower-radon; and if we draw it at 400, these areas are higher-radon and those areas are lower-radon. The more area we have that is higher-radon, the more data we'll have from that area, and things will stabilize a little bit.

When you're talking about pretty unpopulated areas of the region, there are not that many lung cancer deaths in any given year, so it's definitely a statistical thing where the data get more stable as the threshold gets lower.

[Ted Hsu, Liberal, Kingston and the Islands, ON]

Okay.

The y axis of these graphs doesn't cross at zero. Presumably there's a whole bunch of lung cancer from smoking, and then on top of that you're seeing the effects—

[Dr. Sarah Henderson]

That's right. This is all lung cancers. We don't know which ones are attributable to smoking and which ones are attributable to radon. All we can say is that the areas with more radon and the areas with less radon have different patterns.

[Ted Hsu, Liberal, Kingston and the Islands, ON]

Okay.

Is this the only study that has picked out the difference between male and female trends in high radon regions over time?