Health Committee on Dec. 13th, 2022

[Ryan Pitchers]

As my colleague said about exposures to carcinogens, we were in the middle of hundreds and hundreds of homes at any one time that were burning all around us. Unfortunately, we didn't have the luxury of having our personal protective equipment on. Our breathing apparatus was not available, and, quite frankly, it wouldn't have been appropriate for what we were doing at the time.

Throughout the first week of the fire, we didn't have PPE. We didn't have an opportunity to shower, and we didn't have opportunities to clean ourselves to get contaminants off our bodies. They were in our fire trucks, they were in our homes and they were where we were sleeping. Unfortunately, we were sleeping on lawns and in different spots here and there. We couldn't get out of that toxic soup.

You talk about lifetime exposure, I suggest that it probably was. Dr. Nicola Cherry at the University of Alberta has done a study with respect to the respiratory effects of the fire, and they're starting to come up now. We're seeing our members deal with respiratory issues and the like, so I believe that, yes, there was certainly a lifetime of exposure to carcinogens and other issues.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

I'm going to open this question up to all three witnesses, and perhaps they can very briefly answer. Do you believe that regular screening for cancers linked to firefighting is critically important and is an important aspect of this bill?

[Neil McMillan]

Absolutely, it is. As mentioned, we are exposed to a number of chemicals. That affects us in a way that oftentimes practitioners are not fully aware of. A lot of great studies that have come out of the disaster with the World Trade Center show that solid tumour formation can occur with very short latencies.

As a member in Fort McMurray mentioned, these acute, really catastrophic exposures can have a real impact to tumorigenesis that occurs. The only way to get ahead of that is to get screenings. Whether it's lung cancer, ovarian cancer, prostate cancer or breast cancer, survivability when found in the first stage is exponentially higher than survivability when it's found in the fourth stage.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Does anyone else want to answer, or does everyone agree?

[Richard Amnotte]

I agree with what he said. There are studies that show the great advantage that screening has in catching a stage 0 or 1 cancer, compared to when you feel bad and see your physician and they detect the presence of a cancer. By then, it has grown to a degree that would be harder to heal than if it was at stage 1.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

As a kid, I grew up down the street from Fire Hall 3 in Fort McMurray, so firefighters have always been our heroes. They used to feed us when we were kids.

I want to point out a special medal that is underneath the name tag of Mr. Pitchers. That's his wildfire medal, which was awarded to him and to many frontline people in the aftermath of the Fort McMurray fire. I'll note that it has not been put on the same side as the rest of his medals. I'm using this as an opportunity—it's a shameless plug—to ask members from the government to help get this medal recognized by the Governor General so that our service members from Fort McMurray who were awarded this critically important medal for bravery for the wildfire can wear it on the left-hand side.

This is my shameless plug. This is an opportunity to stand up for the thousands of people who were awarded this medal in my community for their tireless bravery in what could have been an absolute disaster. They managed to do amazing work.

[The Chair, Liberal, Sean Casey]

Thank you, Mrs. Goodridge.

We'll go to Mr. van Koeverden, please, for five minutes.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Mr. Chair.

Witnesses, thank you very much for being with us here today.

Thank you very much for helping us with this study.

There's an old saying that an ounce of prevention is worth a pound of cure. I think the awareness element of this bill goes a really long way to ensuring that firefighters and firefighters' physicians are aware of the considerable risk involved, the sacrifice that firefighters make every single day for their communities and the potential health risks of the occupation.

I think this really comes down to two things. One is safety around prevention, screening and awareness. There's also justice and recognizing the true cost of the massive sacrifices that firefighters make every single day.

Just a couple of weeks ago, I had the privilege of joining a celebration of life for James Finn in Milton. He was the chief of fire, a member of the fire service in Milton for about 44 years and a public servant for 47 years in Halton. He was an awesome guy. He died from pancreatic cancer, which is not a recognized presumptive cancer for firefighting in Ontario, and I chatted with his son about that.

He was reassured and heartened by the fact that we're bringing this bill forward, but also disappointed that this is not a homogenous thing across the country. He was very grateful for your work, so I would like to thank all of the firefighters who advocated for this, as well as Sherry for all of her hard work and for dedicating her private member's bill to this.

My question is for anybody who would like to answer. It is around awareness, screening and prevention. It's also about some other potential interventions that could be done. Everybody who's ever visited a fire hall knows that they are the cleanest places on the planet, at least to the naked eye. Perhaps if you took a microscope to it, as you probably do, it might be a different situation.

My father had colon cancer when he was quite young, which made me eligible for a regular colonoscopy starting at a very young age. I had my first one when I was 35, which is a lot younger than your average person who gets screened. Because of that lineage and the added risk factor, I'm eligible, and I think firefighters should be eligible for early screening as well.

Do you have any comments or suggestions on additional interventions we could have, and additional measures for prevention, screening and awareness?

Thank you, gentlemen.

[Neil McMillan]

I agree wholeheartedly. I want to thank you for your comments, and I echo your thanks to the sponsor of the bill, MP Romanado.

Screening is important, and sometimes there can be a disconnect with primary care practitioners, who may not be aware of risk factors. The National Academies of Sciences, Engineering, and Medicine in the U.S. provided guidance for the practitioners of firefighters who have high rates of certain PFAS chemicals. That type of report is important, because when we have high levels of heavy metals and other chemicals in our bodies, we're looking to our doctors to give us recommendations, and they'll need to know what interventions exist to help reduce those contaminants within us.

Again, going back to Bill C-224, this framework will help provide the first step in ensuring that practitioners get the education they require about what we're exposed to, and then hopefully they'll build off that to generate recommendations for interventions.

[Richard Amnotte]

The College of Family Physicians of Canada needs to be aware of this reality, and needs to successfully communicate this information to all medical colleges across Canada.

Furthermore, we know that oncologists, that is to say doctors who specialize in the treatment of cancers, are not fully aware of the reality faced by firefighters in terms of the nature and seriousness of cancers. Statistical data shows that the risk of developing cancer among firefighters is somewhat higher than in the rest of the population, with percentages of 53% or 54% respectively compared to 44%. Most regrettably, the chances of survival are lower for firefighters than for the general population, with the risk of dying from cancer being 14% higher for firefighters than for the rest of the population.

The severity, progression, development and footprint of cancer are greater and more significant in firefighters than in the general population. The great advantage of early detection of cancer is that it can be cured or treated in its early stages, which gives firefighters a better chance of survival.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you very much.

Thank you, Mr. Chair.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. van Koeverden.

Mr. Garon, you have the floor for two and a half minutes.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you, Mr. Chair.

Mr. Amnotte, I understand from your last statement that everyone, that is to say doctors, colleges of doctors and governments, needs to be made aware of your particular situation. I understand that.

We looked into the matter and we realized that little research has been done on health prevention for firefighters. In fact, very little research and very few systematic research programs have been undertaken in Canada, except at the University of Ottawa and McGill University.

I feel that the federal government could, sooner or later, also be made aware of this situation and fund more research on occupational health and safety prevention and exposure.

We also talked about the flame retardants used in the production of all kinds of household goods.

I'd like to know if you have a position on that, on long-term investment in research, so that we know more about your situation.

[Richard Amnotte]

I totally agree. We need to ensure sufficient financial support for the research and science community. This would allow us to make progress in the development of means of prevention and protection for firefighters against the effects of smoke from fires.

It would also allow us to determine as quickly as possible whether the means put in place are effective. To date, these measures are recognized as the best practices known in the fire service community, and they are most likely based on the American model and, increasingly, on the methods and models developed in Canada.

A number of questions need to be asked. Is washing with water and soap sufficient? Is the type of respiratory protection adequate? Are the fabrics used to make firefighters' clothing appropriate and do they block as much of the contaminants as possible?

Zero risk does not exist. However, we must get as close as possible to zero risk, and every means and measure counts.

We believe that the wording of Bill C‑224 would open this door to the Canadian government and the scientific community. It would allow the research to continue, while engaging the stakeholders, and ensuring that the safety of firefighters is taken into account.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Garon and Mr. Amnotte.

The last round of questions will come from Mr. Davies, please, for two and a half minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Mr. McMillan, for my last question, I'm going to pick up on presumptive cancer legislation. Which province would you say currently has the most advanced list in the country?

[Neil McMillan]

On the most advanced list, I would mention the Province of Manitoba and some of the new changes in Nova Scotia, as well as Newfoundland and Labrador and the Yukon. They are leading the way. There is still work to be done because a lot of the latency periods that were applied were initially applied when the presumptive cancers were first established, based mostly on epigenetic research.

For instance, my cancer was not recognized. However, if I were in about 20 or so U.S. states, I would have almost three times the number of years of service required to be recognized. I fell short with my cancer, so it's not just about the number of cancers but about the latency and other disqualifying factors. For instance, there are 23 chemicals shared between cigarette smoke and smoke from residential fires; they're analogues of each other. Smoking can disqualify certain members from claiming for cancers they acquired from their job exposures.

With respect to the question on funding research and prevention, the IAFF has stood up a whole department on that. Our members know the value. We have skin in the game. We have locals who don't even make $15 an hour who are taking money out of their pockets for us to pay for research. That's why I commend all of you for supporting this bill, because it shows that you're standing alongside firefighters in this effort.

[Don Davies, NDP, Vancouver Kingsway, BC]

This is probably the last question I'll have time for.

What's the most important next step that you see once this bill is passed in order to realize the potential of it?

[Neil McMillan]

I think the next step—and hopefully it will be quick—is for January to be recognized as firefighter cancer awareness month across the country and to have funds. If you want something, you have to pay for it. We want the funding for research, for prevention and for awareness to be made available quickly, because science takes time and some firefighters just don't have that time.

[Don Davies, NDP, Vancouver Kingsway, BC]

Is there a number that you recommend?

[Neil McMillan]

I would say as much as is financially responsible.

[Don Davies, NDP, Vancouver Kingsway, BC]

You mean as much as possible.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you very much, Mr. Davies.

To all of our witnesses, thank you so much for being with us and for sharing your experience and expertise. Most of all, thank you for your service.

We are now going to move to clause-by-clause consideration of the bill. Witnesses are welcome to stay, but they're free to leave.

Perhaps we can suspend for about three minutes so the supporting crew for clause-by-clause can take their positions.

The meeting is suspended.

[The Chair, Liberal, Sean Casey]

I call the meeting back to order.

We are now going to move to clause-by-clause consideration of the bill. Just for members' information, we have a couple of people here to support us.

You will see Tim Singer online. He's the director general of environmental and radiation health sciences at Health Canada. If there are technical questions about the bill or the proposed amendments from a departmental perspective, Mr. Singer will be able to help us.

We also have with us, as legislative counsel, Marie-Hélène Sauvé. She will be able to help with any of the procedural, technical and legal elements of the amendments.

Before we start, I'd like to provide members of the committee with some instructions and a few comments on how the committee will proceed with clause-by-clause consideration of Bill C-224. I know you heard this script before when we went through the process on Bill C-31.

Amendments will be considered in the order in which they appear in the bill and in the package each member has received from the clerk. Members should note that amendments must be submitted in writing to the clerk of the committee. Amendments have been given an alphanumeric number in the top right corner to indicate which party submitted them. There's no need for a seconder to move an amendment. Once moved, you'll need unanimous consent to withdraw it.

During debate on an amendment, members are permitted to move subamendments. These subamendments must be submitted in writing. Once every clause has been voted on, the committee will vote on the short title, the preamble and the title of the bill itself. An order to reprint the bill may be required—if amendments are adopted—so that the House has a proper copy for use at report stage.

Pursuant to Standing Order 75(1), consideration of clause 1, the short title, and of the preamble are postponed.

The chair, therefore, calls clause 2.

(Clause 2 agreed to)

(On clause 3)

Is there any discussion?

Go ahead, Mr. van Koeverden.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Mr. Chair.

Amendment G-1 has been circulated. I move that clause 3 be amended by replacing line 15 on page 2 with the following:

ing with the goal of improving access for firefighters to

Would the committee like an explanation, or are we all in agreement?