Health Committee on Dec. 13th, 2022

[The Chair, Liberal, Sean Casey]

I call the meeting to order.

Welcome to meeting number 49 of the House of Commons Standing Committee on Health.

Today we meet for two hours to consider Bill C-224, an act to establish a national framework for the prevention and treatment of cancers linked to firefighting.

Today's meeting is taking place in a hybrid format, pursuant to the House order of June 23, 2022.

For those participating online, I have a couple of reminders. On the bottom of your screen, you have interpretation. You can choose floor, English or French. For those in the room, you can use your earpiece with the same three options. For those participating online, I remind everyone that taking screenshots or photos of your screen is not permitted. The proceedings will be made available via the House of Commons website.

In accordance with our routine motion, I am informing the committee that all witnesses have completed the required connection tests in advance of the meeting.

I will now welcome the witnesses who are with us for the first hour of the meeting.

From the Canadian Association of Fire Chiefs, we have Mr. Richard Amnotte, second vice-president, French Language and Language Diversity.

We have, from the Fort McMurray Firefighters Association, Mr. Ryan Pitchers, battalion chief, by video conference; and from the International Association of Fire Fighters, Mr. Neil McMillan, the director of science and research.

I thank all the witnesses for being with us today. Let's get started.

Mr. Amnotte, welcome to the committee. You have the floor for five minutes for your presentation.

[Richard Amnotte, Second Vice-President, French Language and Language Diversity, Canadian Association of Fire Chiefs]

Thank you, Mr. Chair.

The Canadian Association of Fire Chiefs would like to thank the Standing Committee on Health for the opportunity to express its views on Bill C‑224.

My name is Richard Amnotte, and I am the assistant director of the City of Lévis fire service and the second vice-president of the association's board of directors.

I am here today to lend my unwavering support to C‑224 along with our invaluable colleagues from the International Association of Fire Fighters, which represents thousands of firefighters in Canada.

Founded in 1909, the Canadian Association of Fire Chiefs represents the leaders of some 3,200 fire services across Canada, both permanent and volunteer. The association boasts an advisory board with representatives from each of Canada's provinces and territories, their fire chiefs' associations, as well as affiliated associations.

Our vision is to unite the leaders of the Canadian fire and rescue services. Our mission is to advance fire safety to ensure better protection against fire and other disasters across Canada.

Last week, nearly 40 Canadian fire chiefs were on Parliament Hill to meet with members of Parliament and members of the Senate from all parties and present the results of a major Canadian fire service survey and the state of fire services today, which is more critical than ever before.

We sincerely thank all MPs, senators and cabinet members for listening and being open-minded and open-hearted to the alarming findings and to the solutions we propose.

As our president, Ken McMullen, director of the Red Deer fire service in Alberta, so aptly put it, fire safety is a team sport, and we are all part of that team.

One of the requests that has been made is to ensure that there is an adequate response capability for firefighters in Canada. Every citizen, no matter where in Canada, is directly affected. The results of our survey were picked up by Ici Radio-Canada in 19 Canadian cities, in addition to CTV and Global TV, to name but a few.

According to our study, there are 126,000 firefighters in our great country, that is, 36,000 permanent firefighters and no less than 90,000 volunteer firefighters. Our survey also shows that there is a shortfall of more than 15,000 firefighters to adequately respond to the emergency calls of Canadians.

Several measures could be taken to recruit and maintain the necessary number of firefighters, and thus ensure better safety. These include increasing the tax credit for volunteer firefighters from $3,000 to $10,000, reinstating the joint emergency preparedness program to upgrade firefighters' equipment, maintaining funding for mental health programs for first responders, and passing Bill C‑224, An Act to establish a national framework for the prevention and treatment of cancers linked to firefighting.

Why is it so important to pass this bill? Cancer is simply killing too many firefighters. The bill is clear, consistent and respectful of the jurisdictions of different levels of government. It recognizes that a firefighter is a firefighter, whether he or she is from my home province of Quebec or from anywhere else in Canada, from a large city, a rural municipality or an aboriginal community, whether he or she is a permanent or volunteer firefighter, regardless of gender or age. Cancer does not discriminate.

Last week, more than 50 scientists, researchers and firefighters gathered in Ottawa for the first Canadian workshop on prioritizing cancer research in firefighters. We heard chilling accounts of the number of firefighters dying from cancer and other firefighting-related illnesses. The situation is alarming and concrete action must be taken immediately.

Bill C‑224 would provide a national framework for the research, prevention and treatment of firefighter-related cancers. It recognizes that the work of firefighters presents a particularly high level of risk because they work in a very different context, in a noble way, to protect the lives of Canadians from fire.

In conclusion, we sincerely thank MP Sherry Romanado for introducing Bill C‑224. We also thank all parliamentarians for being sensitive to the need to provide a better living environment for Canada's firefighters.

I reiterate our unwavering support for Bill C‑224.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Monsieur Amnotte.

Next we will hear from the Fort McMurray Firefighters Association. Mr. Ryan Pitchers is online.

Welcome to the committee, sir. You have the floor for up to five minutes.

[Ryan Pitchers, Battalion Chief, Fort McMurray Firefighters Association]

Thank you, Mr. Chair.

Good morning. On behalf of the Fort McMurray firefighters, IAFF 2494, I am grateful to be with you today to talk about my experience as a 22-year firefighter, currently serving with the rank of battalion chief, and to share my thoughts on why I support Bill C-224.

Six years ago, the world watched in astonishment as images of our city being overtaken by a massive wildfire were flashed across the news. Few people could forget the images of tens of thousands of citizens fleeing the area in their vehicles with a massive ball of flames in the background. I'll never forget hearing the ominous radio call from a fellow captain ordering crews to clear the Beacon Hill subdivision of the city as a 50-foot wall of flames started to engulf scores of houses in the area. My heart dropped and my thoughts ran amok when the scope of this emergency hit me.

With citizens evacuating, firefighters from Fort McMurray and eventually other cities in Alberta rose to the immense challenge in front of us, saving as much of the city as we could from the flames that were rolling mercilessly across our neighbourhoods street by street, and protecting the egress of our citizens and our own families trying to get out. Firefighters worked beyond the point of exhaustion, working up to 48 hours straight with little to no sleep and no food, putting themselves in immediate danger almost every minute, day after day. We endured smoke so thick it was choking. We felt intense heat as we chased rolling embers from street to street in our attempts to quell the massive wildfire. We did this for six days until the flames finally moved on.

In Fort McMurray 2,400 structures were lost, but I'm proud to say that 25,000 were saved. I think I can speak for my fellow firefighters when I say that it really was our finest moment, and a landmark in our careers that we will never forget.

Sadly, however, the dangers to the firefighters who raced to save Fort McMurray did not end when the smoke faded and the last of the flames were extinguished. The danger persists to this day in the form of illnesses that firefighters have suffered as a direct result of the massive, acute exposure to the toxic carcinogens we endured during this heroic response. These toxins were the product of tonnes of combusted organic and man-made materials cast into the air in thick pillows of smoke impossible for a firefighter to completely avoid even with modern personal protective equipment.

Three Fort McMurray firefighters contracted cancer in the immediate aftermath of the 2016 wildfire. One of them, Chris Relph, my good friend, died tragically of an aggressive form of cancer rarely seen in younger people. A proud and hard-working firefighter originally from Bathurst, New Brunswick, Chris was just 29 years old when he passed away in 2018, leaving behind a loving wife and a two-year-old daughter, in addition to his parents and other grieving family members.

The long-lasting effects of the 2016 wildfire on the firefighters who responded are still being studied. These also included respiratory problems and mental health injuries. We're concerned that more cancers may develop among the firefighters who helped save Fort McMurray.

We have all come to learn that cancer is an epidemic in the fire service. In Alberta alone, we have lost 51 full-time firefighters to job-related cancers in just the past 10 years. We have heard that a firefighter's cancer could be a cumulative effect of exposures throughout their career, or it could be a result of exposure during one specific emergency. For Fort McMurray firefighters, the wildfire of 2016 was that emergency.

We also know that cancer is a problem in fire departments across Canada. As firefighters, we have all lost colleagues to this terrible disease, we have all attended funerals and we have all consoled grieving family members while coping with our own grief. If anything can be done to reduce cancer's toll on our profession and our families, let's please do it.

Cancer in the fire service is a national problem that needs a national solution, one that strives to recognize the impacts of situations like the one we faced in Fort McMurray while creating equity and fairness for all firefighters across this great nation who risk their health and safety every time the alarm sounds and the trucks start rolling.

Bill C-224 addresses cancer in the fire service at a national level with measures that would undoubtedly make a difference and save lives, in my view. It proposes a solid framework that touches every aspect of this issue, defining the link between cancer and our profession, engaging the medical community and promoting research, data collection, knowledge-sharing and early cancer screening for firefighters, among other measures.

I'm grateful to my MP, Laila Goodridge, for inviting me to testify before this committee, and to MP Romanado for bringing this bill forward. It gives me comfort knowing that cancer in the fire service is becoming a national priority and that our federal government has our backs when we are putting ourselves in harm's way on behalf of our fellow Canadians.

Thank you, and I'm happy to answer any questions you may have.

[The Chair, Liberal, Sean Casey]

Thank you very much, Mr. Pitchers.

We'll now go to the International Association of Fire Fighters, represented by Mr. Neil McMillan.

Welcome to the committee, sir. You have the floor.

[Neil McMillan, Director, Science and Research, International Association of Fire Fighters]

Thank you very much, honourable members and Mr. Chair.

My name is Neil McMillan and I'm from the International Association of Fire Fighters. I serve as director of science and research. I'm here today, invited by the member of Parliament for Vancouver Kingsway, Don Davies, to speak in support of Bill C-224.

I truly believe that you can't have healthy communities without healthy firefighters. I wish to thank you for committing to extinguishing cancer in the fire service. When voiced like that, it can sound like a monumental task. As the IAFF's general president Ed Kelly has said, “Before you can do it, you have to say it.” I'm here for all of my sister and brother firefighters to “say it” and bear witness to the bold steps you are all taking to protect those who serve others.

The grim reality is that firefighters face a stacked deck. Over the last 10 years alone, we've recognized 420 Canadian IAFF members who have died of occupational cancer, which represents 95% of all professional firefighter line-of-duty deaths during that time frame. Firefighters, by all accounts, are a healthy workforce, yet we experience a staggering incidence of cancer—over 3,300 in this province alone. Awareness, prevention, research and early detection are key in turning the tide of occupational cancer in the fire service. Firefighter research has proven that mortality rates drop by a factor of 12 when cancer is detected through proactive screenings, as opposed to the appearance of noticeable symptoms. We also know the cost of a fatal firefighter cancer is seven times higher than that of a non-fatal cancer.

I've witnessed firefighter families being denied recognition and facing financial hardship due to the cancers acquired, which would be readily accepted in neighbouring provinces or in jurisdictions in the U.S. However, it's important to know that in most respects, the science has been settled. The World Health Organization's IARC reclassification of firefighting is proof of this.

Now, I would be remiss if I did not mention the brave members of IAFF Local 18, who serve MP Davies' riding in Vancouver. John Hudson is one of the firefighters who served out of station 15 on East 22nd Avenue. John is a survivor of two occupationally recognized cancers. Another firefighter who worked out of station 15 is Brandon Currie. He was diagnosed with cancer at the age of 26. Brandon returned to duty earlier than recommended by his doctors. He answered calls, even though he was frequently sick from the treatment he received.

Prior to serving in my current position with the IAFF, I rolled down these very streets here in Ottawa as a firefighter with Local 162. After 13 years of fighting fires, at the age of 37, I was diagnosed with cancer. In 2021, another Ottawa firefighter, Ryan Hill, who worked a few short blocks from here at station 13, died of brain cancer the day after he turned 37 years old. He left behind a widow and two young boys, Ryker and Reilly. Through five brain surgeries, and in under a year from his diagnosis, cancer took everything from him. However, he hung on to hope. Cancer took his strength, memory and dignity, but it didn't take his love for the job.

Ryan died with the uncertainty of not knowing how his young family would support themselves. It took all the resources of the IAFF to combat the City of Ottawa's attorneys, who claimed his cancer had nothing to do with his career as a firefighter despite physicians' reports to the contrary. Only after we fought multiple claim denials was his cancer successfully recognized as work-related. Your community's firefighters and their families should not have to battle bureaucracy while at the same time battling cancer. Most do not have the resources.

I applaud your proposed framework as a path to a harmonized system that will better serve this nation's firefighters, but the fact remains that it's too late for many of us. It's too late for the families of Les McBride, Gordie Moore and Martin Michels, all of whom died recently of pancreatic cancer. It's a cancer for which coverage is dependent on which postal code you fight fires in. For Martin, it was our pensioners who passed the hat to pay for his immunotherapy. If Martin had served in one of the five provinces that now recognize pancreatic cancer, he would not have looked for a handout to receive the treatments he needed, and his death would be officially recognized for the sacrifice it was.

It's not too late for our daughters and sons, who will one day follow us into this noble profession. For them, there is hope. It's the same hope Ryan held on to. Bill C-224 transcends parties, because from coast to coast to coast, no matter what community you represent, firefighters are there answering the call and keeping their oath. Every time they leave the station when the alarm is struck, they're willing to lay down their life to save the life of another. For those reasons, I again thank you all for providing that hope, taking that action and being brave enough to “say it”.

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you very much, Mr. McMillan.

We'll now proceed with rounds of questions.

Colleagues, I propose doing two full rounds, which will take us a bit past the top of the hour. It should still leave us enough time to do clause-by-clause. As we get closer, if there are any concerns about that, please let me know.

We're going to start with Dr. Ellis for six minutes.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much, Chair.

Thank you to the witnesses for being here. It's certainly an important topic.

One question I have specifically relates to families. Mr. McMillan, maybe we'll start with you.

You referenced two cases specifically and I heard you talk about families. One was a firefighter named Ryan and one was named Neil McMillan. If you could speak to that specifically, I'd like to hear about the impact that this bill may have on families.

[Neil McMillan]

The recognition is what's important for most families. They're willing to give up weekends and holidays with their family member who's serving in the community as a firefighter. There are certain risks to that, like not knowing whether their family member will come home at the end of their shift. When that family member acquires an illness that's attributable to their workplace occupation, it revictimizes the families when there's no recognition of that.

With the inequity I see in how certain presumptive cancers are being covered across different provinces, it's my hope that through this bill and the language within it, there will be an impetus from the federal level to help with that harmonization. Fighting fires is the same whether you're in Montreal, Ottawa or Vancouver. The chemicals we're exposed to are the same, and the application of prevention measures, awareness measures, and presumptive benefits and entitlements should be the same.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I understand you're on the International Association of Fire Fighters. How close does this get Canadian jurisdictions to being in line with what we're seeing internationally?

[Neil McMillan]

There are many different jurisdictions that operate differently. Some will recognize any cancer that is attributable to an IARC-recognized chemical, which allows for certain jurisdictions to be flexible with their coverage. For instance, in a lot of provinces, esophageal cancer is covered and colorectal cancer is covered, but anything in between is not, whereas tracts—digestive tract and reproductive tracts, whether male or female—are covered because the science has caught up.

As stated by a number of individuals who were in Lyon and participated in the reclassification of firefighting as an occupation for IARC, the science is settled. Out of all the different characteristics of carcinogenesis, half of them already have sufficient information that says firefighting is linked to them, whether it's chronic inflammation or oxidative stress. There are also some of the epigenetic effects and genotoxicity. We need an impetus for some of the acts, statutes and legislation to catch up.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Mr. McMillan, I have some questions for your colleagues, but as a final thought from you, if anything could have been added to this, what do you think might have been a good addition?

[Neil McMillan]

I think this bill is a fantastic start. What I'd like to see is that it's passed quickly.

This bill has been recognized. My colleagues in the U.S. have recognized it. Different state legislatures have recognized it. It's really setting the benchmark for progressive legislation that best protects those who protect their communities, such as firefighters.

All I can ask is that this bill is passed quickly so that the hope I mentioned that the families are holding on to can be reaffirmed.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much.

Richard, we heard very clearly from your numbers that there's a significant lack of firefighters. The numbers are going down.

Will this bill help that or hinder it by bringing light to the even more dangerous parts of the profession?

[Richard Amnotte]

For one thing, for sure it will help individuals understand the risks associated with firefighting. In addition, it would provide hope to the current firefighters to stay on board and remain firefighters, because there are ways they will be better protected through science, through development and through better PPE, for example. Early screening would allow them to detect the source of the cancer at early stages for better medical care. The bill will also avoid making people afraid of becoming either a volunteer firefighter or a full-time firefighter.

Yes, the bill will help to acquire the numbers that are definitely required in our country to better protect our population.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much for that.

Mr. Pitchers, maybe you could talk a bit about the impact on your family of being a firefighter and how this bill may help that.

[Ryan Pitchers]

Personally, I've dealt with many members in our department, and five members of ours have died from cancer in the last 10 years. A couple, unfortunately, were not covered. Christopher Relph, as I mentioned before, was not covered under the provincial legislation in this province due to the fact that his cancer didn't meet the time periods. We're currently in the WCB appeal process to try to get it covered.

How this affects my family is about the knowledge and understanding that they may not be covered going forward. That always weighs on my wife's mind. There's a possibility that I won't be covered should I unfortunately contract cancer as my fellow colleagues did. That's always on their minds, and it's a bit sad for them to not have the knowledge that they would be fully covered.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you very much.

Thanks, Chair.

[The Chair, Liberal, Sean Casey]

Thank you, Dr. Ellis.

Next we have Dr. Powlowski, please, for six minutes.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Good morning.

I know this is a bill to establish a national framework and not so much about the specific contents of what would be included in that framework.

I wonder if you could tell me—partly out of curiosity, but I don't know the technical problems—how much of the exposure to carcinogens is through inhalation and how much is through skin contact and having clothes and equipment that are contaminated and bringing those home.

As for respiratory inhalation, my understanding is that you have some sort of respirator if you're going into a smoke-filled area, but surely before you go in you have to put it on and there's some exposure of smoke beforehand, possibly after, with remnants on the clothes.

What is the etiology of the exposure?

[Neil McMillan]

The exposures are wide and varied for firefighters. Overall, just so you understand, we carry a high body burden of toxins, chemicals and carcinogens. The respiratory route of exposure is still real and still there. A lot of the work done by Dr. Ken Fent and Dr. Gavin Horn has shown that the hazardous zone outside of the internal structure has lots of particulate matter, polycyclic aromatic hydrocarbons and volatile organics, so even the firefighters operating from the exterior of a structure fire are exposed.

We're also really good at harvesting and depositing contaminants, and studies on fire stations note that there are a number of polybrominated flame retardants and PFAS chemicals being deposited in fire stations, as well as heavy metals and a lot of PAHs. That is problematic because there is a sense that wearing a self-contained breathing apparatus will protect you.

We have seen a lot of new studies with respect to dermal exposure specifically. Jennifer Kerr just published one recently, this month, showing the high rates of polycyclic aromatic hydrocarbon metabolites found in the urine, with the expectation that those have been absorbed within seconds or minutes of being inside a structure.

We don't have the opportunity to engineer out these exposures as firefighters. We're going to be exposed to them. As mentioned last week, there are PFAS chemicals in our bunker gear. There are PFAS chemicals in AFFF use. There are all sorts of routes from absorption, inhalation and ingestion.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

How much is prevention amenable to certain measures you take after exposure to a fire?

Maybe it was Sherry who brought this up last week. In Toronto and Montreal, after somebody goes into a fire, they get hosed down. It's probably more complicated than being hosed down, but basically there's a procedure to decontaminate you after exposure.

How much difference is there between what big fire departments do and what smaller departments or volunteer firefighters do?

[Richard Amnotte]

Fire services across Canada have put in place several measures to try to reduce exposure to contaminants, both in terms of the concentration of contaminants and the duration of exposure. The measures must be implemented equally across the country. At present, fire services with permanent structures may have more financial resources and may be more likely to effectively implement exposure reduction and decontamination measures.

One of the objectives of Bill C‑224 would be to ensure that this information is shared more widely across the country so that good practices developed in one province can also be shared in all other provinces and around the world.

The other specific element that we need to consider in Bill C‑224 is the research aspect. Are the methods we use today actually reducing exposure to contaminants and their uptake? Are there new methods or technologies that would allow us to protect firefighters and at the same time strike a balance between overprotecting, which would create problems for firefighters, and reducing the uptake of contaminants by the respiratory or dermal route?

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

I think this is a difficult question, but how concerned are you that this bill will establish standards—perhaps expensive standards—for post-exposure reduction of risk? How able are volunteer firefighters, for example, to access that same sort of protection?

Is this going to create liabilities for volunteer firefighting units that may not have the ability to undergo the decontamination steps post-exposure? Are you worried about the liability and the fact that volunteer firefighters won't want to do it because they don't have the means to meet the same standards as, say, big, urban units?

[Richard Amnotte]

I can understand that some fire services might find it difficult to make the investments that would allow them to do this. However, failing to do so would mean ignoring a reality: the risk of cancer is always present, whatever the structure of a fire service, whether it is small or large or whether it has permanent or volunteer firefighters.

Fire services will have to make this shift to ensure better protection for their firefighters. Indeed, they should not have as their only recognition the possibility of developing cancer. It is scientifically proven that the threat of cancer is present among firefighters. A structure must be put in place to ensure the protection of firefighters.

That is one of the reasons why I said in my speech that the Canadian Association of Fire Chiefs wanted the joint emergency preparedness program to be revived. This would make new money available to Canadian fire services to purchase the equipment they need to protect firefighters while protecting the Canadian public.

Canadian firefighters are the first line of civil defence in Canada. Canadian citizens depend on the effectiveness, performance and presence of firefighters across the country. Without it, their safety is necessarily at risk.