National Defence Committee on Dec. 10th, 2024

[Mario Simard, Bloc, Jonquière, QC]

Thank you, Mr. Chair.

Mr. Salisbury, thank you for the explanation you gave regarding causality. In medicine, perhaps there is too much focus on treatment and not enough on causality.

The fact that DND has a hard time recognizing the occupational illnesses of people in the armed forces suggests that the data are not actually representative of the reality. I'm thinking of Ms. Beauchamp's situation. From the department's standpoint, what can be done to deal with and support people with chemical exposure-related illnesses, if the data aren't available?

I gather that, once someone is out of the Canadian Armed Forces, it's difficult to get a diagnosis that proves the causal link between the illness and the person's exposure to chemicals on the military base.

Isn't there a data gap in the department's decision-making?

[Col (Ret'd) David Salisbury]

Thank you for your question.

I won't respond in French, because my hearing aids have made it very difficult for me to understand French directly.

Yes, I believe there is a gap, and I think it is both bureaucratic and scientific. I'll take my own example. I had 11 different postings in a 28-year career. In at least three of those postings, I had four offices. How are you going to document all of the exposures I possibly had? That's not to mention the inadvertent ones I had from doing aircraft accident investigations, when I was dealing with the combustion products of an aircraft fire, or the six months I spent in Croatia, where nothing was documented.

It's very difficult for us to put two and two together. If we demand causation proof, we're going to undercare for the people who have illnesses.

[The Chair, Liberal, John McKay]

Thank you, Mr. Simard.

Ms. Mathyssen, you have two and a half minutes.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Along that same line, one of the questions I had for Veterans Affairs, Dr. Salisbury.... I didn't understand why they weren't ultimately doing that, seeing that there were these large issues of toxins and so on, and just attributing that presumptive diagnosis. There was also an explanation from them that the reason they didn't follow more of that American model under the PACT Act was that in the United States, veterans affairs has its own direct health administration.

I'm not sure if I buy that. I would love your opinion on that, considering whether the government decides it's going to treat this with all seriousness.

What would you have to say in that regard?

[Col (Ret'd) David Salisbury]

I don't think we can create in Canada something similar to the VA in the United States. This is an enormous health delivery organization that's actually bigger than the military itself in its provision of services.

It's not right to say that we can't use presumptive diagnosis as a guide for who we're going to provide care for and who we're going to look after. We could come up with our own version in Canada of what we believe to be places that are worthy of that consideration and a list of diagnoses to go with them. We have lots of research around the world. The ILO list that the previous witnesses mentioned is a good starting point. Also buried in or integral to the PACT Act is what the presumptive diagnoses are and what exposures the VA in the United States is currently prepared to compensate for and deal with.

There is no reason we couldn't just borrow it 100%. I don't see any harm in doing that. We spend too much time fighting about compensation and too much time.... We've devised an adversarial system, and it shouldn't be an adversarial system. That may work in law, but it doesn't work in medicine, so I think we need to go there.

[The Chair, Liberal, John McKay]

Thank you.

Mr. Stewart, you have five minutes.

[Don Stewart, Conservative, Toronto—St. Paul's, ON]

Thank you, Mr. Chair.

Thank you to the witnesses for being here today.

I was thinking about this as a bit of a statistical exercise in some regard, to figure things out. In a perfect world, we could have a computer box and put in all of the illnesses that have been diagnosed, the sites where people have lived, worked and served, the list of ILO chemicals, the jobs, the lengths of time people were in places and some other factors we could come up with.

Could we not then feed that data into a computer with some AI and come up with some relationships that would allow us to put a pretty darn good estimate on a relationship—maybe not causation—among those factors to allow us to assign some responsibility?

[Col (Ret'd) David Salisbury]

I'll give you an example.

The ILO document is a 620-page document. It has already done that for you. It links it by exposure and by what diagnoses they consider to be occupational diseases, or occupationally related to that. As I indicated earlier, you can't just blindly accept this, because, as I said, there is the attributable risk issue. It's estimated that 45% to 50% of all Canadians will develop cancer. Of course, we are all exposed to environmental hazards. How are we going to tease that out?

I think the issue needs to be that we provide care, look after the people who are sick, and stop arguing about causation. I know that will be unsatisfactory for some people. We need to start concentrating on care for people who are sick and not have them battle the bureaucracy over compensation and owning up to some responsibility. That is only wasting a lot of resources, which could be better spent on providing care to the patients who need it.

[Don Stewart, Conservative, Toronto—St. Paul's, ON]

I'm wondering about the chemicals that are persistent for some length of time.

What is going on at Defence sites now, in locations where we have these chemicals in the ground and have exposure?

[Col (Ret'd) David Salisbury]

I'm sorry. You're way out of my wheelhouse on that one. I haven't been in uniform for 20 years.

[Don Stewart, Conservative, Toronto—St. Paul's, ON]

Thank you for your service as well.

Maybe this is a question for Gary or Eileen.

What kind of outreach has DND offered in terms of talking to you about exposure to chemicals, what you might have been exposed to in the past and in what concentrations, and where, when and for how long?

[Gary Goode]

I can answer that question.

We've had two meetings with Saleem Sattar, the director general of environment and sustainability at DND. He started off by giving us a PowerPoint-type presentation on the two and a half barrels the Americans sprayed there in 1966 and 1967, over a seven-day period.

He did not mention or allude to the fact that DND sprayed 6,504 barrels of the exact same chemical starting back as early as 1956. We asked him about that.

[Don Stewart, Conservative, Toronto—St. Paul's, ON]

Does DND come to you and say, “You may be concerned about this, because we have x number of people who have developed such and such illnesses and they were in the same spots you were”?

[Gary Goode]

No, they have not done that.

Actually, the fact-finding project done at Base Gagetown was, in my opinion, pretty much designed to focus entirely on 1966 and 1967 and on the two and a half barrels the Americans sprayed. It didn't disregard the fact that they sprayed other chemicals, but they did not come forward with the amount of chemical they sprayed, and what those chemicals were.

For example, in 1956, they sprayed—

[Don Stewart, Conservative, Toronto—St. Paul's, ON]

I have one other question for you.

Are you collaborating with any other organizations to conduct research?

[Gary Goode]

No, I'm not collaborating with any other organizations to conduct research. You would have to elaborate on which organizations you might be referring to.

Personally—

[Don Stewart, Conservative, Toronto—St. Paul's, ON]

It's an open-ended question.

[The Chair, Liberal, John McKay]

Mr. Stewart is going to have to elaborate in some other manner.

Our final questioner is Mr. Powlowski.

You have five minutes for this round.

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

Dr. Salisbury, before I started working here, I had a real job, as a doctor. Anyhow, I agree. As a doctor, you don't worry about causality. Who cares? Somebody has cancer.

Certainly, what we do here.... This goes far beyond this particular subject of the military. Every day, people get cancer. As you say, 40% of people, or whatever the numbers are, will get cancer.

We know that certain things in the environment may lead to cancer, but as a government, as you regulate industry, as you regulate the military, as you.... If it's government money, we do have to worry about the public purse. The real issue would seem to be how far we go in trying to link an exposure to an actual outcome and to bear the financial obligations that come with that, whether it's us, as a government, or private businesses. However, we, as the government, set the rules, right? This is, and I think increasingly ought to be, an issue for governments: how to attribute risk and how far we go in trying to link an outcome with the causality. This seems like a monumental problem.

If you look specifically at the issue before us, can you tell us whether the military has looked at and examined people who lived in different places at different times? For example, we've heard here about Gagetown. Have they looked at whether people who've served at Gagetown from any particular period of time have a higher risk of, for example, certain kinds of cancers?

[Col (Ret'd) David Salisbury]

I wouldn't know the answer to that, certainly not during my time at the directorate of force health protection. That single question would be a monumental epidemiological study.

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

I wonder if, perhaps, there isn't a little bit of an answer to this. If we have the records, we know who served where. We also have the epidemiological records as to who gets what kind of cancer. Certainly, in the old days—which was, like, a year ago—it would take a monumental effort to try to match those up, but with AI.... Are there efforts within the public health world to use the computer strength of AI to match those things up and say that, yes, if they served in Gagetown between this year and that year, then they have, statistically, a 50% higher chance of developing bladder cancer or something?

[Col (Ret'd) David Salisbury]

That would be how you do the study, but the issue will be that if we date it from the acknowledged date of exposure to Agent Orange in 1966 and 1967, that is 60-plus years times an average number of people in the armed forces of between 90,000 and 100,000, with changing cohorts of who's in that group and varying amounts of exposure, some not exposed at all and some exposed.... I mean, it is a huge puzzle.

It's doable. Certainly, AI is coming to the fore in public health in doing those kinds of studies if the documents are digitalized, which they may or may not be. Of course, if you want to get back to an individual, then you have a privacy issue, and you have to deal with that if you're going to run a study.

I'm not going to say that it's not doable, but I wonder if the amount of effort would be worth the benefit you'd get out of it as opposed to saying, “Let's just say that with regard to the people who were there at such-and-such a time and have such-and-such a diagnosis, we're going to look after them.” That would be much simpler.

A lot of compensation.... We're badmouthing the DND, but this is true of workers' compensation writ large. All our workers' compensation systems are set up on an adversarial basis.

[The Chair, Liberal, John McKay]

I'm sorry again. It seems as though all I do is interrupt and say “sorry”. It's rude, and I feel bad.

I also feel bad that the bells start ringing at 5:52. Apparently they're 15-minute bells, not half-hour bells. That means that we are going to have to wind up at 5:52. We'll go for a third round of four minutes. I have Bezan, Lapointe, Simard and Mathyssen for that four-minute round.

If that is satisfactory, Mr. Bezan, you have four minutes.

[James Bezan, Conservative, Selkirk—Interlake—Eastman, MB]

Thank you, Mr. Chair.

I want to thank our witnesses for being here.

Mr. Goode, you said that the dioxins from Agent Orange and other pesticides that were used at Gagetown are caught up in the soil and will have environmental effects for the next 100 years.

Are we doing soil sampling and testing of the land there to see how bad that contamination is? Do you know if National Defence is carrying out that monitoring?

[Gary Goode]

Going back to the Gagetown base area fact-finding project, there were samples taken, yes. They stated that the majority of the levels of dioxin, for example, were mostly in the areas that the Americans sprayed in '66 and '67, the Clones bivouac area, the Murphy bivouac and some ranges, which would be the rifle range, the grenade range and the rocket range. They were all sprayed repeatedly. They were reported as high as 50, 75 and 143 times above the limit of the Canadian Council of Ministers of the Environment for dioxin in the soil.

I personally spoke with Dr. Furlong in his office in CFB Gagetown during that fact-finding project. He informed me that the Clones bivouac area alone was 170 times above the limit of the Canadian Council of Ministers of the Environment, not 143.

I have no idea what they're doing now.