Veterans Affairs Committee on Feb. 26th, 2013

[Nicholas Priest]

Certainly most of the relevant research relates to uranium rather than depleted uranium. Has it picked up and reviewed all of the available evidence on uranium toxicity? No, it hasn't. But there again, the Royal Society report was two volumes thick. The IOM report was extensive. I think the Capstone report that the Americans produced was about 1,000 pages long.

[Bob Zimmer, Conservative, Prince George—Peace River, BC]

Right. So I guess the key word is “effective”, right?

[Nicholas Priest]

As for whether I think it has adequately covered the area, I think the answer is yes.

[Bob Zimmer, Conservative, Prince George—Peace River, BC]

Yes, that's fair.

And last, in your opinion, does this final report complete the tasks requested of the committee, which were to “review and summarize the published scientific literature on the human health effects of depleted uranium and evaluate the strength of the evidence for causal relationships”?

[Nicholas Priest]

Yes, I think in respect to the latter part of that, it has done very well, in that it has gone back and looked at all of the relevant epidemiological data for uranium. I can't think it has missed anything, okay. It picks up all the major studies.

[Bob Zimmer, Conservative, Prince George—Peace River, BC]

And you agree with the findings?

[Nicholas Priest]

I agree with the findings there.

As I said, it's difficult to know where to draw the line. I'll tell you why. Uranium isn't toxic, radiologically. It's not uranium that causes the problem. It's the alpha particle that is generated the moment uranium disappears, and an alpha particle is an alpha particle. So strictly, the only thing that uranium does is determine where in the body that alpha particle is released. And other different materials, such as plutonium or radium, would have a different distribution so the alpha particles will be released in a different place.

So if you were going back and saying where do you draw the line, I could make a very strong argument to say, “Look, since it's the alpha particles that are causing the toxicity, you should go back and review all of the data on all of the materials that emit alpha particles”.

That would be a nonsensical thing to do, but it would be logically coherent. Okay? But I think that in terms of the scope of this, a reasonable job was done. Yes, you wouldn't get the same level of knowledge and understanding from a group reviewing it like this as you would if it were an expert group that came up and did it, but there again, you'd probably end up with a report you couldn't understand.

So I think they've done a reasonable job, a good job.

[Bob Zimmer, Conservative, Prince George—Peace River, BC]

So for all intents and purposes, and the purpose of this study, DU cannot be attributed as a factor in the negative health effects. Is that what you're saying?

[Nicholas Priest]

Personally I can think of no way that depleted uranium exposures of Canadian, British, American, or French personnel in either the Balkan or the Gulf War could have given rise to the adverse health effects that are claimed by the Gulf War veterans. Personally, if I were doing it, I would look at it given that the level of worry amongst veterans varies according to nation, and I believe that the French army has fewer concerns about Gulf War syndrome. It might be best to go back and look at some of the differences in practices between different operational groups within the Gulf War to see whether you can correlate the level of concerns within the population, the veteran population, with those practices.

The uranium aspect is the most unlikely of all, I think. It's not something that worries me in the slightest.

[The Vice-Chair, NDP, Peter Stoffer]

Thank you, Mr. Priest.

We'll now go to Ms. Papillon for a shorter round of four minutes in our second round.

[Annick Papillon, NDP, Québec, QC]

Thank you, Mr. Chair.

Mr. Priest, thank you for your testimony. Thank you for explaining why you agree with the report submitted by the Scientific Advisory Committee on Veterans' Health.

You also agree that there is no scientific research. Really the report is just a compilation of research and studies that are currently available around the world. So nothing has really been updated. In addition, like me, you saw that the case studies were excluded from the scientific approach in the report.

In light of that, do you still agree with that method, with the scientific approach that was used in the report?

[Nicholas Priest]

Could you repeat the first part of your question, please?

[Annick Papillon, NDP, Québec, QC]

The report does not include any new scientific research. It is simply a compilation of studies on depleted uranium, mainly American studies, as you said. In addition, the sample case studies were specifically excluded from the report. The samples were probably considered too small to carry out a proper analysis of the situation.

In light of that, do you still feel that the right scientific approach or method was used in dealing with the small sample, which may very well change everything?

[Nicholas Priest]

Okay, thank you very much. I apologize for asking you to repeat it. I was concentrating so much on the second part of your question, I forgot the first part.

Regarding the new scientific research, there haven't been any studies published recently, and that's because when you're studying populations and looking at these effects, you look at them over their lifetime. Then you might give occasional progress updates. For example, people are still studying the victims from Nagasaki and Hiroshima, the atomic bomb survivors.

So, you follow a cohort of people from the time of exposure to the time they die, and when the cohort has completely passed away, you can make a conclusive statement on whether or not you have any adverse effects.

In that respect, the studies that are the most important are the studies of workers, which were undertaken in the forties and fifties in Britain and the U.S.A., because there were a large number of people in those studies. If you have small studies, then they're subject to significant error. This is just a consequence of small numbers. If you toss a coin 1,000 times, it's going to be closer to a one-to-one ratio for heads and tails than it is if you toss a coin three or four times. So there is an inevitable concentration on the larger studies, because those are deemed to be the most powerful. Studies of people from a while ago—a lot of whom have died, and so we have a good history on those individuals—are the most powerful ones as well.

That is why I think it's justified to do that. I think it's very important to realize though that these individuals, these people, who claim to be damaged have real problems. Something caused those problems, and it's important to find out what caused those problems. I don't believe it was uranium.

[Annick Papillon, NDP, Québec, QC]

Exactly. The one case in a million may make all the difference. For instance, one individual may be particularly affected compared to the rest of the population.

The seventh conclusion in the report indicates that, when an individual needs appropriate care, physicians are responsible for providing that care, regardless of whether they have a diagnosis or not. Perhaps it is not possible to do the necessary tests for a diagnosis.

Do you feel that the individual must receive the proper care and that veterans must be given the benefit of the doubt?

[Nicholas Priest]

There's no real indication of super-sensitivity in individuals, which is, I think, what you were suggesting with the one person in a million. If we'd had super-sensitivity in people, I think it would have been identified by now, because, as I said, there are a huge number of people who are exposed to quite significant amounts of uranium in the world. It's a common thing. Everybody has uranium in them.

With regard to the treatment, it's not really very amendable to that. If you have uranium in the body, it's one of the materials that are difficult to remove. It gets deposited in the skeleton.

[Annick Papillon, NDP, Québec, QC]

Let me interrupt you for five seconds to ask you something. If the doctor says—

[The Vice-Chair, NDP, Peter Stoffer]

Madame Papillon, I'm sorry, but you're over your time. If you let him finish what he was saying, we'll carry on.

[Nicholas Priest]

I don't think there is any effective way you could easily remove uranium from the body of somebody without causing skeletal problems, because you have to mobilize the skeleton in order to release the uranium.

There are ways of removing it from the lungs, because you can remove particles. If people have cystic fibrosis, they do something they call lung lavage, whereby basically they pass saline down into the lung and wash the lungs out. You can actually do that; if somebody had a huge dose of particulate radioactive material, this is one of the things they would do, and you can wash the activity out. But you would never do that for depleted uranium exposure.

[The Vice-Chair, NDP, Peter Stoffer]

Thank you.

Now we go on to Mr. O'Toole, please, for four minutes.

[Erin O'Toole, Conservative, Durham, ON]

Thank you, Mr. Chair.

Thank you, Dr. Priest. It's very helpful to have you here today.

I'm going to change the order of my questions, first to address or perhaps clarify my colleague Madame Papillon's question, which I think didn't reflect the total report. She asked why not new research, as distinct from a global overview of existing research.

Wasn't it clear in the report—and please comment on your review of this when looking at the Balkans and the Gulf—that even with the close-in weapon system or CIWS on our ships, that is the Phalanx, there was no area of likely exposure for Canadian Forces personnel to DU anyway? That was a finding of the report, is that correct?

[Nicholas Priest]

Yes. There's no obvious route to exposure for Canadian Forces or for the vast majority of British or American or French forces that operated in the Gulf—

[Erin O'Toole, Conservative, Durham, ON]

So in those circumstances, wouldn't a review of the existing literature be appropriate?

[Nicholas Priest]

Yes. As I said, it's not true that no research is being done; these populations will continue to be monitored for the rest of their lives as part of epidemiological studies. It's just that you don't report epidemiological studies every year. You come back every five or ten years, or perhaps at an even longer interval than that, to report the study, particularly if nothing has been found.

[Erin O'Toole, Conservative, Durham, ON]

Thank you.

I'm going to be quick, partly because when you're in the second round you have less time.

You would have reviewed in your overview, your peer review of the study, the seventh conclusion, which talks about a small number of veterans who have persistent symptoms, many of whom had thought that DU might explain some of those persistent symptoms.

Let me ask a question similar to the one Mr. Zimmer asked. While we all agree that the symptoms, however they manifest themselves, are real, do you agree with the conclusion of the report that DU would not be the cause of these symptoms?