Second Update on Results of Lead and Arsenic Testing

A second update on results of health testing for lead and arsenic in the Sydney area was released today. Two hundred and fifty seven results have come back from the labs -- all but 14 of the 271 tests conducted so far.

A total of 13 people -- 10 children and three adults -- had levels of urinary arsenic requiring followup tests.

Seven followup tests, which check the results of the first tests, have also been received. Five of those seven tests are negative, while two remain above the followup level. One adult has a blood lead level requiring followup.

The results included three families, each with two members being followed up. Ninety-five per cent of the results are normal.

The results have been given to the individuals involved. Public health staff, in consultation with family doctors and others, are following up on those that were above the pre-set levels. Dr. Jeff Scott, the provincial medical officer of health, said the follow up level for arsenic, which is 20 micrograms per litre, was purposely set low to flag all potential exposures to arsenic.

"We don't expect to see health effects at this level," said Dr. Scott. "What we are seeing so far are normal, healthy children."

Followup procedures include confirmatory testing, testing of other family members, consulting with family doctors and investigating all potential sources of exposure to arsenic.

"People are concerned, but once we visit with them to explain what the test results mean and how we will be following up, they have a better understanding of the process," said Agatha Hopkins, director of public health services in the Cape Breton District Health Authority. "We appreciate that this is difficult for them and they're very co-operative and helpful with the followup investigation."

Because of soil concerns in the area, environmental testing on the property is being offered as part of the followup. All other potential sources of arsenic, including things like foods, pressure-treated wood, cigarette smoking, pesticides or herbal remedies, are also being considered.

While awaiting results of the followup tests, people are being given practical advice on reducing exposure to soil and dust. Such advice includes keeping children from playing in areas where there has been disposal of coal ash, which is known to contain arsenic.

If followup test results are still above levels, the person will have a medical assessment by the family doctor. There is a support and referral network in place for family doctors.

"If they need to, they can share information and consult with pediatricians or specialists whom we've made available as part of the testing program," said Dr. Scott. He said it is unlikely that treatment will be required.

Public health will continue investigation even when a follow up, or confirmatory test is negative. A confirmatory test may be negative for several reasons. The initial urine test may give what are referred to as false positives because first-morning urine tends to be more concentrated. The confirmatory test requires urine collection for a 24-hour period and is a more precise measure of exposure. It is also possible that any exposure that was happening had stopped at the time of the second test.

"To be certain, we're following up on all potential exposures identified by the initial test, whether they were confirmed or not," said Dr. Scott. "We will look for the source and make recommendations in the short term so health effects can be prevented," he added. Long-term, or chronic, effects of lead and arsenic are being considered in the risk-assessment process now under way.

The health testing program was initiated after environmental testing results showed elevated levels of substances such as lead and arsenic in the soil around the North of the Coke Ovens area.

Confirmatory testing and followup is ongoing. Another clinic is scheduled for Wednesday, Aug. 1, for pregnant women, children ages one to five and residents of the seven streets North of the Coke Ovens. An appointment can be arranged by calling 578-5575.

There will be a final summary report on the lead and arsenic testing within the next month. This report will contribute to the chronic risk assessment which will be completed Aug. 31.

BACKGROUNDER

The following is an interim summary report.

PROGRESS REPORT #2: Testing Program to Examine Current Exposure to Lead and Arsenic in the Residents around the Coke Oven Site

Cape Breton District Health Authority and Office of the Provincial Medical Officer of Health July 26/2001

Introduction

The Cape Breton District Health Authority and the Nova Scotia Department of Health are offering clinical tests to residents of neighborhoods near the Coke Ovens site to determine their current exposure to lead and arsenic. This document provides a progress report on this testing program.

The objectives of this program are to assess current individual exposures to lead and arsenic in the population living near the Coke Ovens Site in Cape Breton, Nova Scotia and to make recommendations to reduce exposure as appropriate. The specific target group includes children age 1 to 5 and pregnant women in Whitney Pier, North End of Sydney and parts of Ashby (including and north of Welton and Prince Streets) as well as individuals of any age living in the Area North of the Coke Ovens (ANOCO).

This program was developed in response to environmental sampling results that demonstrated lead and arsenic in the soil in ANOCO. These findings led to an escalation of concerns of residents in the area which, in turn, led to this testing program.

Testing Process

The testing protocol was developed after a review of the literature, consultation with experts and a review of testing programs in other communities. The testing program has been well publicized through public service announcements on the radio, newspaper ads, flyers handed out at schools and churches and through the news media. Individuals are invited to attend a community clinic where the testing process is explained to them and informed consent is obtained. Each individual provides a urine sample for inorganic arsenic and a blood sample for lead. The samples are sent to a specialized laboratory for analysis. Results with an explanation are provided to everyone tested.

Individuals who exceed a predetermined level of blood lead or urine arsenic are being followed up as appropriate on a case by case basis. Follow up may include confirmatory testing, medical assessment, assessment of other family members and of sources of exposure. Recommendations are made to reduce exposure as required.

This testing program is one of a number of initiatives looking at various aspects of risk to health in this area. Long term exposure is being looked at in a chronic health risk assessment being carried out by Health Canada.

Results

The first clinic was held on June 12/2001. 10 clinics have been held to date. Clinics are ongoing based on demand. The next clinic is being held on Wednesday August 1st.

These results are based on the information available as of the end of the day on July 25/2001.

To date 271 individuals have been tested for at least one of lead or arsenic. All individuals tested up to and including the clinic on July 11th have been advised of their results. No results are back yet for the July 18th clinic.

Lead:
271 individuals have been tested for lead. Results are available on 257. Blood Lead was normal in 256 out of 257 individuals. One adult from Whitney Pier had a blood lead level above the value set for follow up.

Arsenic:
261 individuals have been tested for urinary inorganic arsenic. Results are available on 247 individuals. Urinary inorganic arsenic was normal in 234 (95%) of individuals. Urinary inorganic arsenic was above the level set for follow up in 13 individuals. This includes 7 children age 5 or under, 2 children between the ages of 5 and 10 years of age, 1 child between 11 and 15 years and 3 adults. Of these individuals, 7 live in Whitney Pier, 4 in North End Sydney and 2 in Ashby. This represents 10 families because three families have two individuals who are being followed up.

Follow up is underway on all individuals with results above the predetermined level.

Results are now available for 7 individuals who had follow up testing for urine inorganic arsenic. Five individuals now have urine arsenic within the normal range. Two individuals have results that remain above normal.

Summary

Approximately 94% of the results of blood lead and urinary arsenic testing done to date are now available. Of these, one individual has a blood lead level that is being followed up and 13 individuals have a urinary arsenic level requiring follow up.

It is too early in the testing and follow up process to draw any conclusions. A final report will be prepared when the testing process is complete and all results are available.