Asbestos hotzone

Petrochemical heartland home to vigilant MDs

The Sarnia area is home to several large industrial plants. According to a report by Ecojustice, evidence suggests the local environment— and the health of its residents—has been severely compromised.

In Sarnia, Ontario, caregivers are constantly on guard for workplace-related health problems, while advocating for a cleaner community

SARNIA, ONTARIO. | It isn’t very often that a small medical clinic gets credit in a high-profile report by an influential environmental group.

But then few clinics are as focused on the health impact of a specific area’s environmental and workplace pollutants as the Occupational Health Clinic for Ontario Workers (OHCOW) office in Sarnia, Canada’s petrochemical heartland.

Sarnia’s roughly 75,000 residents contend with arguably the worst air pollution in the country, according to the report published in October by Toronto-based Ecojustice (formerly the Sierra Legal Defence Fund).

To whit: According to industry data compiled by Environment Canada and cited by Ecojustice, there are 46 large effluence-emitting industrial plants in Ontario within 25 km of Sarnia. On the U.S. side of the St. Clair River, the body of water on which Sarnia sits, there are 16 similar facilities. In 2005, the Canadian smokestacks alone emitted more than 5 million kg of pollutants deemed to be toxic, Ecojustice said.

“The toll these emissions are taking is dramatic and there is growing evidence that the health of the residents of Sarnia and the Aamjiwnaang First Nation (a Sarnia-area reserve), and the local environment has been severely compromised,” said Ecojustice.

Yet while that report focused on the air pollution, all elements of Sarnia’s natural surroundings are affected by the region’s concentration of heavy industry. As a result, the OHCOW clinicians “see no distinction between the ambient environment and the workplace,” when they contemplate the health of the region’s population, said Dr. James Brophy, (PhD), executive director of the Sarnia office.

It is because of that lack of distinction that Dr. Brophy, who is also an occupational and environmental cancer researcher, and his physician colleagues decided to work with Ecojustice, he explained in an interview.

“We believe Ecojustice has performed an important public health role in alerting the community about the extent of environmental exposures emanating from the petrochemical industry,” said Dr. Brophy.

OHCOW is a six-city clinic, born of the provincial labour movement in the late 1980s, and specializes in handling workplace-related health problems. Its physician services and office overhead are largely funded by the Ontario Workplace Safety and Insurance Board.

While OCHOW’s core patient population is current and past workers of the major industries, its Sarnia health professionals worry about the risks the wider Sarnia population faces, including outdoor workers such as construction crews, landscapers and home remodellers, people “who are out there in this environment every day,” said Dr. Brophy.

Despite clear and ample evidence that much of Sarnia’s population faces a frightening day-to-day reality as a result of the pollution, the doctors must nevertheless keep their medical objectivity.

Dr. Abe Reinhartz, a general practitioner here, explained “patients often come to us with undifferentiated health complaints, and they are interested in exploring whether or not there is a workplace connection.”


A worker memorial stands guard in Sarnia.
He continued, “Often, we can make a diagnosis here of some other ailment that is not work-related, and get patients to communicate with their primary-care physician or initiate a referral ourselves to get a problem sorted out.”

Dr. Reinhartz noted that despite their concerns about Sarnia’s pollution, for physicians such as himself, “it is not so easy to clinically tease out the environmental exposures in terms of health effects in an individual.”

He said wider, epidemiological studies are better suited to revealing those negative health implications of pollution than individual patient investigations.

Dr. Reinhartz, for one, doesn’t see himself and his colleagues as environmental activists as the term is popularly understood, despite their involvement with Ecojustice and an Aamjiwnaang environmental committee, but more as “patient advocates for their medical-legal rights.”

The OHCOW doctors said their public profile has led to occasional negative feedback from other doctors, ones who to Dr. Reinhartz “are paid by corporate entities to provide medical services and are very willing to toe the party line.”


“We should be aiming for zero emissions or zero releases, and supporting industry in that way.”
—Dr. John Howard
Real-world laboratory
For Dr. John Howard, a professor of pediatrics and medicine at the University of Western Ontario Schulich School of Medicine in London, Ont., Sarnia, in Ontario’s extreme southwest, offers an unintentionally perfect real-world laboratory for bringing home the lessons of the ecosystem health courses he teaches to his school’s medical students.

Dr. Howard, who has been to Sarnia many times and works closely with Sarnia’s OHCOW clinic, recalled grimly an image that to him typifies the plight of the area. On the Aamjiwnaang reserve, “right by the river . . . there is this sign that says, ‘Doing anything in this water is toxic.’ ”

Ecosystem health is geared toward training doctors to “think of (a patient’s) health in a very broad sense . . . to try to think of the sickness in the human as a symptom of the environment.”

In February, the governing federal Conservatives, a party critics say is not given to especially sensitive views on the environment, called the St. Clair River “severely contaminated,” especially immediately downstream of Sarnia, and would spend up to $3.3 million to clean it up.

Dr. Howard said he believed the river clean up would have a benefit for Sarnia, but “we should be aiming for zero emissions or zero releases, and supporting industry in that way.”

The Sarnia OCHOW clinic spends a lot of time dealing with what Dr. Brophy called the largest documented cohort of asbestos diseases—patients with pleural plaques, asbestosis, lung cancer and mesothelioma—in Canada. Asbestos, a high-profile pollutant in the 1970s and 1980s, remains a major environment-related killer in Sarnia. “There is barely a blue-collar family that hasn’t been directly affected or doesn’t know somebody who has.”

Asbestos is so prevalent in some parts of the city that the soil is toxic. Dr. Reinhartz’s colleague, Dr. James Mackenzie, recounted how several years ago the province proposed a new offramp of Highway 402 in an asbestos hotzone. The clinic’s doctors took part in a community (and government) awareness-raising campaign about the soil’s toxicity.

The offramp was eventually built, but the ground was treated like the toxic waste site it was: The area needed to be decontaminated by construction crews who had to don hazmat gear, while their equipment—even their trucks and tractors—needed to be constantly scrubbed down, recalled the doctors.

They physicians have also taken other high-visibility roles, such as after a news release in 2000 in Sarnia, “publicly indicating what the risks of benzene exposure are,” among other things.

Matthew Sylvain
May 06, 2008
www.medicalpost.com