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Health

Aftermath of Canadian submarine fire: PTSD, asthma and depression

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HALIFAX — The commander of the Royal Canadian Navy issued an apology Thursday to the sailors who fought a deadly fire aboard the submarine HMCS Chicoutimi in 2004, saying a five-year delay in releasing a study on their health is unacceptable.

“For this delay, for which I can offer no explanation … and for our failure to continue communicating routinely with the ex-crew during the intervening period, I have offered my unreserved apology,” Vice-Admiral Art McDonald told a news conference at Canadian Forces Base Halifax.

“We should have done better, and we will do better.”

The study, which should have been released in 2014, found the submariners suffered from elevated levels of post-traumatic stress disorder, depression and asthma between 2004 and 2009. However, no cases of cancer were reported during that time frame.

The used British submarine, one of four purchased by the Canadian military in 1998, was on its maiden voyage to Canada on Oct. 5, 2004, when it caught fire in rough seas off the coast of Ireland.

Navy Lt. Chris Saunders later died from smoke inhalation, and two other crew members were badly injured by the toxic fumes.

“He and his family will forever remain in the thoughts of the Royal Canadian Navy,” McDonald said. “Each and every sailor on board Chicoutimi acted admirably and heroically.”

After the fire, virtually all of the crew spent an additional five days on the sub — working on equipment covered in grey soot — as it was towed to safety in Scotland.

Another group of military personnel, a 42-member contingent known as the care and custody team, provided security and maintenance for the submarine after it arrived in Scotland.

Their health during the first five years was compared with the sub’s crew and a control group made up of 152 healthy submariners.

Navy officials confirmed that one crew member died in 2016, but they declined to confirm the cause of death, citing privacy concerns.

The study found 60 per cent of the sailors aboard the vessel when it caught fire were diagnosed with post-traumatic stress within five years.

That means the 56 crew members were 45 times more likely to be diagnosed with PTSD than the control group, none of whom reported a PTSD diagnosis. The rate of PTSD among the custody team was one per cent.

Col. Rakesh Jetly, the military’s senior psychiatrist, said it would be difficult to say anything conclusive about the PTSD numbers.

“The reality is, it’s a number,” he told the news conference. “We don’t have a comparison group. It’s not like there’s seven similar sub fires within our NATO alliance that we can compare our rates to the other.”

However, Jetly said it was important to note that all of the submariners had been exposed to a deeply traumatizing event.

“Within seconds, in a high sea state, a complete blackout. You couldn’t see. A fire was there. There were casualties … It’s one of those events that imprints on people … The number 60 per cent? It wouldn’t be surprising if it was higher.”

The study also found that between 2004 and 2009, 21 per cent of crew members reported suffering from asthma and 15 per cent were battling depression — rates well above what was found within the custody and control groups.

The study also found the submariners required more sick leave, and the proportion of sailors released from the military for medical reasons — 12.5 per cent — was more than double the rate for the other two groups.

However, no cases of cancer were reported among the crew during that time period, even though the military has confirmed the sailors were exposed to a nasty chemical cocktail in the thick, black smoke that filled the vessel.

The navy shared the results with serving and former sailors earlier in the day, and officials offered them three options for a longer-term study that will look at the period between 2009 and 2019.

Over the past 14 years, many sailors have come forward to state they were worried about being exposed to toxic fumes that are known to cause cancer, but the navy has repeatedly noted that the fire was extinguished quickly, resulting in limited exposure.

In May 2005, a board of inquiry determined that as the sub’s conning tower was being repaired on the surface, a rogue wave pushed a torrent of seawater through two open hatches, partially flooding two compartments and causing an electrical short-circuit and fire.

In June 2008, the navy produced an 89-page report that said the fumes and soot likely contained recognized carcinogens such as benzene, polycyclic aromatic hydrocarbons, dioxins and furans.

And it said the crew likely inhaled cancer-causing contaminants.

”The actual risk of developing cancer will depend on the amount, or dose, of exposure,” the report said.

The report also found that the known carcinogen Peridite — a noxious insulation adhesive — was among the materials that burned in the blaze.

At the time, military officials insisted it was unlikely crew would develop any form of cancer since their exposure was limited to the fire and the five days they spent breathing in the fumes.

Though the 2005 board of inquiry concluded that “human factors” contributed to the tragedy, the submarine’s captain and crew were cleared of any blame.

The 700-page report recommended numerous improvements to Canada’s submarine fleet, including more splash-proof electrical insulation, better firefighting training, and restrictions on when a sub’s surface hatches can be open.

Michael MacDonald, The Canadian Press




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Health

Food fight: Liberals, Tories trade shots as pre-campaign battles intensify

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OTTAWA — Health Minister Ginette Petitpas Taylor is trying to distinguish the Liberals as a party of scientific, evidence-based policy while she says Conservative Leader Andrew Scheer is spreading misinformation about Canada’s new food guide.

Petitpas Taylor held a news conference in Ottawa today, along with her colleague Marco Mendicino, to say the Conservatives are willing to throw away research and evidence underpinning the creation of the new dietary guide.

In January, Health Canada released an overhauled document that did away with traditional food groups and portion sizes and focused instead on broader guidelines, including eating more plant-based protein and drinking more water.

Last Wednesday, Scheer told an annual gathering of the Dairy Farmers of Canada in Saskatoon that the process to craft the new version of the document was “flawed” and that the guide needs to reflect what “science tells us.”

He also pledged that a Conservative government would “absolutely” review the guide, adding there was a “complete lack of consultation” on the new version.

Petitpas Taylor’s news conference followed an appearance by the Conservatives’ Pierre Poilievre, attacking the Liberals for bringing back Gerald Butts as a campaign adviser following his resignation in the SNC-Lavalin affair last winter.

The Canadian Press

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Environment

Lyme-spreading ticks so common thanks to mild winters, some places stop testing

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Lyme infected ticks becoming common in Canada

OTTAWA — Lyme disease has settled so deeply into parts of Canada many public health units now just assume if you get bitten by a tick, you should be treated for Lyme disease.

In Ottawa, where more than two-thirds of the ticks tested in some neighbourhoods carry the bacteria that causes Lyme disease, the public-health unit no longer bothers to test ticks at all.

Dr. Vera Etches, the unit’s top doctor, said that in 2016 and 2017 more than one-fifth of black-legged ticks tested in Ottawa came back positive for Lyme.

“That’s a threshold,” she said. “Once you know that more than 20 per cent of the ticks in your area carry Lyme disease bacteria then we don’t need to check in on that. That is what we now call an ‘at-risk area.’ “

That means if a tick is found on a person, and is believed to have been there for more than 24 hours, then the patient should get antibiotics to prevent Lyme infection, even without any testing of the tick. It takes 24 hours before bacteria in the tick’s gut move to its salivary glands and are transferred to a person.

After three days, the preventive treatment won’t work so patients then wait for symptoms or enough time for antibodies to evolve to show up on a test. It can take more than a month before symptoms appear. They’re mostly similar to the effects of influenza, including fever and aches, as well as — usually but not always — a rash. It typically takes just about as long for the immune system’s antibodies to show up on a lab test.

If left untreated, Lyme disease can cause serious illnesses such as meningitis, but Etches is quick to point out that because it is caused by a bacteria, it’s treatable with drugs.

“It’s a good-news story, actually, that there is antibiotics that work to treat Lyme disease,” she said.

Most public-health offices in Canada used to test ticks submitted by the public, as well as conducting their own surveillance by actively seeking out tick populations and testing them. Some, including Ottawa’s, have decided now that Lyme is endemic, they should shift to public education and prevention as well as treatment.

Lyme disease was named after the town of Lyme, Conn., where the first case was diagnosed in 1975. It is caused by bacteria that are traded back and forth among black-legged ticks and migratory birds and small mammals like mice and chipmunks. Ticks bite birds and small mammals infected with the bacteria and get infected and then spread the disease when they bite their next victims.

Before 10 years ago, most of the cases diagnosed in Canada were in people bitten by ticks while travelling in the United States. But climate change has led to southern Canada seeing milder winters, which means the ticks that migrate to Canada on the backs of migratory birds are now surviving the winter in larger numbers, spreading the Lyme-causing bacteria more rapidly.

Canada started keeping track of Lyme disease cases in 2009, when 144 cases were confirmed or considered probable. Only 79 of those cases were believed to have been contracted in Canada.

In 2017, more than 1,400 cases were confirmed or probable across the country, more than two-thirds of them in Ontario and most of them believed to have been contracted locally.

National statistics for 2018 are not yet available but in Ontario, the number actually fell significantly, from 967 in 2017 to 612 in 2018. Etches said that was because 2018 was hotter and drier than 2017, and ticks thrive in wet, cool weather.

A 2014 study by the National Collaborating Centre for Infectious Diseases at the University of Manitoba suggested the Lyme-carrying ticks are expanding their territory by about 46 km a year, an expectation being borne out in health units’ mapping

In 2017 and 2018, Point Pelee National Park near Windsor, Ont., was considered to be an at-risk region but the rest of Windsor-Essex County in Ontario’s southernmost tip was not. In 2019, almost all of the county has been added as an at-risk area.

In 2017 all of Nova Scotia was declared to be at risk for Lyme Disease.

In New Brunswick, six of 15 counties were declared at-risk as of 2018.

There are also at-risk areas for Lyme in southern Manitoba, northwestern Ontario, British Columbia and Quebec. While some cases of Lyme have been found in the other four provinces, the numbers are very low and mostly contracted elsewhere.

Mia Rabson, The Canadian Press

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