A. C. Goddard Hill, B. Sc, MD, CCFP

 General and Family Physician

 306-210 Dundas Street East

 Belleville, Ontario K8N 5G8


July 24, 2009


Dr. Arlene King

Chief Medical Officer of Health

Public Health Division

Ontario Ministry of Health and Long Term Care

11th Floor, Hepburn Block

Queen's Park

Toronto ON M7A 1R3


Re: Clarington Incinerator EA


Dear Dr. King,


Thank you for the reply from your manager of the Environmental Health division, Mr. Amalfa, to my letter to you of May 24, 2009 on this issue.


Enclosed is some further material which I have assembled for your consideration.


I believe that there are problems with this proposal, as there are in air quality regulation by the Ontario Ministry of Environment.


I would be grateful for your opinion.


Sincerely yours,


Alban Goddard Hill


cc. Dr. Robert Kyle, Commissioner and Medical Officer of Health, Durham Region


Dr. Richard Schabas, MOH, Hastings Prince Edward Counties


Dr. Peter Munt, Chief of Staff, Kingston General Hospital


Dr. Elaine Macdonald, Ecojustice




Clarington Incinerator Proposal :


Outstanding Issues :


Verbatim extracts from Peer reviews and other sources,


on the Clarington SSHHRA,


each illustrative of problematic issues.


Submitted to the Chief Medical Officer of Health, Ontario


Dr. Arlene King


Alban C. Goddard Hill, B.Sc, MD, CCFP


July 23, 2009


FROM SENES EA Municipality of Clarington PEER REVIEW, July 6, 2009


1. From Senes, comment 3, "There is a fundamental concern with the generation of the CALMET meteorological wind fields, which if inappropriately represented will introduce bias in the results and potentially over or underestimate impacts at various locations."


2. comment 4, "The purpose of the report is very weak, and does not indicate that the focus of the RA is only related to air emissions.


3. From Senes, comment 12, "The cumulative effects case was not quantitatively assessed during the HHERA, just in the Air Quality Assessment Technical Study, as sufficient details on other future projects and emission rates were not available to the team at the time. ( JW was the consultant in the proposed St. Mary's cement plant proposal, see later, my comment.)


4. comment 17, no discussion on St. Mary's, Darlington, or the Eastlink effect on regional air quality.


5. comment 18, nothing on 1,3 butadiene from waste incineration.


6. comment 32, on S 7.4.3, "This section is supposed to present the results of the Exposure analysis; however no results are presented...Exposure results are necessary to check the intermediate steps in the RA. This relates to calculations of exposure for each pathway that were used to calculate the risk. (Note that the media considered for HHRA in the RA document were: air for direct inhalation; soil; produce; meat; milk and eggs; drinking water and fish)


7. comment 48, Toxicity Reference Values, TRV's and profiles have not been updated to reflect the WHO guidelines.


8. comment 50, "Not all the values presented in the table on TRV's are actually TRV's. E.g, the reliance on air guidelines as sources of TRV's may not be appropriate. Air guidelines may not be based on health effects and thus concentrations ratios obtained using these values would not be considered valid. The values used to assess health risks in the HHRA must all be actual TRVs. (RA then says: "We acknowledge however that for benchmarks related to PM, values are often derived based on Policy and not only Health.) Reviewer then says: "As long as this is discussed in the Uncertainty Section, that the use of the Concentrations ratios based on AAQCs may not be fully protective of all health effects."


9. comment 53, "The values presented for PM 10 and PM2.5 do not reflect the current science on PM. The National Ambient Air Quality Objective for PM has reference levels for health based values of 15 mcg/m3 for 24h PM2.5 and 25 mcg/m3 for 24h PM10. In addition, CARB 2008 provides a summary of the latest research on PM 2.5. It should be noted that in some cases scientists think that there is no threshold that is safe for exposure to PM 2.5 and others think ranges from 3 - 7 mcg/m3 are protective of health for PM 2.5. The discussion in App H is inadequate as it does not reflect the latest literature on PM.


The RA responds: "The PM 2.5 values have been updated with the WHO criteria. That being said it is acknowledged that there is considerable debate in the literature and by regulatory agencies from around the world on appropriate PM 2.5 values. It should be noted that the addition of PM 2.5 at the MGLC from the Facility itself will be lower than the values cited above.


The reviewer further responds: "This is inadequate and as discussed in the original comment a proper discussion on the science related to PM 2.5 is requested. The WHO criteria are not protective of human health, and the WHO in their document indicated a level of 3-5 mcg/m3 where health effects have been observed. All of this should be discussed and an appropriate value selected."


10. comment 58, "we were unable to find Cadmium annual average .005 mcg/m3, in the MOE AAQC 2008 document, where did the number come from? (The RA gives an apparently incorrect response to this question, and the matter remains unresolved.)


11. comment 66, why was methyl mercury value of 2 X 10-4 mg/kg-d (Health Canada 2004) used instead of the more conservative 1 X 10-4 mg/kg-d(IRIS 2001, EPA integrated risk information system)? RA answer: "The HC value of 2 was selected for use in this assessment because it is the provisional TDI for pregnant women and toddlers in Canada and is consistent with WHO/FAO Expert Committee on Food Additives recommended provisional tolerable weekly intake of methylmercury of 0.00016 mg/kg bw/week, (equivalent to 0.00023 methylmercury/kg bw/day) (?? Looks like the weekly figure has 1 zero too many here, my comment) in order to sufficiently protect the developing fetus. We believe this value to be more applicable to the current RA."


12. comment 69, "As discussed, comment 50, AAQC standards were used for comparison for the Metals and CAC. As these AAQC may not be true health-based values, the limitations of this approach should be discussed in the Uncertainty Section."


13. comment 70, the evaluation of health based effects from PM is not appropriate and needs to be revisited.


14. comment 74, "There is no discussion on the use of AAQCs as TRVs rather than health based numbers. The use of AAQCs underestimate the risk...... The use of AAQC values do underestimate risk as shown for PM 2.5 for example, health effects are seen at values that are below the WHO values. This should be reflected in the report, (but is not.)




15. This is where this BMJ article is so important. It really
summarizes in one short sentence the current state of the PM issue, which
has been boiling away in the general medical literature for some years
now. In essence, it says that a 10 mcg increase in PM 2.5 exposure long
term produces an increase in mortality of  6% overall, 9% from heart ,
lung and brain attack, and 8% from lung cancer.  Extrapolating
(interpolating?) , a 1 mcg increase therefore produces an increase of
0.6, 0.9 and 0.8% in respective mortalities, and I think that it is within
the realm of possibility that 30 Tonnes of PM (or possibly more, we really have no idea) added annually by Covanta in Clarington may well push the 29 mcg to 30.   So there you have it, actual figures on respective mortality effects  (and that for PM effect alone,
never mind metals and organics) , in contra distinction to our marvellous
Risk Assessment which asserts that there will be no health effect at all. (see REFERENCE I, appended.)


16. . You have also done a very nice job in conveying the idea that these
Particulates are vehicles for the Nasties, if they are not inherently
nasty themselves. The chemical composition of particulates is infinitely
varied as far as I can see. Keep in mind that there are 80,000 chemical
compounds being synthesized globally now, so the possibilities for
Particulate composition solid and liquid,  are virtually endless.


17. In communicating health effects of the Big Three, it might be best to use
the term Carcinogens, instead of Organics. An organic chemist understands
that these refer simply to carbon based molecules (in contradistinction to
Inorganics, of which Metals are our example)  and some of which of course
are extremely toxic and carcinogenic. Unfortunately the popular meaning of
the word Organic conveys something entirely different, namely that it's


good for you! So it is a very confusing term, probably best avoided.


18. You have picked up well on the "modern" incinerator distinction, which I
think is entirely specious. As far as I know, bag houses, electrostatic
precipitators and lime injectors did not suddenly get invented in 1998.


19. Your point about no controls or analysis of the feedstock as it goes into
the magic  machine is very germane and is  the other half of the argument.
This could be translated to "Garbage In, Garbage Out" as an analysis of
the Risk Assessment. These people have no idea what goes into the unit,
and they have no idea what comes out, and yet they are supremely confident
in their No Health Effect conclusion! Amazing!


20. Don't assume that the US regulations are the same as ours. Maybe they actually
have an equivalent of the A7 guideline (it is not a regulation) at the state or federal level which sets a half decent standard. We certainly found this out in the Lafarge
case in Bath, Ontario,  where  predicted emissions from the unit when
burning tires was totally acceptable to the Ontario MoE , at the same
time as an exact same proposal for Ticonderoga New York was rejected under
American standards as being over their Particulate emission limit.


21. Your point:   " Exactly how was Covanta's emissions data determined?  Page
44 of the SSHHERA says the estimates were made on "the basis of
engineering design data from Covanta" .........is very important.  I don't
think these people yet have ever produced, or ever will produce, any
actual physical air sampling data from an equivalent unit anywhere. It all
seems to be theoretical stuff based on,  as you say, "engineering design
data",  which, as a local MoE official once explained to me, suggests that
the unit "should work."  In other words, based on hope and possibly a


22. The proponent's continued emphasis on the Robust, Continuous monitoring  reveals how serious is the most fundamental flaw in the proposal, which is that the regulatory requirement of annual testing for the nasties is completely meaningless. The truth is, they don't have a clue what the annual total of pm, metals and organic emissions really is, and they don't have to find out because there is no requirement to do so. Very convenient for the company, but very awkward for the regulator, the MOE, who is now likely going to have to try to explain this amazing point during the next phase of the EA.  Keep in mind that in the recent Lafarge case, in the same circumstances, two levels of Ontario Courts of Appeal  described the regulator's performance as  "egregious, a failure of public trust, and/or bungled".  So the regulator hardly has a sterling track record in the regulation of industrial air emissions, and in fact they are currently in a state of disgrace.  It becomes increasingly obvious that the current A7 guideline " limits" on the Big Three (see below) are based entirely on Best Available Control Technology, and have nothing whatsoever to do with health effect considerations despite all of their noble


statements about the new Ambient Air Quality Criteria techniques.


23. Durham Region a signatory to the Inter Governmental Declaration on Clean Air no less !!  Statement 1.1 certainly says the right things. Too bad it is not legally binding.


24. It's interesting that by lauding their own decision to provide continuous monitoring of D/F, compounds which in my opinion are of less proven health import than the Big Three (pm, metals, organics), the proponent has tacitly acknowledged the low power  of  single day annual analysis. In other words, if for D/F, then why not for the Big Three?


25. Common, intuitive, sense suggests that you cannot burn 400,000 tonnes of municipal waste , containing a mixture of Lord knows what,  in the middle of a densely populated area without having some effect on human and/or environmental health. Yet we are being told , through  the smoke, mirrors and magic of a Risk Assessment , that the Covanta people have an Energy from Waste machine that can do exactly that. Rubbish. What we actually have here is a machine that can convert .4 megatonnes of Waste into . 5+ megatonnes of Waste each year , using a Waste Of Energy process, in the course of which, as Paul Connett says, polite people get poisoned. 


26. Peter Montague, July , 1999:  "All risk assessments are fiction, shot through with assumptions, guesstimates, judgments and biases--all disguised disingenuously as "good science". The only thing that allows Risk Assessors to hold their heads up in public is that most people don't have the faintest idea what risk assessors do for a living or the consequences that their work entails."


27. Your question to the consultant about the confidence intervals on the RA is very good. Unfortunately, the consultant did not know the answer.


28. One of your fundamental messages is that the whole presentation of this thing is one big exercise in deception, distortion, and misrepresentation. The most obvious example is CO2 emissions being presented as trivial relative to the total, but you have extended this to the examples of NOX  ("3% vs 3000%"), mercury, lead, PM, etc.   This is a technique that Big Pharma has used so successfully in marketing to minimize the impression of risk and to maximize the impression of Benefit. Big Waste has obviously taken their cue from the drug industry. I don't think that there is any doubt that this deception is being done intentionally, and the word fraudulent comes to mind when the public is repeatedly reassured that there will be "robust, continuous" monitoring of emissions.


29. It must be embarrassing for the proponent to have to announce that there will be 139,000 tonnes GHG generated for each 140,000 tonnes waste burned , and although these people obviously don't embarrass easily it's not a point that they will thank you for highlighting. There is no doubt that there is significant public concern about the CO2 issue now, so that is point that really needs to be advertised.


30. The figures from the Commission for Environmental Cooperation have just been published.  (www.cec.org).  The 2005 total chemical releases for the 3 North American countries is 5.5 Billion Kg (=  5.5 million tonnes).  Essentially what your RA consultant is saying, as you so nicely point out, is that because current releases of whatever are so large, we might as well throw caution to winds and dump whatever we want out there as it's not going to make a "significant" difference. The irony is of course that they should be making exactly the opposite argument.  


31. Another example is from the United Nations Environment Program which has just published a Position statement on mercury pollution, in which they point out that the global burden of mercury is now 6000 tonnes annually, and they also remind us that 1 in 12 women living in the United States ALREADY have mercury levels in their bodies above the US EPA so called recommended limit. (JAMA, March 18 2009, reporting on UNEP report, "Tackling Mercury Pollution.") 


FROM DR. SMITH'S PEER REVIEW, Aug 20, 2007, amended Sept 28, 2007


32. The "incinerator literature" alone cannot be used to support or dismiss possible health effects from the measured load of some of the contaminants in people living around incinerators.


33. The generic RA of the model community is limited, as are all RAs, in that it did not make calculations for complex mixture exposures, unless such mixtures are already regulated as such (i.e. PAHs, d/f)). It did not consider PM unless the particulate is characterized and regulated (i.e. PM 10, PM 2.5). Hence the issue of "nanoparticles" exposure was not and could not be addressed as a regulated toxic exposure; there are no specific RA techniques or sufficient toxicological information available currently to do so. Therefore this is not a failing of the RA methods used or of this report per se.


34. The highest level of emissions from the facility would be deposited in the area identified as the Local Risk Assessment Study Area (LRASA). The LRASA extends approximately 10 km in all directions around the site, i.e. 10 km radius.


35. (Compare the above to JW Final Report): Baseline studies conducted prior to operation of an incineration facility: The sample locations were selected through review of atmospheric dispersion modelling results which provide the predicted zone of influence of a facility's emissions, typically within 1 km of the facility. For Ambient Air Monitoring studies: The zone of potential influence appears to be no greater than 2 km from the stack, with the majority of research (as found in the literature review) focused in areas less than 0.5 km from the facilities. Baseline or control studies formed a critical part in all of the studies.


36. On Hazard Assessment: HA defines the concentration of chemicals at which there is the potential for health effects. Safe levels are established by international regulatory agencies and are commonly referred to as TRVs, toxicity reference values. There are cancer effects, and non cancer effects. For non cancer effects, if the exposure amount is less than the safe amount, then the chemical is not considered to pose a risk. .....In the Inhalation assessment for human health effects, the results indicate that no acute (1 hr or 24 hr) or chronic (annual average) exposures at the maximum ground level concentration exceed the regulatory bench mark for any of the 10 evaluated cases. ( for what???, my comment)


37. The result of the multipathway assessment indicate that exposure to facility related air emissions will result in no adverse health effects to human receptors living or visiting the LRASA. The only exceedences were from existing conditions in the Baseline Case.


38. There are currently no regulatory benchmarks to evaluate chemical mixtures, therefore, the exposures associated with the chemical mixtures could not be definitively stated......Chemical mixtures were evaluated for information purposes only in the RA.




39. We conclude that this SSHHRA is satisfactory. Although it would be possible to use different receptor characteristics, exposure assumptions, and TRVs (and thus arrive at different Hazard Quotient and incremental lifetime Cancer Risk estimates), we consider it unlikely that the conclusions of the SSHHRA would change.


40. In most cases we expect the proposed installation will not provide any appreciable change in the concentrations of chemicals in air, soil, dust, water or food. For example, the maximum Ground Level Concentration of PM2.5 on an annual basis under Normal Operations is expected to be increased by 0.022 mcg/m3 vs a current baseline concentration of 9.8 mcg/m3. This, in our opinion, is insignificant. Similarly, the projected increases in the concentrations of metals, PAH, d/f, pcbs and other chemicals are very minor relative to current concentrations.


41. Validation of exposure point concentrations is considered to be outside of the mandate of this review. We note that this review of the SSHHRA has not evaluated the accuracy of the exposure point concentrations (from the air modelling emissions) and thus, all of the exposure point concentrations assumed in the SSHHRA are assumed to be accurate. (There is obviously a lot of "assuming" going on in this most fundamental of issues.  It is likely that our point about the 1000 variable formula with 1000 possible sources of error in the multipathway assessment of exposure applies equally to meteorologic dispersion and deposition modelling. Apparently Dr. Smith is not prepared to take responsibility for the problem, my comment)


42. (This same point is made again on page 40, my comment). Overall, it appears that exposure assessment was appropriately completed and is unlikely to underestimate exposures that persons would experience from the facility. We note again that the methods used to estimate exposure point concentrations were not part of the current review. We have assumed, therefore, that the exposure point concentrations presented provide reasonable estimates of environmental concentrations. If other reviewers identify issues with the predicted exposure point concentrations, our conclusions on the adequacy of the exposure assessment would need to be revisited.


43. JW committed to provide additional information in their final report on their rationale for not including Ozone, dioxin-like pcbs and acrolein in the SSHHRA. In the case of ozone, JW noted that the exclusion of ozone from such a facility is commonly accepted by air dispersion modellers at the Ontario MoE. In the case of dioxin like PCBs and acrolein, JW has indicated that they do not consider these chemicals to be key drivers in the SSHHRA and they will provide the justification for this conclusion.


44. For Criteria pollutants PM2.5 (etc) Health Canada (2004) provides an approach for estimation of Mortality effects rather than Toxicity effects beyond a straight comparison to criteria. (In subsequent correspondence, JW stated that consideration of mortality effects would not impact the SSHHRA and has indicated that the rationale for lack of consideration for such effects will be provided in a revised report.)


45. In some cases, HQ values from background sources are greater than 1, and Lifetime cancer risks are greater than 1 X 10-6. However such scenarios do not mean that absolutely no additional exposures can occur (at least from a regulatory perspective). Instead, health agencies and scientists tend to evaluate issues on a chemical specific "case-by-case" basis. In the case of d/f and pcb's, these are the chemicals contributing the greatest background risks. However, the increased exposure from the facility for these chemicals is quite minor by comparison (on the order of 0.5% increase in total exposures, see Table 7-34) and such values do not increase risk significantly. From the scientific perspective, these small increased risks are considered trivial because the greatest component of risk is from non-facility sources, i.e. food.


46. Globally the government legislative requirement for environmental surveillance of incineration facilities is continuous and periodic testing of chemical emissions at the stack. The adoption of this level of surveillance for a modern incineration facility, that would incorporate BACT, Best Available Control Technology, was deemed by the Study Team to be scientifically justified to ensure the protection of both human health and environmental health. Continuous stack monitoring of a limited number of chemicals , e.g NOX, SOX, are used as Surrogates for other chemical parameters between periodic manual stack testing events. This level of surveillance ensures that the facility is operating within its purported emissions control limits for all chemicals.


47. Option 1 (c): Inclusion of New Stack Sampling Technology for D/F not Routinely Sampled in Ontario EFW or incineration facilities, is also concordant with the literature and with state of the art technology. This represents an added level of surveillance (of operations.) The added programming continuous (sampling of) stack emissions resonates with both state of the art technology, and with the public's need for constant oversight. The public must understand that continuous monitoring means continuous sampling and periodic analysis, not continuous analysis and reporting.


48. (my comment: Dr. Smith is clearly very impressed with the final draft of the SSHRA by the Risk Assessor, has she notes, at various times, how " focused, greatly improved, orderly, crisp, tight, clear, precise, easily accessible, colossal, and thorough" is the final draft.)


From EFW IN PERSPECTIVE: FACTS, May 12, 2009, (York Region Residual Waste Study)


49. In Europe, the Paris Appeal is an international declaration put together by a group of 68 experts who proposed 164 recommendations and measures to be implemented in the broad field of environmental health. This appeal underlines the relationship of cause and effect between chemical pollution and disease. The Paris Appeal has been signed by many international scientific key figures and the Standing Committee of European Doctors, which represents all medical governing bodies and medical organizations in the 25 EU Member States. Recommendation M145 was a call for a Ban on the Building of Any New Incinerator.....An open letter from 33,000 doctors opposing the changes to the Waste Framework Directive defining EFW as recovery was sent to the European Parliament. (Nevertheless, these changes were subsequently approved by 27 European Environment Ministers.)


From SPEECH BY MINISTER OF STATE (PUBLIC HEALTH), Dr. Carolyn Bennett, June 20, 2005, at the SHARED AIR SUMMIT (on the subject of Mercury pollution.)


50. It is the numbers that Dr. Sunderland gave you from the CDC in Atlanta, that one in 12 women of childbearing age in the US has unsafe mercury levels and that there will be 630,000 babies each year in the US born from exposure to mercury.


51. This is obviously work in progress, and its very interesting as even last year's article in Pediatrics in April when Davidson Myers and Weiss were (reviewing) what is actually know about mercury neurotoxicity and neurodevelopmental risk.


52. Canada has no formal reference exposure level for mercury vapour in the air and by default Canada's risk assessor and regulators rely instead on the US EPA's recommendations. However those are based on data and studies dating from 1983 and these guidelines do not reflect the new science on neurotoxicity of mercury vapour that has been published over the past two decades. It is apparent from the review of that literature, the neurological effects occur at levels of exposure much lower than believed when the EPA reference exposure was first established.


From SCIENTIFIC CONSENSUS STATEMENT ON ENVIRONMENTAL AGENTS ASSOCIATED WITH NEURODEVELOPMENTAL DISORDERS, Developed by the Collaborative on Health and the Environment's Learning and Developmental Disabilities Initiative, Nov 7, 2007. (Scientific Review Committee: Bellinger, Goldman, Grandjean, Herbert, Landrigan, Lanphear, Mclgunn, Myers, Pessah, Schettler, Weiss. Published Feb 20, 2008.


53. Given the established knowledge, protecting children from neurotoxic environmental exposures from the earliest stages of fetal development clearly is an essential public health measure if we are to help prevent learning and developmental disorders and create an environment in which children can reach maintain their full potential.


Critical recent discoveries:


54. Even very low doses of some biologically active contaminants can alter gene expression important to learning and developmental function.


55. Exposures during fetal development can adversely affect learning and development of the individual and last a lifetime.


56. Humans are exposed to complex mixtures of chemicals that can interact to enhance adverse effects .


57. Due to genetic variation (polymorphism) people differ in susceptibility to exposures. Not identifying and studying susceptible subgroups can result in failure to protect those at high risk.


58. Children are often more susceptible than adults to the effects of exposure to environmental agents.




59. The scientific evidence we have reviewed indicates environmental contaminants are an important cause of Learning and Developmental Disabilities, LDD.....Despite some uncertainty, there is sufficient knowledge to take preventive action to reduce fetal and childhood exposures to environmental contaminants. Given the serious consequences of LDDs, a precautionary approach is warranted to protect the most vulnerable of our society.




60. (My comment) How does the impact of the St. Mary's Cement proposal, EBR # s 010-4892 (Bowmanville) relate in cumulative impact to the Covanta proposal RA? That cement plant has applied for a CoA to burn alternative fuels in the form of paper biosolids, post-recycling residual plastics and post composting residual plastic film. The same "big three" air pollutants will be emitted there, along with others such as d/f. Although, according to LOWK, there is a legal requirement to hold an Environmental Review Tribunal hearing in the event of such a proposal, the province (MoE) has decided to bypass that step to allow for tests burns for the collection of emissions data. According to LOWK this is illegal under the provisions of the province of Ontario Environmental Bill of Rights. The Risk Assessor for the Bowmanville application is Jacques Whitford, Report No 1037300.01B.


61. In 1991, the Ontario Minister of Environment noted that "The combustion of municipal solid waste during incineration releases a wide range of air pollutants, including dioxins, furans, VOCs, nox, C02, and heavy metals such as mercury, lead and cadmium...It is estimated that 70% by weight of incinerated substances are released to the atmosphere as exhaust as suspended particles. Between ¼ and 1/3 by weight of the original material entering incinerators remains as bottom ash and fly ash. The disposal of this ash, particularly hazardous fly ash, is a major concern. Incineration is an environmental sleight of hand which gives the illusion of making waste disappear when, in fact, it reappears in different and often more hazardous forms."


62. How will emissions interact with the air currents in this particular site? For the Bowmanville plant, this includes shoreline fumigation modelling related to temperature inversions, as described in the attached expert report by Dr. Henry Cole. (Reference: Henry S. Cole, "A Description of Lake Ontario Effects on Shoreline Emission Sources" (2008) ("When stable air flows onshore, it has a dramatic effect on the levels of air pollution from emission sources such as coal burning power plants, incinerators, and cement kilns......The cap of stable air combined with the rapid mixing below results in a process known as shoreline fumigation....Regulatory agencies require estimates of annual and maximum pollutant concentrations using computer-based air quality models. The models generally used however are not equipped to simulate coastal fumigation. This often results in estimates of ground level concentration that are far lower than "real world" concentrations.")


63. The Bomanville cement plant site (and the proposed Covanta site, my comment) are adjacent to water. Will the emissions settle out of the air, into the water? How will this affect fish, and fish habitat given the evidence that dioxins bioaccumulate in fish? How will this affect drinking water sources?


64. The Statement of Environmental Values, SEV, of the MoE requires the Ministry to make a decision based on a consideration of the cumulative impacts of the proposal. This includes a survey of historic and ongoing sources of contamination in proximity to the proposed site. One example of a proximate source of pollution that must be considered is the proposed Durham York "Energy from Waste" garbage incinerator. Located adjacent to the Bowmanville St. Marys Plant, any contamination from this project will contribute to the cumulative pollution in the area, and thus must form part of the MoE's decision making process.




65. The proposed Guideline sets out "the minimum expected standards that the Director will apply in exercising his or her discretion in considering applications for C of A on a case-by-case basis." The Guideline proposes a "site specific limit" for PM.....however the "site specific limit" is not based on the requirement for consideration of cumulative, site specific effects imposed by the common law......This is misleading given the omission from the Guideline of the legal requirement to consider cumulative effects....The Guideline also runs contrary to the common law, and nearly every other principle of environmental law, through its policy on Heavy Metals. According to the Guideline, if a raw material contains a concentration of heavy metals that will cause the emissions to exceed the standards, a higher limit for that site will be established. If the purpose of establishing regulatory emissions limits is to protect human health and the environment, it is contradictory to raise those limits where an applicant wishes to burn more harmful substances. The limits must be based on a precautionary approach and scientific evidence of the potential ecosystem effects of emitting harmful substances.




66. There was a four day interval between the release of the (3500 page +) SSHHRA and the first public meeting at which questions were to be answered by officials. Likewise, there was a four day interval between the release of the Peer Review of the SSHHRA (Dr. Smith) and the voting by Council on the issues. How does this satisfy the basic requirement of the EA process, which is to allow the public to participate in a meaningful way?


67. Is Paul Connett's analogy of the economics of this publicly funded, hugely expensive, proposal, which he likens unto a suckling pig with many piglets crowded around trying for their share of mother's milk, fair?


68. Would someone please take one of the many (124) formulae in the multipathway exposure calculation in step 3 of the RA, and work through it as an example.


69. Let's say that you had two incinerators, and you wanted to publish an article in a peer reviewed scientific journal to demonstrate the superiority of A over B with respect to emissions released into the air. On the input side, you have no data to describe the composition of the material which is going into the incinerators. On the output side, you have data from sampling done one day each year for metals, carcinogens, and PM. How likely is it that you could get your article published in said journal?


70. What is the fate of hazardous residues which are collected as fly ash and bottom ash. Has an RA been done on these?


71. Where do the "limits " that are established in Guideline A7 for various pollutants which are released into the air by municipal incinerators come from? Are they based on Best Available Control Technology? (The Lafarge example suggests that they are not based on Human Health or ecologic considerations.)


72. These A7 guideline emission limits are concentration limits, presumably being a vestige of the days before MISA in water pollution control when the philosophy was "the solution to pollution is dilution." Are there any absolute limits on air emissions in Ontario or Canada for metals, PM or carcinogens?


73. How is PM concentration and risk incorporated into the Hazard Quotient? How is this figure derived? Does it reflect the recent epidemiologic literature on the subject?


74. 30 Tonnes of PM are purportedly going to be added, according to the SSHHRA, to the local atmosphere by the Clarington incinerator, without, according to the RA, any increased risk of heart, lung or brain attack. How does this square with the BMJ summary of the impact of PM on these diseases? (see appendix I)


75. How about Lead? 6 Tonnes over the life of the facility in a 10 Km (or 1 Km) radius zone, without, according to the RA, any increase in human health or ecologic effect.


76. How is the information of Neurodevelopmental injury from toxics described by the Landrigan/Grandjean group incorporated into the HQ for metals and organics? Is there a reference provided to show that this has been done?


77. In the Halton case, the MOH contracted with Dr. David Pengelly, a McMaster University researcher who specializes in air quality, to conduct a peer review in that case. "Dr. Pengelly found no evidence to support the contention that modern incinerators, despite being cleaner than their predecessors, are safe. In fact he said that they emit the same dangerous pollutants as earlier incinerators." (Liz Benneian)


78. As of November 2007, 16 Clarington physicians and 43 from across the Region of Durham had signed a petition indicating their disapproval of the Durham-York proposal which would deal with residual waste by incineration.


It appears that Risk Assessment is fundamentally flawed in all of its four steps.


79. Step 1: Incinerator Emissions. On this most fundamental, prime, number, we have no actual data on facility emissions from any equivalent facility anywhere. In the main, the risk assessor has used the maximum allowable emissions from the Ontario A7 guideline.


80. Step 2: Meteorologic Dispersion and Deposition Modeling. How accurate is this after all, based as it is in another complex mathematical model? Dr. Smith twice disavows any responsibility for these data. There appears to be no allowance for the Fumigation effect.


81. Step 3. Multipathway Exposure Assessment. This model uses more than a thousand variables and 124 highly complex formula, and thus susceptible to error and manipulation.


82. Step 4. Risk Calculation of Cancer and Non Cancer risk, each involving two formulae. As Montague says, RA essentially uses the device of demonstrating additional cancer risk of less than 1 per million to license a facility to pollute the biosphere for decades to come. Non cancer risk assessment uses the Hazard Quotient, which appears to be a crude indicator covering all other diseases which may accrue from the facility. When current knowledge about the myriad non cancer effects of PM, inorganics, and organic pollutants is appreciated, the current HQ method may be regarded as primarily cosmetic.




83. Clearly there are many problems with the Clarington proposal, as a review of the preceding extracts illustrates. In the mid 19th century, in the debate over Free Trade vs Protection, Disraeli opined that Protection was not just dead, but dead and damned. In the 21st century debate over Zero Waste vs incineration, given our current understanding of waste management issues as they relate to human health, the question is whether incineration should be declared not just dead, but dead and damned.






REFERENCE: bmj jun22,09  Long term exposure to air pollution decreases life
expectancy, UK report finds
; Susan Mayor, 1 London

Long term exposure to air pollutants is associated with increased
mortality, warns a major UK report published this week, which has also
defined the most useful measure of air pollution in developing strategies to reduce adverse effects on health.

The new report follows up a 2001 review that looked at the long term
effects of exposure to air pollutants on health, itself based on two major
US studies. That review said that a causal relationship with mortality was
"more likely than not" and that the studies' findings were applicable in
the UK.

Research in the field has progressed rapidly since its earlier review, so
the Committee on the Medical Effects of Air Pollutants-an expert committee
that advises the UK government-decided it needed to review the latest
evidence, including a European cohort study.


"We are left with little doubt that long-term exposure to air pollutants
has an effect on mortality and thus decreases life expectancy," the
committee warns in its report, and it explains that the new evidence has
strengthened the association, particularly with particulates.

After reviewing a first draft of the report Michael Krzyzanowski, regional
adviser on air quality to the World Health Organization and health head of
the European Centre for Environment and Health, Bonn, said, "The estimates
of burden of disease, based on the conclusions from this evidence,
indicate very significant public health impacts and have important policy

The committee recommends PM2.5 (the mass per cubic metre of particles
passing through the inlet of a size selective sampler with a transmission
efficiency of 50% at an aerodynamic diameter of 2.5 micrometres) as the
best measure of particulate air pollution for quantitative assessment of
the effects of policy interventions. Particles less than 2.5 micrometres
in diameter are small enough to be deposited in the alveoli, particularly
in high risk groups such as children and sick people.

The committee found that the relative risk of mortality from all causes
rose by 6% with a 10 microgram per cubic metre increase in PM2.5. With the
same increase in particulate matter, the risk of cardiopulmonary mortality
rose by 9% and of lung cancer mortality by 8%.

Evidence for the possible effects of long term exposure to the common air
pollutant gases-sulphur dioxide, nitrogen dioxide, and ozone-was less
clear than that for particulate air pollution.

"In none of these cases [gases] have we been persuaded that the evidence
base is yet sufficiently strong to warrant quantification," the committee
reported. "The problem is one of inadequate evidence rather than evidence
for there being no effects. Better evidence might well lead us to change
our views in this area."

The committee is now working on a further report looking at the effects of
exposure to air pollutants on morbidity.


Cite this as: BMJ 2009;338:b2532
Long-Term Exposure to Air Pollution: Effect on Mortality (Final Report) is


APPENDIX 2: (Prior submission)


 A. C. Goddard-Hill, MD, CCFP

 General and Family Physician

 306-210 Dundas Street East

 Belleville, Ontario K8N 5G8


May 24, 2009


Dr. Arlene King

Chief Medical Officer of Health

Public Health Division

Ontario Ministry of Health and Long Term Care

11th Floor, Hepburn Block

Queen's Park

Toronto ON M7A 1R3


Dear Dr. King,


Congratulations on your recent appointment as Chief Medical Officer of Health for Ontario.


Enclosed is some correspondence directed to Dr. Robert Kyle , Commissioner and Medical Officer of Health, Durham Region, on the matter of the proposed municipal waste incinerator in Clarington, Ontario.


I call on you to put a stop to this proposal, for the benefit of the Ontario public health.


Sincerely yours,


A. C. Goddard-Hill



A. C. Goddard-Hill, MD, CCFP

General and Family Physician

306-210 Dundas Street East

Belleville, Ontario K8N 5G8


May 24, 2009


Dr. Robert Kyle, MD, FRCP

Commissioner and Medical Officer of Health

Durham Region

605 Rossland Road East

P.O. Box 730
Whitby, ON L1N 0B2


Dear Dr. Kyle,


Recently I have examined the Review of International Best Practices of Environmental Surveillance for Energy-from-Waste Facilities (Jacques Whitford) as well as the Generic, and the Site Specific, Human Health and Ecological Risk Assessment Reports (Jacques Whitford), as presented by the consultant to Durham Region in support of the proposed 400,000 ton per year municipal waste incinerator for Clarington, Ontario.


I have also attended a public meeting in Bowmanville on May 19 held in compliance with EA requirements for the project, and hosted by the consultant Risk Assessor.


As a result I am concerned that this project constitutes a threat to public health and safety in the Durham Region (most particularly to the community of Bowmanville) and Eastern Ontario, as well as being out of compliance with binational agreements on transboundary air pollution as developed over the past two decades by the International Joint Commission of the Great Lakes.


Enclosed are a series of five questions posed to the consultant Risk Assessors and which highlight some of the concerns. Many other relevant questions were also posed by members of the public in attendance.


In Risk Assessment theory there are two classes of human disease, namely Cancer, and Non cancer (i.e. "everything else") diseases. It appears that the calculation of risk for Non Cancer diseases is fundamentally flawed. Non Cancer disease risk is estimated from a Hazard Quotient , the Reference doses of which are based on toxicological studies, and which seem to virtually ignore the recent epidemiologic medical literature. This literature demonstrates increased risk of cardiovascular and lung disease from atmospheric Particulate Matter, as well as the occurrence of neurocognitive and developmental injury in infants and children accruing from metal and "organic" chemical environmental exposure.


Specifically, I do not believe that adequate consideration for the future health of children, pregnant women, and other adults in the community of Bowmanville, particularly vulnerable as it is located immediately downwind from the proposed incinerator, has been shown.


It is a matter of record that under the current regulatory program for air quality in the Province of Ontario, in excess of one million tonnes of chemicals are being released into the Great Lakes basin atmosphere annually by industry. Clearly the so-called science of Risk Assessment, as it has been practised by industry for the past 30 years, is allowing this to occur. Current Ontario air regulations in essence allow industry to dump as much chemical waste into the atmosphere as it wants as long as the wind is blowing in the right direction. Clearly there is a need for a Public Inquiry into air quality regulation in Ontario, just as there was for water quality earlier this decade under the auspices of Justice O'Connor.


You will recall that in February 2005, eighteen Ontario Medical Officers of Health were signatory to a successful Petition to the United States Senate in the matter of the effect of the proposed Clear Skies Act on American transboundary air pollution as it affects our country.


I also note your presence at the 2005 Shared Air Summit conference in which Dr. Carolyn Bennett, at that time Minister of State for Public Health, gave a speech about mercury pollution which is of great relevance in the Clarington case. At that meeting you inquired as to how Local Health Agencies can contribute to improving transboundary Air Quality.


Here is an opportunity to do just exactly that.


It would be an embarrassment if the clear air of Clarington were polluted by this project, and the City had to be renamed Foggington. The public health of the community, both financial and medical, would benefit from your intervention.


I compliment you on your excellent work as a public health specialist in our province these many years now. You have the power to stop this pernicious project. I call on you to do so.


Sincerely yours,


A.C. Goddard-Hill


cc. Dr. Arlene King, Chief Medical Officer of Health, Ontario


Dr. Richard Schabas, MOH, Hastings Prince Edward


Dr. Peter Munt, Chief of Staff, Kingston General Hospital


Dr. Elaine Macdonald, Ecojustice




Site Specific Human Health and Ecologic Risk Assessment for the Clarington municipal waste incinerator: Public Meeting for presentation of the Report , including question and answer session, Tuesday May 19, 2009, Garnet Rickard Recreation Complex, Bowmanville, Ontario, 1900 - 2200 hours. (Panel included consultants from Jacques Whitford and Stantec)


Question 1.


Why are there no public health physicians on the panel at this public meeting organized to present the long awaited Site Specific Human Health and Ecologic Risk Assessment for the Clarington municipal waste incinerator proposal?


Answer. (various explanations given)




Question 2


If I were a resident of Bowmanville

and I learned that I was going to be living

immediately downwind

of a garbage incinerator

that would burn 400,000 tonnes of garbage

every year.... for the next 35 years

I think that I would want some reassurance

that whoever is regulating this facility

is going to have a very good idea

of exactly what chemical emissions

are coming out of that incinerator smokestack,

because with the prevailing wind being SouthWest as it is,

living in Bowmanville, I might well find myself breathing in

some of those chemical emissions.


For an answer to this concern, I could turn to a Report entitled

Review of International Best Practices of Env Surveillance.

It was written by 5 highly qualified scientists,

including Dr. Olsson

and Peer Reviewed by a very eminent Public Health Specialist,

Dr. Smith


These people together have reviewed

5000 scientific papers,

in the course of their deliberations.

So one could conclude

that this is a credible and authoritative source.

And indeed the central message of this Review

seems to be very reassuring.

because the conclusion of this group

as it is stated in Option 1 (a), which is their recommended option:

is that (quote) "Robust.... Continuous ......

stack monitoring of combustion gases,

in Combination With

Annual source testing

would ensure ...... that chemical concentrations

used in the Risk Assessment are being achieved." (end of quote)


My question to you Dr. Olsson

is that in communicating with the public

about how ....monitoring ....of stack emissions is going to be done

is this a Clear Statement......or is it a Misleading statement.

(Option 1 (a) statement repeated)


Answer: (consultant indicated that it is a clear statement to the public.)


Member of the public, further comment:


"Thank you for your answer.

 Just for the Record, and with respect, in my opinion,

 this statement about Robust and Continuous monitoring

 is a...... Very..... Misleading ......statement.... for the General Public.

 In fact, I think it is a False statement,


The reason is simply that

 the Statement..... Fails.... to make the Distinction between

 monitoring of what I call Nuisance chemicals,

 such as Nox and Sox,

 which will give you a runny nose ,

 or cause your asthma to be a little worse .....

 and which will indeed be Continuously monitored.


 It fails to distinguish between them and

 the..... Nasty Chemicals,

 such as Particulates......and Metals...... and the Carcinogens,,

which we now very well know

may cause, and do , cause....serious illness,

such as .....heart attack and..... lung attack ...... and brain attack (stroke),

and..... brain damage in children,

and ....cancer.


These nasty chemicals are not going to be monitored

Robustly and Continuously.


These nasty chemicals are going to be sampled......

once each year.......three times on one day...

with lots of advance notice to the Operators.

Indeed the numerous Carcinogens (SVOC, Pah, Mah, VOC)

will not be measured individually at all

(but rather as Total Organics, as Methane.)


This is not.....Robust.....Continuous monitoring,


Rather it amounts to ....no Meaningful Monitoring at all

as it will be monitoring that covers ... 1/1000 , if you work it out, 1/1000

of the annual operating time of this incinerator.


So this is a Very misleading, ambiguous statement

subject to misinterpretation ....by the public,

and I believe that it is falsely reassuring .....to the public."




Question 3


Recently, in Eastern Ontario, a Risk Assessment was done

for various emissions coming from the smokestack

of a Cement Plant.... in a community in Eastern Ontario.


The Mercury emissions for that plant

were reported through the ESDM,

the Emission Summary and Dispersion Modelling,

as .....15 kg .......per year.


The RA on this case,

which was done according to standard Government of Ontario methods,

(AAQC methods)

as you have done here,

showed that there was

no......Human Health Risk from 15 kg of Mercury

and furthermore.... that the plant would have had to release

more than 100 times that amount,

in other words, more than 1500 Kg

of mercury each year

in order for the RA to trigger a human health alert.


To put things into perspective, 1500 kg of mercury

is about 1/3 of the total releases of mercury into the air each year

by the state of Texas,

which has been the largest industrial polluter

in North America for many years, so it is a significant amount.


So this case itself suggests that,

although you might think that RA

is a very ...Sophisticated... Device

when you look at these highly technical 3245 page reports

that in fact this case suggests that .. Risk Assessment.....

is a very Crude ...and Ineffective... device

for the protection of human health.


Because this RA seems to say

that if it wanted to, this company could discharge

1500 Kg of Mercury into the atmosphere

without triggering a human health Alert.


Dr. Olsson, my question is,

how much mercury will be released annually

by your incinerator,

when it is burning 400,000 Tonnes per year?

and how much mercury would have to be released

 in order to trigger a Health Alert

 using your Risk Assessment?


Answer: (Consultant did not seem to know how much mercury would be released, and did not know how much mercury would have to be released in order to trigger a Human Health Alert using his Risk Assessment.)


Answer: (From the SSHHERA documents):


Mercury: 2 Tonnes over the life of the facility, (increasing the background burden by 50%)


Particulate Matter: 30 Tonnes annually, adding to the background burden of PM 2.5 which is already near the maximum level according to the Canada Wide Standard. (29 mcg at the Courtice monitoring station, 30 mcg CWS)




Question 4.


Both .....the Generic and the Site Specific RA 's

contain 128 ....Equations.

124 of those are...... equations that calculate

exposure of some individual person

to the chemical of concern

by each of the various routes,

e.g. inhalation.....skin absorption....eating... drinking.....etc

and these in turn are fed into

the final 2 equations each

for the calculation of

Cancer Risk, .....and Non Cancer risk ("Hazard quotient")


Of these 128 equations,

some have as many as 15 variables,

and , at a conservative estimate

there must be approximately.......1000.... variables

(and a few Constants in addition)

which lead up to the calculation

of Cancer..... and Non Cancer risk ....for each chemical.


With 1000 variables in the formula,

it appears that in each RA

there are 1000 opportunities

for Error in the Risk calculation,

to say nothing of a significant opportunity

for Manipulation of results.


(We have recently had two examples of this in Eastern Ontario.)


My question is:


Do you agree that... with 1000 variables

in the formula for calculation of Cancer and Non Cancer Risks

that RA is very prone

to Error,

and to Manipulation, of results?


Answer: (consultant seemed to find this question risible, and disagreed.)


Background Information: 2 Eastern Ontario examples:


In the first, an RA by the MoE on chemical emissions from a hazardous waste incinerator produced Exceedences for some carcinogenic chemicals. The response of the MoE on receiving these reports from the consulting laboratory was to send the data back for reanalysis "using a different model."


In the second Eastern Ontario example, in the late 1990's, a consultant Risk Assessor (GPEC International) found significant cancer and non cancer risks on a City of Belleville recreational site that was located on a former hazardous waste site. That RA was replaced by the City concerned with another Risk Assessor (University of Ottawa, Sam Kacew), who confirmed the findings of the first. The City then replaced that RA with a third, who found that there were no human health risks after their new RA. That Risk Assessor was Stantec (associated in the Clarington RA with Jacques Whitford).




Question 5.


According to Risk Assessment theory,

there are two kinds of human diseases,

namely Cancer,

 and Non Cancer (i.e. everything else) diseases.

 Non Cancer Risk

 is calculated using a Hazard Quotient

 which uses Reference Doses

 which are obtained........from the toxicologic literature.


However it appears to me

that the Hazard Quotient

that you have used in your RA

fails to take into account

the recent epidemiologic literature

on, for example,

the relationship between atmospheric Particulate Matter

and the occurrence of

Heart attack, .... and Lung attack, ......and Stroke in adults,

and, as another example,

the relationship between...

atmospheric heavy metals and "organic" chemicals

and the occurrence of brain damage in infants and children.


Do you agree that for this reason,

your Risk Assessment is fundamentally flawed,

and that therefore your RA

fails to protect the health

of the children,


and the pregnant women

and the other adults

of the community of Bowmanville in particular,

and of Durham Region .........and Eastern Ontario in general?


Answer: (consultant disagreed.)