Proceedings - Science Advisory Board (SAB), February 1-2, 2012

February 1-2, 2012 Meeting

Table of Contents

Executive Summary

The Science Advisory Board met on February 1 and 2, 2012 in Ottawa, Ontario. Renaldo Battista chaired the meeting with ten of the Science Advisory Board (SAB) members present.

Presentations

Synthetic Biology: Issues and Options Analysis - Sandra Fry and Kirsten Jacobsen, Emergency Management and Corporate Affairs Branch, Public Health Agency of Canada. 
The SAB would like to see a paper emanating from this work that would more clearly define the meaning of "synthetic biology" and contain the sets of questions they will need to address. As PHAC moves forward, it should look at opportunities for international collaboration (beyond the US) to share some of the efforts required to move on such a complex topic. The key is to strike the right balance between the need for supporting innovation and dealing with public health benefits / risks.  This paper should take the case study approach to frame the situation.

Regulatory Modernization -Paul Glover, Health Products and Food Branch, Health Canada. The Board supports the Branch's efforts to roll together/harmonize legislative frameworks that will improve the efficiency of activities involved in the regulation of food and health products. The Board felt it is important to maintain the highest standards and not seek the lowest common denominator in order to achieve this goal. Beyond the six years life of this initiative the SAB recommended that there be a mechanism embedded to allow for continuous updates to reflect current realities.  Health Canada should consider using its Web site as a plain language source to help consumers understand the information found on food and health product labels.

Development of a Governance Structure-Regulatory Framework for the Use of Human Participants in Pesticide Testing -Cheryl Chaffey, Pest Management Regulatory Agency.  The Board recommended that PMRA find a more suitable title for their Framework (i.e., "The Use of Human Participants in the Research for Pesticide Regulation"). The Board recommended that the document clearly distinguish between experimental versus observational or epidemiological data; experimental studies using children or other vulnerable populations should not be considered whereas observational studies could be considered where they offer health and safety data. The Board did not voice any objection to the proposed regulatory framework.

Immunization, Innovation and Strategy - Rainer Engelhardt and John Spika, Infectious Disease Prevention and Control Branch, Public Health Agency of Canada. The SAB sought clarity as to whether the strategy was aimed at developing vaccines or aimed at raising immunization rates; the strategy was aimed at allowing Canada access to new vaccines in a timely manner in spite of its relatively small market size. The SAB stressed the importance of going back in time and trying to integrate past experience (such as with CANVAC), which demonstrated this country's research strengths in vaccination development. It is important to conduct this work in partnership with PHAC taking the lead working with industry and academic researchers. The SAB would like to see an operational plan going beyond this strategy.  The business plan should focus on promoting an increase of Canadian capacity to develop and manufacture vaccines.

First Nations and Inuit Health Branch's Strategic Plan -Valerie Gideon and Jennifer Pennock, First Nations and Inuit Health Branch, Health Canada. The SAB recommended that linking a focus on governance of the health system with social determinants of health should be a strategic priority. Health indicators should include social determinants of health broader indicators, not just health system outcomes. FNIHB should take advantage of "natural experiments" in the delivery of health services, such as the new First Nations Health Authority in British Columbia.

Update on the implementation of CIHR's Strategic Plan, its key reforms and research priorities -Alain Beaudet, Canadian Institutes of Health Research. The SAB commended CIHR on this innovative and bold plan. The Board recognized the tremendous amount of work being done, in particular the number of people consulted and international input.  Consensus was that the nest steps will be crucial, underscoring the need to consult broadly and thoroughly with Stakeholders and taking as much time as needed. The Board recognized that this reform will not happen overnight.  CIHR should focus on interventions that have a positive impact on the health system and seek excellence above all.  HC and PHAC should be asked what they think of the plan before it is finalized to provide the opportunity to align research activities / themes and improve collaboration in the Health Portfolio. There needs to be a concerted effort to disseminate this plan to Provincial funding agencies and gather their comments before the plan is finalized.

Health Canada Policy on External Advisory Bodies (2011) - Carol Della Penta and Brandon Northwood, Public Affairs, Consultation and Communications Branch, Health Canada. This new policy was developed through a collaborative consultative process which helped identify the gaps, drivers, and practices to bring the Department up to a level comparable with our international counterparts.

The SAB congratulated Health Canada on developing this important and comprehensive policy that promotes effective and consistent external advisory body management practices across the department.

Health Canada's Policy and Research Approach to Wind Turbines -Beth Pieterson, Tara Bower and David Michaud, Healthy Environments and Consumer Safety Branch, Health Canada. The Board found that Health Canada's approach to this issue is reasonable and impressive. Advice on the actual methodology of the study was provided which included reinforcing the need for appropriate controls and a recommendation that all reference to "causality" be removed from the study description as no matter how good a design, it can only be expected to show associations. The Board furthermore suggested that Health Canada consider a longitudinal study to assess response before and after wind turbine installation, in addition to recommending that investigators consider supplementing hair cortisol with a group that provides saliva cortisol for diurnal patterns. The policy and research work plan will contribute useful information to the growing body of evidence and will need to be considered in context of other studies in order to support conclusions about wind turbines and health effects. The data generated will contribute greatly to the body of evidence, helping governments to make sound science-based decisions.

Attendance

Science Advisory Board (SAB) Members

  • Present
    • Renaldo Battista
    • Stephen Bornstein
    • Jack Gauldie
    • Chris Loomis
    • Renee Lyons
    • John O'Neil
    • Marie-Élise Parent
    • Lori Sheremeta
    • Lorne Tyrrell
  • Regrets
    • Ahmed El-Sohemy
    • Claire Franklin 
    • Susan Kennedy
    • Yola Moride

Ex-officio Members

  • Present
    • Glenda Yeates, Deputy Minister
    • Abby Hoffman, SPB
    • Frank Plummer, PHAC
    • Rainer Engelhardt, PHAC
    • Paul Glover, HPFB
    • Hilary Geller, HECSB
    • Alain Beaudet, CIHR
    • Janet Storch, Research Ethics Board
  • Alternates
    • David Clapin, HPFB
    • Peter Chan, PMRA
    • Marie France Berard, RAPB
    • Ken Scott, PHAC
  • Invited Participants/Presenters
    • Kendal Weber, HPFB
    • Carol Della Penta, PACCB
    • Brandon Northwood, PACCB
    • Valerie Gideon, FNIHB
    • Jennifer Pennock, FNIHB
    • Debra Gillis, FNIHB
    • Kirsten Jacobsen, PHAC
    • David Michaud, HECSB
    • Tara Bower, HECSB
    • Beth Pieterson, HECSB
    • Sandra Fry, PHAC
    • Cheryl Chaffey, PMRA
    • John Spika, PHAC
  • SAB Secretariat - HC
    • Jean Sharp, SPB
    • Laird Roe, SPB
  • Observers
    • Ken Mcallister, FNIHB
    • Jonathan Nagle, CIHR
    • Peter Monette, SPB
  • Regrets
    • Health Canada
      • Anne Lamar, PACCB
      • David Miller, CSB
      • Germain Tremblay, CFOB
      • Debbie Beresford-Green, RAPB
      • Jamie Tibbetts, CFOB
      • Richard Aucoin,  PMRA
      • Michel Roy, FNIHB
      • David Butler-Jones, CPHO
      • Kathryn F. Howard, PHAC
      • Judith Bosse, PHAC

Key to Acronyms

HC
Health Canada
RAPB
Regions and Programs Branch
CFOB
Chief Financial Officer Branch
HPFB
Health Products and Food Branch
PACCB
Public Affairs, Consultation and Communications Branch
PMRA
Pest Management Regulatory Agency
HECSB
Healthy Environments and Consumer Safety Branch
FNIHB
First Nations and Inuit Health Branch
SPB
Strategic Policy Branch
CSB
Corporate Services Branch
PHAC
Public Health Agency of Canada
IDPCB
Infectious Disease Prevention and Control Branch
EMCA
Emergency Management and Corporate Affairs
CIHR
Canadian Institutes of Health Research

Proceedings

Day 1, Wednesday, February 1, 2012

1. Preliminary Matters

Opening / welcoming remarks were provided by Renaldo Battista. It was noted that Jacques Simard, a SAB member since 2006 has resigned due to workload concerns.

2. Remarks from Abby Hoffman, Assistant Deputy Minister, Strategic Policy Branch, Health Canada

Abby Hoffman provided the Science Advisory Board with an update on the notable changes in the Strategic Policy Branch that have occurred since the SAB meeting in May 2011. Ms. Hoffman is now the Assistant Deputy Minister of the Branch as of early October, 2011; Pierre Charest, former Director General of Science Policy Directorate, is now an Associate Vice President at NSERC; and Laird Roe has taken on the duties of Acting Director General in his place.

The Department is currently reviewing how it fulfills its mandate, including the manner in which research and scientific activities are conducted, and health care services delivered. This exercise will lead to improvements in the efficiency and effectiveness of their delivery. The Board will be briefed on the outcome of this work and how it will affect its operation.

In this context, the Department is exploring how best to tap the expertise of the SAB and relay its advice across the Department and the Public Health Agency.

3. Opening remarks from Frank Plummer, Chief Scientific Officer - Public Health Agency of Canada

Dr. Plummer gave the Board a briefing on the following topics:

  • A review of the National Immunization Strategy is currently taking place to ensure the program remains relevant and is delivered more effectively and efficiently. Dr. Rainer Engelhardt provided further information on this topic.
  • Tuberculosis (TB) - PHAC is continuing work on a guidance document for tuberculosis prevention and control. The document is designed to further reduce the spread of TB in Canada over the longer term. Science and research will continue to play an important role in Canada's TB reduction goal. Activities such as strong laboratory services; public health surveillance; and TB-related research will support this approach. This guidance document is expected to be released in the near future and will offer best practices for all the different players involved in managing TB (F/P/T, municipal governments, academia, and the health sector).
  • Obesity - on November 25, 2011, Ministers of Health endorsed Actions Taken and Future Directions 2011, the first report on Curbing Childhood Obesity: A Federal, Provincial, Territorial Framework for Action to Promote Healthy Weights". A Healthy Weights Summit is planned for February 27, 2012 in Ottawa to build on the "Our Health Our Future" national dialogue and promote multi-sectoral partnerships, healthy eating, active living and supportive environments to curb obesity and promote healthy weights. Following the Summit, work will begin on determining federal objectives and proposed actions to deliver on "Actions Taken and Future Direction 2011".
Status Updates
  • Antimicrobial Resistance (AMR) - at the May 2011 meeting, the Board recommended that HC and PHAC work together to look at the cumulative effects of antibiotic use on the health of Canadians. The Board also noted the need for improved education and awareness (on reducing the need for antimicrobials for physicians and the public), and suggested the Health Portfolio look at best practices in other jurisdictions. An action plan to combat AMR was intended for Board comment in summer 2011; however, given the scope of the issue, the number of players involved, and the policy work required, a plan will likely not be ready until later in 2012. PHAC is developing a coordinated approach to address AMR in Canada and continues to engage with HC and partners on this issue to identify opportunities for coordination and action. Furthermore, engagement continues with partners through the Communicable and Infectious Disease Steering Committee of the Public Health Network, the Council of Chief Medical Officers of Health, and the Canadian Council of Chief Veterinary Officers of Health.
  • PHAC Science and Research Strategic Plan - a number of outcomes have been generated through the science and research strategic plan process to date: An extensive Agency-wide consultation has been completed and a consultation report is ready to be published; the Agency has also developed a vision, guiding principles, and goals and objectives for the management of its science and research activities. As a result of the federal government's efforts at deficit reduction, the plan was repositioned as a Science and Research Excellence Framework.
  • Some of the upcoming science and research activities that will advance the Framework's goals and objectives are:
    • Development of science and research priorities
    • Inventory of current science and research work
    • How to better engage and work with CIHR
    • Knowledge Translation Strategy

4. Synthetic Biology: Issues and Options Analysis

Synthetic Biology is an area of growing interest and research intensity that seeks to design and construct novel biological systems not found in nature. Socially responsible scientific innovation plays a critical role in Canada's economic development and social well-being; however, the Government of Canada needs to develop a balanced approach to supporting the development of synthetic biology while mitigating the risks associated with its use. The Public Health Agency of Canada has initiated discussions about synthetic biology (given its mandate to enforce the Human Pathogens and Toxins Act) with other Federal Departments. An options paper has been drafted to identify key issues and provide a preliminary outline of options for moving forward. SAB's input was sought on the key issues and the proposed work plan.

Discussion

The Board would like to have this item brought back to the table in the future. The SAB recommended that a clear definition is needed for "synthetic biology" to clearly differentiate it from activities such as site-specific mutagenesis; it was not apparent how this project was looking at activities different from "normal" genetic modification.

Summary Advice
  • The SAB would like to see a paper emanating from this work that would more clearly define the meaning of "synthetic biology" and the sets of questions they need to address. The key is to strike the right balance between the need to support innovation and dealing with public health benefits / risks.  This paper should take the case study approach to frame the situation.
  • As PHAC moves forward, it should look at opportunities for international collaboration (beyond the US) that would assist in the work required to move on such a complex topic.
  • The SAB advised PHAC to not waste time quantifying the types of activities that are going on because it is such a fast moving field, it would be a never ending exercise.
  • Although the issue of duel use is a concern, attention should also be paid to potential unintended consequences / results of synthetic biology. Take a broad holistic systems approach to assessing risk rather than a narrow health focus - there might be an unintended impact on ecosystems if these organisms are not controlled. The active engagement of students and practionners will make them aware of these potential risks.

Action items: PHAC will determine how to engage the broader community to move this activity forward.

5. Regulatory Modernization

HPFB is drafting a Roadmap for Modernization which provides the vision to transform nearly a dozen current frameworks for food and health products that are of various ages and regulatory approaches into an efficient, transparent, and comprehensively aligned regulatory system that contributes directly to the safety of Canadians and the benefits they gain from food and health products.  Currently the draft document is a concept, the details of which will be developed and shared internally and externally as the work progresses, resulting in a comprehensive regulatory proposal to take forward.

Discussion

The SAB endorsed the Department's approach and has full confidence in the direction being taken.

Summary Advice
  • The Department should ensure that rolling together/harmonizing legislative frameworks does not end up being a race to the bottom, i.e., seeking the lowest common denominator.
  • The SAB feels that there should be a mechanism/flexibility built into the initiative that would allow for continuous updating/revamping and not leave it to the end of its life of six years.
  • Health Canada should consider using its Web site as a plain language source to help consumers understand the information found on food and health product labels.

6. Development of a Governance Structure-Regulatory Framework for the Use of Human Participants in Pesticide Testing

The proposed policy and overall approach for the use of human participants in pesticide testing addresses a significant gap that currently exists in Canada regarding the ethical conduct and assessment of individual human studies that are required or submitted voluntarily to HC's PMRA.

PMRA sought advice from the SAB for: 

  • Comments on the proposed document entitled: The Use of Human Participants in Pesticide Testing, particularly Part 2;
  • PMRA's plan to host a workshop with interested stakeholders (end of March 2012) to further guide the PMRA in developing the final policy.
Discussion

The SAB noted that much of the advice given at a previous meeting was well integrated into this framework; however there are some key elements that still need some attention.

Summary Advice
  • The Board recommended that PMRA find a more suitable title for their Framework (i.e., "The Use of Human Participants in the Research for Pesticide Regulation").
  • A clear methodology should be developed to clarify the issue of research design, i.e., the use of experimental versus observational data.
  • The Board recommended that the document clearly distinguish between experimental versus observational or epidemiological data; experimental studies using children or other vulnerable populations should not be considered whereas observational studies could be considered where they offer health and safety data.
  • The Board did not voice any objection to the proposed regulatory framework.

7. Immunization, Innovation and Strategy

There are numerous factors influencing the Canadian immunization context. While Canada faces challenges as a minor market for vaccines, there are opportunities for more strategic and innovative approaches, including leveraging novel vaccine platforms. The purpose of the presentation was to discuss the scientific merit of exploring how immunization-related gaps in Canada pertaining to vaccine-related R&D could be bridged and to identify additional scientific and technical issues needing consideration.

Discussion

The SAB engaged in a thorough discussion of the situation governing the production vaccines in Canada and immunization rates and attitudes among Canadians.

Summary Advice
  • The SAB sought clarity as to whether the strategy was aimed at developing vaccines or aimed at raising immunization rates; the strategy was aimed at allowing Canada access to new vaccines in a timely manner in spite of its relatively small market size.
  • The SAB stressed the importance of going back in time and trying to integrate past experience (such as with CANVAC), which demonstrated this country's research strengths in vaccination development.
  • It is important to conduct this work in partnership with PHAC taking the lead working with industry and academic researchers.
  • The SAB would like to see an operational plan going beyond this strategy.  The business plan should focus on promoting an increase of Canadian capacity to develop and manufacture vaccines.
  • On the benefits of vaccination - Health Canada and PHAC should boost public awareness and trust regarding scientific disproving of the "autism statement". Information aimed at the elementary and High School level could influence families. The National Vaccine Strategy should be predicated on a clear statement that vaccinations are important and safe for Canadians.
Remarks from Glenda Yeates, Deputy Minister, Health Canada

The Deputy Minister engaged the SAB in a discussion on the important role of science advice at Health Canada and PHAC.

The Deputy Minister noted that Health Canada is a multidisciplinary Department which requires a range of scientific advice, and therefore uses a number of mechanisms and bodies, including the Science Advisory Board, to provide expertise. 

As a regulatory body, the Department depends on sound scientific evidence to make decisions. Although Health Canada staff is comprised of highly trained scientific professionals, from time to time external scientific advice is sought for specific purposes.  The Deputy Minister noted that the SAB has provided very useful science advice to the Department.

The discussion focused on how the Department could best make use of the SAB to address these needs, explored whether the SAB is the best vehicle to do so, and discussed how to strengthen the process to realise the greatest impact. 
 
The Deputy reinforced her message by thanking the SAB for its service and assistance.

8. First Nations and Inuit Health Branch's Strategic Plan

The First Nations and Inuit Health Branch's Strategic Plan development was launched in May 2011. The Plan will identify a vision, principles, strategic goals and associated actions, and an indicators framework for Health Canada's First Nations and Inuit Health Business Line. The Plan will be finalized by March 31, 2012.

Advice sought:

  • Does the SAB feel the outlined process is sufficient and comprehensive? Are there gaps in the proposed goals and actions?
  • What role does the SAB see for research and capacity building within the context of the Strategic Plan?
Discussion

SAB commended the work to date on FNIHB's first, well-articulated Strategic Plan draft framework and looks forward to seeing the plan as it is being developed. The Board was very interested in seeing what indicators FNIHB will be using and would like to review them after they are peer reviewed. CIHR has offered to assist in this process with the provision of a report on rural indicators that could be used as baseline data.

The Board felt that this Plan is a good statement of general ideas and that many conceptual issues have been raised, but there is a need to articulate the role of indicators in assessing results. How these indicators are going to be used is very important.

Health Canada can strive to do everything right, however much of the outcomes are going to be out of their realm of control as there might not be a noticeable improvement on the major indicators. The discussion focused on the level of indicators - a small set of specific national indicators that make sense to measure an overall effect, but local level indicators should be developed to measure progress/impact based on local agency/ organization/ community's plans.

First Nations and Inuit communities are not homogenous and success on those individual community level indicators could provide positive/good news stories that would reinforce their activities, and support for this work. The SAB endorsed the development of targeted workforce training, in particular Aboriginal nurse practionners. This would encourage economic development as well. The Board encouraged Health Canada to seek out interdepartmental committees that link housing and economic development with health. There is a movement within the FNI community to link education and economic development, and the SAB sees this as an opportunity to improve and reinforce interdepartmental cooperation.

Summary Advice
  • The SAB recommended that linking a focus on governance of the health system with social determinants of health should be a strategic priority.
  • Health indicators should include broader social determinants of health indicators, not just health system outcomes. FNIHB should take advantage of "natural experiments" in the delivery of health services, such as the new First Nations Health Authority recently established in British Columbia.
  • By working with CIHR, Health Canada can take advantage of their expertise in the development of indicators.  It is important that they get the resources they need to succeed, monitor and evaluate, and respond to natural experiments.
  • Use the collected data on selected indicators to produce annual reports, not just three to five year reports.

Action items : The SAB will comment on the plan and indicators when they are available. CIHR will provide the rural indicators report to Health Canada for dissemination to the SAB.

Day 2, Thursday, February 2, 2012

9. Update on the implementation of CIHR's Strategic Plan, its key reforms and research priorities

In its strategic plan (2009-2014), Health Research Roadmap: Creating innovative research for better health and health care, CIHR recognizes that changes are needed to enhance the way it funds both investigator-initiated research and strategic health research to fulfill the broad spectrum of CIHR's mandate and sustain the Canadian health research enterprise. Since that time, CIHR has solicited, received and analyzed feedback from the research community about CIHR's core programs and has taken steps to address the challenges, notably by modernizing and simplifying its suite of open programs and provide more focus to its strategic investments.  The presentation focused on the changes to CIHR's strategic funding processes.

Discussion

The Board highly commended CIHR on this solid and bold strategic plan which represents a major transformation of this important organization. The SAB recognized that CIHR has consulted the right stakeholders (domestic and international) and that the main challenge will be to operationalize the Plan and that this will not come over night, in particular changing the open grant process and the peer review system.

The Board encouraged CIHR to support the development of young / new investigators. Concern was expressed that the funding of research based only on impact will leave out important research areas dealing with health prevention / risk factors.

There was a thorough discussion on the types of research being targeted, cross cutting areas, and the programmatic impact of the research being funded and how the transition of peer review (open grants) will be managed. The SAB would like to see fields that seek to understand rather than simply act upon not be neglected, such as epidemiology or social science based research. They support attention to such interventions that will have a positive impact on the health system.

Summary Advice
  • The SAB suggested that the CIHR focus on what works - interventions that have a positive impact on the health system and to seek excellence above all.  HC and PHAC should be consulted on the plan before it is finalized to provide the opportunity to align research activities / themes and improve collaboration in the Health Portfolio. There needs to be a concerted effort to disseminate this plan to Provincial funding agencies and gather their comments before the plan is finalized. 

10. Health Canada Policy on External Advisory Bodies (2011)

As a follow up to the Public Affairs, Consultation and Communications Branch's presentation to the SAB in June 2010, the branch provided an overview of key policy standards of the new departmental policy on External Advisory Bodies which was ratified by the Deputy Minister in September 2011. The Branch is now working with all Health Canada external advisory body secretariats to integrate these policy changes into their management and operations, thereby promoting effective and consistent external advisory body management practices across the department.

This item was presented for information purposes only and in response to member concerns regarding accountability it was clarified by the presenters that the new policy is grounded in the principles of openness, transparency and accountability and is intended to improve the consistency of advisory body management across the department by providing concrete direction to secretariat managers and staff on accountabilities, governance, membership, reporting to the public, monitoring and evaluation. The new policy also strengthens the Department's accountability with respect to providing members with a follow-up report on how their advice was used and timely evaluation of the external advisory bodies and the usefulness of its advice.

Action item : Specific mechanisms need to be developed by the SAB Secretariat to provide accountability and feedback to the SAB. The Board will like to see this plan at the next meeting. 

11. Health Canada's Policy and Research Approach to Wind Turbines

Health Canada has developed significant expertise in noise measurement and assessment through its responsibilities under the Radiation Emitting Devices Act (REDA) and the Canadian Environmental Assessment Act (CEAA), providing advice to responsible authorities on noise measurement and the health effects of noise relating to sound levels, including that from wind turbines. Despite the projected growth of wind energy in Canada, public resistance to wind turbine farms is increasing based on concerns over potential health impacts from wind turbine noise.

Advice sought:

  • In the SAB's view, and given the context provided, is Health Canada's approach to this issue reasonable?
  • Does the board feel that the proposed work plan will provide adequate information to assess a causal association between wind turbine noise and human health effects?
  • Would the Board recommend additional steps or considerations?
Discussion

The Board found that Health Canada's approach to this issue is reasonable and impressive. The policy and research work plan will contribute useful information to the growing body of evidence yet will need to be considered in context of other studies in order to support conclusions about wind turbines and health effects.

In relation to the research project proposed by HC, advice on the methodology of the study was provided. The SAB questioned the presenters on aspects of study design with special attention to the questionnaire, control groups and data sources. They were satisfied that the team had covered many of the concerns associated with a study such as this.

Specific aspects covered included the recommendation that all reference to "causality" be removed from the study description as no matter how good a design, it can only be expected to show associations. Also HC was encouraged to consider comparison groups felt essential to adequately assess annoyance. If was felt that the absence of community comparators exposed to sources generating similar complaints (e.g. cell towers) may render interpretation of the questionnaire more difficult. The comparator group doesn't need to have the exact same environmental conditions as the study group. HC agreed to raise this point with the study design peer committee.

The SAB recommended that HC consider undertaking a longitudinal study and acquire, for example, blood pressure histories (pre wind farm) in test groups to assist in the determination of causal attribution. A study of a community post wind turbine development could assess habituation - i.e. whether after many years the annoyance level is reduced as one habituates to the noise levels. Are there any pre-wind farm communities for which HC could gather baseline data? Statistics Canada will provide much of the data that will be used in the study. 

The study needs to mediate confounding factors - how they are framed is vital - social influence and contagion, although difficult to factor in, e.g., real estate values, need to be taken into consideration.

Selection bias of the study participants is a concern and the Board wants Health Canada to pay particular attention to this issue. Community reaction is often strongest prior to the installation of the turbines so the study could be contaminated.  Sometimes reaction goes down after the project is completed and effects are difficult to attribute. The SAB recommended that it would be beneficial to the study if a social scientist, psychologist or sociologist be involved in the design of the survey to ensure that this is covered.  HC provided assurances that this was the case and the Board were satisfied with HC's capacity and expertise to carry out the work. Overall it was felt that the data generated will contribute greatly to the body of evidence, helping governments to make sound science-based decisions.

Summary Advice
  • The Board found that Health Canada's approach to this issue is reasonable and impressive. Advice on the actual methodology of the study was provided. The work plan will contribute useful information but needs to be interpreted in context of other studies in order to support conclusions about wind turbines and health effects.
  • This current study design will not yield causal association data on its own. One study is not enough, but these data will contribute greatly to the body of evidence, helping governments to make sound science-based decisions.
  • When packaging data such as stress studies for dissemination use sub-study comparison groups.
  • Don't waste time on measuring the prevalence of reported health effects from wind farms; assume that they are going to proliferate in the future. There doesn't seem to be value in trying to gauge the annoyance factors associated with aesthetics of the turbines, rather the important thing is to measure the health effects due to noise.

12. Closing Remarks - Renaldo Battista

Dr. Battista thanked the organizers of the meeting, ex officios and SAB members for attending. He summarized the recommendations made over the past two days and solicited from the members, agenda items for the next meeting and their comments. He then adjourned the February, 2012 SAB meeting.

Potential agenda items for the June 2012 meeting:
  • Sodium Reduction File - Next steps - HC
  • Multiple sclerosis file - joint CIHR / HC
  • Antimicrobial Resistance developments (especially C. dificile) (repeat updates)
  • Chronic Disease agenda and files - obesity strategy (i.e., funding), hospital and community-based infections - PHAC
  • PHAC Research Agenda
  • Blood Safety Issues - HC
  • Review and Evaluation of the Science Advisory Board - HC / PHAC
  • A comprehensive briefing on paediatric issues from HC and PHAC, i.e., Fetal Alcohol Syndrome Disorder
  • Comments on the performance evaluation of the Drug Safety Effectiveness Network
  • Barriers to clinical research with humans in Canada
    • Research Ethics Board Standards
    • Scientific Integrity
  • Health Care sustainability research at Health Canada
  • Nanotechnology - HC
  • The regulation and monitoring of Natural Health Products / Non-traditional therapies - HC
  • Personalized medicine - HC
  • Exposure to pesticides: Pest Management Regulatory Agency's Integrated Toxicology Testing report - PMRA
  • Scientific literacy in Canada
  • Re-use of single use medical devices - HC

Next meeting: To be announced.

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