Review shows IBD numbers dropping

A review of trends related to certain digestive diseases show a drop over a five year period.

A timely review of trends related to the incidence of certain digestive diseases in Trail was released to council and the Trail Health and Environment committee at the Monday governance meeting.

The report came a month after a U.S. law firm indicated it is gearing up to file a suit on behalf of Northport residents diagnosed with chronic inflammatory bowel diseases (IBD) claiming the cluster of Crohn’s disease and ulcerative colitis diagnoses are related to historic environmental pollution discharged by Teck into the Columbia River.

“About a year and a half ago I heard the media reports about this issue in Northport,” explained Dr. Tom Kosatsky medical director for environmental health services at the BC Centre for Disease Control, during the meeting. “And I thought why not use administrative data as a quick way to study the occurrence of the disease (in Trail).”

According to the report that was presented in chambers by Dr. Kosatsky and Dr. Andrew Larder, senior medical officer for Interior Health (IH), the rate of IBD occurrence was higher in Trail from 2007-2011 than a neighbouring community and the rest of the province, but over the five-year period, those occurrences have decreased.

The report compiled data from administrative health records of 10,551 residents in Trail who had doctor visits, hospitalizations, and medications related to a IBD diagnosis during that period.

Those results were then compared to over 14,000 people living in Nelson, 17,523 residents in Williams Lake, more than 700,000 patients in the entire IH region and over 4 million people in the province.

“What we did was look at the whole population as a total count and within it the number of people who

had those diseases,” said Kosatsky. “Then we broke those numbers down into percentages,” he said. “Given that the people in Trail tend to be older and use more health services when we looked at a proportion of all health services, IBD is not very much different in Trail than other areas.”

Overall, the study included 235 patients diagnosed with the disease in Trail, Nelson 154, and 99 cases in Williams Lake.

IBD is a group of chronic inflammatory conditions of the large and small intestines that can cause serious illness requiring ongoing medication reviews, possible surgery and in some cases lead to cancer.

The major types of IBD, Crohn’s disease and ulcerative colitis, are reported to occur as a cluster in Northport, meaning an unusually large number of people are sickened by a disease in a certain place and time.

However, any relationship between IBD and environmental pollutants have no known connection and are entirely speculative at this time, according to Dr. Larder.

“The point made during the presentation about how we investigate clusters is really critical,” he explained. “As a medical health officer I have been asked to investigate clusters of disease before and the first thing to do is to gather preliminary easily collectible information to make an assessment of whether it is necessary to devote much greater resources in the study.”

Both doctors recommend to further the study with recent data amassed locally over the last two years.

“I am grateful that this analysis has been done after concerns identified by media activity around Northport,” said Dr. Larder. “Where we are right now reassures me that there isn’t anything critical going on here and we have the time to look at another couple of years worth of data to see if there really is any suggestion of something going on.”

In August 2012, a survey conducted by researchers from the Harvard medical school was published which identified high rates of IBD incidents in Northport.

“It is my understanding that in this survey that with respect to diseases, inflammatory bowel disease stood out,” said Kosatsky. “So they said let’s look at that one starting within a general overview based on the respondent proportion.”

The researchers from Harvard hypothesized that activities of the smelter in Trail was associated with the high prevalence of IBD in Northport, and the BC public health authorities deemed it important to assess the occurrence of IBD upstream, in Trail.

“My initial take on the data that I have seen is that Trail is trending back towards the rest of Interior Health,” he explained. “So I have a very low level of anxiety right now about there being an unusually high prevalence of IBD here.”

Reports of concerns about health problems in Northport attributed to pollution first surfaced in 1994, and prompted an investigation of IBD and kidney disease by the BC Ministry of Health at that time.

That study found hospitalization rates for IBD among Trail residents were no higher than those for residents of the entire Central Kootenay Health Unit.

“Teck is committed to the health and safety of the community in which we live and work,” Richard Deane, manager of environmental health and safety at Teck Trail Operations. “As a member of the Trail Area and Environment Committee (THEC) we will support any additional work deemed necessary.”

Since 1990, THEC has been in partnership with the local community, the City of Trail, Interior Health, and the BC Ministry of Environment, to work on initiatives focused on the health and wellbeing of the Greater Trail community,

“We continue to improve our environmental performance,” said Deane. “Investments we have made over the last 20 years have reduced emissions to air and water by 95 per cent and we remain committed to continuing to enhance our environmental performance.”

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