First Nation reserve and lung disease from uranium mining in the 1940s-60s among the Navajo in the South Western United States (Brugge and Goble, 2002).
1 Running head: URANIUM MINING IN NUNAVUT
Uranium Mining: Assessing the potential health impact of uranium mining in Nunavut
Group Members: Rika Moorhouse Golareh Habibi Danielle Richard Tsogtbaatar Byambaa Tiffany Fabro
Simon Fraser University, Burnaby BC Canada Faculty of Health Sciences HSCI 845: Environmental and Occupational Health December 2011
1
Table of Contents 1.0 Introduction ............................................................................................................................. 3 2.0 Methods .................................................................................................................................... 4 3.0 Background Information ....................................................................................................... 5 3.1 Uranium mining and global markets............................................................................................... 5 3.2 Uranium mining in Nunavut. ........................................................................................................... 5 3.3 Mining and Aboriginal populations. ................................................................................................ 6 3.4 Technical Background on Uranium Mining. .................................................................................. 8 3.4.1 Uranium Mining and Milling........................................................................................................ 8 3.4.2 Onsite Waste Management at Uranium Mines ............................................................................. 9 3.4.3 Environmental risks from mines. ................................................................................................ 11
5.0 HEALTH EFFECTS OF IONIZING RADIATION ......................................................... 12 5.1 Human exposure pathway .............................................................................................................. 12 5.2 Mode of Action................................................................................................................................. 14 5.3 Mechanisms of action and adverse health outcomes (respiratory abnormalities). ................... 18 5.4 Other adverse health outcomes of radon exposure. ..................................................................... 21 Table C. 2. Potential Health Outcomes Associated with Uranium Mining (WISE , 2011) ............. 21 5.5 Co-exposures (synergistic effect) .................................................................................................... 22 5. 6 Evidence linking radon and adverse health outcomes. ............................................................... 22
6.0 RISK CHARACTERIZATION........................................................................................... 24 6.1 Exposure Estimates and Evidence ................................................................................................. 24 6.2 Populations at Risk.......................................................................................................................... 25 6.3 Occupational exposure in Canada. ................................................................................................ 26 6.3.1 Epidemiology studies.................................................................................................................. 27 6.4 Community Exposure in Canada. .................................................................................................. 28
7.0 Inuit Determinants of Health ............................................................................................... 30 7.1 Acculturation. .................................................................................................................................. 30 7.2 Productivity and income distribution. ........................................................................................... 31 7.3 Housing............................................................................................................................................. 32 7.4 Food security. ................................................................................................................................... 32 7.5 Social safety net and addictions. .................................................................................................... 32 7.6 Environment. ................................................................................................................................... 33
8.0 Canadian Regulatory Framework....................................................................................... 34 8.1 Canadian Nuclear Safety Commission. ......................................................................................... 34 8.2 Mining and Nunavut land. .............................................................................................................. 35 8.3 Nunavut Tunngavik Incorporated (NTI). ..................................................................................... 36 8.4 Mineral policies in Nunavut. .......................................................................................................... 37 8.5 Public participation in the licensing process. ................................................................................ 37
9.0 Discussion and Recommendations....................................................................................... 38 9.1 Prevention framework for uranium mine in Nunavut. ................................................................ 38
10.0 Limitations and Assumptions ............................................................................................ 40 11.0 Conclusion ........................................................................................................................... 40 13.0 References ............................................................................................................................ 42 APPENDIX A .............................................................................................................................. 52 APPENDIX B .............................................................................................................................. 53 Figure B.1 Nuclear Fuel Production .................................................................................................... 53 Figure B.2. Uranium Mill Tailings Hazards ....................................................................................... 53 Table B.1. Environmental Concerns.................................................................................................... 53 Figure A.3 Exposure Pathways ............................................................................................................ 54
2 APPENDIX C .............................................................................................................................. 55 Figure C. 9 Mechanism of Potential Pulmonary Fibrosis Development .......................................... 57
APPENDIX D .............................................................................................................................. 58 Table D.1 Summary of Epidemiological Studies for Occupational and Community Exposure .... 58
APPENDIX E .............................................................................................................................. 61 Table E.1: Limitations and Assumptions.................................................................................. 61
3 1.0 Introduction Uranium mining has been proposed in the Kivalliq Region of Nunavut, 80km west of Baker Lake. Historically, the Nunavummiut have rejected uranium mining in the territory with 90% of the community voting against it in 1990 (McPherson, 2003). The question of uranium mining in Nunavut has recently re-opened with the Kiggavik mining project proposed by a French company, Areva Resources. Nunavut Tunngavik Incorporated (NTI), the Inuit organization responsible for overseeing the Nunavut Land Claims Agreement and for promoting mineral rights, has recently reversed its ban on uranium mining and is working on a new position and policy (Mining Watch Canada, 2011). The territorial government is also interested in fostering industrial development. The Kiggavik project is in the early stages of conducting an environmental impact assessment (EIA). Mainstream EIAs are often limited to exploring physical health rather than broader determinants of health. However, sensitive Northern ecologies and Aboriginal health inequities in Canada make it vital that EIA construct appropriate frameworks for evaluating the long-term effects of resource development in Inuit communities (Kryzanowski and McIntyre, 2011; Noble and Bronson, 2010). Since April 2010, the Government of Nunavut has solicited input from communities about the proposed Kiggavik mining project. Observers note that Nunavummiut have had limited access to unbiased information on uranium mining’s potential impacts in Nunavut and with no involvement of public health experts (Mining Watch Canada, 2011). The new direction taken on uranium mining in the territory will set the stage for future conditions of the industry's exploration and excavation around Baker Lake, in the Thelon River Basin and in Nunavut generally. Without clear information on what types of changes uranium mining might induce, it is not possible for Nunavummiut to make authentically informed decisions.
4 This paper reviews the pathways by which uranium mining affects population health from the societal level to the cellular level, assesses health risks, and offers prevention recommendations to minimize negative impacts of uranium mining in Nunavut. The biological effects addressed are those related to ionizing radiation with a focus on exposure to radon gas. The intended primary users of this report are Nunavummiut themselves, who will hopefully have the opportunity to shape policies related to uranium mining in Nunavut, and in developing prevention and risk mitigation strategies that are responsive to community concerns.
2.0 Methods This is an exploratory paper premised on the data collection techniques used in a rapid assessment process (RAP). RAP appraisals are often employed to develop a quick preliminary understanding of an issue (Beebe, 1995). This report asks the question, what are the potential population health impacts of uranium mining in Nunavut? The paper presents a critical population health perspective that considers the prevailing culture and values within Inuit communities (Kryzanowski and McIntyre, 2011; Labonte et al., 2005; Noble and Bronson, 2010). Furthermore, a modified risk assessment is also integrated into the report. It uses epidemiology studies, case studies and grey literature to: 1. Identify hazards associated with uranium mining; 2. Determine possible impacts of uranium mining on health determinants in Nunavut; and 3. Describe impacts of ionizing radiation on health outcomes.
Risks to Inuit health at the individual and community levels are also characterized (refer to appendix A for methods schematic). A population health framework is used within this paper to define the boundaries of exploration around our key question and includes the determinants of health. Recently, indigenous determinants of health and models for defining relevant health
5 indicators for First Nations and Inuit communities have been proposed in the academic literature (Kryzanowski and McIntyre, 2011; Richmond and Ross, 2009). Due to the space constraints of this paper, six key determinants identified by the Inuit Tapariti Kanatami (2007) will be addressed here. These determinants are the following: acculturation, productivity and income distribution, housing, food security, social safety nets and addictions, and the environment. Finally, a prevention framework will be applied to the paper’s findings in order to make recommendations for community action. These recommendations are focused on preventing and mitigating adverse health impacts from uranium mining in Nunavut.
3.0 Background Information 3.1 Uranium mining and global markets. The primary commercial use for uranium today is the generation of nuclear energy for civil electricity requirements (World Nuclear Association, 2011). Other uses of uranium include nuclear medicine, food irradiation, and nuclear weapons. In 1932/3, Canada developed its first uranium mining operations in Port Radium, North West Territories and Port Hope, Ontario. Demand at this time was for radium, which had niche applications. Military demand in the 1940s and 50s supported uranium mining activity in Ontario. However, high quality ore and low production costs in Northern Saskatchewan led to Ontario de-commissioning its uranium mines in the 1990s. Saskatchewan is currently the only province with active uranium mines, alone in supporting Canada as the second biggest producer of uranium on the global market (World Nuclear Association, 2011). 3.2 Uranium mining in Nunavut. Uranium prices on the global market experienced significant upward growth from 2005 to 2007 (Locantro, 2005). These prices reached a high of about $300/kg in 2007, with a corresponding rise in stock price for uranium mining companies and the spurring of uranium
6 exploration (Mickey, 2008). The territory of Nunavut reversed its ban on uranium mining during this period. In the 1980s and 1990s, Cameco Corporation had sought licensing of the Kigavvik project in order to mine rich uranium deposits in the Kivalliq Region of what is now Nunavut. Community resistance in the territory led to a ban on uranium exploration and mining, and this struggle was a key political catalyst for the settlement of the Nunavut Land Claims Agreement with the federal government. Since that time, Areva Resources Incorporated, an arm of the French government, has purchased the Kiggavik property and is currently undergoing an environmental impact assessment in order to secure its license to mine the area (WISE Uranium, 2011). Opening Nunavut to greater industrial activity can be understood as a way to bring prosperity to Nunavut through job opportunities, taxes, royalties and fees associated with mining. However, it is also part of a larger sea change tied to climate warming, the resultant melting of sea ice in the North West Passage, and consequent interest by the Canadian state in industrial opportunities that a navigable route through the Arctic Ocean presents for off-sea exports of mineral commodities (Byers, 2011). There is an important overarching theme of environmental dispossession that runs through the historical and contemporary relations between Canada’s Northern Aboriginal communities and their Southern counterparts. This report attempts to present some of the potential health risks to Inuit associated with this political context while also presenting the biomedical risks linked to radon exposure. 3.3 Mining and Aboriginal populations. There has been mass exploitation of natural resources from traditional Aboriginal lands in Canada since the 1800s (Lapaime, 2003). While mining operations bring the promise of employment and some infrastructure development, historically, Aboriginal communities have experienced negative environmental and health outcomes as a result (Fidler and Hitch, 2007). High profile examples include the 1970s mercury contamination on Ontario's Grassy Narrows
7 First Nation reserve and lung disease from uranium mining in the 1940s-60s among the Navajo in the South Western United States (Brugge and Goble, 2002). While mining industry regulations for occupational and environmental safety appeared in the 1970s, the recent state of emergency called by the Attawapiskat First Nation in the North's James Bay is an important example of how abject poverty in indigenous communities can persist alongside lucrative diamond mining operations just 90km away (Angus, 2011). As the potential benefits of mining for the Canadian economy gained recognition in the 1900s, the Government of Canada began to conceptualize the industry as a 'public good' (Lapaime, 2003; McPherson, 2003). Regulation and the legal framework in the provinces and territories reflected a 'free-entry' system in which mining companies could essentially explore all Crown lands with little to no state interference (McPherson, 2003). This permissive atmosphere has arguably created a regulatory culture that de-emphasizes environmental and human health concerns in practice. In the 1990s, Inuit from Quebec's Nunavik region expressed outrage at the presence of oil and chemical wastes and the deteriorating storage conditions at abandoned exploration sites (Duhaime, Bernard, and Comtois, 2005). In the face of inadequate mining consultations and lack of industry interest in historical, spiritual, cultural and other dimensions of community concerns, Inuit to the East and North East of Nunavik fought for and eventually won control and ownership rights in 1993 over what is now the territory of Nunavut (McPherson, 2003). However, the shift to Inuit-controlled government in Nunavut has not translated into a consensus on regional land use policies. Despite numerous government directives on sustainable development and Aboriginal involvement in mining industry decision-making, observers note that industry accountability and substantive community engagement in the environmental assessment and licensing processes are
8 still lacking (Lapaime, 2003; Mining Watch Canada, 2011; Sub-committee of the Intergovernmental Working Group on the Mineral Industry, 2005). NTI’s decision to change its uranium mining policy without community consultation and complaints that Nunavummiut are not receiving clear, unbiased information on potential uranium mining impacts are examples of these enduring problems (Mining Watch Canada, 2011). While the scrupulous observation of government regulations and standards is essential across industries, the stakes are particularly high in uranium mining. Due to the long half-life of radioactive decay products, contamination of the environment from uranium waste is essentially irreversible (Vakil and Harvey, 2009). Not only do uranium progeny have direct impacts on human health and cause long lasting change to the environment, but ionizing radiation is known to act synergistically with other contaminants that are occupationally and residentially prevalent in some populations. These conditions make uranium potent and particularly harmful, and why it generates such safety concerns among public health experts and communities close to facilities. The next section of this report (section 3.4) provides some technical background on uranium mining and the on-site hazards associated with its excavation and processing. 3.4 Technical Background on Uranium Mining. 3.4.1 Uranium Mining and Milling The nuclear fuel chain is the series of steps required to prepare, use, manage and dispose of nuclear fuel. This cycle includes uranium mining, uranium enrichment and refinement, nuclear power generation, and waste disposal. While every step in this cycle has important implications for environmental and human health, the sections below briefly review the processes and waste products associated with uranium mining and milling. This limited review acts as a background for our later discussion on the health effects of exposure to radon.
9 Uranium mining is the process of extracting uranium ore from the ground. As with other types of hard rock mining, there are several techniques of extraction. In Canada, open-pit and underground mining are most widely used, with the Kiggavik project proposing three open pit mines and one underground (World Nuclear Association, 2011; WISE Uranium, 2004). Open-pit mining is the process of extracting rock or minerals from an open pit, and is used when minerals are near the earth surface. Underground mining involves construction of shafts and tunnels to access and remove uranium ore. This technique contributes to less wasted rock removal and less environmental impact. Uranium mills are typically located near the mines to limit transportation of the ores. In the mill, the ore mined in open-pit or underground mines is crushed, ground, and then leached (with sulfuric acid or alkaline solution) to dissolve the uranium oxides and separate them from the other solution constituents to recover the uranium. Essentially, a uranium mill is a chemical plant designed to extract the uranium from the ore. The uranium concentrate, commonly known as "yellow cake"(U3O8 with impurities) is then packed and shipped in casks from the mill for further refinement and enrichment. Refer to Figure B.1 for an image of the nuclear fuel production process and for information on uranium waste (described below). 3.4.2 Onsite Waste Management at Uranium Mines While waste management problems are common throughout the nuclear fuel chain, waste management onsite at uranium mines poses a significant challenge due to the presence of radioactivity.
While uranium itself is barely radioactive, the mined ore is associated with
radioactive elements from the radioactive decay chain such as radium and radon. The wastes generated from mining generally fall into four categories: waste rock from the actual mining, tailings from the ore processing (milling), waste water, and industrial waste (World Nuclear Association, 2011). For the purpose of the report, waste rock and mine tailings, the two principal wastes generated from uranium mining, will be explored.
10 Waste Rock- Waste rock is produced during open-pit and underground mining. The waste piles are either placed near the pit, are relocated into a former open pit, or can be processed into gravel or cement used for road or railroad construction. In an open-pit mine, the amount of waste rock removed is several times the volume of the ore mined. Waste rock may be barren of the mineral of interest, or it may contain trace quantities at too low a concentration to be economically extracted. The solid wastes contain all of the radium present in the original ore. When this radium undergoes a natural radioactive decay it produces radon gas. Waste rock often contains elevated concentrations of radioisotopes compared to normal rock. (World Nuclear Association, 2011). Mill Tailings- The waste generated from the milling process is the uranium mill tailings, ranging in character from sludge to coarse sands. Since uranium represents only a minor fraction of the ore (for example 0.1%), the amount of sludge produced is nearly the same to that of the ore mined. The sludge contains nearly 85% of the initial radioactivity of the uranium ore (ACAT, n.d.; WISE, 2004). As all the uranium in the ore cannot be extracted due to technical limitations, the sludge contains 5-10% of the uranium initially present in the ore and also contains other contaminants such as arsenic and polonium (WISE, 2004). In Canada, tailings are primarily placed in mined-out pits or engineered dams (World Nuclear Association, 2011). However, historically, tailings were disposed in the nearest receptacle, as a matter of convenience and cost. Disposal sites included topographic depressions in wet environments (e.g. valleys, lakes), or the piling of waste products on flat areas in drier climates (IAEA, 2004). Many of these methods were deemed unacceptable because of the high probability of containment failure. More recent uranium disposal and containment methods have narrowed in an effort to contain the tailings more securely. Current uranium disposal methods
11 favor disposal of tailings in mined-out open pits (IAEA, 2004). Special construction is done to eliminate excess pore-water pressure and to promote the flow of groundwater around, and not through, the tailings. This preferred method reduces human intrusion and eliminates the release of radon into the environment. Presenting the most serious long-term hazard generated from uranium mining, the uranium mill tailings have to be managed with particular care (World Nuclear Association). Hazards from mill tailings- A ‘hazard’ is a source of potential harm. For the purposes of this report, hazards of interest are defined as (b) ionizing radiation and (a) anthropogenic sources of ionizing radiation. Anthropogenic hazards from mill tailings pose great human health risk due to the presence of radioactivity. Hazards from mill tailings include the following (WISE, 2004; IAEA, 2004): • • • • • • • • • •
Gamma (and beta) radiation from the surface of the tailings pile (especially after initial deposit); Dust blowing to surrounding areas containing radioactive and toxic constituents (radium and arsenic) when uncovered residues dry out; Radon gases (new radon continuously formed by decay of radium) being released and transported to large distances, settlement of communities and people near tailings increasing exposure; Seepage release containing radioactive and toxic constituents into the soil and into the ground and surface water; Dam failure due to erosion, flooding, earthquake and heavy rain; Physical weakness of embankments and slopes leading to breaching; Cracking induced by settlement; Spillway collapse by heavy overflow of decant or slurry after severe rainfall; and Possible collapse from excavation during open-pit mining activities. Refer to Figure B.2, for an image of uranium mill tailings hazards. 3.4.3 Environmental risks from mines. The potential impacts of open-pit and underground mining and milling residues on the
environment are numerous. They include environmental degradation, contamination, reduced ecosystem viability and biodiversity, and aesthetics (IAEA, 2004). Many environmental impacts are a result of acute and chronic impoundment failures at mining/milling facilities and have
12 important repercussions for both population and environmental health. While these facility failures are not exclusive to uranium mining, the radioactive waste in tailings adds an additional health risk to the existing concern around effective prevention at mine sites. This report is interested in population health and thus addresses environmental impacts as they relate to Inuit community health (see section 6.4 below). Unfortunately, a full treatment of uranium mining and milling impacts on environmental health is beyond the scope of this report. Refer to Table B.1 for a list of environmental concerns related to uranium mining and waste management.
5.0 HEALTH EFFECTS OF IONIZING RADIATION 5.1 Human exposure pathway Populations most at risk of exposure to uranium and its radioactive elements are those employed in the mining and milling operations, or in uranium enrichment and processing activities (ATSDR, 2009). Communities located near uranium mining districts may also be at risk of exposure to increased radiation doses from mining, milling wastes, transportation of radioactive materials, radioactive dust, and contaminated water and food sources (IAEA, 2004). The community of Baker Lake is 80km away from the proposed Kigavvik mine site. However, temporary accommodation and amenities could be constructed much closer to the mine and milling compounds. The geographic proximity to mines for each of these residence locations raises their own population health concerns and will be discussed in section 6.4. The most common routes of exposure to ionizing radiation from uranium mining are inhalation, ingestion, and absorption (dermal).
Refer to Figure B.3 for a graphic of the
exposure/biological pathways for ionizing radiation from uranium mining. 5.1.1 Inhalation. Inhalation is the primary ionizing radiation exposure pathway for workers during the mining and milling process (ATSDR, 2009). The general population in
13 nearby mining communities are also exposed (ATSDR, 2009). For example, due to wind erosions and insufficient covering of tailings, small dust particles containing radioactive elements can be blown from the tailings, while radioactive radon gas diffused from the piles and can also be released into the atmosphere, both having the ability to contaminate the environment and travel to nearby communities. In addition, inappropriate uses of mill tailings and waste rock as re-useable building materials (mainly sand for concrete making or backfill), can expose workers and the larger community to the radioactive elements of uranium, mainly by inhalation of contaminated dust particles or radon gas (IAEA, 2004). Therefore, radon concentrations can be found both indoors and outdoors many kilometers away from the heap (IPPNW, 2010). When this occurs, radioactive substances are brought into the body by inhalation. 5.1.2 Ingestion. The most common non-occupational ionizing radiation exposure pathway associated with uranium mining/milling is ingestion (ATSDR, 2009). Surface water, groundwater, and soils can be contaminated through uranium mining and waste activities (e.g. water seepage and dust from the tailings, and high precipitation causing migration of the radioactive elements). Contaminated water and soils then lead to uptake of radioactive elements into the body via food chain (e.g. caribou), vegetation and water. 5.1.3 Absorption (dermal). Workers are particularly at risk of dermal exposure to uranium powders and metals during the mining and milling process, and when coming into contact with uranium wastes (ATSDR, 2009). Many of the radioactive decay products in mine tailings produce gamma radiation, which poses a health hazard to people in the immediate vicinity (US Environmental Protection Agency). Gamma rays are absorbed through the entire body.
14
5.2 Mode of Action. 5.2.1 Uranium decay chain. In order to grasp how exposure to radioactive elements can cause adverse health effects it is useful to understand the basic underlying physics. There are 92 occurring elements on earth. Some of these elements have more than one type or ‘isotope’. In the natural environment, uranium is composed of three isotopes (U-238, U-235, U-234). These isotopes can be found in uranium ore (WISE, 2004). Uranium-238 is the most prevalent isotope in natural ore, and the most unstable of the three. It makes up over 99% of natural uranium by weight with a half-life of 4.46 billion years (IEER, 2005; WISE, 2004; Vakil and Harvey, 2009). These uranium isotopes are radioactive. This means they are unstable elements prone to spontaneously decay into other isotopes or elements, releasing subatomic particles and photons along the way. In the radioactive decay process, the unstable isotope jettisons subatomic particles or photons from the nucleus (IEER, 2005). These subatomic particles or photons are ejected as alpha particles, beta particles or gamma radiation. The uranium radioactive isotopes proceed through the decay chain in order to reach a more stable state (refer to figure C.1). A key element in the uranium decay chain is radon-222, which emits alpha particles when it decays further. Radon will be discussed more in section 5.2.d below. The decay chain ends at lead-206, which is a stable isotope (IEER, 2005). When the decay chain occurs underground, the majority of alpha and gamma particles are absorbed by the earth before reaching its surface (FEMAPO, 2011). However, mineral mining changes things radically (FEMAPO, 2011). Once mobilized, uranium ore cannot return to its original condition as found underground (FEMAPO, 2011). If ore dust or radon gas are inhaled or ingested by miners or surrounding community members above ground, there is a potential risk
15 of adverse outcomes such as chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, lung cancer and other malignancies increasing (IEER, 2005; WISE, 2004). 5.2.2 Ionizing radiation. Collectively, the alpha, beta , and gamma ejected during the decay series are known as “atomic radiation” (Vakil and Harvey, 2009). When they pass through a material, their energy can knock an electron out of orbit (IEER, 2005). The knocked out electron leaves behind a positively charged ion. This process is called ‘ionization’, and is why atomic radiation is also known as “ionizing radiation” (IEER, 2005). Refer to figure C.2. Alpha Particles. Alpha particles are a helium nuclei composed of two protons and two neutrons (Vakil and Harvey, 2009; IEER, 2005; figure C.3). The eight alpha emitting nuclides in the U-238 decay series are most destructive to humans and animals when compared to emitted beta and gamma radiation (WISE, 2004; Vakil and Harvey, 2009). Since alpha particles are heavy (compared to the beta particles and gamma rays) and are positively charged, they do not have the ability to pass through paper or the skin (refer to figure C.4). Beta Particles. Beta particles are released when an isotope loses one electron through the radioactive decay chain (refer to figure C.3). In other words, beta radiation is composed of massless, high-energy electrons that are negatively charged (IEER, 2005). Beta particles can penetrate human flesh superficially but can be stopped by aluminum or glass (IEER, 2005). Figure C.3. Ionizing Particles
Source: IEER (2005). Uranium: Its uses and hazards. Retrieved on November 12, 2011 from: http://www.ieer.org/fctsheet/uranium.html
16 Gamma rays. Gamma rays are high-energy electromagnetic waves that are also emitted through radioactive decay (CAREX Canada, 2011). Gamma rays consists of photons and their weight is almost negligible. Therefore, they have the ability to penetrate through the skin and internal organs. The release of gamma radiation from the decay of Pb-214 (lead) and Bi-214 (bismuth) contribute to external radiation hazards located near uranium mines (IEER, 2005). Gamma rays have the ability to ionize atoms and split chemical bonds in the cell (refer to figure C.4) (IEER, 2006). This process of cell damage categorizes this hazard as a form of “ionizing radiation” (Health Canada, 2008). Gamma rays “are more likely to cause single point damage in DNA, and single-strand DNA breaks which are more readily repaired (Vakil and Harvey, 2009; p.14). However, during the repair stages, cell mutations can occur (Vakil and Harvey, 2009).
Figure C.4. Schematic Figure for Ionizing Radiation
Source: IEER (2005). Uranium: Its uses and hazards. Retrieved on November 12, 2011 from: http://www.ieer.org/fctsheet/uranium.html 5.2.3 Ionizing radiation and human organs. Based on a recent report by New York State University Department of Health, tissues and organs respond differently to ionizing radiation. For instance, bone marrow, breast, thyroid gland , and lungs are highly sensitive to radiation whereas the cervix or the prostates are very insensitivity. Table C.1 ranks tissues and organs based on their sensitivity to radiation from high to low sensitivity (www. health.state.ny.us). Factors that influence the risk associated with exposure to radiation include dose rate, sex, age, latency, genetic susceptibility, tumour type and cellular factors (IARC, 2000).
17 As the dose rate and absorbed dose of radiation increases, so does the severity of the health outcome (IARC, 2000; Health Canada, 1998). The dose-response relationship will be discussed more in section 6.0. Table C.1. Human Tissues and Organs Ranked by Sensitivity to Radiation . High Moderate Low Bone Marrow Stomach Brain Breast (premenopausal) Ovary Bone Thyroid (child) Colon Uterus Lung bladder Kidney Skin Esophagus Liver Source: New York State Department of Health. Radiation and Health. Retrieved November 20, 2011 www. health.state.ny.us 5.2.4 Alpha radiation from radon gas. Radon gas is not very harmful when it is outside of the body. However, once it is inhaled, its “short lived” progeny (half-life of few minutes or less) emit alpha particles, which are very harmful inside the body (refer to figure C.5). Alpha particles released from the radon progeny cannot travel long distances and thus do not leave the airways of lungs and travel to other organs. Therefore, it is not surprising that the risk of respiratory diseases such as lung cancer, pulmonary fibrosis and COPD is much higher in uranium miners and surrounding communities (IEER, 2005; CAREX Canada, 2011). Radon gas itself is mainly dispelled from the body through exhalation. However, the radon progeny remain in the lung airways and go through further radioactive decay, releasing more alpha particles. The amount of energy release by the progeny is hundreds of times more than what is produced by the original decay of radon (IEER, 2005). “An alpha particle emitted from radon daughter decay is in the form of a high energy helium ion, He2+. These helium particles transverse cell nuclei in a linear pattern and deposit energy in a fashion known as LET. LET, otherwise known as Linear
18 Energy Transfer, refers to the energy transferred per unit of path traveled by the ionizing particle,” (IEER, 2005). As mentioned above, in comparison to beta and gamma radiation, alpha particles are massive and cannot travel long distances. Therefore, they are efficient in transferring energy and their LET quantity is high. When this energy is transferred, it can lead to double-stranded deoxyribonucleic acid (DNA) damage, stress to the cell cycle or even cell death. Epithelial cellular changes caused by the alpha particle emission from a single radon daughter can be seen by microscope. This report is focused on understanding the cellular mechanism behind exposure to radon gas (particularly alpha radiation) from uranium mines and the development of pulmonary diseases such as COPD, pulmonary fibrosis, silicosis and lung cancer (IEER, 2005; Samet et al., 2000). 5.3 Mechanisms of action and adverse health outcomes (respiratory abnormalities). Through the inhalation exposure pathway discussed above, particles generated through the mining process are deposited in the lung based on their size. Particles with a diameter of 10 micron or larger are deposited in the higher part of respiratory track and are often eliminated through the lung’s mucosa. However, smaller particles are more of a concern because they defuse further into the respiratory system and cannot be eliminated by the immune system. As mentioned above, radon progeny that are deposited into the airways of the lung continue decaying and often emit alpha particles and gamma rays that can be extremely dangerous to internal organs (Samet et al, 2000): “alpha particles release small bursts of energy which are absorbed by nearby lung tissue. This results in lung cell death or damage” (Health Canada, 2011). Alpha radiation can potentially lead to lung diseases through two main mechanisms: DNA double strand breaks and by creating reactive free radicals (Field RW, 1999; CAREX Canada 201: IARC, 2000).
19 5.3.1 Mechanism A: Alpha radiation results in DNA double strand breaks. Lung cancer is the more serious health outcome linked to uranium mining and its decay products (IEER, 2005). Ionizing radiation occurs in the body when energy released from alpha particles and gamma rays emit enough energy to knock out electrons in the cell causing the disruption of the chemical bonds in DNA material and neighbouring water molecules (Refer to figures C.5, C.6) (Miller RC et al, 1999; CAREX Canada, 2011; IARC, 2000). When compared to other forms of radiation, alpha particles are more likely to cause double-strand DNA breaks (Vakil and Harvey, 2009). Recent studies report that alpha radiation breaks the covalent bond between tyrosine and Adenine nucleotide on DNA double strand sequence (CAREX Canada, 2011). Double strand DNA breaks are very hard to repair and “attempts at repair can lead to deletions, inversions, acentric fragments and cross-linking, as repair enzymes try to work with missing and scrambled pieces” (Vikal and Harvey, 2009, p.13). In addition, a single track of radiation, at any dose, can disrupt the DNA base and double strand binding (IARC, 2000). However, cell mutation and genetic damage is usually caused by low radiation doses (Tubiana, 2009, Suit, Goldberg, Niemierko, et al., 2011). The stochastic effect occurs when these modified cells have the potential to become malignant (IARC, 2000). When cells are in the dividing cycles, they are at greatest risk for proliferating into cancerous cells if they are ionized (EPA, 2007, Health Canada, 1998). For instance, DNA double strand breaks results in mutation in p53 (tumour suppressor gene). P53 involves cell differentiation and cell cycle arrest in G1 phase of a cell that is dividing and going through a cell cycle (Adams PD et al, 1999). This means that p53 naturally works as a cell “gate keeper.” If there is any abnormality in cell, such protein does not let cell division take place. Instead a series of mechanism results in apoptosis or program cell death of that particular cell. Such mechanisms
20 prevent abnormalities to pass from one cell to another or from one generation to another (Adams PD et al, 1999). However, when p53 is mutated, its function is altered. When p53 cannot function normally, abnormal cells can pass through the “gate,” divide limitlessly, and become malignant (IEER, 2005). Figure C. 5. Inhalation of Radon Result in Alpha Radiation
Source: IEER (2005). Uranium: Its uses and hazards. Retrieved on November 12, 2011 from: http://www.ieer.org/fctsheet/uranium.html 5.3.2 Mechanism B: Oxidative reactive species. Alpha particles from radon progenies also result in creation of reactive oxygen species (ROS). These species are a result of DNA mutation which may alter the function of some of the key proteins such as P53. Mutation in such key proteins results in cancer development and/or progression (IEER, 2005; Azad N et al, 2008). Moreover, reactive oxygen species such as superoxide and hydrogen peroxide either directly or indirectly, through formation lipid peroxidation products, such as 4-hydroxy-2-nonenal and F2isoprostanes, result in oxidative stress and lead to increased inflammation (refer to figure C.7; Azad N et al, 2008). Oxidative stress initiates by activation and phosphorylation MAPKinase pathway, one of the critical intercellular signalling pathway, results in activation of “redoxsensitive transcription factors such as nuclear factor- κB and activator protein-1” (Azad et al, 2008; refer to figure C.8). Activation of the above mentioned transcription factors result in over expression of pro-inflammatory chemokines such as tumour necrosis factor-a (TNFa),
21 interleukin(IL)-6.The abundance of such pro-inflammatory cytokines lead to several malignancies such as lung cancer (Azad et al, 2008; Barnes, 2010). ROS that is generated from alpha radiation of radon progenies can also potentially lead to emphysema, pulmonary fibrosis, COPD, silicosis, and chronic interstitial pneumonia (CAREX Canada, 2011; Barnes, 2010; IEER, 2005). Figure C.7 ROS Directly or Indirectly May Result in Oxidative Stress
Source: Azad N, Rojanasakul Y, VallyathanV. (2008) Inflammation and Lung Cancer: Roles of Reactive Oxygen/Nitrogen species. Journal of Toxicology and Environmental Health, Part B, 11:1–15 5.4 Other adverse health outcomes of radon exposure. Radon can get into the body through other exposure pathways such as ingestion and absorption. Radon progeny can also get into blood stream by crossing the lung membrane, reaching other organs and causing other malignancies and diseases. Table C. 2. Potential Health Outcomes Associated with Uranium Mining (WISE , 2011) Potential Health outcome Biological pathway/ Exposure Lung cancer Inhalation Nonmalignant respiratory diseases Pulmonary fibrosis Inhalation Silicosis Inhalation COPD Inhalation
22 Leukemia (blood cancer) Childhood cancer Breast cancer Kidney cancer Colorectal cancer Prostate cancer Birth defect Kidney (renal degeneration) Arteritis Psychological disorder
Ingestion/inhalation Inhalation/ingestion Ingestion/inhalation Ingestion-water Ingestion-water Ingestion-water Inhalation/ ingestion Ingestion-water Ingestion-water Ingestion/inhalation/absorption
5.5 Co-exposures (synergistic effect) Co-exposure with tobacco smoke is important to understand because of its synergistic effect with radon. The National Research Council (1998) reported that there is significant evidence on synergistic effect between radon and smoking: …the number of cancers induced in ever-smokers by radon is greater than one would expect from the additive effects of smoking alone and radon alone. Nevertheless, the estimated 15,400 or 21,800 deaths attributed to radon in combination with cigarette-smoking and radon alone in never-smokers constitute a public-health problem (NRC, 1998). In addition, since uranium miners are exposed to high levels of dust, silica from the ore dust may act as a modifying factor that increases effects of radon progeny on the body; similarly radon is thought to play a contributing role, through an additive effect, on the development of silicosis (Samet et al 1984; Hnizdo et al, 1997). Other modifying factors that may increase the effects of radon on the body include diesel exhaust and dose rate. 5. 6 Evidence linking radon and adverse health outcomes.
5.6.1 Overview. Epidemiological studies were reviewed to evaluate the link between uranium and uranium decay products and adverse health outcomes for miners and surrounding communities (refer to appendix D). These studies involved case-control studies, cohort studies,
23 in vivo testing and in vitro testing. Overall, these studies provide evidence for the association between radon and radiation exposure from uranium mining and the increased incidence and mortality of lung cancer, other respiratory disease (tuberculosis, pneumoconiosis), and urinary system disease. There is strong evidence suggesting that uranium miners have an increased risk for developing lung cancer and other respiratory illnesses. 5.6.2 Limitations of available epidemiology studies. There are a few limitations to consider when reviewing the epidemiology studies on the association between radon and radiation exposure from uranium mining and adverse population health outcomes. There was only one epidemiology study based in Canada examining the impact of uranium mining on miners. The majority of the epidemiology studies were conducted in the United States. There is a great need for epidemiological studies to take place in Northern Canadian environments to explore the impact of uranium mining on the unique ecosystems and their communities. Secondly, there were a limited number of epidemiology studies that examine the health impact of uranium mining on nearby communities. The recruitment of participants from nearby mining communities for a long-term cohort study may be difficult due to the nature of the mining development cycle (mining communities are often highly transient). Another limitation to the epidemiology studies is that for communities, since there is a long latency period for cancer to develop from various exposure pathways, it may be difficult to draw direct associations due to confounding factors. More studies are needed to explore the various exposure pathways from uranium mining and their impact on indigenous populations. These indigenous populations are often vulnerable populations who are at greater risk for developing adverse health outcomes. Lastly, due to the strong evidence supporting the health outcome of uranium miners, these
24 epidemiology studies will be used in the report to draw inferences for population health concerns.
6.0 RISK CHARACTERIZATION This report does not attempt to quantify risk of exposure to radon for Inuit communities. Instead, data on exposure and risk in occupational and residential settings is reviewed. This report assumes that occupational exposure to radon via inhalation poses the greatest population health risk in light of literature supporting this (see Table D.1). Specific population characteristics described below (section 6.2) suggest that community exposure to indoor radon by inhalation might pose a key secondary health risk that should also be considered. Risks from low dose exposure only are discussed in this report. Radon is a known human carcinogen with biological effects that are dependent on exposure rates. Specifically, there is an inverse dose-rate effect. As a carcinogen, radon is most effective at chronic low rates of exposure (1000 WLM was 20, 57, and 71 respectively. In addition, the researchers found that the SMR for pulmonary fibrosis from cumulative radon progeny exposure (with a 95% CI above 1.0) from 120 – 400 WLM, 400 – 1000 WLM and >1000 WLM was 3.3, 7.0, and 6.8, respectively (Schubauer-Bergan et al., 2008). This data strongly suggested an association between adverse health outcomes and occupational cumulative exposure to radon decay products above 100 WLM. 6.4 Community Exposure in Canada. The same strength of evidence linking community exposure to radon from uranium mines and lung cancer is not available. A series of reports were published from 1989 to 2004 on community health effects for populations near nuclear reactors, but findings were inconclusive due to small study samples (Clarke et al., 1989; McLaughlin et al., 1992; Johnson and Rouleau, 1991; Green et al., 1997; Zablotska et al., 2004). Population, geography and exposure considerations from these studies are also significantly dissimilar to the risks for communities in Nunavut. While the literature points to ingestion of radon as the most likely non-occupational exposure route for populations near uranium mines (ATSDR, 2009), specific susceptibilities and vulnerabilities characteristic of Canadian Inuit present the possibility that indoor radon exposure via inhalation may be the most likely non-occupational exposure. Generally, exposure to high concentrations of indoor residential radon is the result of naturally occurring radon underground. A 2010 Health Canada survey indicated that no homes sampled in Nunavut had radon concentrations above the Canadian Radon Guideline (Health
29 Canada, 2010). Arctic ice and snow are responsible, in part, for blocking the radon gas’s passage up through the earth and into homes. However, anthropogenic sources of indoor radon have not been given much space in the literature. High concentrations of indoor radon as a result of mill tailings might be a key consideration for those living in accommodation near the mines. A casecontrol environmental exposure assessment of uranium mining and milling sites near Karnes County, Texas looked at this phenomenon. Households within 1 mile downwind from the sites, or 0.5 miles in other directions were considered exposed (Au et al., 1998). Among other significantly higher levels of uranium and its progeny in soil and water, the study found that indoor dust samples from exposed homes were statistically higher (p=0.0003). Inuit homes are generally single-storey units with poor ventilation (Kovesi et al., 2007). Overcrowding (the worst in Canada with an average of six people per dwelling) and indoor smoking (94% in sampled homes) have been associated with high rates of lower respiratory tract infections in Inuit children (Kovesi et al., 2007). A young Canadian Inuit population, synergistic effect of tobacco smoke and radon, the greater biological susceptibility of children to the effects of radon gas (Bi et al., 2010), and a high background rate of lower respiratory tract infection present, combined, a potentially disastrous level of risk for Inuit children living in homes close to uranium mines. Lack of access to antioxidants such as fresh fruits and vegetables due to remote Northern geography (ATSDR, 2011; Beaumier and Ford, 2010) and elevation of radon levels in cold climates (CMCH, 2010) have not been assessed for their potential influence on susceptibility and vulnerability to adverse health outcomes. Those who do develop respiratory disease have little access to public health care services (Inuit Tapiriit Kanatami, 2009). Early detection of disease requires screening programs, diagnosis requires appropriate technology and recruitment/retention of skilled human resources,
30 and
treatment/care
requires
infrastructure,
procurement
and
supply
chains,
and
recruitment/retention of more skilled human resources. Cultural barriers (language, different knowledge systems) create additional access issues, with palliative care virtually unknown and non-existence in many Inuit communities (Inuit Tapiriit Kanatami, 2009). These are critical prevention failures that need to be considered when attempting to mitigate potential impacts of uranium mining in Nunavut.
7.0 Inuit Determinants of Health Mining affects all aspects of the determinants of health. This section will explore the potential impact of mining on Inuit specific determinants of health, identified by the Inuit Tapariti Kanatami (2007), which include: acculturation, productivity and income distribution, housing, food security, social safety nets and addictions, and the environment. 7.1 Acculturation. The Western labor system has greatly impacted the culture of Aboriginal communities through different forms of communication and lifestyle (Gibson and Klinck, 2005). The need for English-speaking public establishments in Northern mining communities has contributed to the loss of Aboriginal languages (Gibson and Klinck, 2005). This may be a concern for the Inuit community in Nunavut, since only 50% of Inuit reported speaking an Inuit language as the primary language spoken at home in 2006 (Inuit Tapariit Kanatami, 2008). In addition to the threat of losing traditional language, the identity and cultural cohesion of the Inuit that is embedded in traditional harvesting activities and the consumption of traditional food, may also be greatly impacted by mine development (Egeland, Faraj, and Osborne, 2010, Buell, 2006). Cultural festivities and rituals that are structured around meat harvest are greatly impacted by shifting male roles (from traditional hunters to miners) (Gibson and Klinck, 2005). Miners who
31 traditionally hunt spend less time on the land when they gain employment as a miner (Gibson and Klinck, 2005). For the community, who rely on the hunters, this threatens the consumption of traditional meat such as Cariboo (Gibson and Klink, 2005). Furthermore, the male role transition also inhibits the passing of traditional skills and ecological knowledge to younger generations (Gibson and Klink, 2005). 7.2 Productivity and income distribution. Employment opportunities from mining development have the potential to foster independence, freedom and pride (Gibson and Klinck, 2005). Northern Aboriginal communities in Canada can greatly benefit from the discovery of several mineral deposits, through job creation, business opportunities, royalties, and industrial taxes (Bowes-Lyon, Richards, and McGee, 2009). In the Northwest Territories, the main economic driver is the mining industry, which has created approximately 3100 direct and indirect jobs (Gibson and Klinck, 2005, Buell, 2006). This could be a possible economical outcome with uranium mining in Nunavut, since the hiring of Aboriginal peoples is already embedded in negotiated agreements with the mining industries (Gibson and Klinck, 2005). Mining also offers the highest wages in the resource sector in Canada (Gibson and Klinck, 2005). In the 2000 census, mining employees earned on average $ 1,130.50/week compared to $626.45/week in other industries (Gibson and Klinck, 2005). Mining employment opportunities offers ample benefits for mining families. However, despite the economic opportunity, there are other health consequences to consider with the rapid rise and fall of disposable income, such as the increased risk for addictive behaviours (substance abuse, gambling) and the rising incidence of mental stress following mine closure (Gibson and Klinck, 2005).
32 7.3 Housing. Access to housing is already limited for Inuit populations residing in rural areas (Egeland, Faraj, and Osborne, 2010). In Nunavut, 53.9% of children live in crowded housing (Egeland, Faraj, and Osborne, 2010). The influx of transient mining populations are known to burden the housing infrastructure in remote northern locations (Buell, 2006, Gibson and Klinck, 2005, Lovell and Critchley, 2010). Not only is housing affected by near-by mines, the rising population of mining towns also puts stress on the availability of traditional foods (Gibson and Klinck, 2005). 7.4 Food security. In 2000, nearly 75% of Inuit adults harvested country foods, which include: caribou, fishing, and gathering wild berries (Inuit Tapaririit Kanatami, 2008). Northern communities are already at risk for accessing contaminated food supplies due to “ the invisible contamination of traditional foods with man-made chemicals such as polychlorinated biphinyls (PCBs), dioxins, toxaphenes, and other pesticides, which are transported to the Arctic by ocean and atmospheric currents and then are biomagnified in the marine food web, ultimately end up in humans” (Bjerregaard, Young, Dewailly, and Ebbesson, 2004, p. 32). Since, the consumption of traditional foods and medicine from their land is even more vulnerable to surrounding industrial activity, Inuit populations are at an increased risk for consuming contaminated country foods near-by mining sites (Mudd, 2007, Kuyek, 2004, Richmond and Ross, 2009). 7.5 Social safety net and addictions. The social strata and influx of transient populations often disrupts community connectedness (Lovell and Critchley, 2010). Inuit communities disrupted by the influx of a transient workforce, often have poorer mental health outcomes (Buell, 2006). Kwiatkowski et al. (2009) suggests that resource development can lead to the loss of cultural identity and breakdown of community support networks. As traditional male roles change, family stress increases (Gibson and Klinck,
33 2005). Miner’s spouses, generally women, are burdened with increased household responsibilities and financial stress (Gibson and Klinck, 2005, Sharma, 2010). The Government of the Northwest Territories speculates that with the diamond mine development, the percent of single-parent families doubled from 15% to over 30% in small local communities (2009). Women who are often forced to move to remote mining areas, lose their support network and often struggle to function in the dominant male social structures (Sharma, 2010). Furthermore, violence against women is also known to increase in mining communities (Kuyek, 2004). The psychological well being of women in mining communities can be greatly influenced by the shifting social environment (Lovell and Critchley, 2010). In addition, due to environmental dispossession, coping mechanisms used in mining communities often involve the use of alcohol and drugs (Richmond and Ross, 2009). In 2002, Brubacher and Associates reported an increase in alcohol-related abuse in communities surrounding the Nunavut’s Nanisivik mine (Gibson and Klinck, 2005). 7.6 Environment. Indigenous communities rely heavily on their environment for their socio-economic, cultural, spiritual, physical wellbeing, and their identity (Kwiatkowski et al., 2009, Richmond and Ross, 2009). Contaminated environments resulting from the establishment of mines often leads to major lifestyle changes such as sedentary activity and the adoption of Western diets (Richmond and Ross, 2009). Long-term environmental degradation from mining, impacts local water and food supply and causes the release of toxic emissions to local areas (Mudd, 2007, Kuyek, 2004). A survey from 2001 revealed that 43% of Inuit respondents from Nunavik, and 13% from Nunavut, felt that their home supply of drinking water was unsafe to drink (Inuit Tapaririit Kanatami, 2008). Furthermore, of all respondents from the Nunavut Inuit Child Health Survey, 33% expressed concerns that their country food was contaminated (Egeland, Faraj, and
34 Osborne, 2010). Contaminated food and water supplies has a direct impact on the physical and spiritual well being of Aboriginal peoples (Richmond and Ross, 2009).
8.0 Canadian Regulatory Framework As one of the largest uranium producers in the world, where demand is increasing rapidly, Canadian federal and provincial governments are building supportive environments in line with the standards and protocols established by the International Atomic Energy Agency (IAEA). Uranium, a source of “renewable energy,” is a federal responsibility in Canada; however, Nunavut is an exception (Nunavut Planning Committee, 2007). Federal and provincial governments regulate the mining industry largely through licensing mechanisms based on existing acts (CNSC, 2007). In general, the licensing process for new uranium mine occurs after the exploration stage (identification of a potential ore body) and before an environmental assessment is conducted (Golder Associates, 2011). The modern legislative framework for uranium regulation is provided by the Nuclear Safety Control Act (NCSA) that came into force in May 2000. Prior to the NSCA, the federal nuclear regulatory function had been conducted by the Atomic Energy Control Board, which had been established in 1946 by the Atomic Energy Control Act (CNSC, 2007). The NCSA established the Canadian Nuclear Safety Commission (CNSC) as the independent federal agency that develops and implements the nuclear regulatory regime (CNSC, 2007). 8.1 Canadian Nuclear Safety Commission. The CNSC is a federal government organization responsible, under the NSCA, for regulating all nuclear facilities and nuclear-related activities in Canada (CNSC, 2007). The CNSC regulatory framework draws upon Canadian and international standards and best practices, including the nuclear safety standards of the IAEA (CNSC, 2007). In addition to
35 receiving a land permit from the Indian and Northern Affairs Canada, any person or company must receive a license issued by the CNSC to prepare, construct, operate, decommission, or abandon a uranium mine or mill, and to possess, use, transport or store nuclear substances (CNSC, 2007). The CNSC is also responsible for enforcing compliance with the NSCA, regulations, and any licensing condition. On behalf of the Government of Canada, the CNSC implements the Safeguards Agreement and Additional Protocol between Canada and the IAEA to monitor Canada’s commitments to the peaceful use of nuclear energy and materials (CNSC, 2007). The CNSC also cooperates with other national governments to: (1) ensure compliance with the non-proliferation terms and conditions of Canada’s bilateral nuclear cooperation agreements; and (2) advance multilateral nuclear non-proliferation arrangements (CNSC, 2007). 8.2 Mining and Nunavut land. The Government of Canada regulates Crown land in Nunavut through Indian and Northern Affairs Canada (INAC). In 1999, a Nunavut Land Claims Agreement was established by the federal government over an agreement between the Inuit of the Nunavut Settlement Area, then part of the NWT. The Nunavut Land Claims Agreement gave title to IOLs and established a public government to serve the territory. In Nunavut, 80% of the region is Crown land and 18% is Inuit owned land, which belongs to three Regional Inuit Associations (Nunavut Tunngavik Incorporated, 2009). The three Regional Inuit Associations (RIAs) include: (1) the Kivalliq Inuit Association (27%), (2) the Kitikmeot Inuit Association (30%) and (3) the Qikiqtani Inuit Association (43%) (Nunavut Tunngavik Incorporated, 2009). The RIAs administer access and use of only surface IOLs by issuing land use licenses to companies that plan any development projects in the respective regions (Nunavut Tunngavik Incorporated, 2009). On the other hand, the Government of Nunavut controls and administers Crown land, which generally fall within
36 RIAs community boundaries and include both surface and mineral portions (Minister of Public Works and Government Services Canada, 2009). When resource development occurs, the mineral ownership within the RIAs regions has been, or will be, vested in aboriginal owners rather than the Crown. In these cases, the Canada Mining Regulations no longer applies. However, when resource development occurs in land where the surface land is owned by Aboriginals and the mineral land is owned by the Crown, then the Canada Mining Regulations continue to apply. The overall regime of land use management, environmental protection, project review, surface rights and local benefits is context specific to the resource development site. 8.3 Nunavut Tunngavik Incorporated (NTI). Nunavut Tunngavik Incorporated (NTI) is Canada’s largest Inuit organization that monitors the federal and provincial government’s commitment and obligations to the Nunavut Land Claims Agreement ((NLCA) Golder Associates, 2011). They also coordinate and manage Inuit responsibilities set out in the NLCA. In 1999, the Inuit exchanged their Aboriginal title to all traditional land in the Nunavut Settlement Area, for the rights and benefits set out in the NLCA. The NTI is composed of specialized agencies, which include the Nunavut Planning Committee (NPC) and the Nunavut Impact Review Board (NIRB). In the NLCA, the NIRB has the authority to assess projects in Nunavut through the use of an environmental assessment (EA) and other legally required documents. In addition, the NIRB reviews permit applications from companies that plan development activities, including uranium mines. The potential environmental and socioeconomic impacts of a company are proposed development is reviewed by the NIRB prior to permit approval (Whitford-AXYS, 2007). Using both traditional knowledge and scientific methods, NIRB recommends which development projects can go ahead and under what conditions. Although in other provinces, this would have required a federal environment
37 assessment panel, the NLCA clause (as recommended by Federal Indian and Northern Affairs office) has transferred this responsibility to the NIRB (WISE, 2011). 8.4 Mineral policies in Nunavut. Mineral rights to the Inuit Owned Land are held by the NTI in Nunavut. The NTI promotes mineral rights and participates in financial agreements with exploration and mining companies. In 2007, both, the Nunavut government and the NTI established separate uranium policies to ensure that mining and exploration is done in an environmentally- and sociallyresponsible way (Kosich, 2007). The major difference between the two policies is the distinction of what entity is responsible for the potential health impact of the uranium mine on workers and the nearby community. In the NTI policy principles, workers and all of Nunavummiut were mentioned, whereas only workers involved in uranium development were included in local government’s principles. Since the 1990s, NTI has banned uranium mining and exploration in the Nunavut territory. However, in September 2007, the NTI boards voted to reverse its ban and enacted a pro-uranium development policy. In contradiction to the local land use plan, Nunavut’s Inuit Land Claims Commission adopted a policy in favor of uranium mining returning the legacy of uncertainty to the area (Kosich, 2007). 8.5 Public participation in the licensing process. By the Canadian Nuclear Safety Commission’s rules of procedure, transparency efforts should include the engagement of all stakeholders, including Aboriginal groups, through a variety of appropriate consultation processes to ensure effective information sharing and communication. Typically, public hearings for licensing applications for uranium mines and mills are supposed to take place over two hearing days within a ninety-day period, with public intervener submissions taking place on the second hearing day (CNSC, 2007). Public hearings give affected parties and members of the public an opportunity to be heard before the
38 Commission. Moreover, according to Nuclear Safety Control Act, an Environmental assessment (EA) for a new uranium mine or mill should provide significant opportunities for Aboriginal involvement. An environmental assessment is a planning tool used in certain projects by federal authorities – ministers, departments and agencies of the Government of Canada – to identify the possible significant environmental effects of a proposed project and to determine whether those effects can be mitigated before the project is allowed to proceed (CNSC, 2007).
9.0 Discussion and Recommendations 9.1 Prevention framework for uranium mine in Nunavut. Prevention is an action aimed at eradicating, eliminating or minimizing the impact of disease and disability, or if none of these are feasible, slowing the progress of disease and disability (Salama, 2010). Given the absence of population health risk assessment that is Northern and Inuit-specific, the overarching recommendation from this report is for decisionmakers to use a precautionary approach to permitting uranium mining in Nunavut. Prevention recommendations for pulmonary and respiratory diseases are made below at the primordial, primary, secondary and tertiary prevention levels. 9.1.1 Primordial prevention. Primordial prevention consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living. It is the prevention of the emergence or development of risk factors in population groups which they have not yet appeared (Salama, 2010). Primordial prevention occurs during the planning stages of the uranium mine development. Proposed primordial preventions: •
Increase awareness and build capacity of Inuit community and encourage their active participation in Uranium discussion.
39 •
Integrate community-appropriate population health analysis into environmental impact assessments.
9.1.2 Primary prevention. Primary prevention can be defined as the action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. It signifies intervention in the pre-pathogenesis phase of a disease or health problem (Salama, 2010). Primary prevention strategies are set in place during the operation of the uranium mining and milling processes. Proposed primary preventions: •
Better promote and coordinate regulatory requirements at all levels, including consistency between the Nunavut Government and NTI on uranium policies.
•
Develop a conflict of interest policy in order to prevent involvement of those with vested interest in uranium regulation enforcement practices.
•
Health promotion related to tobacco smoking (indoor in particular), obesity, and healthy eating practices; awareness campaigns to mitigate use of contaminated construction materials and increase indoor residential air ventilation.
•
Develop guidelines and plans for meeting increased demand for health care services. 9.1.3 Secondary prevention. Secondary prevention is defined as “action which halts the
progress of a disease at its incipient stage and prevents complications” (Salama, 2010). Secondary prevention strategies are concerned with preliminary screening of disease development for workers and community members. Proposed secondary preventions: •
Set up a surveillance system for detecting environmental contaminants in water (drinking and fish) and country food (plant and animal) around nearby communities
•
Initiate background radon level testing in environment and residences.
•
Creation of community wide screening system for lung cancer and other health outcomes.
•
Create enforceable, efficient, and quality waste management protocols.
40 9.1.4 Tertiary prevention. Tertiary prevention is used when the disease process has advanced beyond its early stages (Salama, 2010). Intervention that should be accomplished in the stage of tertiary prevention is disability limitation, and rehabilitation. Proposed tertiary prevention: •
Develop comprehensive care, treatment and infrastructure development guidelines and standards for diseases associated with uranium mining.
•
Establish dedicated funding for occupational and community level compensation in the event of significant impact on health outcomes or health determinants associated with uranium mining.
10.0 Limitations and Assumptions A description of the report’s limitations and assumptions are found in Appendix E. 11.0 Conclusion The uranium mining proposal for the Kivalliq Region of Nunavut presents many concerns for involved stakeholders, including Nunavut’s government, Inuit communities, and public health practitioners. Potential hazards from mine tailings and waste products pose significant risk to uranium mine workers themselves and to surrounding communities. During the radioactive decay chain, ionizing radiation is emitted from the radioactive isotope U-238 and its progeny in the form of alpha particles, beta particles, and gamma rays. For the purpose of the report, health risks associated with the inhalation of radon, a radioactive element, and its progeny (particularly alpha particles) were reviewed. At chronic low dose radon exposure, lung cancer and other respiratory diseases are potential health outcomes. Furthermore, the susceptibility and vulnerability of the Northern Aboriginal context potentially puts Inuit communities near the Kivalliq region at risk for negative health impacts from mining development. Preventative strategies discussed involved the strengthening of regulatory and industrial standards,
41 environmental monitoring, screening and health care infrastructure. Since this report used a rapid assessment approach, further research is encouraged to understand the long-term health impacts of uranium mining development in Northern Canadian Inuit communities.
42 13.0 References ACAT- Alaska Community Action on Toxics. (n.d.)Uranium Mining: http://www.akaction.org/Publications/Mining/Uranium_Mining.pdf Adams P.D., Li X., Sellers, R.W., Baker, K.B., Leng, X., Harper, W.J., Taya,Y., and Kaelin Jr., WG. (1999) Retinoblastoma Protein Contains a C-terminal Motif That Targets It for Phosphorylation by Cyclin-cdk Complexes Mol. Cell. Biol. February vol. 19 no. 2 10681080 Ardoch Algonquin First Nation. (2007). Ardoch Algonquin First Nation Statement on Uranium Mining. ATSDR- Agency for Toxic Substances and Disease Registry. (2011). Toxicological profile for uranium: http://www.atsdr.cdc.gov/toxprofiles/tp150.html ATSDR- Agency for Toxic Subsrances and Disease Registry. (2009). Uranium Toxicity: Who Is at Risk of Exposure to Uranium?: http://www.atsdr.cdc.gov/csem/csem.asp?csem=16&po=7 Au, W.W., Lane, R.G., Legator, M.S., Whorton, E.B., Wilkinson, G.S., & Gabehart, G.J. (1995). Biomarker Monitoring of a Population Residing near Uranium Mining Activities, Environmental Health Perspectives, 103(5) 466 - 470 Azad N, Rojanasakul Y, VallyathanV. (2008) Inflammation and Lung Cancer: Roles of Reactive Oxygen/Nitrogen species. Journal of Toxicology and Environmental Health, Part B, 11:1–15 Barnes PJ (2010) Chronic Obstructive Pulmonary Disease: Effects beyond the Lungs. PLoS Med 7(3):e1000220. doi:10.1371/journal.pmed.1000220 Beaumier, M. C., & Ford, J. D. (2010). Food insecurity among Inuit women exacerbated by socioeconomic stresses and climate change. Canadian Journal of Public Health. Revue Canadienne De Santé Publique, 101(3), 196-201. Bi, L., Li, W. B., Tschiersch, J., & Li, J. L. (2010). Age and sex dependent inhalation doses to members of the public from indoor thoron progeny. Journal of Radiological Protection: Official Journal of the Society for Radiological Protection, 30(4), 639-658. doi:10.1088/0952-4746/30/4/001 Boden L. Workers’ compensation. In: Levy B, Wegman D, eds. Occupational Health: Recognizing and Preventing Work-Related Disease and Injury. 4th ed. Boston, Mass: Lippincott, Williams & Wilkins; 2000:237–256.
43 Boice Jr. J.D., Mumma, M., Schweitzer, S., & Blot, W.J. (2003). Cancer mortality in a Texas county with prior uranium mining and milling activities, 1950–2001, Journal of Radiological Protection, 23, 247-262 Boice Jr. J.D., Cohen, S.S., Mumma, M.T., Chadda, B., & Blot, W.J. (2008). A cohort study of uranium millers and miners of Grants, New Mexico, 1979–2005, Journal of Radiological Protection, 28(3), 303 Bowes-Lyon, L. Richards, J.P., & McGee, T.M. (2009). Socio-economic impacts of the Nanisivik and Polaris mines, Nunavut, Canada, In Richards, J.P. (ed.). Mining, society and a sustainable world. Berlin, Heidelberg: Springer Berlin Heidelberg Bronson, J. & Noble, B.F. (2006). Health determinants in Canadian northern environmental impact assessment, Polar Record, 42(233), 315-324 Brubacher & Associates (2002). The nanisivik legacy in arctic bay: A socio-economic impact study. Ottawa, ON. Buell, M. (2006). Resource extraction development and well-being in the north: A scan of the unique challenges of development in Inuit communities. Ottawa: National Aboriginal Health Organization. Brugge, D., Goble, R. (2002). The History of Uranium Mining and the Navajo People. American Journal of Public Health 92(9):1410-1419 Canada's largest Inuit group reverses ban on Nunavut uranium exploration, mining[website] Retrieved on November 28, 2011 from: http://www.mineweb.com/mineweb/view/mineweb/en/page38?oid=27266&sn=Detail Canadian Centre for Occupational Health & Safety (2007). Radiation: Quantities and units of ionizing radiation. Retrieved on November 27, 2011 from: http://www.ccohs.ca/oshanswers/phys_agents/ionizing.html Canadian Coalition for Nuclear Responsibility: Uranium- A discussion guide: http://www.ccnr.org/nfb_uranium_0.html Canadian Nuclear Association (2010). History of uranium mining in Canada. Retrieved on November 27, 2011 from: http://www.cna.ca/curriculum/cna_can_nuc_hist/uranium_hist_miningeng.asp?bc=History%20of%20Uranium%20Mining%20in%20Canada&pid=History%20 of%20Uranium%20Mining%20in%20Canada Canadian Nuclear Safety Commision (2007). Licensing process for new uranium mines and mills in Canada, March 2007, Ottawa, ON: Minister of Public Works and Government Services Canada
44 CAREX Canada (2011). Carcinogen profile. Retrieved on November 25, 2011 from: http://www.carexcanada.ca/en/carcinogen_profiles_and_estimates/ Castrilli, J.F. (n.d.) Environmental Regulation of the Mining Industry in Canada: An Update of Legal and Regulatory Requirements Catelinois, O., Rogel, A., Laurier, D., Billon, S., Hemon, D., Verger, P., & Tirmarche, M. (2006) Lung Cancer Attributable to Indoor Radon Exposure in France: Impact of the Risk Models and Uncertainty Analysis, Environmental Health Perspectives, 114(9), 1361 – 1366. CMCH (Canadian Mortgage and Housing Corporation) (2010). Cold Climate Radon Mitigation: A Canadian Perspective. CNSC- Canadian Nuclear Safety Commision (2007). Licensing process for new uranium mines and mills in Canada, March 2007, Ottawa, ON: Minister of Public Works and Government Services Canada Dolter, B. (2004) Uranium mining in saskatchewan. Briar Patch, 33(1), 14-14-16+. Retrieved from http://search.proquest.com/docview/204489532?accountid=13800 Dawson, S.E. & Madsen, G.E. (2011). Psychosocial and health impacts of uranium mining and milling on Navajo lands, Health Physics, 101(5), 618-625 Esteves, A.M. (2008). Mining and social development: Refocusing community investment using multi-criteria decision analysis, Resources Policy, 33, 39-47 EPA (2011). Radiation protection: Ionizing and non-ionizing radiation. Retrieved on November 12, 2011 from: http://www.epa.gov/radiation/understand/ionize_nonionize.html#ionizing Falkenbach A, Kovacs J, Franke A, Jörgens K, Ammer K., et al. (2005). "Radon therapy for the treatment of rheumatic diseases--review and meta-analysis of controlled clinical trials". Rheumatology international 25 (3): 205–10. FEMAPO-Foundation for Environmental Management and Campaign Against Povety (2011). Dangers, risks and consequences of uranium exploration and mining. Retrieved on November 12, 2011 from: http://femapo.org/dangers_uranium.html Field, R. W. (1999). "Radon Occurrence and Health Risk" (PDF). Retrieved on November 23, 2011 from: http://www.cheec.uiowa.edu/misc/radon_occ.pdf . Retrieved Nov 23 Fidler, C. (2010). Increasing the sustainability of a resource development: Aboriginal engagement and negotiated agreements, Environmental Development and Sustainability, 12(2), 233-244.
45 Ghafoori, P., Marks, L.B., Vujaskovic, Z., Kelsey, C.R. (2008) Radiation-Induced Lung Injury: Assessment, Management, and Prevention. Oncology. Vol. 22 No. 1 Gibson, G. & Klinck, J. (2005). Canada’s resilient north: The impact of mining on aboriginal communities, Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health, 3(1), 115-140 Gilliland, F.D., Hunt, W.C., Pardilla, M., & Key, C.R. (2000). Uranium Mining and Lung Cancer Among Navajo Men in New Mexico and Arizona, 1969 to 1993, Journal of Occupatoinal and Environmental Medicine, 42(3), 278 - 283 Golder Associates, (2011). Uranium in Nunavut Review, February 2011 Gottlieb, L.S. & Husen, L.A. (1982). Lung cancer among Navajo uranium miners. American College of Chest Physicians, 81(4), 448 - 452 Hanahan D, Weinberg RA. (2000). The hallmarks of cancer. Cell. Jan 7;100(1):57-70. Health Canada (2008). What is ionizing radiation? Retrieved on November 12, 2011 from: http://www.hc-sc.gc.ca/hc-ps/ed-ud/event-incident/radiolog/info/radiation-ion-eng.php Health Canada (2011). What are the health effects of radon? Retrived on November 23, 2011 from: http://www.hc-sc.gc.ca/ewh-semt/radiation/radon/effects-effets-eng.php Health Canada (2010). Cross-Canada Survey of Radon Concentrations in HomesYear 1 Interim Report. Retrieved on November 29, 2011 from: http://www.hc-sc.gc.ca/ewhsemt/radiation/radon/survey-sondage-eng.php Health Canada (1998) Assessment and management of cancer risks from radiological and chemical hazards. Retrieved on November 12, 2011 from: http://www.hc-sc.gc.ca/ewhsemt/pubs/radiation/98ehd-dhm216/index-eng.php Hei, T.K., Piao, C.Q., Han, E., Sutter, T., & Willey, J.C. (1996). Radon-Induced Neoplastic Transformation of Human Bronchal Epithelial Cells, Radiation Oncology Investigations, 3, 398-403
Hnizdo E, Murray J, Klempman S (1997). Lung cancer in relation to exposure to silica dust, silicosis and uranium production in South African gold miners. Thorax 1997;52:271–275 271 IAEA: International Atomic Energy Agency. (2004). Environmental Contamination from Uranium Production Facilities and their Remediation : http://wwwpub.iaea.org/MTCD/publications/PDF/Pub1228_web.pdf
46 IAEA: International Atomic Energy Agency (IAEA). (2004). Long Term Stabilization of Uranium mill tailings: http://www.pub.iaea.org/MTCD/publications/PDF/te_1403_web.pdf IARC (2000). IARC monographs on the evaluation of carcinogenic risks to humans. Retrieved on November 12, 2011 from: http://monographs.iarc.fr/ENG/Monographs/vol75/index.php IEER (2005). Uranium: Its uses and hazards. Retrieved on November 12, 2011 from: http://www.ieer.org/fctsheet/uranium.html IEER (2006). Glossary of technical terms. Retreived on November 12, 2011 from: http://www.ieer.org/clssroom/glossary.html International Agency for Research on Cancer (2001). IARC monographs on the evaluation of carcinogenic risks to humans: Ionizing radiation, part 2: Some internally depositited radionuclides, Volume 78, France: World Health Organization Inuit Tapiriit Kanatami (2007). Social determinants of Inuit health in Canada: A discussion paper. Retrieved on August 1, 2011 from: http://ahrnets.ca/files/2011/02/ITK_Social_Determinants_paper_2007.pdf Inuit Tapiriit Kanatami (2009). Inuit and Cancer: Fact Sheets. International Physicians for the Prevention of Nuclear War (IPPNW). (2010).Factsheet 4 “Health effects of uranium mining,”Retrieved on November 28, 2011 from: http://www.ippnw.org/pdf/uranium-factsheet4.pdf Jacques Whitford-AXYS, Final report, Environmental screening of Simpson Lake site, 2007 Kelly, J., Lanier, A., Santos, M., Healey, S., Louchini, R., Friborg, J., Young, K., et al. (2008). Cancer among the circumpolar Inuit, 1989-2003. II. Patterns and trends. International Journal of Circumpolar Health, 67(5), 408-420. Kulich, M., Řeřichab, V., Řeřichac, R., Shored, D.L., & Sandlere, D.P. (2011). Incidence of nonlung solid cancers in Czech uranium miners: A case–cohort study, Environmental Research, 111(3), 400-405 Kurttio P, Harmoinen A, Saha H, Salonen L, Karpas Z, Komulainen H, Auvinen A. 2006. Kidney toxicity of ingested uranium from drinking water. Am J Kidney Dis 47(6):972-82. Kosich, D. (2007). Canada's largest Inuit group reverses ban on Nunavut uranium exploration, mining [website article]; Retrieved on Nov 17, 2011 from: http://www.mineweb.com/mineweb/view/mineweb/en/page38?oid=27266&sn=Detail
47 Kovesi, T., Gilbert, N. L., Stocco, C., Fugler, D., Dales, R. E., Guay, M., & Miller, J. D. (2007). Indoor air quality and the risk of lower respiratory tract infections in young Canadian Inuit children. CMAJ: Canadian Medical Association Journal = Journal De l’Association Medicale Canadienne, 177(2), 155-160. doi:10.1503/cmaj.061574 Kurttio P, Harmoinen A, Saha H, Salonen L, Karpas Z, Komulainen H, Auvinen A. 2006. Kidney toxicity of ingested uranium from drinking water. Am J Kidney Dis 47(6):972-82. Lane, R.S.D., Frost, S.E., Howe, G.R., & Zablotska, L.B. (2010). Mortality (1950–1999) and Cancer Incidence (1969–1999) in the Cohort of Eldorado Uranium Workers, Radiation Research, 174, 773-785 Lubin, J.H., Linet, M.S., Boice Jr., J.D., Hatch, E.E., Kleinerman, R.A., Tarone, R.E., & Wacholder, S. (1997). Case-Control Study of Childhood Acute Lymphoblastic Leukemia and Residential Radon Exposure, Journal of the National Cancer Institute, 90(4), 294-300 Magdo, H.S., Forman, J., Graber, N., Newman, B., Klein, K., Satlin, L., Amler, R.W., Winston, J.A., & Landrigan, P.J. (2007). Grand Rounds: Nephrotoxicity in a Young Child Exposed to Uranium from Contaminated Well Water, Environmental Health Perspectives, 115(8), 1237 - 1241 Malin, S.A. & Petrzelka, P. (2010). Left in the dust: Uranium’s legacy and victims of mill tailings exposure in Monticello, utah, Society & Natural Resources, 23(12), 1187-1200 Markstrom, C. A., & Charley, P. H. (2003). Psychological effects of technological/humancaused environmental disasters: examination of the Navajo and uranium, American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 11(1), 19-45. Retrieved from EBSCOhost. Miller RC, Randers-Pehrson G, Geard CR, Hall EJ, Brenner DJ. The oncogenic transforming potential of the passage of single α particles through mammalian cell nuclei. Proc Natl Acad Sci USA 96:19–22. 1999. Minister of Public Works and Government Services Canada (2009). Implementing canada’s economic action plan: Impact for aboriginal and northern communities. Retrieved on October 10, 2011 from: www.hrsdc.gc.ca Ministry of Health (2009). 2008 Report on occupational exposures in Canada. Retrieved on November 25, 2011 from: http://www.hc-sc.gc.ca/ewh-semt/alt_formats/hecssesc/pdf/pubs/occup-travail/2008-report-rapport-eng.pdf Minister of Public Works and Government Services Canada (2009). Implementing Canada’s economic action plan: Impact for aboriginal and northern communities. Retrieved on October 10, 2011 from: www.hrsdc.gc.ca
48 Native Unity working paper, Retrieved on October 31, 2011 from: http://nativeunity.blogspot.com/2010/02/canada-oh-canada-uranium-mining-and.html National Research Council (NRC). Health Effects of Exposure to Radon (BEIR VI). Washington, DC:National Academy Press, 1998. National Toxicology Program, Department of Health and Human Services (2011). Report on Carcinogens, Twelfth Edition. Retreived on November 25, 2011 from: http://ntp.niehs.nih.gov/ntp/roc/twelfth/profiles/IonizingRadiation.pdf Nelsen, J.L., Scoble, M. & Ostry. A. (2010). Sustainable socio-economic development in mining communities: north-central British Columbia perspectives, International Journal of Mining, Reclamation and Environment, 24(2), 163-179. New York State University, Department of Health. Retrieved on November 21, 2011 from: www. health.state.ny.us Nunavut Tunngavik Incorporated (2009). Inuit owned lands; mining and royalty regimes [presentation] Retrieved on November 25, 2011 from: http://www.tunngavik.com/documents/publications/administration/IOL%20and%20Mine rals%2025Nov09.pdf Nunavut Planning Committee, Report of the Uranium Mining Workshop, 2007 O’Faircheallaigh, C. (2007). Environmental agreements, EIA follow-up and aboriginal participation in environmental management: The Canadian experience, Environmental Impact Assessment Review, 27, 319-342. Periyakaruppan, A., Sarkar, S., Ravichandran, P., Sadananadan, B., Sharma, C.S., Ramesh, V., Hall, J.C., Thomas, R., Wilson, B.L., & Ramesh, G.T. (2009). Uranium induces apoptosis in lung epithelial cells, Archives of Toxicology, 83, 595 - 600 Pinney, S.M., Freyberg, R.W., Levine, G.H., Brannen, D.E., Mark, L.S., Nasuta, J.M., Tebbe, C.D., Buckholz, J.M., & Wones, R. (2003). Health effects in community residents near a uranium plant at Fernald, Ohio, USA, International Journal of Occupational Medicine and Environmental Health, 16(2), 139 —153 Popp, W.,Vahrenholz, C., Schuster, H., Wiesner, B., Bauer, P., Täuscher, F., Plogmann, H., Morgenroth, K., Konietzko, N., & Norpoth, K. (1999). p53 mutations and codon 213 polymorphism of p53 in lung cancers of former uranium miners, Journal of Cancer Research and Clinical Oncology, 125(5), 309-312 "Radon Health Mines: Boulder and Basin, Montana". Roadside America. http://www.roadsideamerica.com/story/2143. Retrieved Nov, 20, 2011
49 Rasha Salama, 2010, Presentation on Concepts of Prevention and Control, Suez Canal University, Egypt, Retrieved on Nov 23, 2011 from: www.pitt.edu/~super7/3201133001/32311. Raymond-Whish, S., Mayer, L.P., O’Neal, T., Martinez, A., Sellers, M.A., Christian, P.J., Marion, S.L., Begay, C., Propper, C.R., Hoyer, P.B., & Dyer, C.A. (2007). Drinking Water with Uranium below the U.S. EPA Water Standard Causes Estrogen Receptor– Dependent Responses in Female Mice, Environmental Health Perspectives, 115(12), 1711- 1716. Řeřicha, V., Kulich, M., Řeřicha, R., Shore, D. L., & Sandler, D. P. (2006). Incidence of Leukemia, Lymphoma, and Multiple Myeloma in Czech Uranium Miners: A Case -Cohort Study. Environmental Health Perspectives, 114(6), 818-822. doi:10.1289/ehp.8476 Richmond, C.A.M. & Ross, N.A. (2009). The determinants of First Nation and Inuit health: A critical population health approach, Health & Place, 15(2), 403-411. Ridlington, E. (2010). NTI stands by uranium policy. NWT News/North, 1-4. Yellowknife. Roscoe, R.J., Deddens, J.A., Salvan, A., & Schnorr, T.M. (1995). Mortality among Navajo uranium miners, American Journal of Public Health, 85(4), 535 – 540 Roscoe, R.J., Steenland, K., Halperin, W.E., Beaumont, J.J., & Waxweiler, R.J. (1989). Lung Cancer Mortality Among Nonsmoking Uranium Miners Exposed to Radon Daughters, The Journal of the American Medical Association, 262(5), 629-633 Salama,R. (2010) Presentation on Concepts of Prevention and Control, Suez Canal University, Egypt, Retrieved on Nov 23, 2011 from: www.pitt.edu/~super7/32011-33001/32311. Samet JM, Young RA, Morgan MV, Humble CG, Epler GR and McLoud TC. (1984) Prevalence survey of respiratory abnormalities in New Mexico uranium miners. Health Physics 46(2):361-70 Samet JM, Eradze GR 2000. Radon and Lung Cancer Risk: Taking Stock at the Millenium. Environ Health Perspect 108:635-641. http://dx.doi.org/10.1289/ehp.00108s4635 Schubauer-Bergan, M.K., Daniels, R.D., & Pinkerton, L.E. (2008). Radon exposure and mortality among white and American Indian uranium miners: An update of the Colorado Plateau cohort, American Journal of Epidemiology, 169(6), 718-730 Shandro, J., Koehoorn, M., Scoble, M. & Hurrell, C. (2009). Mining and community health: A british Columbia based research project [summary report]. Vancouver, BC: University of British Columbia
50 Statistics Canada (2006). Aboriginal Peoples in Canada in 2006: Inuit, Métis and First Nations, 2006 Census. Stephens C, Ahern M. 2001. Worker and Community Health Impacts Related to Mining perations Internationally A Rapid Review of the Literature. Mining, Minerals and Sustainable Development No. 25:1-59 Sub-committee of the Intergovernmental Working Group on the Mineral Industry (2005). Report on Aboriginal participation in mining in Canada: Mechanisms for Aboriginal community benefits [Thirteenth Annual Report]. Indian and Northern Affairs Canada, under the asupices of the Sub-committee of the Intergovernmental Working Group on the Mineral Industry. Retrieved on July 31, 2011 from: http://www.aincinac.gc.ca/ps/nap/minmin_e.html Suit, H., Goldberg, S., Niemierko, A., Ancukiewicz, M., Hall, E., & Goitein, M. (2011). Secondary carcinogensis in patients treated with radiation: A review of data on radiationinduced cancers in human, non-human primate, canine and rodent subjects. Radiation Research, 167(1), pp. 12-42. The International Human Rights Clinic at Harvard Law School (n.d.). Bearing the burden: The effects of mining on first nations in British Columbia. Retrieved on October 10, 2011 from: www.fns.bc.ca/pdf/Harvard_Summary.pdf The Uranium Institute (1997). Participation of northerners and aboriginal people in uranium development in saskatchewan. London, ON. The atlas of Canada- Uranium resources: http://atlas.nrcan.gc.ca/auth/english/maps/economic/energy/uranium/1 Tubiana, M. (2009). Can we reduce the incidence of second primary malignancies occurring after radiotherapy? A critical review. Radiotheraphy and Oncology, 91(1), pp. 4-15. US Environmental Protection Agency. Radiation Protection: http://www.epa.gov/radiation/docs/radwaste/402-k-94-001-umt.htm Vakil, C. & Harvey, L. (2009) Human health implications of uranium mining and nuclear power generation. Retrieved on November 12, 2011 from: http://www.ccamu.ca/pdfs/humanhealth-im_ation-2009.pdf Wagner, S.E., Burch, J.B., Bottai, M., Puett, R., Porter, D., Bolick-Aldrich, S., Temples, T. Wilkerson, R.C., Vena, J.E., & Hebert, J.R. (2011). Groundwater uranium and cancer incidence in South Carolina, Cancer Causes Control, 22, 41-50 Weber, B. (2010). Concerns over uranium mining prompt Nunavut to take the issue to the people. The Canadian Press.
51 Whitford-AXYS,Jacques. Final report, Environmental screening of Simpson Lake site, 2007 Wikipedia (2011). Secular equilibrium, Retrieved on November 12, 2011 from: http://en.wikipedia.org/wiki/Secular_equilibrium WISE (2004). Uranium radiation properties, Retrieved on November 12, 2011 from: http://www.wise-uranium.org/rup.html#USERIES WISE (2011). Health Hazards for Uranium Mine and Mill Workers Retrieved on November 20, 2011 http://www.wise-uranium.org/uhm.html#NATAM Wise-Uranium, 2011, retrieved on November 23, 2011 from: http://www.wiseuranium.org/upcdnnn.html World Nuclear Association: http://world-nuclear.org/info/inf49.html World Nuclear Association http://world-nuclear.org/education/mining.htm World Nuclear Association: http://www.world-nuclear.org/sym/1998/frost.htm Women in Mining Canada. (2010). Ramp-up: A study on the status of women in Canada’s mining and exploration sector [Final Report]. Retrieved on July 29, 2011 from: http://www.mihr.ca/en/publications/resources/Ramp-UPFinal2010.pdf Yu, I. T.-S. and Tse, L. A. (2007), Exploring the joint effects of silicosis and smoking on lung cancer risks. International Journal of Cancer, 120: 133–139. doi: 10.1002/ijc.22133 Zamora, M.L.L., Zielinski, J.M., Moodie, G.B., Falcomer, R.A.F., Hunt, W.C., & Capello, K. (2009). Uranium in Drinking Water: Renal Effects of Long-Term Ingestion by an Aboriginal Community, Archives of Environmental & Occupational Health, 64(4), 228 – 241.
52 APPENDIX A
53
APPENDIX B
Figure B.1 Nuclear Fuel Production
Source: WISE (http://www.wise-uranium.org/stk.html?src=stkd01e)
Figure B.2. Uranium Mill Tailings Hazards
Source: WISE (http://www.wise-uranium.org/uwai.html)
Table B.1. Environmental Concerns Environmental concerns related to uranium mining and waste management: (IAEA, 2004) Radioactivity is retained from the ore and is very long lived They contain a range of biotoxic heavy metals and other compounds They may contain sulphide minerals which can generate acid mine drainage Susceptibility to leaching erosion or collapse due to their granular and slime consistency Increased risk of radiation release, radioactive and geochemically toxic dusts, and interaction with surface water systems due to the common method of surface disposal by exposing a large surface area to the natural elements. Large areas of land are adversely affected and potentially valuable land rendered unfit for other uses due to the large surface area of the tailings deposits (piles).
54
Figure A.3 Exposure Pathways
55 APPENDIX C Figure C.1. Uranium-238 238 Decay Chain Chain. Source: CAREX Canada (2011). Surveillance of environmental & occupational exposures for cancer prevention. Retrieved on January 31, 2011 from: http://www.carexcanada.ca/en/ionizing_radiation/occupational_exposure_estimates/phase_2/
Figure C.2. Mode of Action: Ionizing Radiation Source: CAREX Canada (2011). Surveillance of environmental & occupational exposures for cancer prevention. Retrieved on January 31, 2011 from: http://www.carexcanada.ca/en/ionizing_radiation/occupational_exposure_estimates/phase_2/
Figure C.6. Molecular Mechanism of Alpha Radiation
56 Source: IEER (2005). Uranium: Its uses and hazards. Retrieved on November 12, 2011 from: http://www.ieer.org/fctsheet/uranium.html
Figure C.8 Cellular Mechanism of Potential Cancer Development
57 Source: Azad et al (2008) Inflammation and Lung Cancer: Roles of Reactive Oxygen/Nitrogen species. Journal of Toxicology and Environmental Health, Part B,11:1–15
Figure C. 9 Mechanism of Potential Pulmonary Fibrosis Development
Source: Ghafoori, P., Marks, L.B., Vujaskovic, Z., Kelsey, C.R. (2008) Radiation-Induced Lung Injury: Assessment, Management, and Prevention. Oncology. Vol. 22 No.
58
APPENDIX D Table D.1 Summary of Epidemiological Studies for Occupational and Community Exposure OCCUPATIONAL EXPOSURE Location Exposure Outcome Findings Canada Lung cancer • Uranium mining • Lung cancer mortality (SMR = 1.31, P1000 WLM was 20, 57, and 71 respectively • SMR for pulmonary fibrosis from cumulative radon progeny exposure with a 95% CI above 1.0 for 120 – 400 WLM (3.3), 400 – 1000 WLM (7.0)and >1000 WLM (6.8) United Mortality: cancer, • Radiation exposure • Increased mortality in malignant cancer (SMR 2.17) States resp. disease, • Cohort uranium miners • Lung cancer excess likely due to radon and tobacco United Lung cancer • Radon exposure for • Mean cumulative radon exposure was 1139.5 working level States uranium miners months • 62.5% small cell undifferentiated cancer • Smoking acts as promoting agent United Mortality: lung • Uranium miners • SMR for lung cancer with cumulative exposure to radon of States cancer, retrospective cohort 120-400, 400-1000, >1000 was 0.7, 4.2, and 7.4 respectively tuberculosis, mortality study • Elevated SMR for lung cancer (3.3), tuberculosis (2.6), pneumoconiosis. pneumoconiosis and other respiratory disease (2.6) • RR for 5-year duration of exposure vs. non: lung cancer (3.7), pneumoconiosis and other respiratory diseases (2.1),
Reference Lane et al., 2010
SchubauerBerigan et al., 2008
Boice Jr. et al., 2008 Gottlieb & Husen, 1982
Roscoe et al., 1995
59
United States
• •
Radon exposure Cohort study of nonsmoking uranium miners United • Radon exposure States • Cohort study of neversmoker uranium miners • Nested case-control Czech • Uranium miners Republic exposure to radon • Case-cohort study Czech • Uranium miners Republic exposed to radon • Retrospective casecohort study COMMUNITY EXPOSURE Location Exposure United • Uranium mining and States milling exposure in Karnes County • Case-control study United • Community exposure (< States 2 miles) to uranium plant • Used well drinking water • Cohort study United • Radon exposure from States uranium mining • Case-control study United States
• •
Indoor Radon Exposure Case-control study on children under 15 years
Lung Cancer
•
Lung Cancer
• •
Non-lung solid cancers Leukemia, Lymphoma and Multiple Myloma
• • • • •
Outcome Cancer
Urinary system disease
Chromosome aberration
Acute lymphoblastic leukemia
tuberculosis (2.0) SMR = 12.7 for lung cancer observed among non-smoking miners 14 lung cancer deaths among 516 white uranium miners RR of lung cancer for miners for miners with greater than 1450 WLM exposure compared to less than 80 WLM exposure was 29.2 (95% CI 5.1 – 167.2) Average dose rate is inversely assoc with lung cancer risk RR 0.88 for all non-lung solid cancers from cumulative lifetime radon exposure to 3 WLM Radon not significantly assoc. with cancer incidence RR for high radon exposure (110 WLM) to low radon exposure (3 WLM) was 1.75 for all leukemia and 1.98 for chronic lymphocytic leukemia RR not significant for myeloid leukemia & Hodgkin lymphoma
Findings • The RR of cancer mortality was 1.0 between both Karnes County and control group. • RR of cancer mortality in Karnes County before, during and after were similar ranges. • Increased prevalence of urinary system disease (standardized prevalence ratio 2.15) • SPR kidney disease 2.15 • Bladder disease SPR 1.32 • Residents have higher spontaneous frequency of abnormal cells and cells with chromosome deletion • Study group had more problems in the repair of DNA damage than the reference group (p- values 0.032 to 0.0004). • Mean radon concentration was lower for case subjects (65.4 Bqm-3) compared to control subjects (79.1 Bqm-3) • RR radon exposure for ALL exposure >148 Bqm-3 was 1.02
Roscoe et al., 1989 Gilliland et al., 2000
Kulich et al., 2011 Řeřicha et al., 2006
Reference Boice Jr. et al., 2003
Pinney et al., 2003
Au et al., 1995
Lubin et al., 1997
60 France
• •
United States
• •
United States
•
United States
•
United States
United States United States
• • • • • •
Indoor Radon Residential case-control study Uranium exposure In vitro study of lung epithelial cells In vitro study: epithelial cells Chronic ingestion of uranium in well water (
