Canadian Occupational Safety

APRIL/MAY 2018 21 of the miners receiving treatment had already been diagnosed with the dis- ease, although some were considered "borderline cases" and did not have an official diagnosis. Shortly after, miners breathing in aluminum dust before their shift became commonplace. Robson and his co-creator, J.J. Denny, the chief metallurgist for McIntyre Porcu- pine Mine, patented the powder and mining companies had to purchase a license for use from the McIntyre Research Foundation. At most mines, the powder was blown into the dry where the miners would change their clothes, but some had a specially built tunnel or room just for the inhalation of McIntyre Powder. "It was a gas chamber, basically. They were locked in from outside, so they were forcibly confined and forced to inhale this neurotoxin without informed consent," Martell says. The recommended exposure was an aluminum dust concentration of 20,000 to 34,000 parts per millilitre air in the miners' changing rooms before each underground shift for 10 minutes. However, the actual amount dispensed varied widely and archi- val documents from the McIntyre Research Foundation show they don't actually know how much aluminum dust these miners received, according to Martell's research. Of note, McIntyre Powder was a controlled substance under federal regulation and it was supposed to be administered through a prescription. "Anyone who goes to a doctor for any kind of medicine, the doc has to go through a whole checklist: Do they have these symptoms? Is it contraindicated with other medication? They did none of that," Martell says. "They were part of a giant public health experiment." Another major concern of the practice was the fact that ventilation was turned off when the powder was being administered, says Martell. But there was a breakdown of commu- nication somewhere along the line. After their initial tests on lab animals, the McIntyre researchers released their report in 1937 that stated: "It is imperative that the use of aluminum for the prevention of silicosis should in no way interfere with the standard practice of ventilation, as large quanti- ties of even inert dust will damage the lung structure." In the 1960s, the unions started to push back on the practice. They had argued adequate ventilation and respi- rators could prevent silicosis. In 1965, the United Steelworkers' Local 4608 in Val D'Or, Que., was successful in stop- ping the McIntyre Powder process in its East Sullivan Mine. In its petition against the practice, the union noted several experts, including the Ameri- can Medical Association, had said "aluminum has nothing to do with sil- icosis in humans" and that "aluminum dust can itself cause grave illnesses." In 1979, after CBC reporters broke the news of the practice on the Fifth Estate, the Ontario Ministry of Labour investigated. Although it found a decrease in mortality rates from silico- sis during the term of the program and that McIntyre Powder did not produce any apparent adverse effects, it con- cluded there was insufficient evidence of the effectiveness of the powder, thus stopping the practice later that year. COMPENSATION Workers' exposed to McIntyre Powder who have developed neurologi- cal problems have not been able to get workers' compensation due to a Workplace Safety and Insurance Board (WSIB) policy on the matter. The policy states: "Dementia, Alzheimer's disease and conditions with neurologic effects are not occupational diseases or inju- ries by accident under the Workplace Safety and lnsurance Act when they are alleged to result from occupational aluminum exposure." This is the only policy in the com- pensation board's 100-plus year history that states a particular exposure does not cause a particular disease. Normally, workers are able to apply with evidence and make their own case linking workplace exposure to their health issues but this policy auto- matically denies the related claims. Martell learned this first hand when she submitted a claim on behalf of her father in September 2011 for Par- kinson's related to McIntyre Powder exposure. Her claim was denied and she appealed the decision. She was preparing to take the case to the Work- place Safety and Insurance Appeals Tribunal, but after finding the "nega- tive" policy, she withdrew the claim. "I quickly realized you can't win a case on an individual basis because they have this policy that shuts it down," she says. The policy was established in 1993, after a report on occupational aluminum exposure and health by Ontario's Industrial Disease Stan- dards Panel. The report noted there was some evidence to suggest high levels of occupational aluminum exposure might lead to cognitive and neurological effects, but there was an insufficient number of studies to establish consistent results. However, the panel said it recog- nized a lack of evidence does not mean that a relationship does not exist. "lt only means that medical science cannot yet answer these questions. Clearly, further research is needed in order to resolve the significant uncertainties about aluminum and to answer the important concerns of workers," the panel said. In 2016, after mounting public pressure spurred by Martell's work, the WSIB commissioned a report to look into the effects of McIntyre Powder. Intrinsik, a Mississauga, Ont.-based regulator y consulting firm, prepared a systematic review of studies that assessed workplace alu- minum exposure and negative health conditions, including nervous system and respiratory disorders, cancers, cardiovascular disease, mortality and immunological response. The report noted there were only three studies that specifically assessed McIntyre Powder inhalation. Ultimately, the report said, "Although these findings cannot conclusively state whether or not aluminum exposure leads to the development of negative health condi- tions, the evidence considered in total has not supported a link." A systematic review of the literature on McIntyre Powder by a WorkSafeBC practice group echoed Intrinsik's con- clusion. Its report said the available evidence did not support any poten- tial (causal) association between occupational exposure to McIntyre Powder and the development of neurological disorders, such as Par- kinson's or Alzheimer's. But one of the studies that both agencies reviewed resonated with Martell. It showed a positive asso- ciation between the powder and decreased performance on cognitive tests, but no increase in diagnosed nervous system disorders. This 1990 study by Sandra Rifat of the Univer- sity of Toronto is 408 pages in its entirety. Rifat compared more than 600 miners who had been exposed to McIntyre Powder at gold and ura- nium mines with a control group who worked in nickel and copper mines where the powder was not used. The participants completed stan- dard cognitive tests and 13 per cent of the miners exposed to McIntyre Powder showed signs of cognitive impairment, compared with five per cent of the control group. In men exposed for more than 20 years, the effect was more pronounced, with 20 per cent showing impairment. The study found a clear dose-response effect, meaning the longer the men were exposed, the worse their cogni- tive functioning. "That was the first scientific indica- tion that there could be harm done by inhaling aluminum," says Martell. The WSIB officially revoked its policy in June. At press time, there were 76 claims registered for a number of conditions related to McIntyre Powder: 15 have been allowed (all for non-neurological issues); 29 remain pending; and 32 were denied. Of the approved claims, the most common condition is chronic obstructive pul- monary disease (COPD), says Aaron Lazarus, vice-president of communi- cations and intergovernmental affairs at WSIB. Very, very few miners who have neurological disorders have filed a claim with WSIB because they have been playing the waiting game, says Martell. They were waiting for the "negative policy" to be revoked and now that it has, they are waiting for the results of the various studies so they can use that evidence to support their claim. In August, the WSIB commissioned researchers from the Occupational Cancer Research Centre in Toronto to conduct a new independent study on the relationship between McIntyre Powder and the development of neurological health outcomes in former miners. "They are going to look at the It is imperative that the use of aluminum for the prevention of silicosis should in no way interfere with the standard practice of ventilation, as large quantities of even inert dust will damage the lung structure.

• Cover