Wednesday, May 8, 2013

Testimony Of Dr. Alan Hirsch On Physical And Psychological Impacts Of Air Pollution From Pulp Mills

"Dr. Hirsch said that at least two of the six appellants of the Powell River pulp mill permit extension were suffering olfactory and immune impairment, and that such problems were common near mills and other sites:
"It's clear odour is more than a nuisance. It can cause health effects, neurologic effects, immune effects, respiratory effects, chemosensory effects ... andcardiovascular effects. These effects can be permanent and ... for the majority there's no good way of treating them ... the best treatment is prevention and elimination of exacerbation and the best way to do it is to get rid of the bad odour, in this instance as a result of the pulp mill."
The following is an excerpt from the transcript of the hearing of the Environmental Appeal Board in Powell River, B.C., July 7, 1999, in the matter of Fleischer, et al, and Assistant Regional Waste Manager and Pacifica Papers Inc.
THE CHAIRPERSON: We'll just swear you in, Mr. Hirsch.
A. HIRSCH, Sworn:
THE RECORDER: Would you please state your full name for the record and give the correct spelling?
THE WITNESS: Alan Richard Hirsch, A-l-a-n H-i-r-s-c-h.
THE CHAIRPERSON: Thank you.
MR. ANDREWS: Before we begin, I'll hand this to the Board. And the other parties have received copies of Dr. Hirsch's curriculum vitae.
EXAMINATION IN CHIEF BY MR. ANDREWS:
Q. Dr. Hirsch, the first order of business is to review your qualifications as an expert in the area of the effect of malodours on human health. The parties and the board have copies of your curriculum vitae. Could you please tell the Board what your background is?
A. Yes. I am a neurologist and psychiatrist and I'm the Neurological Director of the Smell and Taste Treatment and Research Foundation in Chicago. I went to medical school at the University of Michigan in Ann Arbor and I completed a residency in neurology and a residency in psychiatry and I'm boarded by the American Board of Psychiatry and Neurology in neurology, psychiatry, addiction psychiatry, geriatric psychiatry and completed two residencies including Chief Residency in Neurology at St. Luke's Medical Centre in Chicago.
Q. May I interrupt for a moment. There may be some difficulty hearing at the back, so if you could keep your voice up.
A. Oh, I'm sorry.
THE CHAIRPERSON: That microphone is just to pick it up. You have to speak louder.
A. Okay. I'm sorry. I have reviewed -- I have been asked to review several articles in the field. I have written in the area of smell, taste and neurotoxicological facts, give or take 100 articles or so and have written a few books as well as done book reviews in the area of neurotoxicological facts
I have been asked to evaluate different sites for neurotoxicological facts of malodours including -- and have had to testify in the past regarding them sometimes, including a site outside ofBremerton -- outside of Seattle, Washington, Bremerton; EPA Superfund site near New Orleans. I was asked by the Illinois EPA and the Attorney General's office, State of Illinois to evaluate a mulching site southeast of Chicago; evaluated a site, Rosco, Illinois, where we looked at almost the entire town. We also looked at a site outside the Alamo Dome in Texas. We've looked at other sites in Texas that have been exposed to a variety of different low level, relatively low level chemicals that had secondary odour affects as well.
BY MR. ANDREWS: Q. You've had also the opportunity to consult with some individuals here in Powell River?
A. Yes, I have. I've consulted with six of the individuals who are involved here and talked with them about the potential effects of the odour/toxins that they were exposed to.
MR. ANDREWS: Thank you. Madam Chair, at this point I would rest my questions on the witness's expertise.
THE CHAIRPERSON: I took your opening remarks that you want him qualified as an expert on the effect of malodours on human health; is that correct?
MR. ANDREWS: That is correct.
THE CHAIRPERSON: Okay. Is there any objections? Mr. Cassidy?
MR. CASSIDY: I have some questions.
THE CHAIRPERSON: Yes.
MR. CASSIDY: That was the effect of malodours on human health?
THE CHAIRPERSON: Yes. This is dealing with his qualifications issue.
MR. J. KEAYS: I appreciate but the final sentence was, as I recall --
THE CHAIRPERSON: Oh, sorry, the effect of malodours on human health is the area of expertise he is being qualified for.
MR. J. KEAYS: But he mentioned the toxicological components of the air as well as odour. You said odour slash --
A. Yes. It becomes a semantic issue because what happens is when the level -- when the levels become very low we talk about the odour effects; when it becomes much higher we talk about the toxic effects but for many of the chemicals they approach each other and so that --
MR. J. KEAYS: It's a continuum?
A. Yes.
MR. J. KEAYS: Thank you.
THE CHAIRPERSON: Okay. I was just taking your words.
BY MR. ANDREWS: Q. Well, can I ask, what term do you use?
A. It depends on the realm. I mean, if you want to talk about the odour effects, that's fine, with the realization that different ones, we know the odour threshold for many of the different chemicals so we know what the threshold levels are. So if you want to talk about -- in general, we could talk about the odour effects, specially when we -- at the site that we're looking at, it's a mixture and we really don't know the exact levels. All we know is they were smelling bad-rotten-egg-odour so we say, well, gee, it sounds very much like hydrogen sulphide at levels of a few parts per billion for instance. But it depends on what the exact odour is.
Q. So when you use the term malodour, you're referring to the effect of a variety of chemicals?
A. That's right. That's correct.
THE CHAIRPERSON: Okay. I think we take that gloss on your definition. Mr. Cassidy?
CROSS-EXAMINATION BY MR. CASSIDY:
Q. Dr. Hirsch, when I heard you were going to become a witness here I went looking on the internet and I found your web page and I was a little surprised when I saw the first page of your web page which reveals that in fact you were the author of Dr. Hirsch's Guide to Scentsational Weight Loss and Dr. Hirsch's Guide to Scentsational Sex. By that, it appears to me, Dr. Hirsch, your real expertise is in respect of these areas and that is your principal expertise is in respect of odour and weight loss and odour and sexual performance; do you agree with me?
A. Well, I would suggest to you that that is -- those are two areas that we've done research in but that we've done research in a whole host of other areas as well, whereas we've written, I think, about six articles about the effects of odours and sexual arousal and about four articles on odours and the effects on weight loss. I've written well over 20 articles on effects of malodour.
Q. Well, if these are not the significant parts of your research then why are they on the front page of your web page?
A. Well, those are things that lay-people have much interest in and those are also books that I have written that are available to the lay-public.
Q. So you would not consider these to be serious pieces of academic research then?
A. Oh, no. I would suggest that they are serious. Our studies on how odours can impact on weight loss involved a study of 3,193 people over six months where we found that different odours, for instance banana, green apple and peppermint impacted upon the appetite and weight. Our study looking at how odours can impact upon sexual arousal came upon some -- our treatment of patients who have smell and taste disorders, we have found when people lose their sense of smell about 17 per cent develop sexual dysfunction so we began to explore how odours can impact upon sexual arousal. We initially looked at "normals", both men and women, and then we began to look at men who had vasculogenic impotence from diabetes as well as women with sexual arousal disorders. So those are very serious.
Q. And are you the author of any peer reviewed articles in the topic of odour emissions from kraft mills or pulp and paper mills?
A. Well, the -- from kraft mills, no. I think we did refer to pulp mills in that one article, that review article on Negative Health Effects of Malodours in the Environment, A Brief Review from the Journal of Neurology, Orthopaedic Medicine and Surgery (1998).

Q. And that was peer reviewed?

A. That's correct.

Q. Right. So that's it?
A. Of --
Q. In respect of pulp mills.
A. That deals directly with pulp mills, that's correct.
Q. There's nothing else dealing with pulp mills?
A. Not specifically with pulp mills.
Q. Right. And nothing with regard to kraft mills?
A. Nothing with regard to kraft mills, that's correct.
Q. And in fact, therefore, you have written more extensively in the area of scentsational sex and scentsational weight loss than you have in the area of pulp mills?
A. Well, I've written several articles. I've written about four articles about weight loss, or so, and six articles about sex, in that range, as well as one book on each of those, whereas there is not a big demand from the lay-public for a book about kraft mills.
Q. Right. And so that's why in fact you have this website, because you're trying to meet a public demand; is that what your reason is?
A. Well, it was to --
Q. You're marketing yourself; is that correct?
A. It was to facilitate the sale of books.
Q. That sounds to me like marketing; is that correct?
A. You can describe it as you wish.
Q. In fact on the website you're referred to as the Calory King, on the Internet. Are you aware of that?
A. As the what?
Q. On the Internet you're described as the Calory King. Are you aware of that?
A. No. What's the --
Q. Do you know --
MR. G. KEAYS: I object to all of this.
MRS. KEAYS: I object. This is personal assassination.
MR. G. KEAYS: This is personal assassination and we're not going to stand for it.
BY MR. CASSIDY: Q. Do you know, Dr. King, what -- Dr. Hirsch, what chemicals are produced in recovery boilers?
A. Well, the chemicals that -- in review of the material that was provided for here, it was my understanding that the chemicals that are in question are particularly hydrogen sulphide, methylenecaptan, dimethody (phonetic) sulphide and dimethyl sulphide. Questions also exist regarding sulphur dioxide and NOx and NO2 and then there were a -- as I read over the material there appeared to be a variety of trace metals that are -- had been reported to exist including lead and manganese, arsenic, mercury and zinc.
Q. When was the last time you were in a pulp mill?
A. I've never -- last time I was in a pulp mill?
Q. Yes.
A. I was in a pulp mill about four years ago when I was consulted by the pulp mill regarding odour effects and what to do to minimize them.
Q. Any other times?
A. That is the last time I recall being in one.
MR. CASSIDY: Madam Chair, I have concerns about the expertise of this witness with regard to the issues that are at stake in this hearing. It is my submission, he is not qualified to give expert evidence with regard to human health effects of pulp mills. He does not have a significant part of his resume dealing with these issues at all. His evidence is of a more general nature with regard to odours and it appears to be, from his perspective, more important that he deal with issues like weight loss and sexual performance and, as a result, I do not believe he comes forward as a credible expert witness with regard to odours from pulp mills. And, as a result, that is what's really at issue in this hearing and specifically with kraft mills and in particular with regards TRS or particulate and I just don't believe that he represents the expert that can be of assistance to this Board and the issues before it and therefore I object to him be qualified as an expert.
THE CHAIRPERSON: Mr. Andrews?
MR. ANDREWS: I guess my submissions are in short that there's no merit to the objection. The witness is probably one of the most qualified experts in the world on the topic
The impact of odours on humans is a topic that exists independently of the source of the odour. The chemicals involved are ones that come from a wide variety of sources and the witness has already indicated that he has experience in the health effects of odours from a wide variety of sources including having consulting with a pulp mill. There's no reason, in my submission, that this expert should not be qualified -- this witness should not be qualified as an expert on the topic.
THE CHAIRPERSON: Mr. Hirsch, I just have one question for you.
QUESTIONS BY THE CHAIRPERSON:
Q. On the chemicals that you've listed -- that you looked at in association with this pulp mill, are those chemicals that you've evaluated in other research or --
A. Oh, yes. Those are chemicals that we look at for a variety of them including EPA.
Q. Right. And you mentioned you did consulting for a pulp mill.
A. That's correct.
Q. What did that involve?
A. That involved the -- going down to the site which was in Ohio and talking with them about their odours, evaluating the odours and trying to give them some ideas of ways that they can minimize their odour effects. What happens with pulp mills -- in the process of it I had to learn pretty much about pulp mills. One of the difficulties is that around the sites of the pulp mill one sees a large degree of odour which tends to cause permanent olfactory impairment in people who live around the site and that's one of the big concerns, at least in the States, is that because permanent olfactory impairment can have marked impact upon an individual's lifestyle. And they asked what can we do to help get rid of the odours, what can we do -- then they asked us to give an idea of how much effect the olfactory impact was having on people around the site.
THE CHAIRPERSON: Right. I think, clearly, Dr. Hirsch is being tendered as an expert on the effect of malodours on human health with obviously malodours including the effects of chemicals and I think certainly in his extensive curriculum vitae has certainly a focus, if you like, on environmental impacts and has indicated he has dealt with the chemicals of concern in this site in other context. We accept that he has limited, certainly, experience in the pulp and paper area but he is testifying on the impact of these particular chemicals on human health. So we will allow his testimony at this hearing.
MR. ANDREWS: Thank you.
EXAMINATION IN CHIEF BY MR. ANDREWS (Con't.):
Q. Dr. Hirsch, you have an article called the Negative Health Effects of Malodours in the Environment that you were planning to use as something of a --
THE CHAIRPERSON: Let me just mark his CV as Exhibit 15 and the material provided by Mr. Cassidy -- do you want that marked?
MR. CASSIDY: Yes, please.
THE CHAIRPERSON: Exhibit 16 and the Negative Health Effects article will be Exhibit 17.
--- EXHIBIT 15: Curriculum Vitae, Dr. A.R. Hirsch
--- EXHIBIT 16: Internet material, Dr. Hirsch
--- EXHIBIT 17: Paper, Negative Health Effects of Malodours in the Environment
MR. ANDREWS: Ready to proceed?
THE CHAIRPERSON: Yes, thank you.
BY MR. ANDREWS: Q. Could you begin by giving us a general background to the factors that are relevant to the connection between odours and the chemicals that cause them and human health?
A. Sure. You know, when we think about odours, we just think of them as a nuisance, you know, if it smells bad you go away from it. But odours can really have a much greater impact when we think about it for several reasons. Number one, you have to understand that each of us is different in our perception of odours. In a normal -- well, in the world of vision, for instance, if you look at somebody who has 20/20 vision and somebody else who has 20/200 vision we know one is blind, the other has normal vision. In the world of smell those both would be considered normal. One's olfactory ability is of such great variation that a 10,000 variation in ability to smell would all be considered within the realm of normality. Given that, some people can detect odours at much lower concentrations than others.
On top of that, what happens is that some individuals are predisposed to the health effects of odours to a far greater degree than others. For instance we think of asthmatics. There are a number of studies been done now suggesting that in asthmatics an odour can induce, even a relatively insignificant odour, is of much greater risk of inducing an asthma attack in somebody who has unstable asthma. In somebody with more stable asthma a strong odour can induce the asthma attack.
So given that there's different variations of individuals in terms of how much an odour will affect them, let's talk a little bit about some of the studies suggesting that odours -- malodours can have negative health effects. And not all -- and I have to say that many of them do not deal with pulp mills but keep in mind that the concept of the malodour in and of itself can have negative effect regardless of the source of the malodour.
In 1980 Miner described the results of exposure to livestock waste and he described odours and the effects including depression, headaches, insomnia, impaired appetite and difficulty with breathing. Now, we, over the last almost 20 years, have studied a variety of different sites and their effects, the effects of malodour. We looked at outside the Gaylord Chemical plant which I think, outside of Bogalusa, Louisiana. We looked at the effects of exposure to nitrogen tetroxide as well as hydrogen sulphide. We looked at acute chlorine gas exposure causing neurotoxicity in -- outside of Las Vegas. Neutra reported hazardous -- reported effects of malodour on people who live around hazardous waste sites. And Shusterman demonstrated that even levels that were considered to be non-toxic there were effects of odours on physical symptoms. So if we divide it for ease of understanding into basically six different areas in terms of how odours can affect people's behaviour, we think about respiratory effects which we talked about already in terms of making people who have asthma much more unstable; chemosensory effects; cardiovascular effects; immune effects; neurologic and psychological effects or psychiatric effects.
Chemosensory effects I think are the ones that I'd like to spend a little bit of time talking about because -- for a few reasons. Number one, exposure -- the current exposure to malodour induces olfactory loss period. It exists around pulp mills. It exists around sites of chemical release, of continual chemical release or industrial sites. We just completed a study looking at all the firemen in the City of Chicago. We found a substantial number of them, also from the current exposure, had some olfactory deficits. In a large study done -- actually it was done with National Geographic where there were over a million responders where they did scratch and sniff tests -- what was found was in sites around pulp mills there was impaired olfactory ability. All of these suggest that the impact has negative affect on ability to smell.
When we've been studying people who left the site where they lived near the pulp mill and then they moved to another site away from the pulp mill odour, we found years after leaving the pulp mill sites their olfactory impairment persisted, suggesting that we were looking at chronic permanent olfactory deficits as a result of exposure to pulp mill sites.
Now, you say, well, who cares if you can't smell? You know, so you can't -- well, not being able to smell has a marked -- can have a marked impact upon an individual. When you can't smell you're going to have a much greater risk of being involved in food poisoning. Since about 90 per cent of what we call taste is really smell so you'll have much greater incident of being either hospitalized for it or at least in the emergency room for food poisoning. You can't -- when you can't smell you can't detect the ethyl capstan that's added to natural gas to give it its gas-like smell so you'll more likely be involved in gas explosions. When people lose their sense of smell there's a much higher incidence of both -- of DSM3R, AXIS I and II diagnoses, actually 96 per cent ends up being that criteria when we studied it but those are -- there's much higher incidents of psychiatric disorders, dysthymia, a form of chronic depression, internalized anxiety disorder being the most common.
We also --
Q. Can I interrupt for a moment to ask you repeat the DSR --
A. Oh, DSM3R is the old diagnostic standard for psychiatry. Now, it's come out to DSM4 but unfortunately we did all our studies when it was still the DSM3R so we haven't reported on them as such. But what that does is it categorizes psychiatric illness and what we found is when people lose their sense of smell there's a much higher incidence of depression and anxiety.
Also, when people lose their sense of smell there's a much higher incidence of a whole host of social effects. When people lose their sense of smell they develop a contrite reaction. They become much more fearful of going out. They don't know if they themselves smell so they avoid others. There's more familial disharmony when people lose their sense of smell and part of it may have to do because they've lost contact with others so not only do they have the inherent loss of one of the senses, so they can't appreciate the holidays -- they go to Christmas dinner and they feel like they're in a plastic bubble because they have none of the smells associated with it. They lose their ability to appreciate food or wine or flowers, but, even more important, it has major health effects on people who lose their sense of smell.
I bring this up because we're going -- we'll talk about this more later, but one could estimate with a very high degree of reliability that a substantial number of people who live around the pulp site here have impaired olfactory ability, a substantial impaired olfactory ability.
Malodours can also induce cardiovascular effects and this is -- malodours effect -- can do this by causing an increase in adrenocortical discharge, an adrenomedullary response which causes an increase in blood pressure and the increase in blood pressure then causes secondary cardiovascular effects.
A number of studies have suggested that increase in cortical response, in cortisal response in response to -- like a stress reactions occurs in response to malodour.
Q. Can I ask you, is that -- does chest pains describe that?
A. Well, chest -- you can have chest pains -- usually what happens is you have -- you think of your fighter-flight response, how you get really nervous or anxious, sort of like testifying in front of a room of semi-friendly people, so you have this sort of adrenalin response and associated with this adrenalin response there's an increase in constriction of the arteries which leads to -- if it occurs over a chronic period of time ends up causing an increase in blood pressure and predisposes to stroke and cardiac disease. Even independent of increase in blood pressure, they're predisposed to stroke and cardiac disease.
Another area is the immune and immune system, there can be -- can be comprised -- it can be affected directly as a result of the olfactory projections as a result of the malodour, the olfactory projections to the area of the brain which then goes to lymphoid tissue or it can be secondarily affected as a result of malodour inducing depression and then that causes secondary immune compromise.
This area becomes particularly interesting. When I saw the output of the trace metals that were described here and I saw zinc was one of them that is reported and there was whole flurry of articles that just came out recently talking about why you shouldn't use zinc. We used to use zinc treatment for olfactory loss and we used to use zinc for a variety of different conditions and there was a whole series of articles suggesting that zinc alone causes immunal compromise in individuals. That's why they say don't give it to patients who have AIDs because it will cause them much more immunal compromise. So my concern is that when you combine levels of trace metals combined with the odour you may be having even a further degree of immunal compromise than otherwise occurs.
Now, neurologic effects can also occur as a result of exposure to malodours. Chronic exposure to intermittent malodours from a navy dump site induced cortical and subcortical dysfunction which was manifested by people becoming encephalopathic or having trouble thinking and having difficulties with limbic encephalopathy or difficulties with the part of the brain that controls emotions. We did that outside of Washington State.
There's also been a number of other studies suggesting that malodours can affect it. There was one very interesting study that looked at nitrogen dioxide and sulphur dioxide at levels below the olfactory threshold and in that group they found that individuals had impaired visual processing. They had difficulty with adaptation, light adaption. It was like when you go into a movie theatre and you can't -- everything seems black and it takes a few seconds for you to be able to see it where there's much prolonged olfactory adaptation. They also found that there was -- in response to those malodours there was change in EEG as well as some impairment in reflexes which was persistent in nature.
Psychological effects of odours have been recognized for centuries. As a matter of fact, Freud recognized this and described it in great detail.
There's evidence that's suggesting that people who already may be somewhat psychologically compromised are more likely to be susceptible to the effects of malodour which goes along with what we know most predominantly in the neurologic and psychiatric literature, which is that if you already have an area that's partially damaged you have less reserve and hence it's more likely to become more affected by the insult.
And it makes logical sense that odours could affect mood and behaviour because the part of the brain that we think smells, or the olfactory lobe, is actually part of the limbic lobe or the emotional brain. So anatomically they're connected up. As a matter fact, MacLean, when he originally defined the limbic lobe included the olfactory lobe to be part of it.
Now, there are a whole host of different mechanisms whereby odours can actually pathophysiologically affect the limbic lobe or affect emotions. One, it could do this by inducing a Pavlovian condition response. It could -- so, for instance -- or through -- a second is through olfactory evoked nostalgia and a third is by direct action on the brain similar to a drug.
Let's talk about the last one because you can actually show presentation of hydrogen sulphide and presentation of malodours causing EEG change or brain wave changes in individuals when they're exposed to it at the time.
Bad odours can tend to induce a variety of negative effects, both acutely and in a more chronic nature. They can induce trigeminal nerve stimulation.
Now, let me backtrack for a second what we're talking about. The olfactory nerve you smell from, the top of the nose. The trigeminal nerve is the nerve that's the irritant. You know, when you cry when you cut an onion, the reason you cry when you cut an onion is because the trigeminal nerve is being stimulated. When the trigeminal nerve is stimulated, as occurs around pulp mill sites, what happens is it induces an adrenalin release or it's basically a painful response and the painful response can induce a more angry state.
Q. Can I just interrupt to ask, first of all, how to spell trigeminal?
A. Oh, I'm sorry. T-r-i-g-e-m-i-n-a-l.
Q. And, for the record, you were pointing to your eyes, the corners of your eyes when you were talking about that nerve?
A. Yes, that's correct.
What happens when people are exposed to bad odours, well, I mean, this initially makes them in an angry state because the trigeminal nerve is stimulated. And then a variety of different experiments have been performed looking at what do people do when they're exposed to a bad odour. I think one of the most interesting ones was where college males were told by turning a knob to the right a colleague would get an electric shock. Okay? And when they did this same experiment when the college males were exposed to malodour then tended to turn the knob much further to the right suggesting that they were being more aggressive. All of this goes along with that malodours tend to increase aggression. I mean, not that college males need to be induced to be aggressive anyhow, but, you know -- so, other studies have suggested that there's increased incidents of motor-vehicle accidents in the presence of bad odours, suggesting that drivers are driving more aggressively.
Now, we studied a mulching site where there was -- for the Attorney General's office where there was a bad odour that would waft across the street where there was a school across the street and on days when there was the bad odour there was an increase in behavioural problems in the school kids. So all of these suggest that malodours tend to increase levels of aggression.
When people were studied next to swine operations there was -- subjects reported an increase in tension, fatigue, confusion, depression, anger and a decrease in energy.
Also ambient pollutants cause people to become more irritable. In sort of an interesting study in Germany where there was -- in an urban area, moods of young adults would fluctuate according to the daily ambient air quality. And this was particularly true amongst those who were already emotionally unstable, so suggesting that there may be a group that's more susceptible to malodours than others.
There have been a variety of other studies suggesting that not only are emotions affected in people who are emotionally unstable initially but even in those who have diseases, for instance, in one study in Bavaria variations in feelings of wellbeing varied depending upon the air quality in individuals -- in women who suffer from chronic diabetes.
Q. Excuse me, can you repeat that? You went a little fast.
A. Oh, sure. I'm sorry. In a study in Bavaria in women who had chronic diabetes, their feeling of wellbeing varied depending upon the level of ambient air quality, suggesting that they don't have to be emotionally unstable for it to be affecting. All they have to be is in some way more susceptible than others and it could be on a physical basis as well. Similar results were found in a study in Israel as well, urban health effects.
There have been a variety of studies looking at if odours can affect -- if malodours can affect psychiatric status one would expect that it would affect utilization of psychiatric facilities as well, which is what has been found as well. For instance there's an increase in instances of 9-1-1 calls. There's increases instances of violent behaviour as well as psychiatric admissions in the presence of malodours. One relatively interesting study looked even at use of drug overdoses and the presence of drug overdose -- sorry, in the presence of malodour there's an increase in incidences of drug overdoses. So all of these suggest that malodours impact in a negative way the psychiatric health of the individual.
Now, even more than that, it affects not just people who are already partially ill. It can affect normals as well. There have been -- it was a very good study that looked at what happens when -- what happens to long distance runners in the presence of malodours and what happens is their time drops. They do worse in the presence of malodours. So all of this suggested that the presence of malodours can have a negative impact on the overall health and wellbeing of individuals even if they don't have an underlying disease state. It can affect the community at large. And so the prolonged exposure to malodours can lead individuals to a feeling of helplessness, depression which then they can either respond to through negative effects or just accept it and have a negative overall health in the community and have a negative impact upon the community.
So, that sort of in a nutshell give you an idea of what some of the effects of malodours can have, both acutely as well as chronically in terms of the overall health of the individuals in the community.
We looked at six of the people who were involved here. Not all six had effects of malodour. Some of them had other predisposing factors so that they would be more susceptible to effects of malodour. But of the six we found that two had respiratory effects of the exposure to odour; two had chemosensory deficit or trouble with smelling as a result; two had evidence that there been some immune logic effect of the malodour; four had complaints of neurologic impairment as a result of the odour and four had complaints consistent with psychological effects of the odour.
And I had to say that six people does not a study make. And I would suggest to you that six is not enough. I would like to look at the whole community to see if it effects. I would suggest to you that while only two people appeared to have chemosensory deficit in this group, I would suggest to you that the actual effect is far greater than that because we find that people lose their sense of smell and if it's of a gradual nature they don't usually recognize it. They don't complain about it. So that I would not be surprised if we saw a far greater incidence of olfactory impairment in the population that is around this site.
In addition to that, people -- we all tend to deny things. We all tend to think, well, you know, where I am is safe. It's the people next door that have difficulties. So people tend to deny their deficits so if you actually examine people who live around a site such as this you're much more likely to find deficits than they would otherwise complain of.
Q. Would it surprise you for some individuals in the community to say that although they have lived here for a long time they don't have any difficulty with the smell, nor do they feel it's had any effect on them?
A. Oh, no. No, it wouldn't surprise me. But actually, you bring up some very good points with that. Number one, what happens is as you -- I think this may be what happened with one of the individuals who we looked at -- is that when you're here -- first off, if you're committed to the community you want to minimize the effects and you want to minimize the effects on yourself. You know, you want to think, oh, gee, I'm okay, and therefore you tend to minimize it. That's number one. Number two is some people are more susceptible than others -- some are very resistant -- by and large because they start off at different levels so they may not have a deficit to begin with or they may have such super good ability that they lose a little bit and it doesn't really bother them.
Another reason is that what happens is as you're exposed to malodour recurrently, and we see this all the time, is that you lose the -- in people working around pulp mill sites in particular and other sites -- is you lose the ability to smell the malodour so what happens is that you say, "The odour isn't that bad. You know, I only notice it a few times a year." The reason being is because your olfactory ability has become impaired to such a strong degree you don't even recognize it but it's there. That doesn't mean it doesn't cause any secondary effects because the olfactory threshold, the olfactory ability allows you to detect when the chemical is present so you know to move away from it.
When people lose their sense of smell, as I said, they often don't recognize it, specially if it's gradual. I have to say that in the group -- every area is different in terms of medical care and medical intervention. In the cities, in non-rural areas, people tend to seek medical intervention I think to a quicker degree than in the rural areas just because of maybe the ease of obtaining a specialist's care and one would anticipate that even individuals who say, "Oh, there's no effect," if they were actually examined you might actually see an effect.
Q. Can you comment on the difference, if any, in effect between chronic exposures, long-term exposures at certain, say, medium or lower levels versus exposure which is characteristic of peaks and then very little or no exposure?
A. Sure. One of the difficulties we have, and we have it here and we have it virtually at every exposure site that we look at, is that you don't -- you only can estimate what their exposure was, too. The reason being is because your monitors aren't always at the sites where the exposure is and the monitors average it over an hour, a day, whatever, so you don't know, so if you have one level that's very, very high and you got it absent for the rest of the day it'll average to be a really variable level, yet that high level could be severe enough, even for a transient period of time, to cause marked neurologic olfactory effects.
Q. So you're saying that -- I mean, is there a comparison? Is it appropriate to say that it's the peaks that make the big difference or is it both?
A. Well, no, it's really both but the peaks -- peaks in and of themselves can have an effect and we see this and we know that peaks occur because we know that individuals who are exposed to trigeminal levels of some of these chemicals and we know -- let me backtrack. Olfactory level is at a point when you can detect if an odour is present and then you go the next step higher and it's olfactory recognition level where you can actually recognize, oh, yeah, that smells like ethylene capstan or that smells like hydrogen sulphide, and then you go to another level up higher, usually like 100 times higher -- it depends on your chemical -- where you actually have the trigeminal threshold where the person cries when they're exposed to the odour or it stings in their nose.
We know these individuals were exposed to relatively high levels of different chemicals, of the group of the six I talked to, at least for five of them -- maybe for all six. I have to look back in my notes -- they had at times experienced trigeminal thresholds which suggested they were at times exposed to relatively high levels of the odourance.
Q. Can you explain again what the trigeminal threshold symptom would be?
A. They would complain of not only the intense smell but the burning of their eyes or a stinging in the nose. So those are very good indicators that they're exposed to relatively high levels at least transiently. And transient high levels in and of themselves can have an effect so we see -- sometimes -- at one site we had no record at all of any levels being elevated on the monitoring systems yet we clearly showed deficits and we knew there was effects because the entire community described trigeminal effects.
MR. ANDREWS: Thank you. Madam Chair, I don't know what the schedule is. Shall we break at this point or?
THE CHAIRPERSON: Where are you in --
MR. ANDREWS: I have basically a small amount more.
THE CHAIRPERSON: No, I think we'll take the lunch break now and come back at ten after one and then we'll continue with your questions.
--- PROCEEDINGS RECESSED AT 12:06 P.M.
--- PROCEEDINGS RESUMED AT 1:13 P.M.
THE CHAIRPERSON: Mr. Andrews?
MR. ANDREWS: Thank you, Madam Chair. First, to keep the paper work in order, can I ask that this review article, Negative Health Effects of Malodours, be entered as an exhibit?
THE CHAIRPERSON: That one already is. Exhibit 17.
MR. ANDREWS: Oh, all right. That happened while I was doing something else.
THE CHAIRPERSON: I think we're up to date.
R.A. HIRSCH, Resumed:
EXAMINATION IN CHIEF BY MR. ANDREWS (Cont'd.):
Q. Dr. Hirsch, there was a question earlier about a moniker for you to do something along the lines of the Calory King. I gather you didn't understand what the word was and you now know what that was reference to.
A. Yes. I suspect that's in reference to that I work on odours and weight loss but I have to say that actually doesn't bother me too much because I've been called much worse. The New York Times called me Jacques Cousteau of the nose and Oprah called me the Magellan of the Nasal Passages so within perspective Calory King is okay.
Q. You said early on in your testimony that weight loss was a serious issue that you've done work on in relation to odours. Can you tell the panel what the implication is there?
A. Oh, sure. I tell you why that has some importance for today, although when -- in treating patients who have lost their sense of smell we find that they initially gain 10 or 20 pounds. Why that's so important, if we're looking at a community that has as a group impaired olfactory ability it would predispose them to becoming more obese, or towards obesity so as part of the secondary complications of having chemosensory loss, or loss of sense of smell, you see a much higher incidence of obesity so that would predispose this community to that health risk.
Q. And, likewise, the effect of odour on sexual function?
A. That's right. That also -- done some serious work with it and a real important part about that is that we found this connection between olfactory dysfunction, if you lose your sense of smell one sees a much higher incidence of sexual disorders, sexual dysfunction, impotence and sexual arousal disorders. Again, it would suggest that as a community, if we're seeing this chemosensory dysfunction in the group, you would also expect to see a higher incidence of sexual dysfunction in the group as well. So all of this relates to what we're talking about today. It is not a primary effect but it is a secondary effect of the odours from the pulp mill.
Q. Do you have any comments on the effect or the relationship between odours and tourism or people's movement, behaviours?
A. Oh, sure. And we've done -- again, it's not health effects so much as the effects on the community as a whole. We've done studies looking at how odours impact upon tourist's behaviour, particularly we looked at a few different sites. We looked at Garry, Indiana. We also looked in Las Vegas. And it's very clear that when pleasant odours are present people will persist in those areas for much longer than if an unpleasant odour is present. When there's an unpleasant odour, people tend to avoid those areas. So, if anything, having unpleasant smell around the area will negatively impact upon tourists staying here very long. It may not effect them deciding to come out here but once they're here and they smell the bad odour they're not going to want to stay around for very long.
Q. Can you discuss the synergistic effects, the implications of odour causing agents in combination with each other?
A. Sure. Usually when we talk about effects of a neurotoxin we talk about low levels, TLVs, or various low levels and what their effects are and they talk about -- usually we talk about one agent at a time. This is the level of one agent that causes an effect. This is the Level H2S that causes an effect. This is the level of whatever. With malodours these chemicals tend to have a synergistic effect so they can be at much lower levels but when you combine them together, it's not just additive but it's more than additive. It's hyper-additive. And literature supports that malodours act in a hyper-additive way, in a synergistic way to cause negative health effects.
Q. You mentioned also delayed effects. Can you explain what that is?
A. Sure. If you get shot in the arm, you're shot in the arm. You know it right then. But what happens with malodour effects, literature is very clear that what happens is you can have an impact and the impact will -- you can be exposed and you may not manifest the exposure for years after the time of the toxin or the odour exposure. So that even though you were exposed today or this month it may be two years till you show the major effects of it and that's one of the relatively unique things about neurotoxicology and odour effects as compared to some of the other areas of medicine. If you have an infectious disease, well, it's true -- let me backtrack. It's true amongst some infectious diseases as well. For instance, if you have AIDs now you may not manifest the AIDs encephalopathy for five years or six years so it's true amongst other areas of medicine as well but it's very clear that delayed effects can occur.
Q. What is your view of the effect on public health of a delay of any given amount of time in improvements to the air quality, whether it be two months, six months, one year?
A. Yeah. It's not good medicine to do that. It's very clear that malodour is having a negative health effect on this group and most likely the community as a whole. If you delay it for four years, for two years, for one year, for six months, it doesn't make any logical sense. What you want to do is you want to stop the exposure as soon as possible or minimize the exposure to the greatest degree that you possibly can. Delaying it for six months or for four years doesn't make sense. You just continue to expose people and cause continued medical damage to them and harm to the individuals which, to a large degree, appears to be irreversible in nature.
Q. You've had considerable experience with public health and environment officials at least in the United States. Can you describe the way in which they approach odour and health issues?
A. Sure. Depending upon the site, it's not too different than this. I was called by the City of Boston to come and testify for them regarding a plant that was going to be opened up and I was called and I evaluated the area and we held a public hearing and I discussed the potential health effects of malodour in the site in terms of -- because there was so many people with asthma living nearby, because there were so many people who were older in the community living nearby and because of the density of the community it was very clear that the malodour would cause a negative health impact on the community. And so I testified -- I was called by the City of Boston to testify. We did it for some Commission, I guess the City, some Commission there and then they eliminated the -- the prevented the zoning from the factory going up so it's very -- it's not unlike what happens here.
Now, sometimes I'm called in, like, by the EPA to come and evaluate a site where there's a malodour coming out and then I'll come and I'll evaluate the people who live around the site or who work around the site. We'll talk with the people. Sometimes we'll examine the people and then, depending upon what we find, we'll present that. We'll either present it in court or a public hearing like this and depending upon what happens -- in those situations they've eliminated the odour. They closed down the site. So it depends on the exact area but it's not too different than this where there's clear potential risk to the community as a whole.
Q. Thank you. We've talked about a variety of different aspects of this. How would you summarize your conclusion about the relationship between odours and air pollution from the mill in Powell River itself and health effects in the community?
A. Yeah, just bear with me. It's clear odour is more than a nuisance. It can cause health effects, neurologic effects, immune effects, respiratory effects, chemosensory effects. It can cause -- and cardiovascular effects. These effects can be permanent and there's no good way of treating them -- well, for the majority there's no good way of treating them. I mean, you can help if there's a heart attack and that sort of thing but there's no good way of -- the best treatment is prevention and elimination of exacerbation and the best way to do it is to get rid of the bad odour, in this instance as a result of the pulp mill.
MR. ANDREWS: Thank you. Now, if I could raise one issue I neglected to mention earlier, is that Dr. Hirsch has a flight out at 5:40 and I don't anticipate we'll go anywhere near that long but I did want to mention that that is an outside constraint on his availability. Thank you.
THE CHAIRPERSON: Mr. Keays, you're first up.
MR. J. KEAYS: I would like to ask my questions in the context of information that I guess I enter now as an exhibit. Is that -- I mean, I want to give Mr. Hirsch some information and ask him some questions about it and I obviously can't give it just to him so I give it to everybody.
MR. CASSIDY: Excuse me, Mr. Keays, do you have one for the Union representatives as well?
CROSS-EXAMINATION BY MR. J. KEAYS:
Q. The graph is pictures of particulate levels in Powell River. The particulate levels at Level "B" are 50 on the scale and there are no Level "A" standards that I'm aware of for ambient air. But it's clear from the picture that there's occasional spikes in the information. People are subjected at one time or another to, say, over 60 whereas on average they're subjected to 15, okay, roughly, parts per million of particulates. Now, my question is, in evaluating the health impacts of things like this, do you think there would be a greater effect from the constant low exposure or the temporary periodic high exposures?
A. I don't know which would be greater. It's my perception that limited high exposures are very -- the way in which it's usually taught in medicine is intermittent high exposures are bad but at this moment I can't answer your question. Clearly both are not good.
Q. Okay. On the second one, I've got the papers were stapled backwards. It's information on poly-aromatic hydrocarbons and there's a picture circled on the right of the second to last page of a molecule that's retene, but these pictures are of molecules that tend to be hydrophobic. They don't like water. They tend to be stored in fat. So you were saying that the effect of a -- an effect on people of bad odours was an increase in weight. And my question is, would it then follow that molecules like this that store in fact would tend to be stored more because there was more fat?
A. Yes. If there's a greater lipid area there would be more to be stored in so whether it be DDT or other compounds that store in fat you expect that.
Q. My last question is, I was looking at some samples from a lake and I came across balls of resin from trees. They were microscopic balls of resin and I tried to separate them so I could get them analysed and in trying to separate them I managed to get some in a Petri dish and I made a mistake and put some alcohol in the dish so it evaporated. And I started sneezing and I got a strong headache and I think that the molecule that was common -- it smelled like a low tide, where in a log boom area where you've got a lot of rotten wood -- and I smelled the low tide and I noticed I couldn't stop sneezing and I had a strong headache and I think that the molecule that I was smelling was this molecule retene. Do you know anything about retene? It looks a bit like estrogen. It's a --
A. Not -- well, very little about it.
Q. So I have reason to believe that retene is fairly common as a result of this mill. Now, given that it induced this strong reaction in me, my question is, is there a general relationship between induction of asthma -- I assume these were kind of asthmatic responses. Is sneezing and a headache -- why would I get a headache and start sneezing from that molecule? Or if it isn't that molecule, what happened?
A. Those are very good questions and let me start of by telling you, asthma -- when we talk about asthma we talk about hyper reactivity of the airway, of the small areas of the airway, of the bronchioles and the airway and so they are hyper reactive to all sorts of different things, odours, very, very cold temperature for instance. A single exposure to something usually does not induce an asthma attack. It usually requires a few -- or it does not usually -- it can induce an asthma attack but does not induce somebody to develop asthma. Usually asthma requires recurrent exposures to something for the development of the asthma. Then, once you have it, it's sensitive. It's sensitized to all sorts of different things. When you -- it could be that what made you sneeze -- you sneezed first or had the headache first?
Q. I ignored both as long as possible so I don't know. I was trying to do something and I -- I don't know.
A. There's a phenomenon where you sneeze and then develop a headache because your head moves so quickly and then you can get a trauma induced headache and actually people develop subdural haematomas after they sneeze recurrently so that's one possibility. The same way that snuff, if you go out -- you take snuff and you sniff that and it makes you sneeze -- people have developed severe headaches when they recurrently sneeze from that. So my suspicion is that the headaches were secondary to the sneezing and there was something here, whether there be retene or something else, that induced you to develop this irritant. In fact, the sneeze is really a mild form of irritation like the trigeminal nerve being stimulated.
Q. But if you stimulate the trigeminal nerve do you sneeze?
A. You can sneeze. It's a very interesting gradient because when you do it at a very small level you get sneezing. If you get to the high level you get a burning.
MR. J. KEAYS: Okay. I've very much enjoyed your participation. Thank you. And, in as much as the answers were responsive to this, shall I ask that this be number --
THE CHAIRPERSON: Yes, 18.
MR. J. KEAYS: 18?
THE CHAIRPERSON: And that will be -- call it material filed by John Keays.
--- EXHIBIT 18: Material filed by John Keays
MR. J. KEAYS: I have hundreds of questions but we're out of time so I'm going to shorten them. I really did enjoy listening to you.
A. Thank you. I'm sorry I couldn't answer your question in more detail.
MR. J. KEAYS: Unanswered questions may be the best ones.
THE CHAIRPERSON: Okay. Mr. Grant Keays?
MR. G. KEAYS: I have no questions. I would like to say something to though, which is that your testimony here is the first time I forgot I was at a hearing. Thanks.
THE CHAIRPERSON: Sally Keays?
MS. KEAYS: Yeah, I have a few questions.
CROSS-EXAMINATION BY MS. KEAYS:
Q. I take it that you have -- that you're an expert in two fields, both the field of odour and the field of neurotoxicity?
A. Well, they tend to come together because -- but, yes, I would say that that's the case.
Q. How many experts are there in these fields in America today anyway?
A. Well, in the world of odours and their effects, there's very few. We're very, very frequently called to comment on things all over the world. We're called by lay-public to talk about odours, malodours. Oprah we talked about effects of malodours and we talked -- we've been called on Mindy O'Leary and all the different, you know, 20/20, 48 hours and Dateline and all the different TV shows when we have to talk about malodours, they'll ask us to come in and talk. And also we see people with malodour problems from all over the world. Even though we're in Chicago, about half of the patients we see come from out of Illinois. A quarter of the patients we see come from other countries. You know, we see people from Asia and Europe all over, come in with different malodour difficulties, so it's a very rare thing. Mayo Clinic sends their patients that have malodour problems to see us or the people out in California, Kaiser, fly their people out to see us so it's very, very rare.
Q. But do you have like -- as a group, have you peer reviewed publications, et cetera? Do you all share the same knowledge, the same ideas?
A. Well, no. You know, I'm one of the reviewers from some of the medical journals that reviews articles. There are many different -- everyone views things from a different aspect. As a neurologist and psychiatrist and somebody who works in smell, I'm probably -- probably the only one in North America that does specifically that. But there are other people who are just neurologists or other people who just work in smell or just work in toxicology.
Q. And are these views apt to be opposing to yours or is there a generalized view that there's neurotoxicity happening because of TRS and H2S and --
A. Oh, yeah. Oh, there's general consensus in that regard. Pretty much everybody in the field has -- most of the people in the field have the same sort of approach. You have some outlyers, people who say, oh, we should be going higher with -- for instance, with lead. Leads a good example. Here we have lead that's coming out from -- that's found in the site. Almost everybody in the world of lead suggests that you should be having either tolerance for any level of lead or it should be very, very, very low, much lower than what its currently allowable standard is. You have a very few people who are outlyers who say lead is really not a danger until you get to very high levels but almost -- and they are the ones who usually work with the industry so as a general rule -- it's sort of like -- it's very similar to, I think, what we see in tobacco smoke. I mean, almost everybody will say that tobacco causes cancer but you still have a few people who will say there's no connection.
Q. Thank you. Now, my understanding is that some of the chemicals bypass the blood brain barrier; they go straight up the nose into the brain. Is this correct?
A. Well, yes. We didn't get into the pathophysiology of how the odours have an effect. But odours can actually -- there's four areas in the brain where there's no blood brain barrier. The brain is like this size inside your head and it's surrounded by a blood brain barrier and what happens is there's four areas of the brain where there's no blood brain barrier, where things can just go straight from the bloodstream or from the external surface into the brain. One of them is the -- up through the nose. As a matter of fact one of the hypotheses for why we see this increasing incidence of dementia in the elderly is that aluminocylicates are progressing through the olfactory nerve up into the brain and then causing secondary spread there and secondary destruction there. So that's one of the mechanisms whereby heavy metals, for instance, cadmium, which was again listed from the site, is one that's been known to traverse the nose and go into the brain through that mechanism.
Q. Directly to the brain? If you breathe cadmium in through your nose it can go directly to and adhere, I would assume, parts of your brain?
A. Cause destructions of cells. As a matter of fact with -- I think the study that was done, in hamsters where they infused, but that's correct. And there's a variety of different toxins that will do that. That's one of the hypotheses why toxins can cause olfactory loss very early on in the process.
Q. Would this be causal in Parkinson's Disease?
A. Parkinson's Disease is a very much more difficult question to answer. Let me tell you why. The story of Parkinson's Disease is -- there is some environmental evidence suggesting that exposure to pesticides and other industrial toxins and solvents may be associated with the development of Parkinson's Disease. At this moment there's no evidence that I know of where odours or levels of chemicals that produce odours are enough to induce Parkinson's Disease in individuals.
The best model for Parkinson's Disease is MPTP where it's injected into an individual and they develop Parkinson's Disease. But the latest demographic data does suggest that there seems to be some sort of exposure component in a large group of Parkinson's patients. There's also a sub-group that appears to be primarily genetically mediated, in which case the environments have very little impact.
Q. Are there any tests -- now, I get Chemical Injury Information Network newsletter and they say that there are some relatively simple tests that can define chemical injury. I know that the National Research Council has seven parameters that can be used in diagnosing chemical injury and if you have four out of these seven -- they are chronic sinus, nasal, throat, pulmonary damage, peripheral nerve damage, CNS damage, certain antibodies, elevated lymphocyte profile and the presence of immune disease panel. This is from the veterans that came back from the -- Desert Storm veterans that came back with all chemical sensitivities. And I have one other paper that says that the one thing that chronic fatigue, multiple chemical sensitivity, fibromyalgia, some of those malaise-type sickness have in common are multi porphyries --
A. Porphyries, yes.
Q. Porphyries, and that it's quite different than the established normal porphyria that has heretofore been the cause, relatively rare. Is there any simple test that we as a community could ask -- I sit on the Health Council and I think that they would be very interested in getting this information to the doctors in our community if we had some direction from the EAB.
A. That's a great question. Let me comment about them in twofold. Let me first comment about an important distinction I want to make here just for the audience and for everybody to understand. Multi chemical sensitivity are the people who are sensitive to ultra low quantities or chemicals where a smell of perfume, a small amount of perfume might cause somebody to be horribly ill or a small amount of some toxic chemical might cause a person to be horribly ill, whereas in the rest of the individuals in the population are not affected.
Leaving that aside, what we've been talking here today is not about MCS patients only. We're talking about you and I. We're talking about the general population that are not affected by multi chemical sensitivity that are being impacted upon by levels of odour or levels of the toxin. Okay, that's just as a starting point.
Multi chemical sensitivity is a very, very difficult disease to diagnose and to treat and we've written pretty extensively about it and I've lectured about it. One of the theories about it has to be porphyria rings and that's -- I think it remains still a little hypothetical for routine testing. If you wanted to do something for the community to help see are people being exposed to these toxins, what would I do? If I wanted to do something very cheap and easy that a doctor could do in the office and could routinely do I would routinely do olfactory testing in the office. And if they did it on every patient that came through or even did it as a mass screening, I think that way, it doesn't involve drawing blood. It's relatively easy for them to do. And they by finding -- by looking at that you can then move from there because olfactory deficits are seen in people who have multi chemical sensitivity as well but it's also seen in people who have exposure to pulp mill toxin.
Originally -- a little confusing, but originally the literature talked about with multi chemical sensitivity they're supposed to be hyper-sensitive to smell so we tested individuals with this diagnosis of MCS and what we found is that they didn't have -- they weren't hyper-sensitive to smells. They actually had hyposmia. What happens is instead of having a better ability to smell than normal, people with MCS have a worse ability to smell but instead of smelling all the notes in the chord they're just smelling two or three of them. Those stand out --
MR. G. KEAYS: Hyposmia?
A. Yes. A reduced ability to smell. In the -- I'm sorry, the website that you referred to, we actually have a whole bunch of -- which is in the record here, I think -- we have a whole bunch of definitions. I think we define hyposmia and we go through a whole bunch of different definitions of different aspects of smell and taste loss. But hyposmia is the reduced ability to smell.
But that would be one way --
BY MS. KEAYS: Q. Is this a definitive test? What do they do? I thought that olfactory, you went from 200 to one. How can you --
A. No. There's no -- one of the problems with multi chemical sensitivity is that there's at this moment no definitive test. It's really still a disease being defined by clinical -- by symptoms and some clinical signs.
Q. No, I meant for the olfactory testing that you recommended for this town. Is this a definitive test?
A. Oh, there's -- there a whole bunch of different type of ones that can be done. Some of them, like the University of Pennsylvania Smell Identification test is something that's been well standardized and we've done it on over 10,000 people for instance and it's probably been done in thousands more than that. So this is something that a physician could easily do in the office. That's just one example. Or something that could be done as part of the community. That way you could use it to help screen individuals and then once you find the smell loss you can go from there.
Q. And that simple. You just go in and they say smell this or?
A. Well, no, it's a 40 question scratch and sniff so you scratch and say this smells most like. You know, these are four choices -- it'll scratch and it'll say this smells most like gasoline, banana, root beer, leather and then you'd have to choose and then be able to grade it.
Q. Okay. So one of the -- another thing that I would like to ask is does hydrogen sulphide anaesthetize the nose?
A. Well, that's a good question. Actually I wrote an article that just appeared this last month, Long Term Effects on the Olfactory System of Exposure to Hydrogen Sulphide, which appeared in some -- can't tell the name of the journal here but it appeared in the journal this last month. And the answer -- the answer to your question is yes, it does -- hydrogen sulphide -- here's what happens. You smell it at low levels. You can smell it. It smells, like we all think of it, right? Rotten egg smell? And then as the level goes up higher it develops a sweet smell. As it goes up higher you can't smell it. Next thing you're knocked down. It's called knock down but really you pass out.
If you are continually exposed to a low level of hydrogen sulphide you lose your sense of smell -- first you adapt to it so you may even lose your -- you may -- you won't -- if you're continuously exposed to this low level where you're just detecting the rotten egg smell, when it goes higher, next the sweet smell, the next thing you'll do is you'll be knocked out. Chronic exposure to low level of hydrogen sulphide or acute exposure to a very high level for a very short period of time can wipe out permanently the olfactory ability of an individual.
Q. All right.
A. So it is one of the -- it acts very much like cyanide on the olfactory apparatus.
Q. Would that cause, like, near fainting episodes or is that -- you can't say obviously?
A. Yeah. It would depend. Near fainting, so many things can cause that. It's hard for me to give you an assessment on it.
Q. Okay. Well, in one of the pieces of information that Mr. Cassidy sent to us, he said that -- he used the term psychogenic for, I believe it was in reference to something that had neurogenic inflammation of the nasal passages. Are those two terms interchangeable? Are you crazy if your nerves are inflamed from --
A. Well, you could -- let me -- it's a very -- maybe I can clarify.
THE CHAIRPERSON: Excuse me. Do you know -- what are you referring to specifically?
MS. KEAYS: I don't have it with me.
THE CHAIRPERSON: Is it in the material that was filed with the --
MS. KEAYS: It was in the material that he gave us and -- I can let that one go.
THE CHAIRPERSON: If you have it that's fine. We just need the reference so we can --
MS. KEAYS: Where will we find it?
Q. Okay. Now, you said that in -- you described that near a pulp mill that there is a clear -- that you examined people -- when you did your pulp mill examination, that they were at a clear potential risk. Could you -- for cardiovascular, respiratory, immune. Now, is that -- this was just one pulp mill? Is that H2S everywhere or is it --
A. Well, that's -- that is a good, very good question. I mean, clearly H2S is there. We see a lot of different things in pulp mills very similar to what we see at your pulp mill. And the problem is each of them are a little bit different.

The other problem is that we have a lot of things that they just sort of group together as VOCs or as total sulphur compound. I mean, what you do is you have some big ones and you have a lot of little ones and we're not altogether sure which one is causing the effect. Because what you end up having is you have this big, for better term, soup. It's all soup of different compounds that are causing the impact and when we can identify a single one it's great. But usually we can't. Usually it's a whole mixture and it could be that the mixture is having the effect. The mixture is causing the bad odour and the bad odour, we're seeing the secondary results of the bad odour.
Q. You have studied more than one pulp mill or you've read information for more than one pulp mill.
A. Oh, yes.
Q. But you've just published on one pulp mill; is that --
A. Well, we wrote about one there and I've talked about and --
Q. You've evaluated?
A. Oh, yes.
Q. Oh. You've evaluated a lot. Okay. My last -- can you become sensitized -- you used the term sensitization a couple of times. Would you just define that a little bit clearer for me?
A. Sure. There -- okay. There are different -- this is a difficult physiology concept but I'll try to sort of make it brief. But there's a phenomena of adaptation, you know, where you put on a cologne or perfume, you put it on and you smell it. Smells fine to you, right? Twenty minutes later you notice you go in an elevator and people come next to you and say, "Oh my goodness, so much perfume or so much cologne." That's a phenomena of adaptation, where after ten, twenty minutes you can't sense it any more and other people notice it.
One form of what sensitization is called is when you put -- when you have an odour, let's say, and you are able to detect it because you're attuned to it and watching out for it, you're able to detect it at a much lower level than you would have otherwise; that's one form of sensitization.
Another form of sensitization is when you're able to detect an odour of chemical because on a physiological basis your receptor sites have now improved so now you may not be detecting any better but because you've grown more receptor sites you're able to detect the odour.
Another form of sensitization is where the same level of odour that you have, or same level of toxin or whatever it is that you're exposed to you have, you now develop symptoms from -- you otherwise would have developed symptoms from and then there's something that happens with that that's called generalization where it expands not just from -- the symptoms expand not just from the first odour but from many, many different odours. So, for instance, sometimes we'll see individual who develops severe headaches, migraine headaches, as a result of exposure to a volatile compound, let's say tetrachloroethylene or something, and that causes a migraine headache. But over time what happens is they then begin to develop headaches in response not to just that odour but to other similar odours and that generalization effect is sometimes what we call sensitization.
There's another -- whole other concept which is that one odour causes you to respond when it's presented at the same time as the second odour to generalize the effect but I would sort of leave it like that.
So, depending upon the framework within which you're talking about it has different meanings, and I have to apologize, because I sort of -- I was very loose in my phraseology but that's the basic concepts.
MS. KEAYS: Thank you.
THE CHAIRPERSON: Mr. Robb? No, Mr. --
MR. CASSIDY: Usually I go ahead of them. Doesn't matter to me.
THE CHAIRPERSON: Okay.
MR. ROBB: I don't know, we've been switching back and forth.
THE CHAIRPERSON: No, no. He goes next.
MR. ROBB: I'll go whenever.
THE CHAIRPERSON: You go last.
MR. CASSIDY: All right. That's fine. I'm delighted to go last.
CROSS-EXAMINATION BY MR. ROBB:
Q. One of the first things you provided evidence on was the effects of malodourous -- am I speaking loud enough? Okay. The effect of malodourous compounds on local residents of Powell River and you cited a number of effects that you observed. I just wondered if you can give us some information how you came to those conclusions. Like, is it surveys or what data did you rely upon?
A. Sure. I'm happy to. Again, I have to -- let me start off by telling you that we looked at just six people here who were involved and what I did with them is I talked with them and was able to get a perspective in discussion with them, getting their old history and their current complaints. In an ideal world I would have liked to have done further examinations and different physiologic tests supporting it and further delineating their diagnosis. But, given what we had, this is the best that I could do in the time constraints.
Q. So you took their diagnosis, I'm sorry, or did you --
A. No, I took their histories and -- their histories of their old -- their past medical histories and their histories of their exposure and was able to delineate these individual functional diagnosis.
Q. Okay. So they referred to you their symptoms and then you made conclusions on what had occurred? I'm not --
A. They talked to me. I asked them questions about what was going on with them, their past medical history, what currently was going on with them, what was happening when they were exposed to it, what the odours smelled like, the frequency of the odour exposure and then I was able to ascertain that these were the diagnosis that best fit into what they had.
Q. So, for example, the ones where people have realized a drop in their ability to smell -- chemosensory deficit, is that what you call it?
A. That's correct.
Q. That was based not upon tests or anything like that; that was based on verbal information?
A. We did a -- that was based on history but it was based on history consistent with what you'd expect to see in an individual who's lost their sense of smell. For instance, if you haven't lost your sense of smell, most people don't realize that they can't taste either. Okay? So people who come in saying, "Oh, I can't smell," and they really can. They'll say, "Yeah, I can't smell, I can't smell," and then I'll ask them about how food tastes and they'll say, "Oh, food tastes fine," you know, no problem. Well, we know that's probably not real.
In the two individuals who appeared to have chemosensory loss as a result of the exposure, they complained, "Yeah, I can't smell," and they were telling me about their smell. They both said, oh, you know, and they can't -- and food, doesn't have any taste any more. It's bland. It's flavourless. The sorts of things that you'd expect to see for somebody who really has smell loss as opposed to somebody who's just making it up.
Q. Okay. But it's not like a double-blind test or anything like that that --
A. No. No. Those are all things that in an ideal world one would do.
Q. Okay. And, similarly, your observation of other effects was based on similar types of information communicated to you?
A. That's right.
Q. And your ability to ferret through various questions and come to a conclusion based on their information they provided you; is that correct?
A. That's correct.
Q. All right. And the next question is, you talked about synergy occurs between different compounds.
A. Yes.
Q. And do you ever get masking between different compounds?
A. Yes, you do. You do get masking and that's a very interesting question. Let me tell you the masking story because the whole question of masking came up when we were consulting by the pulp mills to help them with masking of their odours.
For those of you who are not in the world of smell, the concept of masking is this, that you take a bad smell and you add either a good smell and it eliminates the bad smell or sometimes you add a bad smell, you add the second bad smell, and the combination together is pleasant or at least it's not as unpleasant. So the concept of masking is that you can take one odour and mix it with another and inhibit the negative effects of it. And, yes, you can do that. You can do that with -- you can try do that with malodours. We do it all the time.
The worst one, we were called by the City of Buffalo Grove, Illinois. We were called because they had a pig farm across the street from a bank -- across the street from -- yeah, from a bank and they were complaining, the people in the bank were complaining that, "My God, this is horrible. I can't stand the way this smells." The workers didn't like the way it smelled. They said -- they called us up. They said, "What can you do to get rid of this bad smell from the pig farm?" Now, you know, I have to tell you that's not something we learn about in medical school but I figured, well, let's give it a try. What we suggested, we added chlorophyll to the pig chow and it worked. It changed the way the pigs -- the smell that came from that and eliminated the bad odour and they were able to do it. Now, eventually they tore down the pig farm and put up a used car sales lot and we still have problems but what can you do.
But masking does come about, yes.
Q. And chlorophyll added to pig chow will actually reduce the --
A. That's right.
Q. I deal with all other sectors, too. Agriculture as well.
A. That's right. That's correct. There are other interesting problems, too. Sometimes in masking we have a problem -- some people call in a more serious light from nursing homes 'cause they have the uriniferous smell sometimes that's very difficult for -- not for the residents who often can't smell so much but for the workers there and sometimes you can use an odour to temporarily mask that.
Q. Okay. My next question is -- there's two, I guess, parts of it -- one is, I'm looking at the effect of other contaminants in the environment and my personal experience here is, like, my hotel room, I walk into it. I walk in from the outside. I don't like the smell inside my hotel room, not having been there for a while and stuff like that, so I'm just wondering, indoor air pollutants -- there's more and more concern about those -- do they have the same kind of effects?
A. Well, you know --
Q. And I wanted to add in tobacco in there, tobacco smoke.
A. In the United States the current belief is that -- at the current time in the US indoor air pollution may be of a greater health risk overall than outdoor air pollution in the US as a whole. Part of the reason has to do with the number of people who stay indoors for the duration of time they stay indoors. I think the last data was they're outside, actually outside outside like less than two hours a day, something like that, and they're inside either at work or at home all the rest of the time or inside their car. So indoor air pollutants are a potential problem depending upon where you are. Most of the -- most people will do things to try and eliminate the malodours from the indoor environment.
Tobacco smoke is a very serious problem and the one thing I can encourage everybody in the audience is -- while I can't do anything to stop the mill, you can do something -- you yourself can take control and stop smoking because smoking causes a whole host of different neurotoxic effects, both in terms of neurologic and respiratory systems and olfactory toxic effects and it would be a well worthwhile thing to do is to quit smoking. I know it's very easy to say. Sometimes it's hard to do. But with some of the newer medications, like, globutrin, SR, it's much easier to do so I would encourage you to do that. But, you're right, both indoor and secondary effects of passive smoking cause marked impact.
Q. And I just wanted to make sure I understood what you felt was a good action to take on behalf of the community doctors, would be to do some testing of olfactory response and the type of testing, you said a scratch and sniff, which sounds to me like a qualitative test as opposed to a quantitative?
A. Well, no. That's actually a quantitative test because you get numbers based on the 40 responses and you're able to classify them as being --
Q. Oh, 'cause they're different concentrations they result in?
A. No. What it is, each one is a different odour and since it's been used on so many people you're able to -- based on the number correct you're able to identify whether they're anosmic, no sense of smell, hyposmic, reduced sense of smell, normosmic, or malingering and you're able to categorize people in those patterns. That's something that I think would be well worthwhile to do, especially where you're in an area where there's a high likelihood of there being a problem.
Q. You also mentioned that people can have malodourous impacts from chronic exposure to, for example, low levels of H2S or an acute exposure?
A. That's correct.
Q. And I was wondering, I know no two people's noses are the same and stuff, but, you know, I was just wondering if you're able to give us some idea of what kinds of concentrations you're talking about where these effects may occur, the chronic one? Are we talking about hundreds of ppm? Are we talking about parts per billion?
A. Yeah. That's -- I have a -- I thought you were going to ask that question and there were so many chemicals involved, I can tell you from the literature -- I can provide the literature if you want it. Unfortunately I only have one copy of each of the articles I had sent here. John Amore, it's A-m-o-r-e, wrote two articles, and he just recently died, but one was entitled Effects of Chemical Exposure on Olfaction in Humans and the other one is entitled Odour as an Aid to Chemical Safety, Odour Thresholds Compared with Threshold Limit Values and Volatiles for 214 Industrial Chemicals in the Air in Water Dilution. And in these articles he goes through what the literature talks about for the lowest -- both lowest levels of toxics that have effected the olfactory ability and he also goes through the literature talking about the lowest levels of chemicals that are the olfactory threshold and your trigeminal threshold for the different odours.
Q. Trigeminal, that's the one where you start to get some response like tearing?
A. That's right. Actually there's another trigeminal article, too. The Oregon Lung Association, and if you want -- unfortunately I didn't bring that amongst the rest of the articles but I'd be happy, if you call me in the office, I'd be happy to provide you the reference for that one.
Q. Okay. So -- but for H2S, for example --
A. Okay. I can tell you the article -- well, as a matter of fact -- well, I'll try and dig that our for you now. For hydrogen sulphide, for acute exposure, for a second at 100 parts per million has been shown to cause anosmia.
THE CHAIRPERSON: I'm sorry, could you just repeat that.
A. I'm sorry. For hydrogen sulphide at 100 parts per million for a second it causes anosmia, a total loss of sense of smell. For chronic exposure -- I'm just trying to go through the charts here -- it may take me a little bit of time to go through the charts but they talk about the chronic exposure as well. I know in our article we talk about a level for chronic exposure as well and I don't recall what that level was right now.
THE CHAIRPERSON: We'll give you a minute, if you'd like, to find it 'cause I think it would be useful to have that number.
A. Yeah. In --
THE CHAIRPERSON: Five. We can take a five minute break because we want you to find the number so --
--- PROCEEDINGS RECESSED AT 2:08 P.M.
--- PROCEEDINGS RESUMED AT 2:20 P.M.
THE CHAIRPERSON: Okay. Quiet, please.
CROSS-EXAMINATION BY MR. ROBB (Cont'd.):
A. I don't have an answer for you because the article of Amore was actually another one. The one I brought only dealt with the acute exposures. The chronic one was an article by Amore in the textbook Smell and Taste in Health and Disease edited by Getchell and all and -- but I'd be happy -- I have that back in Chicago. I'd be happy to send a copy of that chapter to you where he talks about chronic facts of the exposures and that's where he has the numbers. I only brought -- amongst all of these things I didn't bring that one.
I, also, in the -- but one thing I did find for you while in the process is a reference, which I couldn't find the reference for, for the article I wrote on effects of hydrogen sulphide on olfaction, in the journal Occupational and Environmental Medicine, Volume 56, 1999, so that was the article that I wrote on it. But, again, for the level for long term effects of H2S on olfactory impairment, I'd have to reference you back to that which I left in the office and I'm sorry, I don't have a number for you. It's clearly going to be under 100 parts per million.
Q. Hundred times less? A thousand times?
A. It would be speculative for me because I just don't remember. Amongst all these different numbers I'm lucky to remember my phone number.
MR. ANDREWS: Madam Chair, could I ask for a spelling of Getchell?
A. G-e-t-c-h-e-l-l. I'm sorry, it's G-e-t-c-h-e-l-l.
MR. ANDREWS: Thank you.
BY MR. ROBB: Q. Might as well get the name of the textbook again, too?
A. Smell and Taste in Health and Disease.
Q. Smell and Taste in Health --
A. ...in Health and Disease.
Q. Okay. You don't have anything that masks mushroom composting odour, eh?
A. Mushroom compost? We've never actually looked for that.
Q. That's fine. I actually didn't want to diverge too much. If you had a quick one, fine.
My last question is, I'm just wondering whether in your opinion you think it's appropriate to set different objective levels for the ambient environment in different communities with different pulp mills or should there be -- is this the kind of assessment that should be done for setting an objective for a province or a country, some kind of objective standard that should be met to deal with the types of concerns that you're --
A. You know, that's more of a public policy issue than my expertise. I could tell you that --
Q. Well, the way I should rephrase it then is, is it likely -- are there likely to be different needs between different communities? I guess one aspect of that, I guess, you mentioned that people that are particularly prone to psychological dysfunction might be exceptionally prone but, other than that kind of thing, is --
A. Or asthmatics, let's say, if you had a lot of asthmatics, people with chronic diabetes so, I mean -- you know, I think that you have to be sensitive to the community -- unfortunately what's happened in the States, this is what's been happening, is that in areas, like in the suburbs, you have very high standards. They would never allow anything like this to occur in the suburbs and what you have is in the inner cities and in the rural areas where there's not the same sort of influence, that's where all the sites end up being placed. But I think you have to be sensitive to the community standards for each one. I mean, theoretically personally I'd like to see a single very reasonable standard to be nation wide but that's not very realistic.
Q. But, say a rural standard in one area of the province shouldn't be different than a rural standard in another area because, I mean, the people have the same kind of effects.
A. Well, you know, I think it depends -- a lot of factors impact upon what happens in different areas. You know, they have -- in Nevada they have a big nuclear waste dump site right near an Indian reservation. I wouldn't really want that near me so you'd have to sort of -- it has to be met from spot to spot. I think, in an ideal world you'd have the same standards throughout the whole world but it's rarely that --
Q. So people should be afforded with equal level of environmental protection though?
A. That's what I -- I mean, again, this is not my area of expertise. I'm not a public policy person but that's how I would approach it.
Q. But people's needs are similar, I guess, although there's --
A. Yeah. That's right, except for certain groups that tend to be more sensitive than others. But, you know, the problem is throughout our population we have that. Just like with children, because their blood brain barrier isn't as well developed, are more sensitive to the neurotoxins so that they need greater protection than anybody else.
Q. Presuming that there's children in all communities, I mean, the same level of protection should be required for all communities?
A. Yeah. One would hope that they're protected throughout, that's right.
MR. ROBB: Thanks. That's it for my questions.
CROSS-EXAMINATION BY MR. CASSIDY:
Q. Dr. Hirsch, I think you were talking about -- in response to the questions about chronic you were unable to come up with a number, but you referred back to your study on the long-term effects on the olfactory system and exposure to hydrogen sulphide, and in there the workers were exposed to --
A. 243 parts per million.
Q. 243 parts per million so that would be acute exposure then?
A. Well, the problem with -- let me tell you the problem with that. They had long-term exposure. They were working with -- these were in the Virgin Islands and in Texas I think. And they were working in a construction site and working with hydrogen sulphide, not infrequently they were exposed to this, what's called sour case is what they call it. And so you had a long term of exposure, low level, with occasionally bursts of high level and that's why I referred to John Amore's article in Getchell's book that talks about chronic effects at lower levels.
Q. So the 243 then to those workers was acute then?
A. That was -- that's right. That was --
Q. That's right?
A. I think we said like four hours at 243 parts per million. But we know it can't have been four hours because they're still alive.
Q. Yeah, I wasn't asking about duration. I was asking about whether or not you considered that to be acute exposure.
A. No, I think -- yeah, I think, the way I wrote is that they had both chronic and acute exposure there.
Q. So 243 is either chronic or acute?
A. No. The 243, that was -- the one, that four hour period, that was acute 243 --
Q. Okay.
A. -- and we know it wasn't the whole four hours because they're still here with us because it would have been lethal for them.
Q. And in that study there's also a reference to some troy workers exposed to amounts of 2873 parts per million. I guess that's really acute exposure; isn't it?
A. Well, they also had -- that was in Texas and --
Q. Yes, I know where it was but that was also -- that's pretty acute; isn't it?
A. Well, they had it for a short term, that's correct, and it's a relatively high level, yes.
Q. I think the word's acute, isn't it, Dr. Hirsch?
A. Acute means short term.
Q. Do you have a problem with calling that acute?
A. No. Acute means short term and the level you're talking about is the extent of exposure.
Q. Right. So that's an acute exposure they'd suffered?
A. Yeah. You see, one of the problems is both those groups had acute exposure, a short-term exposure, as well as a long-term exposure.
Q. Right. And in that study you refer to there being confounding factors that may prevent you from concluding that that was unrelated to exposure to H2S, for example, several workers had ingested alcohol at the time; is that right?
A. You'll have to let me just look at the paper --
Q. Sure.
A. -- so I can correctly refer to it. Yes, some of the -- I'll read from it.
Some of our construction worker patients had histories of considerable toxic exposures, including use of alcohol, which we've shown can induce olfactory deficits. It seems possible that our findings of olfactory deficits are unrelated to exposure to H2S and that, instead, are associated with confounding factors such as collateral toxin exposures.
Q. Can you tell me more about these confounding factors?
A. Sure.
Q. In fact, as I understand it, the loss of smell can be caused by things other than TRS emissions; is that correct?
A. Oh, by all means. As a matter of fact, chronic alcohol use can cause olfactory loss. Acute can cause transient loss. We did a study for the court system in the State of Illinois where we took workers for the State of Illinois and had them drink and got them drunk and with State Troopers there standing watching and as they got drunk -- and we measured their blood alcohol levels as they took more and more drinks, and as they got drunk their olfactory ability kept dropping as they drunk until one of the persons passed out before she reached the legal level of intoxication in the State of Illinois, but the other ones all reach the legal level of intoxication and had impairment of olfactory abilities as they became intoxicated. When they -- when they were -- when their levels went back down to normal in the next day, when they were sobered up, their olfactory ability was back to normal suggesting that you can cause transient olfactory impairment when you drink.
Q. So in fact one of the difficulties in your field, I guess, one of the sources of ongoing research in your field is trying to sort out what is the cause of olfactory loss, whether or not it's things such as exposure to H2S or exposure to other chemicals or exposure to other forms of lifestyle or whatever; is that fair to say? That's a subject of ongoing research?
A. One of the things that we like to do, and that's why I said six people does not a study make, 'cause one of the things we like to do is we like to see if -- make sure that there's no potential confounding things occurring that may be affecting them all. You know, all of us do different things. For instance, the one thing I encourage everybody to do not only is not smoke but to always wear your seat belt because the number one cause of smell loss that we see is from motor-vehicle accidents, from head trauma, so if you wear your seat belt you substantially reduce your risk of that happening so I always encourage everyone to wear their seat belt. But you're exactly right: there are many potential confounders that occur and that's why one of the things you want to do is you want to look at many people around the same site because it's much less likely that many people have the same confounder.
Q. In fact that probably makes it somewhat difficult to extrapolate from six people to a whole community; is that fair to say?
A. If it was just the six people here that we saw today and I didn't have any prior knowledge of things I would be -- it would be very hard. As it is, it's difficult. But we know that around pulp sites olfactory impairment occurs. And so that is -- we already know that happens and with these six, even looking at these six, we're suggesting that two of them appear to have -- at least two appear to have olfactory impairment but I would suspect a lot more in the community do as well. I would strongly suspect that.
Q. Well, I'm interested in that because I looked at your paper, which is Exhibit 17, and you say -- just said that we know pulp mills cause this and yet when I look at your paper, Exhibit 17, on Negative Health Effects of Malodours in the Environment, A Brief Review, the only reference I could find to pulp mills was in the reference under "Negative Health Effects" on the first page of the paper and the reference to chemosensory loss, chronic exposure to malodours from pulp mills can cause permanent olfactory loss. And you're referred to your work around pulp mills that I guess you've done and yet when I look at the cite you've got there there is no reference to any of your work. There's only a reference to Maruniak, a reference by Maruniak. Why have you not referenced in your own work your apparently extensive studies on pulp mills?
A. Well --
Q. As part of that statement.
A. Oh, sure. Well, one, I think Maruniak's work was good in terms of that; two, we haven't written up specifically our work with the pulp mills.
Q. So none of that's peer reviewed then?
A. Well, other than this one article that we have here.
Q. Right. But other than that none of your work has been peer reviewed?
A. Oh, no. I mean, that's not the case. Many of our articles have been peer reviewed.
Q. In respect of pulp mills?
A. Oh, in respect of pulp mills, no. This is the only article that I specifically referred to pulp mills in I believe.
Q. All right. And so I went back and looked and Mr. Maruniak's document, because it appears to be the only thing you're relying on in that paper. Did everybody get one? Can't forget the Union. And I looked at it and you cited page 463 of that paper and I looked at page 463 of this paper and all I can see is the last paragraph as being reference to pulp mills and it starts, and I'm going to read it:
Data from the aforementioned studies suggests that people living in conditions in which there is a single continuous dominant odour may run the risk of changes in their olfactory bulbs. It is not known what impact such hypothetical changes in the bulbs may have on their olfactory ability or that such changes will be reversible or if other consequences of such stimulation might arise. Furthermore there are no data to be able to address the question of whether odour stimulation has to be continuous in order to produce such effects. It is possible, for example, that living and working in some of environments, such as around a pulp mill, may produce chronic exposure to a single dominant odour sufficient to cause olfactory bulb changes.
Now, my understanding of science is that when people use words like "may", "it is possible" and "suggest", it's no where the definitiveness with which you've shown it today and said that TRS causes the emissions consequences that you were talking about. Do you agree with me or not?
A. I would suggest to you that I don't think that my statements were definitive this is definitely this or that, but that there was a high degree of probability that that was the case.
Q. I'm asking you what evidence do you have to rely on it. You've produced no clinical studies. There's no control study you've produced. The only study that you have done is actually a literature review, and in fact the only cite you've got is from a document that uses words like "may" and "suggest" and you translate that into high probability?
A. Let me backtrack.
Q. I would be interested in you backtracking, Dr. Hirsch.
A. Let me try and answer your question to the best of my ability. Number one, diagnosis is based on one's experience, of which we have substantial in the area; it's based on history which we obtained; the physical examination which we weren't able to obtain; as well as on site tests which we were not able to obtain; and also is further confirmed based on material that's available in the literature. This is one of the documents that's available in the literature. Other literature that talks about the effects of pulp mill effects on malodour -- or, I'm sorry -- effects of pulp mill malodour on olfactory ability comes from material that was performed when the National Geographic survey was conducted where, again, as I mentioned, there were over a million respondents and as a result what one is able to do is to look at different areas of the country, as well as in Canada and the world, and correlate where there is sites of pulp mills and where there's olfactory impairment and that's what's been found.
Q. Did you do a physical examination of any of these Appellants?
A. No, I did not.
Q. When did you arrive in Powell River?
A. This morning.
Q. Had you ever been here before?
A. No, I had not.
Q. So you've had at most two hours to meet the Appellants; is that correct?
A. No. I spoke with one, Janet Morrison, a few weeks ago, 6/5/99, and then the others I spent time with this morning, a few hours this morning.
Q. Right. And that's the extent of it?
A. That is correct.
Q. Did you ask to see their medical histories provided by their physicians?
A. I asked if that was available to be looked at.
Q. And was it?
A. It was not available.
Q. They never produced anything to you, did they?
A. That is correct.
Q. That would have been helpful presumably because you asked for it, wasn't it?
A. Yes, I would have liked to have had that. Any information that one can get is betterment.
Q. Yet, notwithstanding that, you were prepared to come here and make that strong probability and strong prediction that you can extrapolate to these six to the community at large?
A. No. I first wanted to talk with them to be able to assess that so I wasn't ready to come and state without talking to them first. Again, my suggestion to you is that it's well worthwhile for us to look at the community as a whole. Unfortunately it's not an ideal world. Based on the complaints, hearing about the odour and complaints, reading all the material that I was provided describing the odour complaints and where the odours were reported, the different times the odour was reported and the frequency with which the odours were reported, plus the toxins that were reported to be released, all was consistent with this concept that we were dealing with malodour induced variety of different deficits including neurologic, chemosensory, immune and respiratory.
MR. CASSIDY: I have no further questions.
MR. J. KEAYS: Excuse me. The language of science is cautious. This is badgering. You say in science "possible carcinogen". You don't say "absolute". To accuse somebody like this of claiming to be certain when they didn't say they were certain because of words like "may be" -- "may be" is the language of science. People who are doing science don't say "absolutes" and this is badgering. I object.
THE CHAIRPERSON: We have his testimony on the record and we can review that and we will. So, okay, Mr. Andrews, do you have any re-direct?
MR. ANDREWS: I don't.
THE CHAIRPERSON: Okay. Questions from the panel?
QUESTIONS BY DR. CAMERON:
Q. Has it been your experience, Dr. Hirsch, that you found smokers to be more sensitive to odours than other people?
A. No. Well, it's a very good question. It's very clear that there's a direct correlation between duration of smoking and olfactory ability. The more you smoke for the longer period of time the worse your ability to smell. After you stop smoking, after a period of time your sense of smell begins to come back but you're asking -- there's another issue that you bring up that I think is a very good one and that is that former smokers describe when they smell cigarette smoke they get the urge to smoke. They feel sensitive to it and actually their ability to smell is no better but their just more consciously aware of it and the addiction feels like it's coming out. So, you're right. Cigarette smoking clearly impairs an ability to smell and I encourage everybody to quit smoking. One of the difficulties is that we always have, if there's impaired ability to smell because of cigarette smoke it's already down, so it takes a little more for it to even become that much worse because they've already used up their reserve. Assuming that all of us have a certain level of reserve of ability to smell and then cigarette smoking drops it down, it doesn't take very much more for it to even drop down further.
Q. I guess I should have phrased my question a little more clearly I think. What I really meant wasn't their ability to smell. It was whether or not they were more sensitive to harm from odours.
A. Yes.
Q. That really was my question.
A. The answer is yes. They are -- the belief is that because they already have smell loss, it may be an artifact. And let me tell you why I say that, is we have norms for ability to smell. Let's say from here to here it's bad -- here to here it's bad and from here to here it's considered normal, so you can -- let's say you have a toxin but you drop from here to here, no big deal. But let's say you have cigarette smoke and it's already dropped you to here, the toxin doesn't make it much -- it doesn't take much to drop you even to the abnormal level. And you, as an individual -- I wrote a paper about this called "Subjective Hyposmia" where people will come in and complain that they can't smell and we test them and their normal but they're just the low end of normal and our hypothesis is that our tests aren't so -- there's such a wide variation of normal we're inadvertently calling people who probably are deficit normal. So, but, yes, it makes them more sensitive, just like -- there's a theory of the weak link in the chain in neurology where if there's any damage in a certain area the additional damage -- if you have any additional damage that's what will manifest.
Q. There was some discussion about this scratch and sniff test.
A. Yes.
Q. And I got the impression that you were saying that this was a quantitative type of test and I want to question that because it seemed -- when I think about something quantitative I speak of being able to identify a concentration, a number.
A. Okay. Sure. And I guess there's two ways of looking at that. You're right. One form of quantitative test is like threshold tests of Amore where they take -- where you have different bottles and you're able to see at what level the person is able to detect a chemical, you know, whatever chemical it is and you say, okay, they're able to get it at 35 deci-smells or 50 deci-smells or whatever. That's one quantitative measurement and that tests detection threshold.
The opposite, the scratch and sniff test, tests recognition threshold and what it does is it basically -- you're able to quantitate it because you're able to say, okay, they got 40 right out of 40 and given the normative values for age and sex you're able to plot where they fall in the population. It's sort of like the difference between a test of memory, how many digits can you remember forward, five or seven or how ever many, and the IQ test where it comes with a single number.
Q. Yeah. So the scratch and sniff is a recognition threshold?
A. Exactly.
Q. Okay. And I don't know whether you have got the information to answer this question but we're using total reduced sulphur as a measure, essentially sort of a control measure or a measure to see whether or not there is a pollution problem. Do you think that that is an appropriate, or do you have the experience to answer, is that an appropriate measure for the types of compounds or chemicals that might be coming out of a pulp mill?
A. Personally I don't like that. I mean it's -- and, again, I'm probably speaking out of turn but I'll tell you what I don't like about that is because that's a mixture of a lot of different chemicals and it's got hydrogen sulphide mixed with capstans. I mean, that's one of the -- that's my big -- so the problem is you're going to have a very toxic level of a compound in it and less of a toxic and that's what you're measuring. I mean, I prefer having separate ones for each, if it's possible. You know, it's not possible, but that's my own -- I like it simple and easy to understand.
Q. Yeah. That was my next question then. If that isn't acceptable, then what is practically? I think you said several times we're living in a real world.
A. I mean, this is not uncommon. This is -- in Europe they use the same levels and we've seen it used other places in other articles so, I mean, it's not -- it's used but -- and, if that's as good as you have that's what you can use, but, I mean, I like individual compounds myself.
Q. Okay. So do you have any experience at all in standards that might be set in other parts of the world or the United States, what things are being measured as evidence of air pollution problems?
A. Well, I have -- yeah, and I actually brought -- well, there's a whole bunch of different standards. You have TLVs which are threshold limit values where what's allowed for a worker in a 8-hour day, you know, 40 weeks a year or something like that or 40 hours a week for 50 weeks a year, and those are levels that many people use. There's also a level called a community standard level --
Q. Yeah, but those are TLVs of what?
A. Of all the -- of a whole bunch of different compounds, each one --
Q. Yeah, it's compounds I was after.
A. They have hydrogen sulphide; they have the TLVs for hydrogen sulphide; they have TLV for the recaptures; they have TLV for each of the different chemicals. That's not necessarily the best evidence. There's also lowest community standard, or something like that. There's like community standard ones and NIOSH has come out with one for -- there are a whole host -- there's also emergent levels where if you're exposed to them for 15 minutes it's unacceptable, you know, so they have different levels for each different chemical. To me, that's easier, a simple way that's much easier for me to understand.
Q. Okay. So just so I'm clear in my head here, you're aware of situations for pulp mills where the -- for lack of a better word -- the pollution control permit, okay, allows a discharge of various contaminants and the concentrations allowed are for a whole series of different things at say a TLV or something like that?
A. That's my understanding. I'm not sure if it's pollution board or what but that's -- regulatory agencies, that's my understanding, yes.
Q. Okay. So that it's fairly common then in the United States not to just have, say, one thing like this total reduced sulphur but several things?
A. That's right. That's my understanding. You would subdivide off -- you would also have a sub-group of VOCs, a level for VOCs so you'd have -- for most of them you'd have individual level that was allowed.
Q. Do you have any idea of what the concentration of the threshold odour value of H2S is, just roughly, compare with that 100 part per million and one second acute exposure thing?
A. Yeah. I have it right here. Well, for hydrogen sulphide, depending upon who you read, the odour detection threshold might be five parts per billion or it might be 1.1 part per million. It depends on who you're reading. The odour recognition threshold is about 47 parts per billion and the -- so there's a difference there between -- in other words, you detect -- the difference is -- and this is where it becomes somewhat important. I can detect an odour is present. I know there's a smell there. I can't tell if it's skunk or perfume but I know there's a smell there. At one point in time I could recognize it smells like rotten eggs.
MR. ROBB: Could I ask that he repeat? I didn't quite get the --
THE CHAIRPERSON: Yes.
A. Okay. The odour detection threshold is, dependent upon who you read, either is 5 parts per billion, although depending on who you read, it could be as high as 1.1 part per million. The odour recognition threshold is about 47 parts per billion.
BY DR. CAMERON: Q. Now, one more number, if you've got it, and effect level for H2S?
A. Well, okay, this is -- okay. Let me define it for you. If we use the threshold limit value, the lowest level that a worker can be exposed to without in theory having effects for eight hours a day, 40 hours a week is, at one point, and this is several years old, it was thought to be set at 2 parts per million.
Q. That would be higher than the threshold odour value?
A. That's correct.
Q. Do you have any numbers for anything other than the eight hour per day, 40 hour per week exposure?
A. Not with me. Well, not that I have easy access with me. There's a -- not that I have easy access to.
DR. CAMERON: Okay. Well, that's -- we won't get into that then. That's fine, thank you.
THE CHAIRPERSON: Ms. Mayall?
QUESTIONS BY MS. MAYALL:
Q. Just, in the pulp mill that you were looking at, do you know what the permit -- first of all, were they just measuring the TRS and particulates or were they looking at other --
A. Well, the one that -- well, the one I looked at in Ohio, they looked -- we had all sorts -- the whole listing out of must have been 30 different chemical compounds and they were concerned -- they were meeting the criteria in Ohio for their community in terms of pollution problems but they were having a problem with the odour in the community so they were concerned about the impact of the ambient odour and wanted to know what we could do to get rid of the ambient odour.
QUESTIONS BY THE CHAIRPERSON:
Q. And in a number of situations, both pulp mills and other plants, is your sort of -- is it the case that usually these operations are meeting criteria and then you're looking at an odour problem that exists at the same time or are you looking at sites where they may be in exceedances, or is it both?
A. It's both. Usually the pulp mill ones are usually meeting criteria and we're having a problem with the -- so they're already meeting it here but they're having the secondary effects of the odour. The EPA Superfund site, you know, it's already a superfund site so that's not an issue, but with the pulp mill that's exactly what happens.
Q. And what material were you provided for as far as a list of chemicals?
A. I was provided with these two (indiscernible) journals here, a whole host of different ones --
Q. Just in relation to this -- okay. I don't know where you --
MR. ANDREWS: Not all of that has been admitted to evidence.
A. Oh, I'm sorry. Okay.
BY THE CHAIRPERSON: Q. No, I was just wondering if you were referred to a specific document that we -- with a list of chemicals that you looked at.
A. Well, I marked off -- as I say, after -- I marked off some of these. The chemicals I thought were provided from the pulp mill or from their monitoring sites.
Q. Okay. That's what I -- if you're referring to some source just want to make sure we're all at the same -- working from the same list.
A. Well, yeah, like, here's --
Q. Okay, just so we have the title of the document and then we can --
A. One is title PAH/NOx Trace Metals Emissions, Survey Monitoring Report, Pacifica Papers Inc.
Q. Okay. So those are the -- okay, you looked at that and that's --
A. Yeah. That's one of them and then the other ones were -- that went through the different metals and it was those sorts of things. Here's one that -- this one had PAH/CDD/PCDF Emission Survey, Monitoring Report, March 1995 Survey.
Q. We have that.
A. Yeah, go through a whole bunch of those.
THE CHAIRPERSON: And I think -- yes.
QUESTIONS BY DR. CAMERON:
Q. Just a follow-up question that Ms. Vigod asked. You said that the Ohio plant was meeting the air standards, right?
A. That's correct.
Q. But that there was an odour problem?
A. That's correct.
Q. Okay. Were there any health problems?
A. There -- there seemed to be, seemed to be health problems, particularly ones that we looked at appeared to be -- we looked at clearly had olfactory loss around the site. We didn't assess them for the neurologic deficits and the psychiatric deficits because there was another issue involved and we were trying to deal with the olfactory problems that were involved.
Q. Okay. The mill was basically -- they were just concerned about the odour though?
A. That's right. That's right. The plant was concerned about that and what would be the best way of getting rid of the odour.
Q. So with the olfactory losses then I guess there would be the spectre of the possibilities that you raised about accidents in cars and things like that, weight gain and --
A. That's right. There were a lot of -- there were a lot of -- the more that we looked into the more problems arose, exactly.
DR. CAMERON: Okay. Thank you.
THE CHAIRPERSON: Just one follow-up to that.
QUESTIONS BY THE CHAIRPERSON:
Q. Did the regulatory agencies take any steps to follow up on that particular --
A. Not on that -- not on that one. It was -- I think my involvement was a preemptive involvement to prevent any sort of regulatory involvement. They did -- in Illinois they did take charge and close down the site that we were involved with.
Q. What were your recommendations in that Ohio site?
A. I suggested that -- and this is a summary with respect to advice -- I suggested that they somehow change the processing so that they can change around the amount of olfactory toxins that were being emitted, the use of the hydrogen sulphide and somehow affecting the NOx but it was -- that area of the technical component was a little beyond my expertise and I was able to evaluate and say we're having a serious problem here and I can't -- masking alone, which was really what they wanted us to do, wasn't going to do it.
Q. All right. And -- okay. So the kind of community test that could be done here, what do those results tell you?
A. Well, what I would -- well, if I was asked to come in what I would do is I would come in and I would do the -- test maybe random people who live around the sites, pulling it from a phone book or something, use random people, test their -- start off with some very simple survey form plus the simple olfactory testing. If we found that there was substantial olfactory impairment it would confirm the belief that this is a major community problem and I would -- it would again confirm that, continue stopping the plant from functioning.
You could also use that as a baseline so if the plant continues to function you could watch and see as it's continuing to pollute and contaminate the environment and the people who are there, you could see continued health effects.
Q. Would you recommend a progression of tests as well or --
A. Ideally -- in an ideal world what I would do is I would stop -- in an ideal world we'd have it already bagged -- stop right now. We'd stop the emission and do testing and I would do serial tests to see, you know, over years and watch and see, to continue to watch and see if there's any improvement in olfactory ability or to see if there's -- as well as the other neurologic effects.
Q. I was thinking more if you did sort of the first, if you like, the scratch and sniff test --
A. Right.
Q. -- and then if that told you that a percentage fell into your class -- there was a concern --
A. Right.
Q. -- then would there then be a second level of a more complex test?
A. Oh, yes. You could do it that way, too. You could do it where you do just a simple test like that and if you saw problem then you can do more positive testing and identify a larger population and do more detailed olfactory testing to determine the extent of it.
Q. Okay. So get more into a more quantitative study?
A. That's right, exactly, which is much harder to do. You can't send those bottles but whereas the scratch and sniff things are much easier to do.
THE CHAIRPERSON: Thank you very much.
MR. ANDREWS: Just one very simple question arising.
RE-EXAMINATION BY MR. ANDREWS:
Q. You used the term NIOSH, that the National Institute of Occupational Safety and Health; is that right?
A. That's correct.
THE CHAIRPERSON: Yes.
MS. KEAYS: I, too, have a couple of questions.
MR. J. KEAYS: I have, too.
THE CHAIRPERSON: Oh, sorry. John?
CROSS-EXAMINATION BY MR. J. KEAYS (Cont'd.):
Q. I need clarification. The detection is one part per billion but workers were exposed for many years to 1.1 part per million under regulation?
A. No. You're talking about for H2S, what the TLV is?
Q. Yes.
A. I think the TLV -- unless I copied it wrong the TLV is two parts per million hydrogen sulphide --
Q. The level at which you can detect it?
THE CHAIRPERSON: That's the threshold limit value.
BY MR. J. KEAYS: Q. That's the threshold level but one part -- I've got ppb here -- part per billion for detection.
A. Yes, part --
Q. So I can smell it at one part per billion?
MS. KEAYS: No, that's detection. You can smell it at --
A. Detected. For H2S you can detect it at 5 parts per billion.
BY MR. J. KEAYS: Q. Per billion?
A. Per billion. Or -- or -- or you can detect it at 1.1 part per million, depending upon the study you read.
THE CHAIRPERSON: So there was a range, right?
A. Exactly.
THE CHAIRPERSON: I think he said according -- just to clarify -- according to the literature he said --
MR. J. KEAYS: I thought people were being exposed regularly to high levels under some authority. I got it.
A. Well, they might be. They might be exposed -- almost -- there's some issue on the TLV and that's a relatively old article and the TLV may have dropped since that -- since that time but I'm pretty sure the TLV in that article suggested it was two parts per million -- the average exposure over an eight hour period.
Q. And people in this community are whining at a thousand times less? That's what I feel I'm missing. We're at two parts per billion.
A. I know.
Q. And I'm injured.
A. There's some reasons for that. Number one, talking about healthy worker effect. Healthy workers can be exposed and they don't demonstrate the deficits because people who are injured by it leave. That's one of the reasons. Second reason it has to do is you're dealing with a mixture of chemicals rather than a single chemical so you're not seeing the synergistic effects. And those are -- and also, that level of TLV, I'm pretty sure it's been reduced since that article was written substantially and they have been continuing to do so.
MR. J. KEAYS: Thank you.
CROSS-EXAMINATION BY MS. KEAYS (Cont'd.):
Q. My question is that -- okay, I have to think for just a second. 99 per cent of the sulphur that's detected coming out of the recovery boiler stack is in the form of SO2 not TRS. Would all this extrapolate only be kind of linearly more with SO2 or is it less or are they similar or --
A. Well, SO2 has actually been demonstrated to have effects on cognition, for instance, and in thinking processes, levels that are below detection threshold and I think it was -- going to have to -- they talk about health effects and SO2 at 35 micrograms per cubic metre which --
Q. Much lower?
A. Well, I don't know what that translates to. The odour detection threshold of SO2 is about 2,700 parts per billion so I don't know when you convert parts per billions of micrograms, my chemistry is not so good when it has to do with the molecular weight of it.
Q. So this would be -- SO2 is -- has more cognitive difficulties than H2S or more olfaction difficulty than --
A. SO2 has both cognitive and olfactory deficits. H2S -- you know, when you think about hydrogen sulphide think about cyanide because you're talking almost one and the same. It's really a very toxic compound and it's -- it blocks the mitochondrial electron transport chain. It's very, very toxic. In SO2 it doesn't have the same level of toxicity because -- but it's still not a very good compound to have around.
Q. Together? Synergistic?
A. Synergistically those combined with other chemical compounds have a hyper-additive effect.
MS. KEAYS: Okay. Thank you.
THE CHAIRPERSON: Mr. Robb?
CROSS-EXAMINATION BY MR. ROBB (Cont'd.):
Q. I'd like to show you something from Exhibit 13. You see the part on TRS?
A. Yes.
THE CHAIRPERSON: What page is that?
MR. ROBB: Oh, sorry. It's the Ambient Objectives. Page 11.
THE CHAIRPERSON: Okay. That's what's happened to us.
BY MR. ROBB: Q. And I just wanted to clarify, you felt the odour detection level for H2S was in the range of 5 parts per billion to one part per million; is that correct?
A. 1.1 part per million.
Q. Okay, roughly one part per million. And of the TRS, total reduced sulphur compound, H2S is the most toxic?
A. That's correct.
Q. Okay. So the number that is in column "A" which is our most protective level for the one-hour average, can you see what it is in ppm with the subscript "B"?
A. Is it the 0.005 parts per million?
Q. Yeah. So that would be --
A. It would be 5 parts per billion.
Q. Which you advise is at the low end of the detection range that's been reported for hydrogen sulphide?
A. Correct.
Q. So would you consider that to be a protective level for TRS in the ambient environment?
A. No.
Q. No?
A. No. Because -- the reason is -- there's several reasons. One reason is because the detection threshold, when you're talking about it like that, means the person's awake, alert and looking for it. It's been shown that if people are not paying attention, not looking for an odour you can see levels up to a thousand times higher until they're able to detect something is present so that would be one of the reasons for it. The other has to do with --
Q. So people can't detect the odour but they can have effects? I'm not --
A. Yes. That toxic -- you can have an effect without people consciously detecting the odour and I think that's what -- we referenced before regarding SO2.
Q. Okay. So do you have a number that would, in your opinion, be protective for hydrogen sulphide?
A. I don't know as we sit here today what level -- what number it would be. Clearly you're going to want it less than 5 parts per billion, less than or in that range.
Q. So less than people can detect with their nose would be protective?
A. Yeah. You want to see it in or less than that range of 5 parts per billion but less than they can detect, that's correct.
Q. And how about for the other total reduced sulphur compounds?
A. I don't -- well, I don't have a number for you. I do for methyl mercaptan, at least what the TLV is. It's 0.5 parts per million.
Q. So I just want to be clear. You feel that there will be malodourous effects -- effects from malodourous compounds at levels below which people can detect? I'm having trouble with that concept.
A. Yeah. It's a -- it remains an unclear area. There's literature suggesting that sub-threshold levels can still cause the toxic effects for some of the chemicals we're talking about. If we're talking about it as --
Q. And they're malodourous type --
A. Yeah, these are some of the same ones we've been talking about today. If you're talking about effects of the malodour, clearly they have to be able to detect an odour.
Q. So from an odour perspective, is that 5 ppm protective, do you think? Or 5 ppb, sorry.
A. From an odour perspective that would be -- from an odour -- you see, why this is becoming such a difficult issue is because of our original dichotomy between the effects of the odour and effect of the neurotoxin itself. If I can't smell at all, I can't smell -- let's say I have anosmia -- I can't smell at all -- and I can be exposed to hydrogen sulphide at high levels, I won't even detect it until I'm killed. Does that mean that it's not -- that it doesn't have a malodour effect? Well, it doesn't have a malodour effect because it's just a straight neurotoxic effect.
Some chemicals, the odour is greater than the recognized neurotoxic effect levels. Some, the odour is lower than the recognized neurotoxic levels. So, for instance -- does that help explain it at all?
Q. Well, my understanding of why there's a limit for TRS is 'cause it's stinky stuff; people don't like the smell of it. So it's not so much the health impact. That's what I understand. PM10's health; TRS, mostly it's objectional stuff so we've put in a number to deal with the odour issues. When these criteria were developed it was intended to protect the environment, to protect people from experiencing unpleasant odours and so --
A. And so what I would suggest to you is that the unpleasant odours that they are experiencing is not just unpleasant odours, that it's having both a direct effect, a neurotoxic effect, and then there's secondary effects, when they smell bad odours it causes secondary psychological effects with the associated impact.
Q. But your expertise mostly is with respect to the connection between the bad odour and the, whatever, effect?
A. And also the low level toxins and whatever the effect is, correct.
Q. My understanding is that TRS number is not there to protect human health as much as it is to deal with objectionable odours.
A. I don't know --
Q. So from the objectionable odour perspective, would that be protective? If the detection limit is 5 ppb and that's what our Level "A" standard is for a one-hour average --
A. If the purpose of TRS is to just avoid objectionable level, forgetting about health effects of having the bad odour, and you can't detect it then you're right. If you can't detect it then it's going to be acceptable which in theory would mean of everyone around the plant loses their sense of smell you can go as high as you want and people wouldn't be able to detect it.
Q. But normal people, the range that's been reported in the literature --
A. Yes.
Q. -- what you say is that normal people, 5 ppb is the low end of the range what people can detect.
A. That is correct.
Q. I think the TRS compounds is actually a little lower but maybe not hydrogen sulphide.
A. That is correct. Methyl mercaptan they talk about 1.6 parts per billion.
Q. All right. So your conclusion is that to protect people from malodourous effects, 5 ppm for TRS is unacceptable?
A. Well, if you're going to include methyl mercaptan in it then you'd have to drop down to 1.6 parts per billion so you'd have to drop -- I mean, because TRS is a combination of all those together, is my understanding.
Q. Yes.
A. So you'd probably have to drop it down by half or so.
Q. Yeah, I think generally they say around one part per billion is what people can detect the group of TRS compounds. We set the standard at seven, recognizing that we're setting a standard higher than what people can detect -- sorry. I'm talking micrograms per cubic metre, not actually ppm. But any ways, as far as H2S goes, which you've said is the nastiest of the TRS group --
A. In terms of the -- nasty in terms of being damaging to the body. Not nasty in terms of being malodourous.
Q. Okay. So other ones in the TRS --
A. Are also malodourous.
Q. But still the range on TRS is 5 to 1 ppm; the standard there -- or, sorry -- the range on hydrogen sulphide is 5 to 1.1 ppm; the standard in there is 5. So if it was all H2S it would be protective from the malodourous effect?
A. That's correct.
MR. ROBB: Okay. Thanks.
THE CHAIRPERSON: Thank you very much. Yes, we should mark that handbook. That would be Exhibit 19. That's the handbook of olfaction and gustation.
--- EXHIBIT 19: Handbook of Olfaction and Gustation
--- (Witness Excused)"

http://www.smellandtaste.org/

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