Amazon S3



WRITTEN OUTLINE OF SUBMISSIONS ON BEHALF OF THE

LUNG HEALTH RESEARCH CENTRE

1. INTRODUCTION

1. These submissions are made on behalf of the Lung Health Research Centre (LHRC) of the University of Melbourne and rely upon the written and oral evidence of Professor Gary Anderson in addition to the written submissions of the LHRC (Submission No. 432).

2. The LHRC is an academic centre of the University of Melbourne which represents a number of combined disciplines and expertise in respiratory biology, respiratory medicine, epidemiology, public health, pharmacology and oncology.

3. The LHRC does not receive separate funding in fact, each of its members sources his/her own independent funding. It is not for profit and does not receive any corporate sponsorship.

4. The LHRC participates in extensive collaborative work both within the University and with Royal Melbourne Hospital, Walter and Eliza Hall Institute of Medical Research, Peter MacCallum Cancer Centre, Peter Doherty Institute of Infection and Immunity. International collaborations also exist with Harvard University, Imperial College London and major teaching hospitals in New Zealand.

5. The LHRC has approximately 80 fulltime staff affiliated with it who performs basic research, clinical research and practice work.

2. BASIC CONTENTIONS

1. The LHRC is not opposed to the West Gate Tunnel Project (Project) particularly given that the Environmental Effects Statement (EAS) is one of the first environmental assessments of a major road project in Victoria which includes a specific Health Impact Assessment (HIA).

2. However, the LHRC is concerned with the following:

• Lack of a detailed literature review including up to date published studies;

• The failure to analyse the full spectrum of health impacts as opposed to health end points;

• The analysis of State Environment Protection Policy Air Quality Management (SEPP-AQM) and the lack of safe exposure to Particulate Matter2.5 (PM2.5); and

• The lack of rigorous analysis in the HIA.

3. EVIDENCE

1. The LHRC relies upon the evidence of Professor Anderson to support its submission. Professor Anderson has more than 30 years’ experience in lung health research and is the author of many academic papers in addition to holding a number of academic appointments both in Australia and overseas.

2. In summary, Professor Anderson is of the view that the performance objectives of the HIA cannot be met by the current design of the ventilation structures.

3. Professor Anderson’s opinions are arrived at on the following bases:

• The HIA does not address the most current understanding of mechanisms of pollution induced disease including both acute and long-term adverse health effects and outcomes and thus is an inappropriate baseline;

• The failure to identify any safe lower limit of exposure for air pollutants; and

• Reducing exposure is the key to producing air pollution related health outcomes.

4. SUBMISSIONS

Lack of a detailed literature review including up to date published studies

1. Australian air quality compares favourably to other countries, and therefore the issue of air pollution is often overlooked. There is a general lack of awareness that even with relatively low levels, there are significant health impacts. Importantly, 3430 annual Australian deaths are attributed to ambient pollutants, PM’s and ground level ozone with associated costs estimated to be up to $A17.8 Billion. Road vehicles contribute the largest proportion of air pollutants. In 2015, vehicle emissions were estimated to be responsible for more deaths (1715) than our national road toll (1205).

2. Those figures alone are alarming and require a detailed attention. Whilst the HIA considers proximity to roads in terms of residences, the location of work to busy roads and time spent commuting in traffic (drivers, commuters, cyclists and pedestrians), are also critical in dictating personal exposures. Cyclists utilising the roads are likely to be exposed to much higher doses of air pollution than that detailed in the HIA. Further, the residents in closer proximity to Millers Rd compared to the residents who live further away will also be exposed to much higher doses of air pollution. It is the position of the LHRC that the use of aggregated data and weighted averages for risk calculations are not particularly informative to community members who are making decisions regarding their residence, internal ventilation options or exposures to their children.

3. It cannot be denied that this is an area in Melbourne that is already vulnerable to high levels of air pollution. The hospital data clearly indicates Maribyrnong is a known ‘hot spot’ for emergency hospital presentations for paediatric respiratory disease. The LHRC is of the view that it is highly likely there is a correlation between the ‘hot spot’ for emergency presentations and the poorer air quality in the area.

4. The Project represents an opportunity to abate some of these impacts and to capitalise on net health gains. However, it is essential that the flow-on issues to adjacent communities are minimised to the fullest possible extent and the opportunity is taken to capture the tunnel emissions from the point source at the ventilation structures. Without capture the emissions disperse into the local air-shed, where they are mixed and diluted before joining the regional air-shed. Regardless of purported dilution, they still pose a threat to public health, as there is no safe level beyond which impacts do not. Therefore, the LHRC considers that the dispersal method does not sufficiently minimize the tunnel emissions.

5. This is further execrated by the fact that the expert statement of Dr Wright (page 7) specifically states that a detailed literature review of all published studies was not in the scope of works to be undertaken in the HIA. It is accepted that a detailed literature review of published studies would involve an enormous amount of work, and that further, not all the published studies involve robust analysis or demonstrate a causal link. However, in coming to such a conclusion it is submitted that at least a precursory analysis of more up to date literature review would be required and then if those studies are not helpful, such studies would be discounted. Instead, it appears that the HIA has not turned its mind to more recent published studies.

6. As a matter of principle, in order to provide a balanced assessment in respect of human health impacts, it is necessary indeed imperative, to have regard to recent published studies particularly if those studies provide a different conclusion to previous studies.

7. Interestingly, a detailed literature review of recently published studies was not in the scope of works to be undertaken by the expert. Whilst it is understood and accepted that there are vast volumes of research in relation to air quality, the failure to have regard to more recent studies (even if they are then discounted) is not sufficiently rigorous.

8. We understand that the studies relied upon by the Western Distributor Authority (WDA) being US-EPA, World Health Organisation and European studies were thought to be sufficiently robust and to a standard appropriate for use in risk assessments. However, the point remains that in order to discount or not have regard to more recent studies, one must as a matter of logic, review such studies.

9. Otherwise, the basis of the studies which ultimately leads to the risk assessment does not provide complete information to risk managers or in this case, to the Advisory Committee. Without that rigorous analysis, it is submitted that the best possible decision or an acceptable decision cannot be made.

10. We understand that the WDA disagrees with the LHRC submissions that the HIA was not rigorous however, we dispute that and rely upon the evidence of Professor Anderson.

11. In its written submissions, the LHRC referred to the Woolcock Institute Centre for Air Quality and Health Research Evaluation (CAR Report) prepared in 2015. Notwithstanding, reviewing the CAR report after receiving the submissions of the LHRC, it was the evidence of Dr Wright that it would not change her position. This is interesting given that the CAR Report was produced for the NSW Environment Protection Authority and the NSW Ministry of Health, Environment and it is understood from the written evidence of Dr Wright that much discussion was had with NSW in the preparation of the HIA.

12. Again, notwithstanding the detailed submissions of the LHRC and its reference to the CAR Report no real comment is provided in Dr Wright’s evidence until cross-examination.

13. The CAR Report states under the Executive Summary:

This report provides a comprehensive review of international and Australian evidence related to the health effects of exposure to outdoor (ambient) particulate matter (PM) air pollution. Background information is presented on the characteristics of PM and emission sources, and the various health effects that have been attributed to inhalation of ambient PM. These health effects include: mortality, respiratory, cardiovascular, cancer, central nervous system, developmental and reproductive effects. Many epidemiological studies have demonstrated that increased levels of ambient air PM pollution are associated with increases in mortality and, respiratory and cardiovascular morbidity. These studies form the majority of evidence presented in this report.

Although the relationship between exposure to ambient PM and adverse respiratory and cardiovascular health effects appears solid, the potential for publication bias in air pollution health studies may have influenced the findings of this review. Studies with evidence of significant positive associations are likely to have more chance of being published than studies which show that ambient PM exposure has no health effect. Nevertheless, consistent evidence from a variety of different types of studies, conducted in different locations, with different populations, and by different investigators, is less likely to be undermined by publication bias than evidence with a narrow focus from a few sources. The evidence that ambient PM has impacts on mortality and, respiratory and cardiovascular health is consistent across many sources and hence can be considered to be strong.

14. It is quite frankly inexplicable that the CAR Report was not used as part of the literature review notwithstanding the ‘discussions’ with NSW department of health.

The failure to analyse the full spectrum of health impacts as opposed to health end points

15. Some studies such as the CAR Report provide higher relative risks for all health impacts except respiratory mortality. The evidence for the WDA was that a difference of 8% (6% to 14%) did not change the risk assessment outcomes. Whilst that might be true when one undertakes a complicated statistical analysis, the doubling of relative risks in relation to health impacts is a major concern. Essentially, if the bottom line is higher, that must have a downstream impact.

16. In fact, our client’s position is that if the HIA underestimates the relative risks associated with a particular health impact, that it is a substantial failing of the risk assessment.

17. The criticism of the CAR review is that some of the subsets involved small studies although, not all of the studies had been reviewed in order to ascertain whether the background studies were sufficiently robust.

18. In terms of the respiratory effects whilst hospital admissions were taken into account in the HIA, it appears that it is the view of the WDA that there is a relationship between air pollution and the exacerbation of asthma but the studies are not sufficiently robust and to use the words of the expert “we are not there yet”. This leads to a further question “if we get there what mechanisms have been put in place in the design of this project which allows for these matters to be dealt with?”

19. Further, it is clear from the evidence of Professor Anderson that exposure to PM2.5 leads to irreversible damage as these particles accumulate in the human body, cause irreversible molecular injury which increase the risks of cancer and other serious and incurable diseases and that the exposure is cumulative and becomes compounded with the aging process placing all children exposed to PM’s at risk.

20. Further, the WDA’s own evidence is that lung cancer is causal to exposure to PM and further a long-term and lifelong cancer risk. That, in and of itself should be sufficient for mitigation measures to be required as part of the design of the Project. That conclusion must follow given there is no safe limit of exposure of particulate matter.

SEPP-AQM and the lack of safe exposure to PM2.5

21. It is understood that the relevant guideline to which the Advisory Committee is to have regard to is the SEPP-AQM rather than the NEPM. However, it is also understood that these documents contain the same relative figures. The WDA case is essentially that, the cumulative 24 hour average and annual average concentrations of PM2.5 from the ventilation structures are below the guideline and hence do not require any mitigation work.

22. Whilst that is true, that is an extraordinary conclusion given that the evaluation objective which sets the framework for an assessment of environmental effects in relation to health, amenity and environmental quality states:

“To minimise adverse air quality … on health of nearby residents.”

23. How can it be said that firstly, the impacts of air quality are being minimised when there is no filtration system proposed for the ventilation structures. What is most telling is page 101 of the HIA and particularly Table 6.12 where at every scenario in 2022 and 2031 (all respecters and sensitive respecters) the levels of PM2.5 increases with the project in the maximum 24 hour average calculation. There are slight increases in the PM2.5 concentration in the annual average with the Project. When this is coupled with an acceptance by all experts that there is no safe level of exposure of PM2. It can hardly be claimed that the ventilation structures are minimising health impacts. This is also complicated by the fact that the SEPP-AQM does not allow for any maximum allowable exceedances for PM2.5.

24. What this indicates is that any exposure regardless of its duration or whether it complies with a guideline set out in policy poses a threat to human health.

25. It is the position of the LHRC that the current design provides as follows:

• PM’s are still in the air;

• PM’s are still able to be absorbed by humans;

• PM’s are potentially able to be transformed once moving through the ventilation structures by oxidative processes; and

• Given no safe levels exist, there will be an impact on human health.

26. This is to be contrasted with use of appropriate filtration systems which:

• Are able to reduce the concentration of PM’s from the air;

• Reduce the exposure of PM’s by humans; and

• Reducing the impacts on human health.

27. Noting, one of the most important issues is that once human health is impacted, those impacts are irreversible in most cases. This is further to be understood having regard to the total number of Australian deaths attributed to air pollution (3430) and the associated costs of such deaths.

28. The witness for the WDA whilst accepting there is no safe limit of exposure to PM2.5 discussed a method for looking at non-threshold chemicals, their impacts and what is the change in human health. The conclusion was that the impact was very low and in order for there to be a human health impact, it needed to translate to a meaningful number in the community.

29. The analogy that was used was the presence of carcinogens in drinking water. The reality is that some organisation has deemed that a low level presence of carcinogens will have no impact on human health and hence is a default ‘safe limit’. The same cannot be said for PM’s.

Lack of rigorous analysis in the HIA

30. It is apparent that the HIA was generally prepared by Dr Wright with assistance from Ms Manning and with many excerpts from other reports. At no time has there been any independent and separate analysis undertaken on behalf of the WDA. The only supposed review has been undertaken by Dr Buroni who resides oversees and was not called to given evidence (written or oral). One would have thought that with a project of this size and given its importance to the State that a separate and independent review would have followed from the receipt of submissions.

31. Instead, the Advisory Committee is left with a witness who prepared the original HIA, reviewed submissions to her own work and did not make a single recommendation for change to the EPR’s.

32. To complicate matters further, recently published data is discounted without proper or more accurately, any review.

5. CONCLUSION

1. The material before the Advisory Committee can be summarised as follows:

• There is no safe level of exposure to PM2.5;

• Exposures to PM2.5 leads to irreversible accumulation of these particles in the human body;

• Exposure to PM2.5 causes irreversible molecular injury that increases cancer risk and the risk of other serious and incurable diseases;

• The exposure risk is cumulative and harm compounds with normative aging, placing children at particular risk (because of length of exposure);

• The maximum 24 hour average concentration of PM2.5 will increase in all scenarios at 2022 and 2031;

• No information is provided to any changes that may occur to the PM when dispersed;

• Exposure to PM causes lung cancer and adverse cardiovascular effects, damage to respiratory health and increased mortality; and

• Reduction in exposure of PM2.5 leads to a net health gain.

2. On that basis, how can it be said that the following EES Evaluation objective is achieved:

Health, amenity and environmental quality – to minimise adverse air quality….effects on the health and amenity of nearby residents, local communities and road users…

3. Without intervention such as filtration to the ventilation structures it cannot be said that the Project minimises adverse air quality impacts rather, the highest that can be said is that the statistical analysis demonstrates no change.

4. That conclusion is simply deficient and does not achieve the EES Evaluation objective.

6 September 2017

Lung Health Research Centre

Teresa Bisucci

Best Hooper Lawyers

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download