Author: gohuuechi

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Clinical and Community Care Support Projects

Answering Enquiries from Patient Support Groups: EHI-Canada responds to questions from support groups submitted by e-mail, or refers to someone knowledgeable. EHI-Canada also encourages patient support groups by editing their letters requesting help.

International Association of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (IACFS/ME)-Both Dr. Alison Bested and Dr. Lynn Marshall attended the 2014 conference in San Francisco, California, and Dr. Bested attended  the conference in Ottawa in September 2011 and presented at a public forum that was part of the conference. Topics covered at the conferences included virology, exercise physiology, immunology, epidemiology, pediatrics, genomics and neuro-endocrine function, as well as diagnostic and treatment issues. Health professionals from 18 countries attended. Dr. Bested is a member of IACFS/ME, and was part of the Health Canada-selected international panel that published ME/CFS: Clinical working Case Definition, Diagnostic and Treatment Protocols in 2003.

Translation of Environmental Sensitivities/Multiple Chemical Sensitivity Status Report into German, at the request  of a German support group in 2014. Translation and review were arranged by Dr. Annette Lorenz.

Environmental Health Association of Ontario- Dr. Lynn Marshall is a member and, at the request of the EHAO in 2011, she and the other doctors at the Environmental Health Clinic wrote the ES/MCS Status Report. She organized meetings with consumer representatives at the Environmental Health Clinic, February 27 and April 14, 2009, and six teleconference meetings in 2010 about the multiple needs of those with environmental sensitivities.

Myalgic Encephalomyelitis Association of Ontario (MEAO)- Dr. Alison Bested is a long-standing Medical Advisor and Dr. Lynn Marshall a Member since 2007. In 2013-14, EHI-Canada and CELA sponsored their teleconferences about needs for increase in health/social services.

The National ME/FM Action Network- n 2011, the Network analysed data from the 2010 Canadian Community Health Survey (Statistics Canada) regarding the prevalence of myalgic encephalomyelitis/chronic fatigue syndrome, fibromyalgia and environmental sensitivities in comparison with the 2005 Canadian Community Health Survey results and the prevalence of other chronic diseases. The data show a high prevalence and indications of a high degree of disability and will be helpful to raise awareness of the plight of those with these conditions who are underserved in the health and social service systems, and often impoverished. EHI-Canada helped to disseminate the findings.

Canadian Partnership for Children’s Health and Environment, with EHI-Canada as a partner, and Ontario Chronic Disease Prevention Alliance met together In October 2010 as part of the Ontario Trillium Foundation 3-year grant, and a joint statement of participants and 13 organizations, including CPCHE, was issued to an international conference sponsored by the Government of Canada on Bisphenol-A- A Statement of Health and Environment Organizations on Endocrine Disrupting Chemicals.

Centre for Equality Rights in Accommodation (CERA)–  Dr. Lynn Marshall met with CERA staff on February 17, 2010 and March 1, 2010 re environmental sensitivity patients’ housing issues, and participated in teleconferences on March 10 and19, 2010 with representatives from CERA, federal, provincial and municipal governments, a building biologist, and MCS consumer advocates.

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RentSafe

What is RentSafe?

RentSafe is a 3-year initiative, led by the Canadian Partnership for Children’s Health and Environment (CPCHE), to address indoor environmental health risks affecting low-income tenants in both urban and rural communities in Ontario.
With active involvement of public health, legal aid, community health and other stakeholder organizations as well as tenants themselves, we aim to build awareness and capacity in the social services sector so that low-income tenants, when faced with lead, mould, pests, pesticides, radon and other indoor health threats, are better able to get the support they need to achieve healthier living conditions for themselves and their families. The project is funded by the Ontario Trillium Foundation via a grant to the Environmental Health Institute of Canada, the lead CPCHE partner for the project, and by in-kind contributions from multiple project partners.

Why is RentSafe needed?

A growing body of scientific knowledge underscores the vital role that safe, healthy housing plays in preventing/reducing chronic health effects, supporting healthy child development and fostering physical and mental well-being. Low-income and marginalized tenants in Ontario experience not only housing insecurity but also significant indoor environmental health risks. Children, the elderly and people with existing medical conditions are at the greatest risk. At present, there isinsufficient capacity and coordination in the social services sector to effectively address housing-related health risks in low-income housing.

What does RentSafe aim to achieve?

The primary aim of RentSafe is to improve knowledge, capacity and responsiveness within the social service sector to better address housing-related health risks facing low-income tenants, as an important step towards the goal of creating healthier living conditions in low-income/marginalized communities and reducing housing-related health inequities. Through the coordinated efforts of many organizations and sectors, RentSafe will lead to a more tenant-centred system of support and assistance, increased knowledge and empowerment among low-income tenants, and improved policy and systemic responses.

What will be done through RentSafe?

RentSafe will unfold in three phases. Phase 1, which will culminate in the publication of a baseline report, is focused on gathering and synthesizing knowledge and experience on tenants’ concerns and the existing capacity within the social services sector to respond to such concerns, drawing upon province-wide surveys with the public health and legal aid sectors as well as focus groupswith tenants in two urban and two rural communities.Phase 2 will be the convening of a multi-stakeholder Roundtable aimed at identifying actions and strategies for building social services capacity and responsiveness on indoor environmental health concerns.Phase 3, capacity building and education, will result in a video for educating service providers, medical students and others on the visible and invisible housing conditions that may be affecting their clients’ health, and outreach materials to increase public awareness on housing-related health risks and where/how to seek assistance.

For more information:

March 2015

Organizations involved in RentSafe implementation include: the Canadian Environmental Law Association (survey of legal aid clinics, review of case law), the Ontario Public Health Association (survey of public health units), South Riverdale Community Health Centre (tenant focus groups), Toronto Public Health (tenant focus groups), theCentre for Environmental Health Equity at Queen’s University (expertise on tenant engagement), Grey Bruce Health Unit (survey of municipal property standards officials; survey of landlords; tenant focus groups), Lanark Renfrew Health and Community Services (tenant focus groups) and McMaster Institute for Healthier Environments (host of the Roundtable). Additional organizations and individuals are involved via the RentSafe Advisory Committee and/or in the various community-based and province-wide efforts being led the above-named organizations.

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Education and Health Promotion projects

A number of other Education and Health Promotion Projects are featured in this post.

American Academy of Environmental Medicine (AAEM) Dr. Lynn Marshall is a long-standing member of the AAEM, a Past President, and was a long-serving member of the Board of Directors and Education Committee. She is on their Listserv, and shares articles with her colleagues and patient support groups. She taught Instructional courses and regularly presents to the Annual Scientific Conference- in 2014, Failure is my Mentor; in 2013, Evidence to Action; in 2010, Cultivation of a “Health Garden” to Combat Complex Chronic Conditions, with Dr. Alison Bested.

Legal Issues related to Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome and Fibromyalgia- Dr. Alison Bested presented to the B.C. ME/CFS Support Group in British Columbia in fall of 2014 and upcoming in June of 2015.

Chronic Diseases Prevention Alliance of Canada, 2014 spring conference, Evidence of Early Environmental Risk Factors for Chronic Disease, presentation by Dr. L. Marshall.

Early Exposures to Hazardous Chemicals/Pollutants and Associations with Chronic Disease: A Scoping Review, published in June 2011, was followed up by three webinars, presented by Canadian Partnership for Children’s Health and Environment, Canadian Environmental Law Association, and EHI-Canada. Kathy Cooper was the lead speaker, and co-authors contributed, including Dr. Lynn Marshall: Part 1, January 31, 2013- Introduction to the Scoping Review; Part2, February 12, 2013- Focus on Endocrine Disruption and Obesogens; Part 3, March 6, 2013- Policy Implications. Online access starts with: http://www.healthyenvironmentforkids.ca/resources/EE-and-CD-Webinar-Part-One-Slide-Deck

South Riverdale Community Health Centre presentation by Dr. L. Marshall, Consumers at the Crossroads: Research about Chemicals and Diabetes/Obesity, April 2013.

International Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Fibromyalgia, and Environmental Sensitivitiies/Multiple Chemical Sensitivity Day, Queen’s Park, May 7, 2013- Dr. Lynn Marshall made a public presentation at the request of the Myalgic Encephalomyelitis Association of Ontario (MEAO), and on May 12, 2011, Dr. Alison Bested made a public presentation at the request of MEAO, and Dr. Lynn Marshall, at the request of the Environmental Health Association of Ontario.

Department of Family and Community Medicine, University of Toronto, November 19, 2013, presentation by Dr. L. Marshall Evidence of Environmental Hazards to Action.

Canadian Society for Clinical Hypnosis- Ontario Division- In order to encourage the use of clinical hypnosis in medical practice, particularly for chronic conditions with pain and sleep disturbance, Dr. Marshall ensured that the 2012 and 2011 Introductory, Intermediate and Advanced courses in Clinical Hypnosis were accredited by the College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC), and attendees at all three courses were awarded a Certificate in Clinical Hypnosis, or if they attended three Intermediate/Advanced  courses, they were awarded an Advanced Certificate from the University of Toronto. Apparently, this was the first time such a certificate has been granted in North America.

University of Toronto Mini-Med School– Is Our Environment Making Us Sick? Dr. Alison Bested made a public presentation on September 29, 2011, and Dr. Lynn Marshall on April 19, 2012.

Environmental Health Conference- Clinical Pearls, co-sponsored by the Environmental Health Clinic and Environmental Health Institute of Canada, and CFPC- and RCPSC-accredited, was held at Women’s College Hospital on May 4, 2011. Drs. Bested and Marshall both presented.

Movie Chemerical– Dr. Bested and Dr. Marshall were Panel Members, with other Environmental Health Clinic (EHC) physicians and movie director Andrew Nisker, discussing the important points this humorous movie was portraying.

The showing and Panel were CFPC- and RCPSC-accredited, and sponsored by the Environmental Health Clinic and EHI-Canada on April 20, 2011 at Women’s College Hospital (WCH). Dr. Marshall was interviewed in the movie in the EHC. http://www.chemicalnation.com/content/

Continuing Medical Education and Professional Development, Faculty of Medicine, University of Calgary– Dr. Marshall was a member of the planning committee for ME/CFS Diagnosis and Treatment, April 2, 2011, invited by the Course Director, Dr. Eleanor Stein.

Toxics Reduction Strategies for Health Care: The Environmental Health Institute of Canada was the Functional Lead Partner of this Canadian Coalition for Green Health Care (CCGHC) one-year $68,500 Ontario Trillium Foundation (OTF) grant, July 2009-Sept. 2010. The Canadian Association of Physicians for the Environment, of which Dr. Marshall is a Member, was the Financial Lead Partner. There were several goals with this grant, as OTF put it, to “develop and implement a greening of health care strategy that results in a reduction of toxics and use of alternative cleaning products, implementation of fragrance and scent-free policies, and feasibility study of local food project” (for patient meals and cafeterias). In the conduct of this project, the capacity of the CCGHC was expanded, methods were researched for increasing local food use in health care, and there was a review of the scientific literature and knowledge translation (with Nancy Bradshaw, Community Outreach Coordinator of the Environmental Health Clinic, Dr. Lynn Marshall and Linda Varangu, CCGHC Partnership Director) for a Fragrance Free Implementation Kit for Health Care Facilities. The CCGHC managed to leverage the OTF funding to $280,000 for ongoing work on the local food use research. A written Green Best Practice Case Study # 4, ChemTRAC proves to be catalyst of changewas developed in 2011 as part of the ChemSPEC project sponsored by Toronto Public Health, and Dr. Marshall reviewed and revised.

Canadian Network for Human Health and the Environment Network Meeting, June 13, 2010, presentation by Dr. Lynn Marshall Climate Change and Child Health.

Women’s College Hospital Grand Rounds- May 19, 2010, presented by Dr. Alison Bested and Dr. Lynn Marshall- Is the Environment Hurting Our Health?

Canadian Society for Clinical Hypnosis- Ontario Division (CSCH-OD)-    Dr. Annette Lorenz and Dr. Lynn Marshall taught Group hypnosis with medical patients: environmental sensitivities, fibromyalgia and chronic fatigue syndrome, at an Intermediate Workshop in Clinical Hypnosis, March 6, 2010.

Women’s Healthy Environment Network sponsored a public health promotion event, at which Dr. Lynn Marshall was asked to give a presentation: Why fragrance free?November 18, 2010 in Toronto. Dr. Marshall has been named a mentor for WHEN.

CELA and EHI-Canada Making the Links Project, Dr. L. Marshall spoke in Cornwall September 28, 2009  on topics of environmental health interest to that community, and in Hamilton, December 11, 2009, on Indoor air quality and Health, with Drs. Alison Bested, David Coates, and John Molot.

Nanaimo Regional Hospital Family Practice Rounds–Dr. L. Marshall was invited to present Multiple Exposures, Multiple Effects: Managing Complex, Chronic, Environment-associated Conditions on June 25, 2009, Nanaimo, BC.

College Quebecois des medecins de famille, Assemble scientifique annuelle, en anglais et francais, Child Health and the Environment- A Determinant of Health, and Multiple Exposures, Multiple Effects; Managing Complex, Chronic, Environment-associated Conditions (e.g. chemical sensitivities, chronic fatigue syndrome, fibromyalgia) ; Les enfants et l’environnement : conseils pratiques pour proteger la sante des enfants contre les risques environnementaux, et Pour mieux se sentir : comment aider vos patients sensibles aux substances chimiques a faire face aux defis environnementaux de tous les jours, with Myriam Beaulne, Laval, P.Q., Novembre 12, 2009.

Canadian Partnership for Children’s Health and the Environment- First Steps in Lifelong Health, A Vision and Strategy for Children’s Health and the Environment– Dr. Lynn Marshall was an invited speaker at the launch, December 16, 2008: Health Implications of Toxic chemicals in the Womb and During Childhood: A Physician’s Perspective- 3 Points.

CHNET-Works! Fireside Chat, hosted by the Population Health Improvement Research Network of the University of Ottawa– webinar, December 10, 2008, presentation by Dr. L. Marshall Why children are more vulnerable to environmental contaminants.

College of Family Physicians of Canada, Family Medicine Forum 2008– Workshop presented by Dr. Annette Lorenz and Dr. Lynn Marshall Taming toxic Thoughts and Planning for Health with Complex, Chronic Conditions.

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Prenatal Environmental Health Education (PEHE) Forum

The PEHE forum was held November 20-21, 2014 at the University of Ottawa, and Dr. Lynn Marshall presented on a panel about existing efforts to integrate environmental health education into clinical practice. The Canadian Partnership for Children’s Health and Environment (CPCHE) was highly involved in organizing the Forum, along with many other collaborators. The event was well-attended, bringing in over 100 people from diverse health fields (physicians, obstetricians, midwives, nurses, researchers, professors, students, policy makers etc.). Dr. Bruce Lanphear gave the keynote speech on Little Things Matter, and launched his video of the same name (https://www/youtube.com/watch?v=E6KoMAbz1Bw), which will soon be available on the Environmental Health Atlas (www.ehatlas.ca). His presentation opened discussion on upstream methods of managing chemicals versus expecting parents to take total responsibility for exposure reduction. There was also much discussion about the need for better information in medical schools and in clinical settings, especially in preconception and prenatal care. Participants also thought that early education about health-environment connections (e.g. in elementary and high schools) would be advisable as well.

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Making the Links

Progress on Environmental Health, Equity, and Law: Making the Links Project with the Canadian Environmental Law Association (CELA)

The first year (2009) was spent researching aggregate data from various sources to identify six Ontario communities with high pollution, chronic health problems, and significant poverty, and to discover how best to engage and empower them to take action on their concerns about their environment and health. Over the year, six communities were selected, one of which was a first nations community. Communication was initiated with these communities by a CELA lawyer and members of the Steering Committee about their environmental health concerns and important community contacts. Key contacts were made, and local action committees were formed with our support.

In 2010, the issues important to each community were clarified with the action committees, and public meetings were held in each community with speakers whose topics were geared to that community. This was followed by discussion about building on current activities and initiating new actions to address the issues of concern. Helpful tools were discussed and the project provided what was available or web-links from other sources.

In 2011, progress was made with the action committees in each community supporting successful actions, and providing tools or contacts to enable them to make new initiatives on their issues of concern. At year end, there was a meeting in each community to encourage ongoing action after this project ends. In addition, evaluation was sought for the Making the Links project.

The Steering Committee (including Lead Theresa McClenaghan and Member Dr. Lynn Marshall) met in mid-January, 2012 to chronicle what we learned from this project, and how its successes and opportunities for improvement can be applied to future projects to encourage communities to take action on environmental degradation.

Early Environmental Exposures and Chronic Disease Prevention in Ontario In 2011, the Canadian Partnership for Children’s Health and Environment (CPCHE) completed a 3-year Ontario Trillium Foundation-funded collaboration with the Ontario Chronic Disease Prevention Alliance (OCDPA). The lead partner was the Ontario Public Health Association, a member of both CPCHE and OCDPA. Dr. Lynn Marshall represented EHI-Canada on the Steering Committee. In October, 2009, and in 2011, in addition to monthly teleconferences, a stakeholder forum was held to encourage ongoing discussion and collaboration among partners whose mutual goal was to discover how environmental health protection would help sustain child health and prevent development of chronic, environmentally-associated illnesses. Meanwhile, the evidence was being appraised by Kathleen Cooper of CELA, linking early environmental exposures with chronic disease outcomes. This culminated in a substantive review by her and three co-authors, including Dr. Lynn Marshall, Early Exposures to Hazardous Chemicals/Pollutants and Associations with Chronic Disease: A Scoping Review. The review was published in June 2011 by the Canadian Environmental Law Association, Environmental Health Institute of Canada, and the Ontario College of Family Physicians. The report can be found athttp://www.healthyenvironmentforkids.ca/resources/EE-andCD-scoping-review.

CPCHE and its partners (including EHI-Canada) took the evidence outlined in the Scoping Review, and, in 2012, devised a health promotion plan, called Top Five Tips, Creating Healthy Home Environments for Kids, which included a brochure, plain language fact sheets, translated, not only into English and French, but six other languages. They were, and are being disseminated via insertion in Today’s Parent magazine, distribution to public health units and health practitioner offices, and a video. Dr. Marshall and Kathy Cooper served on the Video Development Committee, and both gave multiple presentations about the project.