The Family Physician as patient advocate

by Roy D Jeffery, MD, FCFP

I would like to suggest another important role for family physicians in the domain of public health. That is to advocate for the victims of environmental illness. Currently in Ontario and indeed in jurisdictions across Canada and abroad the public health system seems to be struggling to come up with a sensible response to the growing public health phenomena associated with industrial wind turbines (IWT). In the light of increasing numbers of victims in every jurisdiction of the province where IWT’s have been built in close proximity to human habitation, we would have expected a recognition from the public health authorities that more in depth surveillance and precautionary measures were appropriate.

 
In their article entitled “The family physician and the public health perspective”, Sikora and Johnson identify three scenarios where the benefits of incorporating public health elements into practice are made clear. They remind us that the Canadian advisory Committee on Public Health 2001 identified 6 key domains of public health practice, the first three being “health protection” (taking action to protect individuals against health and safety risks), “health surveillance” (identifying health events of concern through the collection, integration, analysis and interpretation of data with the dissemination of results to the appropriate people and organizations), and “disease and injury prevention” (developing interventions to reduce the likelihood or progression of disease). (1)

I would like to suggest another important role for family physicians in the domain of public health. That is to advocate for the victims of environmental illness. Currently in Ontario and indeed in jurisdictions across Canada and abroad the public health system seems to be struggling to come up with a sensible response to the growing public health phenomena associated with industrial wind turbines (IWT). In the light of increasing numbers of victims in every jurisdiction of the province where IWT’s have been built in close proximity to human habitation, we would have expected a recognition from the public health authorities that more in depth surveillance and precautionary measures were appropriate. Rather than a process based on the above key domains of surveillance, protection and prevention the response seems to have been characterized by political posturing related to government and corporate agendas around “green energy”. I wonder if the victims of industrial turbines were experiencing the side effects of a new experimental drug whether the authorities would have as much difficulty coming to the realization that data collection was appropriate. In addition I suspect that if monitoring was in place and a rash of new and serious syndromic illness developed shortly after the introduction of a new drug to a community, the response would not be “there is as yet no proof, more studies are needed before taking action”. Rather our public health officials would move immediately to protect the health and safety of the citizens by withdrawing the new experimental drug.

In the case of IWT’s we have a new and rapidly evolving technology. Turbines are now 40 stories tall and sweep an area greater than the size of a jumbo jet. They emit an effect well known to cause illness (noise at a variety of frequencies including ultra low frequencies).(2) Although industry data indicates that most IWT’s now emit over 106 dB at the source, little is known about how the various frequencies of sound diffuse through the environment. Computer generated sound modeling has been shown to be highly inaccurate. Further officials in the Ministry of the Environment for Ontario have admitted that they lack the technology to monitor compliance with noise guidelines. A rapidly increasing number of people living in the shadow of turbines are describing a well defined syndromic illness which subsides when they leave the area and redevelops when they return. Many people have had devastating effects on their health largely mediated through sleep deprivation. I believe it is desirable for family physicians who are working in the affected areas to advocate for their patients (even for those who are facing the threat of health effects from improper placement of IWT’s). Family physicians can ask some of the following questions. Why are the public health agencies not collecting data on health effects? Why are some officials insisting that the syndrome does not even exist? Rather than calling for a moratorium on new IWT installations less than 2 km from human habitation to ensure that many more people are not injured, why is our Ministry of Health calling for more research and study?

Family physicians can advocate for a public health agency which bases its policy on the precautionary principle. In the case of IWT’s this would involve immediately setting up an unbiased database for monitoring health and safety effects and ensuring that no new IWT’s are built within 2 km of human habitation, schools and gathering places. In this role of patient advocacy family physicians would certainly be a “resource to their community” and a “major partner in disease prevention, surveillance and promotion in Canada.”

Roy Jeffery MD,FCFP Little Current, Ontario

1. Advisory Committee on Population Health, Public Health Agency of Canada; 2001 2. Night Noise Guidelines for Europe, World Health Organization; 2007

3 thoughts on “The Family Physician as patient advocate

  1. Thank you Dr. Jeffery for having the courage to come forth with such a balanced approach on how to deal with this phenomena happening within Industrial Wind projects. I have visited myself a group of residents in the Norfolk area and I clearly saw a group of people not wanting to abandon their homes yet feel compelled to do so because they can no longer live in their toxic environment. Your response is much different than my own family physician who asked me after requesting for baseline levels of my health, that I should be considering all of the people in Windsor who were suffering from the lung disease and how things such as Wind Energy would help alleviate this. So thorough the green washing has been that not even a man of science can discern that wind will do nothing to help with air pollution.

  2. Thank you Dr. Jeffery
    And yes, I can personally attest to the fact that there is no help from the local family physician or the local health authorities available on the IWT issue.

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