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Landfill schools given clean bill of health but cancer debate continues

An official report commissioned by the Scottish government has given a school campus that became a focus for occupational and public health concerns a clean bill of health, although questions have been raised around its analysis of occupational bladder cancer risk. 

The NASUWT teaching union is also proceeding with a planned strike amid concerns that the review team failed to fully address the bladder cancer cluster among teachers at the school, three of whom worked on the same corridor.

Occupational and environmental health specialist Professor Andrew Watterson, of the University of Stirling, welcomed the report but said that it still left some “gaps”, and did not provide any new information on historical contamination at the site.  

While he agreed that occupational exposure was fairly “unlikely” as a cause, he criticised health authorities’ failure to carry out air and dust sampling to look for possible carcinogens, either after the cancer cases came to light or since completion of the campus in 2012.

After health concerns among teachers and students in 2018-19, and widespread media coverage, in June the Scottish government commissioned a report to analyse evidence on St Ambrose High School and Buchanan High School, a school for pupils with additional needs.  

It was carried out by Dr Margaret Hannah, former director of public health at NHS Fife, and Paul Cackette, a solicitor and senior civil servant in the Scottish government's planning and environmental appeals division.  

The two schools, with around 1,200 and 100 pupils respectively, were built in 2010-12 on a former landfill site used by Gartsherrie Ironworks for industrial waste, including substances such as arsenic, nickel and lead, from 1945 to 1972.

Launching the report, Hannah said: “Our principal finding is the school is safe, the site is safe and there is no link between the school and the reported health issues”.

However, the report recommends that a new "site recovery" group should be established to share and communicate information about the site in the future.

NASUWT acting general secretary Chris Keates said that the union would keep its position under review. "Our experts and legal counsel are examining the report and we are awaiting their advice on the next steps. We have also posed some interim questions to the council and we are waiting for answers to those."

The concerns raised by parents and staff centred on:

  • a “cluster” of three teachers at Buchanan High with bladder cancer, and a fourth who had a diagnosis of bowel cancer with bladder cancer diagnosed a year after an “all clear”;  
  • “blue water” with high levels of copper from the taps in Buchanan High;
  • a pupil who developed sight loss and had a urine test showing elevated arsenic levels; and
  • general reports of ill-health and fatigue among pupils and staff.  

The review team analysed evidence submitted by a range of public bodies, members of the project’s construction team and teaching unions; and also commissioned 50 tests of soil samples from grassy and garden areas in the school campus.

 

Our principal finding is the school is safe, the site is safe and there is no link between the school and the reported health issues

Dr Margaret Hannah report co-author

 

The report concludes that “blue water”, showing higher copper levels than water quality standards permit, was linked to corrosion in the school’s pipework and was fully addressed once 1,800 m of pipework was replaced, in December 2018.

Although tasting unpleasant and possibly causing an upset stomach if drunk in large quantities, the copper-contaminated water was not linked to any wider health problems and was not carcinogenic, the report said.  

Addressing reports of general ill-health in the school population, from headaches to stomach cramps, fatigue and joint pain, the report found that reported levels were broadly in line with survey levels from a similar population.

Staff absence data, until the period when health concerns were widely reported, were also slightly lower than staff absence rates at another comparable local school. 

However, the report agrees that the school may have a problem with raised carbon dioxide levels, a common problem in schools, which may warrant further testing.

In the case of the first year pupil with sight loss, a urine test had shown raised levels of arsenic, as had a urine test from another pupil, but these were most likely to have a dietary explanation.

While exposure to arsenic over an extended period can result in sight loss, the pupil had only been at the school for a few months and could not have been sufficiently exposed to a degree likely to damage his sight.

The report also dismissed the possibility that the “cancer cluster” was anything other than a random occurrence, arguing that the “latency period” for bladder cancer – or the time that elapses between the initial exposure to a carcinogen and the diagnosis of cancer  was at least 15 years.  

The report says: “Even when the risk of bladder cancer is known to be high, studies provide mean and median periods of latency from exposure to disease of between 15 and 40 years.”

As the school had only opened in 2012, this made it statistically highly unlikely that any environmental exposure at the school was linked to the cancer diagnosis.

The report also argued that “cancer of the bladder is the ninth most common cancer in Scotland with 80-100 cases a year expected in a population the size of Lanarkshire”.

In addition, a “problem assessment group” made up of the local public health team, experts from the University of Glasgow and Health Protection Scotland, concluded that the cases equated to “what could be deemed the norm in a cross-section of the population of a similar demographic to the school teaching population”.

Bladder cancer is often linked to exposure to “aromatic amines”, which are found in tobacco smoke and also in other chemicals known to have been used on the site. The report does not discuss the smoking history of the affected teachers. 

Some of the report’s arguments around bladder cancer have been called into question by Professor Andrew Watterson, a member of the occupational and environmental health research group at the University of Stirling.

 

Environmental monitoring [could have] have ruled out conclusively any exposure to bladder carcinogens in the building and corridor where the three staff worked if that was the result of the monitoring but no such monitoring has happened

Professor Andrew Watterson

 

In his submission to the review team, he contradicted the report’s assertion on latency, saying that “a leading international cancer epidemiologist and former head of the Massachusetts Cancer Registry …. thought it not unreasonable in the circumstances to use a four-year minimum in assessing the Lanark cluster”.

He also criticised NHS North Lanarkshire’s handling of concerns, suggesting that “environmental monitoring [could have] have ruled out conclusively any exposure to bladder carcinogens in the building and corridor where the three staff worked if that was the result of the monitoring but no such monitoring has happened”.   

He notes that such a programme of environmental monitoring was put in place at the former nearby Ravenscraig steelworks site.  

The review team did commission soil samples under areas of grass and in raised beds around the school campus.

While the chemical analysis showed 150 different compounds, including heavy metals, hydrocarbons, asbestos, volatile organic compounds (VOCs), pesticides and dioxins, in 49 cases out of 50 these were deemed to be within acceptable limits for a secondary school. .

However, one sample was found to contain higher than expected concentrations of polychlorinated biphenyls (PCBs), compounds that have been linked to liver, stomach and thyroid cancer.

This area of the site is now being remediated.

Evidence was submitted by North Lanarkshire Council, which operates the two schools, the Drinking Water Regulator for Scotland, Health Protection Scotland, the Scottish Environment Protection Agency (SEPA) and Scottish Water. 
 From: https://www.healthandsafetyatwork.com/news-and-prosecution/landfill-schools-given-clean-bill-of-health-but-cancer-debate-continues

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