A "tainted smoke" inquiry should be launched against the BC Lung Association

In the late 1970s, blood operators from around the world began to panic as vulnerabilities in their risk management systems were exposed due to the global spread of new and difficult to detect pathogens. As a result of these failures, thousands of Canadians were infected with HIV and Hepatitis C from blood and blood products.

In Canada, the Canadian Red Cross Society ran the blood system until it was dismantled following recommendations from the Royal Commission of Inquiry on the Blood System in Canada which was led by Justice Horace Krever.

Two new non-profits emerged to take over Canada's blood system after this 1997 report was released, and the groundwork for Canadian Blood Services and Hema Quebec were laid out by these recommendations, new insurance and reinsurance arrangements, and a new corporate governance structure with newly defined roles for the federal Minister of Health and Provincial and Territorial counterparts.

The Canadian Red Cross Society made several key mistakes over the decades and failed to understand the significance of changes resulting from new, fast moving pathogens, published material and guidelines, and the lessons learned by other jurisdictions around the world who responded much more quickly then they did resulting in less lost lives and impacted families.

The tainted blood scandal was a horrible time in our history, and many of the same things are happening with wood smoke and the management of it by governments and the roles played by organizations like the BC Lung Association.

A "tainted smoke" inquiry is needed, and the BC Lung Association is significantly exposed to liability due to their ongoing role in supporting and profiting from wood stove exchanges. Let's hope that they don't double down on their position. They do excellent work and it would be shame to have them dismantled and lose public trust in a manner similar to what we saw a few decades ago with blood operators.

There are several parallels between the tainted blood scandal and the issue of wood smoke. Much of this work comes from drawing upon the book The Gift of Death (1995) by Andre Picard, the Krever report itself, and the experience of one of our members who sat on the national Board of Directors of Canadian Blood Services.

First, the Red Cross ignored the risks for many years because of a culture within the organization that was strictly hierarchical and somewhat "militaristic" in tone. Bench scientists and others had few direct pathways to the senior administration or the board to flag or raise issues. As a result, the Red Cross was slow to respond and ignored many warnings from staff and others.

With wood smoke, BC Lung is doing something very similar. It has ignored the warnings including research provided by third party groups and individuals about the risks. It has systematically deleted postings from wood smoke activists including external scientists and physicians who have commented about this issue on their Facebook and Twitter sites in particular. Moreover, it has failed to be proactive and it has held, or participated in, several events recently on air pollution while ignoring the request of such individuals to participate and present at these events. A massive blindspot exists in the organization that is very similar to what we saw in the tainted blood scandal.

Second, the Red Cross assumed that the blood system would remain safe because of a misplaced trust in altruism and goodwill. Their senior administrative team believed that people would only donate blood if they were healthy or otherwise low risk in terms of lifestyle or health status factors. They put the burden on individual donors to screen themselves out of the system, and assumed that such individuals fully understood the risks personally.

With wood smoke, BC Lung's support of the wood stove exchange program and its support of "Burn Clean" kind of programs relies on the skills and judgment of people who burn wood in residential settings where others are exposed to this air pollution. It is a misguided approach, and our extensive program of air quality monitoring shows that significant air pollution is generated by experienced residential wood burners who use dry and seasoned wood and in EPA certified appliances. There is no way to burn clean. This is a myth and the Province of BC also needs to change its tone and messaging on this.

There are several other parallels to the tainted blood scandal but we wish to make the following closing points:

1. The BC Lung Association needs to clearly and unambiguously state that wood burning, of all kinds, is hazardous to human health and that no safe thresholds for exposure exist. There needs to be no equivocation on this issue. Anything less than a full statement like this is tantamount to support.

Would they prevaricate on smoking? Would they recommend vaping, low tar or "light" cigarettes? Would they accept money from the tobacco industry to support smoking sections in restaurants and bars on the assumption that this lowers the risk? No, these things would be foolish and suicidal for such an organization given the evidence. There are now hundreds of scientific and medical articles available on the risks associated with wood smoke. We recommend the following starting point on the website Doctors and Scientists Against Wood Smoke Pollution.

2. BC Lung should work with community groups and other partners who receive funding for this exchange program to require that wood-for-wood exchange of appliances is no longer acceptable. It can use these resources from the province, and still retain financial support for administering the program, by funding changeovers to clean technologies including heat pumps. It is not enough to argue that removing an old wood stove from operation and replacing it with an EPA stove saves lives and cuts pollution. Again, this is analogous to supporting light cigarettes or vaping. It also simply legitimizes wood stoves and is leading to more installations of them and greater overall risk.

3. Lastly, BC Lung should play an advocacy role and speak to local governments and others about this issue. We know from personal experience that they have ignored requests to join delegations who presented information to local governments about wood smoke.

They should support local citizen science initiatives to monitor the air with low cost solutions made available by PurpleAir and SensorUp, and they should provide these to people in the province who have concerns about the hyperlocal effects of wood smoke pollution. Anything less suggests an incomplete and partial commitment to fully and holistically deal with respriratory health and drivers of risk.

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