DOCSLIB.ORG

Evidence Summary on Poisoning in Canada

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Evidence Summary on Poisoning in Canada Evidence Summary on the Prevention of Poisoning in Canada PARACHUTE AND INJURY PREVENTION CENTRE, UNIVERSITY OF ALBERTA JULY 23, 2020 Suggested citation: Jiang A, Belton, KL, & Fuselli P (2020). Evidence Summary on the Prevention of Poisoning in Canada. Parachute: Toronto, ON. ACKNOWLEDGEMENTS Working collectively on a collaborative project is very rewarding. The process brings together individuals from different organizations who occupy a wide range of roles. Together, the following advisors have generously contributed their time and expertise to the creation of this paper, and we extend our sincerest gratitude. Felix Bang, Public Health Agency of Canada James Hardy, Health Canada Minh Do, Health Canada Richard Wootton, Health Canada Lisa Belzak, Public Health Agency of Canada Steven McFaull, Public Health Agency of Canada Xiaoquan Yao, Public Health Agency of Canada Laurie Mosher, IWK Poison Centre Dr. Nancy Murphy, IWK Poison Centre Sandra Newton, Child Safety Link Guillaume Bélair, Centre Antipoison du Quebec Dr. Maude St. Onge, Centre Antipoison du Quebec Anna Leah Desembrana, Ontario Poison Centre Dr. Margaret Thompson, Ontario Poison Centre Sandra Padovani, Parachute Kelley Teahen, Parachute Cara Zukewich, Saskatchewan Prevention Institute Colleen Drul, Injury Prevention Centre George Frost, Injury Prevention Centre Patricia Chambers, PADIS Jane Huang, PADIS Dr. Mark Yarema, PADIS Victoria Wan, BCCDC Dr. Roy Purssell, BC Drug and Poison Information Centre Dr. Ian Pike, BC Injury Prevention Research & Prevention Unit Fahra Rajabali, BC Injury Prevention Research & Prevention Unit Evidence Summary on the Prevention of Poisoning in Canada ACKNOWLEDGEMENT | 1 TABLE OF CONTENTS Executive Summary . 3 Current Poisoning Prevention Initiatives . 42 Surveillance and Surveillance Systems ....... 42 Purpose . 4 Public Health Agency of Canada ........ 42 Introduction . 5 Toxicovigilance Canada ................ 43 Canadian Surveillance System for Poison Definition Of Poisoning . 6 Information (CSSPI) .................... 44 Poison Prevention Week ................... 45 Poison Centres In Canada . 7 Toxicovigilance canada’s Public outreach History ................................... 7 and Communication Working Group ........ 45 Canadian Poison Centres .................... 7 Canadian Collaborating Centres on Injury Prevention ......................... 45 Canadian Association of Poison Control Centres ........................... 7 Parachute’s #PotcanPoisonkids Program .... 46 Product Formulations Database .............. 8 Government of Canada: Federal Actions on Opioids ................. 46 Populations At Risk . 9 Remaining Challenges . 47 Pediatric, Youth and Young Adults ........... 9 National Poison Centre Access .............. 47 Older Adults ............................. 10 Products Database ........................ 47 Intentional Self-Harm Poisonings ........... 10 Integrated Surveillance Systems ............. 47 Indigenous Peoples .........................11 Emerging Poisoning Issues ................. 47 The Impact Of Poisonings In Canada . 12 Recommendations And Future Steps . 48 Methodology ............................. 12 Advocating for Best Practices ............... 49 Deaths ................................... 13 Access to Canadian-Specific Hospitalizations .......................... 16 Product Information ....................... 49 Emergency Department Visits .............. 19 Understanding Emerging Issues ............ 49 Canadian Hospitals Injury Reporting and Carbon Monoxide Detectors ................ 50 Prevention Program (CHIRPP) .............. 22 National Leadership ....................... 50 Calls to Canadian Poison Centres ........... 23 Limitations of Poisoning Data .............. 25 Conclusion . 50 Economic Burden of Unintentional Poisonings in Canada ................................ 26 Appendices . 51 A: Poison Control Centres ................. 51 Emerging Poisoning Issues . 27 B: Data Sources and Methodology ........... 52 Cannabis ................................. 27 C: Top Causes for Poison Centre Calls ........ 53 Opioids and Illicit Drugs ................... 28 D: Undetermined Poisonings ............... 55 E-Cigarettes and Vaping ................... 30 Laundry Detergent Pods ................... 32 References . 58 Poisoning Prevention Best Practices . 33 Poison Centres ............................ 34 Legislation and Policy ..................... 35 Safer Medication and Substance Packaging ... 35 Safe Storage .............................. 36 Carbon Monoxide Detectors ................ 37 Interventions for Poisonings due to Illicit Drug Use ................................ 40 Raising Awareness and Educating .......... 41 Evidence Summary on the Prevention of Poisoning in Canada TablE OF CONTENTS | 2 EXECUTIVE SUMMARY Poisoning represents a major cause of mortality unintentional poisoning hospitalizations remained and morbidity in Canada and around the quite similar from 2008 to 2014; however, rates world. Furthermore, poisonings account among males in the later end of the observed time for a significant number of hospitalizations period increased compared to females. and an even greater number of emergency department visits each year in Canada. While Available data from emergency departments in it is important to recognize that poisonings two Canadian provinces (Alberta and Ontario) can occur in individuals from all walks of demonstrate a gradual increase in visits due to life regardless of age, sex or socioeconomic both unintentional and intentional poisonings, status, certain populations have been identified with the rate of unintentional poisonings being through research and surveillance as being at more than double that of intentional self-harm an elevated risk for poisoning. These include poisonings in 2018 (Figure 9). pediatric, youth and young adults, older adults Based on data from five Canadian poison and Indigenous peoples. centres that collectively serve 11 provinces and Data indicate that deaths due to unintentional territories (British Columbia, Yukon, Alberta, poisonings have shown a marked increase from Saskatchewan, Northwest Territories, Nova 2008 to 2018, with a peak observed in 2017 Scotia, Prince Edward Island, Ontario, Manitoba, (Figure 3). Comparatively, poisoning deaths due Nunavut, and Québec), 209,534 cases were to suicide have shown a modest decrease during opened in 2018 to local poison centres, which the same time period. When poisoning deaths are averages to 574 cases per day. analyzed by sex (Figure 4), mortality rates among Over the past decade, there has been an males are consistently higher than females for emergence of several issues that have produced both unintentional and intentional poisoning changes in the trends associated with poisoning. deaths during the available time period. The legalization of cannabis, the opioid crisis and Importantly, the mortality rate for unintentional the introduction of new products such as laundry poisonings among males more than tripled detergent pods have resulted in an increase in from 2008 to 2017, and the bulk of the observed calls to poison centres, emergency responses and increase in unintentional poisoning deaths are the healthcare system as a whole. among males as opposed to females. The age groups with the highest observed mortality rate Using an evidence-informed approach in due to unintentional poisonings were individuals prevention planning ensures that the use of ages 30 to 49 (Figure 5). Individuals ages 40 to different types of evidence occurs at more than 64 had the highest mortality rates from suicide one point in the planning process (MacKay poisoning (Figure 5). 2005). Knowledge of this process is essential in order to ensure a plan has real impact and uses Data on rates of hospitalization due to scarce resources effectively. There are essential poisonings indicate that unintentional poisoning components that need to be considered, which hospitalizations have shown a steady increase include: using the best available research; from 2008 to 2018 (Figure 6). Hospitalization considering the local health issues and local rates for intentional self-harm poisonings context; using existing public health resources; were consistently higher than unintentional and understanding the community and political poisonings but did not show a clear trend during climate (National Collaborating Centre for the observed time period. When analyzing data Methods and Tools, 2013; Brownson et al., 2009; between males and females (Figure 7), rates for Saunders et al., 2005; Ciliska et al., 2010). Evidence Summary on the Prevention of Poisoning in Canada EXECUTIVE SUMMary | 3 Over the past decade, there has been increased across all age groups to inform current and activity in the field of poison prevention and future prevention initiatives. Recent statistics the theme woven throughout all activity is and analyses are provided to reflect the growing collaboration. We are collaborating to create magnitude of the issue, as well as discussion and launch a new surveillance system along of emerging issues, poisoning prevention best with supporting working groups, taking practices and current poisoning prevention collective action on public awareness efforts initiatives across the country. through Poison Prevention Week, integrating professionals who are focused on prevention Broad recommendations are made from the and treatment of those affected by poisoning and evidence gathered as well as proposed actions. supporting government action on issues such
Load more

Recommended publications
  • News and Notes 97
    96 Injury Prevention 1998;4:96–97 ... while in Canada, helmet laws nated eVorts. It sets targets for the reduction Inj Prev: first published as 10.1136/ip.4.2.96 on 1 June 1998. Downloaded from knocked of deaths and injuries requiring hospitalisa- NEWS AND tion for traYc collisions, fires, drownings, and As summer approached, the debate over those in the workplace and home. Recognis- NOTES bicycle helmets in Canada was heating up. ing the lack of information on sport and rec- Countering a growing movement to get reational injuries the report notes that this helmet laws passed in every province is an area requires further attention. Further details: organization called the Ontario Coalition for Minister’s Injury Prevention Committee, c/o Better Cycling whose web site applauds the OYce for Injury Prevention, Environmental Revised injury control manual from failures of helmet law lobbyists and the Health Assessment and Safety Branch, BC Ministry of Health, 7-1 1515 Blanshard AAP watering down of Ontario’s law (only cyclists younger than 18 must wear helmets or face a Street, Victoria BC V8V 3C8, Canada (fax: The new injury control manual from the fine in that province). The group argues that +1 250 952 1342). American Academy of Pediatrics (AAP) is the government should instead mandate now available and by all accounts is well cycling education in schools, on the grounds Our Healthier Nation worth looking at. It contains new chapters on that more crashes and injuries can be violence, sports injuries, agricultural injuries, prevented “by getting children to appreciate A Contract for Health is how the UK govern- the need to cycle responsibly”.
    [Show full text]
  • List of Contributors
    List of Contributors ADAMS, P.C., London Health Sciences Centre-University Campus, 339 Windermere Rd., London, ON N6A 5A5. Tel: (519) 858-5125 Fax: (519) 858-5114 E-mail: [email protected] ALLARD, J.P., University Health Network-Toronto General Hospital, EW 217A-200 Elizabeth St., Toronto, ON M5G 2C4. Tel: (416) 340-5159 Fax: (416) 348-0065 E-mail: [email protected] ARCHAMBAULT, A.P., Hôpital Maisonneuve-Rosemont, 5415 boulevard de l’Assomption, Montréal, QC H1T 2M4. Tel: (514) 252-3822 Fax: (514) 252-3486 ARMSTRONG, D., Associate Professor, Division of Gastroenterology, Chief of Clinical Service, Division of Gastroenterology, Hamilton Health Sciences, McMaster University Medical Centre, HSC-4W8-1200 Main St. W, Hamilton, ON L8N 3Z5. Tel: (905) 521-2100 ext. 76404 Fax: (905) 521-4958 E-mail: [email protected] BAIK, S.K., Associate Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, 162 Ilsan-dong, Wonju, South Korea 220-701. Tel: (82) 33-741-1223 Fax: (82) 33-745-6782 E-mail: [email protected] BAIN, V.G., Director, Liver Unit, University of Alberta, 205 College Plaza, 8215- 112th St., Calgary, AB T6G 2C8. Tel: (780) 492-8128 Fax: (780) 492-8130 E-mail: [email protected] BECK, I.T., Gastroenterology/Internal Medicine, Hotel Dieu Hospital, 166 Brock St., Kingston, ON K7L 5G2. Tel: (613) 544-0225 Fax: (613) 544-3114 E-mail: [email protected] 2 list of contributors BURKE, J., Queen Elizabeth II Health Sciences Centre, 1278 Tower Rd., Halifax, NS B3H 2Y9.
    [Show full text]
  • Health Claim About Vegetables and Fruit and Heart Disease
    Summary of Health Canada's Assessment of a Health Claim about Vegetables and Fruit and Heart Disease Summary of Health Canada's Assessment of a Health Claim about Vegetables and Fruit and Heart Disease December 2016 Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch 1 Summary of Health Canada's Assessment of a Health Claim about Vegetables and Fruit and Heart Disease Health Canada is the federal department responsible for helping the people of Canada maintain and improve their health. We assess the safety of drugs and many consumer products, help improve the safety of food, and provide information to Canadians to help them make healthy decisions. We provide health services to First Nations people and to Inuit communities. We work with the provinces to ensure our health care system serves the needs of Canadians. Également disponible en français sous le titre : Résumé de l’évaluation par Santé Canada d’une allégation santé au sujet des légumes et des fruits et de la maladie du cœur To obtain additional information, please contact: Health Canada Address Locator 0900C2 Ottawa, ON K1A 0K9 Tel.: 613-957-2991 Toll free: 1-866-225-0709 Fax: 613-941-5366 TTY: 1-800-465-7735 E-mail: [email protected] This publication can be made available in alternative formats upon request. © Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2016 Publication date: December 2016 This publication may be reproduced for personal or internal use only without permission provided the source is fully acknowledged.
    [Show full text]
  • HISTORY of LEAD POISONING in the WORLD Dr. Herbert L. Needleman Introduction the Center for Disease Control Classified the Cause
    HISTORY OF LEAD POISONING IN THE WORLD Dr. Herbert L. Needleman Introduction The Center for Disease Control classified the causes of disease and death as follows: 50 % due to unhealthy life styles 25 % due to environment 25% due to innate biology and 25% due to inadequate health care. Lead poisoning is an environmental disease, but it is also a disease of life style. Lead is one of the best-studied toxic substances, and as a result we know more about the adverse health effects of lead than virtually any other chemical. The health problems caused by lead have been well documented over a wide range of exposures on every continent. The advancements in technology have made it possible to research lead exposure down to very low levels approaching the limits of detection. We clearly know how it gets into the body and the harm it causes once it is ingested, and most importantly, how to prevent it! Using advanced technology, we can trace the evolution of lead into our environment and discover the health damage resulting from its exposure. Early History Lead is a normal constituent of the earth’s crust, with trace amounts found naturally in soil, plants, and water. If left undisturbed, lead is practically immobile. However, once mined and transformed into man-made products, which are dispersed throughout the environment, lead becomes highly toxic. Solely as a result of man’s actions, lead has become the most widely scattered toxic metal in the world. Unfortunately for people, lead has a long environmental persistence and never looses its toxic potential, if ingested.
    [Show full text]
  • Cyanide Poisoning and How to Treat It Using CYANOKIT (Hydroxocobalamin for Injection) 5G
    Cyanide Poisoning and How to Treat It Using CYANOKIT (hydroxocobalamin for injection) 5g 1. CYANOKIT (single 5-g vial) [package insert]. Columbia, MD: Meridian Medical Technologies, Inc.; 2011. Please see Important Safety Information on slides 3-4 and full Prescribing Information for CYANOKIT starting on slide 33. CYANOKIT is a registered trademark of SERB Sarl, licensed by Meridian Medical Technologies, Inc., a Pfizer company. Copyright © 2015 Meridian Medical Technologies, Inc., a Pfizer company. All rights reserved. CYK783109-01 November/2015. Indication and Important Safety Information……………………………………………………………………………….………..…..3 . Identifying Cyanide Poisoning……………………………………………………………………………………………………………….…………….….5 . How CYANOKIT (hydroxocobalamin for injection) Works……………………………………………………………….12 . The Specifics of CYANOKIT…………………………………………………………………………………………………………………………….………17 . Administering CYANOKIT………………………………………………………………………………………………………………………………..……….21 . Storage and Disposal of CYANOKIT…................................................................................................................................26 . Grant Information for CYANOKIT……………………………………………………………………………………………………………………....30 . Full Prescribing Information………………………………………………………………………………………………….………………………………33 Please see Important Safety Information on slides 3-4 and full Prescribing Information for CYANOKIT starting on slide 33. CYANOKIT (hydroxocobalamin for injection) 5 g for intravenous infusion is indicated for the treatment of known or suspected cyanide poisoning.
    [Show full text]
  • From Signal Detection to Safety Assessment and Selection
    3/13/2017 HEALTH CANADA’S PHARMACOVIGILANCE ACTIVITIES FOR MARKETED PHARMACEUTICAL PRODUCTS: FROM SIGNAL DETECTION TO SAFETY ASSESSMENTS AND SELECTION OF RISK MITIGATION STRATEGY Nadiya Jirova M.Sc. Marketed Pharmaceuticals and Medical Devices Bureau Marketed Health Products Directorate Health Canada CAPRA meeting, January 2017 Outline Overview of Pharmacovigilance at MHPD Signal Detection • Signal Detection Working Groups • Prioritization of safety issues Signal assessment • Work process • Sources of data • Considerations • Options • Recommendations • Examples of Signal Assessments Summary Safety Reviews http://www.hc-sc.gc.ca/ewh-semt/pubs/occup-travail/balancing_six-equilibre_six/index-eng.phpQuestions 2 1 3/13/2017 MPMDB within Health Canada Health Canada Health Products Branches and Food Branch Directorates Marketed Health Products Directorate Marketed Pharmaceuticals Bureaux and Medical Devices Bureau 3 Lifecycle Approach to Product Vigilance MPMDB activities span the lifecycle of a Health Product in Canada 4 2 3/13/2017 MPMDB Activities within MHPD Medication PSUR Policy InfoWatch Complementary Advertising Incidents Review Development Activities Signal Signal Risk RMP Review Detection Assessment Minimization review Activities AE Risk Comms Risk Comms Risk Comms Risk Comms Basic Reg. collection Pharmac. Biologics NHPs Med. Dev. Activities 5 Pharmacovigilance at MHPD Signal detection working groups • Safety literature • Canada Vigilance database • Foreign agency actions • Info submitted by MAH • TPD Bureau requests Other Emerging
    [Show full text]
  • Poisoning (Pdf)
    n Poisoning n What puts your child at risk Poisoning is a common and often serious emer- gency in children. Poisoning most often occurs of poisoning? when toddlers and preschoolers find poisons in Crawling infants and toddlers are at highest risk! Most the home and eat or drink them. If you have an poisonings occur in children under age 5. infant or toddler, you need to “poison-proof” your home and make a plan for what to do if poisoning Poisoning is much less common at ages 6 and older. occurs. Teenagers may poison themselves in suicide attempts or while attempting to get “high.” Not poison-proofing your home! Ninety percent of poisonings in children occur at home. What types of poisoning occur in children? How can poisoning be prevented? The average home contains many products that could Poison-proof your home by putting away all medicines, cause poisoning in a young child. Many common medica- household cleaners, and other possible poisons. All of tions can be harmful when taken in large doses. Infants these products should be locked up or put away where and toddlers are at risk of poisoning because they love to your child cannot see or find them. (Remember, toddlers explore their environment and will put almost anything in love to climb!) their mouths. Teach your child never to put anything but food or drink “ ! If you have an infant or toddler, it is essential to poison- into his or her mouth. Never tell your child that medicine ” proof your home so that your child cannot find and eat is “candy.” or drink anything harmful.
    [Show full text]
  • Approach to the Poisoned Patient
    PED-1407 Chocolate to Crystal Methamphetamine to the Cinnamon Challenge - Emergency Approach to the Intoxicated Child BLS 08 / ALS 75 / 1.5 CEU Target Audience: All Pediatric and adolescent ingestions are common reasons for 911 dispatches and emergency department visits. With greater availability of medications and drugs, healthcare professionals need to stay sharp on current trends in medical toxicology. This lecture examines mind altering substances, initial prehospital approach to toxicology and stabilization for transport, poison control center resources, and ultimate emergency department and intensive care management. Pediatric Toxicology Dr. James Burhop Pediatric Emergency Medicine Children’s Hospital of the Kings Daughters Objectives • Epidemiology • History of Poisoning • Review initial assessment of the child with a possible ingestion • General management principles for toxic exposures • Case Based (12 common pediatric cases) • Emerging drugs of abuse • Cathinones, Synthetics, Salvia, Maxy/MCAT, 25I, Kratom Epidemiology • 55 Poison Centers serving 295 million people • 2.3 million exposures in 2011 – 39% are children younger than 3 years – 52% in children younger than 6 years • 1-800-222-1222 2011 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System Introduction • 95% decline in the number of pediatric poisoning deaths since 1960 – child resistant packaging – heightened parental awareness – more sophisticated interventions – poison control centers Epidemiology • Unintentional (1-2
    [Show full text]
  • WHO Guidance on Management of Snakebites
    GUIDELINES FOR THE MANAGEMENT OF SNAKEBITES 2nd Edition GUIDELINES FOR THE MANAGEMENT OF SNAKEBITES 2nd Edition 1. 2. 3. 4. ISBN 978-92-9022- © World Health Organization 2016 2nd Edition All rights reserved. Requests for publications, or for permission to reproduce or translate WHO publications, whether for sale or for noncommercial distribution, can be obtained from Publishing and Sales, World Health Organization, Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi-110 002, India (fax: +91-11-23370197; e-mail: publications@ searo.who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.
    [Show full text]
  • Methadone Poisonings in France
    2019 Extended Abstract Clinical Pharmacology & Toxicology Journal Vol. 3 No.2 Methadone Poisonings in France: A Seven-Year Experience of the French Poison Control Center Network Katharina von Fabeck1, Romain Torrents1, 2, Mathieu Glaizal1, Luc de Haro1, Nicolas Simon 1 Centre Antipoison et de Toxicovigilance, Service de Pharmacologie Clinique, Hôpital Sainte Marguerite, APHM, Marseille, France 2 Aix-Marseille University, Marseille, France Methadone is an opioid agonist prescribed in France for the methadone must be considered as a highly toxic medicine. treatment of opioid dependency. In order to evaluate the This investigation is a review examination of methadone exposures clinical toxicity of methadone, the authors present a seven- answered to the nine FPCC between October 15, 2010 and October year experience of the French Poison Control Center (FPCC) 15, 2017. The two pharmaceutical structures (case and syrup) Network at the national level. This study is a retrospective were thought of. Youth inadvertent poisonings were prohibited analysis of methadone exposures reported to the nine FPCC (diverse examination). 1415 instances of methadone harming between October 15th 2010 and October 15th 2017. The two were incorporated (29% female, 71% male, normal age 34 +/ - pharmaceutical forms (capsule and syrup) were considered. 10). 90% of the patients had history of compulsion and 69% were Childhood accidental poisonings were excluded (different treated with methadone (31% were gullible patients). The two study). 1415 cases of methadone poisoning were included (29% primary conditions were addictions (47% of the cases) and self- female, 71% male, average age 34 +/-10). 90% of the patients destruction endeavors (41%). In 45% of the cases it was containers, had history of addiction and 69% were treated with methadone in 35% syrup, obscure for 20%.
    [Show full text]
  • Health Canada's Biomonitoring Approach
    Health Canada’s Biomonitoring Approach Environmental Health Surveillance Workshop February 2013 Douglas Haines Chemicals Surveillance Bureau Environmental and Radiation Health Sciences Directorate Health Canada Presentation Objectives • To provide an overview of Health Canada’s biomonitoring approach • Main focus on the biomonitoring component of the Canadian Health Measures Survey • Framework and infrastructure for biomonitoring 2 Chemicals Management Plan In 2006, the Government of Canada launched the Chemicals Management Plan (CMP) to advance and improve the management of chemical substances and safeguard the health of Canadians. Risk Assessment Research Reporting, Risk Communication Management & Cooperation Monitoring & Surveillance Compliance, Promotion & Enforcement 3 Human Biomonitoring Context Knowledge Action Dissemination Exposure Biomonitoring Users synthesis & •Regulatory decision making •Public health Supporting Science: Identifying Priorities • Study design • Chemicals • Laboratory methods/validation • Population • Biomarker development • Geographic area • Pilot studies • Statistical methods • Tools to interpret biomonitoring data 4 Health Canada’s Multi-Pronged Canadian Health Measures Survey Biomonitoring Approach • General population (n=5,000-6,000) • Nationally representative Cycle 1 – 15 sites (2007-2009) Cycle 2 – 18 sites (2009-2011) Cycle 3 – 16 sites (2012-2013) Maternal-Infant Research on Environmental Chemicals • Pregnant women-infant cohort (n=2,000) • 10 study centres • Targeted recruitment First Nations Biomonitoring
    [Show full text]
  • Corporate Planning Highlights 2018-2021
    CORPORATE PLANNING HIGHLIGHTS 2018-2021 The Agency will improve the services it provides to Canadians so that clients receive the assistance that they deserve and rightly expect. —The Honourable Diane Lebouthillier, P.C., M.P Minister of National Revenue A MESSAGE FROM THE MINISTER This plan shows how the CRA, through innovation and the services it offers to Canadians, is striving to be a world-class tax and benefit administration. We face many challenges, and I am proud of the tremendous work that the Agency’s 40,000 employees are doing. I am especially proud of their ongoing efforts to improve and Meanwhile, Canadians can be assured that the Agency expand the services the CRA offers, and to implement more effective, fair and is taking action against those who seek to evade, efficient compliance measures to protect Canada’s revenue base. or aggressively avoid, their tax obligations. Further to recent revelations in both the Panama Papers and Paradise Papers, we undertook major work and In my role as Minister, I especially want to see the concrete and meaningful steps to make CRA services invested significant funds to crack down on tax evasion CRA exemplify service excellence in all aspects of its to northern residents more helpful and easier to use; and aggressive tax avoidance. Our goal is to ensure a operations. The Fall 2017 Report of the Auditor General supporting the Government’s goal of renewing and fair tax system and a level playing field for all Canadians. on the operations of our call centres shows that we establishing a better relationship with Indigenous peoples; Non compliance with Canada’s tax laws will not be do not always provide Canadians with the help they and expanding the popular and very useful Community tolerated as it erodes the integrity of the tax system.
    [Show full text]