Wednesday, 30 May 2018
Senator RHIANNON: I'd like to go back to your work on the PFAS contamination.
CHAIR: We're going back to PFAS? That's fine. Can I interrupt there for a second. We have got confirmation that the TGA are no longer required, so they are released, along with those in program 5.1 who are not needed for a later outcome. Sorry, Senator Rhiannon, I just wanted to let people go home when they can.
Senator RHIANNON: Yes, that is understandable. I want to continue with some questions about PFAS contamination. Does the department have a policy when it comes to applying the precautionary principle?
Dr Hobbs: Yes. Thank you for the question, Senator. The approach that we are taking is a very precautionary population health approach, and it really does reflect the advice of the expert health panel, which basically stated in their summary that, even in the absence of any consistent ill-health effect in humans from exposure to these chemicals, because they persist in the environment and can bioaccumulate, you do need to take a precautionary approach, and that approach is certainly to mitigate ongoing exposure of the population. The second approach, of course, is—in recognition of the concern, worry and in some cases mental health distress that this can cause residents in those investigation areas—to provide ongoing support through the approaches that we talked about before, so the online support through Support Now, face-to-face psychological support and obviously working with local general practices or Aboriginal medical services.
Senator RHIANNON: I got down notes about mental health issues, but what was the first aspect of how you're responding in terms of the precautionary principle, please?
Dr Hobbs: The precautionary approach is that, because these chemicals persist in the environment and can bioaccumulate, even in the absence of any consistent evidence of human harm due to exposure, the approach should be to mitigate or reduce ongoing exposure to the chemicals over time.
Senator RHIANNON: Thank you very much. Going on to the report of the Expert Health Panel for PFAS, I just want to read out this quote because I think it is probably what you're referring to in part: … the panel noted that even though the evidence for PFAS exposure and links to health effects is very weak and inconsistent, important health effects for individuals exposed to PFAS cannot be ruled out based on the current evidence. I imagine that's the summary of the report that then gives a frame for your approach with the precautionary principle. Is that fair to say?
Dr Hobbs: Yes, that's correct, Senator.
Senator RHIANNON: You've outlined the mitigation and then also handling people's wellbeing and their mental health. Wouldn't it be wise, in the context of a precautionary principle approach of making a recommendation to other government departments dealing with PFAS contamination, for the residents actually to be bought out so they can leave their properties?
Dr Hobbs: That is a matter for the government. It's certainly not a matter for Health.
Senator RHIANNON: But how do you distinguish what's a matter for government and what's a matter for the health department? I've been interacting with the Department of Defence over this for many years, and I note that they will make decisions about supplying people with clean water and giving them advice about what they can eat and can't eat, but, when you get to aspects of this issue that involve large amounts of money, then it becomes a government decision. It was a very impressive answer that you gave with regard to the precautionary principle. Particularly, it was really welcome to hear how you set out the issues to deal with the worry that many people have, the mental health issues, and the support that you're giving. Many of those mental health problems are arising because people are now not certain of their future. They literally don't know what to eat. In many cases they've given up a hope of staying in their place and feel that they need to move now, but their place is worthless. Nobody will buy it. They've also got no money for their future, because many people's assets are tied up in their family home. So isn't the issue of compensation or the issue of buyouts part of a mental health approach?
Dr Hobbs: The approach from a Department of Health point of view is, first of all, to look at the evidence, to mitigate ongoing exposure and to understand that each community has its own special requirements or specific details. That's where the human health risk assessment comes in—that very, very extensive piece of work undertaken by experts to understand, in that specific investigation area, the routes of exposure. Most of that is through water, but there are some exposure risks through locally produced food, of course. There is mitigation of that ongoing exposure through provision of safe water. That's been through either bottled water in the short term or tank water or indeed a connection to the reticulated water through the local council. There is provision of mental health services, of course—noting that there is no treatment for reducing levels of these chemicals. They do reduce slowly over time. When it comes to broader considerations about compensation or the like, that certainly is not a matter for Health; that is a matter for the task force and for the whole of government. That is certainly not from the Department of Health, Senator.
Senator RHIANNON: I will just explore that a little bit further. You've again spoken about water and produce. I imagine that those decisions are decisions that your department's making and that you wouldn't be giving the answer, 'Well, that's a matter of government.' Is that fair?
Dr Hobbs: Clearly, the Department of Health has worked closely with colleagues from the Department of Defence, the Department of the Environment and Energy and the Department of Agriculture and Water Resources in having a joined-up approach, because not all the levers and approaches to mitigate ongoing exposure sit with the Department of Health. Our primary role, of course, is to bring evidence to the table around exposure to these chemicals ongoing, and then clearly we look to new evidence as it might come forward, but clearly other departments across government have an important role here as well. We work closely with them, and that has happened through the interdepartmental structure. Maybe my colleagues can speak to that.
Prof. Murphy: I think, Senator, Dr Hobbs made it pretty clear that our remit in the Department of Health is to look at the potential health impacts of exposure to PFAS and to do what we can do mitigate those health effects. It's not our remit to look at the broader issue of compensation for people who feel that they may well have suffered financial hardship. That's a matter for other departments of government and government itself. It's not a matter for the Department of Health.
Senator RHIANNON: Let's take the word 'compensation' out of it. Going back to the answer to the original question about the precautionary principle: the second aspect was that detailed answer about the mental health aspects of it and the recognition that supports need to be given and how you're giving support. If part of the consequences of this contamination is that people's remaining in their home, remaining on their land, is causing the mental health aspects, isn't part of the precautionary principle recommending that something be done about that?
Prof. Murphy: I think that the role of the health department in that particular regard would be to reassure them about the fact that there really isn't a risk to their health, on current data, but the precautionary principle is such that they should make sure that they reduce exposure, and to try to provide counselling to support their mental health issues. But, broader than that, to deal with their life circumstances, as with anyone with mental health concerns, is probably not the broader remit of the Department of Health.
Senator RHIANNON: But isn't the definition of 'precautionary principle' not just about reducing the exposure but actually about removing the exposure? There are some very interesting examples around health issues where the science may not be conclusive or isn't conclusive but there are certainly concerns, and then the precautionary principle, if it kicks in, is about people or the environment—about not using those chemicals because of the potential problems that can occur. It seems as though you're using a slightly different—
Prof. Murphy: No, I think we have been saying that our precautionary principle is to determine very safe levels in water and food and to recommend that all steps are taken to reduce exposure, with a huge margin of error, because, as we say, there is currently no evidence of adverse health impacts. That's very much in the remit of the Department of Health and its evidence base. More broadly, you could draw the analogy of people with mental health conditions because of their social circumstances and other situations. It's not our remit to address all of these issues. Our remit is to address the evidence of health issues and the response to those health issues. The other arguments are for broader government consideration.
Senator RHIANNON: But, again, it would appear that you have veered away from the accepted definition of 'precautionary principle', which I understand is used by policymakers to justify discretionary decisions in situations where there is a possibility of harm from making a certain decision when extensive scientific knowledge on the matter is lacking. Now, we know that there are a divergence of views around PFAS, but there is certainly a view—and it was identified in the quote that I shared with you from the Expert Health Panel for PFAS, where it says—that 'health effects for individuals exposed to PFAS cannot be ruled out based on the current evidence'. Therefore, I come back to the accepted definition of 'precautionary principle'. When extensive scientific knowledge on the matter is lacking or not decisive, one then avoids the harm by removing it, whereas your mitigation measures are still leaving people in a situation where they can be exposed.
Prof. Murphy: No; our mitigation measures are reducing exposure. That's why there is an alternative water supply in Katherine. That's why we have made recommendations. That's why we have measured the environmental exposure. We have made recommendations based on the best available health evidence to reduce exposure, exactly consistent with what the expert panel has recommended.
Senator RHIANNON: But you're leaving them in the situation where they still are exposed to it.
Dr Hobbs: If I may say, Senator, that's why the human health risk assessment is so important. As I said, that's a very, very extensive and intensive study of the environment in those investigation areas—the groundwater, surface soil and various foodstuffs produced locally. The roots of exposure for that population in that particular circumstance are very well understood, so you can put in place ways to mitigate ongoing exposure, and that is exactly what happens. We know that the major root of exposure is through water. So providing alternative sources of water is the No. 1 priority. Giving advice about limiting locally-produced food the local jurisdictions—and obviously Food Standards Australia and New Zealand talked about trigger factors for that—is very much a sitespecific approach informed by the evidence collected as part of that human health risk assessment. Then there is the ongoing reduction of exposure over time. I'm confident that, when those measures are put in place, the risk to people of ongoing exposure to these chemicals is mitigated to a very large extent.
Senator RHIANNON: I want to move on to some questions about how the panel is working and the interaction with Defence. What input did the Department of Defence have in the expert health panel for the PFAS report?
Prof. Murphy: There was no input at all. We were very careful to select people who were experts in the area of toxicology and pharmacology who had no engagement with Defence. In fact, we excluded some experts who had been consultants for Defence in the past. We did not consult Defence. This panel was appointed by the Minister for Health on the basis of their independence, including an international expert who had no knowledge of Australia at all, and the other Australian members were people who were completely devoid from any of the Defence responses. It was entirely independent. The minister was very clear about the need to have true independence to get community credibility.
Senator RHIANNON: I also want to ask about the National Health and Medical Research Council's four-year study. Is the entire $12.5 million to be allocated to the NHMRC and its targeted call for research?
Prof. Murphy: I believe so, Senator.
Ms Appleyard: Senator, I think that's correct. There may be a small amount of that, around $200,000, available to support the expert health panel. I would just have to clarify that for you, but I think that's correct.
Senator RHIANNON: That was my next question. Has some of it gone to the Department of Health's expert panel and the PFAS report?
Ms Appleyard: Yes. My understanding is that that's $200,000, but I will correct that for you on notice if that does not happen to be correct.
Senator RHIANNON: The NHMRC has stated: The Government will invest $12.5 million over four years to increase the body of evidence and understanding of potential human health effects of prolonged exposure to per- and poly-fluoroalkyl substances (PFAS). That statement clearly covers a large territory. You've really got a wide range of investigation there. Could it be involved in increasing the body of evidence of understanding of potential human effects of exposure to PFAS? Have you thought of narrowing it down?
Dr Hobbs: One of the outcomes of the work of the expert health panel was to better inform that targeted call for research. The expert health panel have made several suggestions about how that research could be taken forward, including the need for longitudinal cohort studies and use of blood tests over time. There is a range of suggestions considered as part of that expert health panel report, and they have been provided to the NHMRC to help inform them as well.
Senator RHIANNON: So will it be the Department of Health or the NHMRC who will be responsible for designing the parameters for the research?
Dr Hobbs: It will be the NHMRC.
Senator RHIANNON: I actually meant the research grants. So they'll work on all that. When can we expect to see the details of the NHMRC's target?
Prof. Murphy: We'll have to take that on notice and consult with the NHMRC. I should point out that there is also a pre-existing significant research study being conducted by ANU on epidemiology of PFAS. This was funded previously by government some years ago. That's well advanced and that's being informed by the three investigation sites and the blood test program that's being done. They've done their own literature review and they're doing a significant study of the epidemiology of those areas. So that's already underway.
Senator RHIANNON: I wasn't aware of that, so thank you for that. Considering that, which sounds substantial, from a great university, was it judged we needed additional work, or is this in parallel to it?
Dr Latham: I think this will be additional research work. It may complement the work that the ANU has been doing—that's to be determined—but I think government is very keen to address the unanswered questions, as you said in the report, that there is still, given the accumulation of these substances, the potential that we can't be absolutely sure that there are no adverse human health effects and, therefore, more research is needed. Australia has a very strong research community in this area, and I think we want to get as much evidence as possible.
Senator RHIANNON: Can you also take on notice the time line for the grant applications?
Dr Latham: We can provide that.
Senator RHIANNON: Will the purpose of the research simply be observational? Will the studies be limited to a periodic measurement of health parameters and PFAS levels in the affected population?
Dr Hobbs: That's to be determined.
Senator RHIANNON: Geographically, considering this is in so many areas now, is that to be determined?
Dr Hobbs: Again, that will be determined.
Dr Latham: That's in contradistinction to the work taken forward by the National Centre for Epidemiology and Population Health at ANU, which is concentrating on the communities of Oakey, Williamtown and Katherine.
Senator RHIANNON: I also notice that the panel recommends involving representatives of the exposed occupational group and/or community in study advisory committees for future PFAS research. Will this recommendation be included in the department's request to the NHMRC for the targeted call for research?
Dr Hobbs: That advice has been given to the NHMRC as part of the panel's report, so they have that already. Again, going to the work of the ANU, they are conducting as part of their study protocol community consultations with focus groups in each of those three affected communities.
Senator RHIANNON: You mentioned the university study. There's also been a Department of the Environment and Energy study. I think they looked at remediation and contamination in the soil. Will you be pulling in all these other studies as well?
Ms Appleyard: That's a separate research process that's occurring as well.
Prof. Murphy: It might be helpful if we agree on notice to ask the NHMRC to provide you with a detailed report on their plans, because they're not here at the moment and it would be helpful if they responded in detail.
Senator RHIANNON: Okay, good. Thank you.