Minister Cassar and medical experts insists ‘no link’ between power stations and cancer

Health Minister Joe Cassar, flanked by a panel of medical experts, said that there is no tangible link between the Marsa and Delimara power stations and higher incidence of lung cancer, asthma, or other respiratory diseases.

This comes in the wake of recent claims by Labour Leader Joseph Muscat that the Marsa and Delimara power stations are the cause of widespread respiratory diseases, who dubbed them "factories of cancer."

During the address, Minister Joe Cassar was pressed by the media to answer to these claims and justify government's rebuttal a handful of days ago. He was also referred to a case reported in local media of a woman suffering from cancer.

Cassar insisted that the government has "made it clear with statistics and research, that there is no link between a heavy-fuel oil power station, and cancer."

He insisted that "the probability of association of asthma is related to traffic and other factors, and not power stations using HFO."

Cassar also warned against using specific medical cases to generalise across entire areas or medical conditions. He also warned against using individuals or specific cases to score political points.

Cassar insisted that Malta's two power stations - both Marsa and Delimara - are operating within EU emission regulations, adding that the Environment and Health Ministry are working with Enemalta to ensure that EU directives are being respected and monitoring is on going.

Pressed about the role that power station air pollution plays in cancer and asthma, Cassar however insisted that in medicine, "it is impossible to be ever 100% sure. Medicine is not the field of absolutes. We can never know for sure."

He however pointed to the evidence presented by the medical expert panel.

The panel said that there are no findings that suggest that Malta's power stations are a leading cause of cancer, asthma, or other air-quality related health complications.

The panel downplayed factors such as power station pollution, pointing instead to what they insisted were far larger contributors, such as both first-hand and second-hand smoking, high-congestion traffic flows, and genetic predisposition towards the inheritance of such medical conditions.

The panel was composed of consultant oncologist Dr Nicholas Refalo, consultant respiratory physician Dr Martin Balzan, Director of health promotion and Prevention Dr Charmaine Gauchi, Director of Department of Health Information and Research Dr Nevile Calleja, National Health Screening Programmes Head Dr Nadine Delicata, and national health and screening consultant Mr Joe Psaila.

Dr Neville Calleja said that according to the World Health Organisation data, cancer in Malta in general is "at the bottom of the league in Europe" according to 2008 figures, adding that "we are the 2^nd lowest."

Both mortality rates and incidence rates are below EU average, and in terms of asthma, Calleja said "it is well known that we have a high rate of asthma in Malta, as confirmed by international studies."

He said that what is positive is that while the incidence of asthma in children increased between 1995 and 2001, the same rate dropped among teenagers. He also said that the lowest rate of asthma is in the South-East of Malta.

Calleja also said that the leading cause of lung cancer is "clearly" smoking, adding "while other causes exist, we would be kidding ourselves if we did not mention smoking as the leading cause."

"In terms of links with power stations, I researched foreign literature. I found studies linking coal-fuelled power stations with lung cancer. However with regards to fuel oil, the only study I found linking lung cancer with fuel oil are old studies dating back to before EU emissions regulations were introduced."

He also said that today, both power stations are operating with low sulphur emissions.

Regarding asthma, Calleja said that there are many factors affecting asthma, but insisted that "there is a strong element of con-genital inheritance. Meaning that 60% of asthma cases are inherited."

He noted that other environmental factors include the home environment, such as pets, smoking in the household.

"Obviously, as one goes down the list, one doesn't need to spell out, one finds pollution," he however conceded.

Calleja said that while it is true that asthma is on the rise, Malta is not alone, but conforms with a global trend where allergy-related illnesses, including asthma, are increasing across the EU.

Similarly, Dr Nicholas Refalo emphasised that lung-cancer is overwhelming related to smoking. He said that lung-cancer is the most frequent type of cancer, and that "9 out of every 10 cases are generally related to smoking."

"Air quality is undoubtedly significant, but it plays a minimal part," he said. "If smoking had to be cut out completely, lung cancer would become almost inexistent."

Regarding the power station issue, Refalo said that given Malta's size. "It is very hard to measure cancer with regards to higher or lower rates in specific areas given how one has such a small area. Malta is smaller than most cities in fact."

"I have no evidence that shows that there is one area of Malta that is harder hit than others by this sort of cancer," Refalo said.

Dr Martin Balzan recounted a study he had conducted between 1989 and regarding people who receive hospital care for asthma.

He noticed that Fgura and Cottonera, between 1989 and 1994, in adults aged between 15 and 55, the incidence of asthma was three times higher than the national average. He said that a similar hotspot was Msida.

Balzan said however said when the university tunnel was constructed and traffic was deviated away from Msida, the rate of asthma in Msida dropped to the national average - while Fgura and Cottonera remained a hotspot.

He said that the biggest environmental contributor were air particulates, which he said rose and dropped along with traffic peak hours.  He also noted that the Dry Docks used to have regular grit-blasting.

While he said that "the hardest thing in science is to establish cause and effect," he said that this suggests that the higher-than-average asthma incidence rate is related to the traffic created by the Zabbar road, than it is related to power stations."