NB Report finds herbicides, heavy metals not cause ‘most’ unknown neurological diseases
environmentIndoor substances such as herbicides and heavy metals are likely not causing the neurological symptoms reported by hundreds of New Brunswickers, according to the findings of the province’s investigation into a so-called mysterious brain illness.
Chief Medical Officer of Health Dr. Yves Leger on Friday released the final report on the investigation into 222 cases of “uncontrolled neurological disease.”
The investigation was launched last March To further understand concerns raised in 2023 by Moncton neurologist Dr. Elior Marrero about elevated levels of the herbicides glyphosate and glufosinate and several different metals, such as aluminum, arsenic, lead and mercury, in some patients.
“The main findings do not suggest that exposure to certain environmental substances was the likely cause of disease in all or most of the patients studied,” Léger said at a news conference in Fredericton when the report was released.
Asked for clarification, Léger said the findings are based on the group of patients as a whole and do not point to any “broad… risk” that is “contributing to the majority of patients’ illnesses.”
“We can’t speak specifically to individual patients because we didn’t look at individual patient files, we looked at individual (test) results,” he told CBC News.
The report does not identify what is causing people to become ill, with symptoms ranging from painful muscle spasms and hallucinations to memory loss and behavioral changes – a condition that has generated international headlines and heated debate for years.
New Brunswick’s chief medical officer of health says all available evidence points to a known cause for many of the cases that some had suspected were a new or unknown disease.
But Leger said the latest findings as well 2022 report of the previous government The initial group of 48 patients consisted primarily of people from the Acadian Peninsula and the Moncton area, as well as a scientific group. The study published last May in the Journal of the American Medical AssociationSuggest that the patient is potentially suffering from a disease that can be diagnosed.
He said the nine autopsies reviewed pointed to known conditions such as Alzheimer’s disease, Lewy body disease and Creutzfeldt-Jakob disease (CJD).
Leger said, “When we started this work, we knew it would not provide all the answers patients were looking for. We knew this would not be the end of the work that needed to be done on this file.”
Patient reviews are mixed
Sarah Nesbitt, 42, of Canaan Station, north of Moncton, is one of Marrero’s patients and works as a co-liaison between patients and the government. He described the report as “double-edged”.
Many patients are “frustrated,” he said. They still don’t know what caused their illness, how to get better, or how to prevent others from getting sick.
“They think it’s the same as the first one (reported in 2022), but at least this time, they found ‘some patients who had elevated levels of herbicides and heavy metals,'” he said.
According to Léger, the data collected by Marrero had “significant limitations”.
For example, the best type of specimen to test for a particular substance, such as blood or urine, was not always used, and “very few” patients who tested high were retested to verify the results.
Still, for herbicides, the province found that about 95 per cent of results were “within normal or expected limits” when compared to laboratories’ reference ranges and were similar to levels for other Atlantic Canadians.
For heavy metals, approximately 93 percent of the results were within normal or expected levels when compared with reference limits and were similar to or lower than most Canadian samples “Some elevations were noted for some metals.”
Nesbitt questioned the lack of follow-up testing. She has been ill since 2020, she said, when she lived in Steeves Mountain, about 20 kilometers east of Moncton, and Marrero tests her every six months.
“I get about 23 to 24 vials of blood and a 24-hour urine test every time,” he said.
Still, patients are encouraged to know the province is no longer going to “give up” on them, he said. “There is still work to be done.”
3 recommendations
According to Leger, the report makes three recommendations that provide a “way forward.”
There have been calls for a process to be introduced to help patients get a second, independent assessment and diagnosis of their illness, which will help them get the care and follow-up they need.
The report said testing for herbicides or metals should only be done “when there is a clear reason, such as when symptoms are present, or a potential risk has been found.” The correct type of sample must be used to provide more accurate and reliable results, and tests showing high levels should be repeated at least once.
Furthermore, the report recommends that a formal process be implemented, requiring two experts to review and agree on reports of unknown neurological disease in a patient.
Léger said he hoped all three would be implemented “as soon as possible”.
The provincial government has asked the Public Health Agency of Canada, or PHAC, to review the raw data from individual patients “to see if there are any trends or issues of concern,” Leger said.
A timeline for the agency’s work will be set once the informed patient consent process is completed, the data-sharing agreement is in place and the data is shared, he said.
An unidentified PHAC spokesperson declined to comment, referring all inquiries back to the province.
Nesbitt said he hopes they will approach patients and “think deeper instead of just sitting behind a desk reading paperwork.”
Dalhousie Junction patient co-liaison Stacey Quigley-Cormier, whose Stepdaughter Gabrielle, 24, is one of the youngest patients Suffering Symptoms also hopes that the PHAC review will “present a more accurate picture of why patient clusters exist, have unusual presentations of the disease and will take into account environmental concerns.”
“The patient reality is that there are geographic clusters, testing results are similar and there is a large portion of patients who have had repeated tests,” he said in an emailed statement.
Regulatory body to determine next steps
Leger referred questions about Marrero’s capabilities and any possible disciplinary action to the College of Physicians and Surgeons and Vitality Health Network.
The province has no intention of filing a complaint against him, he said, adding that neurology is a complex field and diagnosis can take months or even years.
Having said that, he added, “… there is a body of good evidence” that suggests that patients may have conditions that may be underdiagnosed, which is “very worrying” because they are suffering and do not have a proper treatment plan.
In an unsigned email statement, the provincial regulatory body said it “recognizes how difficult this situation has been for the many patients affected.
It added, “We will carefully review the report and its recommendations to determine whether any further action is required by the college.”
Vitalite also said it would “take time to carefully review the report before determining next steps.”
It said patients will be kept informed.
Nesbitt said patients stand with Marrero.
“I want people to focus on the patients, not shame and attack the doctor who has done his best for us and done his due diligence for his patients,” she said.
Marrero did not respond to requests for comment.
