Camelford water pollution incident

The Lowermoor Incident Health Advisory Group (LIHAG) was set up in January 1989 to provide expert advice to the Cornwall and Isles of Scilly District Health Authority on the health implications for the population of the Camelford area.[29] In 1989 the LIHAG reported that there was no convincing evidence of a harmful build-up of aluminium and that there was no increase in ill health from poisoned water. A further enquiry by the same group in 1991 acknowledged the affair had caused "real suffering" in the community.[30][31] However, Dame Barbara Clayton concluded that this was because of sensational reporting of the incident. She stated that "In our judgment it is likely that these symptoms would have occurred in the normal course of events," and the symptoms were wrongly attributed to the contamination because of "inaccurate and exaggerated" claims of health damage by scientists and the news media.[32] When the Clayton report was released in July 1989, it caused "outrage in Camelford and wide disbelief in the scientific community."[33] One section was later amended to read "alarming statements by pseudo-scientists" rather than "...by some scientists".[33]

In June 2000 Environment minister Michael Meacher announced that there would not be an independent public inquiry, and declared "All the facts are fully known and there is no reason to believe that a public inquiry could add to that."[34] In November 2000 the Environmental Law Centre prepared a petition to the European Parliament calling for a Brussels-based inquiry.[35] On 14 August 2001 the government announced that an investigation – although not a full public inquiry – into the incident would take place.[36] The investigation was to be undertaken by the newly formed Lowermoor Subgroup (LSG) consisting of scientific and health experts and local resident representatives, chaired by Frank Woods, a professor of medicine at the University of Sheffield.[36] Woods was also the head of the government's Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT), of which the Lowermoor team was a subgroup.[37] Its remit was to advise on whether the incident had caused, or was expected to cause, long-term harm to human health and examine whether the existing programme of monitoring and research into the human health effects was sufficient.[38]

A draft report, published on 26 January 2005, was inconclusive, saying that the long-term health effects on the population were still unknown and that there was insufficient scientific information available to determine whether the health problems being experienced were caused by the contamination.[39] Woods called for further studies and said: "We will be putting the strongest possible case to the minister. I believe carrying out that work is important, it is not something which should be dropped and pushed aside."[39]

The following year, Meacher made several criticisms of the group:

• the requirement to examine the DoH's handling of the incident was removed from the terms of reference
• no independent expert on aluminium toxicology was included in the working group
• an attempt was made to include Waring as medical adviser to the group, even though he was the author of the original letter stating that no lasting ill effects would result
• no objective testing of the exposed population was carried out
• too much reliance was placed on the water sample analysis from the South-West Water Authority, the compromised party
• the amount of sludge reported to have been in the contact tank at the time was ignored
• experts were drawn on who had potentially vested interests in the aluminium industry
• the DoH pre-released a highly misleading statement of the findings two days before the draft report was due to be made public
• the executive summary, prepared without the group's approval, and which effectively concluded that the illnesses reported bore no connection with the water poisoning, was "misleading and biased".[27]

Two members of the LSG committee claimed in December 2007 that the DoH had known from the start that some people were at especially high risk from aluminium poisoning but deliberately suppressed this evidence to protect the government's plans for water privatisation.[40][41]

The final report was published in April 2013, and concluded that it was unlikely that the exposure to chemicals could have caused long-term health problems. Key findings of the report include:

• there is no evidence that the combination of metals which occurred as a result of the incident could have caused delayed health effects
• there was an increase in childhood infections in the area, but this increase occurred before the pollution incident
• a study of cancer incidence and mortality showed that there was no increase in cancer incidence in the area after the pollution incident
• a dermatologist investigated skin and nail problems reported by individuals affected by the incident, and reported that the problems are similar to those experienced by the general population
• there is no evidence that the contaminants can cause joint or muscle pain and/or swelling, and these complaints are common in the general population
• a Camelford resident who died of severe cerebral amyloid angiopathy was found to have higher than normal aluminium concentrations in the brain during an autopsy. However samples from the brain of a patient with similar neuropathology but unknown aluminium exposure found similar higher than usual concentrations. Research commissioned by the coroner compared 60 postmortem brains and found no correlation between aluminium or iron concentrations and the level of congophilic angiopathy or senile plaques[11][12]

A diverse array of short-term health effects was reported by members of the public who either drank the contaminated water or came into contact with it while bathing.[16][28] These included:

• urinary complaints,
• blistering and peeling of skin,
• hair turning blue or green,
• diarrhoea and vomiting, and
• joint pains.

A 1999 report in the British Medical Journal concluded that some victims had suffered "considerable damage" to their brain function.[42] This contradicted the 1991 LIHAG report telling residents that their symptoms were due to anxiety. The study was led by a consultant nephrologist at John Radcliffe Hospital, Oxford, and was the first large-scale clinical study of the affected residents. The report stated that their symptoms were similar to those of Alzheimer's disease, which has also been linked with large quantities of aluminium accumulating in the brain.[32] Rejecting the findings of the LIG, the report called for further research to determine the longer term prognosis for the affected individuals and led to fresh calls for a public inquiry into the pollution incident.[43] Although the study was carried out in 1991, its publication was delayed by the ongoing litigation between SWWA and the victims.[44]

Victims have reported:[31][35][45]

• fatigue,
• fibromyalgia,
• premature ageing,
• loss of short-term memory, and
• multiple chemical sensitivity.

Seven months after the contamination, one victim underwent a bone biopsy which "found a ring of aluminium like the rings you see in trees" that could not have resulted from normal aluminium absorption.[18][27]

The husband of Carol Cross, who died of a rare form of dementia in 2004, said in 2006 that he believed that his wife and twenty other people had died as a result of the disaster, and that more cases were emerging.[16]

Victim Sarah Sillifant, who was in her twenties when she was exposed, hanged herself in 2005 after suffering dementia and other symptoms similar to those experienced by Carol Cross.[16] In June 2007, Irene Neal, who lived in Rock, near Camelford at the time of the incident, died aged 91. A post-mortem examination found an "unacceptable amount of aluminium in the brain".[46]

In 2006 a post-mortem inquest into the death of Carol Cross at age 58, who was exposed to the contaminated drinking water aged 44, showed that her brain contained 23 micrograms of aluminium per gram of brain, compared to the normal brain levels of 0–2 micrograms per gram. Her death was caused by a form of early-onset beta amyloid angiopathy, a cerebro-vascular disease usually associated with Alzheimer's, which could be connected to the abnormally high level of aluminium in her brain.[47][48] Michael Rose, the West Somerset Coroner, said of the findings: "Further research will be needed before the significance of the elevated brain aluminium concentration in this case can be clarified. A scientific report on the case has been submitted for publication."[48] Daniel Perl, of New York's Mount Sinai School of Medicine said: "If additional similar cases were to appear among the 20,000 exposed individuals then the implications of this incident would become extremely important. Only time will tell. At the very least, increased efforts towards surveillance of individuals exposed in Camelford is certainly warranted."[49]

Rose had adjourned the inquests for Cross and Neal pending further studies, but in 2008 said the Government had refused "to either finance or assist" research to test the hypothesis of a link between exposure to aluminium and congophilic amyloid angiopathy. He said this research was necessary to determine the consequences of the deceased having such a high level of aluminium. He later sought support from Somerset County Council so that the work could go ahead and once more adjourned the inquest into the death of Carol Cross, although Neal's inquest went ahead.[50]

In July 2009 Rose announced that the inquest into Cross's death would resume in November 2010.[51] Rose said that "ongoing medical research would not be completed until late summer" 2010. He explained "This research is necessary to prove whether or not the high level of aluminium in Mrs Cross's brain causing her death through beta amyloid angiopathy (a form of cerebrovascular disease) on 19 February 2004, could be attributed to the aluminium sulphate placed in the public water supply at Lowermoor treatment works on 6 July 1988. This is the last adjournment I am able to agree and the inquest will commence on Monday 1 November 2010 at Taunton."[51]

When the inquest was reconvened Dr. Chris Exley, a reader in bioinorganic chemistry at Keele University, said "The brain aluminium concentration was so high that it is highly likely that it contributed to her brain pathology, probably being responsible for the aggressive form and very early onset of the disease." Neuropathologist Prof. Margaret Esiri, from the John Radcliffe Hospital, said "I have never seen a case such as this at this age. I have seen one case in a woman who died aged 81 but the literature shows only a handful of cases worldwide."[52] As a result of their evidence the inquest was again adjourned to allow South West Water Authority time to seek its own expert evidence.[53]

Carol Cross's inquest was finally completed in March 2012. The coroner returned a narrative verdict recording the circumstances without attributing the cause, in which he said the water supply company, South West Water Authority had been "gambling with as many as 20,000 lives" when they failed to inform the public about the poisoning for 16 days, a delay he called unacceptable. An expert said at the inquest that the levels of aluminium in her brain were "beyond belief".[5]

Rose stated: "I found there was a deliberate policy to not advise the public of the true nature until some 16 days after the occurrence of the incident," and that "[T]he failure of the authority to visit every house after the incident to advise them to thoroughly flush their systems [w]as a serious dereliction of duty. I can say that the incident may either have contributed to or possibly caused Mrs Cross's death, but I do not have sufficient evidence to say so conclusively."[54]