Wanted: two million volunteers in Ontario to take part in what is being billed as the most ambitious long-term health study in North America and possibly, the world.Organizers are trying to capture a snapshot of the health of this legion of individuals and occasionally update it for the rest of their lives. About 100,000 volunteers will be asked to visit a health clinic for extensive measurements of health factors, such as vision, hearing, lung function and blood sugar levels.Of the 13 million people in Ontario, about 9.5 million adults qualify. Planners hope at least 20 per cent will register. Nearly all universities and teaching hospitals have endorsed the study.No one else in the world is doing this,said lead scientist Lyle Palmer, a biostatistician and genetic epidemiologist recruited from Australia to head the effort.Hopefully, the results will outlive all of us.In Ottawa, the recruitment drive is being highlighted on the outside and the inside of city buses, some 750 posters are going up in outdoor spots around Ottawa and the project is being promoted on Facebook and on Twitter.Large businesses and unions are also being asked to get their workers and members involved. By the end of January, it is estimated that about half a million emails will have been sent, said Palmer.
The information gathered will be a gold mine for health researchers.Much as it is taken for granted now, a similar long-term, large-scale study that started out in 1948 in Framingham, Massachusetts, eventually pointed out the link between smoking and lung cancer, and connected cholesterol, high blood pressure and obesity with heart disease.The Ontario study will eclipse Framingham, said Dr. Bob Roberts, president, CEO and chief scientific officer at the University of Ottawa Heart Institute.I think this is one of the all-time great things in Canadian medicine,said Roberts. We’ve wanted to do this for decades.A massive study like this allows researchers to tap into the population as a laboratory to determine how well new approaches work compared to existing treatments.
It can also point to lifestyle factors that damage or protect health, which can be cross-referenced with genetic factors. Heart disease researchers believe that 30 per cent of heart attack risk is genetic and 30 to 40 per cent can be prevented.It’s a critical step if we want to prevent cancer and heart disease,said Roberts, who expects the study will show geographical and lifestyle variables in patterns of illness.There are well-known carcinogens like smoke and asbestos. There are others yet to be discovered.Dr. Dean Fergusson, senior scientist and director of clinical epidemiology at the Ottawa Hospital Research Institute, studies drug safety and the effects of blood transfusions on cancer patients suffering from anemia. Having hundreds of thousands of patients in a database will help sort out the risks involved.
It’s hard to figure out all of the rewards that will be reaped 60 or 70 or 80 years down the road, said Fergusson.The Ontario project is even more significant than the famed Nurses’ Health Study, said Palmer. Established in 1976 and updated 1989, the nurses’ study followed 238,000 registered nurses. It is considered the most definitive long-term epidemiological study; it allowed researchers to look at how factors ranging from consumption of alcohol and whole grains to hormone replacement therapy have affected women’s health.This is far beyond what the nurses’ health study was able to do, said Palmer.The Ontario study will be able to probe health differences between ethnic groups. For example, immigrants from Asia have an increased risk of heart disease and some forms of cancer once they come to Canada, but the reasons aren’t entirely clear, he said. The study may also explain links between depression, heart disease and cancer.
Research results can also be funnelled back to the volunteers. People with diabetes, for example, would get the latest study results and tips on how to apply these to manage the condition.
Palmer said Canada has the good fortune of having some of the best-linked health data in the world.Participants will be able to register online. On paper, the questionnaire would be 55 pages. Online, the questionnaire immediately skips the questions that don’t apply. Women won’t be asked about their prostate history and men won’t be asked about their pregnancies. The questionnaire takes about 17 minutes to complete.But the success or failure of the recruitment drive depends on getting a rather complicated message across to the public on a relatively small budget. Billboards, for example, are too expensive. The project, one of five similar provincial projects across the country, has $42 million over five years in federal funding and another $27 million over five years in provincial money. Most of that will be spent getting the project off the ground.
The current ads appeal to a sense of altruism.We don’t want your money! We just want a few minutes of your time,reads one street poster.Ontario’s future generations need your help! says another.The job ahead won’t be easy, said Roberts, who jokingly suggested the study will need to get the kind of attention a Rolling Stones concert attracts in every major community.We need to have significant recruitment up front, or we’ll lose momentum.The opportunities for research will increase as technologies evolve, said Palmer.And there are a lot of questions we haven’t thought of yet. Finding out new things is interesting, But you have to translate that into the bedside,he said.
