http://www.redflagsweekly.com/superjuice.html
EQUINOX December 1994
SUPERJUICE: A PERILOUS PRESCRIPTION
A murky and deadly stew, Brandon sewage lagoon four, abutting the Assiniboine River, holds the waste from a controversial plant that processes the estrogen-rich urine of pregnant mares. Environmentalists, animal rights activists, and women's health groups are rallying against the production of the resulting drug, Premarin.
Premarin is a popular menopause drug. Few users know the side effects of its creation-horses as urine machines and a fouled prairie river.
Article by NICHOLAS REGUSH
Photography by DAWN GOSS
Five kilometres east of downtown Brandon, Manitoba's second largest city, I turn off the highway, steer quickly around a no-trespassing sign, and follow a narrow dirt road as it winds its way along what appear to be several small and medium-sized lakes. The largest of the "lakes" immediately seizes my senses. At least 30 hectares in area, it is being churned by windmill-like devices on pontoons, about 40 in total. The oversize blenders cause greyish foam and black crud to accumulate, giving off a swirling stench of urine and rotten eggs.
"That's it, lagoon four," says biologist Bill Paton of Brandon University. Paton is my unofficial guide on this hot summer day for a trek to the city's sewage-lagoon system, through which most of the wastewater from the city passes before heading to the fabled Assiniboine River. Dressed in rural casuals and sporting for adventure, Paton suggests we leave the car for a closer look.
Once outside, I reflexively pinch my nose. Brandon City Lagoon Cell No. 4 is essentially a giant vat of at least 18 million litres of decomposing urine from pregnant mares, known around town as PMU (pregnant-mare urine). The stench from the lagoon wafts over to Brandon from early spring to midsummer, making the city, in the eyes of some, the "odour capital of Manitoba." The owners of 500 prairie horse farms in Manitoba, Saskatchewan, Alberta, and North Dakota have their own name for PMU: superjuice. To them, the wrenching odour from lagoon four is the sweet smell of business success. From October to March, the farmers collect the urine from more than 60,000 pregnant mares and ship the fluid to Brandon-based Ayerst Organics Ltd., a division of Wyeth-Ayerst, a multinational pharmaceutical company. At the Ayerst plant, the only one of its kind in the world, highly valued estrogens are extracted from the PMU (estrogens are the hormones responsible for the development and maintenance of female reproduction). The extract is then shipped to manufacturing facilities in New York City and Montreal for use as the primary active ingredient in Ayerst's widely used menopause drug, Premarin.
On guard for the Assiniboine, biologist Bill Paton warns that sewage lagoons are useless in cold climates.
At lagoon four, Paton sees the cost of medical enterprise, and he does not like what he sees. On the basis of his survey of the international research on sewage lagoons, he is convinced that PMU waste by-products, particularly ammonia nitrogen, will adversely affect air and water quality in the region and have disastrous effects on the already-polluted Assiniboine. Driving past the lagoon to the banks of the river, I note that its waters are dark and murky, typical of silty prairie waterways. "You can't see it by looking, but this lagoon system is messing up that river and everything around it," Paton says sadly. So far, however, there has not been a thorough assessment of the environmental impact of the PMU waste, which is expected to reach the 40-million-litre level in the lagoon by 1997. At lagoon four, I watch Paton's benevolent face sour. "This is insane," he says in disbelief.
Paton's cry of alarm over PMU is just one of a number of disturbing flash points in a complex story. Noisy and downright ugly battles over the environmental impact of PMU have erupted in the Manitoba Legislative Assembly in Winnipeg. On a second front, animal rights activists in Canada and the United States have accused the superjuice industry of cruelty to pregnant mares and their foals. And on a third front, women's health groups are calling attention to the use of Premarin itself, arguing that synthetic substitutes are available for those in true need estrogen therapy. With their $50-million-a-year business at stake, PMU farmers, who have up to now said little in their own defence, are acknowledging that the choir of dissent is settling in for an extended run, and they are considering ways to mute the public impact. Only Brandon's Ayerst Organics, at the behest of its American parent, has opted for silence and business as usual.
Friendly, burly Rick Borotsik, mayor of Brandon, is telling me how wonderful it is that Ayerst chose his city for its PMU operation. "The company is a good corporate citizen that has brought cash flow to an agricultural region that can be rocked by the volatility of markets and prices," says Borotsik, his moustache dancing a polka. "PMU is not a very romantic product, but it brings stability."
When estrogen-replacement therapy was first employed in the 1940s for women experiencing menopause, the estrogen was extracted from the urine of pregnant women. By the time Premarin became popular as a menopause drug, the urine from pregnant mares was the new active ingredient. Today, according to Ayerst, Premarin is the most prescribed product among all pharmaceuticals in the United States, bringing in worldwide sales of US$749 million last year. That is the sort of stability of which Borotsik speaks.
But why Brandon, some 200 kilometres west of Winnipeg? Why not? he replies. Ever since it was laid out by surveyors of the Canadian Pacific Railway and incorporated in 1882, Brandon has been first and foremost agricultural. What better place to raise horses and establish a new kind of horse industry? When the multinational company came looking for can-do prairie spirit in the 1960s, some risk takers, strong on agriculture, activated the Brandon entrepreneurial ethic, and a relationship was established that has never looked back.
The years have, indeed, been good for Ayerst Organics in Brandon. So good, in fact, that in 1991, the company announced plans to expand plant facilities and to double production, at a cost of $123 million. The Western Economic Diversification Fund, a federal initiative, contributed a $25 million loan. The province of Manitoba, viewing the expansion plans as good for the economy, kicked in with a gift of $1 million for capital construction costs and qualified Ayerst Organics for up to $7 million in tax credits. Today, the new processing plant, painted a spanking bluish green, sits adjacent to the old one in the Green Acres Industrial Park in east-end Brandon, and was scheduled to go in full operation in the fall of 1994.
The arrival of Ayerst was a godsend for scores of area farmers. Instead of being exposed to the volatility in grain prices and other agricultural uncertainties, farmers who built up their operations with horses, pastureland, and special stables watched a nice, regular income flow in. It is not unusual, for example, for a PMU farmer to sell $150,000 worth of pregnant-mare urine to Ayerst each year. For Charlie Knockaert, a second-generation dairy farmer who converted his operations to PMU three years ago, the attraction is obvious, as I discover from touring his operations. In range of the town of Bruxelles, about 80 kilometres from Brandon, the Knockaert farm is post-card pretty, with a log cabin, a long row of planted trees, a large modern barn, several corrals, and hundreds of hectares of hilly and flat pasture.
After introductions, I sit with Knockaert at his kitchen table. A hardy 38, he laughs with gusto and is unfailingly pleasant and polite. I expect to hear the PMU party line, since he is president of the Manitoba PMU Producers Association, but Knockaert sticks to the personal. Farming runs in the family, he tells me. His Belgian grandfather started dairy farming when he arrived in Bruxelles in the 1920s. "Grandpa did a lot of hard work and a lot of sweat," Knockaert says. "His farm was turned over to my dad and then to his brother. We bought our own farm for dairy, and my father signed the note."
Eighteen years of milking cows turned out to be enough for Knockaert and his wife. In 1992, they sold the cows and spent $300,000 on Belgian horses. It was their son, Aaron, who suggested they apply to Ayerst Organics for a contract. The company was expanding, and the Knockaert farm was among 160 selected nearly three years ago from a waiting list of 900. The waiting list has since grown to about 1,200.
Knockaert finds the rhythms of PMU farming very different from the consistent routines of dairying. Summer is a relaxing time. The mares, which have recently given birth, are in the pastures with their foals. About 130 are grouped with seven stallions and will soon likely become pregnant again for another round of 11 months.
In October, the work on the farm intensifies. The mares are rounded up and taken to the barn. While the rest of the horses are housed in sheltered corrals, those which are pregnant, about 90 this fall, will remain in harness through March in stalls measuring 2.5 metres long and up to 1.5 metres wide. Once in harness, the "on-line" mares are fitted with a rubber "boot," or pouch, that collects their urine. It is attached to a hose that deposits the urine in a jug, which is emptied twice daily into a cooling tank. On Wednesdays and Saturdays, a tanker truck arrives and hauls the urine to Ayerst Organics in Brandon.
In caring for his horses, Knockaert follows strict guidelines set out by Manitoba's Ministry of Agriculture and Ayerst Organics. The dietary section instructs PMU farmers on how to use mature hay and grains in order to give the mares a properly balanced diet. Following the regimen supposedly makes it unnecessary to restrict water to get low volumes of concentrated urine.
Knockaert says Ayerst Organics inspectors pay the odd unannounced visit to a PMU farm. "But we don't need anyone else telling us to be good to the horses," he says. "My wife and I are always in the barn to make sure that everything is running smoothly." They check to see whether the urine pouches are comfortable on the horses and watch for signs of illness; if there are any, they isolate the horse in a large stall during the recovery period. They ensure the smooth operation of the automated machines that dispense oats and water and clean out the manure every day and sometimes even twice, to keep the air in the barn fresh.
Thus far, Knockaert hasn't mentioned what happens to the foals, so I bring it up. I detect a rise in emotion on his sunburned face. "We take them away from their mothers when they're three or four months old, beginning in September," he says. I ask him whether it is true that the foals are sold at auction to feedlots, fattened, and then sold for meat in Europe and Japan and for dog food. "Most of them are," he admits, "but some are sold for recreation or to dairy farms." The issue is a sensitive one: the Manitoba Animal Rights Coalition and groups in the United States, including People for the Ethical Treatment of Animals, are protesting the killing of some 60,000 to 75,000 foals in North America each year. They refer to them as by-products of an industry based on cruelty.
The same groups also claim to have reliable sources who have witnessed how some farmers abuse their horses. They say mares are confined in cramped stalls, fed poorly, denied water, and neglected. The groups also object on principle to the use of mares to produce the raw ingredients of Premarin, considering that synthetic hormones are available.
Elizabeth Carlyle, coordinator for the Manitoba Animal Rights Coalition, recently visited Knockaert. He describes the exchange as friendly but tough. "I told her that if she had evidence of any abuse, then I wanted to see it too," he says. "Sure, there can be problems from time to time. But if activists find one incident, they make it sound like the whole industry revolves around the one bad apple." Knockaert also suggested to Carlyle that PMU farmers take better care of their horses than some people are cared for in Winnipeg. So why didn't her group focus its energy on helping the homeless and the starving? Why was it picking on the horse industry?
Later, in the pasture, watching the big Belgians swish their tails to beat back horse flies, Knockaert turns to me and asks: "If I didn't have this, if I didn't farm, what could I do? Wind up in Winnipeg? And do what? Go on welfare?"
Beginning its 1,070-kilometre run in eastern Saskatchewan and meandering across southern Manitoba before joining the Red River in Winnipeg, the Assiniboine was once a vital water highway for the canoes of fur trappers and for the steamboats that transported settlers and goods. Old photographs show the river to have been a popular place to swim. Today, the water supply is being endangered by inadequately treated municipal waste, a prairie-wide problem. A 1991 federal environmental report rated prairie water quality as "close to a minimum level at many locations," and some predict that current economic, social, and climatic trends may cause it to drop to an unacceptable level.
Water quality is a particular problem in Brandon. For many years, the town piped all its wastewater, including the PMU waste, to its mechanical-treatment plant and then in a more clarified form to sewage lagoons for further dilution and ultimate discharge into the Assiniboine. But by 1986, the increasing volumes of alkaline and salty PMU waste were overwhelming the system. It was then mutually agreed that Ayerst Organics would truck its wastewater directly to lagoon four. The processing of PMU, however, was steadily on the rise, and the highly concentrated waste could not be diluted efficiently, resulting in foul odours. With the Ayerst expansion in 1991, the company proposed, with the city's blessing, to upgrade lagoon four at its own cost of $4 million. As part of the agreement, it vowed to correct the odour problem once and for all.
At the sewage-lagoon site, windmill-like aerators, costing about $10,000 apiece, are supposed to stir up the air so that lagoon bacteria requiring oxygen for survival will more easily break down the organic parts of the PMU. Ayerst Organics claims that the process will lead to the discharge of diluted, and therefore safe, levels of toxic products into the atmosphere. Today, the new dumping station at the site is ready to receive PMU waste from the company's tanker trucks on a daily basis. And there is a small newly dug lagoon adjacent to number four to remove any solids before treated wastewater is finally released into the Assiniboine.
Bill Paton has seen Ayerst's latest waste-engineering feats and is not impressed. He says Ayerst Organics and Brandon, like many companies and cities across the prairies, are not addressing the basic shortcoming of sewage lagoons. "They just don't do the job," he says, sitting in his laboratory at Brandon University, where he has taught for 20 years. "Unless they are all replaced by adequate treatment plants, the rivers, streams, and lakes will become more polluted and totally undesirable and unproductive. The fish will go, and all the biodiversity will be lost."
For one thing, he says, treated water released from sewage lagoons contains higher levels of phosphates than water processed in a treatment plant. Phosphates produce toxin-producing blue-green algae blooms and ammonia, he says. Also, sewage lagoons require a minimum temperature of 10 degrees C to sustain the bacteria required to break down sewage effectively and therefore are better suited to warm climates than to Manitoba's brutally cold winters.
Paton found some support for his views in the October 1992 report of the Manitoba Clean Environment Commission. It recommended that a study be conducted of sewage-lagoon design, construction, and operation. Environmental groups, condemning construction guidelines as being hopelessly out of date, want Manitoba to follow Quebec and Ontario policy and issue a moratorium on sewage lagoons. More recently, residents of several small communities in the province have questioned the viability of treating liquid waste and manure in sewage lagoons built near large hog farms.
There is little surprise that the Manitoba legislature has not acted on the commission's recommendation, Paton says. Indeed, the Conservative-led Manitoba government of Gary Filmon firmly supports lagoons, which are the cheapest form of sewage treatment. The Ministry of the Environment contends that waste is properly treated, because it is kept in lagoons for long periods and is discharged into rivers in a timely manner.
Paton counters that in 1992, the Clean Environment Commission identified 10 percent of Manitoba lagoons, including those at Brandon, as having a long record of failing to meet their licensed objectives. And, he adds, licensed objectives do not necessarily reflect modern standards. "There isn't even any restriction on phosphates," he says. "Total nitrogen levels, particularly ammonia, which is highly toxic to all forms of life, are often not regulated. And there is virtually no toxicity testing."
In December of 1992, he had one chance to raise his concerns about Ayerst's plans for the sewage-lagoon upgrade, months after the company had received the go-ahead from the city. Transcripts from the public meeting, held in the Brandon council chamber, document that Paton raised his concerns about the potential dangers of ammonia release from lagoon four. He wanted proof from the company and city that the emissions could be safely controlled. Ayerst Organics was directed to look into the matter and to submit to the province a broad report on the lagoon upgrade that would include answers to Paton's questions.
The company issued the report for provincial review in September 1993. It concluded, on the basis of a mathematical model, that ammonia emissions would be light during the summer months and significant in the winter, when they would cause little harm. Ayerst Organics also predicts that a significant volume of the PMU waste will be broken down microbiologically through a process called nitrification, an oxidation process whereby ammonia is converted to a less damaging nitrate. In short, there is nothing to fear.
Paton has studied the report and dismisses its conclusions. He says the company has no sound data that significant nitrification will occur, and he finds it peculiar that anyone would predict that air emissions of ammonia would be low in summer. "There is good data from prairie lagoons and from Holland that ammonia can be given off into the air in significant amounts during hot weather," he says. "We also have high wind conditions in the summer."
By contrast, he predicts that ammonia will rise and fall again in a 10-kilometre radius and then drain into the river. He is also concerned that the ammonia will continue to deplete the leaves of trees and shrubs of vital nutrients. His tests of plants in the area show that their alkaline content is high. "It isn't acid rain that is destroying prairie trees and shrubs, because there is little acidity to be found," he says. "It is ammonia that is doing the damage."
When I bring up Paton's dismissal of this new chapter in PMU waste management as a corporate and political fantasy, Brandon mayor Rick Borotsik acts as though I have just stolen candy from a happy baby. "Bill Paton is a critic of just about everything," he declares in a blink. "Our lagoon system doesn't fit into his philosophy." And he quickly adds: "He's a lone voice. I am convinced, my engineers are convinced, my council is convinced, and more than the majority of the community out here, both agricultural and urban, is convinced that we're right. Paton is a detractor."
Back in the 1940s and 1950s, when researchers were gaining a better understanding of menopause as an "estrogen-deficiency state," hormone therapy was initiated as a medical treatment for symptoms associated with "the change," such as hot flashes and vaginal dryness. In the 1960s and 1970s, women were also told that hormone therapy would protect against wrinkles, keep hair glossy, and reduce depression.
Now hormone therapy is being touted as protection against porous bones, or osteoporosis. For several decades, it has been known that estrogen helps protect women's bone. After menopause, when estrogen production declines, there is accelerated bone loss. To date, however, it is not clear how much this problem is due to the loss of estrogen as opposed to lifestyle and genetics. Furthermore, all women are not at equal risk for bone thinning and fractures.
Hormone therapy is now also being suggested for the prevention of heart disease, which rises dramatically in women over the age of 50. A report released recently by the Canadian Menopause Consensus Conference says that estrogen therapy can lower a woman's risk for developing heart disease by up to 50 percent.
There are, however, unknowns. For one thing, estrogen alone increases the risk of developing uterine cancer. There is also concern that estrogen has the potential to promote the growth of breast cancer.
Unfortunately, solid scientific information on the use of drugs in menopause is unimpressive. A report issued in May 1992 by the United States Office of Technology Assessment emphasized that there have not been sufficient studies that meet adequate design, duration, and sample-size requirements to determine the risks and benefits of hormone therapy, whether involving Premarin or synthetic medications. "It is quite a long-term commitment, perhaps 30 years, for women to make without knowing the long term effects of hormone therapies," says Nori Korsunsky, a health educator who runs menopause information sessions at the Women's Health Clinic in Winnipeg.
Meanwhile, a variety of daily side effects are known to be associated with estrogen supplements. They include nausea, changes in body weight, elevation in blood pressure, aggravation of migraine headaches, allergic reactions and rashes, nervousness, and dizziness. - N.R.
I am in Winnipeg, sitting on a bench on the grounds of the legislative assembly, listening to Marianne Cerilli's concerns about the expansion of Ayerst Organics and its boosted PMU production. First elected four years ago, Cerilli, 28, was until recently the New Democratic Party environment and workplace safety and health critic.
In February 1993, her office released a document entitled "The Business of Estrogen Production, the Environment and Women's Health." It called for a federal environmental-impact assessment of the PMU industry, taking into account not only the impact of PMU waste on the environment but also looking into the overuse of estrogen supplements. Cerilli is concerned about what she calls the "medicalization of menopause." She and other critics of Ayerst Organics point out that Premarin remains the only drug for menopause that is derived from animal estrogen and that other, synthetic forms of estrogen and estrogen substitutes are readily available. Estradiol tablets and patches are said to be safe, effective, and economical for those women in need of hormone therapy. Estrogen substitutes can be derived from Mexican yams or soybeans, and there are also alternative therapies, such as dietary changes, exercise, and the use of vitamins, that can be initiated to lessen symptoms of menopause.
"What's happening in Brandon is a perfect example of the lack of proper planning," says Cerilli, who was characterized as the enemy of jobs for Manitobans for questioning the PMU industry. "There were no connections being made between environment, economy, and health. We have a controversial product, and here is a decision being made to financially encourage the company to expand production, which could needlessly increase pollution."
The true challenge in North America, she says, is to guide industrial development toward a sustainable economy "where we're not destroying the very ecosystems that are keeping us alive and are the basis for the economy. The fact remains that this kind of economic development -- overproduction and overconsumption that ultimately lead to pollution -- is catching up with us. We will have to come to terms with that."
In the end, I have discovered, there is much to come to terms with: how we treat our water resources and animals and how we treat ourselves. But I am also left thinking of Charles Knockaert's stake in all this, both financial and emotional. On our drive back to Brandon after the tour of lagoon four, Bill Paton turned to me and said: "I want you to know that I want the best solution for Brandon, its environment, and even for Ayerst. But, damn it, tell me, Why can't we have an intelligent approach to this problem?"
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