AIR ISSUES AND HUMAN HEALTH: DIAGNOSIS AND PRESCRIPTION

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AIR ISSUES AND HUMAN HEALTH DIAGNOSIS AND
PRESCRIPTION
Dr. Quentin Chiotti Air Programme Director and
Senior Scientist qchiotti_at_pollutionprobe.org www.
pollutionprobe.org
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Pollution Probe is a Canadian non-profit
organization that

• Defines environmental problems through research
• Promotes understanding through education and
• Presses for practical solutions through advocacy

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Pollution Probe Programme Areas

• Major
• Air
• Water
• Energy
• Indoor Environments
• Climate Change

• Special
• Childrens Health
• Mercury Reduction
• Air Toxics
• Environmental Policy Development

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CLIMATE CHANGE 101
What is weather and climate?

• Weather is the day to day conditions 5-day
  forecasts
• Climate is average weather
• - and its variability
• - for a particular region
• - over a period of time
• Includes many different elements

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What climate change is NOT?
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What is climate change?

• Climate change is a shift in climate relative
  to a given reference time period

• It is caused by

• Natural factors
• Solar variability
• Volcanic dust levels
• Internal variability
• - Geological change

• Human factors
• - Greenhouse gases
• - Aerosols
• - Ozone depletion
• - Land use change

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The Atmospheres Energy Budget
Natural greenhouse effect warms the surface by
33?C -19?C instead of 14?C
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Primary Contributors to the Natural Greenhouse
Effect
OTHER
CARBON DIOXIDE
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25
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WATER VAPOUR
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Fossil Fuel Use
Energy Production and Use
Emissions
Atmospheric Issues
ACID RAIN SMOG CLIMATE CHANGE HAZARDOUS
AIR POLLUTANTS
NOX VOCs SO2 N2O CH4 CO2 PARTICULATE MATTER
TOXICS
COAL OIL NATURAL GAS OTHER
Limited emissions from various sources,
including biomass burning.
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Humanity is conducting an unintended,
uncontrolled, globally pervasive experiment whose
ultimate consequences could be second only to a
global nuclear war. World Conference on
The Changing Atmosphere Toronto, June
1988
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Cautious
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The IPCC progression in confidence
FAR "Our judgement is that the size of global
warming is broadly consistent with predictions of
climate models but it is also of the same
magnitude as natural climate variability SAR
"The balance of evidence suggests a discernible
human influence on global climate. TAR "There
is new and stronger evidence that most of the
warming observed over the last 50 years is
attributable to human activities."
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Global surface temperatures are rising
Relative to 1961-90 average temperature
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Proxy data also indicate that the recent warming
is likely unprecedented in at least the past
millennium
Source IPCC(2001)
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Canadian temperatures have also increased
substantially during the past decade
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Changes in temperature are unevenly distributed
Trends for 1950-98
Degrees C
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Canada is becoming less cold
Trend in 5th percentile of daily Tmin (Winters,
1900-1998)

• Number of cold spells are also decreasing
• Number of frost days are decreasing

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Northern Hemispheric intense winter storms appear
to be occurring more frequently
Figure 4
100
80
60
Storms per Winter
40
20
0
1900
1920
1940
1960
1980
2000
Year
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Arctic sea ice has become much thinner

• Arctic sea ice is becoming less extensive
• Arctic melt seasons are becoming longer
• Arctic spring snow cover has been declining
  rapidly

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Scientists have studied the relationship between
greenhouse gas concentrations and climate for
more than a century
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CO2 concentrations are now unprecedented in at
least the past 400,000 years
Methane and Nitrous Oxide
CO2 Concentration (ppmv)
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The abundance, atmospheric lifetime, and Global
Warming Potential of GHGs vary considerably
Carbon Dioxide
Methane
Nitrous Oxide
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CO2 concentrations will likely double and could
triple by 2100
Relative to pre-industrial
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These changes will make the world MUCH, MUCH
warmer than during the past millennium

• 4-6oC for central and northern Canada
• 3-4oC along western and eastern coastlines
• 3-8oC in Ontario

5.8C
1.4C
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Changing Temperatures
Annual mean
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By 2090, winter temperatures in most of Canada
could rise by 5 to 15 degrees or more
Winters 2080-2100
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and summer temperatures by 4 to 10 degrees
Summers 2080-2100
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Climate Change Commitments

• KYOTO PROTOCOL
• (2002)
• Commitment by developed countries to reduce
  greenhouse gas emissions 5.2 below 1990 levels
  by 2008-2012
• Canada is committed to a 6 reduction

• UNFCCC, ARTICLE 2 (1992)
• The ultimate objective is to achieve the
  stabilization of greenhouse gas concentrations in
  the atmosphere at a level that would prevent
  dangerous anthropogenic interference with the
  climate system. Such a level should be achieved
  within a time-frame sufficient to allow
  ecosystems to adapt naturally to climate change,
  to ensure that food production is not threatened
  and to enable economic development to proceed in
  a sustainable manner.

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Meeting the Kyoto target is a major challenge for
Canada
Projected BAU emissions 809 Mt
Emissions in 2000 726 Mt
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Kyoto and the Inevitability of Climate Change
The overwhelming majority of scientific experts,
whilst recognizing that scientific uncertainties
exist, nonetheless believe that human-induced
climate change is inevitable. . The question is
not whether climate will change... but rather how
much... how fast, and where Robert Watson, Chair
of IPCC to CoP6 Delegates, The Hague, November
2000
Stabilization 40 Kyotos Needed
Adaptation is necessary More mitigation is needed
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Benefits to Canadians include
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and lower space heating costs
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but there are also reasons for concern
Lowered freshwater levels
More severe weather events
Droughts
Higher cooling costs
Sea-level rise on all three coasts
Etc
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Impacts on our ecosystems
Forest fires
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C-CIARN CANADIAN CLIMATE IMPACTS AND ADAPTATION
NETWORK

• Sectors and Regions
• http//www.c-ciarn.ca/home.asp
• Health Climate Change Health Office, Health
  Canada
• 8 sub- issues
• http//www.hc-sc.gc.ca/hecs-sesc/hecs/climate/acti
  vity_update_q102.htm
• Adaptation and Impacts Research Group, MSC,
  Environment Canada
• Meteorological Service of Canada - Ontario
  Region, Environment Canada

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The Polar Bear THE symbol of Canadas animal
ecology at risk.
Is this a sufficient symbol to stimulate action?

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What about our own backyard?
Impact on human health?
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Towards an Adaptation Action Plan Climate Change
and Health in the Toronto-Niagara Region
POLLUTION PROBE in partnership with Environment
Canada Health Canada Ontario College of Family
Physicians City of Toronto City of
Mississagua/Peel Health University of
Toronto Quentin Chiotti, Ian Morton, Ken Ogilvie,
Abdel Maarouf and Maria Kelleher www.pollutionprob
e.org/Reports/adaptation.pdf
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Middlesex London Health Unit

• Media Releases
• West Nile Virus
• Cold Alert
• Boil Water Advisory
• Influenza
• Air Quality Monitoring

• In Our Opinion
• Air Quality
• Food Safety

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Health Effects from Climate Change

• Direct
• Temperature Extremes
• Extreme Weather Events
• Indirect
• Vector-borne and Rodent-borne Diseases
• Air Quality and Indoor Environments
• Water-borne and Food-borne Diseases
• UV Radiation

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Climate Change Health Pathways
Complex Non-linear Synergistic Counteractive
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Deaths due to excessive heat vs. excessive
cold 183 vs. 2,875
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Temperature Extremes

• Currently 19 - 40 deaths in Toronto due to heat
  during an average summer could exceed 150 during
  hot years
• Climate change would increase the frequency of
  hot days, (e.g., Toronto) leading to an increase
  in 239-835 heat-related deaths annually 171-447
  elderly in TNR by the mid 2020s
• 31 days over 30ºC in 2002, an average summer in
  2030

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Extreme Weather Events
Injuries, illness and death caused by carbon
monoxide poisoning, hypothermia, house fires,
motor vehicle accidents, slips and falls,
chainsaw accidents, electrocution, falling ice,
food poisoning, flu epidemics, stress and violence
Saguenay Flood, 1996
Hurricane Hazel, 1954 81 Deaths, 2,000 evacuated,
hundreds homeless, 1 Billion damage
Ice Storm 1998 25 deaths, 60,000 injuries 2
Billion damages
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Extreme Weather Events

• Warmer and more variable climate likely to cause
  more frequent and more intense severe weather
  events
• e.g., hurricanes, tornadoes, thunderstorms,
  floods, droughts
• Potential health impacts
• direct physical injury or death (e.g., due to
  storms, floods, etc.)
• psychological distress due to the loss or injury
  of loved ones and property
• mass evacuations
• moving into shelters
• Consequences
• increased demands on emergency preparedness and
  community health and social services

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Weather-related Road Accident Risk

• Weather affects road safety
• Billions invested annually
• Large residual risk remains

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Vector-borne and Rodent-borne Diseases

• West Nile Virus
• Malaria
• Dengue Fever
• Lyme Disease
• Hantavirus

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Weather/Climate and Vector-Borne Diseases

• Drought/intense precipitation
• Hotter summer temperatures
• Over-wintering
• Vector migration

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WNV IN ONTARIO

• April 2003
• 281 confirmed positive birds
• 598 confirmed positive mosquito pools
• 107 confirmed positive cases in horses
• 307 confirmed positive cases in humans 83
  probable 17 confirmed deaths
• EOHU 4 birds 2 MPs

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Imported Cases of Malaria in Canada, 1984-1997

• West Nile Encephalitis, New York, 1999
• 59 reported cases, 7 deaths
• Epicentre study 8,200 infections (3,500
  13,000), 1,700 with fever
• Study in Halton Region?

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2,000 PERSONS INFECTED
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Quantity/Quality of Water and Food

• Heat waves and droughts
• lower flows of water in lakes and rivers
• lead to water scarcity, poor water quality and
  may increase water-borne diseases
  (Cryptosporidium,Giardia)
• Heavy storms and floods
• surface water can be contaminated by storm sewer
  overflows
• (Pathogens from livestock sources and heavy
  rainfall/runoff linked to contamination of
  drinking water (e.g. Walkerton outbreak of E.
  coli O157)
• Hot weather
• can cause increased growth of micro-organisms and
  disease outbreaks at recreational beaches, as
  well as food poisoning from fish and shellfish

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Seasonal Distribution of Confirmed Food Poisoning
Cases in Canada, 1995
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UV-Radiation

• Warmer climate will encourage more outdoor
  activities (esp. among children) leading to more
  exposure to UV-B radiation
• Number of days with high/extreme UV has increased
  from 30-40 days in 1989 to 60 days by 1995
  (Toronto)
• Ozone layer will take 50 years to recover,
  leading to increased risk of skin cancer, eye
  disorders and impaired immune system mortality
  will peak in 2060

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Air Quality and Local Meteorology
Year Advisories Days 1993 1
1 1994 2 6 1995
6 14 1996 3
5 1997 3 6 1998
3 8 1999 5
9 2000 3 4 2001
7 23 2002 10 27
Influence of Hot Weather on O3
London 2002 14 days poor, 52 days moderate
2003 5 days poor, 67 days moderate, 34 days
NA
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Health Effects from Smog
In Ontario Annually

• 1,925 premature deaths
• 9,800 hospital admissions
• 13,000 emergency room visits
• 47 million minor illness days
• 1 Billion in costs

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Air Quality Monitoring and the Air Quality Index

• Fine Particulate Matter Added
• Health-based Index
• Air Quality Problem Potentially 365 Days a Year
• Physical activity and children

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Air Quality
Offensive air masses 5- 8X Background ambient
levels of ground level ozone could increase by 40
ppb
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The pictures pretty bleak, gentlemen The
worlds climates are changing, the mammals are
taking over, and we all have a brain about the
size of a walnut.
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Adaptive Response

• Public Education Communication
• Surveillance and Monitoring
• Ecosystem Intervention
• Infrastructure Development
• Technological/Engineering
• Medical Intervention

• Hot Weather/Health Watch Warning System
• Emergency Response Plan
• West Nile Virus Prevention and Control Programs
• Smog Alert (AQI) Smog Alert Plans

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Adaptation Action Plan

• Research
• Monitoring and Surveillance
• Education
• Partnership Building
• The Development of Structures to Coordinate
  Responsibility for Climate Change and Human Health

Toronto Star, Oct. 25, 2002
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Role of Local Health and Environmental Groups

• Provide information on key climate variables and
  health indicators
• Help educate and inform the public
• Address both mitigation AND adaptation
• Help assess the effectiveness of adaptation to
  current climate vis-à-vis climate change
• Consider using the Impacts message to engage
  the public in addressing mitigation actions
• Effective adaptation is essential to reduce
  vulnerability and adverse effects

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Role of Individuals - Adaptation

• Heat
• Stay in cool buildings, drink water, limit
  outdoor activities, wear light coloured clothing,
  wear a wide-brimmed hat, listen to weather
  reports for humidex advisories
• Extreme Weather
• Stay home be prepared
• Air Quality
• Avoid outdoor exercise, avoid exposure during
  peak periods
• Vector-borne diseases
• Wear protective clothing, apply insect repellent,
  remove standing water around your home, avoid
  outdoors during dawn and dusk, get vaccinated
  when traveling

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Mitigation Actions

• Uncertainty is no justification for inaction
• Precautionary Principle/No Regrets
• Co-benefits between GHG emission reductions and
  air quality

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Canadas GHG emissions involve many gases
and many economic sectors
2000 emissions
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GHG CONTRIBUTION FROM CITIES

• GREATER THAN 50 OF ALL EMISSIONS ARE UNDER THE
  DIRECT AND INDIRECT CONTROL OR INFLUENCE OF
  MUNICIPAL GOVERNMENTS, 1990

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Actions by individual Canadians account for 28
of GHG emissions each year - equal to just over
5 tonnes per year
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One Tonne Challenge
Reduce your emissions by 1,000 Kg
20/20 The Way to Clean Air
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Ontarios Smog Emissions Profile (2000)
Sulphur Dioxide (SO2)
Nitrogen Oxides (NOx)
Misc. 10
Other Industrial Point Sources 11
Vehicles 33
Misc. 12
Other Industrial Point Sources 18
Electricity 28
Electricity 16
Other Transportation 8
Off-Road Engines 22
Non-Iron Smelters - 42
Volatile Organic Compounds (VOCs)
Fine Particulate Matter (PM2.5)
Misc. 5
Misc. 2
Other Industrial Point Sources 19
Other Industrial Point Sources 14
Vehicles 10
Vehicles 19
Off-Road Engines 7
Off-Road Engines 8
Other Area Sources 8
Other Primary Metals 6
Non-Iron Smelters 5
Electricity 7
Residential (Area Sources) 12
Residential (Area Sources) 25
General Solvent Use 24
Surface Coatings 10
Other Area Sources 19
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Transportation The Major Polluter in Toronto
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Transportation

• Reduce emissions of the current transportation
  system using new and improved technologies
• Get more people out of cars and into public
  transit, particularly for commuting to and from
  work
• Change development patterns to slow urban sprawl
  and to encourage denser development

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CAFÉ Standards
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Transit ridership in Ontario 1991 - 2001
Ridership increased by over 15 in the last five
years
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Save Money and the Air by Reducing Trips

• Sponsors

Sponsored by the Government of Canada Climate
Change Action Fund and Transport Canadas Moving
on Sustainable Transportation Program
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• Central Ontario will grow by over 3 million
  people over the next 30 years
• Ontario could have an additional 3.5 million cars
  on the road
• VKT 157 million to 258 million
• 42 per cent increase in GHG emissions from
  vehicles

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NET GAIN PRINCIPLE

• Net gain is the overarching principle against
  which future urban form and growth management
  should be assessed.
• The basic concept is that growth cant be smart
  unless it results in a net environmental benefit.
• The Central Ontario Zone ecosystem is already
  overstressed in terms of pollution that
  results in poor air, water and soil quality.

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NET GAIN PRINCIPLE (continued)

• The net gain principle is directed towards
  restoring natural capital (e.g., forests,
  wildlife, agricultural land, clean air and water)
• The Central Ontario Zone should set aggressive
  net gain targets (relative to established
  baselines) and track progress using
  environmental indicators