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Monday, 13 February 2012

Air pollution, health effects and the Air Quality Health Index (AQHI)

As noted previously, the AQHI is a uniquely Canadian approach to communicating the risk from poor air quality.  Communicating the risk of weather.  There are an estimated 4000-20000 Canadians who die prematurely each year from poor air quality.  The higher number comes from the Canadian Medical Association analysis http://www.cma.ca/icap .   Health Canada, Environment Canada and the Auditor General use numbers between 4000-5900.   Irrespective, the cumulative deaths from air pollution exceed or on par with all other weather related health impacts in Canada.  

Innumerable reviews of the health impacts of air pollution are available, a reasonable short synthesis at Health Canada health_effects of air pollution.   For the more enthralled in the topic, read the technical documents produced by the US EPA on specific pollutants.  All speak to the devastating impacts that deteriorating air quality has on human health. 

Most older air quality indices work by measuring a suite of pollutants and reporting  on the most severe on any one particular day – ignoring the contribution of other pollutants.  The old AQIs in Canada were actually at least 6 different indices.  To add confusion, what is reported in Canada as 50, is reported in the US as 100.   Other countries use similarly diffuse methods of communication which preclude portability

Unlike the other indices, the Canadian AQHI works by estimating the health impact by reporting the total effect as a surrogate measured by commonly monitored pollutants.  The AQHI is now available to just of 60% of the Canadian population, mostly thanks to the Weather Channel which is the most consistent form for reporting air quality nationally. Look for the AQHI on Canada's most visited website at the Environment Canada Weatheroffice http://www.weatheroffice.gc.ca/canada_e.html  

Ontario’s ego is a barrier to further implementation throughout the country.  It is only through the determined work of public health professionals in Toronto, Windsor, and a few other communities that the AQHI is available to those communities.   The Ontario Ministry of the Environment remains resistant to appropriately informing residents of the province of the risk they face from poorer air quality in the fashion received by most of the rest of the country.   The Ontario Ministry of Health and Long Term Care is complicit with the MoE stating the need for a full scientific review.  Of course, such bureaucratic rationalization is a great way to procrastinate and ultimately back away from unification of risk communication across the country. The AQHI is not prefect, but a lightyear ahead of other air quality indices in use currently. 

Similar resistance exists in parts of Quebec, although Quebec has aggressively attempted to communicate air quality risks for longer than most parts of Canada and switching modalities is somewhat more problematic as there is no attempt to hide the problem.

The science of air quality and health has advanced dramatically in the past decade.  Yet, many health care providers lack the information to adequately inform their patients/clients of how to manage health risks – and until we have a pan-Canadian risk communication tool, such dialogue is unlikely.  So, in the meantime, Ontario contributes to the death and disability of its own residents and those of the rest of the country.  Most of the country of which has openly adopted the importance of ensuring the public has the right to information on which to protect their health.  

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