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Towards Healthy Public Policy: Assessing

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Towards Healthy Public Policy: Assessing & Mitigating Health Burden from Air Policy Analysis for Air Quality and Health Workshop at Metro Hall, Toronto May 19, 2005 – PowerPoint PPT presentation

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Title: Towards Healthy Public Policy: Assessing


1
Towards Healthy Public PolicyAssessing
Mitigating Health Burden from Air
  • Policy Analysis for Air Quality and Health
  • Workshop at Metro Hall, Toronto May 19, 2005
  • Monica Campbell
  • Environmental Protection Office
  • Toronto Public Health

2
People can spend a lot of time close to pollution
sources
3
Presentation Overview
  • Healthy Public Policy
  • Areas of activity
  • Integration of assessment tools
  • Policy questions of local significance

4
Healthy Public Policy
  • Fundamental concept in public health
  • Particularly relevant for environmental threats
    to health
  • Advocates for shifts in public policies that
    adversely impact health (eg. transportation,
    energy, urban form)
  • Need good assessment tools

5
Areas of Activity in Influencing Policies Related
to Air
  • Exposure assessment and health risk
  • Risk communication
  • Broad determinants of health (e.g. social aspects)

6
Exposure Assessment Health Risk
  • Local point sources of community concern
  • - St. Johns Crematorium (2000)
  • - Lakeview coal-fired power plant (2000)
  • Ambient air pollution
  • - Toronto Air-Pollution Burden of Illness
  • study (2004)

7
St Johns Crematorium (Toronto)
  • Method
  • Stack testing to establish emission rates of
    PM10, heavy metals including mercury, dioxins
    furans
  • Ambient air monitoring before after crematorium
    started operations
  • Dispersion modeling
  • Comparison of modeled and actual ambient levels
  • Benchmarks
  • - Ambient air quality criteria (OMOE)
  • - Toxicological criteria (RfD RsD from US EPA)

8
St Johns Crematorium (Toronto)
  • Results and Conclusions
  • Crematorium actual and modelled emissions were
    very low and far below provincial standards
  • Worst-case concentrations were at most 1 of AAQC
    and 25 of health criteria
  • Background levels of PM10 high and sometimes
    exceeded provincial standard but crematorium
    contribution very small

9
Lakeview Coal-Fired Power Plant
  • Modelling study (2000) to estimate ambient
    concentrations of NOx and SO2 with different
    operating conditions
  • Lakeview (1997 base year operating at 19
    capacity) found to contribute
  • lt 0.3 of ambient annual NOx in GTA
  • lt 9.2 of ambient annual SO2 in GTA.

10
Annual Air Emissions from Lakeview Plant
11
Air Pollution Burden of Illness Study
  • Why Do One?
  • To estimate magnitude of health impact in
    cost-effective manner
  • To provide health status information on which to
    base public health programs
  • To communicate health risk
  • To influence decision makers

12
Whats Involved in Conducting a BOI Study?
  • Is a form of risk assessment
  • Applies risk coefficients from existing
    epidemiological studies worldwide
  • Uses community-specific data on daily pollution
    levels
  • Uses community-specific data on adverse health
    outcomes such as hospitalizations and mortality
    (e.g. for respiratory and cardiac causes)

13
Calculating Burden of Illness
  • Hp(outcomes/yr) Hb x Fp
  • Where
  • Hp estimated air-pollution burden of illness
  • Hb background rate of adverse health
    outcomes/year
  • Fp fraction due to air pollution
  • (Fp? Hp/unit x P where ? Hp/unit is the risk
    coefficient per unit pollutant from published
    epidemiological studies, and P is the effective
    annual pollutant concentration)

14
Air Pollution Burden of Illness - Toronto
  • 1,700 premature deaths/year
  • 6,000 hospitalizations/year
  • Would likely not have occurred when they did
    without exposure to air pollution
  • Preventable
  • Increases severity or frequency of common medical
    conditions and illnesses

15
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16
Impact of 2000 BOI Study
  • Gave rise to first Smog Summit in June 2000
  • Catalyzed creation of 20/20 The Way to Clean Air
  • Initiated low-sulphur fuel purchases by City
  • Gave rise to further research Condition
    Critical Fixing our Smog Alert Warning System
  • Increased participation in policy discussions
  • Facilitated NGOs in advocating for clean air

17
Risk Communication
  • Studies that influence communication
  • policies
  • Toronto Air Quality Index - Health Links Analysis
  • Condition Critical Fixing the Smog Warning
    System
  • Evaluation of smog advice

18
The Air Quality Index (AQI)
AQI Scale
Category
0 - 15
Very Good
Good
16 - 31
Increasing severity of health effects
32 - 49
Moderate
Smog Alert
50 - 99
Poor
At AQI 50, OMOE calls Air Quality Advisory
100
Very Poor
19
Mixed Messages
Health Evidence (based on 2000 study)
  • Torontos air quality is good or very good
    almost all the time
  • Triggers smog alerts only in the summer months
  • Torontos air pollution leads to 1,000 premature
    deaths and 5,500 hospitalizations each year
  • Air pollution affects health year round

AQI
20
Distribution in Health Outcomes by AQI Category
(based on 2000 study)
21
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22
Why the AQI MisrepresentsHealth Risk
  • It did not include fine particulates (PM10/PM2.5)
  • It is based on out-of-date air quality standards
  • It is based on a single driver pollutant, not
    the total mix of AQI pollutants

23
Days of Poor Air Quality in Toronto resulting
from inclusion of PM2.5 in the AQI
24
Evaluation of Smog Advice
  • Personal exposure monitoring that compares
    typical day exposures to PMlt1, PM2.5, VOCs and
    ozone levels among paired scenarios of
    individuals who did or did not follow smog alert
    advice
  • Tries to understand how much total daily
    exposures can be reduced by shifting individual
    behaviours
  • Collaboration among Chemical Engineering
    Applied Chemistry at U of T, Health Canada,
    Environment Canada and Toronto Public Health

25
Incorporating Broad Determinants of Health
Social Aspects
  • Air emissions and health status studies related
    to Ashbridges Bay Treatment Plant
  • Health Impact Assessment Designated bus route

26
Ashbridges Studies
  • Air emissions study modelled 17 key pollutants
    under 4 scenarios, including with full
    incineration and no incineration at sewage
    treatment plant
  • Health status study examined mortality,
    hospitalization and cancer rates in South
    Riverdale and Beaches community, in comparison to
    SES- matched communities

27
Ashbridges Studies
  • Overall, the emissions profile improved over time
    as incinerator use was phased out and with
    projected improvements for odour control
    (including fugitive emissions)
  • Both communities had higher mortality and
    hospitalization rates (overall) than their
    respective comparison communities
  • South Riverdale has been burdened with more
    illness and pollution sources than other
    communities, although it is not possible to
    suggest a causal relationship

28
Ashbridges Studies
  • Policy recommendation arising
  • That the OMOE considers the cumulative impact of
    emissions from any new or modified industrial
    facility on adjacent residential areas with
    elevated rates of illness or mortality prior to
    issuing a C of A
  • Cumulative currently means taking into account
    all emission sources from a facility

29
TPH Perspective on Cumulative Impact
Cumulative impact is
Total impact of all emission sources
Impact of current ambient air pollution levels
Impact of modelled new source contribution


30
Environmental Justice Aspects
  • Should consider integrating social dimensions
    such as environmental justice concepts when
    developing public policy
  • Environmental justice concepts can lead to an
    examination of spatial distribution of pollution
    sources and correlations with community
    characteristics such as income levels, minority
    status or ethnicity.
  • Can take into account that people of lower income
    are more likely to be exposed to air pollution
    and likely more susceptible to adverse effects
    from air pollution

31
Health Impact Assessment
  • Methodology may be quantitative but typically
    includes a qualitative assessment of social
    aspects
  • HIA results supported introduction of congestion
    charges (toll roads) in London, England
  • Toronto Public Health is completing a pilot HIA
    on the designated bus route planned to connect
    subway users to York University

32
Rapid Bus Route Pilot Health Impact Assessment
Outcomes Examined
  • Vehicle pollution
  • Stress (commuting driving)
  • Equity issues (who benefits)
  • Commute time
  • Accident rates

33
Integration of Assessment Tools
Air Emissions
Policy Options
Health Burden
Ambient Levels
34
How to Deal with Different Health Outcomes?
Pyramid of Health Effects Toronto Annual
Estimates for Inhalable Particulates (PM10)
35
Some Policy Questions of Local Significance
  • How does health burden shift if
  • Network of surface designated transit lanes
    introduced?
  • Road congestion pricing is introduced?
  • Bicycle network is created that reduces space for
    cars?
  • Older vehicles are required to be retrofit or
    retired?
  • Zoning is changed to reduce urban sprawl?
  • Existing point sources are required to meet
    health-based air quality standards?
  • Comprehensive energy conservation plan is
    implemented?
  • Coal-fired power plants are replaced with natural
    gas?

36
For More Information
Visit our Healthy People Healthy Environment home
page at www.toronto.ca/health/hphe
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