Hamilton Air Quality and Health Impacts Study - 2011 Presented to: Upwind Downwind Conference Presented by: Dr. Douglas Chambers February 27, 2012 1

Background Project a result of interest by Clean Air Hamilton (CAH) to update Health Impacts Assessment Significant work undertaken by CAH and partners to lower air concentrations in Hamilton for many pollutants 2

Some Initiatives to Improve Air Quality Public Health initiatives (AQHI) Sustainable transportation initiatives (anti-idling, mobile monitoring) Improved air monitoring (Hamilton Air Monitoring Network On-line) Air Quality communication (CAH website) Emission reductions (wood burning efficiency initiative) 3

City of Hamilton Boundaries

Air Pollutants Considered Fine Particulate Matter PM10 and PM2.5 Nitrogen Dioxide Surrogate for NOx as NO converted rapidly to NO2 Sulphur Dioxide Ozone Carbon Monoxide

Air Quality - PM2.5 6

Air Quality – PM10 7

Air Quality – NO2 8

Air Quality – SO2 9

Air Quality – O3 10

Air Quality – CO 11

Previous Study - 2003 Used Dr. Pengelly’s Hamilton Air Quality Initiative 1997 report as a basis Used same methodology to allow for comparison Updated the relative risk outcomes for PM10, NO2, SO2, CO and O3 Adjusted health outcomes by 42% due to errors in the derivation of the relative risks from the literature 12

Current Study Used same methodology as 2003 study Updated air quality data Obtained from the MOE Updated mortality and morbidity health data Obtained from Hamilton Public Health Services 13

Current Study …cont’d Updated relative risks where new studies were available All relative risks for mortality updated Only some for morbidity Adopted relative risks from 2003 study Included health outcomes for PM2.5 14

Assumptions Used in Current Study Focus on relative risks of acute exposures Similar to previous study Used average relative risks values Separate relative risks for each air pollutant May result in double-counting Considered representative air concentrations No consideration of proximity to industry or major roadways

Health Data Obtained Health Data from City of Hamilton Public Health Services Mortality Data Only available up to 2005 Morbidity Data Cardiovascular hospital admissions up to 2008 Respiratory hospital admissions up to 2008

Mortality and Morbidity Rates for Hamilton * Approximated by Total Acute Care Hospital Discharges for Disease of the Circulatory System ** Approximated by Acute Care Hospital Discharges for Disease of the Respiratory System 17

Relative Risks Used in the Study Air Pollutant NT Mortality (changes per 10 pollution units) Respiratory Hospital Admissions Cardiovascular Hospital Admissions (changes per 10 pollution units) PM2.5 (µg/m3) 0.77 - 0.8 PM10 (µg/m3) 0.45 2.1* 0.7 SO2 (ppb) 0.36 3.0 1.1* NO2 (ppb) 0.68 4.9* 0.94 CO (ppm) 1.7 1.95* O3 (ppb) 0.72 2.8* 0.2 Note: “-” no data available in the literature to determine a relative risk * relative risks obtained from Sahsuvaroglu and Jerrett (2003) as no new data available 18

Model Equation Risk (due AQ) = ER[excess relative risk due to AQ] x [baseline rates] =  [ERR (per unit Concentration)] x [Air concentration] x [ baseline rates]

NT Acute Exposure Mortality 20

Respiratory Hospital Admissions Note: PM10, NO2 and O3 Respiratory Hospital Admissions Adjusted by 42% as Using RR Values from 2003 Study 21

Cardiovascular Hospital Admissions Note: PM10, NO2 and O3 Respiratory Hospital Admissions Adjusted by 42% as Using RR Values from 2003 Study Note: SO2 and CO Cardiovascular Hospital Admissions Adjusted by 42% as Using RR Values from 2003 Study 22

for Particulate Matter Results Summary for Particulate Matter Note: No relative risks from literature for respiratory admissions for PM2.5

Results Summary for NO2 and SO2

Results Summary for O3 and CO Note: No relative risks from literature for respiratory admissions for CO

Summary of Results for Current Study 26

Comparison of Relative Risks Between Current and Previous Studies NT Acute Exposure Mortality Respiratory Admissions CV Admissions (changes per 10 units pollutant) range of RR estimates 1997 Study 2003 Study Current Study PM10 (μg/m3) 1 0.76 0.45 0.7 2.1 0.6 1.4 PM2.5  - 2.88 0.77 0.8 SO2 (ppb) 2 0.36 0.4 3.7 3 1.1 NO2 1.15 1.9 0.68 4.9 6.55 0.94 CO (ppm) 3.68 1.7 -  5 1.95 O3 0.3 1.38 0.72 2.8 4.5 0.2 27

Comparison of Mortality Outcomes Note: All 1997 and 2003 study data adjusted by 42% to account for overestimation of RR values 28

Comparison of Respiratory Outcomes Note: All 1997 and 2003 study data adjusted by 42% to account for overestimation of RR values PM10, NO2 and O3 current study values adjusted by 42% as no updated RR values were available 29

Comparison of Cardiovascular Outcomes Note: All 1997 and 2003 study data adjusted by 42% to account for overestimation of RR values SO2 and CO current study values adjusted by 42% as no updated RR values were available 30

Alternative Models - ICAP Details: Developed by DSS Management Consultants for the Canadian Medical Association PM10, PM2.5, SO2, NO2, CO, O3 Historical census division specific air quality data from NAPS stations Input: risk rates, air quality or trends, baseline/background air quality Output: annual events and economic damages attributable to increase in specific parameter level from baseline/background 31

Alternative Models – ICAP … cont’d Limitations for this application: 2006 starting year complicates comparison with current model Cannot easily calculate incremental benefit or savings (damages only) For this study can only demonstrate incremental health effects and economic impact with ozone as benefits associated with other pollutants Cannot evaluate all pollutants in one run Output format inconvenient to work with Evaluates total mortality only (not chronic and acute separately) 32

Comparison of Relative Risks Between Current Study and ICAP NT Acute Exposure Mortality Respiratory Admissions CV Admissions (changes per 10 units pollutant) range of RR estimates ICAP* Current ICAP PM10 (μg/m3) - 0.45 2.1 0.7 PM2.5 (μ/m3) 1.0 0.77 1.2  - 0.9 0.8 SO2 (ppb) 0.4 0.36 7.5 3 1.9 1.1 NO2 0.68 7.4 4.9 7.6 0.94 CO (1 ppm) 1.7 -  1.95 O3 0.5 0.72 2.8 0.2 * ICAP NT Mortality is Total While Current is Acute Only 33

Results from ICAP Model - Ozone 34

Alternative Model - AQBAT Details: Developed by Dave Stieb and Stan Judek, Health Canada PM10, PM2.5 (limited), SO2, NO2, CO, O3 Historical census division specific air quality data from NAPS stations Input: risk rates and air quality or trends Output: annual events and damages attributable to increase in specific parameter level from baseline Limitations for this application: Cannot Input Air Quality Prior to 2003 for Comparison to Baseline Difficult to Compare to Total Events per Year 35

Comparison of Relative Risks Between Current Study and AQBAT NT Acute Exposure Mortality Respiratory Admissions CV Admissions (changes per 10 units pollutant) range of RR estimates AQBAT Current PM10 (μg/m3) - 0.45 2.1 0.7 PM2.5 (μ/m3) 0.77 0.75  - 0.71 0.8 SO2 (ppb) 0.46 0.36 3 1.1 NO2 0.68 4.9 0.94 CO (1 ppm) 1.9 1.7 -  1.95 O3 0.84 0.72 2.8 0.2 36

Results from AQBAT (1) 37

Results from AQBAT (2) 38

Economic Valuation - AQBAT Savings Cost Millions of Dollars 39

Summary Updated Health Study showed improvements to health outcomes Due to decreases in air concentrations Ozone the exception Due to decreases in relative risks from literature studies Limited utility of other available models for this application Direct comparisons difficult to make between models Cost heavily dependent on model Can vary widely (in this example at least 5-fold) Should update the health study in another 5 years 40