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

2. 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

3. 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

4. City of Hamilton Boundaries

5. 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

6. Air Quality - PM2.5 6

7. Air Quality – PM10 7

8. Air Quality – NO2 8

9. Air Quality – SO2 9

10. Air Quality – O3 10

11. Air Quality – CO 11

12. Previous Study
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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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]

20. NT Acute Exposure Mortality20

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

22. 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

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

24. Results Summary
for NO2 and SO2

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

26. Summary of Results for Current Study26

27. 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

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

29. 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

30. 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

31. 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

32. 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

33. 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

34. Results from ICAP Model - Ozone34

35. 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

36. 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

37. Results from AQBAT (1) 37

38. Results from AQBAT (2) 38

39. Economic Valuation - AQBAT
Savings Cost
Millions of Dollars 39

40. 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