There's a lot more than just spring in the air

Ground level 03 causes serious problems for urban Canadians,
and not just those with respiratory problems. A season for shut-ins

By Sharon Aschaiek

The sun's beating down with all its might, but you wouldn't know it with the thick toxic fog blanketing the city. Trapped at home are the elderly, children and those with heart or lung conditions � shuddering at the mere thought of stepping outdoors. Even the most fit who do venture out may feel a bit winded by the end of the day.

Sound like a scene out of On The Beach? In fact, it's what's happening right here, right now with the arrival of smog season, and it's putting Canadian physicians on high alert for their most vulnerable patients.

"I had some patients who had exacerbated asthma or congestive heart problems who were out of control," says Dr Ted Boadway, Executive Director of Health Policy at the Ontario Medical Association (OMA) and a veteran family physician. "Most often, you can't tell when a patient's condition is worsened by air pollution or by something else."

Dr Boadway oversaw a June 2001 report called Ontario's Air: Years of Stagnation, which chronicled the health hazards of air pollution. It found that about 2,000 Ontarians die annually as a result of air pollution and that treating pollution-related ailments costs the province more than $1 billion a year.

THE SKY IS FALLING
A large contributor to sickness caused by air pollution is ground level ozone, a major component of smog. Different from the ozone layer that screens out ultraviolet rays, ozone forms just above the earth's surface when nitrogen oxides (NO) and volatile organic compounds (VOC) interact in the presence of sunlight. Over the years, certain human activities like burning oil, gas and coal have sped up the production of NO and VOCs.

Recent developments underline the need to take swift and forceful action on this issue. On May 13, Ontarians were met with the first smog advisory of the season � more than a month earlier than last year's June 24 advisory. And if that doesn't set off alarm bells, a new study out of York University in the UK shows that during heat waves, sunlight turns NO into ozone at a much faster rate.

Environment Canada data shows that there has been a levelling off of ozone levels in Canada since the 1990s. But Ken Smith, Environment Canada's Manager of the National Smog Program, isn't ready to break out the champagne. "All of the projections indicate that the actions we're taking now will yield improvement, but at some point those advances will be overtaken by economic development," he says. "We need to work on a variety of approaches."

CLEAR THE AIR
Environment Canada set nationwide air quality concentration targets for 2010, and has collaborated with the provinces and territories, excluding Quebec, to develop emission reduction strategies. It has also been involved in AIRNow, a co-operative venture of Canadian and American government agencies that monitors ground level ozone concentrations over eastern North America.

Across the country, Canadians can monitor their area's air quality through news reports or at the Weather Network's website (www.weather.ca), which issues daily air quality indexes.

In the meantime the best course of action is probably to keep advising vulnerable patients to steer clear of busy intersections where pollution is concentrated, avoid exercising outdoors and, if possible, stay inside altogether. For its part, the OMA plans to keep up the pressure on government for stricter anti-smog regulations.

"We should do everything that's reasonable to ameliorate air pollution in our communities," say Dr Boadway. "The role of the medical establishment is to give advice on the health effects, and look at what the cost savings are if we act. We want to be a part of that debate."

For more information on AIRNow, please visit www.epa.gov/airnow/canada