Air Pollution Burden of Illness in Toronto
Toronto Public Health
EXECUTIVE SUMMARY Toronto Public Health sought to identify and document the morbidity (illness) and premature mortality (death) associated with common air pollutants in Toronto. While premature mortality estimates are available for Ontario, this information did not exist for Toronto. Burden of illness information is essential to support municipal air quality improvement initiatives, and to understand the significance of air pollution as a determinant of health for Toronto's 2.4 million residents. It has long been recognized that poor ambient air quality has an adverse effect on public health. Within the last decade, data and methods have become available which allow for the quantification of adverse health effects associated with exposure to air pollution. Studies carried out in Europe, South and Central America, the United States and Canada have provided numerical coefficients that link a wide range of health end points with air pollutants, both alone and in combination. From reviews of these studies, it is possible to summarize the results in such a way that the coefficients may be used to estimate the air pollution burden of illness in a community, even if no explicit epidemiological studies have been previously conducted in that community. This can be done if air pollution levels have been measured in the community (or can be otherwise estimated), and if disease specific overall burden of illness data (e.g., hospital admissions, mortality) are also available in the community. Using this approach, we examined the recent epidemiological literature, as well as recent Canadian reviews carried out for regulatory purposes, and established a rational and defensible set of coefficients of the air pollution-related burden of illness applicable to Toronto. Given that these coefficients are based on up-to-date international scientific studies, it is reasonable to expect that they are also useful to staff in other health units across Canada who seek to estimate the air pollution burden of illness for their respective communities. These coefficients, expressed as unit incremental health risk ( H% per unit pollutant), are shown below. Unit Incremental Health Risk Values Unit Incremental Health Risk Pollutant Nontraumatic Mortality 0.08 0.22 Respiratory Hospital Admissions 0.17 0.27 Cardiac Hospital Admissions 0.23 0.25 1.69 3.48 0.119 0.225 0.04 0.249 0.276 0.11 0.452 0.39 6.0 Congestive Heart Failure in Elderly

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