The air we breathe

It's all around, it keeps us alive ... and it can be deadly

MEGAN GILLIS
The Toronto Sun - Monday, May 29, 2006

Take a deep breath before you read this.

That gulp was just one of up to 20,000 litres of air you'll breathe today -- indoors and out.

You may not want to take another after you read this.

Even in relatively clean Ottawa, the air outdoors is taking lives.

It damages our lungs and hearts, brings on asthma bouts and heart attacks and leaves people with such ailments as chronic obstructive pulmonary disease struggling just to breathe.

In Toronto, summer hasn't even officially begun and the city already had its first smog advisory on the weekend.

Last year, Torontonians endured a record 48 smog advisory days and the first winter smog since officials started measuring the tiny particles that do the most damage to our bodies.

It's not that air pollution drifting in the wind from the U.S. or from our own tailpipes and smokestacks is getting worse. Generally -- except for lung-irritating ground-level ozone -- it's better than three decades ago.

Experts say we have more smog days because of variations in weather -- hot summers cook up more smog, for example.

What's changed is we're learning more and more about how smog damages our health -- even when the air seems clean.

NO AIR POLLUTION SAFE

Experts conclude no amount of air pollution is safe.

"It's a fundamental determinant of health -- people can't be healthy unless they have clean air to breathe," says Ontario Medical Association president Dr. Greg Flynn.

"You have a choice of whether to smoke or not to smoke, exercise or not exercise. You don't have a choice about the air we breathe."

The association tallied the costs of air pollution -- in suffering and cold hard cash -- to make the impact clear. It estimates air pollution killed 5,800 Ontarians last year, sent about 60,000 to the emergency room and cost about $507 million to the health care system.

Those numbers, which the OMA calls conservative, are expected to spike by 2026 -- even if air pollution gets no worse -- because more of us will be old and frail.

The vast majority who will die are the most vulnerable -- the elderly and ill. Researchers believe babies and children with health problems are at risk of dying, too. There just isn't enough research to predict how many.

"We're getting used to looking through a haze," Flynn says.

"We're trying to make it real to people and help governments understand the cost -- a billion dollars a year -- and the human suffering. Thousands, probably millions, of people in Ontario have minor health effects on a daily basis from air pollution."

The doctors' study is one of three Canadian reports that came up with similar death tolls by combining research on the health effects of pollutants, data from air quality monitoring stations and population statistics.

It's the same way experts made us wake up and realize the terrible human cost of smoking.

5,900 A YEAR KILLED

A Health Canada study was even grimmer than the OMA's, estimating the five common air pollutants -- carbon monoxide, nitrogen dioxide, sulphur dioxide, ozone and fine particulate matter -- kill 5,900 people a year in eight big Canadian cities.

"It's a what-if analysis," says Dr. Dave Stieb, of Health Canada's air health effects division. "If we were able to eliminate air pollution from all human sources, what would that mean for a reduction in the risk of death for the population? It works out to 340 deaths per year (in Ottawa). That represents 7% of deaths from all causes in Ottawa."

That's not much better than the Big Smoke -- it's 10% in Toronto -- and more than in Calgary or Vancouver.

The air is making people sick even when it looks clear.

A Toronto study found more than nine in 10 premature deaths and hospitalizations caused by pollution occurred when the air was good or very good, according to the air quality index.

Scientists and doctors have long known smog kills.

More than 4,000 London residents died in 1952 when cold weather increased coal burning and stagnant air kept the toxic haze over the city.

In response, countries such as Canada tightened air pollution standards in the 1950s and 1960s.

Scientists thought that when the worst pollution disappeared in the 1970s and 1980s, so would the damage to our health. They were wrong.

"The new studies have demonstrated that even at those lower levels of exposure, we see adverse health effects," Stieb says.

"It's a change in perspective. Things aren't safe -- even at these lower levels."

We know air pollution outside is harming our health.

GRAVE THREAT

In a Healthy Indoors survey last summer, six in 10 people said air pollution is the gravest environmental threat facing Canadians -- and will continue to be.

More than half thought it would hurt their health and nearly four in 10 said it already had.

What we may not know is that our homes are no safe refuge.

Experts say the air inside our ever-tighter homes is just as serious a threat to our health, potentially full of pollutants that trigger asthma and allergies in kids and cause respiratory problems, cancer and even fatal poisoning.

"You're more likely to be affected by pollutants indoors than outdoors," says Jay Kassirer, executive director of the Healthy Indoors Partnership, formed by groups to fight inaction on indoor air.

"Canadians have the impression indoor air is better than outdoor air -- for a number of substances, it's not," Kassirer says.

"In terms of being exposed to pollution that will have an impact on people's health, one is more likely to be exposed indoors than outdoors because we spend so much time indoors and we're closer to the sources."

Yet many indoor environments in Canada are just as polluted as 30 years ago, despite decades of reports and conferences.

Canadians don't see the air they breathe at home as a threat.

Almost three-quarters of people surveyed for Healthy Indoors reported potential health threats in their homes. Nearly one in 10 families with children, for example, had visible mould.

Only a third recognized the threat to their health.

"Over 73% of people reported signs of potential health risks -- only half took action," Kassirer says. "Half didn't know where to turn."

INDOOR SCIENCE LAGS

The science -- and funding for research and action -- in indoor air quality has lagged when compared to the air outside.

"This is a very similar situation to climate change 10 years ago," Kassirer says. "People are saying the evidence points to real issues, but people say the science isn't very hard yet.

"We need to do more research."

No one knows, for example, how many people become sick and die because of indoor air. There's no way to measure pollution in the more than 300,000 dwellings in Ottawa alone.

But there is a lot scientists do know about indoor air threats that isn't reaching the public.

A Lung Association review of studies links indoor air pollutants to a string of ailments -- from difficult breathing and wheezing to asthma, respiratory infections, bronchitis, emphysema and lung cancer.

"People know a lot about outdoor air quality, they listen to smog warnings, but their basements are full of mould," says Dr. Virginia Salares, Canada Mortgage and Housing Corp.'s indoor air researcher.

"They're not attuned to the environment where they're spending more time relative to the outdoors. The consensus is there is a strong relationship between indoor air quality and health.

"Smoking, for example, is linked to upper respiratory effects in children. Carbon monoxide from a poorly maintained furnace is poisoning -- it can be fatal. Dust mites and asthma -- it's a powerful link. The cause and effect are established. Moulds: Study after study show moulds are associated with health effects that include allergies, exacerbation of asthma and other symptoms."

It's only in our homes that we cover up genuine health threats with more air pollution, Salares says, pointing to air fresheners used to mask the smell of potentially dangerous mould or pesticides to kill bugs drawn by moisture or waste.

"Anything you put in the air people breathe," she says. "We're meant to breathe clean air, free of any pollutants.

"That's what clean air is."

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