Anatomy of heat waves and mortality in Toronto: lessons for public health protection.

BACKGROUND: Periods of unusually hot weather, especially in temperate climates, carry with them a burden of morbidity and mortality, particularly in urban areas. With lessening debate on its origins, and signs of global warming already apparent, it is becoming imperative for public health practitioners to recognize and predict the risks of "heat waves", and to develop protective community responses to them. This study makes use of historical data and a methodology developed previously to examine the pattern of hot weather experienced over the last five decades in the City of Toronto, and to assess the associated burden of mortality. METHODS: Synoptic classification of air masses based on meteorological data for Toronto was used, to assign the annual mean burden of illness (in terms of elevated mortality) associated with hot weather and air pollution. Then, coefficients relating daily mortality risk to historical daily weather and air quality data were determined with a model system that (for each air mass) assessed the factors that contributed to day-to-day variability in mortality. RESULTS: Over the period of study, there were 120 (95% CI: 105-135) heat-related deaths on average per year, with great variability from year to year, reflecting the variability of hot weather. Mortality was greatest in July and August, when the greatest number of multi-day heat episodes occurred. Furthermore, the longer the episode, the greater was the daily risk for mortality. INTERPRETATION: The method can be used to forecast the risk of heat-related mortality, and to facilitate the development of public health responses to mitigate that risk.

Should people be physically active outdoors on smog alert days?

BACKGROUND: Given the importance of physical activity to well-being, there is a need to encourage people to be physically active year-round. At the same time, many people are vulnerable to adverse health effects from air pollution, especially on smog alert days. This study was undertaken to determine when air pollution levels tend to be lowest so that the public can modify strenuous outdoor activity accordingly. METHODS: Existing hourly air pollution data for Toronto were analyzed to determine how pollutant levels varied from hour to hour throughout each 24-hour day, to identify the times when pollution levels are at their lowest on average. RESULTS: Pollutant levels vary throughout the day, with concentrations of some pollutants (such as ozone, particles and sulphur dioxide) being highest during mid-day, and others (such as carbon monoxide and nitrogen dioxide) being highest with morning rush hour. Overall, pollutant concentrations tend to be lowest before seven a.m. and after eight p.m. INTERPRETATION: The public should be encouraged to maintain regular physical activity outdoors while monitoring any air pollution-related symptoms. The intensity of outdoor activity should be reduced, or activities replaced with indoor exercise, at those Air Quality Index (AQI) levels that trigger individual symptoms and when AQI values exceed 50. Where possible, strenuous activity should be taken when and where air pollution levels tend to be lowest, namely early in the morning and in low-traffic areas. More research is required to guide development of health protective advice on exercising when air quality is poor.

Accumulation of metals, trace elements and semi-volatile organic compounds on exterior window surfaces in Baltimore.

Organic films have been found to develop on window surfaces [Diamond et al., Environmental Science and Technology 34 (2000a) 2900]. The film contains organic compounds that are in dynamic equilibrium with the gas-phase in air, and organic and inorganic compounds and elements associated with deposited air particles. In this study, the exterior surfaces of windows were sampled in downtown and suburban Baltimore, Maryland. Higher concentrations of PCBs, PAH, metals and trace elements were found at downtown than a suburban site. PCBs in the films at downtown sites were dominated by penta and hexa homologue groups and PAH signatures resembled that of vehicle emissions. Twenty-six metals and trace elements were separated into two groups according to their enrichment factors (EF). Ag, Hg, Se, Sb and Zn had EF > 100, suggesting anthropogenic sources of these metals in the films; whereas Fe, Ca, Co, Cr and others had EF <10, suggesting a crustal origin. An unusual profile dominated by deca- and nona- PCBs and relatively higher concentrations of Ag, Hg and Zn may be attributable to emissions from a medical waste incinerator. Dry deposition fluxes of selected metals on windows were 1.4-94 times higher on windows with than without films, indicating that the film increases the dry deposition of particles and their associated chemicals. This implies that film development, which is associated with elevated VOC and SOC emissions to urban air, will increase film development that will, in turn, increase the accumulation of other atmospherically deposited constituents such as metals.