Abstract
Objective
Wildfire smoke is an important source of air pollution associated with a range of cardiopulmonary health conditions. The Air Quality Health Index (AQHI) is the most widely used tool in Canada to communicate with the public about air pollution, but it may not adequately reflect health risks from wildfire smoke. The objective of this study was to evaluate the ability of the AQHI and four alternate AQHI-Plus amendments to predict adverse population health effects from wildfire smoke.
Methods
The maximum 1-h values of the AQHI and the four amendments were calculated for each 48-h period of the wildfire seasons from 2010 to 2017 for 32 health units in British Columbia. Generalized Poisson models were used to estimate the association between these values and daily counts of five health outcomes: all-cause mortality; physician visits for all circulatory causes; visits for all respiratory causes, including asthma; asthma-specific visits; and dispensations of salbutamol sulfate (i.e., Ventolin®). Model fit was evaluated with the Akaike information criterion.
Results
The AQHI and the four amendments were all associated with all five health outcomes. The AQHI exhibited best fit to the all-cause mortality and circulatory physician visits during all wildfire seasons, while the 1-h PM2.5Only AQHI-Plus exhibited best fit to the asthma-related outcomes during all wildfire seasons.
Conclusion
Individuals with common respiratory conditions such as asthma and chronic obstructive pulmonary disease are particularly susceptible to wildfire smoke. As such, the 1-h PM2.5Only AQHI-Plus amendment was recommended for communicating about potential health effects of air quality during wildfire seasons in BC.
Résumé
Objectif
La fumée des incendies de forêts est une importante source de pollution atmosphérique associée à un éventail d’états pathologiques cardiopulmonaires. La cote air santé (CAS) est l’outil le plus communément utilisé au Canada pour aviser le public des niveaux de pollution atmosphérique, mais elle pourrait ne pas bien tenir compte des risques pour la santé de la fumée des incendies de forêts. Notre étude visait à évaluer les capacités de la CAS et de quatre indicateurs modifiés (AQUI-Plus, ou « CAS-Plus ») de prédire les effets néfastes de la fumée des incendies de forêts sur la santé des populations.
Méthode
Les valeurs maximales en 1 heure de la CAS et de ses quatre modifications ont été calculées pour chaque période de 48 heures durant les saisons des feux de forêt 2010 à 2017 pour 32 bureaux de santé de la Colombie-Britannique. Des modèles de Poisson généralisés ont servi à estimer les associations entre ces valeurs et le dénombrement quotidien de cinq résultats sanitaires : les décès toutes causes confondues; les visites chez le médecin attribuables à l’ensemble des problèmes circulatoires; les visites attribuables à l’ensemble des problèmes respiratoires, dont l’asthme; les visites spécifiquement attribuables à l’asthme; et la distribution de sulfate de salbutamol (Ventolin®). La qualité du modèle a été évaluée à l’aide du critère d’information d’Akaike.
Résultats
La CAS et ses quatre modifications ont toutes été associées aux cinq résultats sanitaires. La CAS présentait le meilleur ajustement avec les décès toutes causes confondues et les visites chez le médecin attribuables aux problèmes circulatoires durant toutes les saisons de feux de forêt, tandis que l’AQHI-Plus (1-h PM2.5only) présentait le meilleur ajustement avec les résultats liés à l’asthme durant toutes les saisons de feux de forêt.
Conclusion
Les personnes ayant des états pathologiques respiratoires courants comme l’asthme et la maladie pulmonaire obstructive chronique sont particulièrement sensibles à la fumée des incendies de forêts. C’est pourquoi la modification AQHI-Plus 1-h PM2.5Only est recommandée pour communiquer les informations relatives aux effets possibles de la qualité de l’air sur la santé durant la saison des feux de forêt en Colombie-Britannique.
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Funding
This study was funded by the British Columbia Ministry of Environment and Climate Change Strategy.
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Yao, J., Stieb, D.M., Taylor, E. et al. Assessment of the Air Quality Health Index (AQHI) and four alternate AQHI-Plus amendments for wildfire seasons in British Columbia. Can J Public Health 111, 96–106 (2020). https://doi.org/10.17269/s41997-019-00237-w
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DOI: https://doi.org/10.17269/s41997-019-00237-w