Exposure

Air Pollution

Toxins in Traffic Emissions

In Canadian communities, as in those Dockery and his colleague monitored for their Six Cities Study, air pollution is primarily from roadway traffic: cars, trucks, buses, and other motorized vehicles. Traffic-related emissions expose residents of cities to a range of toxins, including nitrogen dioxide (NO2), sulphur dioxide (SO2), and particulate matter or PM—tiny solid particles or liquid droplets. Size is often used to describe particulate matter: particles 20 to 50 microns in diameter (total suspended particles or TSP), particles less than 10 microns in diameter (PM10), and particles less than 2.5 microns in diameter (PM2.5). The smallest particles, which can easily penetrate deep in airways, are the most harmful.

Particulate Matter and Mortality

In a large national cohort study of Canadian adults, Crouse and his colleagues (2012) found that long-term exposure to fine particulate matter was associated with increased risk of death from ischemic heart disease and other nonaccidental causes.1 The study relied on census data for mortality causes from 1991 to 2001 and pollution estimates derived from satellite remote sensing observations and Environment Canada monitoring stations.

The research results showed that ground-based readings for PM2.5 levels from stations in 11 of Canada’s largest cities were highly correlated with satellite images of particle concentrations for other parts of Canada. This novel use of technology allowed the researchers to map particulate pollution in detail and study a larger population. In the end, they showed that there were health impacts with concentrations of particulate matter as low as a few micrograms per cubic metre—an important finding that leads us to ask, Is there a safe level of exposure to particulate matter?

Air Pollution in Urban Environments

As the study by Crouse demonstrates, research into air pollution over the last decade has evolved. Time series and cohort studies have provided important insights about the effects of pollutants in cities and will continue to do so. Meanwhile, we are learning that the health effects of ambient air quality vary over short distances and, crucially, this likely leads us to underestimate exposure and health impacts with large-area models. This is especially true in the dense and complex landscape of big cities, where air quality can vary from one street to the next. Today many study designs are being used to uncover different health impacts in Canada’s three largest cities—Toronto, Montreal, and Vancouver.     

Toronto

A study of Toronto air quality by Buckeridge and his colleagues (2002) focused on particulate matter in 334 neighbourhoods of about 500 people (Figure 1)2. The researchers used fine particles (PM2.5) as a measure of urban air pollution. They looked at neighbourhoods with different levels of exposure to PM2.5 concentrations and compared hospital admission rates for respiratory conditions and genitourinary conditions. As expected, they found that higher exposure to fine particles did not raise admission rates for genitourinary conditions but did raise admission rates for asthma, bronchitis, chronic obstructive pulmonary disease, pneumonia, and upper respiratory tract infection by about 24%.

In another study of Toronto air quality, Buzzelli and Jerrett (Figure 2) relied on land use regression (LUR) to find variations in traffic-related nitrogen dioxide (NO2) estimates.3 Land use regression is a way for researchers to estimate the distribution of airborne pollutants using air monitors that are distributed across a community. The investigators found the highest NO2 concentrations in the downtown core (Inset 1) were near major roadways, such as Toronto’s 401 highway (Inset 2). The widest expressway corridor in North America, the 401 carries over 400,000 vehicles per day. The NO2 concentrations in some areas of Toronto exceed the US Environmental Protection Agency (EPA) National Ambient Air Quality Standards for 24-hour values. Anyone living near these heavy traffic areas is persistently exposed to high concentrations of PM2.5 and NO2—a cause for concern, since NO2 is known to irritate the lungs and worsen asthma symptoms.

Montreal

In Montreal, Smargiassi and his colleagues (2006) showed that exposure to traffic emissions increased respiratory-related hospital admissions.4 Their study differed from the Buckeridge Toronto study in four important ways:(1) they used morning peak traffic intensity as a proxy for auto emissions; (2) they used a case-control approach to study hospital admission and discharge data, with cases defined as subjects with respiratory diagnoses and controls defined as subjects with non-respiratory diagnoses; (3) they focused on persons 60 years and older; and, finally, (4) they took account of subjects’ socioeconomic status (SES) as indicated by home prices. They found that higher traffic intensity was associated with an 18% higher hospital admission rate and concluded that respiratory-related hospital admissions could be attributed to air pollution exposures (as represented by the traffic intensity proxy) independent of the subjects’ socioeconomic status.

Vancouver

In a Vancouver study, Gan and his colleagues (2010) wanted to find out if proximity to roadways and the air pollution generated by traffic on them is a risk factor for coronary heart disease.5 They did this by mapping the residential location of 450,000 adults aged 45 to 84 years who lived in Vancouver and did not have heart disease, and then followed these subjects for several years. By comparing subjects living away from traffic with subjects living near traffic, the researchers found those living close to a highway or major road were about 29% more likely to die from coronary heart disease (Figure 3).

  • 1. Crouse DL, Peters PA, van Donkelaar A, et al. Risk of nonaccidental and cardiovascular mortality in relation to long-term exposure to low concentrations of fine particulate matter: a Canadian national-level cohort study. Environ Health Perspect 2012;120:708-714.
  • 2. Buckeridge DL, Glazier R, Harvey BJ, et al. Effect of motor vehicle emissions on respiratory health in an urban area. Environ Health Perspect 2002;110:293-300. www.ncbi.nlm.nih.gov/pmc/articles/PMC1240770/.
  • 3. Buzzelli M, Jerrett M. Geographies of susceptibility and exposure in the city: environmental inequity of traffic-related air pollution in Toronto. Can J Reg Sci 2007;30:195-210. http://cjrs-rcsr.org/archives/30-2/BUZZELLI-final.pdf .
  • 4. Smargiassi A, Berrada K, Fortier I, et al. Traffic intensity, dwelling value, and hospital admissions for respiratory disease among the elderly in Montreal (Canada): a case-control analysis. J Epidemiol Community Health 2006;60:507-512. http://jech.bmj.com/content/60/6/507.
  • 5. Gan WQ, Tamburic L, Davies HW, et al. Changes in residential proximity to road traffic and the risk of death from coronary heart disease. Epidemiology 2010;21:642-649. http://journals.lww.com/epidem/Fulltext/2009/11001/Change_in_Residential....