Sarah Henderson, PhD
BC Centre for Disease Control
Extreme Summer Weather and Respiratory Health Sarah Henderson, PhD BC Centre for Disease Control
Extreme and unprecedented summer weather
Credit: Mel Reasoner, 2012
“It’s tough to make predictions, especially about the future.” -- Yogi Berra
Sweltering Smog Smoke Storms
In hospital In community Maximum Minimum
Paris 2003: the most famous event?
Vancouver 2009: the least famous event?
Previous Weeks
Characteristic
Comparison Group
OR
95% CI
<65
≥ 85
1.1
0.9 – 1.5
65 – 74
≥ 85
1.5
1.1 – 2.1
75 – 84
≥ 85
1.0
0.8 – 1.4
Male
Female
1.1
0.9 – 1.4
Died out of care
Died in care
1.5
1.2 – 2.0
>1000 persons/km2
≤1000 persons/km2
1.2
1.0 – 1.5
65+ living alone
65+ living alone
1.3
0.9 – 1.8
>20% low income
≤20% low income
1.2
1.0 – 1.4
60
Assumed heat-related deaths Proportion of Deaths
50
Typical summer deaths
40 30 20 10 0 Low
Low/Mid
Mid
Mid/High
Neighbourhood Deprivation
High
Proportion of Deaths
35
Assumed heat-related deaths
30
Typical summer deaths
25 20 15 10 5 0 Cardiovascular
Respiratory
Cancer
Underlying Cause of Death
External
• 1 extreme heat • 4 accidental pharmaceutical poisonings • 7 illicit poisonings • 7 intentional self harm • 14 respiratory co-morbidities
Heat + sunlight are key ingredients in photochemical smog formation
Acute and chronic health impacts
Acute impacts on the population: the air pollution pyramid
Some people are more susceptible
High ozone hours in Ontario, summer 2013
Long-term trends
Forest fire smoke causes the worst air quality most Canadians will ever experience
Smoke is a complex mixture of pollutants
Acute impacts on the population: the air pollution pyramid
Underlying Cause
ICD-10
Deaths
Smoky Days
All non-accidental
Excluding V-Y
137,841
1.02 (1.00-1.04)
All cardiovascular
I00 - I99
44,648
1.04 (1.00-1.07)
IHD
I20 - I25
20,162
1.01 (0.96-1.06)
Stroke
I69
10,764
1.08 (1.01-1.15)
MI
I21 - I23
9,208
1.01 (0.93-1.09)
J00 - J99
14,287
1.09 (1.03-1.15)
COPD
J44
5,618
1.03 (0.94-1.13)
LRI
J13 - J22
5,130
1.11 (1.00-1.21)
All respiratory
BC fires of 2003 in Kelowna
BC fires of 2010 in Williams Lake
My rule of thumb for every 10 mg/m3 increase in PM2.5: â&#x20AC;˘ 2% increase in overall mortality â&#x20AC;˘ 5% increase across all respiratory outcomes
More extreme temperatures means more thunderstorms
1991-1995 US Monthly Averages
Thunderstorms make pollen more allergenic
We MUST expect the perfect storm
Moscow 2010
Key messages: • Extreme summer weather WILL happen • EVERYONE is at risk
• People with lung disease are MORE susceptible • We MUST expect combined impacts • Planning and preparation are REQUIRED