On the Island interview: health impacts of air pollution

The following is a transcript of an interview by radio host Gregor Craigie with guest Dr. Paul Hasselback, a Medical Health Officer with Island Health.

CBC radio – On the Island, Feb 21, 2017

Gregor Craigie: A couple of stories in the news last week got us thinking about air quality here at CBC.

First we saw that municipal councillors in North Cowichan were considering tougher laws restricting wood burning. The restrictions would include no burning during air quality advisories, no open burning for land clearing and an outright burning ban within North Cowichan’s urban areas.

In Port Alberni a door-to-door survey will be undertaken to find out how many people use wood stoves and their perceptions of air quality. All of this, of course, is to address the health problems caused by the fine particulate matter that drifts into the air from burning wood.

To talk more about this, we’re joined this morning by Dr Paul Hasselback, medical health officer with the Vancouver Island Health Authority.


Dr Hasselback, good morning.

Paul Hasselback: Good morning, Gregor.

Craigie: What is the medical problem caused by fine particulate matter from wood fires?

Hasselback: Well, it’s not just wood fires specifically, but I think [with] the two instances that you discussed, wood fires are a significant component. When we talk about pollution in general, we know we see increases in respiratory problems, including deaths, both in the short-term and the long-term development of lung problems.

But just as severe, we see about as many people who have severe mortality from cardiovascular events also caused by the emissions that are in the air. There’s lots of other evidence that’s come out about a whole range of health problems that might be caused by air pollution, pretty similar to that list that you might talk about when we are talking about smoking.

Craigie: Who are the most susceptible to respiratory problems? Are some groups more susceptible than others?

Hasselback: We often talk about those over the age of 65, those that are very young, anyone who has a chronic illness that requires medical care, particularly cardiac and respiratory, but it also seems to make diabetes worse. It makes inflammatory illnesses worse.

“…a high percentage of the population actually will have significant symptoms to poor air quality”

There’s lots of good rationale for why that’s occurring as well. It turns out that it’s not quite the majority but a high percentage of the population actually will have significant symptoms to poor air quality, and you and I, being relatively healthy, will still possibly get symptoms if the air quality is significantly bad.

Craigie: Now, when you talk about symptoms, are we just talking about coughing and wheezing, or are there other signs of distress?

Hasselback: Well, at the most severe, it can lead to something like a heart attack or event that results in death. I think we often think about coughs and exacerbation of asthma, those that have chronic breathing problems, become worse as well. They’re the most common manifestations but not the only ones.

Craigie: In general, where are some of the worst and best spots in our listening area when it comes to air quality issues? Is it usually just a question of how deep a valley someone lives in, or does it go beyond that?

Hasselback: Here in the Island we have a unique situation where we do have some valley communities, and the geography of the area around those valleys traps air in the valley.  And where you’ve got wood smoke being developed, or other forms of pollutants getting emitted into the air, and there’s trapped air mass, it actually leads to poor air quality.

On the other hand, there are parts of the Island that have some of the best air quality because most of our air is coming off the Pacific and is fairly clean.

It is important to understand that we have significant variation even over small distances. Rural areas tend to be better, but outside of a valley is definitely better as well. But our three major valley communities all have issues that they’re looking very carefully at how they can improve the quality of air within those communities.

Craigie: That’s presumably where woodstoves come in. They’re not going to be the only cause of it, but they’re an obvious place to start. Is that fair to say?

“…we often get the use of wood furnaces during those cold spells during the winter, which is exactly when the air gets trapped, and so we get these very high poor-air-quality events that happen in Comox, Alberni and Cowichan valleys.”

Hasselback: Well, we often get the use of wood furnaces during those cold spells during the winter, which is exactly when the air gets trapped, and so we get these very high poor-air-quality events that happen in Comox, Alberni and Cowichan valleys during those particular times.

So those communities, particularly Alberni and Cowichan right now, are looking at what can they do to mitigate what has been a problem for them and they end up in air quality advisories often during those winter events. Part of that begins looking at how do you use wood appliances and what can be done to reduce the amount of particulate matter being generated from those wood furnaces.

Craigie: It seems like there is a fair bit that can be done, starting with the appliance itself. Isn’t that right? I mean, some are a lot more efficient and produce a lot less particulate matter than others, don’t they?

Hasselback: Well, if we’re talking specifically only about wood appliances, there are two important things. One is high-efficiency, low-emission units, and the technology is getting better and better all the time.

If we look at our colleagues south of the border, their standards are continuously improving — not quite the same as natural gas, but some days the expectations are getting pretty close to that.* But that only works as good as the quality of the fuel that you put in, and I think one of the real challenges we have here on the Island is we have so much precipitation that we don’t often have people seasoning the wood, drying it out adequately before they burn it. That is a major contributor to poor air quality, so we need to change that practice as well.

Craigie: How seasonal is this? I mean, is this essentially a wintertime issue when people are staying indoors and trying to keep themselves warm?

Hasselback: I think we’ve got several seasons here. Certainly, the wood furnace issue is predominantly a winter one, and that’s when we often get the air quality issues, but we have people who still burn yard clippings and brush during the fall season, and we get smoke events occurring at that time. We also have contributions from forestry and agriculture, which are more regulated but in some instances lead to significantly reduced air quality in some of the communities on the Island.

Craigie: Is this only an outdoor thing? I wonder how much of a concern it is indoors. One stat mentioned in the articles I talked about in the introduction suggested up to 70% of the bad air ends up inside. Is there a way to improve that percentage, do you think?

“The very fine particulate matter that is generated that causes the illness actually gets into homes very quickly.”

Hasselback: One of, I think, the fallacies out there is just going indoors, you won’t get exposed. The very fine particulate matter that is generated that causes the illness actually gets into homes very quickly. Concentrations are as much as equal but often 70% of what’s outside, so when it’s poor air quality outside, it’s probably poor air quality inside as well. You can make that worse by smoking inside, by lighting candles. Even some of our cooking practices may make indoor air quality worse when we’ve got an outdoor air quality problem — all of which leads to we need to learn a lot more about how to keep our air cleaner, both within our own homes but within our communities as well.

Craigie: I know your first concern obviously is human health, but I wonder if there’s any way of putting a financial cost to the health care system caused by all of this.

“I think that we’re learning more that it’s not just about these spikes in poor air quality but also the longer-term exposure.”

Hasselback: We certainly know what the increases are in terms of the demand on the health care system based on how bad the air is getting. I think that we’re learning more that it’s not just about these spikes in poor air quality but also the longer-term exposure. Often, living in rural areas does have an advantage to living in urban areas in the long-term well-being. Urban areas tend to have higher levels of other forms of pollution as well.

So lots of information coming out about how that affects our well-being. Estimates on a national basis often use numbers like 4,000 additional deaths per year from poor air quality across the country. I don’t have numbers here for BC or the Island, though.

Craigie: Dr Hasselback, it’s good to talk to you again. Thanks very much for joining us right now on the show.

Hasselback: Thanks for having me, Gregor. Have a great day to all.

 

* BCACV NOTE: Newer wood stoves emit more fine particulates than other non-wood burning heating appliances. Additionally, tests of emissions during actual use greatly exceed laboratory emission tests used to rate stoves.  For one, emissions are only tested once the stove has reached a stable burn phase; start-up emissions are not included. To learn more about wood stove emissions, including concerns with newer certified stoves and testing results, please read https://woodsmokepollution.org/wood-stoves.html

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