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1.  Health effects of outdoor air pollution 
Canadian Family Physician  2011;57(8):881-887.
Abstract
Objective
To inform family physicians about the health effects of air pollution and to provide an approach to counseling vulnerable patients in order to reduce exposure.
Sources of information
MEDLINE was searched using terms relevant to air pollution and its adverse effects. We reviewed English-language articles published from January 2008 to December 2009. Most studies provided level II evidence.
Main message
Outdoor air pollution causes substantial morbidity and mortality in Canada. It can affect both the respiratory system (exacerbating asthma and chronic obstructive pulmonary disease) and the cardiovascular system (triggering arrhythmias, cardiac failure, and stroke). The Air Quality Health Index (AQHI) is a new communication tool developed by Health Canada and Environment Canada that indicates the level of health risk from air pollution on a scale of 1 to 10. The AQHI is widely reported in the media, and the tool might be of use to family physicians in counseling high-risk patients (such as those with asthma, chronic obstructive pulmonary disease, or cardiac failure) to reduce exposure to outdoor air pollution.
Conclusion
Family physicians can use the AQHI and its health messages to teach patients with asthma and other high-risk patients how to reduce health risks from air pollution.
PMCID: PMC3155438  PMID: 21841106
2.  Effets de la pollution de l’air sur la santé 
Canadian Family Physician  2011;57(8):e280-e287.
Résumé
Objectif
Faire connaître aux médecins de famille les effets de la pollution atmosphérique sur la santé et indiquer quels conseils donner aux patients vulnérables pour qu’ils soient moins exposés.
Sources de l’information
On a consulté MEDLINE à l’aide des termes relatifs à la pollution atmosphérique et à ses effets indésirables. On a révisé les articles en anglais publiés entre janvier 2008 et décembre 2009. La plupart des études contenaient des preuves de niveau II.
Principal message
Au Canada, la pollution de l’air extérieur cause une morbidité et une mortalité importantes. Elle peut affecter le système respiratoire (exacerbation de l’asthme et de la maladie pulmonaire obstructive chronique) et le système cardiovasculaire (déclencher l’arythmie, l’insuffisance cardiaque et les AVC). La cote air santé (CAS) est un nouvel outil de communication mis au point par Santé Canada et Environnement Canada qui indique sur une échelle de 1 à 10, le risque pour la santé causé par la pollution atmosphérique. La CAS est largement diffusée dans les médias et cet outil pourrait être utile au médecin de famille pour inciter les patients à haut risque (comme ceux qui souffrent d’asthme, de maladie pulmonaire obstructive chronique ou d’insuffisance cardiaque) à réduire leur exposition à la pollution atmosphérique.
Conclusion
Le médecin de famille peut se servir de la CAS et de ses messages sur la santé pour enseigner aux asthmatiques et aux autres patients à risque élevé la façon de réduire les risques pour la santé causés par la pollution atmosphérique.
PMCID: PMC3155462
3.  A Cohort Study of Traffic-Related Air Pollution and Mortality in Toronto, Ontario, Canada 
Environmental Health Perspectives  2009;117(5):772-777.
Background
Chronic exposure to traffic-related air pollution (TRAP) may contribute to premature mortality, but few studies to date have addressed this topic.
Objectives
In this study we assessed the association between TRAP and mortality in Toronto, Ontario, Canada.
Methods
We collected nitrogen dioxide samples over two seasons using duplicate two-sided Ogawa passive diffusion samplers at 143 locations across Toronto. We calibrated land use regressions to predict NO2 exposure on a fine scale within Toronto. We used interpolations to predict levels of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5) and ozone levels. We assigned predicted pollution exposures to 2,360 subjects from a respiratory clinic, and abstracted health data on these subjects from medical billings, lung function tests, and diagnoses by pulmonologists. We tracked mortality between 1992 and 2002. We used standard and multilevel Cox proportional hazard models to test associations between air pollution and mortality.
Results
After controlling for age, sex, lung function, obesity, smoking, and neighborhood deprivation, we observed a 17% increase in all-cause mortality and a 40% increase in circulatory mortality from an exposure contrast across the interquartile range of 4 ppb NO2. We observed no significant associations with other pollutants.
Conclusions
Exposure to TRAP was significantly associated with increased all-cause and circulatory mortality in this cohort. A high prevalence of cardiopulmonary disease in the cohort probably limits inference of the findings to populations with a substantial proportion of susceptible individuals.
doi:10.1289/ehp.11533
PMCID: PMC2685840  PMID: 19479020
air pollution; GIS; mortality; nitrogen dioxide; traffic air pollution; Toronto

Results 1-3 (3)