Western University Scholarship@Western Electronic Thesis and Dissertation Repository 12-5-2014 12:00 AM Environmental Health Effects of Multiple Exposures: Systemic Risks and the Detroit River International Crossing Study Tor H. Oiamo The University of Western Ontario Supervisor Dr. Isaac Luginaah The University of Western Ontario Joint Supervisor Dr. Joy Parr The University of Western Ontario Graduate Program in Geography A thesis submitted in partial fulfillment of the equirr ements for the degree in Doctor of Philosophy © Tor H. Oiamo 2014 Follow this and additional works at: https://ir.lib.uwo.ca/etd Part of the Environmental Health and Protection Commons, Environmental Indicators and Impact Assessment Commons, Environmental Public Health Commons, Nature and Society Relations Commons, and the Urban Studies and Planning Commons Recommended Citation Oiamo, Tor H., "Environmental Health Effects of Multiple Exposures: Systemic Risks and the Detroit River International Crossing Study" (2014). Electronic Thesis and Dissertation Repository. 2553. https://ir.lib.uwo.ca/etd/2553 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. ENVIRONMENTAL HEALTH EFFECTS OF MULTIPLE EXPOSURES: SYSTEMIC RISKS AND THE DETROIT RIVER INTERNATIONAL CROSSING STUDY (Thesis format: Integrated Article) by TOR HENNING OIAMO Graduate Program in Geography (Environment and Sustainability) A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy The School of Graduate and Postdoctoral Studies The University of Western Ontario London, Ontario, Canada © Tor Henning Oiamo 2015 ABSTRACT This thesis examines cumulative exposures to traffic noise and outdoor air pollution on environmental and health related quality of life in Windsor, Ontario, and provides a critical analysis of the environmental assessment process for the Detroit River International Crossing (DRIC) Study. The research utilizes a systemic risk framework to understand environmental health and stress effects of cumulative exposures. The significance of this research is based on a relative absence of literature on the systemic health risks of cumulative exposures and the need to elucidate environmental annoyance as a health outcome for risk assessment. The objectives of the research were to (1) Demonstrate the impact of high volume traffic facilities on the noise annoyance dose-response; (2) Evaluate the effect of cumulative exposures and odour annoyance on noise annoyance; (3) Conceptualize and test a model for annoyance as a health outcome of multiple exposures, and; (4) Critically appraise the capacity of environmental impact assessment to address environmental health in megaproject planning. Data from a community survey (n=610) in 2013 were combined with spatial data exposures to traffic noise and ambient nitrogen dioxide. Bivariate analyses, multivariate regression and structural equation modeling were used for the quantitative analysis. Document and media analyses were used to construct stakeholder discourses on environmental health and risk perceptions of relevance to the DRIC Study. The results of an ordinal location-scale model used to predict noise annoyance demonstrated a dose-response effect of noise, significant interactions between noise and air pollution, and a strong confounding effect of odour annoyance. A structural equation model for environmental and health related quality of life indicated that noise annoyance had a negative impact on functional mental and physical health, and that odour annoyance and levels of co-exposure were important covariates. The ii results of the quantitative analysis corresponded with community discourses on environmental health during the DRIC Study. Further analysis showed that the environmental assessment process obfuscated community health risks and stakeholder participation, lending support to the utilization of systemic risk perspectives and integrated environmental impact health assessments in megaproject planning. The DRIC study findings were in disagreement with public perceptions and previous research that demonstrates strong contributions of border traffic to air pollution and significant associations between air pollution and health in Windsor. The results of this thesis complement these findings by showing that ambient stressors in Windsor and in the environmental context of the DRIC megaproject had a systemic effect on health. This provides a unique contribution to the environmental health literature on cumulative effects of exposure to environmental noise and ambient pollution. It also provides a methodological contribution to systemic health risk assessment for measuring impacts of multiple environmental exposures on health related quality of life. For future research on environmental health the results warrant explicit consideration of multiple exposures and their combined effects as ambient stressors. Keywords: Environmental health, systemic health risks, risk perception, cumulative exposure, exposure assessment, traffic noise, outdoor air pollution, noise modelling, land use regression, odour annoyance, noise annoyance, noise sensitivity, quality of life, health related quality of life, SF-12, environmental assessment, health impact assessment, systemic risk assessment, Windsor, Ontario. iii CO-AUTHORSHIP STATEMENT This thesis is made up of a collection of papers which are currently being prepared for publication. While these papers were co-authored with my thesis supervisors and others, as the first author I conducted the majority of research and writing for Chapter Two and all research for Chapter Three, Four and Five relating to problem formulation, literature review, survey and traffic noise data collection, data analysis and writing. The co-authors provided guidance on revising the manuscripts, while Alison Grgicak-Mannion and Dr. Xiaohing Xu conducted the monitoring and modeling of air pollution. Chapter Two: Oiamo, T.H., Lafreniere D., and Parr, J. The Making of a Key North American Environment of Mobility: the Windsor-Detroit Borderland. Forthcoming in: Coates, C., Young, J., and Bradley, B. (Eds.). Moving Natures: Environment and Mobility in Canadian History. Calgary: University of Calgary Press and NiCHE series, Energy, Ecology, and the Environment. Chapter Three: Oiamo, T.H., Baxter, J., Grgicak-Mannion, A., Xu, X., Luginaah, I.L. Combined effects of air pollution and traffic noise on noise annoyance and the mediating role of odours (being prepared for publication). Chapter Four: Oiamo, T.H., Luginaah, I.L. Baxter, J. Cumulative effects of noise and odour annoyances on environmental and health related quality of life (being prepared for publication). Chapter Five: Oiamo, T.H., Lugniaah, I.L., Parr, J. Environmental health impact assessment: a missed opportunity for the Detroit River International Crossing Study? (being prepared for publication). iv ACKNOWLEDGEMENTS I have been very fortunate during my time as a graduate and undergraduate student at Western University, and the completion of this thesis would not have been possible without the support of many great people. I will undoubtedly miss a few here, but hope you know I am forever grateful. First and foremost, I would like to thank my supervisors, Dr. Isaac Luginaah and Dr. Joy Parr. You were an inspiration to follow my interest in environmental health before we met, and you will continue to be my mentors in academic and everyday life. Dr. Luginaah, for believing first in my abilities to complete an undergraduate thesis, then a PhD thesis, I thank you sincerely. You have given me more opportunities than I could have imagined possible, too many to list here, and you were always available for advice and guidance amid awe- inspiring and continuing efforts to support your students. To Dr. Joy Parr, thank you for your time and thoughtful consideration of my wellbeing and intellectual exploits during a challenging time. Thank you also for constantly challenging me to hone my academic skills, and for reminding me to be practical when I (often) forgot. I would like to offer a special thank you to Dr. Jamie Baxter, for all ‘intensive purposes’ a supervisor, and a voice of reason throughout my time as a graduate student. Thank you to Kathy Tang for countless hours of GIS tutoring. I would also like to thank Dr. John Ciriello for introducing me to research during my undergraduate years in his laboratory and Dr. Dan Shrubsole for providing opportunities beyond research during my PhD. To Lori Johnson, Caroline Majeau, Angelica Lucaci, Joe Smrekar and all the staff in the geography department, thank you for making it work. v This work would not be possible without generous support from the Social Sciences and Humanities Research Council through a research grant and scholarships, as well as Western University for graduate funding and other support. Collaborators at Health Canada and the University of Windsor were also instrumental for my timely and successful completion. A special thanks to Hans Forschner at SoundPLAN for the generous support and licensing, and Alan Boucquey at Canadian Viewpoint Inc. for help with the survey. Thanks to my fellow graduate students for truly making my time at Western the best student experience, in particular everyone in the EHHL lab current and past for help and moral