BC LUNG ASSOCIATION state CELEBRATING THE CLEAN AIR MONTH OF JUNE OVID-19’s economic consequences are apparent everywhere. Yet the impact of 1 C COVID-19 restrictions on air quality and health are of less obvious – as are the effects of poor air quality on COVID-19 transmission and illness severity. 2 Accordingly, we begin this year’s State of the Air the Report with key findings on the subject, which a panel of international experts presented at the 18th Annual Air Quality & Health Workshop. We also provide an update on small air sensors’ 20 air reliability in measuring local air quality. Despite issues with certain models, Metro Vancouver and Environment and Climate Change Canada have recognized the potential of sensors in supplementing their air monitoring and forecasting efforts. In 2018, after the Air Quality Health Index (AQHI) periodically under-reported health risks from wildfire smoke in our province, the AQHI-Plus was developed. We feature this novel tool that has been recently adopted as a complementary model to AQHI. Speaking of wildfire smoke, B.C.’s wildfire season is constantly setting new records in both duration and severity. As another wildfire season becomes imminent, we offer 10 best practices to limit our exposure, protect our health, and better prepare us this year. Another innovation we’re featuring is UBC’s SmellVan, a web-based app that collects odour information from user-submitted reports to paint a “smellscape” (smell landscape). The SmellVan app does not replace Metro Vancouver’s odour complaint process, but it offers information useful to the agency’s air quality work. We also examine Metro Vancouver’s efforts to curb traffic-related air pollution – in particular, (i) the findings of a vehicle air emission study it undertook with various federal agencies, and (ii) data from its near-road air quality monitoring station on Clark Drive in Vancouver. This information is vital in developing air quality management plans and transportation policies. In closing, I’d like to thank once again all those who were involved in this year’s Report. And I wish everyone continued good health, safety, and faith during this pandemic. Forget-Me-Not: CHRISTOPHER LAM Illustration by President and CEO, BC Lung Association Natalia Lopes Air Quality and COVID-19 Pandemic COVID-19 was first identified in David Rich from the University of late 2019 and quickly spread world- Rochester spoke about epidemiologi- wide in early 2020. It was declared cal studies of air pollution and respi- a global pandemic in March 2020. ratory infection. This presentation People infected with COVID-19 can covered the current understanding experience a range of symptoms and of links between air pollution and severity of illness. The risk of negative respiratory infections other than CO- outcomes-including death—is higher VID-19. Overall, evidence indicates with COVID-19 than with other com- relationships with illness occurrence mon respiratory viruses. The virus and severity. has the potential to overwhelm public health care systems. impacts of COVID-19 restrictions on Researchers are also The first COVID-19 vaccines became air quality and health. evaluating the effect available in December 2020 and a Researchers are also evaluating the of air pollution on mass worldwide vaccination roll out effect of air pollution on COVID-19 is ongoing. To limit the spread of the COVID-19 transmission transmission and illness severity. His- disease, interactions between people and illness severity. torically, evidence has demonstrated have been restricted in 2020 during that air pollution exposure increases the earlier stages of the pandemic. In Lisa Miyashita from Queen Mary Uni- susceptibility to, and severity of, re- some regions, these restrictions re- versity of London then gave an over- spiratory viral infections and pneumo- sulted in a substantial but temporary view of the mechanisms of air pollu- nia. People exposed to higher levels reduction in vehicle traffic. Research- tion-associated respiratory infection. of air pollution may be at greater risk ers worldwide have taken advantage She included a summary of a study of becoming ill with COVID-19. They of this phenomenon to study the from London showing evidence for a may also experience the most severe biological mechanism by which par- outcomes. ticulate matter pollution may facilitate The 18th annual BC Lung Air Qual- COVID-19 infection. Data from the contents ity and Health Workshop was held study showed that respiratory cells virtually on March 3, 2021 with the exposed to traffic-related particulate 1 Foreword theme “Air Quality and the COVID-19 matter pollution had increased levels Pandemic”. The goal of the 2021 of the ACE2 cell receptor COVID-19 2 Air Quality and the Pandemic Workshop was to explore the latest uses to infect cells. 3 Monitoring Air Quality with research on: Small Sensors Eric Lavigne from Health Canada • The impact of restrictions on air summarized recent studies on air 5 The Air Quality Health Index in B.C. quality and health. pollution and COVID-19 incidence (AQHI+) • The role of poor air quality in COV- and outcomes from around the ID-19 transmission and illness severity. 6 Pollution Levels: world, including studies in Canada. How Does B.C. Measure Up Kristin Aunan from the Centre for In- He described the existing epide- 8 Trends: Air Pollution Through ternational Climate and Environmen- miological evidence for air pollution the Years tal Research in Oslo (CICERO) started and COVID-19. He highlighted the the day off speaking about the effect limitations of existing research from a 9 Prepare for the Worst: of decreased traffic during COVID-19 policy perspective. He concluded that, Get Ready for Wildfire Smoke lockdowns on air quality across the while recent studies provide evidence 10 Mapping the Metro Vancouver globe. She described widespread for a link between air pollution and Smellscape reductions in nitrogen oxide (NO2) COVID-19 incidence and outcomes, 11 Reducing Exposure To Traffic and particulate matter (PM2.5) as well further careful research is needed. Emissions as slight increases in surface ozone Paul Villeneuve from Carleton Uni- in some regions. Overall, the results 12 Legacy for Airway Health versity spoke about methodologi- provide evidence to support poli- cal considerations for studying an 14 Updates from Partner Agencies cies aimed at reducing traffic-related association between air pollution 16 Contact Information of Agencies emissions. 2 Monitoring Air Quality with Small Sensors and COVID-19. He described the Air quality monitoring stations oper- events such as wildfires. The pilot challenges in conducting epidemio- ated by federal, provincial or regional project is assessing the potential for logical studies of air pollution and governments use sophisticated instru- using small, low-cost sensor technol- COVID-19. He provided examples ments. These “reference monitors” ogy for a collaborative crowdsourc- of problematic designs and conclu- sions, and gave recommendations meet strict performance and operating ing approach in regions that do not for future studies. standards. The high quality data they have real-time particulate matter (PM) Shelly Miller produce is used for decisions about data. Evaluations have shown that of the Univer- regulations and policies and for re- the sensors reliably capture elevated sity of Colo- ports on the state of the air. Recently, PM concentrations during smoke rado Boulder there has been a proliferation of small, events. They are typically accurate to finished the low-cost air sensors that are easy to plus or minus one Air Quality Health day with a buy, set up, and operate. These small Index unit (AQHI-Plus formulation for presenta- tion on policy sensors are increasingly popular among biomass smoke). Sensor information and inter- residents and “citizen scientists” for can supplement information provided ventions for measuring local air quality. But, limited by ECCC’s air quality forecast models COVID-19, air quality, and health. certification and guidance for selection, and help people make informed health She provided a model of infection set up, and use can result in misleading decisions. risk, including the importance of collection or interpretation of data. aerosol transmission and the role A mapping tool, developed in collabo- of superspreading. She described Here’s an update on what’s happening ration with Dr. Peter Jackson at the the efficacy of a variety of interven- with small sensors: University of Northern BC, shows near tions and concluded with strategies real-time data from the sensors. It also for reducing COVID-19 risk. These Pilot Project to Make Particulate included recommendations regard- shows traditional air quality data from ing ventilation rates and the use of Matter (PM) Data Available the National Air Pollution Surveil- HEPA air cleaners for smaller rooms Environment and Climate Change lance Program network. Colour coded and germicidal UV light for larger concentration icons on the map will rooms. She also gave recommen- Canada (ECCC) is working on a pilot inform users at a glance where PM is dations for improving community project, in collaboration with partners, respiratory health after COVID-19, to enhance real-time air quality data elevated. By clicking on the icon, users including: and forecasting during high-impact can view the change in PM concentra- • mandating cooking exhaust hoods in all residences • electrifying homes to reduce reliance on biomass burning • addressing traffic related air pollution exposures. The workshop was attended by 396 participants; most of them join- ing from Canada but also including participants from the US, Europe, the Middle East, South Africa, and South America. The speakers’ slides are available online https:// bc.lung.ca/health-professionals/air- quality-health-workshop Photo credits Charlotte May, Tim Mossholder from Pexels Image from: https://cyclone.unbc.ca/aqmap (Cont’d on p.4) 3 (Cont’d from p.3) tion over time and associated health messaging.