Copies of this report are available from: Office of the Provincial Health Officer B.C. Ministry of Health Services 4th Floor, 1515 Blanshard Street Victoria, BC V8W 3C8 Telephone: (250) 952-1330 Facsimile: (250) 952-1362 and electronically (in a .pdf file) from: http://www.healthservices.gov.bc.ca/pho/ Suggested citation: British Columbia. Provincial Health Officer. (2004). Every Breath You Take…Provincial Health Officer’s Annual Report 2003. Air Quality in British Columbia, a Public Health Perspective. Victoria, BC Ministry of Health Services. National Library of Canada Cataloguing in Publication Data Main entry under title: Provincial Health Officer’s annual report. – 1992 – Annual. At head of title: A report on the health of British Columbians. Some issues also have a distinctive title. None issued for 1993. ISSN 1195-308X = Provincial Health Officer’s annual report 1. Health status indicators - British Columbia - Periodicals. 2. Public health - British Columbia – Statistics - Periodicals. I. British Columbia. Provincial Health Officer. II. Title: Report on the health of British Columbians. RA407.5.C3B74 614.4’2711 C93-092297-2 Every breath you take… Provincial Health Officer’s Annual Report 2003 Air Quality in British Columbia, A Public Health Perspective Ministry of Health Services Office of the Provincial Health Officer Ministry of Health Services Victoria, BC December 9, 2004 The Honourable Colin Hansen Minister of Health Services Sir: I have the honour of submitting the Provincial Health Officer’s Annual Report for 2003. P.R.W. Kendall, MBBS, MSc, FRCPC Provincial Health Officer Provincial Health Officer’s Annual Report 2003 • Air Quality in British Columbia, a Public Health Perspective i Table of Contents Highlights . ix Chapter 1: The Air We Breathe . .1 What is Air Pollution? . .2 Global Climate Change-Greenhouse Gases and Chlorofluorocarbons . .3 Outdoor and Indoor Air Pollution: Is There a Difference? . .4 Outdoor Air Pollution . .5 Indoor Air Pollution . .5 Exposures and Pathways . .5 Methods of Study . .7 Toxicological Studies . .7 Epidemiological Studies . .7 Health Impacts of Air Pollution, Overview – “From Intuition to Evidence” . .8 Direct Health Effects . .9 Indirect Health Effects . .9 Air Quality: Risks vs. Benefits . .11 Air Quality is Everybody’s Business . .12 Chapter 2: Outdoor Air Pollutants and Their Health Effects . .13 Types of Outdoor Air Pollutants . .13 Criteria Pollutants . .13 Particulate Matter . .13 Sulphur Dioxide . .14 Carbon Monoxide . .14 Nitrogen Dioxide . .14 Ozone . .15 Selected Non-Criteria Pollutants . .15 Lead . .16 Benzene . .16 Dioxins, Furans, and Polychlorinated Biphenyls . .17 Provincial Health Officer’s Annual Report 2003 • Air Quality in British Columbia, a Public Health Perspective iii Table of Contents Pesticides . .18 Ammonia . .18 Hydrogen Sulphide . .19 Pollens and Spores . .19 Chapter 3:Indoor Air Pollutants and Their Health Effects . .23 Indoor Air Pollution . .23 Combustion By-Products and Tobacco Smoke . .24 Volatile Organic Compounds . .24 Formaldehyde . .24 Toluene . .24 Asbestos . .25 Radon . .25 Microbiologic Agents . .25 Second-hand Smoke . ..