December 11 | 2017

The Chief Public Health Officer’s Report on the State of Public Health in Canada 2017 – Designing Healthy Living

The Chief Public Health Officer’s Report on the State of Public Health in Canada 2017 – Designing Healthy Living

A message from Canada’s Chief Public Health Officer

Without being aware of it, our neighbourhoods and how they are built influence how healthy we are.

I chose designing healthy living as the topic for my first report as Canada’s Chief Public Health Officer because of the tremendous potential that changing our built environment has for helping Canadians live healthier lives.

Chronic diseases like diabetes, cancer and cardiovascular disease are the leading causes of death in Canada. It is alarming that in 2011, almost 2.7 million or 1 in 10 Canadians 20 years and older were living with diabetes. Rising rates of type II diabetes can be considered a red flag for poor health as they are associated with higher rates of other diseases and conditions and linked to an unhealthy diet, low physical activity and higher rates of overweight and obesity. Rates of type II diabetes and other chronic diseases in Canada could be reduced by seamlessly integrating healthy living into our daily lives which can be achieved, in part, by designing and redesigning our communities.

Improving public health and preventing disease through changes to our environment is a well-founded concept. For example, infectious disease rates in the last century were reduced not just through scientific innovation and vaccination, but also through infrastructure planning by improving sanitation and addressing overcrowding in residential neighbourhoods.

This report answers many questions but also raises several others. We need better information if we are to measure the health impacts of community design to incorporate evidence-based strategies into community planning. This report will raise awareness among Canadians about the unique aspects of their communities that they could take advantage of to improve their health. It will also encourage more dialogue across the many disciplines involved in community planning and health promotion so that neighbourhood design considers and promotes physical activity, healthy diets and mental wellness.

Dr. Theresa Tam
Chief Public Health Officer of Canada

https://www.canada.ca/en/public-health/services/publications/chief-public-health-officer-reports-state-public-health-canada/2017-designing-healthy-living.html

December 4 | 2017

Heat and pregnancy-related emergencies: Risk of placental abruption during hot weather.

He S1Kosatsky T2Smargiassi A3Bilodeau-Bertrand M4Auger N5.

Environ Int. 2017 Nov 13. pii: S0160-4120(17)31686-0  DOI:10.1016/j.envint.2017.11.004

Abstract

INTRODUCTION:

Outdoor heat increases the risk of preterm birth and stillbirth, but the association with placental abruption has not been studied. Placental abruption is a medical emergency associated with major morbidity and mortality in pregnancy. We determined the relationship between ambient temperature and risk of placental abruption in warm seasons.

MATERIAL AND METHODS:

We performed a case-crossover analysis of 17,172 women whose pregnancies were complicated by placental abruption in Quebec, Canada from May to October 1989-2012. The main exposure measure was the maximum temperature reached during the week before abruption. We computed odds ratios (OR) and 95% confidence intervals (CI) for the association of temperature with placental abruption, adjusted for humidity and public holidays. We assessed whether associations were stronger preterm or at term, or varied with maternal age, parity, comorbidity and socioeconomic status.

RESULTS:

Compared with 15°C, a maximum weekly temperature of 30°C was associated with 1.07 times the odds of abruption (95% CI 0.99-1.16). When the timing of abruption was examined, the associations were significantly stronger at term (OR 1.12, 95% CI 1.02-1.24) than preterm (OR 0.96, 95% CI 0.83-1.10). Relationships were more prominent at term for women who were younger than 35years old, nulliparous or socioeconomically disadvantaged, but did not vary with comorbidity. Associations were stronger within 1 and 5days of abruption. Temperature was not associated with preterm abruption regardless of maternal characteristics.

CONCLUSIONS:

Elevated temperatures in warm seasons may increase the risk of abruption in women whose pregnancies are near or at term. Pregnant women may be more sensitive to heat and should consider preventive measures such as air conditioning and hydration during hot weather.

Noise Exposure and Cardiovascular Onset | January 10th | 2018 | REGISTER NOW

January 10|2018

9am – 10am pacific |12 noon – 1pm eastern

Environmental noise has been linked to a number of health effects including annoyance, sleep disturbance and cardiovascular diseases (CVD). In this seminar, we will present the current evidence on the association between environmental noise and onset of CVD. We will also present preliminary assessments of associations between noise and CVD in Quebec. These assessments are based on population cohorts created with linked medico-administrative health data and recent noise models. We will also present gaps that remain on the relationship between environmental noise and the onset of CVD.


Audrey Smargiassi is an Associate Professor at the Department of Environmental and Occupational Health at the School of Public Health and a researcher at the Public Health Research Institute at the University of Montreal.


Larisa Ines Yankoty is a PhD Candidate in Public Health, Epidemiology at the School of Public Health at the University of Montreal.

Paper of the Week | November 27 | 2017

Noise exposure while commuting in Toronto – a study of personal and public transportation in Toronto

Christopher M.K.L. Yao, Andrew K. Ma, Sharon L. Cushing and Vincent Y.W. Lin.

Journal of Otolaryngology – Head & Neck Surgery201746:62 https://doi.org/10.1186/s40463-017-0239-6 23 November 2017

Abstract

Background

With an increasing proportion of the population living in cities, mass transportation has been rapidly expanding to facilitate the demand, yet there is a concern that mass transit has the potential to result in excessive exposure to noise, and subsequently noise-induced hearing loss.

Methods

Noise dosimetry was used to measure time-integrated noise levels in a representative sample of the Toronto Mass Transit system (subway, streetcar, and buses) both aboard moving transit vehicles and on boarding platforms from April – August 2016. 210 measurements were conducted with multiple measurements approximating 2 min on platforms, 4 min within a vehicle in motion, and 10 min while in a car, on a bike or on foot. Descriptive statistics for each type of transportation, and measurement location (platform vs. vehicle) was computed, with measurement locations compared using 1-way analysis of variance.

Results

On average, there are 1.69 million riders per day, who are serviced by 69 subway stations, and 154 streetcar or subway routes. Average noise level was greater in the subway and bus than in the streetcar (79.8 +/− 4.0 dBA, 78.1 +/− 4.9 dBA, vs 71.5 +/−1.8 dBA, p < 0.0001). Furthermore, average noise measured on subway platforms were higher than within vehicles (80.9 +/− 3.9 dBA vs 76.8 +/− 2.6 dBA, p < 0.0001). Peak noise exposures on subway, bus and streetcar routes had an average of 109.8 +/− 4.9 dBA and range of 90.4–123.4 dBA, 112.3 +/− 6.0 dBA and 89.4–128.1 dBA, and 108.6 +/− 8.1 dBA and 103.5–125.2 dBA respectively. Peak noise exposures exceeded 115 dBA on 19.9%, 85.0%, and 20.0% of measurements in the subway, bus and streetcar respectively.

Conclusions

Although the mean average noise levels on the Toronto transit system are within the recommended level of safe noise exposure, cumulative intermittent bursts of impulse noise (peak noise exposures) particularly on bus routes have the potential to place individuals at risk for noise induced hearing

November 20 | 2017

Estimating the health benefits of planned public transit investments in Montreal.

Tétreault LF1, Eluru N2, Hatzopoulou M3, Morency P4, Plante C5, Morency C6, Reynaud F7, Shekarrizfard M3, Shamsunnahar Y2, Faghih Imani A7, Drouin L4, Pelletier A5, Goudreau S5, Tessier F5, Gauvin L8, Smargiassi A9.

Environ Res. 2017 Oct 23;160:412-419. https://doi.org/10.1016/j.envres.2017.10.025

BACKGROUND:

Since public transit infrastructure affects road traffic volumes and influences transportation mode choice, which in turn impacts health, it is important to estimate the alteration of the health burden linked with transit policies.

OBJECTIVE:

We quantified the variation in health benefits and burden between a business as usual (BAU) and a public transit (PT) scenarios in 2031 (with 8 and 19 new subway and train stations) for the greater Montreal region.

METHOD:

Using mode choice and traffic assignment models, we predicted the transportation mode choice and traffic assignment on the road network. Subsequently, we estimated the distance travelled in each municipality by mode, the minutes spent in active transportation, as well as traffic emissions. Thereafter we estimated the health burden attributed to air pollution and road traumas and the gains associated with active transportation for both the BAU and PT scenarios.

RESULTS:

We predicted a slight decrease of overall trips and kilometers travelled by car as well as an increase of active transportation for the PT in 2031 vs the BAU. Our analysis shows that new infrastructure will reduce the overall burden of transportation by 2.5 DALYs per 100,000 persons. This decrease is caused by the reduction of road traumas occurring in the inner suburbs and central Montreal region as well as gains in active transportation in the inner suburbs.

CONCLUSION:

Based on the results of our study, transportation planned public transit projects for Montreal are unlikely to reduce drastically the burden of disease attributable to road vehicles and infrastructures in the Montreal region. The impact of the planned transportation infrastructures seems to be very low and localized mainly in the areas where new public transit stations are planned.

 

November 13 | 2017

The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health

Watts et al

The Lancet, DOI: http://dx.doi.org/10.1016/S0140-6736(17)32464-9

Summary

The Lancet Countdown tracks progress on health and climate change and provides an independent assessment of the health effects of climate change, the implementation of the Paris Agreement,1 and the health implications of these actions. It follows on from the work of the 2015 Lancet Commission on Health and Climate Change,2 which concluded that anthropogenic climate change threatens to undermine the past 50 years of gains in public health, and conversely, that a comprehensive response to climate change could be “the greatest global health opportunity of the 21st century”.

Walkability Experts Workshop | November 16-17 | 2017

(Photo credit: Project for Public Spaces)

Dr. Dan Fuller (Neighbourhood Factors Team Co-leader) at Memorial University | St. John’s Newfoundland is hosting this Expert Workshop to:

  • discuss the future of walkability measure,
  • work on conceptual definitions of walkability,
  • identify new and emerging methods for measuring walkability, and
  • chart the way forward for CANUE as we implement the next wave of wakability metrics.

WATCH for the workshop summary on our reports page in December.

Linking Air Quality, Climate and Environmental Inequity | November 21 | 2017 | REGISTER NOW

November 21 | 2017
9am – 10am pacific | 12 noon – 1pm eastern

Main drivers of air pollution, greenhouse gas emissions, and urban environmental inequities often overlap, yet rarely do our efforts to address these problems are carried out in an integrated manner.

The growing political will to reduce greenhouse gas emissions around the world is likely to bring significant investments into mitigation policies, including in urban areas. In this policy context, without rigorous coordination between policies that target climate, air pollution, and environmental justice, cities can miss on a unique opportunity to harvest ancillary public health and societal benefits from their climate investments.

In this talk we explore methods that rely on air quality models and mathematical analyses to quantify the impact of individual pollution sources on various policy endpoints such as health or environmental justice.

We provide examples of decision metrics that link various endpoints to sources of air pollution, and explore ways to leverage the wide range of expertise within CANUE to incorporate such quantitative analyses into an integrated assessment platform.

 

Amir Hakami is an Associate Professor in the Department of Civil and Environmental Engineering at Carleton University. His expertise is in air quality modeling and use of mathematical methods within these models to address problems that lie at the interface of policy, health, and economics of air pollution.

 

 

 

Robyn Chatwin-Davies is a Master’s student at Carleton University studying atmospheric modelling and air quality. Specifically, her research focuses on environmental justice, as she seeks to understand the relationship between pollution and socio-economic status. Robyn previously completed a Bachelor in Environmental Engineering, graduating with High Distinction in 2012.

 

 

 

Angele Genereux is currently completing her Master’s degree in Environmental Engineering at Carleton, after completing a Bachelor of Engineering degree at the same department in 2016. Her work focuses on estimating the health damage from vehicular emissions on an age-segregated basis, and on ways that these emissions affect environmental health in densely populated urban areas.

International Society of Exposure Science | International Society of Environmental Epidemiology Conference | August 26 – 30 | 2018 | Ottawa

CANUE Members are heading to Ottawa in August 2018!

We will be submitting proposals for workshops, symposia and presentations to showcase CANUE data and results!

Join us for a CANUE membership meeting – date and time to be announced – keep in the loop via the Newsletter.

Canadian Public Health Conference | Call for submissions closing Dec 5th

CANUE members are heading to Montreal, May 28th-31st | 2018

We are currently working on a submission for a CANUE symposium featuring analyses of our newly available national data and reviews of greenness metrics and associations with population health.

Let us know if you plan to attend or have additional ideas for our symposium! Email info@canue.ca