# Presentation: 103856

## Air Quality Health Index: Fundamentals and Future  

**Dave Henderson (MSC/Environment Canada) **
**& Kelly Lehman (AHED/Health Canada)**
- US EPA Air Now Conference
- Portland Oregon
- April 7-10, 2008

**Notes:**

Health-based 
Scientifically accurate
User-friendly 
Nationally-consistent
Regionally-flexible.

## AQHI Presentation History

*AQHI Presentation History*

- February 2005 - San Francisco
*Revisiting Canadian Air Quality Indices: A Health Risk Based Approach*
*Development of the AQHI*
- February 2007 - Orlando
*Testing and Evaluating the Air Quality Health Index*
*“**Lessons Learned” from AQHI Development Pilots*
- April 2008 – Portland

## Presentation

*Presentation*

- Fundamentals (Primer)
- Update: What’s new since February 2007
*The transition from pilot to implementation*
- What’s next

## AQHI Primer

## Objectives

*Objectives*

- To create a national communications tool for personal health protection from the adverse health effects associated with the “air pollution mixture”.
- To use “health-awareness” as a tool to promote personal action to reduce air pollution
- To create advocates for reducing pollution

**Notes:**
Marching orders from the 2001 stakeholder workshop which kicked off the development of the index are still in play. The intent being to replace the inconsistent presentation of air quality information across Canada

Health-based 
Scientifically accurate
User-friendly 
Nationally-consistent
Regionally-flexible.

## Concept

*Concept*

- Decouple air quality regulation from provision of health advice
- Support active living
- Based on time series epidemiology
- Uses results from studies of short term health effects
- Multi-city Canadian analysis
- Mortality/ (morbidity)
- Meant to represent risk of mixture – formulation based on multiple pollutants (O3, PM and NO2)
- Rolling 3 hour concentrations
- 1-10+ scale

**Notes:**
No warnings at this time – non-threshold/self calibration concept
Very focused on health – not a strong link to what people can do about their air quality but rather how they should plan their day to maximise benefit and reduce risk
b/c of this it is also a tool to encourage healthy living

## Multi-Pollutant Performance

*Multi-Pollutant Performance*

## Will things look better or worse with the AQHI?

*Will things look better or worse with the AQHI?*

- Depends
- Ozone, PM2.5 not so dominant
- Areas with traffic/NO2 may look worse

- Existing AQI:
- “Air quality is good
- 90% of the time”

- AQHI:
- “Air quality is low risk
- 70% of the time”

- Typically

## AQHI Presentation: UV Index-Like

*AQHI Presentation: UV Index-Like*

- Illustrates level of health risk with **colour &** **number scale** of 0-10+
**Labels the level of HEALTH risk** as “low”, “moderate”, “high” or “very high”
**Forecasts** local air quality for the current and next day
**Empowers individuals** to decide how they might be at risk
- Provides **health messaging** to tell Canadians—both general & at-risk populations—how to minimize that risk

## AQHI Health Messages

*AQHI Health Messages*

**Notes:**
-messages kept very simple
- Separated out general population and ‘at risk’ population

## How do we expect people to use the AQHI?

*How do we expect people to use the AQHI?*

- Self Calibration (no threshold)
*Identify AQHI number that triggers worsening of condition or symptoms, such as coughing or throat irritation (different for at-risk groups)*
- Plan activities
- A way to promote active living

**Notes:**
trying to make a part of people’s lives 
No warnings because not threshold based.  No warning doesn’t necessarily equal ‘safe’

## What’s New

## New Since Last Presentation 

*New Since Last Presentation *

- Funding for implementation

## Joint Implementation Announcement July 2007 by federal Ministers of Environment and Health 

*Joint Implementation** **Announcement July 2007 by federal Ministers of Environment and Health *

| Health Canada | Environment Canada |
| --- | --- |
| Coordinate national roll-out of AQHI with EC | Delivery of Air Quality Reports and Forecasts |
| Develop and disseminate AQHI public health information  | AQHI & Forecast Program Management  |
| Communications Campaign | Delivery of Health & Environment Information and Public Outreach |

- Implementation over 4 years (FY 07-2010)

- **Provinces, municipalities and stakeholders/NGO’s key**

**Notes:**
Jointly administered by Health Canada and Environment Canada
Funding approved as of October 2007 under the Clean Air Agenda
This table gives you an idea of how the roles and money have been allocated
What is key to recognise is that the vast majority of the work and roll-out and outreach work is being done by provinces, municipalities and NGO’s
This is funded through EC and HC

## Implementation: All About Partnerships 

*Implementation: All About Partnerships *

- Monitoring
- Provincial or municipal* – data transferred in close to real time to EC*
- Data Management
- EC* - database for forecasters, WeatherOffice and partners*
- Forecasting
- EC* - Training, forecast tools and issuing multi-pollutant forecasts*
-  Dissemination
- EC* WeatherOffice primary vehicle and other media*
- Outreach and Communications
- Local Public Health* with support from HC (*_Health)_
*NGO partners with the support of EC (*_Environment)_
- Air Health Affects
- HC *- Health messaging, formulation and issues of exposure *
- Evaluation
- Local Partners* (with federal guidance)*

**Notes:**
The pilot/implementation scheme is a partnership

## Implementation Coordination

- Forecast Verification

- NGO activity and evaluations

- Primary Partner Outreach
- Activities and Evaluation

- Dissemination/Operational
- Evaluations

- Toronto

*Implementation Coordination*

- Lessons Learned and Products
- for Implementation

**Notes:**
BC – Forest Fire messaging
Toronto – multi-cultural – multiple languages, outreach prgms
New Brunswick – TRS and SO2 messaging
Still need – rural social marketing piece

## New Since Last Presentation 

*New Since Last Presentation *

- Funding for implementation
- Resolution of the national branding question

## Status of National Branding 

*Status of National Branding *

- Challenging
- Creative work
- Recent Health Canada-sponsored national on-line testing of options
*Approx 3⁄4 approved term Air Quality Health Index*
*French ... Cote Air Sante*
- POR work suggested of finalize “look” of brand

**Notes:**

Decision allows local partners to develop campaigns to support the AQHI at the local level (more later)

## New Since Last Presentation (cont)

*New Since Last Presentation (cont)*

- Funding for implementation
- Resolution of the national branding question
- Development of AQHI forecast capacity

## Forecast Capacity

*Forecast Capacity*

- Necessity to forecast for multi-pollutants
*O3 –good skill, PM –improving and NO2 emerging*
*Surprisingly good forecast scores to date*
- Develop new forecast tools
- Develop air quality capacity in a new forecast region and augment in others

**Notes:**
+ or minus 1 AQHI value 80% of the time

## New Since Last Presentation (cont)

*New Since Last Presentation (cont)*

- Funding for implementation
- Resolution of the national branding question
- Development of AQHI forecast capacity
- Adaptation of dissemination for the AQHI

## Dissemination

*Dissemination*

- Linkages between the provision of weather information and the AQHI
*Study underway to best determine how to capitalize on existing and planned systems*
*POR to look at challenges in conveying AQHI in public forecasting*
- Re-tailoring Weather Office for AQHI
- Building the National Portal
*Vanity url - airhealth.ca*

**Notes:**
Consistency important
Want to direct public to one place (most bang for buck resource wise and minimizes confusion)

## Slide 23

## Slide 24

## Slide 25

## Slide 26

## New Since Last Presentation 

*New Since Last Presentation *

- Funding for implementation
- Resolution of the national branding question
- Development of AQHI forecast capacity
- Adaptation of wx dissemination systems for the AQHI
- New communications tools and partnerships
*Advancing implementation*

## Communications Tools and Partners

*Communications Tools and Partners*

- Development of new E-learning tool for public health professionals
- Study on existing communications
- Public Sharepoint Site
*Sharing of communications products (both ways)*
- teleconferences with US EPA and border states
- Increasing linkages into health and environmental NGO communities

## What’s Next

## Schedule

*Schedule*

- Phased implementation (pilot to implementation)
- 2008-09
*Transition to AQHI in British Columbia (14 locations) – 4 CMAs*
*Ottawa/Gatineau*
*Saint John, NB*
*Expansion to GTA*
*Montreal* tentative
*Halifax (with other potential sites in Atlantic Canada)*
- 2009-2011 – Remaining census metropolitan areas

**Notes:**
The AQHI will not be rolled out on a specific day – it will be phased in taking into consideration the readiness of the stakeholders and technical abilities.

## Slide 31

## Campaign for Toronto

*Campaign for Toronto*

## British Columbia Creative Concept

*British Columbia Creative Concept*

**Notes:**
Good example of one region building on another’s creative work
Other areas will be able to use and tailor to their needs
 will be showing some sample ads – not finished but illustrate the concept

## Radio	

*Radio**	*

- Both BC and Toronto developing
- Toronto’s posted on website
- 	_[http://www.toronto.ca/health/airquality/aqhi/campaign.htm](http://www.toronto.ca/health/airquality/aqhi/campaign.htm)_

## What is Next

*What is Next*

- Introduction schedule
*Learning continues*
*Communications campaigns *
- Ensure index reflects state of science and data
- National media campaign and continue to work with mass media partners (Weather Network and others)
- Evaluation (ongoing and iterative)

## Thank-you

*Thank-you*

- Contact Information:
- Dave Henderson – Environment
- _[Dave.Henderson@ec.gc.ca](mailto:Dave.Henderson@ec.gc.ca)_
- Kelly Lehman - Health
- _[Kelly_Lehman@hc-sc.gc.ca](mailto:Kelly_Lehman@hc-sc.gc.ca)_
- 613-954-4505