The Globe and Mail, Friday, May 19, 2000

Some doctors doubt smog report
  Physician would be 'surprised' if bad air caused 1,000 deaths a year By
James Rusk and RenéE Huang
 

Toronto -- A Toronto public-health study that links 1,000 city deaths a
year to air pollution drew swift calls in some quarters for new efforts to
combat smog. Some local doctors, however, are still cautious about the
study's conclusions, which attribute a high number of breathing-related
deaths to city smog.

Yesterday, Toronto councillor Jack Layton, chairman of city council's
environment task force, said the city should give the highest priority to
measures that would boost public transit and thus reduce the number of
vehicles on the road.

The study found that carbon monoxide and nitrogen dioxide, both found in
vehicle exhaust, as well as ozone, metal fumes and other particulate
matter had adverse effects on human health.

Mr. Layton said the solution is to make it easy for people to leave their
cars at home.

"Offering people other ways of getting around is a really high priority
for reducing this death rate. . . . We need to get very serious about
extending public-transit options into the entire Greater Toronto Area, and
fast, much faster than we had thought," Mr. Layton said.

But Susan Tarlo, a respiratory physician at Toronto Western Hospital and a
lecturer at University of Toronto, said she has not seen an increase in
out-patient calls during days with high air-pollution levels.

"Healthy people are not dropping dead from air pollution. . . . No one
doctor can say that a person died from air pollution."

Dr. Tarlo said that people must be cautious when interpreting studies
based on statistical associations.

"There have been a number of population-based studies that have shown an
increase in hospital admissions for people with heart and lung disease,
and studies that have shown a high level of air pollution [on the same
days]. They do not prove a cause and effect. They prove an association,"
she said.

Isser Dubinsky, chief of emergency medicine at the university health
network, said "there's no question" hospital admissions increase on heavy
smog days, but he was reluctant to blame the spike in respiratory-related
deaths to air pollution.

"Frankly, I would be surprised if smog, in and of itself, accounted for
1,000 extra deaths," Dr. Dubinsky said in a telephone interview. "I don't
know what methodology [the study authors] used."

Whatever the medical debate may be, Mr. Layton said the issues raised in
the report underscore the need for increased support for public transit to
get more people off the road.

He said that financial support for public transit has to rise so that the
system can expand and increase its share of trips in the area. Ten years
ago, 18 per cent of all trips in the GTA were by public transit; now it is
13 per cent.

But the goal is not to get everyone out of their cars. "Ten per cent
[fewer car trips] might bring us down below some of these critical
thresholds with regard to health impacts."
 
 
 

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