Healthy Living in the North

Crunching the numbers to protect our health

To shed some light on a topic that is so often out of view, occurring at the level of tiny particles, I spoke with air quality meteorologist Gail Roth. She took me through a day in the life of someone who spends a lot of time amidst tiny particles with big health impacts!

How do we measure air quality?

The Ministry of Environment has two types of monitors, continuous and non-continuous, that are set up in communities all over B.C. We monitor all sorts of pollutants, including sulphur dioxide, nitrogen oxides, and more.

Because it’s the air pollutant that most often exceeds provincial objectives, a primary area of concern is particulate matter pollution – the tiniest of particles in the air that can get stuck deep in our lungs. These are called PM2.5 – particulate matter (PM) that is 2.5 micrometres or smaller in diameter. For comparison, a human hair is approximately 60 micrometres in diameter. PM2.5 is largely generated from combustion sources (e.g., vehicles, residential wood burnings, industrial processes).

We also monitor PM10 (particulate matter that is smaller than 10 micrometres). These larger particles are mostly caused by big particles like road dust, wood dust, or pollen being broken down.

In both cases, we measure how many of these particles there are in one cubic metre of air. You’ll see this reported as micrograms per metre cubed: µg/m³.

Fire crews assessing wildfire from a helicopter

Although specific smoke conditions might change because of wind, fire behaviour, and temperature, a smoky skies advisory in your area means you can expect higher levels of particulate matter pollution. Photo courtesy of BC Wildfire Service.

What is an air quality advisory?

The provincial objective for PM2.5 levels in a 24-hour period is 25 µg/m³. When a community gets above or close to this level, we issue an air quality advisory. This lets people know that their breathing may be affected and that they should be taking action to protect their health and reduce their emissions. The annual objective, which we use to monitor long term PM2.5 levels, is 8 µg/m³.

The provincial objective for PM10 levels in a 24-hour period is 50 µg/m³. When a community gets above or close to this level, we issue a dust advisory.

If there’s a forest fire in your area, you may also see a smoky skies advisory. Although specific smoke conditions might change because of wind, fire behaviour, and temperature, a smoky skies advisory in your area means you can expect higher levels of particulate matter pollution.

What actions can I take to protect myself during these advisories?

We include these actions right in the advisories, so they can be a helpful tool in protecting your health. The overarching goal of these actions is to reduce your exposure to the poor air. Some specific actions include:

  • Avoid roads with heavy traffic and areas with wood smoke
  • Reduce or stop physical activity if breathing becomes difficult

Further actions, including staying indoors and running air cleaners, may be needed for those who are more sensitive, like seniors, children, and people with underlying medical conditions.

What else do air quality meteorologists do?

In addition to monitoring air quality and issuing public reports and advisories, there are two other main parts to our work:

  1. Technical reviews: As an example, when an industry applies for a permit for a project that might have air pollution emissions, we review the application and evaluate its potential impact on air quality in the local community and surrounding area.
  2. Supporting local airshed management groups: We help to start these groups and translate technical air quality information for them. Local members drive the groups and we’re a resource for them, providing support on the science side.

Where can I learn about advisories in my community?

I’d encourage everyone to visit bcairquality.ca. Whenever an advisory is in place, it will appear as a link on the homepage. Even if there’s no advisory, you can still find current air quality conditions for where you live as well as great resources.


More information

Do you have respiratory sensitivities or want to take extra precautions during wildfire smoke events?

There is a growing body of evidence to suggest that portable air cleaners (equipped with HEPA filters or electrostatic precipitators) are effective at reducing indoor particulate matter concentrations and the associated health effects during short smoke events.

Be sure to research products before purchasing a portable air cleaner! Learn about the type of unit you’re purchasing and the proper sizing for your space. On these devices, you’ll notice a number called the clean air delivery rate (CADR) – if you’re concerned about wildfire smoke, the CADR rating for tobacco smoke is the most relevant to look at.

When using a portable air cleaner, limit the entry of outdoor air. Keep in mind when you’re indoors and using a portable air cleaner, however, that there can be risks from increased heat and indoor-generated air pollutants.


A version of this article was originally published in the summer 2017 issue of Healthier You magazine. Read the full issue – all about healthy lungs – on ISSUU!

Vince Terstappen

About Vince Terstappen

Vince Terstappen is a Project Assistant with the health promotions team at Northern Health. He has an undergraduate and graduate degree in the area of community health and is passionate about upstream population health issues. Born and raised in Calgary, Vince lived, studied, and worked in Saskatoon, Victoria, and Vancouver before moving to Vanderhoof in 2012. When not cooking or baking, he enjoys speedskating, gardening, playing soccer, attending local community events, and Skyping with his old community health classmates who are scattered across the world. Vince works with Northern Health program areas to share healthy living stories and tips through the blog and moderates all comments for the Northern Health Matters blog. (Vince no longer works with Northern Health, we wish him all the best.)

Share

Pulmonary rehabilitation in Prince George

Patient on exercise bicycle monitored by physiotherapist

Pulmonary rehabilitation is a well-established, well-researched intervention to help people with chronic pulmonary diseases cope with shortness of breath, develop activity tolerance, and improve quality of life.

When Dianne Gagne first arrived to take part in the new pulmonary rehabilitation program in Prince George, she had to stop twice to catch her breath en route from the parking lot of the YMCA to the room inside where the program is run. “I couldn’t even shower without getting short of breath,” shared Gagne, whose shortness of breath is caused by chronic obstructive pulmonary disease (COPD) and other complications stemming from a fungal infection of her lungs that first appeared in her 20s.

Robin Roots, a physiotherapist, has seen this before. “For many people with a diagnosis of chronic pulmonary disease,” said Roots, “simply going to Walmart is not an option because of the walking requirement. They are left winded, short of breath, and unable to function.”

It is these challenges and more that the pulmonary rehabilitation program – a partnership between the YMCA of Northern BC, the UBC Department of Physical Therapy, and Northern Health – is working to address. And so far, as Dianne Gagne can attest, it seems to be working. “By the end, I could park and walk up to the room,” said Gagne. “I may never have my full lung function back – I was once an avid cross-country skier – but I’m noticing improvements. I can now do my daily chores without any issues and I’m walking for a full half-hour on the treadmill.”

Pulmonary rehabilitation is a well-established, well-researched intervention to help people with chronic pulmonary diseases cope with shortness of breath, develop activity tolerance, and improve quality of life. Pulmonary rehabilitation includes both an exercise component and education relating to proper disease management delivered by a team of health professionals, including physiotherapists, exercise physiologists, pharmacists, dietitians, respiratory therapists, and specialists.

“Exercise is really the distinguishing feature of this specialized program,” said Roots. “Each participant is assessed and receives an individualized program which is fully supervised. Participants take part in high intensity lower limb aerobic training, strengthening, and balance exercises. Because most participants are on oxygen and many are quite deconditioned, this exercise needs to be very closely monitored. We’ve got some participants on bicycles, some on arm cycles, some on treadmills. It’s all about understanding how much their body can do and designing exercises that increase their ability to take on daily living activities.”

For Gagne, the individualized program really stood out. “They scrutinize you very carefully,” said Gagne. “They would measure my oxygen levels, pulse, and blood pressure before and after exercises. If my oxygen saturation would fall below a certain level, the physiotherapists would stop me. They didn’t push me to do more than I could, but they did challenge me to do as much as I could! The exercise regimes they develop are specific to each individual. Some people were doing 2-3 minutes of activity, others were doing 45. The physiotherapists and students explain things at every step – they would tell me why I would be doing certain exercises.”

The pulmonary rehabilitation program has clearly had a positive impact on Gagne and the other participants. “Participants set their own goals,” said Roots, “and we try to get them there.” For many, the goal is simply to be able to better manage shortness of breath and to function day-to-day without getting short of breath – goals which can significantly improve quality of life. For Roots, however, the research points to an important system level benefit of the pulmonary rehabilitation program. “Research has shown that pulmonary rehabilitation can decrease emergency room visits for acute acerbations of COPD by 40 per cent. We know that there are approximately 300 hospitalizations for COPD per year in Prince George and that the average length of stay for someone with an acute exacerbation is nine days. There is also a readmission rate of 13 per cent. If we can reduce the number of ER visits and prevent hospitalizations, we can save the system a lot of resources.”

Gagne agreed: “This program is a preventive measure. It keeps you out of the hospital and teaches you how to look after your condition on your own.”

The pulmonary rehabilitation program in Prince George is an eight week program, with a cohort of 10-15 participants getting together twice weekly for exercises and education. Anyone with a diagnosis of chronic pulmonary disease can join the program, you just need to complete a pulmonary function test. You can access the rehabilitation program through your physician – ask them about it or tell them about it! Participants have come from as far as Smithers and work is underway to look at how the program can be made more accessible to people living outside of Prince George.

Patients on exercise bicycles monitored by physiotherapist

With one in four people likely to develop COPD in northern B.C., pulmonary rehabilitation programs have the potential to have a massive impact.

According to Roots, the pulmonary rehabilitation program in Prince George, which has received a lot of support from local respirologists Dr. Sharla Olsen and Dr. John Smith, is unique for a few reasons:

  • It represents a partnership between three organizations (a partnership that has also created a second program: cardiac rehabilitation).
  • UBC trains physiotherapy students in northern B.C. and the rehabilitation program offers a valuable site for clinical placements (“It’s win-win,” said Roots). The students provide a valuable service to the program participants while at the same time being trained under the supervision of a licensed physiotherapist.
  • While many pulmonary rehabilitation programs are run out of hospitals, this program is based in the community. This can help encourage participants to think about maintaining the gains they make in the program through active lifestyle opportunities right in the community.
  • The partnership has allowed for the program to be offered at very low cost to participants – just a $10 membership fee.

Both Roots and Gagne have a similar goal: they want more people to know about the program! With one in four people likely to develop COPD in northern B.C., pulmonary rehabilitation programs have the potential to have a massive impact.

“Without the program,” reflected Gagne, “I would be sitting at home, continually going downhill. And though these changes take time, I keep telling my doctors how fantastic the program was. I would like for more people to know about this program – it is available and is really helpful.”

COPD Support Group

Many participants in the pulmonary rehabilitation program see each other one more time each week through the Prince George COPD Support Group. I asked the group to tell me a bit about themselves and this is what the group’s treasurer, Nancy, shared:

The Prince George COPD Support Group, also known as the SOBs (Short of Breaths) gives those diagnosed with COPD (and any other lung issues) a place to learn how to cope with an unforgiving disease. Our group gets exercise directions from a licensed physiotherapist, who also gives informative chats on various issues related to the lungs. As members are all living with the same issues, we have a wealth of lay knowledge to fall back on and share with each other. We have coffee days where we often bring in speakers on a variety of subjects, which goes a long way towards educating us all. We are a dedicated group of boomers helping others as they help us. We are a fun group and invite new members to join – bringing a friend or family member is always welcome!

The group meets every Wednesday, 1 p.m. to 3 p.m. in the AiMHi Gymnasium in Prince George (950 Kerry Street).

What you need to know: Chronic Obstructive Pulmonary Disease (COPD)

Although COPD is the most prevalent condition amongst pulmonary rehabilitation program participants, the program accepts people with any chronic pulmonary disease. Ask your doctor about pulmonary rehabilitation.

From HealthLinkBC.ca:

  • COPD is a lung disease that makes it hard to breathe.
  • COPD is most often caused by smoking. Other possible causes include long-term exposure to lung irritants, neonatal lung disease, and genetic factors.
  • COPD gets worse over time. While you can’t undo the damage to your lungs, you can take steps to prevent more damage and to feel better.
  • The main symptoms are a long-lasting cough, mucus that comes up when you cough, and shortness of breath.
  • At times, symptoms can flare up and become much worse. This is called a COPD exacerbation and can range from mild to life-threatening.

According to the Canadian Lung Association, “chronic lung disease accounts for more than 6% of annual health-care costs in Canada, and COPD is the leading cause of hospitalization.” COPD is the fourth leading cause of death in Canada. The Canadian Thoracic Society reports that a 2008 study “conservatively estimated the total cost of COPD hospitalizations at $1.5 billion a year.”


A version of this article was originally published in the summer 2017 issue of Healthier You magazine. Read the full issue – all about healthy lungs – on ISSUU!

Vince Terstappen

About Vince Terstappen

Vince Terstappen is a Project Assistant with the health promotions team at Northern Health. He has an undergraduate and graduate degree in the area of community health and is passionate about upstream population health issues. Born and raised in Calgary, Vince lived, studied, and worked in Saskatoon, Victoria, and Vancouver before moving to Vanderhoof in 2012. When not cooking or baking, he enjoys speedskating, gardening, playing soccer, attending local community events, and Skyping with his old community health classmates who are scattered across the world. Vince works with Northern Health program areas to share healthy living stories and tips through the blog and moderates all comments for the Northern Health Matters blog. (Vince no longer works with Northern Health, we wish him all the best.)

Share

Podcasters, meteorologists, physiotherapists, wildfire fighters, and more: The many faces of healthy lungs!

Magazine cover with physiotherapy student and pulmonary rehabilitation client.

Healthy lungs take centre stage in the latest issue of Healthier You magazine!

In reading through the latest issue of Healthier You, it becomes clear that respiratory health is a significant issue in northern B.C.

What is also clear, however, is just how many diverse programs, people, communities, and partners are coming together to better understand and take action on this issue. We can all play a role in promoting health, protecting healthy environments, and preventing lung disease!

Take a look through the latest issue of the magazine online or look for a hard copy of the magazine in local doctors’ offices, clinics, and Northern Health facilities near you! All past issues of Healthier You are also available online.

Here are just a few of the healthy lung stories you can read in Healthier You magazine:

Vince Terstappen

About Vince Terstappen

Vince Terstappen is a Project Assistant with the health promotions team at Northern Health. He has an undergraduate and graduate degree in the area of community health and is passionate about upstream population health issues. Born and raised in Calgary, Vince lived, studied, and worked in Saskatoon, Victoria, and Vancouver before moving to Vanderhoof in 2012. When not cooking or baking, he enjoys speedskating, gardening, playing soccer, attending local community events, and Skyping with his old community health classmates who are scattered across the world. Vince works with Northern Health program areas to share healthy living stories and tips through the blog and moderates all comments for the Northern Health Matters blog. (Vince no longer works with Northern Health, we wish him all the best.)

Share