The environmental burden of disease in Canada: respiratory disease, cardiovascular disease, cancer, and congenital affliction.
BACKGROUND
Exposure to environmental hazards contributes to many chronic diseases, yet the magnitude of their contribution to the total disease burden in Canada is not well understood.


OBJECTIVE
To estimate the environmental burden of disease (EBD) in Canada for respiratory disease, cardiovascular disease, cancer, and congenital affliction. Quantifying the contribution of environmental exposures to the overall burden of disease could play an important role in shaping public health and environmental policy priorities.


METHODS
The World Health Organization (WHO) recently estimated the environmental burden of disease globally by using a combination of comparative risk assessment data and expert judgment to develop environmentally attributable fractions (EAFs) of mortality and morbidity for 85 categories of disease. We use the EAFs developed by the WHO, EAFs developed by other researchers, and data from Canadian public health institutions to provide an initial estimate of the environmental burden of disease in Canada for four major categories of disease.


RESULTS
Our results indicate that: 10,000-25,000 deaths; 78,000-194,000 hospitalizations; 600,000-1.5 million days spent in hospital; 1.1 million-1.8 million restricted activity days for asthma sufferers; 8000-24,000 new cases of cancer; 500-2500 low birth weight babies; and between $3.6 billion and $9.1 billion in costs occur in Canada each year due to respiratory disease, cardiovascular illness, cancer, and congenital affliction associated with adverse environmental exposures.


CONCLUSIONS
The burden of illness in Canada resulting from adverse environmental exposures is significant. Stronger efforts to prevent adverse environmental exposures are warranted, including research, education, and regulation.
Boyd
David R
DR
School of Resource and Environmental Management, Simon Fraser University, 8888 University Drive, Burnaby, BC, Canada V5A 1S6. drboyd@uvic.ca
Genuis
Stephen J
SJ
D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D002908:Chronic Disease; D017281:Cost of Illness; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006801:Humans; D009026:Mortality / Q000639:trends*; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D014944:World Health Organization