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Posts Tagged "extend"

28Jun

Smoky summers: Health experts extend their warnings to pregnant women

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When wildfire smoke enveloped Metro Vancouver last summer, Nikki Rogers noticed soot collecting on the walls of her White Rock condo and closed her windows to keep the bad air out.

“I tried to stay inside because I did not enjoy being outside,” recalled Rogers, who works in a hair salon. “I would never do any kind of exercising or jogging or walking outside because anything that promotes heavy breathing outdoors would be terrible.”

This summer she will take even greater precautions because she is pregnant. And this is the first year that Vancouver Coastal Health and Metro Vancouver have included pregnant women on their list of people especially vulnerable to wildfire smoke, along with asthmatics, the elderly, and people with chronic heart and lung conditions.

Rogers said she will research the best way to keep herself and her baby safe, but laments that wildfire smoke is one more thing expectant mothers will likely need to worry about this July and August.

“We shouldn’t have months of just smoke in the air. That’s just awful,” she said. “Every year it gets worse and worse. It is just getting out of hand.”


Nikki Rogers, who is pregnant, will keep the windows of her White Rock condo closed this summer to keep any wildfire smoke out.

Experts believe British Columbians are about to experience another hot, smoke-filled summer, basing their prediction on the higher-than-average temperatures and drought so far in 2019 — a trend that is expected to continue.

“We expect increased wildfire and smoke risk, and that includes in the southwest where we are,” said a Metro Vancouver air-quality engineer, Francis Ries.

Just in the last week, a stubborn wildfire on steep terrain near Lions Bay snarled traffic on the busy Sea to Sky Highway for days, and a fire broke out Monday near Pender Harbour on the Sechelt Peninsula.


A helicopter dumps sea water on June 23 on a wildfire near Lions Bay.

NICK PROCAYLO /

PNG

Fires started earlier in 2019

Hotter, drier conditions contributed to fires in early spring, far sooner than in other years. Since April 1, the B.C. Wildfire Service has recorded 377 fires that have burned more than 110 square kilometres.

The summers of 2017 and 2018 were the worst on record for smoky skies — a provincial state of emergency was declared both years over wildfires — and much of the haze in Metro Vancouver drifted in from big fires in other parts of B.C.

The smoke led officials to issue a record number of air-quality advisories, and give extensive advice on how residents should try to remain healthy.

This year, local health and municipal agencies added pregnant women to the list of those most vulnerable to the smoke after lobbying by Sarah Henderson, an environmental health scientist at the B.C. Centre for Disease Control.

She advocated the change based on an “evidence review” and academic research that showed mothers exposed to extreme wildfire smoke give birth to smaller babies.

A University of California, Berkeley study found that pregnant women breathing in wildfire smoke during their second trimester in 2003, a terrible fire season in Southern California, had babies that were about 10 grams lighter than women not exposed to smoke. The results were small but “significant,” researchers found, because they showed “climate change can affect health.”

Ten grams would be enough to “push some babies into a low-birth-weight category,” added Henderson, noting undersized infants can face challenges.

Based on pregnancy and population statistics, Henderson predicts a repeat of last summer’s smoky skies could lead to 20 babies in B.C. being born a bit smaller. It’s not a big number, but one that could hurt 20 families.

“And that is kind of the tip of the iceberg in some ways because nobody has looked at preterm birth or malformations, if that smoke exposure happens to pregnant women,” added Henderson, who is also an associate professor in the UBC school of population and public health.

She has applied for funding to do her own study of the outcome of women who were pregnant in B.C.’s Interior, where the smoke was the thickest during the last two summers.


Sarah Henderson of the B.C. Centre for Disease Control.

Wildfire smoke is a toxic, chemical soup

Wildfire smoke contains many pollutants, but the most dangerous to human health is fine particulate matter, a mixture of solid particles and liquid droplets that are generally 2.5 micrometers or less in size — about one-30th the diameter on a strand of hair.

“The very small particles can be inhaled deeply into your lungs and then get into your blood stream, and irritate and lead to inflammation,” said Emily Peterson, a Vancouver Coastal Health environmental health scientist.

A typical summer day in Metro Vancouver would feature 10 or 15 micrograms a cubic metre of these fine particulates, but during the height of last summer’s smoky skies the quantity jumped tenfold.

Smoky air makes it harder for lungs to get oxygen into the blood stream, and it can irritate the respiratory system and cause inflammation in other parts of the body. Common symptoms include eye irritation, sore throat, coughing, wheezy breathing and headaches, and there is an increased risk of infections for some, such as pneumonia in older people and ear infections in children.

At-risk people — including those with chronic lung or heart conditions and now pregnant women — should “pay attention to the smoke much earlier” this summer, said the VCH medical health officer, Dr. James Lu.

“We do start with the vulnerable population, but if the smoke (concentration) is high enough we do encourage people who are normally healthy to take precautions as well,” Lu added.

Among the precautions backed by medical experts: Stay inside places with filtered air, such as most community centres, libraries or malls; drive with the windows up, the air conditioning on, and the recirculate-air button activated to reduce the amount of smoke getting into your car; and drink lots of water.

One expert calculated that people doing exercise or working outside during the height of the wildfire smoke could inhale the equivalent of two packages of cigarettes a day.

Because most people typically spend 90 per cent of their days indoors, Henderson highly recommends buying a portable air cleaner, which plugs into a wall socket and can be moved from room to room. These purifiers remove 40 to 80 per cent of the fine particles found in smoke, but people with respiratory conditions are encouraged to buy higher-performing HEPA (High Efficiency Particulate Air) filters, the Centre for Disease Control says.

If people are outside and want to wear a mask, Henderson said the best option is a well-fitted N95 respirator. A surgical mask can offer limited protection. A cloth mask is close to useless at keeping out the fine particles in smoke.

Doctors’ visits, asthma prescriptions skyrocket

Most people can manage irritations from smoke without medical attention, but those with severe symptoms should see a doctor.

Wildfire smoke caused a slight rise last summer in the number of people visiting Vancouver Coastal Health emergency rooms, although the increase wasn’t even across all communities: North Vancouver and Richmond had more hospital visits, while other cities did not, said Lu.

“What we did see were increased visits with respiratory symptoms, asthma and people short of breath,” the medical health officer told Postmedia.


Dr. James Lu of Vancouver Coastal Health.

The B.C. Health Ministry could not provide information about higher traffic in emergency rooms in other health regions, saying its data does not let it differentiate between treatment specifically for wildfire smoke and other respiratory issues.

However, Centre for Disease Control statistics suggest medical services across B.C. were harder hit when wildfire smoke was heavy. In the summers of 2017 and 2018, 45,000 extra doses of asthma medication were dispensed and there were 10,000 extra visits to doctors for asthma-related conditions in B.C., Henderson said.

“It does stack up, the impact is quite extreme,” she said. “On a very smoky day in Metro Vancouver, there were 350 extra doctor visits.”

The Centre for Disease Control tabulates this information daily in the B.C. Asthma Prediction System, which was launched after previous severe wildfire seasons. The surveillance system tracks asthma-related doctor visits and the prescriptions filled for lung conditions, and is used to warn health officials about the anticipated effects of wildfire smoke.

This summer is also expected to experience a boost in asthma treatments, given what happened in May after a significant wildfire near Fort St. John. “We had this one day of smoke in Fort St John, and the asthma visits skyrocketed,” Henderson said.

During the past few years, Vancouver Costal Health has sent reminders to family physicians to help their patients get ready for smoke expected in July and August — such as ensuring medications for patients with chronic heart or lung disease are up to date.

“I think what we are hoping for is to perhaps educate the public and primary-care physicians in helping people to be prepared so that they don’t really need to come to the emergency,” Lu said.

More than 3,000 ‘smoky skies’ bulletins issued

The provincial Environment Ministry issues “smoky skies” warning bulletins when wildfire smoke gets bad in all areas of the province except Metro Vancouver, which releases its own air quality advisories.

In 2017, 1,646 air-quality advisories were issued across B.C., and that jumped to 1,742 in 2018. There have been 69 warnings so far this year, but that number will likely increase as the majority of 2018 bulletins were issued between late July and late August.

The province monitors 63 regions, and six of those have had 100 or more smoky skies bulletins since 2017 due to bad fires nearby, including Quesnel, Penticton, Prince George, Williams Lake and Kamloops. Other communities in B.C.’s Interior and the Cariboo region have also been hard hit, with just under 100 bulletins issued in the last two years in Vernon, Kelowna, Cranbrook and 100 Mile House.


A wildfire near Fraser Lake in May.

Submitted /

B.C. Wildfire Service

Only Haida Gwaii, off B.C.’s northwest coast, has had no smoke-related air quality warnings since 2017.

The Environment Ministry was unable to provide information about how many advisories it issued in years with far fewer forest fires than 2017 and 2018. But statistics from Metro Vancouver indicate those two years were off the charts.

There were 22 days in Metro Vancouver last summer with poor air quality due to forest fires, mainly between late July and late August. In 2017, it was 19 days of unhealthy amounts of smoke.

The region’s figures, dating back to 1996, showed no other years with near that number of hazy days, the closest being 10 days in 2009 and 2015, when there were also some forest fires. In several years, including 2011, 2013 and 2016, there were no days with poor air quality.

Metro Vancouver’s advisories show much of the air pollution came from forest fires in other parts of the province, but the air was also affected by some local blazes, such as a bog fire in Richmond and a barge blaze in Surrey.

No air quality advisories have been issued so far in 2019; Metro Vancouver said the smoke residents smelled earlier this week from the Lions Bay fire was “below advisory thresholds.”

Ozone pollution rises due to wildfires

Metro Vancouver’s summer 2019 outlook warns of the potential for increased ozone due to higher temperatures and wildfires. Ozone is described as “good up high; bad nearby” — ozone in the atmosphere protects from UV radiation, but when lower to the ground it damages lungs and destroys ecosystems according to a Colorado State University academic paper, Ozone Levels Elevated in Presence of Wildfire Smoke.

“We’ve seen high ozone levels at monitoring stations which we never, under normal circumstances, expect to have high ozone,” said Metro Vancouver’s Ries. “We almost never have high ozone in the western part of the valley, downtown Vancouver and through into Burnaby,” he said, except in 2017 and 2018 when “the highest ozone levels we received were in that part of the region.”

Ries said more studies, including ones that focus on B.C., are making a strong link between climate change and the exacerbation of wildfire seasons.


Francis Ries, Metro Vancouver air quality engineer, and Roger Quan, Metro’s director of air quality and climate change.

In 2017, 65,000 British Columbians were evacuated and 509 buildings burned during wildfires that scorched 12,000 square km of land. The 2018 forest fires were even more destructive, consuming 13,500 sq. km — although fewer people were evacuated (6,000) and fewer structures lost (158).

Over the last two summers, the provincial government grossly outspent its wildfire budgets — by 10 times in 2017, when it cost more than $650 million to fight the fires. This year, the NDP is trying to be better prepared for the unknown by nearly doubling its wildfire budget, boosting it from $64 million in 2018 to $101 million.

Smoky summers in Vancouver may become “the new normal,” if not every year then at least every other year, VCH’s Lu predicted.

“We do not expect this to go away. This is going to be a way of life, unfortunately,” he said. “So I think the need to include that in your consideration of how to stay healthy is important.”

[email protected]

Twitter: @loriculbert




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10Jun

New drug helps extend survival rate of men with advanced prostate cancer: B.C. Cancer Agency study

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Dr. Kim Ch, who led a clinical trial which found that over half of patients who used a new type of hormone-reducing medication saw a reduction in their risk of cancer progression and a 33% improvement in overall survival, in Vancouver BC., June 10, 2019.


NICK PROCAYLO / PNG

A new drug has helped reduce the risk of death by 33 per cent in men with prostate cancer that has spread, according to the results of an international trial led by the B.C. Cancer Agency’s Dr. Kim Chi.

The double-blind study on the androgen receptor inhibitor drug called apalutamide was conducted in 23 countries at 260 cancer centres. It involved 1,052 men whose median age was 68. The study was sponsored by Janssen, the drug company who makes apalutamide.

At two years, those taking the treatment drug in addition to their standard treatment had a 52 per cent lower risk of cancer spread or death.

The findings of the TITAN (Targeted Investigational Treatment Analysis of Novel Anti-androgen) trial which began in 2015 are published in the New England Journal of Medicine (NEJM). Results were also recently presented by Chi at the annual meeting of the American Society of Clinical Oncology.

Chi, an oncologist, said overall survival rate is only about five years once prostate cancer has spread beyond the prostate so new treatments are desperately needed. The percentage of patients who took the drug whose cancer did not spread was 68.2 per cent, but in the placebo group the proportion was 47.5 per cent. There was a 33 per cent reduction in the risk of death for those who took the drug.

After about two years, 82 per cent of men in the investigational drug group were alive compared to 74 per cent on placebo. Men in both groups also took standard male hormone deprivation therapy showing that combination therapy helps to improve survival. Male hormones (androgens) like testosterone feed prostate tumours and currently, men with metastatic cancer are put on hormone deprivation treatment that has been the standard of care for many decades. Apalutamide, also called Erleada, is said to more completely block male hormones.

Chi said the drug is “not toxic” and there were no significant differences in the proportion of study participants in the intervention or placebo groups who experienced side effects, but skin rashes were just over three times more common in the drug group.

The drug has already been approved in Canada for certain patients with hormone-resistant, non-metastatic cancer but Chi said now that it is showing benefit for patients whose cancer has spread, he expects the drug will be approved by Health Canada for those patients as well, perhaps later this year. After that approval, provinces will have to decide on whether to expand funding for the drug, which costs about $3,000 a month. Chi said he expects more Canadian patients will have access to it next year.

“This is a next generation, better-designed androgen inhibitor and we really need better drugs for those with metastatic prostate cancer,” Chi said.

“There’s a critical need to improve outcomes for these patients and this study suggests this treatment can prolong survival and delay the spread of the disease.”

Chi was also a co-author on another drug trial, the results of which were published in the same issue of the NEJM medical journal. The ENZAMET trial, as it was called, is on a drug called enzalutamide (Xtandi). The results of that trial were similarly favourable.

About 2,700 men will be newly diagnosed with prostate cancer in B.C. this year. More than 600 men will die from it. 

[email protected]

Twitter: @MedicineMatters




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16Nov

Vote No campaign calls to extend election reform vote due to low voter turnout

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The deadline for the referendum on electoral reform is in two weeks and, as the debate between first-past-the-post and proportional representation rages, some are calling for an extension.

The Vote No campaign has raised concerns about the referendum, saying an extension is needed because of the potential for low voter turnout and mail delivery disruption from the Canada Post strike.

“There are a lot of reasons for Elections B.C. to take action,” said Bill Tieleman, president of the No B.C. Proportional Representation Society.

His main concern is that, without a deadline extension, there simply won’t be enough votes on the issue.

As of Friday, less than 20 per cent of the ballots had been received by Election B.C. They are currently due on Nov. 30.

Less than 20 per cent of ballots have been received by Elections B.C. so far 9:50

“The volume of ballots to come anywhere close to 50 per cent would have to be massive, and there’s just no indication that is what is going on,” he told Stephen Quinn, the host of CBC’s The Early Edition.

The high point of voter turnout is currently about 16 per cent in some ridings, Tieleman said, but that falls to as low as one-and-half per cent in others.

“We could have an extremely small fraction of people deciding what is really fundamental in our democracy — how we elect our representatives,” he said.

Whether B.C. voters cast ballots in the future for individuals, political parties or a mix will be determined in November’s mail-in referendum. (CBC)

Voter turnout

Previous referendums in B.C., like those on the electoral system in 2005 and 2009 or on the harmonized sale tax in 2011, all had a voter turnout of more than 50 per cent.

However, There is no minimum voter participation threshold for any referendum.

“As it is with every election, it’s the voters who turn out who get to decide,” said Bowinn Ma, an NDP MLA for North Vancouver-Lonsdale.

She’s an advocate for proportional representation in the hopes that it will increase voter turnout.  

“We’ve had abysmal voter turnout in elections in general which is why I’m so excited about proportional representation,” Ma said.  

“Generally, when we’re talking about voter response, it ultimately comes down to whether a  voter feels like the vote is important to them.”

Lack of engagement

Lack of voter engagement is at the heart of the matter, according to University of the Fraser Valley political science professor Hamish Telford.

“It doesn’t seem to me like there’s an overwhelming engagement on this issue,” Telford told Michelle Eliot, host of B.C. Today.

“That’s, I think, indicative of the very low return rate of the ballots so far … It may be the case that some people are either still deliberating or may be sitting on their ballots because of the postal worker issue.”

Elections B.C. says it is monitoring the Canada Post situation and, if there are significant delays or impacts on accessibility, extending the voting period is a possibility.

University of the Fraser Valley political science professor Hamish Telford on the proportional referendum and extending the deadline. Jake Fry, co-founder, Small Housing BC, and Rebecca Chaster, community planner at the City of Coquitlam, on tiny homes. 50:58

With files from The Early Edition and B.C. Today.


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