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YORK HP Surveillance Plan Worksheet FINAL Aug_10

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Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Enteric illness incidence rate The rate of new enteric diseases relative to the total  A iPHIS A A Cross reference with IDCD Surveillance Plan Include Annual Surveillance

population (per 100,000) in a specified time period. The

following diseases are classified as “enteric”: Amebiasis,

Brucellosis, Botulism, Campylobacter enteritis, Cholera,

Creutzfeldt-Jakob Disease, Cryptosporidiosis, Cyclosporiasis,

Food Poisoning (all causes), Giardiasis, Hepatitis A,

Listeriosis, Paratyphoid Fever, Salmonellosis, Shigellosis,

Trichinosis, Typhoid Fever, Verotoxin-producing Escherichia

coli (VTEC) infection and Yersiniosis.





Food premises compliance 1.) Proportion of food premises that were inspected (by facility  A PHACTS A A Include Semi-annually Health Protection

risk category) per year;

2.) Proportion of food premises that were re-inspected in York

Food Safety









Region (by facility risk category) per year

Food premises enforcement 1.) Proportion of food premises that were issued a provincial B HP internal A A Include Annual Health Protection

offences notices under Food Premises Regulation 562/90 per database

year;

2.) Proportion of food premises that were issued an order

under HPPA per year

Certified food handler Proportion of food premises in York Region with at least one A PHACTS A A Include Annual Health Protection

current certified food handler on site

Food safety in the home See RRFSS module - Food Safety in the Home for specific A RRFSS A C RRFSS module completed partially for 2009, optional Include Annual Health Protection

definitions content for 2010 (Jaime with

assistance from

Surveillance)

Food safety disclosure Annual number of requests for food premise disclosure in  A Health A A Currently, information can be pulled out of Health Include Annual Health Protection

York Region received by Health Protection Connection Connection, however HP has requested Surveillance

support in developing a system for food disclosure for

2011



Private well water testing 1.) Number of households on private wells per year that  A HP internal A A To discuss with Safe Water Manager re:access to Include Annual Health Protection

submitted a laboratory sample; database, system

2.) Proportion of private wells that have been tested by the WITSEN

Public Health Laboratory at least three times in the past 12

months;

3.) Proportion of households on a specific well type (shallow,

bored, deep/drilled)

Water-related complaints Annual number of water-related complaints and inquiries  B PHACTS A A Include Annual Health Protection

received from the public by requiring a Public Health Inspector’s response, by facility type

facility type (regulated, unregulated, water haulage, small drinking water

systems, public swimming pools and spas, other recreational

facilities, public beaches)

Number of drinking water Annual number of adverse water reports from drinking water A HP internal A A Include Annual Health Protection

systems adverse water quality systems in York Region that fall under Ontario Drinking Water database

incident reports Systems, Regulation 170/03 and Small Drinking Water

Systems, Regulation 319/08

r

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Drinking water systems 1.) Annual number of advisories (boil water and drinking A HP internal A A Include Annual Health Protection

enforcement (advisories and water) issued to drinking water systems under Regulation database

orders issued) 170/03 and Regulation 319/08;

2.) Annual number of orders (boil water and drinking water)

issued to drinking water systems under Regulation 170/03

and Regulation 319/08

Small drinking water systems 1.) Annual number of small drinking water assessments  A RCAT/LRMA A A Inspections for SDWS to begin January 1, 2012 Include Annual Health Protection

completed by York Region;

2.) Annual number of directives issued;

Safe Water









3.) Annual number of SDWS that required sampling

Water haulage facility 1.) Proportion of water haulage facilities that have been A HP internal A A Include Annual Health Protection

compliance inspected per year; database

2.) Proportion of water haulage facilities that required a re-

inspection per year

Waterborne illness incidence The incidence rate of reportable diseases that indicates that B iPHIS A A Include Annual Surveillance

rate water is the source of illness

Public beaches water quality Proportion of days per season that York Region public  A HP internal A A Identified as a priority for 2011; move towards a Include Annual Health Protection

beaches are posted or closed relative to the total number of database modeling approach using risk factors and historical AND Surveillance

days that beach has been monitored per year. Beaches are data. Potential change for acceptable E. coli levels

posted when E. coli levels exceed Ontario Ministry of

Environment Guidelines to Recreational Water Quality





Public beaches assessments 1.) Proportion of public beaches in York Region in which A HP internal A A See above - values collected here to feed into Include Annual Health Protection

assessments were completed per year; database modeling system AND Surveillance

2.) Values for turbidity, temperature and sources of pollution

in each beach

Drowning death rate Annual rate of drowning deaths in York Region (ICD10 B IntelliHEALTH A A Data available up to 2005. Look if coding is available Include Annual Surveillance

Primary Cause = V90, V92, or W65 - W74.99 from Vital and complete for "Place of Injury"; HP is not sure how

Statistics) useful this indicator is to their program, although it has

been used before

Regulated recreational water 1.) Proportion of inspected public swimming pools and spas A PHACTS A A Include Annual Health Protection

facilities compliance per year;

2.) Proportion of swimming pools and spas requiring a re-

inspection per year

Recreational water facilities 1.) Proportion of public swimming pools and spas that were A HP internal A A Include Annual Health Protection

enforcement issued a HPPA order per year; database

2) Proportion of other recreational facilities (e.g. splash pads,

wading pools) that were issued a HPPA order

Air quality standards - particulate Annual number of days that particulate matter 2.5 exceeded A MOE B A Include Annual Health Protection

matter 2.5 Canada-Wide or applicable standards at Newmarket and

Toronto North air monitoring stations

Air quality standards - nitrogen Annual number of days that nitrogen oxides exceed Ministry A MOE B A Include Annual Health Protection

oxides of Environment's or applicable standards at Newmarket and

Toronto north air monitoring stations.

Air quality - ground level ozone Annual number of days that ground level ozone exceeded A MOE B A Include Annual Health Protection

MOE or applicable standards at Newmarket and Toronto

North air monitoring stations

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Perception of outdoor air quality See RRFSS module Outdoor Air Quality. 1.) To identify and A RRFSS A C Data only available for 2008; possibly biannual Include Biannual? Health Protection

measure public awareness of health impacts of poor outdoor availability? To be put into 2011 RRFSS module (Jaime with

air quality; selection assistance from

2.) To identify the level of concern associated with human Surveillance)

health effects of poor outdoor air quality among adults (18+);

3.) To identify methods used to reduce individual exposure to

poor outdoor air quality





Air quality - Air Quality Index Annual number of days where air quality index was in the A MOE C A Include Annual Health Protection

moderate, poor and very poor categories for at least 1 hour on

one day at Newmarket and Toronto North air monitoring

stations.

Hospitalization and emergency 1.) Rate of emergency department admissions related to A Environment B A Annual number of days when the humidex is 40 or Include Annual Health Protection

department visits related to asthma on humidex exceedance days and its 3-day lag Canada and more at the Buttonville monitoring station. The AND Surveillance

asthma on humidex exceedance period. IntelliHEALTH humidex is an index (a computed value as opposed to

days 2.) Rate of inpatient hospitalization admissions related to something measured) devised to describe how hot or

asthma on humidex exceedance days and its 3-day lag humid weather feels to the average person. The

period. humidex combines the temperature and humidity into

one number to reflect the perceived temperature. It

takes into account these two important factors that

affect summer comfort. It is therefore a better measure

of how stifling the air feels than either temperature or

humidity alone. This replaces high temperature and

high humidex days as indicators.



Information (DAD and NACRS) available up to 2008

from IntelliHEALTH; ICD10-CA code J45.

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Hospitalizations and emergency 1.) Rate of emergency department admissions related to A Environment B A Annual number of days when the humidex is 40 or Include Annual Health Protection

department visits related to cardiovascular disease (including stroke) on humidex Canada and more at the Buttonville monitoring station. The AND Surveillance

cardiovascular disease (including exceedance days and its 3-day lag period. IntelliHEALTH humidex is an index (a computed value as opposed to

stroke) on humidex exceedance 2.) Rate of inpatient hospitalization admissions related to something measured) devised to describe how hot or

days cardiovascular disease (including stroke) on humidex humid weather feels to the average person. The

exceedance days and its 3-day lag period. humidex combines the temperature and humidity into

one number to reflect the perceived temperature. It

takes into account these two important factors that

affect summer comfort. It is therefore a better measure

of how stifling the air feels than either temperature or

humidity alone. This replaces high temperature and

high humidex days as indicators.



Information (DAD and NACRS) available up to 2008

from IntelliHEALTH; ICD-10 CA codes I10 (essential

primary hypertension), I11 (hypertensive heart

disease), I20-I22 (angina pectoris, acute myocardial

infarction, subsequent myocardial infarction), I24

(other ischaemic heart diseases), I25 (chronic

ischaemic heart disease), I46 (cardiac arrest), I47

(paroxysmal tachycardia), I50 (heart failure), I51

(complications and ill-defined descriptions of heart

disease), I70 (atherosclerosis). Cardiovascular

disease indicators will be collected as part of CVD-GIS

grant (ongoing project). Data up to 2008. Potential to

tie in with ER Surveillance in 2011.

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Hospitalizations and emergency 1.) Rate of emergency department admissions related to A Environment B A Annual number of days when the humidex is 40 or Include Annual Health Protection

department visits related to respiratory disease on humidex exceedance days and its 3- Canada and more at the Buttonville monitoring station. The AND Surveillance

respiratory disease on humidex day lag period. IntelliHEALTH humidex is an index (a computed value as opposed to

exceedance days 2.) Rate of inpatient hospitalization admissions related to something measured) devised to describe how hot or

respiratory disease on humidex exceedance days and its 3- humid weather feels to the average person. The

day lag period. humidex combines the temperature and humidity into

one number to reflect the perceived temperature. It

takes into account these two important factors that

affect summer comfort. It is therefore a better measure

of how stifling the air feels than either temperature or

humidity alone. This replaces high temperature and

high humidex days as indicators.



Information (DAD and NACRS) available up to 2008

from IntelliHEALTH; ICD-10 CA codes as follows: J06

(acute upper respiratory infections of multiple and

unspecified sites), J20 (acute bronchitis), J22

(unspecified actue lower respiratory infection), J39-J45

(other diseases of the upper respiratory tract,

bronchitis, emphysema, other chronic obstructive

pulmonary disease), J47 (bronchiectasis), J60-J63

(coalworker's pneumoconiosis, pneumoconiosis due

to asbestos and other mineral fibres, pneumoconiosis

due to dust containing silica, pneumoconiosis due to

other organic dusts), J66-J68 (airway disease due to

specific organic dust, hypersensitivity pneumonitis due

to organic dust, respiratory conditions due to inhalation

of chemicals, gases, fumes and vapours), J70.0

Hospitalizations, emergency 1.) Rate of emergency department admissions (visits) related A Environment B A Annual number of days when the humidex is 40 or Include Annual Health Protection

department visits and deaths to excessive cold exposure on windchill exceedance days. Canada and more at the Buttonville monitoring station. The AND Surveillance

related to excessive heat 2.) Rate of inpatient hospitalization admissions related to IntelliHEALTH humidex is an index (a computed value as opposed to

exposure on humidex excessive cold exposure on windchill exceedance days. something measured) devised to describe how hot or

exceedance days 3.) Rate of deaths in York Region due to excessive cold humid weather feels to the average person. The

exposure on windchill exceedance days. humidex combines the temperature and humidity into

one number to reflect the perceived temperature. It

takes into account these two important factors that

affect summer comfort. It is therefore a better measure

of how stifling the air feels than either temperature or

humidity alone. This replaces high temperature and

high humidex days as indicators.



Information (DAD and NACRS) available up to 2008

from IntelliHEALTH; ICD-10 CA codes (T67 and X30);

Vital statistics only available up to 2005.



Potential to tie in with ER Surveillance in 2011

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Hospitalizations, emergency 1.) Rate of emergency department admissions (visits) related A Environment B B Annual number of days when the windchill of -30 or Include Annual Health Protection

department visits and deaths to excessive heat exposure on humidex exceedance days Canada and lower at the Buttonville monitoring station. Wind chill AND Surveillance

related to excessive cold and its 3-day lag period. IntelliHEALTH is the cooling effect of the wind in combination with

exposure on windchill 2.) Rate of inpatient hospitalization admissions related to low temperatures. When it is windy, we feel colder

exceedance days excessive heat exposure on humidex exceedance days and because our skin temperature is lower. This sensation

its 3-day lag period. of cold is what the windchill index quantifies: as such,

3.) Rate of deaths in York Region due to excessive heat the index is not a real temperature and is expressed

exposure on humidex exceedance days and its 3-day lag without units, even though it is calibrated according to

period. the Celsius temperature scale.

Health Hazard Prevention and Management









Information (DAD and NACRS) available up to 2008

from IntelliHEALTH; ICD-10 CA codes (T68-T69,

X31); Vital statistics only available up to 2005.



Potential to tie in with ER Surveillance in 2011









Total point source on-site release Annual total of point source on-site releases of toxic A NPRI (current) C B Data available online up to 2008 at Include Annual Health Protection

of toxic chemicals chemicals in tonnes by municipality as reported by facilities to and provincial http://www.ec.gc.ca/inrp-npri/default.asp?lang=en.

the National Pollutant Release Inventory (water/air) and Toxics Adding values reported by facilities may result in

provincial registry under Toxics Reduction Act Reduction Act errors, facilities may report different amount of

(2011) pollutants that they release/dispose/recycled as new or

more up-to-date information has been received and

reviewed. Facilities may use different methods to

determine how much of a particular substance they

release, dispose or recycle and vary depending on the

substance or facility, and may change year to year

(http://www.ec.gc.ca/inrp-

npri/default.asp?lang=En&n=B5C1EAB8-1).









Environmental health hazard Proportion of environmental health hazard investigations A PHACTS A A Include Annual Health Protection

investigations and enforcement identifying potential health hazards necessitating corrective

action to mitigate health hazard per year.

Indoor air quality enforcement Proportion of indoor air quality investigations (including A PHACTS A A Include Annual Health Protection

mould) or risk assessments identifying potential health

hazards necessitating corrective action to mitigate health

hazard per year

Arena enforcement Proportion of arena ice pad inspections identifying potential A PHACTS A A Include Annual Health Protection

health hazards necessitating corrective action of mitigate

health hazard (includes referrals to Ministry of Environment

and Ministry of Labour) per year

Migrant farm enforcement Proportion of migrant farms that required a re-inspection per A PHACTS A A Include Annual Health Protection

year

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Mortality attributable to outdoor Mortality measures from Air Quality Benefits Assessment A AQBAT model C A AQBAT modeling program - potential to tie in with ER Include Annual Health Protection

air pollutants Tool including: acute exposure mortality attributable to Surveillance in 2011.

outdoor pollutant concentrations, chronic exposure mortality



Morbidity attributable to outdoor Morbidity measures from Air Quality Benefits Assessment A AQBAT model C A AQBAT modeling program - potential to tie in with ER Include Annual Health Protection

air pollutants Tool including: acute respiratory symptom days; adult chronic Surveillance in 2011

bronchitis days; asthma symptom days, cardiac emergency

room visits, cardiac hospital admissions, child acute

bronchitis episodes, elderly cardiac hospital admissions,

minor restricted activity days, respiratory emergency room

visits, respiratory hospital admissions, restricted activity days





Mortality due to air pollution Premature deaths due to air pollution A iCAP model C D ICAP modeling program from Canadian Medical Include Annual Health Protection

Association to be investigated further - potential to tie

in with ER Surveillance in 2011

Pain and suffering of air pollution Pain and suffering costs of air pollution using ICAP model A iCAP model C D ICAP modeling program from Canadian Medical Include Annual Health Protection

Association to be investigated further - potential to tie

in with ER Surveillance in 2011

Health care costs of air pollution Health care costs of air pollution using ICAP model A iCAP model C D ICAP modeling program from Canadian Medical Include Annual Health Protection

Association to be investigated further - potential to tie

in with ER Surveillance in 2011

Lost productivity of air pollution Lost productivity costs of air pollution using ICAP model A iCAP model C D ICAP modeling program from Canadian Medical Include Annual Health Protection

Association to be investigated further - potential to tie

in with ER Surveillance in 2011

Asthma rates Prevalence rate of asthma in population ages 12+ A CCHS A A Prevalence of asthma can only be gathered for those Include Annual Surveillance

12+ years from Canadian Community Health Survey,

data up to 2008

Hospitalizations and emergency 1. Annual rate of hospitalizations in York Region related to A IntelliHEALTH B/C A Information (DAD and NACRS) available up to 2008 Include Annual Surveillance

department visits related to asthma; from IntelliHEALTH; ICD10- CA code J45, data up to

asthma 2.) Annual rate of emergency department visits in York 2008

Region related to asthma

Hospitalizations and emergency 1. The number of emergency visits and hospitalizations in B IntelliHEALTH B B Request to add this indicator on August 2010 TBD, possible TBD Health Protection

department visits related to York Region related to asthma when: a) PM 2.5 exceeds daily and indicator for AND Surveillance

asthma when air quality acceptable values; b) Ground level ozone exceeds daily Environment 2011?

measures exceeded acceptable acceptable values; c) Nitrogen oxide exceeds daily Canada

values acceptable values at Newmarket and Toronto North air

monitoring station. Its 3-day lag period is also examined.

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Hospitalizations and emergency 1.) Annual rate of hospitalizations in York Region related to A IntelliHEALTH B/C A Information (DAD and NACRS) available up to 2008 Include Surveillance

department visits related to cardiovascular diseases, including stroke; from IntelliHEALTH; ICD-10 CA codes I10 (essential

cardiovascular disease (including 2.) Annual number of emergency department visits in York primary hypertension), I11 (hypertensive heart

stroke) Region related to cardiovascular diseases, including stroke; disease), I20-I22 (angina pectoris, acute myocardial

3.) Annual number of emergency department visits in York infarction, subsequent myocardial infarction), I24

Region related to cardiovascular diseases, including stroke (other ischaemic heart diseases), I25 (chronic

ischaemic heart disease), I46 (cardiac arrest), I47

(paroxysmal tachycardia), I50 (heart failure), I51

(complications and ill-defined descriptions of heart

disease), I70 (atherosclerosis). Cardiovascular

disease indicators will be collected as part of CVD-GIS

grant (ongoing project). Data up to 2008. Potential to

tie in with ER Surveillance in 2011.









Hospitalizations and emergency 1. The number of emergency visits and hospitalizations in B IntelliHEALTH B B Request to add this indicator on August 2010 TBD, possible TBD Health Protection

department visits related to York Region related to cardiovascular disease when: a) PM and indicator for AND Surveillance

cardiovascular disease when air 2.5 exceeds daily acceptable values; b) Ground level ozone Environment 2011?

quality measures exceed exceeds daily acceptable values; c) Nitrogen oxide exceeds Canada

acceptable values daily acceptable values at Newmarket and Toronto North air

monitoring station. Its 3-day lag period is also examined.





Hospitalizations and emergency 1.) Annual rate of hospitalizations in York Region related to A IntelliHEALTH B/C A Information (DAD and NACRS) available up to 2008 Include Annual Surveillance

department visits related to respiratory disease; from IntelliHEALTH; ICD-10 CA codes as follows: J06

respiratory disease 2.) Annual rate of emergency room visits in York Region (acute upper respiratory infections of multiple and

related to respiratory diseases unspecified sites), J20 (acute bronchitis), J22

(unspecified actue lower respiratory infection), J39-J45

(other diseases of the upper respiratory tract,

bronchitis, emphysema, other chronic obstructive

pulmonary disease), J47 (bronchiectasis), J60-J63

(coalworker's pneumoconiosis, pneumoconiosis due

to asbestos and other mineral fibres, pneumoconiosis

due to dust containing silica, pneumoconiosis due to

other organic dusts), J66-J68 (airway disease due to

specific organic dust, hypersensitivity pneumonitis due

to organic dust, respiratory conditions due to inhalation

of chemicals, gases, fumes and vapours), J70.0

(acute pulmonary manifestations due to radiation),

J70.1 (chronic and other pulmonary manifestations

due to radiation), J70.8 (respiratory conidtions due to

other specified external agents), J70.9 (respiratory

conditions due to unspecified external agent), J96

(respiratory failure, not elsewhere classified).

Potential to tie in with ER Surveillance in 2011

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Hospitalizations and emergency 1. The number of emergency visits and hospitalizations in B IntelliHEALTH B B Request to add this indicator on August 2010 TBD, possible TBD Health Protection

department visits related to York Region related to respiratory disease when: a) PM 2.5 and indicator for AND Surveillance

respiratory disease when air exceeds daily acceptable values; b) Ground level ozone Environment 2011?

quality measures exceed exceedsdaily acceptable values; c) Nitrogen oxide exceeds Canada

acceptable values daily acceptable values at Newmarket and Toronto North air

monitoring station. Its 3-day lag period is also examined.





Hospitalizations, emergency 1.) Annual rate of hospitalizations in York Region related to A IntelliHEALTH B/C A Information (DAD and NACRS) available up to 2008 Include Annual Surveillance

department visits and deaths excessive heat exposure; from IntelliHEALTH; ICD-10 CA codes (T67 and X30);

related to excessive heat 2.) Annual rate of emergency room visits in York Region Vital statistics only available up to 2005.

exposure related to excessive heat exposure;

3.) Annual rate of deaths in York Region due to excessive Potential to tie in with ER Surveillance in 2011

heat exposure

Hospitalizations, emergency 1.) Annual rate of hospitalizations in York Region related to  A IntelliHEALTH B/C A Information (DAD and NACRS) available up to 2008 Include Annual Surveillance

department visits and deaths excessive natural cold exposure; from IntelliHEALTH; ICD-10 CA codes (T68-T69,

related to excessive cold 2.) Annual rate of emergency room visits in York Region X31); Vital statistics only available up to 2005

exposure related to excessive natural cold exposure;

3.) Annual rate of deaths in York Region related to excessive Potential to tie in with ER Surveillance in 2011

natural cold exposure

Bloodborne infections incidence The rate of new bloodborne illnesses relative to the total  B iPHIS A A Include Annual Surveillance

rate population (per 100,000) in a specified time period. This

includes diseases such as hepatitis B (acute and chronic) and

hepatitis C

Institutional outbreak summary Annual summary of outbreaks occurring in York Region  A iPHIS, IDCD A A Include Annual Surveillance

institutions, including Long-term care homes, day care

centres, and retirement homes. The summary includes a

breakdown by outbreak type (i.e., respiratory vs. enteric),

causative agent and average length of time in outbreak. It will

also include the enteric illness rate (exposure: long term care

home) and the proportion of premises in outbreak per year.

Infectious Diseases Prevention and Control









Vectorborne disease incidence The annual rate of new enteric diseases relative to the total  A iPHIS A A Include Annual Surveillance

rate population (per 100,000) in a specified time period. This

includes diseases such as Lyme disease and West Nile virus



Positive mosquito pools Annual number of positive mosquito pools captured by  A HP internal A A Include Annual Health Protection

mosquito traps per year database

Lyme disease positive ticks Annual number of positive ticks that were submitted to Public A HP internal A A Include Annual Health Protection

Health Lab database

Infection control premises 1.) Proportion of infection control premises that were  A PHACTS A A Include Annual Health Protection

inspection compliance inspected per year by facility type (daycares, LTCH) in York

Region;

2.) Proportion of infection control premises that were re-

inspected in York Region by facility type (daycares, LTCH) in

York Region per year

Infectious Diseases Prevention an

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Personal service setting 1.) Proportion of personal service settings that were inspected  A PHACTS A A Include Annual Health Protection

inspection compliance per year in York Region;

2.) Proportion of personal services settings that were re-

inspected per year in York Region

IPAC complaints by facility type Annual number of infection prevention and control complaints A PHACTS A A Include Annual Health Protection

and inquiries requiring a Public Health Inspector’s response,

by facility type (LTCH, daycares, PSS, community)



Number of HPPA orders issued Annual number of section 13 HPPA orders issued to infection  A CFIA A A Include Annual Health Protection

to infection control premises control premises including LTCH, daycares, and PSS notification



Use of PSS procedures Monitors prevalence of personal care procedures; monitors  A RRFSS A D Complete data summary for available years (2006 and Include Biannual? Health Protection

public awareness regarding licensing of personal service 2007), to add into 2011 RRFSS module selection (Jaime with

settings in York Region residents (18+). See RRFSS module- assistance from

Personal Services Settings Surveillance)

Rabies incidence rate in animals Annual number of animals with confirmed rabies A HP internal A A Include Annual Health Protection

Rabies Prevention and









database

Rabies incidence rate in humans Annual number of humans who die of rabies infection  A iPHIS A A Include Annual Surveillance

Control









Proportion of humans given Proportion of York Region residents given prophylactic  A HP internal A A Include Annual Health Protection

prophylactic treatment for animal treatment for human exposure to rabies per year system

exposure

Rabies immunization for cats and Proportion of cats and dogs that are currently immunized  A HP internal A A Include Annual Health Protection

dogs against rabies during time of animal exposure incidents per system

year

Proportion of tobacco vendors 1.) Proportion of tobacco vendors that were inspected in York  A TIS A A Include Annual Health Protection

inspected Region per year;

Chronic Diseases and Injury (Tobacco









2.) Proportion of tobacco vendors that were re-inspected in

York Region per year

Proportion of tobacco vendor Proportion of tobacco vendors in York Region that were  A TIS A A Include Annual Health Protection

inspections resulting in SFOA issued a provincial offences notice under Smoke Free Ontario

charge Act per year

enforcement)









Proportion of tobacco vendors Proportion of tobacco vendor sites in York Region that have  A TIS A A Include Annual Health Protection

with repeated offences repeated offences in the past year



Current teen smokers Percent of the teen population (12 to 19 years of age) that  B CCHS A A Data current up to 2008 Include Annual Surveillance

were current cigarette smokers from Canadian Community

Health Survey Use of OSDUS as a potential data source - cross

reference with Healthy Lifestyles Division

Use of other tobacco products Percent of the population that have smoked or used other  B CCHS A A CCHS provides data for age group 12+; data current Include Annual Surveillance

tobacco products (cigars, pipe, chewing tobacco or snuff) in up to 2008; focus on chewing tobacco and snuff if

the previous month from Canadian Community Health Survey available

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

15

10

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

Health

Program Currently Data Data Reporting Divisional

Area

Indicator Description Protection Data Source Comments Outcome

Reported Quality Availability Frequency Responsibility

Priority

r Food Safety



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Safe Water

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Health Hazard Prevention and Management



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Infectious Diseases Prevention and Control

Program

Chronic Diseases and Injury (Tobacco Rabies Prevention and





Area

enforcement) Control Infectious Diseases Prevention an

Program

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Program

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r Food Safety



Area

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Safe Water

Program

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Program

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Health Hazard Prevention and Management



Area

Program

Program

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Program

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Area

Infectious Diseases Prevention and Control

Program

Chronic Diseases and Injury (Tobacco Rabies Prevention and





Area

enforcement) Control Infectious Diseases Prevention an

Program

Program

Area

Program

Area

Program

Area

r Food Safety



Area

Program

Program

Area

Safe Water

Program

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Program

Area

Program

Area

Health Hazard Prevention and Management



Area

Program

Program

Area

Program

Area

Area

Infectious Diseases Prevention and Control

Program

Chronic Diseases and Injury (Tobacco Rabies Prevention and





Area

enforcement) Control Infectious Diseases Prevention an

Program

Program

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Program

Area

Program

Area

Divisional Priority Rating Scale Data Quality Rating Scale

Letter Rating Criteria Letter Rating Criteria

A High Priority Indicator integral to A High quality No reporting issues

business operations for overall frequency

on a continual basis estimates of

and included in indicator

program logic

models





B Medium Indicator would be B Medium Some subanalysis

Priority helpful for program quality estimates to be

planning on a interpreted with

continual basis caution/few not

reportable for

municipality only



C Low Priority Indicator would be C Low quality Several subanalysis

helpful, but yearly estimates to be

data is not required interpreted with

caution & several

issues with

reportability





D N/A Indicator is not D No value Interpretation or

required reportability issues

with overall

frequency estimate

of indicator









Note: All indicators in red are recommended to be not included. All indicators in purple should be subject to discussion





To be discussed with team

Not included





Data Sources

1d IPHIS

2d PHACTS

3d HP internal database

4d RRFSS

5d Health Connection

6d WITSEN

7d RCAT

8d LRMA

9d IntelliHEALTH

10d Ministry of Enviroment

11d Environment Canada

12d National Pollutant RI

13d

Data Availability Rating Scale

Letter Rating Criteria

A Annual Indicator data

available every year









B Biannual Indicator data

available every two

years (rotating)









C Optional Indicator may be

Content selected for data

collection, may have

been collected in

past









D Variable Received data for

availability several years,

unknown future

availability





E Limited Received data at

availability one time, not

anticipated in near

future

Indicator Description

Enteric illness incidence rate The rate of new enteric diseases relative to the total population (per 100,000) in a specified time

period. The following diseases are classified as “enteric”: Amebiasis, Brucellosis, Botulism,

Campylobacter enteritis, Cholera, Creutzfeldt-Jakob Disease, Cryptosporidiosis, Cyclosporiasis,

Food Poisoning (all causes), Giardiasis, Hepatitis A, Listeriosis, Paratyphoid Fever, Salmonellosis,

Shigellosis, Trichinosis, Typhoid Fever, Verotoxin-producing Escherichia coli (VTEC) infection and

Yersiniosis.

Food premises compliance 1.) Proportion of food premises that were inspected (by facility risk category) per year; 2.) Proportion

of food premises that were re-inspected in York Region (by facility risk category) per year



Food premises enforcement 1.) Proportion of food premises that were issued a provincial offences notices under Food Premises

Regulation 562/90 per year; 2.) Proportion of food premises that were issued an order under Health

Protection and Promotion Act per year

Certified food handler Proportion of food premises in York Region with at least one current certified food handler on site



Food safety in the home See RRFSS module - Food Safety in the Home for specific definitions

Food safety disclosure Annual number of requests for food premise disclosure in York Region received by Health Protection



Private well water testing 1.) Proportion of households on private wells per year; 2.) Proportion of private wells that have been

tested by the Public Health Laboratory at least three times in the past 12 months; 3.) Proportion of

households on a specific well type (shallow, bored, deep/drilled)

Water-related complaints Annual number of water-related complaints and inquiries requiring a Public Health Inspector’s

received from the public by response, by facility type (regulated, unregulated, water haulage, small drinking water systems,

facility type public swimming pools and spas, other recreational facilities, public beaches)



Number of drinking water Annual number of adverse water reports from drinking water systems in York Region that fall under

systems adverse waterquality Ontario Drinking Water Systems, Regulation 170/03 and Small Drinking Water Systems, Regulation

incident reports 319/08

Drinking water systems 1.) Annual number of advisories (boil water and drinking water) issued to drinking water systems

enforcement (advisories and under Regulation 170/03 and Regulation 319/08; 2.) Annual number of orders (boil water and

orders issued) drinking water) issued to drinking water systems under Ontario Drinking Water Systems Regulation

170/03 and Small Drinking Water Systems Regulation 319/08

Municipal drinking water Annual number of adverse reports received per year when the following chemical parameters in the

chemcial quality municipal water system are over the acceptable level, as outlined in the Ontario Drinking Water

Quality Standards, Regulation 169/03. Chemicals include: antimony, arsenic, atrazine, benzene,

chloramines, chromium, dioxins and furans, glyphosate, lead, mercury, nitrate, N-

nitrosodimethylamine (NDMA), polychlorinated biphenyl (PCBs),sodium, trihalomethanes (THM),

and vinyl chloride

Small drinking water systems 1.) Annual number of small drinking water assessments completed by York Region; 2.) Annual

number of directives issued; 3.) Annual number of SDWS that required sampling

Water haulage facility 1.) Proportion of water haulage facilites that have been inspected per year; 2.) Proprotion of water

compliance haulage facilites that required a re-inspection per year

Waterborne illness incidence rate The incidence rate of reportable diseases that indicates that water is the source of illness



Public beaches water quality Proportion of days per season that York Region public beaches are posted or closed relative to the

total number of days that beach has been monitored per year. Beaches are posted when E. coli

levels exceed Ontario Ministry of Environment Guidelines to Recreational Water Quality



Public beaches assessments 1.) Proprotion fo public beaches in York Region in which assessments were completed per year; 2.)

Values for turbidity, temperature and sources of pollution in each beach

Drowning death rate Annual rate of drowning deaths in York Region (ICD10 Primary Cause = V90, V92, or W65 - W74.99

from Vital Statistics)

Regulated recreational water 1.) Proprotion of inspected public swimming pools and spas per year; 2.) Proportion of swimming

faciltiies compliance pools and spas requiring a re-inspection per year

Recreational water faciltiies 1.) Proportion of public swimming pools and spas that were issued a Health Protection and

enforcement Promotion Act order per year; 2) Proportion of other recreational facilities (e.g. splash pads, wading

pools) that were issued a Health Protection and Promotion Act order

Air quality standards - particulate 1.) Annual number of days that particulate matter 2.5 exceeded Canada-Wide standard (30ug/m3)

matter 2.5 over a 24-hour period at Newmarket and Toronto North air monitoring stations; 2.) Annual number of

days that particulate matter 2.5 exceeded World Health Organization standard (25 ug/m3) over a 24-

hour period at Newmarket and Toronto North air monitoring stations



Air qualtiy standards - nitrogen 1.) Annual number of days that nitrogen oxides exceed Ministry of Environment's 1-hour standard

oxides (200 ppb) at Newmarket and Toronto north air monitoring stations; 2.) Annual number of days that

nitrogen oxides exceed EPA 1-hour standard (100 ppb) at Newmarket and Toronto north air

monitoring stations; 3.) Annual number of days that nitrogen oxides exceeded MOE 24-hour average

standard at Newmarket and Toronto North air monitoring stations





Air qualtiy - ground level ozone 1.) Annual number of days that ground level ozone exceeded Ministry of Environment's 1-hour

standard (80 ppb) at Newmarket and Toronto North air monitoring stations; 2.) Annual number of

days that ground level ozone exceeded Ministry of Environment's standard (65 ppb) at Newmarket

and Toronto North air monitoring stations; 3.) Annual number of days that ground level ozone

exceeded World Health Organization standard (50 ppb) over an 8-hour period at Newmarket and

Toronto North air monitoring station

Perception of outdoor air quality See RRFSS module Outdoor Air Quality. 1.) To identify and measure public awareness of health

impacts of poor outdoor air quality; 2.) To identify the level of concern associated with human health

effects of poor outdoor air quality among adults (18+); 3.) To identify methods used to reduce

individual exposure to poor outdoor air quality

Air quality - Air Quality Index 1.) Annual number of days with at least one hour of air quality index was in the moderate category

for at least 1 hour on one day at Newmarket and Toronto North air monitoring stations; 2.) Annual

number of days with at least one hour of air quality index was in the poor category for at least 1 hour

on one day at Newmarket and Toronto North air monitoring stations; 3.) Annual number of days with

at least one hour of air quality index was in the very poor category for at least 1 hour on one day at

Newmarket and Toronto North air monitoring stations





York Region per capita fossil fuel Special data request to Statistics Canada

consumption

Average greenhouse gas Average greenhouse gas emission reductions achieved by York Region 20/20 The Way to Clean Air

emissions participants per year

High temperature days Annual number of days when the air temperature is over 30 degrees Celsius reported at the

Buttonville monitoring station

High humidex days Annual number of days when the humidex is 40 or more at the Buttonville monitoring station. The

humidex is an index (a computed value as opposed to something measured) devised to describe

how hot or humid weather feels to the average person. The humidex combines the temperature and

humidity into one number to reflect the perceived temperature. It takes into account these two

important factors that affect summer comfort. It is therefore a better measure of how stifling the air

feels than either temperature or humidity alone





Cold weather days Annual number of days when the air temperature is -15 degrees Celsius or lower reported at the

Buttonville monitoring station

High windchilll days Annual number of days when the wind chill of -30 or lower at the Buttonville monitoring station. Wind

chill is the cooling effect of the wind in combination with low temperatures. When it is windy, we feel

colder because our skin temperature is lower. This sensation of cold is what the wind chill index

quantifies: as such, the index is not a real temperature and is expressed without units, even though it

is calibrated according to the Celsius temperature scale





Severe rainfall events Annual number of days where precipitation within a 24 hour period that is equal to or greater than 25

mm.

Number of flood warnings Annual number of flood warnings issued. A Flood Warning is defined as a notice that flooding is

imminent or occurring. The Flood Warning is based upon information received by the Conservation

Authority’s weather monitoring systems, and is intended to provide notice to municipalities and

emergency services that action is required on their part. Flood Warnings may be updated depending

upon weather and runoff conditions, and will be followed by a notice of cancellation once the

potential for flooding has passed.

Spills reported through Ministry Annual number of spills reported. Spills are defined as releases of pollutants into the natural

of Environment Spills Action environment originating from a structure, vehicle, or other container, and that are abnormal in light of

Centre all circumstances. Spills must be reported immediately to the ministry and to the municipality when

they cause or are likely to cause any of the following: impairment to the quality of the natural

environment - air, water, or land; injury or damage to property or animal life; adverse health effects;

safety risk; making property, plant, or animal life unfit for use; loss of enjoyment of normal use of

property; or interference with the normal conduct of business.





Total point source on-site release Annual total of point source on-site releases of toxic chemicals in tonnes by municipality as reported

of toxic chemicals by facilities to the National Pollutant Release Inventory (water/air)

Outdoor air quality investigations Proportion of outdoor air quality or environmental investigations identifying potential health hazards

and enforcement necessitating corrective action to mitigate health hazard per year



Indoor air quality enforcement Proportion of indoor air quality investigations (including mould) or risk assessments identifying

potential health hazards necessitating corrective action to mitigate health hazard per year



Arena enforcement Proportion of arena ice pad inspections identifying potential health hazards necessitating corrective

action of mitigate health hazard (includes referrals to Ministry of Environment and Ministry of Labour)

per year

Migrant farm enforcement 1.) Number of migrant farm inspections conducted per year; 2.) Proportion of migrant farms that

required a re-inspection per year; 3.) Proportion of migrant farms requiring an HPPA order issued

per year

High risk contaminant sites Annual number of high risk sites reported per year, including polychlorinated biphenyl storage sites,

brownfields, contaminated sites and landfills

Fish species in York Region 1.) Number of fish species found in York Region water bodies in every other year; percentage of

sport fish species with eating restrictions for sensitive populations; 2. Eating restriction size of

largemouth bass in York Region water bodies. York Region water bodies include: Mill Pond,

Richmond Hill; Lake Simcoe, Georgina; Musselman's Lake, Whitchurch-Stouffville; Lake Wilcox,

Richmond Hill; Holland Marsh Canals, King and East Gwillimbury; Milne Reservoir, Markham.





Mortality attributable to outdoor Mortality measures from Air Quality Benefits Assessment Tool including: acute exposure mortality

air pollutants attributable to outdoor pollutant concentrations, chronic exposure mortality

Morbidity attributable to outdoor Morbidity measures from Air Quality Benefits Assessment Tool including: acute respiratory symptom

air pollutants days; adult chronic bronchitis days; asthma symptom days, cardiac emergency room visits, cardiac

hospital admissions, child acute bronchitis episodes, elderly cardiac hospital admissions, minor

restricted activity days, respiratory emergency room visits, respiratory hospital admissions, restricted

activity days

Mortality due to air pollution Premature deaths due to air pollution

Economic impact of air pollution Economic impact of air pollution using ICAP model



Pain and suffering of air pollution Pain and suffering costs of air pollution using ICAP model



Health care costs of air pollution Health care costs of air pollution using ICAP model



Lost productivity of air pollution Lost productivity costs of air pollution using ICAP model



Asthma rates Prevalence rate of asthma in population ages 12+

Hospitalizations and emergency 1.) Annual rate of hospitalizations in York Region related to asthma; 2.) Annual rate of emergency

department visits related to department visits in York Region related to asthma

asthma

Hospitalizations and emergency 1.) Annual rate of hospitalizations in York Region related to cardiovascular diseases, including

department visits related to stroke; 2.) Annual number of emergency department visits in York Region related to cardiovascular

cardiovacular disease (including diseases, including stroke; 2.) Annual number of emergency department visits in York Region

stroke) related to cardiovascular diseases, including stroke

Hospitalizations and emergency 1.) Annual rate of hospitalizations in York Region related to respiratory disease; 2.) Annual rate of

department visits related to emergency room visits in York Region related to respiratory diseases

respiratory disease

Hospitalizations and emergency 1.) Annual rate of hospitalizations in York Region related to accidental poisonings; 2.) Annual rate of

department visits due to emergency department visits in York Region related to accidental poisonings

accidental poisonings

Poison control calls/incidents Annual number of poison control centre calls per capita by contaminant and age group

Hospitalizations, emergency 1.) Annual rate of hospitalizations in York Region related to excessive heat exposure; 2.) Annual rate

department visits and deaths of emergency room visits in York Region related to excessive heat exposure; 3.) Annual rate of

related to excessive heat deaths in York Region due to excessive heat exposure

exposure

Hospitalizations, emergency 1.) Annual rate of hospitalizations in York Region related to excessive natural cold exposure; 2.)

department visits and deaths Annual rate of emergency room visits in York Region related to excessive natural cold exposure; 3.)

related to excessive cold Annual rate of deaths in York Region related to excessive natural cold exposure

exposure

Bloodborne infections incidence The rate of new bloodborne illnesses relative to the total population (per 100,000) in a specified time

rate period. This includes diseases such as hepatitis B (acute and chronic) and hepatitis C



Institutional outbreak summary Annual summary of outbreaks occurring in York Region institutions, including long-term care homes,

day care centres, and retirement homes. The summary includes a breakdown by outbreak type (i.e.,

respiratory vs. enteric), causative agent and average length of time in outbreak. It will also include

the enteric illness rate (exposure: long term care home) and the proportion of premises in outbreak

per year.

Vectorborne disease incidence The annual rate of new enteric diseases relative to the total population (per 100,000) in a specified

rate time period. This includes diseases such as Lyme disease and West Nile virus

Positive mosquito pools Annual number of positive mosquito pools captured by mosquito traps per year

WNv awareness Monitors public knowledge, attitudes and behaviour regarding West Nile virus. See RRFSS module

West Nile Virus Awareness

Mosquito protection – personal Monitors personal protective behaviour against mosquitoes. See RRFSS module Mosquito

Protection Personal

Mosquito protection – household Monitors household protective behaviour against mosquitoes. See RRFSS module Mosquito

Protection Household

Infection control premises 1.) Proportion of infection control premises that were inspected per year by facility type (daycares,

inspection compliance LTCH) in York Region; 2.) Proportion of infection control premises that were re-inspected in York

Region by facility type (daycares, long-term care homes) in York Region per year



Personal service setting 1.) Proportion of personal service settings that were inspected per year in York Region; 2.)

inspection compliance Proportion of personal services settings that were re-inspected per year in York Region

IPAC complaints by facility type Annual number of infection prevention and control complaints and inquiries requiring a Public Health

Inspector’s response, by facility type (long-term care homes, daycares, personal service settings,

community)

Number of HPPA orders issued Annual number of section 13 HPPA orders issued to infection control premises including long-term

to infection control premises care homes, daycares, and personal service settings



Use of PSS procedures Monitors prevalence of personal care procedures; monitors public awareness regarding licensing of

personal service settings in York Region residents (18+). See RRFSS module- Personal Services

Settings

Rabies incidence rate in animals Annual number of animals with confirmed rabies



Rabies incidence rate in humans Annual number of humans who die of rabies infection



Proportion of humans given Proportion of York Region residents given prophylactic treatment for human exposure to rabies per

prophylactic treatment for animal year

exposure

Rabies immunization for cats and Proportion of cats and dogs that are currently immunized against rabies during time of animal

dogs exposure incidents per year

Proportion of tobacco vendors 1.) Proportion of tobacco vendors that were inspected in York Region per year; 2.) Proportion of

inspected tobacco vendors that were re-inspected in York Region per year

Proportion of tobacco vendor Proportion of tobacco vendors in York Region that were issued a provincial offences notice under

inspections resulting in SFOA Smoke Free Ontario Act per year

charge

Proportion of tobacco vendors Proportion of tobacco vendor sites in York Region that have repeated offences in the past year

with repeated offences



Support for tobacco enforcement Measures public support for banning smoking in public places not covered under the Smoke-free

Ontario Act. See RRFSS module - Tobacco Enforcement

Reasons for tobacco Assesses public support among York Region residents (18+) for using underage shoppers to check

enforcement opposition if tobacco vendors are selling tobacco products to people under 19 years of age; to determine

reasons for those who oppose. See RRFSS module Tobacco - Tobacco Enforcement



Knowledge of legal age for Assesses general awareness of legal age limits of retailer tobacco sales. See RRFSS module

tobacco sales Tobacco - Minors' Access to Tobacco

Current teen smokers Percent of the teen population (12 to 19 years of age) that were current cigarette smokers from

Canadian Community Health Survey

Smoking law related to To be developed

workplaces and workplace

vehicles

Use of other tobacco products Percent of the population that have smoked or used other tobacco products (cigars, pipe, chewing

tobacco or snuff) in the previous month from Canadian Community Health Survey

Environmental Health Program Standards

Food Safety Safe Water

Indicators Suspected and Public beaches and

Drinking water Drinking water Recreational

confirmed foodborne Food premises public beach water

systems illnesses water facilities

illness illnesses

Enteric illness incidence rate 1d, 1a, 1f

Food premises compliance 2d, 1a, 1f

Food premises enforcement 3d, 1a, 1f

Certified food handler 2d, 2a, 1f

Food safety in the home 4d, 2a, 2f

Food safety disclosure 5d, 1a, 1f

Private well water testing 3d/6d, 1a, 1f

Water-related complaints received from the public by facility type 2d, 1a, 1f

Number of drinking water systems adverse water quality incident reports 3d, 1a, 1f

Drinking water systems enforcement (advisories and orders issued) 3d, 1a, 1f

Small drinking water systems 7d/8d, 1a, 1f

Water haulage facility compliance 3d, 1a, 1f

Waterborne illness incidence rate 1d, 1a, 1f

Public beaches water quality 3d, 1a, 1f

Public beaches assessments 3d, 1a, 1f

Drowning death rate 9d, 2a, 1f

Regulated recreational water facilities compliance 2d, 1a, 1f

Recreational water faciltiies enforcement 3d, 1a, 1f

Indicators





Particulate matter (PM2.5)

Nitrogen oxides

Ground level ozone

Perception of outdoor air quality

Air quality index

Hospitalization and emergency department visits related to asthma on humidex exceedance days

Hospitalization and emergency department visits related to cardiovascalar disease (including stroke) on humidex exceedance d

Hospitalization and emergency department visits related to respiratory disease on humidex exceedance days

Hospitalizations, emergency department visits and deaths related to excessive heat exposure on humidex exceedance days

Hospitalizations, emergency department visits and daths related to excessive cold exposure on windchill exceedance days

Total point source on-site release of toxic chemicals

Environmental health hazard investigations and enforcement

Indoor air quality enforcement

Arena enforcement

Migrant farms enforcement

Environmental Health Program Standards

Health Hazards Prevention and Management

Outdoor air quality Extreme weather Other Indoor air quality

10d, 1a, 1f

10d, 1a, 1f

10d, 1a, 1f

4d, 3a, 2f

10d, 1a, 1f

11d/9d, 2a, 1f

11d/9d, 2a, 1f

g stroke) on humidex exceedance days

exceedance days 11d/9d, 2a, 1f

e on humidex exceedance days 11d/9d, 2a, 1f

on windchill exceedance days 11d/9d, 2a, 1f

12d, 2a, TBD

2d, 1a, 1f

2d, 1a, 1f

2d, 1a, 1f

2d, 1a, 1f

WATER

Private well water testing Proportion of households on private wells; proportion of private wells

that have been tested by the PHL at least three times in the past 12

months; the proportion of households on a specific well type (shallow,

bored, deep/drilled)

Water-related complaints received from the public by The number of complaints received by Health Protection requiring a

facility type PHI response, by facility type (including regulated drinking water

system, unregulated drinking water system, water haulage facility,

small drinking water systems, swimming pools, spas, other

recreational facilities and beaches)

Number of drinking water systems adverse water The number of adverse water reports from drinking water systems

reports (ON Reg 170) that fall under Drinking Water Systems, Regulation 170/03, in York

Region

Drinking water systems enforcement (advisories and The number of advisories (boil water and drinking water) and orders

orders issued) (boil water and drinking water) issued by York Region

Municipal drinking water chemcial quality

The number of adverse reports received per year when the following

chemical parameters in the municipal water system are over the

acceptable level, as outlined in the Ontario Drinking Water Quality

Standards, Reg 169/03. Chemicals include: antimony, arsenic,

atrazine, benzene, chloramines, chromium, dioxins and furans,

glyphosate, lead, mercury, nitrate, N-nitrosodimethylamine (NDMA),

polychlorinated biphenyl (PCBs),sodium, trihalomethanes (THM), and

vinyl chloride

Number of small drinking water systems risk The number of small drinking water assessments completed by York

assessments completed per year Region per year

Water haulage facility compliance The proportion of water haulage facilities that have been inspected,

and the proportion of water haulage faciltiies that requiried a re-

inspection.

Waterborne illness incidence rate The incidence rate of reportable diseases that indicates that water is

the source of illness

Public beaches water quality

The proportion of days per season that Yokr Region beaches are

posted relative to the total number of days the beach has been

monitored. Beaches are posted when E. coli levels exceed Ontario

Ministry of Environment Guidelines for Recrational Water Quality



Public beaches assessments The proportion of public beaches in York Region in which

assessments were completed, and the values for turbidity,

temperature and sources of pollution

Drowning death rate The number of drowning deaths in York Region (ICD10 Primary

Cause = V90, V92, or W65 - W74.99 from Vital Statistics)

Regulated recreational water faciltiies compliance The proportion of inspected swimming pools and spas in York Region,

the proprotion of of swimming pools and spas requiring a re-

inspection

Recreational water faciltiies enforcement The proportion of swimming pools and spas that were issued an

HPPA order in York Region; the proportion of other recreational water

facilities (e.g. splashpads) that were issued a HPPA order in York

Region

FOOD

Enteric illness incidence rate The rate of new enteric diseases relative to the total population (per

100,000) in a specified time period. The following diseases are

classified as “enteric”: Amebiasis, Brucellosis, Botulism,

Campylobacter enteritis, Cholera, Creutzfeldt-Jakob Disease,

Cryptosporidiosis, Cyclosporiasis, Food Poisoning (all causes),

Giardiasis, Hepatitis A, Listeriosis, Paratyphoid Fever, Salmonellosis,

Shigellosis, Trichinosis, Typhoid Fever, Verotoxin-

producing Escherichia coli (VTEC) infection and Yersiniosis.

Food premises compliance Proportion of food premises that were inspected in York Region (by

facility risk category), proportion of food premises that were re-

inspected in York Region (by facility risk category)



Food premises enforcement Proportion of food premises that were issued a provincial offences

notices under Food Premises Regulation 562/90; proportion of food

premises that were issued a section 13 order under HPPA



Certified food handler Proportion of food premises in York Region with at least one current

certified food handler on site

Food safety in the home See RRFSS module "Food Safety in the Home" for specific definitions



Food safety disclosure The number of requests for food premise disclosure in York Region

received via Health Connection

HEALTH HAZARDS

Air quality standards - particulate matter 2.5 Number of days that particulate matter 2.5 exceeded Canada-Wide

(30ug/m3) and WHO standard (25 ug/m3) over a 24 hour period at

Newmarket and Toronto North air monitoring stations

Air quality standards - nitrogen oxides Number of days that nitrogen oxides exceed Ministry of Environment's

1-hour standard (200 ppb) and EPA 1-hour standard (100 ppb) at

Newmarket and Toronto north air monitoring stations; number of days

the nitrogen oxides exceeded MOE 24-hour average standard (100

ppb) at monitoring stations





Air quality - ground level ozone Number of days that ground level ozone exceeded MOE's 1-hour

standard (80 ppb) at monitoring stations; number of days taht ground

level ozeon exceeded MOE's standard (65 ppb) and WHO standard

(50 ppb) over an 8-hour period at Newmarket and Toronto North air

monitoring station

Perception of outdoor air quality Perception of outdoor air qualtiy with respect to different seasons,

activities and beliefs. See RRFSS module Outdoor Air Quality



Air quality - Air Quality Index Number of days with at least one hour of air quality index was in the

moderate, poor and/or very poor category for at least 1 hour on one

day at Newmarket and Toronto North air monitoring staions )



York Region per capita fossil fuel consumption Special data request to Statistics Canada

Average greenhouse gas emissions reductions Averagge greenhouse gas emission reductions achieved by York

Region 20/20 The Way to Clean Air participants

High temperature days Days when the air temperature is over 30 degrees Celsius reported at

the Buttonville monitoring station (Environment Canada, Weather

Office)

High humidex days

Days when the humidex is 40 or more at the Buttonville monitoring

station. The humidex is an index (a computed value as opposed to

something measured) devised to describe how hot or humid weather

feels to the average person. The humidex combines the temperature

and humidity into one number to reflect the perceived temperature. It

takes into account these two important factors that affect summer

comfort. It is therefore a better measure of how stifling the air feels

than either temperature or humidity alone. (Environment Canada,

Weather Office)

Cold weather days Days when the air temperature is -15 degrees Celsius or lower

reported at the Buttonville monitoring station (Environment Canada,

Weather Office)

High windchilll days

Days when the wind chill of -30 or lower at the Buttonville monitoring

station. Wind chill is the cooling effect of the wind in combination with

low temperatures. When it is windy, we feel colder because our skin

temperature is lower. This sensation of cold is what the wind chill

index quantifies: as such, the index is not a real temperature and is

expressed without units, even though it is calibrated according to the

Celsius temperature scale. (Environment Canada, Weather Office)

Severe rainfall events Precipitation within a 24 hour period that is equal to or greater than 25

mm. (Environment Canada, Weather Office)

Number of flood warnings







A Flood Warning is defined as a notice that flooding is imminent or

occurring. The Flood Warning is based upon information received by

the Conservation Authority’s weather monitoring systems, and is

intended to provide notice to municipalities and emergency services

that action is required on their part. Flood Warnings may be updated

depending upon weather and runoff conditions, and will be followed by

a notice of cancellation once the potential for flooding has passed.

The standard content of a Flood Warning may include:

• the date and time of issuance;

• identification of sender (Conservation Authority and person);

• recipient list;

• summary of weather forecast;

• description of potential flood magnitude and a general assessment

of flooding implications;

• specific information regarding the magnitude and timing of the

forecasted flooding, and the locations of anticipated problem areas;

• date and time of next update;

• Conservation Authority contact for additional information (including

adjacent Conservation Authorities when applicable).









Spills reported through MOE Spills Action Centre

Spills are defined as releases of pollutants into the natural

environment originating from a structure, vehicle, or other container,

and that are abnormal in light of all circumstances. Spills must be

reported immediately to the ministry and to the municipality when they

cause or are likely to cause any of the following: impairment to the

quality of the natural environment - air, water, or land; injury or

damage to property or animal life; adverse health effects; safety risk;

making property, plant, or animal life unfit for use; loss of enjoyment

of normal use of property; or interference with the normal conduct of

business.

Total point source on-site release of toxic chemicals Total annual point source on-site releases of toxic chemicals in

tonnes by municipality as reported by facilties to the National Pollutant

Release Inventory (water/air)

Outdoor air quality investigations and enforcement Proportion of outdoor air quality or environmental investigations

identifying potential health hazards necessitating corrective action to

mitigate health hazard

Indoor air quality enforcement Proportion of indoor air quality investgations (including mould) or risk

assessments identifying potential health hazards necessitating

corrective action to mitigate health hazard

Arena enforcement Proportion of arena ice pad inspections identiifying potential health

hazards necessitating corrective action of mitigate health hazard

(includes referrals to MOE and MOL)

Migrant farm enforcement Number of migrant farm inspections conducted per year; proportion of

migrants farms that required a re-inspection; proportion of migrant

farms requiring an HPPA order issued

High risk contaminant sites

Number of high risk sites reported per year, including polychlorinated

biphenyl storage sites, brownfields, contaminated sites and landfills

Pesticides used in agriculture Not included in surveillance plan

Fish species in York Region

Number of fish species found in York Region water bodies;

percentage of sport fish species with eating restrictions for sensitive

populations, eating restriction size of largemouth bass in York Region

water bodies. York Region water bodies include: Mill Pond,

Richmond Hill; Lake Simcoe, Georgina; Musselman's Lake,

Whitchurch-Stouffville; Lake Wilcox, Richmond Hill; Holland Marasha

Canals, King and East Gwillimbury; Milne Reservoir, Markham

Mortality attributable to outdoor air pollutants Mortality measures from Air Quality Benefits Assessment Tool

including: acute exposure mortality attributable to outdoor pollutant

concentrations, chronic exposure mortality

Morbidity attributable to outdoor air pollutants Morbidity measures from Air Quality Benefits Assessment Tool

including: acute respiratory symptom days; adult chronic bronchitis

days; asthma symptom days, cardiac emergency room visits, cardiac

hospital admissions, child acute bronchitis episodes, elderly cardiac

hospital admissions, minor restricted activity days, respiratory

emergency room visits, respiratory hospital admissions, restricted

activity days

Mortality due to air pollution Premature deaths due to air pollution using Canadian Medical

Association's Illness Cost of Air Pollution (ICAP) model

Economic impact of air pollution Economic impact of air pollution using ICAP model

Pain and suffering of air pollution Pain and suffering costs of air pollution using ICAP model

Health care costs of air pollution Health care costs of air pollution using ICAP model

Lost productivity of air pollution Lost productivity costs of air pollution using ICAP model

Asthma rates Prevalence rate of asthma in population ages 12+

Hospitalizations and emergency department visits

related to asthma

Hospitalizations and emergency department visits

related to cardioavacular diseases (including stroke)



Hospitalizations and emergency department visits

related to respiratory diseases

Hospitalizations and emergency department visits due

to accidental poisonings

Poison control calls/incidents Annual number of poison control centre calls per captia by

contaminant and age group

Hospitalizations, emergency department visits and

deaths related to excessive heat exposure

Hospitalizations, emergency department visits and

deaths related to excessive natural cold exposure

rates

INFECTION CONTROL

Bloodborne infections incidence rate The rate of new bloodborne illnesses relative to the total population

(per 100,000) in a specified time period. This includes diseases such

as: Hepatitis B (acute and chronic) and hepatitis C

Institutional outbreak summary Summary of outbreaks occurring in York Region institutions, including

Long-term care homes, day care centres, and retirement homes. The

summary includes a breakdown by outbreak type (i.e., respiratory vs.

enteric), causative agent and average length of time in outbreak. It

will also include the proportion of premises in outbreak per year.





Vectorborne disease incidence rate (WNv, Lyme The rate of new enteric diseases relative to the total population (per

disease) 100,000) in a specified time period. This includes diseases such as

Lyme disease, malaria and West Nile virus

Positive mosquito pools Number of positive mosquito pools captured by mosquito traps per

year

WNv awareness Monitors public knowledge, attitudes and behaviour regarindg West

Nile virus. See RRFSS module West Nile Virus Awareness



Mosquito protection – personal Monitors personal protective behaviour against mosquitoes. See

RRFSS module Mosquito Protection Personal

Mosquito protection – household Monitors household protective behaviour against mosquitoes. See

RRFSS module Mosquito Protection Household

Larvicides and adulticides Not to include in surveillance plan

Infection control premises inspection Routine inspection and re-inspections for daycares and LTCH

complianceProportion of premises inspected (LTCH,

PSS, daycares)

Personal service setting inspection compliance Routine inspection and re-inspections for personal service settings



IPAC complaints received per year (by facility: PSS, The number of complaints received by Health Protection requiring a

LTCH, daycare, community) PHI response, by facility type (including LTCH, daycares, PSS)



Number of HPPA orders issued to infection control The number of section 13 HPPA orders issued to infection control

premises (PSS, LTCH, daycares) premises (LTCH, daycares, PSS)

Use of PSS procedures (popularity) Monitors prevalence of personal care procedures; monitors public

awarness regarding licensing of personal service settings in York

Region residents (18+)

RABIES

Rabies incidence rate in animals Annual number of animals with confirmed rabies

Rabies incidence rate in humans Annual nubmer of humans who die of rabies infection

Proportion of humans given prophylactic treatment for Proportion of York Region residents given prophylactic treatment for

animal exposure to rabies human expsoure to rabies

Rabies immunization for cats and dogs Proprotion of cats and dogs that are currently immunized against

rabies during time of animal exposure incidents

TOBACCO CONTROL

Proportion of premises inspected Proportion of tobacco vendors that were inspected in York Region,

proportion of tobacco vendors that were re-inspected in York Region



Proportion of tobacco vendor inspections resulting in Proportion of tobacco vendors in York Region that were issued a

SFOA charge provincial offences notice under Smoke Free Ontario Act

Proportion of vendor sites with repeated offences Proportion of tobacco vendor sites in York Region that have repeated

offences in the past year

Support for tobacco enforcement Measures public support for banning smoking in public places not

covered under the Smoke-free Ontario Act. See RRFSS module -

Tobacco Enforcement

Reasons for tobacco enforcement opposition Assesses public support among York Region residents (18+) for using

underage shoppers to check if tobacco vendors are selling tobacco

products to epople under 19 years of age; to determine reasons for

those who oppose. See RRFSS module Tobacco - Tobacco

Enforcement

Knowledge of legal age for tobacco sales Assesses general awareness of legal age limits of retailer tobacco

sales. See RRFSS module Tobacco - Minors' Access to Tobacco

Current teen smokers Percent of the teen population (12 to 19 years of age) that were

current cigarette smokers from Canadian Community Health Survey



Smoking law related to workplaces and workplace To be developed

vehicles

Use of other tobacco products Percent of the population that have smoked or used other tobacco

products (cigars, pipe, chewing tobacco or snuff) in the previous

month



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