Since its introduction in 2003 the AQHI has been used by Canadians to help avoid exposure to the health risks associated with poor air pollution. Throughout Canada there has been a significant investment in increasing awareness of the AQHI among identified risk populations as well as the general public. Elite athletes have been identified as an at - risk population because of the intensity and duration of exposure to outdoor air quality. Elite athletes are motivated by any training factors that impact peak performance and have generally low awareness of the impact that air quality can have on both health and performance. Individuals tend to rely on sensory perception to evaluate air quality when, in fact, the pollutants that present the greatest harm to human health are difficult to see or smell. Athletes will not be able to limit exposure if they rely on sensory perception alone even if they understand the potential health impacts of poor air quality. Canada's Air Quality Health Index provides the world's first air quality index that measures the combined health risk of pollutants. Currently, the AQHI is reported on an hourly basis (based on a three hour trailing average) and AQHI maximum is Forecasted twice daily from a network of stationary monitoring stations. Although the AQHI offers Canadians real time reporting of the health risk associated with the current air quality as well as a 36 hour forecast projection , it may require more frequent reporting and forecasting to meet the needs of the elite athlete whose training or competition schedule may include regions without monitors, or may fall between AQHI updates. This report examines the awareness, need and potential use of the AQHI in helping reduce health risk and exposure in the elite athlete population, and reviews current research quantifying the performance impact of training and competing in poor air quality. In addition, the ethical and legal obligations to provide a safe training and competition environment are considered as well as the opportunity for Canada to create a point of difference in the sport event hosting marketplace based on good air quality and excellence in air quality sensing and reporting. Introduction Convergence and opportunity Part 1: athletes and air quality understanding elite athletes Awareness of air quality Increased awareness through international competition Who is at risk Elite athletes High exposure sports Athletes with asthma Paralympic athletes Part 2: health and performance health impacts of air pollution Pollutants of concern Performance impacts of air pollution Health and performance guidelines for international athletes Part 3: evaluating risk and avoiding exposure athletes and the AQHI Future of mobile AQHI sensing and reporting Part 4: discussion health and performance AQHI uptake Legal and ethical obligations Implications for games organizers Part 5: future opportunities - recommendations Bibliography
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