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Air pollution is not merely an irritating backdrop to the Beijing Olympics, it is a big killer here in Canada, the Canadian Medical Association says.

This year alone, 21,000 Canadians will die from the effects of bad air, and smog will take an $8-billion bite out of the economy, according to the report.

"This is an important medical issue and an economic issue," Brian Day, president of the CMA, said in a teleconference.

"Doctors see the impact of air pollution on our patients every day."

He said that, in addition to the deaths, air pollution sickens many and places a tremendous strain on health care resources. In particular, air pollution results in:

11,000 hospital admissions a year;

92,000 emergency department visits annually;

620,000 visits a year to a doctor's office for treatment;

22.5 million cases of minor illness annually.

The report, entitled No Breathing Room: National Illness Costs of Air Pollution, notes that air pollution disproportionately affects older Canadians, particularly those with respiratory and cardiovascular illnesses such as asthma, chronic obstructive pulmonary disease and congestive heart failure.

With the population aging, the research predicts that, by 2031, the annual death toll will rise to 39,000 and the economic costs of smog will hit $18-billion.

The Ontario Medical Association has, for a number of years, produced a report on the impact of air pollution in its province, but this is the first attempt to carry out a national analysis.

In the past, there have been doubts expressed about the accuracy of the projections of deaths and economic costs, but Ted Boadway, director of health policy at the OMA, defended the methodology.

The Illness Costs of Air Pollution model includes an examination of airborne pollutants, principally ozone and particulate matter.

Researchers then calculate the health effects grouped in five broad categories: premature deaths; hospital admissions, ER visits, doctor's visits and minor illnesses.

Economic costs, in turn, are estimated in four categories. For example, in 2008, the economic costs of air pollution were deemed to total $8.1-billion, including:

Loss of life, $6.5-billion;

Lost productivity, $688-million;

Health care costs, $438-million;

Loss of quality of life, $384-million.

The CMA has posted, on its website (http://www.cma.ca) a link that allows individuals to drill down and produce figures for provinces and regions.

According to the report, air pollution is not necessarily most dangerous in big cities and industrialized areas. Rather, pollutants can travel long distances, and where they settle can depend on weather patterns.

"Some of the worst pollution is in rural areas because they're downwind," Dr. Boadway noted.

Similarly, much of the pollution in Ontario and Quebec - the hardest-hit regions of the country - come from across the border in the U.S.

Of the 21,000 deaths caused by air pollution each year in Canada, the CMA estimated that about 2,700 were due to short-term exposure - such as smog days that trigger severe asthma attacks and strokes. The association said the balance were due to chronic exposure to pollutants over time.

Physiologically, pollutants can affect coagulation - essentially making blood thicker and more prone to forming clots that trigger heart attacks and strokes - and they can weaken the muscle cells in arteries, giving rise to atherosclerosis.