How Does Air Pollution Affect Me

I. CHILDREN’S HEALTH

Childhood Cancers and Atmospheric Carcinogens

J. Epidemiol. Community Health 2005;59;101-105

E G Knox

Main points: Air pollution can be hazardous to fetuses and young infants, in that it can increase their risk of childhood cancers.

Summary: Birth and death addresses of fatal child cancers in Great Britain between 1966 and 1980, were linked with high local atmospheric emissions of different chemical species. Significant birth proximity relative risks were found within 1.0 km of hot spots for carbon monoxide, PM10 particles, and a variety of other air pollutants. Calculated attributable risks showed that most child cancers and leukemias are probably initiated by these exposures. Risks seem to be greatest in the prenatal and early infancy periods, and the authors propose that the mothers probably inhale these pollutants and they pass to the fetus via the placenta.

Local Variations in CO and Particulate Air Pollution and Adverse Birth Outcomes in Los Angeles County, California, USA

Michelle Wilhelm and Beate Ritz

VOLUME113 | NUMBER9 | September 2005 • Environmental Health Perspectives

Main points: Exposure to carbon monoxide and particulate matter during pregnancy increases the likelihood of having a low birth weight or premature baby.

ECONOMIC VALUATION OF OZONE-RELATED SCHOOL ABSENCES IN THE SOUTH COAST AIR BASIN OF CALIFORNIA

JANE V. HALL, VICTOR BRAJER, and FREDERICK W. LURMANN

C ontemporary Economic Policy, forthcoming October 2003.

Main Points:

• With better pollution control and decreased levels of air pollution, children are healthier and miss less school. This has economic benefits, because parents don’t miss work/ have to bring child to doctor, etc.
• Reducing air pollution has health and economic benefits for children and their families.

Summary : With declining levels of air pollution in the south coast air basin, there has been a decrease in ozone-related school absences in the 1990s. This reduction in school absences, there is less economic cost to families (decreased work, medical costs, loss of enjoyment time, impact on others in family), which resulted in an estimated $245 million dollars in savings per year, or $75 per every school child in the area.

Nino Künzli, MD, PhD, Rob McConnell, MD, David Bates, MD, Tracy Bastain, MPH, Andrea Hricko, MPH, Fred

Lurmann , MS , Ed Avol, MS, Frank Gilliland, MD, PhD, and John Peters, MD

American Journal of Public Health | September 2003, 1494 | Reviewing the Evidence | Peer Reviewed | Künzli et al. Vol 93, No. 9

Main points:

• All children living in polluted areas have decreased lung function
• Children exposed to air pollution are more likely to develop asthma.
• Children who have been diagnosed with asthma are more likely to have asthma flare-ups if they live in an area with more air pollution
• Asthma flare-ups lead to more absences from school for an asthmatic child.
• Not only do asthma flare-ups affect the child but often a parent must miss work to care for the child and this has economic consequences.

Summary: The Children’s Health Study studied 6000 public school children Los Angeles over several years. It collected extensive demographic data and information about respiratory symptoms in these children, it measured lung function directly each year, and monitored school absenteeism related to respiratory symptoms. It then took this data and compared it with information collected concurrently with regard to air pollution. The study concluded that there were significant morbidities associated with air pollution including asthma development and exacerbation, decreased lung function, and increased school absenteeism. Authors recommend dual strategy of decreasing air pollution in general and then reducing the exposure of children to air pollution with a variety of environmental interventions.

Dennis R. Fitz

Arthur M. Winer, Ph.D. and Steven Colome, Sc.D.

Eduardo Behrentz, Lisa D. Sabin, Seong Jeong Lee, Kenneth Wong, Kathleen Kozawa

October 10, 2003

Main points:

• Children’s lungs are still developing and are very sensitive to air pollution.
• Children are exposed to very high levels of air pollution while on diesel school buses
• The amount of pollution a child is exposed to during a ride on a diesel school bus is far greater than he/she would receive even while waiting for the bus on a busy street.
• We should try to reduce the exposure to this air pollution by using cleaner-burning fuels, reducing commute time and reduce school bus idling time

Summary:

Measured air quality in conventional diesel school buses vs. diesel school buses equipped with a particulate trap as well as a natural gas powered bus. Found that children exposed to higher levels diesel related pollutants compared with ambient levels of pollution outside the bus. This effect is exacerbated when the windows are closed or the bus is driving behind another diesel vehicle. The effect within the bus seems to be a much greater exposure than that experienced during loading and unloading of the bus, probably due to the short amount of time in these other activities.

Asthma in Exercising Children Exposed to Ozone: A Cohort Study

Rob McConnell, Kiros Berhane, Frank Gilliland, Stephanie London, Talat Islam, W James Gauderman, Edward Avol, Helene G Margolis, John Peters

Lancet 2002; 359:386-91

Main points: Children who live in communities with high levels of ozone are more likely to develop asthma if they play outside than children who live in communities with lower levels of air pollution.

Summary : Studied 3535 children with no history of asthma from schools in 12 communities with in southern California and followed them for 5 years. During that time, 265 children were newly diagnosed with asthma. When the communities were stratified into level of ozone and other types of air pollution and the relationship with asthma development and sports participation was studied. Study found that in communities with high levels of ozone, children who played 3 or more sports were 3.3 times more likely to develop asthma. More time spent outdoors was also associated with asthma in high ozone areas but these relationships were not seen in ozone areas.

The Effects of Ambient Air Pollution on School Absenteeism Due to Respiratory Illnesses

Frank D. Gilliland, 1 Kiros Berhane,1 Edward B. Rappaport,1 Duncan C. Thomas,1

Edward Avol, 1 W. James Gauderman,1 Stephanie J. London,2 Helene G. Margolis,3

Rob McConnell, 1 K. Talat Islam,1 and John M. Peters1

Epidemiology January 2001, Vol. 12 No. 1

Main points: Some of the particular chemicals in air pollution seem to cause respiratory illnesses in children that are severe enough that they must miss school.

Summary: Longitudinal, 10 year study looking at school absenteeism for respiratory illness in 2000 4 th graders in California as related to local air pollution. Found that levels of ozone on particular days were correlated positively with school absenteeism from respiratory illness.

II. GENERAL HEALTH

Fine Particulate Air Pollution and Mortality in Nine California Counties: Results from CALFINE

Bart Ostro,1 Rachel Broadwin,1 Shelley Green,1 Wen-Ying Feng,2 and Michael Lipsett 3

Environmental Health Perspectives • VOLUME 114 | NUMBER 1 | January 2006

Main point: Short term exposures to fine particle air pollution causes and increase risk of dying, and may exacerbate the effects of chronic disease.

Summary: Studied the relationship between mortality and fine particle (<2.5 ) in heavily populated California counties, using data from 1999-2002. Considered all-cause mortality and cause-specific (ie. respiratory, cardiovascular, ischemic heart disease, and diabetes.) Also divided the population into a number of subpopulations, including the elderly, males/females, lower education, whites and Hispanics. Using regression analysis, found that a 10 microgram/m3 change in the 2 day average PM 2.5 concentration corresponded to a 0.6% increase in all-cause mortality, with similar results for respiratory disease, cardiovascular disease, diabetes, elderly, females, death out of the hospital, and non-high school graduates.

Report to the California Legislature: Indoor Air Pollution in California

A report submitted by:

California Air Resources Board

Pursuant to Health and Safety Code § 39930

(Assembly Bill 1173, Keeley, 2002)

February 2005

Main points:

• While we traditionally consider air pollution to be something outside, indoor sources of air pollution can have significant health impacts.
• These sources of pollution are not well regulated.
• Asthma, cancer, death, respiratory disease, among other diseases are related to indoor air pollution.
• There are steps individuals, employers, and state regulators can do to reduce the risk from these toxins.

Summary: Available scientific information indicates that indoor air pollution poses substantial health risks in many indoor environments. Indoor pollution ranked high relative to other environmental problems because there are numerous sources of pollutants indoors, indoor air concentrations of some pollutants often occur at levels that create significant health risks, and people spend most of their time indoors. While regulation of outdoor sources such as motor vehicles and industrial facilities is very extensive and has notably reduced pollutant levels in California, indoor pollution sources have not been addressed in a comprehensive manner. Indoor air pollution can cause a variety of impacts on human health, from irritant effects to respiratory disease, cancer, and premature death.

The health impacts of greatest significance include asthma, cancer, premature death, respiratory disease and symptoms, and irritant effects. Extensively discusses individual indoor toxins and their physiologic effects, economic costs of air pollution ($45 billion/year.) Also discusses methods to reduce indoor air pollution, current state of regulation, and regulation recommendations.

Bart Ostro, Rachel Broadwin, Shelley Green,

Wen-Ying Feng, and Michael Lipsett

doi:10.1289/ehp.8335 (available at http://dx.doi.org/)

Online 1 September 2005

Main points: Increase risk of dying even with short-term exposures to fine particle air pollution. The elderly, among other groups, seem particularly sensitive to this effect.

Summary: Examined all cause and cause-specific daily mortality in 9 Los Angeles counties with reference to short term exposures to PM2.5. Also looked at specific subpopulations, including elderly, male/female, Hispanic, education level. After controlling for covariates of temperature, humidity, time, seasonality, and day of the week which could affect daily mortality, authors found an association between PM 2.5 with mortality. Specifically, found a 10 μg/m 3 change in two-day average PM2.5 concentration corresponded to a 0.6% (95% CI = 0.2 – 1.0) increase in all-cause mortality, with similar or greater effect estimates for several other subpopulations and mortality subcategories, including respiratory disease, cardiovascular disease, diabetes, those above age 65, females, deaths out of the hospital, and non-high school graduates.

Spatial Analysis of Air Pollution and Mortality in Los Angeles

Michael Jerrett,* Richard T. Burnett,† Renjun Ma,‡ C. Arden Pope III,§ Daniel Krewski,¶

K. Bruce Newbold,George Thurston,** Yuanli Shi,¶ Norm Finkelstein,

Eugenia E. Calle,†† and Micheal J. Thun††

Main points: Exposure to air pollution in metropolitan areas can cause long term effects, including lung cancer and heart disease.

Summary: Studied the health effects and mortality related to PM 2.5 and ozone exposure. Used the American Cancer Society Cohort database from 1982-2000 and pollution measurements from 23 fine particle and 42 ozone fixed monitors. Using regression analysis and controlling for 44 covariates, found an increase risk of all-cause mortality from PM 2.5 exposure, and higher than previously reported increased risk of death from ischemic heart disease and lung cancer.

Release Date: October 14, 2004

California Air Resources Board. Full report 197 pages.

Summary: The California Air Resources Board (ARB or Board) conducted a health risk assessment of airborne particulate matter emissions from diesel-fueled locomotives at the Union Pacific J.R. Davis Yard (Yard) located in Roseville, California. Part I is a Risk Characterization.

Part II is a Health Risk Assessment To summarize, the key findings of the study are:

• The diesel PM emissions in 2000 from locomotive operations at the Yard are estimated to be about 25 tons per year.
• Moving locomotives account for about 50 percent, idling locomotives account for about 45 percent, and locomotive testing accounts for about 5 percent of the total diesel PM emissions at the Yard.
• Computer modeling predicts potential cancer risks greater than 500 in a million (based on 70 years of exposure) northwest of the Service Track area and the Hump
• The area impacted is between 10 to 40 acres. To provide some perspective on the size, an acre is about the size of a football field.
• The risk assessment show elevated concentrations of diesel PM and associated cancer risk impacting a large area. These elevated concentrations of diesel PM, which are above the regional background level, contribute to an increased risk of cancer and premature deaths due to cardiovascular disease and non cancer health effects such as asthma and chronic obstructive pulmonary disease. Potential cancer risk and the number of acres impacted for several risk ranges are as follows:
  • Risk levels between 100 and 500 in a million occur over about 700 to 1,600 acres in which about 14,000 to 26,000 people live.
  • Risk levels between 10 and 100 in a million occur over a 46,000 to 56,000 acre area in which about 140,000 to 155,000 people live.
• The magnitude of the risk, the general location of the risk, and the size of the area impacted varies depending on the meteorological data used to characterize conditions at the Yard, the dispersion characteristics, and the assumed exposure duration and breathing rate for the proposed population.
• Given the magnitude of diesel PM emissions and the large area impacted by these emissions, short term and long term mitigation measures are needed to significantly reduce diesel PM emissions from the J.R. Davis Rail Yard .

Particulate Air Pollution and Morbidity in the California Central Valley: A High Particulate Pollution Region

Stephen K. Van Den Eeden, PhD

Charles P. Quesenberry, Jr., PhD

12 July 2002

Main points: Air pollution in the San Joaquin Valley leads to more emergency room visits and hospitalizations for respiratory illnesses.

Summary ; The purpose of this study was to evaluate the relationship between particulate air pollution and morbidity among the Kaiser Permanente (KP) membership who reside in the Central Valley (CV) of California. Collected data on air pollution, including PM and ozone and monitored health consequences. Consistently found a positive correlation between air pollution levels and acute and chronic respiratory conditions leading to ER visits and hospitalization. Specifically, PM 10 and 2.5 levels were most associated with these respiratory-related hospital visits, though there was some association with levels of NO 2 and CO. The authors were unable to make conclusions about cardiovascular illnesses and pollution, and a few pollutants like ozone had unexpectedly opposite results.

Lung Cancer, Cardiopulmonary Mortality and Long-term Exposure to Fine Particulate Air Pollution.

C. Arden Pope III, Richard Burnett, Michael Thun, Eugenia Calle, Daniel Krewski, Kazuhiko Ito, George Thurston.

Main points: Long term exposure to fine particulate air pollution increases the risk of dying from all causes, but especially lung cancer and heart disease

Summary: Study looking at the risk of death with increasing exposure to fine particulate air pollution. Utilized the data of the American Cancer Society’s Cancer Prevention Study (CPS) II which collects on adults throughout the US and Puerto Rico on mortality rates, cause of mortality, demographics, various behaviors, etc. This data was compared with air pollution data from specific zip codes (variety of air pollution collection sources). After adjusting for risk factors such as diet, obesity, smoking, the researchers found that for each 10 microgram/mm 3 increase in fine particulate air pollution was associated with a 4% increase in all-mortality, 6% increase in cardiopulmonary mortality, and an 8% increase in lung cancer mortality. This is the first study looking at the long term effects of fine particulate air pollution on mortality rates.

Long-term Air Pollution Exposure and Acceleration of Atherosclerosis and Vascular Inflammation in an Animal Model

Qinghua Sun, MD, PhD, Aixia Wang, BS, Ximei Jin, BS , Alex Natanzon, MD

Damon Duquaine, MS, Robert D. Brook, MD, Juan-Gilberto S. Aguinaldo, MD

Zahi A. Fayad, PhD, Valentin Fuster, MD, PhD, Morton Lippmann, PhD

Lung Chi Chen, PhD, Sanjay Rajagopalan, MD

JAMA, December 21, 2005—Vol 294, No. 23

Main points:

• The PM2.5 in air pollution seems to worsen atherosclerosis by changing the ways that the arteries constrict, as well as causing inflammation and fatty plaque deposition in the arteries of mice.
• When mice were fed a high fat diet, and then exposed to this pollution, they had an even more severe problem with atherosclerosis than with a fatty diet or pollution alone.

Summary: Researchers were trying to understand the mechanism by which exposure to air pollutants (specifically, PM2.5) leads to atherosclerosis. They studied mice, which they fed a normal or a high fat diet. They then exposed some of the mice to PM2.5 for 6 hours/day and compared them to mice exposed to filtered air. They found that PM2.5 exposure leads to more atherosclerosis, more arterial inflammation and increased vasomotor tone in the arteries of these mice. This effect is exacerbated by a high fat diet.

Ambient Air Pollution and Atherosclerosis in Los Angeles

Künzli N, Jerrett M, Mack WJ, Beckerman B, LaBree L,

Gilliland F, Thomas D, Peters J, Hodis HN

doi:10.1289/ehp.7523 (available at http://dx.doi.org/)

Online 22 November 2004

Summary: First study of its kind in humans looking for early signs of cardiovascular disease related to particulate matter exposure. Studied 798 patients who had been selected for other atherosclerosis studies, and measured CIMT (carotid intima media thickness), an early sign of atherosclerosis. Mapped area of residence in terms of particulate matter of 2.5 microns in diameter or greater. Performed regression analysis to associate PM level with CIMT. Concluded that there was an association with this early sign of atherosclerosis and higher levels of PM. Association seems to be more significant in certain populations, including women over 60 years old.

Bullet points:

• Previous studies in animals have suggested that exposure to air pollution can worsen atherosclerosis, or fatty buildup in the arteries, that can lead to heart disease and stroke.
• This study was the first of its kind looking at the early signs atherosclerosis in humans and their relationship to air pollution.
• The study found that atherosclerosis seems to be worsened by long term exposure to the particles in air pollution.
• This early atherosclerosis is seen in healthy people who have no signs of heart disease yet and may contribute to the development of future problems.
• The effect that the researchers saw was especially significant in older women.

Concentration and Size Distribution of Ultrafine Particles Near a Major Highway

Yifang Zhu and William C. Hinds

Department of Environmental Health Sciences, University of California, Los Angeles

Seongheon Kim and Constantinos Sioutas

Department of Civil and Environmental Engineering, University of Southern California,Los Angeles

ISSN 1047-3289 J. Air & Waste Manage. Assoc. 52:1032-1042

Summary: Although they constitute only 1–8% of the mass of particulate matter (PM) in ambient air, ultrafine particles have been suggested as a possible causative agent for increases in mortality and morbidity associated with increases in PM concentration. Motor vehicle emissions usually constitute the most significant source of ultrafine particles in an urban environment, yet little is known about their concentration and size distribution in the vicinity of major highways. The present study, conducted in the vicinity of Interstate 405, shows that particle number concentration near the freeway was ~25 times greater than that at background locations, and that the concentration of ultrafine particles drops to background levels within 300 m downwind of the freeway.

Living with dirty air may boost heart attack risk.

Fatal heart attacks may be more likely among people who spend decades living in heavily polluted areas, Swedish researchers report.

While there was no association between people's exposure to various pollutants over a 30-year period and overall heart attack risk, such exposure did appear to be associated with a greater risk of fatal heart attack, especially heart attacks occurring outside hospitals, Mats Rosenlund of the Stockholm County Council and colleagues report.

The researchers also found that people who had ever lived in pollution "hot spots" with particularly dirty air had a 23 percent increased risk of heart attack, and a 40 percent increased risk of fatal heart attack.

The health effects of short-term exposure to air pollution are fairly well understood, but it is much less clear how long-term pollution exposure affects health, Rosenlund and associates point out in the journal Epidemiology.

Pollution exposure could contribute to heart attack risk by causing chronic inflammation, speeding the progression of atherosclerosis (hardening of the coronary arteries) and altering heart function, they note.

To investigate, they reviewed information on pollution exposure for 1,397 men and women living in Stockholm County who had suffered heart attacks for the first time between 1992 and 1994 and 1,870 healthy controls.

The researchers estimated carbon monoxide, sulfur dioxide, particulate matter and nitrogen dioxide exposure by linking an individuals' address to historical data on emissions and atmospheric dispersion of the pollutants.

Overall, there was no link between pollution exposure and heart attack risk. However, the risk of fatal heart attacks appeared to have some association with pollution exposure, especially among people who died outside the hospital.

This finding "implies that sudden death might be of special importance in relation to long-term air pollution exposure," Rosenlund and colleagues conclude.

SOURCE: Epidemiology, July 2006.

AIR POLLUTION: EPA science update bolsters link between soot, health problems

July 25, 2006
Darren Samuelsohn, Greenwire senior reporter

Recent research bolsters U.S. EPA's two-year-old opinion that microscopic airborne soot and larger-size particles can cause a range of human health problems, including premature death, EPA scientists reported Friday.

EPA's National Center for Environmental Assessment released for public comment an analysis of more than 200 studies finished since the agency last officially closed the book on studying health effects of fine particulates. The new report says recent epidemiologic studies continue to find links between death and sickness and long-term and acute exposure to fine particles.

Other new studies show traffic-related pollution, suspended soil and road dust and regional sulfur emissions cause health problems. And recent research links respiratory problems with short-term exposure to larger thoracic coarse particles, which are measured between 2.5 microns and 10 microns in diameter. Fine particulates are less than 2.5 microns.

EPA's latest scientific compilation builds on the 2,158-page "criteria document" issued just days before President Bush's re-election in 2004. The 2004 study acknowledged how EPA had linked exposure to fine PM and serious human health problems, from respiratory and cardiovascular disease to death.

EPA Administrator Stephen Johnson used that report as a basis for his proposal last winter to update Clinton-era requirements for particulate matter (Greenwire, Nov. 1, 2004). Johnson proposed several options for changing the standard, with a preferred choice to keep a status quo level for soot when it is measured on an annual basis but a more stringent threshold for soot measured over 24 hours.

Johnson has until Sept. 27 before a court-ordered deadline requires him to decide if any final changes should be made to the current soot limits.

Public health groups, environmentalists and even the EPA's outside body of scientific advisers have urged Johnson to set stronger soot limits on both a daily and annual basis. "The science is overwhelming that EPA should set tougher new soot standards," said Frank O'Donnell, head of the advocacy group Clean Air Watch.

But EPA has also gotten an earful from lawmakers and industry officials opposed to stronger soot standards. In a pair of Senate Environment and Public Works Committee hearings earlier this month, several key Republicans attacked EPA for considering a more stringent federal limit.

Chairman James Inhofe (R-Okla.) argued EPA should not set tighter limits in the face of uncertainties connecting soot to adverse public health effects. He said EPA "cherry picked" certain health-effect studies that showed a link to adverse health effects (E&E Daily, July 20).

Click here for EPA's update on the science connecting health effects to particulate matter.

Provisional Assessment of Recent Studies on Health Effects of Particulate Matter Exposure report