Air Quality and Human Health in New England:

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Air Quality and Human Health in New England The
NOAA Funded AIRMAP and INHALE Projects
Cameron Wake Institute for the Study of Earth,
Oceans and Space University of New Hampshire
Making the Connection Human Health and
Environmental Exposures University of New
England, Biddeford, ME 24 October 2003
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AIRMAP Stations
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Atmospheric Measurements at AIRMAP Monitoring
Sites
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How is ozone formed?
Ground level ozone is not emitted directly into
the air but is formed by a chemical reaction when
volatile organic compounds (VOCs) interact with
nitrogen compounds (NOx) in the presence of
sunlight.
VOCs come primarily from vegetation and
industrial sources. NOx comes from automobiles,
trucks, buses, and power plants.
Ozone pollution is a concern primarily during the
summer months when the weather conditions to form
it (lots of sun and hot temperatures) normally
occur.
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Why is ozone bad to breathe?
Ozone can irritate lungs and airways and cause
inflamation. Ozone can aggravate respiratory
illness such as asthma. Health effects
include -coughing -nose and throat
irritation -chest pain -reduced lung
function -increased susceptibility to
respiratory illness Active children and adults,
and people with chronic lung diseases are
particularly at risk during high ozone events.
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Why does New England have poor air quality?
New England lies directly downwind of major urban
and industrial centers in the eastern United
States. As a result our air quality is, at times,
significantly affected by pollution transported
into the region from these upwind sources,
although emissions from automobiles, industry,
and forests in New England also play an important
role in contributing to poor air quality.
Map of common storm tracks across the United
States. Note that many end up over New England.
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http//capita.wustl.edu/otag/reports/aqafinvol_I/a
nimations/v1_exsumanimb.html
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What weather patterns cause high ozone in New
England?
We typically have the worst air quality on the
back side of a high pressure system. Air
circulates clockwise around high pressure systems
in the northern hemisphere. So, when a high
pressure system moves eastward out of New England
(1 July in figure below) it results in the
transport of polluted air into the region from
the mid-west and eastern seaboard.
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Plumes of polluted air take several hours to
travel down the eastern seaboard. Note the times
of maximum ozone concentration in coastal New
Hampshire and Maine during this ozone pollution
episode on 30 June 1997.
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These graphs provide one example of an ozone
event in southern New Hampshire in July 2001.
Note the high levels at Appledore Island on July
24 (125 ppb) compared to lower ozone levels at
Thompson Farm (90 ppb) just 15 miles away. Also
note the general buildup of ozone from the 20th
to the 24th, followed by relatively clean air on
the 25th and 26th.
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Ozone in New England, July 23-24, 2001
http//www.epa.gov/airnow/
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8 hr Ozone Exceedance Days 1983-2002
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8 hr Ozone vs Tmax 1982-2002
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The Environmental Protection Agency (EPA) has
developed a guide for air quality based on the
concentration of pollutants in the atmosphere.
Real time air quality data online
airmap.unh.edu www.epa.gov/airnow
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Reanalysis of the Harvard Six Cities Study and
the American Cancer Society (ACS) Study of
Particulate Air Pollution and Mortality Health
Effects Institute, July 2002
Study Overview Harvard
ACS sulfate particles No. cities
6 151 50 No.
subjects 8,111 552,138 295,223 No.
deaths 1,430 38,963 20,765 Mean age
49.7 58.5 58.6 Air
Quality study based EPA
EPA monitors Total follow up yrs 14-16
about 7 ?PM2.5(µg/m3) 18.6 (11-29.6)
24.5(9-33.5) ?SO4 8.0(4.8-12.8) 19.9(3.6-23.5)
Original Works Dockery et al., An association
between air pollution and mortality in six US
cities, NE Journal of Medicine 329, 1753-1759,
1993. Pope et al., Air pollution as a predictor
of mortality in a prospective study of U.S.
adults. Am J Respir Crit Care Med 151, 669-674,
1995.
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Relative Risk of Mortality Associated with a 19.9
µg/m3 Increase in Sulfate in the Reanalysis of
the ACS Study
Risk Models Base air pollution only Original
air pollution, sex, age, smokers, pack-years
smoking, BMI, education Full Original plus
several other covariates (passive smoking,
marital status, alcohol, etc.)
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Relative Risk of Mortality Associated with an
18.6 µg/m3 Increase in Fine Particles in the
Reanalysis of the 6 Cities Study
Risk Models Base air pollution only Original
air pollution, sex, age, smokers, pack-years
smoking, BMI, education Full Original plus
several other covariates (passive smoking,
marital status, alcohol, etc.)
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Ozone / Hospital Admissions(Burnett, et al 2001)
1.0 0.5 0.0 -0.5
Respiratory Hospital Admissions
Anomalies (adjusted)
-20 0 20
40 O3 (ppbv) difference from mean value (5-day
average filtered Max 1-hour ppb)
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Air Pollution, Weather and Respiratory Emergency
Room Visits in Portland, ME and Manchester, NH
an Ecological Time Series Study
Portland
Manchester
Demographic data from US Census
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Raw time-seriesManchester, New Hampshire
All Respiratory
MinimumTemperature
Relative Humidity
AverageSO2
1998-2000
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Model compares filtered time-seriesManchester,
New Hampshire
All Respiratory
MinimumTemperature
Relative Humidity
AverageSO2
1998-2000
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Model Evaluation
All Respiratory
Asthma
Portland
R2 0.45
R2 0.78
ER Visits
Manchester
R2 0.66
R2 0.31
Modeled ER Visits
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Relative risk of SO2 1 Day Average increased
Interquartile Range
Effects range from 5-10 increases in
Portland Unclear in Manchester
Portland 6.2ppb
Relative Risk
Manchester 5.5 ppb
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Relative risk of O3 Maximum 8-hour Average
increased Interquartile Range
5 increase in Portland Asthma Visits Unclear
in Manchester
Portland 15 ppb
Relative Risk
Manchester 18ppb
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Tip of the Iceberg
Present day adverse health effects that could be
avoided every year by meeting the US EPA's daily
maximum ozone standard (80 ppb 8-hour) in New
York, NY. Figure sections not drawn to scale.
From Thurston, 1997.
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Problem Statement
Health Tracking Issues -access -coarse
spatial and temporal resolution -what to
track -tip of iceberg
Air Quality Issues -indoor vs outdoor -year
round meas. -multi-parameter -discontinuos
(e.g. toxics)
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Integrated Human Health and Air Quality Research
(INHALE)
Goal of INHALE project is to improve public
health by 1) engaging a wide range of
stakeholders in a collaborative effort to better
define the link between broad measures of
pulmonary health and air pollution and 2) using
the results of the investigation to create
informed public policy and guide the product
development of the NOAA air quality forecasting
effort. 3) Determine the health care costs
associated with air pollution events
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INHALE - Key Stakeholders
UNH Departments and Institutes AIRMAP
(Atmospheric Investigation, Regional Modeling,
Analysis and Prediction) Institute for the Study
of Earth, Oceans and Space Office of
Sustainability Programs Dept of Health
Management and Policy Whitemore School of
Business and Economics Masters of Public
Health New Hampshire Institute of Health
Policy Cooperative Extension Stakeholders Lung
Association (Maine, NB) International Center for
Air Quality and Health New Hampshire Department
of Environmental Services New Hampshire Health
and Human Services New Hampshire Department of
Education Vermont Health and Human
Services Manchester Health Department Maine
Bureau of Health University of Southern
Maine/NASA Environmental Human Health
Institute University of Connecticut Health
Center Northeast States for Coordinated Air Use
Management (NESCAUM) Asthma Regional Council
(ARC) of New England EPA Region 1 Center for
Disease Control Environmental Health Tracking
Grants
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Low cost pulmonary function monitor Forced
Expiratory Volume in 1 sec (FEV1) Peak
Flow Download data directly to computer and web
page Plus daily respiratory symptoms
(cough, wheeze, chest tightness,
shortness of breath)
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INHALE - Research Activities
Pulmonary Health Tracking-Individual Spirometry
Measurements PLUS Summer camp pilot project,
Bear Hill Camp, NH NH Schools summer
2004 Retrospective Investigations - Air Quality
and Hospital Visits Portland and Manchester
complete (1997-2000) Extended to other cities
and states in New England Estimating the Economic
Effects of Poor Air Quality in New
England modify Ontario Medical Assoc. Illness
Cost of Air Pollution model
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Summer 2004 New England/North Atlantic Internation
al Climate and Air Quality Field Campaign
detailed 3D, multi-parameter investigation of
air quality in NE NA multiple measurement
platforms to include aircraft (NOAA P-3, NASA
DC-8 P3, DOE, UMD, MSC, CNRS,
ITOP) balloons satellites (Aura, Terra,
EnviSat) Ship (NOAA Ronald Brown) Surface
Stations -EPA/State monitoring programs
(O3-68 SO2-26, PM10-33, PM2.5-44 CO-16
NO2-17) -NOAA Profiler and LIDAR
Networks -AIRMAP Harvard Forest -Buoys
(WHOI) pilot study 2002 New England Air
Quality Study (3 day mtg in May 2003 AGU
special session JGR special issue)
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Summer 2004 New England/North Atlantic Internation
al Climate and Air Quality Field Campaign
Additional Research Platforms
NOAA P-3
DOE G-1
UH/UNH
NASA DC-8
NOAA R/V Ronald H. Brown
NOAA R/V Ronald H. Brown
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Scientific Objectives - Summer 2004 Health
Tracking Campaign

• Summer 2004 represents unique opportunity to
  better understand the relationship between health
  effects and air pollution events
• 1. Collect a hierarchy of health effects data
  relating primarily to pulmonary health
• Daily pulmonary function (FEV1 and respiratory
  symptoms)
• -children at summer camps
• -young adults a summer University sport camps
• -scientists at research facilities
• -federal, state and municipal employees
• -inner city youth (Roxbury, Providence, New
  Haven, Portland)
• Hospital ER visits and drug use in near real
  time (syndromic data)
• standard retrospective data as it becomes
  available to compare to AQ data
• Physican visit data via Sentinal Physician
  Program
• Hospital utilization and Physician Visit Data
  from individual hospitals in near real
• time (e.g., Wentworth Douglas)

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Hidden Health Benefits of Greenhouse Gas
Mitigation Luis Cifuentes, Victor
H. Borja-Aburto, Nelson Gouveia, George Thurston,
Devra Lee Davis actions that reduce GHG
emissions also yield powerful immediate benefits
to public health by reducing adverse effects
of local air pollution air pollution currently
sickening or killing millions throughout
world reducing emissions from older coal-fired
power plants in U.S. could provide substantial
benefits to public health avoidance of 18,700
deaths, 3 million lost work days, 16 million
restricted activity days (Clean Air Task
Force, Boston, MA 2000) reduction in adverse
health effects over 20 years (2001-2020) in 4
cities (Mexico City, New York, Santiago, and
Sao Paulo - combined population 65 million)
through adoption of GHG mitigation
technologies that would reduce ozone and PM by
10. This would avoid 64,000 premature
deaths 65,000 chronic bronchitis cases 37
million person days of restricted activity GHG
mitigation can provide considerable local public
health benefits air pollution reduction-related
health benefits could be strong motivator for GHG
mitigation actions
www.sciencemag.org SCIENCE VOL 293 17
AUGUST 2001
1257
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Impact of Changes in Transportation Behaviors
During 1996 Summer Olympic Games in Atlanta on
Air Quality and Childhood Asthma Friedman et al.,
2001, J. American Medical Assoc., Strategies
to minimize road traffic congestion during the
Olympics -integrated 24 hour-a-day public
transportation system -addition of 1000 buses
for park-and-ride services -alternative work
hours and telecommuting -altered downtown
delivery schedules -public warning of potential
traffic and air quality problems
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Change During 1996 Olympic Period Compared to
Baseline Period change Olympics
Baseline (July 19-Aug 4) (Jun
21-Jul 18 Aug 5 - Sep 1) traffic
counts -23 ---- ----- Public
transportation217 ---- ---- Ozone (1 hr
ppb) -30 59 81 CO (8 hr ppm) -19
1.26 1.54 PM10 (24 hr µg/m3) -16
30.8 36.7 Acute Asthma Events (visits per
day ages 1-16 ) Georgia Medicaid -42
4.23 2.47 HMO -44 1.36
0.67 NOTE little to no change in acute
nonasthma events CONCLUSIONS extended reduction
in ozone and PM10 at levels below EPA National
Ambient Air Quality Standards (NAAQS ozone 120
ppb CO 9 ppm PM10 150 µg/m3)can reduce asthma
morbidity in children decreasing auto emission
through citywide changes in transportation and
commuting practices can prevent a substantial
number of asthma exacerbations requiring medical
attention.
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The EPA has also summarized the health effects of
ozone (note color coding).