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Title: Air Quality, Human Health, and the Economy: Tracking the Links in New England


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Air Quality, Human Health, and the Economy
Tracking the Links in New England
Cameron Wake, PhD (cameron.wake_at_unh.edu) Climate
Change Research Center Institute for the Study
of Earth, Oceans and Space University of New
Hampshire
Asthma 2005 Making Progress in NH 19 January
2004
3
Key Questions
What is the link between climate and health? Why
does New England have bad air quality? How do we
know bad air pollution is bad for human health
and our economy? Why do we need to work
together to improve public health?
4
CO2 Variations over 400,000 years
Source Barnola et al., Ethridge et al., Keeling
and Worf, Wigley et al. Carbon Dioxide
Information Analysis Center , DOE
(http//cdiac.esd.ornl.gov/)
5
Potential Health Effects of Climate Variability
and Climate Change
Population Standard of living Access to health
care Public health infrastructure
Vaccination programs Disease surveillance Protecti
ve technologies Weather/climate
forecasts Emergency managment
From Climate Change Impacts on the United
States, 2000. http//www.usgcrp.gov/usgcrp/nacc/

6
July Heat Index Change - 21st Century
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Vulnerability Sensitivity - Adaptation
The most important and cost-effective adaptation
measure is to rebuild public health
infrastructure. Many diseases and health
problems that may be exacerbated by climate
change can be effectively prevented with adequate
financial and human public health resources . . .
. . IPCC 2001 Impacts, Adaptation, and
Vulnerability (http//www.ipcc.ch)
8
West Coast Alaska Tsunami Warning Center
http//tsunami.gov/
9
Key Questions
What is the link between climate and health? Why
does New England have bad air quality? Why is
air quality important for human health? Why do
we need to work together to improve public
health?
10
New England lies directly downwind of major urban
and industrial centers in the eastern United
States.
Map of common storm tracks across the United
States. We are sometimes the tailpipe of North
America
11
AIRMAPMapping New Englands Changing Climate and
Air Quality
AIRMAP Atmospheric Investigation, Regional Modeli
ng, Analysis, and Prediction
12
Real Time Air Quality Data on the Web
http//airmap.unh.edu
EPA National http//www.epa.gov/airnow/aqimaps.h
tml EPA Region 1 http//www.epa.gov/region1/aqi/
index.html
13
Portsmouth, NH Ozone Exceedance Days (8 hr ozone
gt 80 ppb)
14
Portsmouth 8 hr Ozone vs Tmax 1982-2002
15
Source Regions for High Ozone at Mt.
Washington 1998-2003
Nighttime back-trajectories corresponding to
ozone mixing ratios greater 80 ppbv at Mount
Washington. From Fischer et al., 2004
16
Source Regions for High Sulfate Aerosol at NH
Seacoast (1994 - 2002 n242 days)
17
Source Regions for High Sulfate Aerosol
Red Dots ( ) indicate location of the top 10
sulfur dioxide emitting power plants in US and
Canada. From Irons, 2004.
18
Winter Ozone and Temperature 2002 Vs. 2003
From Mao and Talbot, 2004
19
Quebec Forest Fires - 7 July 2002
NOAA GOES-8 satellite image for shows smoke
(yellow arrows) over the Northeast US and
Atlantic Ocean from forest fires burning in
Quebec. From DeBell et al., 2004
20
July 2002 Elevated CO Fine Particles in New
England
From DeBell et al., 2004
21
Visibility 7 July 2002 Clear Day
Images from www.hazecam.net
22
Key Questions
What is the link between climate and health? Why
does New England have bad air quality? Why is
air quality important for human health? Why do
we need to work together to improve public
health?
23
Health Effects of Exposure to Ozone and PM2.5
Ozone PM2.5
coughing nose and throat irritation chest
pain reduced lung function increased
susceptibility to respiratory
illness aggravation of asthma children and
people with chronic lung disease are particularly
at risk
increased risk of cardiac arrest and premature
death aggravation of asthma respiratory
related hospital visits reduced lung function
and chronic bronchitis work and school
absences children and people with chronic lung
disease are particularly at risk
24
Environmental Protection Agency (EPA) National
Ambient Air Quality Standards (NAAQS)
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  • Deaths Per Year in the United States
  • Guess the Cause?
  • 40,000
  • 70,000

26
From New England Asthma Regional Council Report
Asthma In New England (2001 data)
Factors which cause asthma Hereditary Exposure
to contaminants Cigarette smoke Obesity Hygien
e Air Pollution? Pollen?
Factors which provoke asthma Cigarette
Smoke Biological - Pollen, Mold Emotional
Stress Indoor Air Quality Weather / Outdoor Air
Quality
27
Asthma in exercising children exposed to ozone
a cohort study Rob McConnell et al., 2002, THE
LANCET vol. 359
3535 children 12 communities 5 years
Low ozone max 1 hr median 48 ppb High ozone
max 1 hr median 74 ppb
28
Air Pollution and Health Studies
Harvard Six City Study Dockery et al., 1993,
N Engl. J. Med. Vol. 329, 1753-1759. American
Cancer Society Study Pope et al., 1995, A. Am
J Respir Crit Care Med 151, 669-674 Heath
Effects Institute Reanalysis (Krewski et al.,
2000, Health Effects Institute, Cambridge, July)
The National Morbidity, Mortality, and Air
Pollution Study (Samet et al., 2000, Health
Effects Institute, Cambridge, May)

29
Relative Risk of Mortality Associated with an
18.6 µg/m3 Increase in Fine Particles in the
Reanalysis of the Six 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.)
30
Relative Risk of Mortality Associated with an
24.5 µg/m3 Increase in Fine Particles 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.)
31
Public Transportation 216 Traffic Counts -
23 Ozone -30 PM10 -16
32
Results Acute Care Visits for Asthma1-16 year
old residents of Atlanta
-11
-42
-19
-44
July 19 August 4, 1996 Source Friedman, et
al, JAMA, 2001
33
Results Total Non-Asthma Related Acute Care
Visits1-16 year old residents of Atlanta
July 19 August 4, 1996 Source Friedman, et al,
JAMA, 2001
34
Tip of the Iceberg
Adverse health effects that could be avoided
every year by meeting the US EPA's daily maximum
ozone standard (80 ppb 8-hr) in New York. Figure
sections not drawn to scale. From Thurston 1997.
35
Key Questions
What is the link between climate and health? Why
does New England have bad air quality? Why is
air quality important for human health? Why do
we need to work together to improve public
health?
36
INHALEIntegrated Human Health and Air Quality
Assessment
  • Goal of INHALE project is to improve public
    health by
  • Engaging a wide range of stakeholders in a
    collaborative effort to better define the link
    between human health air quality (physical,
    chemical, biological).
  • Using the results to create informed public
    policy and guide the product development of the
    NOAA air quality forecasting effort.
  • Determining the health care costs associated
    with air pollution events.

37
Indicators of Health in New England
Schematic representation of multi-level city and
school district pulmonary function study. These
indices of pulmonary function will be collected
on a daily resolution in each city so they can be
compared to daily air quality data.
38
Summer 2004 ICARTT Campaign (International
Consortium for Atmospheric Research on Transport
and Transformations)
39
INHALE - Summer 2004 Pulmonary Function Monitoring
Spirometry Twice daily
Respiratory Symptoms Once daily
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Ozone
FEV1
42
Fine Particles
FEV6
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National Inpatient Sample Data - 2000 7.5 million
inpatient stays (71,843 had a primary diagnosis
of asthma) 1,000 hospitals from 28 states. New
England sub-sample - CT, MA, ME 308,448
inpatients stays (2,915 had a primary diagnosis
of asthma)
USA
New England
44
2000
8 days with 8hr ozone above 80 ppb
1998 and 2002
0 days with 8hr ozone above 80 ppb
45
0-4
18-24
gt65
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Hypotheses to Explain the Summer Dips
  • Individuals do not want to go to the hospital in
    the summer
  • Children going back to school transmit colds to
    each other
  • Cold temperatures may lead to an increase in
    respiratory ailments
  • High pollen counts during the fall (ragweed, etc)
  • Response to cumulative effects of summer air
    pollution
  • Operation of dormant forced hot air heating
    systems with cold fall weather
  • Some combination of all the above hypotheses
    mentioned.

47
Air Pollution Transport and How it Affects New
Hampshire
Health related costs from transport of ozone into
NH 234,970,000 TOTAL 1,025,140,000
NH DES, 2004, Air Pollution Transport and How it
Affects New Hampshire http//www.des.state.nh.us/a
rd_intro.htm
48
Air Quality and Indoor Worker ProductivitySummer
2004 Volunteer Employee Survey
  • Objective Explore how air quality effects
    employee and area resident health, productivity
    and behavior.
  • Initial survey included background demographic
    questions
  • On-going surveys Once a week for 7 weeks, used
    to capture changes in behavior and work practices

49
Air Quality and Indoor Worker ProductivitySummer
2004 Volunteer Employee Survey
  • Average Number of Respondents 321
  • 70 Women 30 Men
  • Average Age 42- 43
  • 50 of respondents between 33-50
  • UNH, Cisco Systems Exeter, W-D and Portsmouth
    Hospitals

50
Summer 2004 Survey Results Vs. Ozone
At least 1 respiratory symptom
Felt worse in PM
Less productive
8hr ozone
51
AIRMAP Streaming Real Time Air Quality Data
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Hidden Health Benefits of Greenhouse Gas
Mitigation Implementing modest
greenhouse mitigation measures (200120)
could -reduce ozone and PM by 10 -avoid
64,000 premature deaths in 4 cities Mexico
City, New York, Santiago, Sao Paulo combined
population 65 million -avoid 37 million person
days of restricted activity in 4 cities
Cifuentes et al., 2001, Science Vol. 29, p. 1257
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