The Relationship Between Lung Function and Air Quality During Summer 2004 in New England

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The Relationship Between Lung Function and Air
Quality During Summer 2004 in New England
Association of American Geographers Annual
Meeting April 6th 2005

• Thomas D. Lambert and Cameron P. Wake
• Climate Change Research Center
• Institute for the Study of Earth, Oceans, and
  Space
• Robert S. Woodward
• School of Health and Human Services
• Whittemore School of Business and Economics
• University of New Hampshire

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The adverse health effects that could be avoided
every year by meeting the US EPA's daily maximum
ozone standard (80 ppb over 8-hours) in New York,
NY. Figure sections not drawn to scale. From
Thurston, 1997.
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Goals

• To better understand
• How chemical, biological, physical air quality
  impacts pulmonary function and symptoms
• The relationship between the symptoms people feel
  and pulmonary function

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Methods
Spirometry Twice Daily
Daily Health Questionnaire
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www.airmap.unh.edu
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Population Description
Chronic Obstructive Pulmonary Disease
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New England Air Quality Background

• Air quality in New England depends most on
  weather and transport
• The worst air quality comes when
• Air from the south
• Hot and sunny

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Portsmouth, NH Air quality and weather
Number of ozone exceedance days (8 hour standard)
Cumulative total pollen count (spores/m3 yr3)
N/A
Note axis starts at 10k
Portsmouth, NH number of days above 85º F
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Previous 24 hour maximum temperature exposure
Results
Of pulmonary function observations
Temperature (Fahrenheit)
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Previous 24 hour mean PM2.5 exposures
Good
Unhealthy for sensitive groups
Of pulmonary function observations
U.S. EPA Standard
PM2.5 (µg/m3)
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Maximum 8-hr ozone during previous 24-hr
Unhealthy for sensitive groups
Good
Moderate
Of pulmonary function observations
O3 (ppb)
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FEV1 of subpopulations
9835
2002
1276
n
Forced Volume in the First Second (Liters)
Uses maintenance medication
Has asthma or COPD
No condition
Chronic Obstructive Pulmonary Disease
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Ozone, Temperature, FEV1 over the course of the
summer
Maximum 8-hour average ozone (ppb)
Average Daily Temperature (ºC)
Mean FEV1 at Concord, NH site
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Symptoms and pulmonary function
Non Asthmatic Subjects
FEV1
Wheezing
Coughing
Runny nose
No Symptoms
Chest tightness
Itchy, watery eyes
Shortness of breath
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Symptoms and pulmonary function
Healthy, non-asthmatic subjects
8798
75
118
683
234
411
96
FEV1
Wheezing
Coughing
Runny nose
Itchy, watery eyes
No Symptoms
Chest tightness
Shortness of breath
16
Symptoms and pulmonary function
Asthmatic or COPD Subjects (without medication)
1338
44
253
235
219
306
183
FEV1
Wheezing
Coughing
Runny nose
Itchy, watery eyes
No Symptoms
Chest tightness
Shortness of breath
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Maintenance medication use and sensitivity
Asthmatic no maintenance medication
Non asthmatic or COPD
6821
423
509
372
1596
92
111
80
FEV1
Quartiles of Ragweed (IQR5 spores/m3)
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Are asthmatic subjects more sensitive when they
have symptoms? (coughing, wheezing, shortness of
breath, and chest tightness)
Asthmatic no maintenance medication during
symptoms
Asthmatic no maintenance medication no
symptoms
914
291
245
429
142
119
86
123
FEV1
Quartiles of Fine Particles (IQR22µg/m3)
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Discussion.

• Overall, the air quality was good, except for a
  few moderate events
• Only small, 1-4, variations in mean pulmonary
  function were observed
• Maintenance medication users appear to be
  desensitized

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Discussion

• Having asthma or COPD and having symptoms appears
  to affect sensitivity
• Long term decrease over the course of the summer

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Future work

• Design single and multiple pollutant health
  models
• Investigate observed long term decreases in
  pulmonary function

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Acknowledgements

• I would like to thank
• Ajaya Upadhyay for his help in SAS programming
• Dave Brown for help with the weather data
• Jeff Salloway for helping make sense of the data,
  and
• Tom Kelley for keeping the project on track