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Effects of Air Pollution on the Health of Older Adults

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Effects of Air Pollution on the Health of Older Adults Mickey Leland National Urban Air Toxics Research Center and the EPA June 15, 2005 Changes in Physiology: Nathan ... – PowerPoint PPT presentation

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Title: Effects of Air Pollution on the Health of Older Adults


1
Effects of Air Pollution on the Health of Older
Adults
  • Mickey Leland National Urban Air Toxics Research
    Center and the EPA
  • June 15, 2005

2
Changes in Physiology Nathan Shock,1960
Courtesy of Dr. Ed Masaro
3
Air Quality and Human Health
  • As people age, their bodies are less able to
    compensate for the effects of environmental
    hazards.
  • An important indicator for environmental health
    is the percentage of older adults living in areas
    that have measured air pollutant concentrations
    above the EPA established standards.

4
Indicator 27--Air Quality
  • Air pollution can aggravate heart lung disease,
    leading to increased medication use, more visits
    to health care providers, admissions to emergency
    rooms and hospitals, and even death.
  • Ozone, even at low levels, can exacerbate
    respiratory diseases such as chronic obstructive
    pulmonary disease (COPD) or asthma.

5
Ozone and Particulate Matter
  • Ozone and particulate matter (PM) (especially
    smaller, ?ne particle pollution called PM 2.5)
    have the greatest potential to affect the health
    of older adults.
  • PM has been linked to premature death, cardiac
    arrhythmias and heart attacks, asthma attacks,
    and the development of chronic bronchitis.

6
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7
Ozone in 2000 and 2002
  • In 2002, 46 of people age 65 lived in counties
    with poor air quality for ozone compared with 26
    in 2000.
  • The hot, dry 2002 summer climate was particularly
    conducive to the formation of ground-level ozone,
    and this, in turn, may have contributed to the
    higher ozone measurements in 2002.

8
Population 65 Living in Areas with Poor Air
Quality
  • The percentage of people 65 living in counties
    that experienced poor air quality for any air
    pollutant increased from 41 in 2000 to 49 in
    2002.
  • This increase was largely due to the increased
    number of areas that experienced poor air quality
    for ozone in 2001 and 2002.
  • Air quality varies across the US, thus, where
    people live can affect their health risk.

9
Older Adults and PM
  • A comparison of 2000 and 2002 shows a reduction
    in PM 2.5.
  • In 2000, 27 percent of people age 65 and over
    lived in a county where PM 2.5 concentrations
    were at times above the EPA standards compared
    with 19 percent of people age 65 and over in
    2002.

10
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11
Older Americans 2004 Key Indicators of Well-Being
12
Economic Burden of Chronic Diseases
  • Heart disease, stroke chronic lung diseases are
    exacerbated by air pollution.
  • In 2002, we spent 250 billion on these
    conditions on direct medical costs. 9 billion in
    lost productivity.
  • Source Morbidity Mortality 2002 Chart book
    on Cardiovascular Lung and Blood Diseases,
    National Institutes of Health, NHLBI, May 2002

13
Air Pollution Can Exacerbate the Health of Older
Adults
  • Particle pollution has been linked to asthma
    attacks, chronic bronchitis, changes in heart
    rate, arrhythmias and heart attacks, among other
    health problems.
  • Ozone presents an increased risk to older adults
    because it can aggravate pre-existing respiratory
    diseases. Older adults experience reduced
    sensitivity to symptoms of ozone therefore,
    early warning signs of the harmful effects of
    ozone may be ignored.
  • Older adults most at risk have underlying
    cardiovascular and respiratory diseases.
  • Each year, tens of thousands of older adults die
    prematurely due to air pollution in the US.

14
NAS Workshop, December 2002Cardiovascular
Effects of Particulate Matter
  • Particulate matter can cause inflammation in the
    lungs.
  • Combustion particles penetrate into the blood and
    reach the heart and liver. Particles can lower
    heart rate variability which is a risk factor for
    arrhythmia.
  • Hundreds of studies have demonstrated that
    day-to-day changes in particles are associated
    with day-to-day changes in mortality.
  • Most of those excess deaths are cardiovascular
    deaths, not respiratory deaths.

15
Asthma deaths by age, 1999-2000
Deaths per 1,000,000 population
2010 Target
1999
2000
5-14
15-34
65 and over
Under 5
35-64
Years of age
Obj. 24-1 a-e
Source National Vital Statistics System, CDC,
NCHS.
16
CA Older Adults Highest rate of daily or
weekly symptoms
17
COPD
  • COPD is the 4th leading cause of death in the US,
    claiming 119,000 lives each year
  • In 2000, COPD was responsible for 726,000
    hospitalizations, 1.5 million hospital emergency
    room visits and 8 million doctor visits.

18
Environmental Triggers What You Can Do
  • Avoid tobacco smoke and Smoke from wood-burning
    stoves
  • Reduce mold, dust mites cockroaches in your
    home
  • Keep pets out of sleeping areas
  • Check furnaces and heating units annually
  • Fix water leaks promptly
  • Check the air quality index http//www.epa.gov/air
    now

19
Older Adults and COPD
  • According to the National Health Interview Survey
    in 1999, about 3.1 million persons over 65 years
    of age reported having COPD.
  • The COPD mortality rate per 100,000 was 1.8 for
    persons between the age of 50-54 and 7.6 for
    persons 75-85 years of age.

20
Chicago Heat WaveJuly 14-July 20, 1995
  • 1,000 excess hospital admissions due to heat
    stroke, dehydration, heat exhaustion, renal
    failure and electrolytic imbalances
  • 739 Chicago residents died

21
Unequaled mortality
  • Chicago has no equal in the record of US heat
    disasters
  • 739 more people died than during a typical week
    in July. The proportional death toll from a heat
    wave was unprecedented
  • The victims were primarily older adults (73 were
    over 65 years of age).

22
Mortality by Sex
  • 55 men
  • 45 woman
  • Age-adjusted death rate men were more than twice
    as likely as woman to die
  • These figures confused many gerontologists
    because they knew that women are more likely to
    live alone

23
Mortality by Race
  • Blacks had highest proportional death rate of any
    ethnic group
  • 1.51 in the total age-adjusted population
  • Deaths were concentrated in low income, elderly,
    black and violent regions of the city

24
Aging and Dying Alone Not Just in Chicago
  • The number of persons living alone is increasing
    everywhere in the world making it one of the
    major demographic trends
  • Between 1930 and 1995, households with one person
    increased from 7 to 25 and the percentage of
    people living alone rose from 2 to 10 during
    this same period. (Census)

25
North Lawndale
  • Dangerous ecology of abandoned buildings, open
    spaces, commercial depletion, violent crime,
    degraded infrastructure, low population density,
    and family dispersion undermines the viability of
    public life and strength of local support
    systems.

26
Little Village
  • Busy streets, heavy commercial activity,
    residential concentration, and relatively low
    crime promote social contact collective life, and
    public engagement provide particular benefits
    for the elderly who are more likely to leave home
    when they are drawn out by nearby amenities.

27
Matching pairs
  • North Lawndale 19 deaths, rate of 40/100,000
  • Little Village 3 deaths, rate of 4/100,000
  • Same characteristics

28
Resources
  • You are invited to visit the EPA Aging Initiative
    Website www.epa.gov/aging
  • Please join our Aging list serve that can be
    found on the homepage of the website.
  • A fact sheet on environmental triggers can be
    found in English, Spanish, Chinese, and
    Vietnamese at http//www.epa.gov/aging/resources/e
    pareports.htmfacts

29
Resources
  • Federal Interagency Forum on Aging- Related
    Statistics. Older Americans 2004 Key Indicators
    of Well-Being. Washington, D.C. US Government
    Printing Office. November 2004
  • Heat Wave, A Social Autopsy of Disaster in
    Chicago, University of Chicago Press, 2002

30
Other Resources
  • COPD Coalition website http//www.uscopd.com/
  • CDC MMWR Article
  • Chronic Obstructive Pulmonary Disease
    Surveillance --- United States, 1971--2000
  • http//www.cdc.gov/mmwr/preview/mmwrhtml/ss5106a1.
    htmtab1
  • NHLBI Fact Sheet - What is COPD?
  • http//www.nhlbi.nih.gov/health/dci/Diseases/Copd/
    Copd_WhatIs.html
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