Ozone exposure and mortality: an empiric bayes metaregression analysis

Short-term ozone exposure and cancer mortality in Brazil: A nationwide case-crossover study

Exposure to ambient ozone (O3) is linked to increased mortality risks from various diseases, but epidemiological investigations delving into its potential implications for cancer mortality are limited. We aimed to examine the association between short-term O3 exposure and site-specific cancer mortality and investigate vulnerable subgroups in Brazil. In total 3,459,826 cancer death records from 5570 Brazilian municipalities between 2000 and 2019, were included. Municipal average daily O3 concentration was calculated from a global estimation at 0.25°×0.25° spatial resolution. The time-stratified case-crossover design was applied to assess the O3-cancer mortality association. Subgroup analyses by age, sex, season, time-period, region, urban hierarchy, climate classification, quantiles of GDP per capita and illiteracy rates were performed. A linear and non-threshold exposure-response relationship was observed for short-term exposure to O3 with cancer mortality, with a 1.00% (95% CI: 0.79%-1.20%) increase in all-cancer mortality risks for each 10-μg/m3 increment of three-day average O3. Kidney cancer was most strongly with O3 exposure, followed by cancers of the prostate, stomach, breast, lymphoma, brain and lung. The associated cancer risks were relatively higher in the warm season and in southern Brazil, with a decreasing trend over time. When restricting O3 concentration to the national minimum value during 2000-2019, a total of 147,074 (116,690-177,451) cancer deaths could be avoided in Brazil, which included 17,836 (7014-28,653) lung cancer deaths. Notably, these associations persisted despite observed adaptation within the Brazilian population, highlighting the need for a focus on incorporating specific measures to mitigate O3 exposure into cancer care recommendations.

Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study

BACKGROUND

Epidemiologic studies on the effects of long-term exposure to ozone (O3) have shown inconclusive results. It is unclear whether to O3 has an effect on chronic kidney disease (CKD). We investigated the effects of O3 on mortality and renal outcome in CKD.

METHODS

We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed.

RESULTS

In the single pollutant model, O3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O3 concentration from IDW interpolation, this moving O3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O3. The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014-1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035-1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044-1.054) at the district unit and 1.04 (95%CI: 1.031-1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008-1.017) for administrative districts and 1.04 (95% confidence interval: 1.031-1.05) for individual addresses.

CONCLUSIONS

This study suggests that long-term ambient O3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O3 emissions will substantially benefit health and the environment.

Hydrogen Production Using a Nickel Catalyst Combining Redox Activity and Pendent Base Effects

With the mounting need for clean and renewable energy, catalysts for hydrogen production based on earth abundant elements are of great interest. Herein, we describe the synthesis, characterization, and catalytic activity of two nickel complexes based on the pyridinediimine ligand that possess basic nitrogen moieties of pyridine and imidazole that could potentially serve as pendent bases to enhance catalysis. Although these ligands have previously been reported to be complexed to some metal ions, they have not been applied to nickel. The nickel complex with the pendent pyridines was found to be the most active of the two, catalyzing proton reduction electrochemically with an overpotential of 490 mV. The appearance of a wave that preceded the Ni(I/0) redox couple in the presence of protons suggests that protonation of a dissociated pyridine was likely. Further evidence of this was provided with density functional theory calculations, and a mechanism of hydrogen production is proposed. Furthermore, in a light-driven system containing Ru(bpy)32+ and ascorbic acid, TON of 1400 were obtained.

Effect of short-term exposure to ambient air pollutants on non-accidental mortality in emergency department visits: a time-series study

Objectives

Exposure to air pollution has been linked to an increased risk of premature mortality. However, the acute effects of air pollution on the risk of non-accidental mortality have not been extensively researched in developing countries, and the findings thus far have been inconsistent. Therefore, this study aimed to examine the association between short-term exposure to six pollutants (PM_2.5, PM₁₀, SO₂, NO₂, O₃, and CO) and non-accidental mortality in Beijing, China.

Methods

Daily data on non-accidental deaths were gathered from 1 January 2017 to 31 December 2018. Air pollution data for the same period were collected from 35 fixed-site air quality monitoring stations in Beijing. Generalized additive models (GAM) based on Poisson regression were used to investigate the association between non-accidental mortality in emergency department visits and the daily average levels of air pollutants.

Results

There were 8,676 non-accidental deaths recorded during 2017-2018. After sensitivity analysis, short-term exposure to air pollutants, particularly gaseous pollutants, was linked to non-accidental mortality. Specifically, for every 10 μg/m³ increase (5 μg/m³ in SO₂, 0.5 mg/m³ in CO) of SO₂ (lag 04), NO₂ (lag 04), O₃ (lag 05), and CO (lag 04), the relative risk (RR) values were 1.054 (95% CI: 1.009, 1.100), 1.038 (95% CI: 1.013, 1.063), 1.032 (95% CI: 1.011, 1.054), and 1.034 (95% CI: 1.004, 1.066), respectively. In terms of causes of death, short-term exposure to NO₂, SO₂, and O₃ increased the risk of circulatory mortality. Further stratified analysis revealed that the stronger associations were presented in females for O₃ while in males for CO. People aged 65 and over were strongly associated with ambient air pollution.

Conclusions

Our study showed that ambient air pollutants were associated with non-accidental mortality. Our findings suggested that efforts to control gaseous pollution should be stepped up, and vulnerable groups should be the focus of health protection education.

Response of tropical trees to elevated Ozone: a Free Air Ozone Enrichment study

Tropospheric ozone (O₃) has become one of the main urban air pollutants. In the present study, we assessed impact of ambient and future ground-level O₃ on nine commonly growing urban tree species under Free Air Ozone Enrichment (FAOE) condition. During the study period, mean ambient and elevated ozone (EO₃) concentrations were 48.59 and 69.62 ppb, respectively. Under EO₃ treatment, stomatal density (SD) significantly decreased and guard cell length (GCL) increased in Azadirachta indica, Bougainvillea spectabilis, Plumeria rubra, Saraca asoca and Tabernaemontana divaricata, while SD increased and GCL decreased in Ficus benghalensis and Terminalia arjuna. Proline levels increased in all the nine plant species under EO₃ condition. EO₃ significantly reduced photosynthetic rate, stomatal conductance (gs), and transpiration rates (E). Only A. indica and N. indicum showed higher gs and E under EO₃ treatment. Water use efficiency (WUE) significantly increased in F. benghalensis and decreased in A. indica and T. divaricata. Air Pollution Tolerance Index (APTI) significantly increased in Ficus religiosa and S. asoca whereas it decreased in B. spectabilis and A. indica. Of all the plant species B. spectabilis and A. indica were the most sensitive to EO₃ (high g_s and less ascorbic acid content) while S. asoca and F. religiosa were the most tolerant (lowg_s and more ascorbic acid content). The sensitivity of urban tree species to EO₃ is a cause of concern and should be considered for future urban forestry programmes. Our study should guide more such studies to identify tolerant trees for urban air pollution abatement.

Outdoor air quality and human health: An overview of reviews of observational studies

The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this evidence base, to identify robust associations as well as to evaluate effect variation. An overview of reviews (umbrella review) methodology was implemented. PubMed and Scopus were systematically screened (inception-3/2020) for systematic reviews and meta-analyses examining the association between air pollutants, including CO, NO_X, NO₂, O₃, PM₁₀, PM_2.5, and SO₂ and human health outcomes. The quality of systematic reviews was evaluated using AMSTAR. The strength of evidence was categorized as: strong, highly suggestive, suggestive, or weak. The criteria included statistical significance of the random-effects meta-analytical estimate and of the effect estimate of the largest study in a meta-analysis, heterogeneity between studies, 95% prediction intervals, and bias related to small study effects. Seventy-five systematic reviews of low to moderate methodological quality reported 548 meta-analyses on the associations between outdoor air quality and human health. Of these, 57% (N = 313) were not statistically significant. Strong evidence supported 13 associations (2%) between elevated PM_2.5, PM₁₀, NO₂, and SO₂ concentrations and increased risk of cardiorespiratory or pregnancy/birth-related outcomes. Twenty-three (4%) highly suggestive associations were identified on elevated PM_2.5, PM₁₀, O₃, NO₂, and SO₂ concentrations and increased risk of cardiorespiratory, kidney, autoimmune, neurodegenerative, cancer or pregnancy/birth-related outcomes. Sixty-seven (12%), and 132 (24%) meta-analyses were graded as suggestive, and weak, respectively. Despite the abundance of research on the association between outdoor air quality and human health, the meta-analyses of epidemiological studies in the field provide evidence to support robust associations only for cardiorespiratory or pregnancy/birth-related outcomes.

When a Generalized Linear Model Meets Bayesian Maximum Entropy: A Novel Spatiotemporal Ground-Level Ozone Concentration Retrieval Method

In China, ground-level ozone has shown an increasing trend and has become a serious ambient pollutant. An accurate spatiotemporal distribution of ground-level ozone concentrations (GOCs) is urgently needed. Generalized linear models (GLMs) and Bayesian maximum entropy (BME) models are practical for predicting GOCs. However, GLMs have limited capacity to capture temporal variations and can miss some short-term and regional patterns, while the performance of BME models may degrade in cases of sparse or imperfect monitoring networks. Thus, to predict nationwide 1 km monthly average GOCs for China, we designed a novel hybrid model containing three modules. (1) A GLM was established to accurately describe the variability in GOCs in the space domain. (2) A BME model incorporating GLM residuals was employed to capture the temporal variability of GOCs in detail. (3) A combination of GLM and BME models was developed based on the specific broad range of each submodel. According to the cross-validation results, the hybrid model exhibited superior performance, with coefficient of determination (R2) values of 0.67. The predictive performance of the large-scale and high-resolution hybrid model is superior to that in previous studies. The nationwide spatiotemporal variability of the GOCs derived from the hybrid model shows that they are valuable indicators for ground-level ozone pollution control and prevention in China.

Atmospheric pollution in the ten most populated US cities. Evidence of persistence

The degree of persistence in daily PM₂₅ and O₃ in the ten most populated US cities, namely New York, Los Angeles, Chicago, Houston, Phoenix, Philadelphia, San Antonio, San Diego, Dallas and San Jose is examined in this work. We employ a methodology based on fractional integration, using the order of integration as a measure of the degree of persistence. Using data for the time period from January 1, 2019 to December 31, 2020, our results indicate that fractional integration and long memory features are both present in all the examined cases, with the integration order of the series being constrained in the (0, 1) interval. Based on this, the estimation of the coefficients for the time trend produces results which are substantially different from those obtained under the I (0) assumption.

Short-term effect of fine particulate matter and ozone on non-accidental mortality and respiratory mortality in Lishui district, China

Background

In recent years, air pollution has become an imminent problem in China. Few studies have investigated the impact of air pollution on the mortality of the middle-aged and elderly people. Therefore, this study aims to evaluate the impact of PM_2.5 (fine particulate matter) and O₃ (ozone) on non-accidental mortality and respiratory mortality of the middle-aged and elderly people in Lishui District of Nanjing and provide the evidence for potential prevention and control measures of air pollution.

Method

Using daily mortality and atmospheric monitoring data from 2015 to 2019, we applied a generalized additive model with time-series analysis to evaluate the association of PM_2.5 and O₃ exposure with daily non-accidental mortality and respiratory mortality in Lishui District. Using the population attributable fractions to estimate the death burden caused by short-term exposure to O₃ and PM_2.5。.

Result

For every 10 μg/m³ increase in PM_2.5, non-accidental mortality increased 0.94% with 95% confidence interval (CI) between 0.05 and 1.83%, and PM_2.5 had a more profound impact on females than males. For every 10 μg/m³ increase in O₃, respiratory mortality increased 1.35% (95% CI: 0.05, 2.66%) and O₃ had a more profound impact on males than females. Compared with the single pollutant model, impact of the two-pollutant model on non-accidental mortality and respiratory mortality slightly decreased. In summer and winter as opposed to the other seasons, O₃ had a more obvious impact on non-accidental mortality. The population attributable fractions of non-accidental mortality were 0.84% (95% CI:0.00, 1.63%) for PM_2.5 and respiratory mortality were 0.14% (95% CI:0.01, 0.26%) for O₃. For every 10 μg/m³ decrease in PM_2.5, 122 (95% CI: 6, 237) non-accidental deaths could be avoided. For every 10 μg/m³ decrease in O₃, 10 (95% CI: 1, 38) respiratory deaths could be avoided.

Conclusion

PM_2.5 and O₃ could significantly increase the risk of non-accidental and respiratory mortality in the middle-aged and elderly people in Lishui District of Nanjing. Exposed to air pollutants, men were more susceptible to O₃ damage, and women were more susceptible to PM_2.5 damage. Reduction of PM_2.5 and O₃ concentration in the air may have the potential to avoid considerable loss of lives.

Assessment of sociodemographic disparities in environmental exposure might be erroneous due to neighborhood effect averaging: Implications for environmental inequality research

The neighborhood effect averaging problem (NEAP) is a major methodological problem that might affect the accuracy of assessments of individual exposure to mobility-dependent environmental factors (e.g., air/noise pollution, green/blue spaces, or healthy food environments). Focusing on outdoor ground-level ozone as a major air pollutant, this paper examines the NEAP in the evaluation of sociodemographic disparities in people's air pollution exposures in Los Angeles using one-day activity-travel diary data of 3790 individuals. It addresses two questions: (1) How does the NEAP affect the evaluation of sociodemographic disparities in people's air pollution exposures? (2) Which social groups with high residence-based exposures do not experience neighborhood effect averaging? The results of our spatial regression models indicate that assessments of sociodemographic disparities in people's outdoor ground-level ozone exposures might be erroneous when people's daily mobility is ignored because of the different manifestations of neighborhood effect averaging for different social/racial groups. The results of our spatial autologistic regression model reveal that non-workers (e.g., the unemployed, homemakers, the retired, and students) do not experience downward averaging: they have significantly lower odds of experiencing downward averaging that could have attenuated their high exposures experienced in their residential neighborhoods while traveling to other neighborhoods (thus, being doubly disadvantaged). Therefore, to avoid erroneous conclusions in environmental inequality research and ineffective public policies, it would be critical to take the NEAP into account in future studies of sociodemographic disparities related to mobility-dependent environmental factors.

Comparison of hospitalization and mortality associated with short-term exposure to ambient ozone and PM2.5 in Canada

BACKGROUND

Hospitalization and mortality (H-M) have been linked to air pollution separately. However, previous studies have not adequately compared whether air pollution is a stronger risk factor for hospitalization or mortality. This study aimed to investigate differences in H-M risk from short-term ozone and PM_2.5 exposures, and determine whether differences are modified by season, age, and sex.

METHODS

Daily ozone, PM_2.5, temperature, and all-cause H-M counts (ICD-10, A00-R99) were collected for 22-24 Canadian cities for up to 29 years. Generalized additive Poisson models were employed to estimate associations between each pollutant and health outcome, which were compared across season (warm, cold, or year-round), age (all ages or seniors > 65), and sex.

RESULTS

Overall, ozone and PM_2.5 showed higher season-specific risk of mortality than hospitalization: warm-season ozone: 0.54% (95% credible interval, 0.20, 0.85) vs. 0.14% (0.02, 0.27) per 10 ppb; and year-round PM_2.5: 0.90% (0.33, 1.41) vs. 0.29% (0.03, 0.56) per 10 μg/m³. While age showed little H-M difference, sex appeared to be a modifier of H-M risk. While females had higher mortality risk, males had higher hospitalization risk: for females, ozone 0.87% (0.36, 1.35) vs. -0.03% (-0.18, 0.11) and PM_2.5 1.19% (0.40, 1.90) vs. 0.19% (-0.10, 0.47); and for males ozone 0.20% (-0.28, 0.65) vs. 0.35% (0.18, 0.51).

CONCLUSION

This study found H-M differences attributable to ozone and PM_2.5, suggesting that both are stronger risk factors for mortality than hospitalization. In addition, there were clear H-M differences by sex: specifically, females showed higher mortality risk and males showed higher hospitalization risk.

How will air quality effects on human health, crops and ecosystems change in the future?

Future air quality will be driven by changes in air pollutant emissions, but also changes in climate. Here, we review the recent literature on future air quality scenarios and projected changes in effects on human health, crops and ecosystems. While there is overlap in the scenarios and models used for future projections of air quality and climate effects on human health and crops, similar efforts have not been widely conducted for ecosystems. Few studies have conducted joint assessments across more than one sector. Improvements in future air quality effects on human health are seen in emission reduction scenarios that are more ambitious than current legislation. Larger impacts result from changing particulate matter (PM) abundances than ozone burdens. Future global health burdens are dominated by changes in the Asian region. Expected future reductions in ozone outside of Asia will allow for increased crop production. Reductions in PM, although associated with much higher uncertainty, could offset some of this benefit. The responses of ecosystems to air pollution and climate change are long-term, complex, and interactive, and vary widely across biomes and over space and time. Air quality and climate policy should be linked or at least considered holistically, and managed as a multi-media problem. This article is part of a discussion meeting issue 'Air quality, past present and future'.

Health and economic impacts of air pollution induced by weather extremes over the continental U.S

Extreme weather events may enhance ozone (O₃) and fine particulate matter (PM_2.5) pollution, causing additional adverse health effects. This work aims to evaluate the health and associated economic impacts of changes in air quality induced by heat wave, stagnation, and compound extremes under the Representative Concentration Pathways (RCP) 4.5 and 8.5 climate scenarios. The Environmental Benefits Mapping and Analysis Program-Community Edition is applied to estimate health and related economic impacts of changes in surface O₃ and PM_2.5 levels due to heat wave, stagnation, and compound extremes over the continental U.S. during past (i.e., 2001-2010) and future (i.e., 2046-2055) decades under the two RCP scenarios. Under the past and future decades, the weather extremes-induced concentration increases may lead to several tens to hundreds O₃-related deaths and several hundreds to over ten thousands PM_2.5-related deaths annually. High mortalities and morbidities are estimated for populated urban areas with strong spatial heterogeneities. The estimated annual costs for these O₃ and PM_2.5 related health outcomes are $5.5-12.5 and $48.6-140.7 billion U.S. dollar for mortalities, and $8.9-97.8 and $19.5-112.5 million for morbidities, respectively. Of the extreme events, the estimated O₃- and PM_2.5-related mortality and morbidity attributed to stagnation are the highest, followed by heat wave or compound extremes. Large increases in heat wave and compound extreme events in the future decade dominate changes in mortality during these two extreme events, whereas population growth dominates changes in mortality during stagnation that is projected to occur less frequently. Projected reductions of anthropogenic emissions under bothRCP scenarios compensate for the increased mortality due to increasedoccurrence for heat wave and compound extremes in the future. These results suggest a need to further reduce air pollutant emissions during weather extremes to minimize the adverse impacts of weather extremes on air quality and human health.

Air Quality Implications of COVID-19 in California

The COVID-19 pandemic has significantly affected human health and the economy. The implementation of social distancing practices to combat the virus spread, however, has led to a notable improvement in air quality. This study compared the surface air quality monitoring data from the United States Environmental Protection Agency (U.S. EPA)’s AirNow network during the period 20 March–5 May in 2020 to those in 2015–2019 from the Air Quality System (AQS) network over the state of California. The results indicated changes in fine particulate matter (PM2.5) of −2.04 ± 1.57 μg m−3 and ozone of −3.07 ± 2.86 ppb. If the air quality improvements persist over a year, it could potentially lead to 3970–8900 prevented premature deaths annually (note: the estimates of prevented premature deaths have large uncertainties). Public transit demand showed dramatic declines (~80%). The pandemic provides an opportunity to exhibit how substantially human behavior could impact on air quality. To address both the pandemic and climate change issues, better strategies are needed to affect behavior, such as ensuring safer shared mobility, the higher adoption of telecommuting, automation in the freight sector, and cleaner energy transition.

The recent and future health burden of the U.S. mobile sector apportioned by source

Mobile sources emit particulate matter as well as precursors to particulate matter (PM_2.5) and ground-level ozone, pollutants known to adversely impact human health. This study uses source-apportionment photochemical air quality modeling to estimate the health burden (expressed as incidence) of an array of PM_2.5- and ozone-related adverse health impacts, including premature death, attributable to 17 mobile source sectors in the US in 2011 and 2025. Mobile sector-attributable air pollution contributes a substantial fraction of the overall pollution-related mortality burden in the U.S., accounting for about 20% of the PM_2.5 and ozone-attributable deaths in 2011 (between 21 000 and 55 000 deaths, depending on the study used to derive the effect estimate). This value falls to about 13% (between 13 000 and 37 000 deaths) by 2025 due to regulatory and voluntary programs reducing emissions from mobile sources. Similar trends across all morbidity health impacts can also be observed. Emissions from on-road sources are the largest contributor to premature deaths; this is true for both 2011 (between 12 000 and 31 000 deaths) and 2025 (between 6700 and 18 000 deaths). Non-road construction engines, C3 marine engines and emissions from rail also contribute to large portions of premature deaths. Across the 17 mobile sectors modeled, the PM_2.5-attributable mortality and morbidity burden falls between 2011 and 2025 for 12 sectors and increases for 5. Ozone-attributable mortality and morbidity burden increases between 2011 and 2025 for 10 sectors and falls for 7. These results extend the literature beyond generally aggregated mobile sector health burden toward a representation of highly-resolved source characterization of both current and future health burden. The quantified future mobile source health burden is a novel feature of this analysis and could prove useful for decisionmakers and affected stakeholders.

Short-Term Effects of Ground-Level Ozone in Patients With Dry Eye Disease: A Prospective Clinical Study

PURPOSE

To investigate changes in the clinical features of patients with dry eye disease (DED) according to short-term outdoor ground-level ozone exposure.

METHODS

This prospective observational study included patients with DED who were treated with the same topical drugs (0.05% cyclosporine or 3% diquafosol) and visited the hospital twice at 2-month intervals. Patients who showed a short tear film breakup time and positive ocular surface staining were assigned to the diquafosol and cyclosporine groups, respectively. The ocular surface disease index (OSDI) score, tear secretion, tear film breakup time, and corneal fluorescein staining score were measured at each visit. The mean ground-level ozone concentration for 1 week before the ocular examinations was used as the ozone exposure level. Changes in dry eye parameters according to changes in ozone concentration were analyzed using univariate and multivariate linear analyses.

RESULTS

Thirty-three patients were included in the analysis. The mean age was 55.2 ± 10.5 years. Ozone concentrations were significantly associated with increased OSDI scores (R = 0.304, P = 0.0006) and a decreased tear secretion (R = -0.355, P = 0.0012) in univariate models. In multivariate models, the results were consistent; the OSDI score increased by 3.43 points (β = 3.43, P = 0.002), and tear secretion decreased by 1.43 mm (β = -1.43, P = 0.015) per 0.01 ppm increase in ozone concentrations over a 2-month interval. Notably, the cyclosporine group showed more prominent changes in the OSDI score and tear secretion with changes in the ozone concentration (P < 0.05).

CONCLUSIONS

Short-term exposure to increased ground-level ozone concentration led to increased ocular discomfort and decreased tear secretion in patients with DED.

The benefits of lower ozone due to air pollution emission reductions (2002-2011) in the Eastern United States during extreme heat

Using the Community Multiscale Air Quality (CMAQ) model and the Benefits Mapping and Analysis Program - Community Edition (BenMAP-CE) tool, we estimate the benefits of anthropogenic emission reductions between 2002 and 2011 in the Eastern United States (US) with respect to surface ozone concentrations and ozone-related health and economic impacts, during a month of extreme heat, July 2011. Based on CMAQ simulations using emissions appropriate for 2002 and 2011, we estimate that emission reductions since 2002 likely prevented 10- 15 ozone exceedance days (using the 2011 maximum 8-hr average ozone standard of 75 ppbv) throughout the Ohio River Valley and 5- 10 ozone exceedance days throughout the Washington, DC - Baltimore, MD metropolitan area during this extremely hot month. CMAQ results were fed into the BenMAP-CE tool to determine the health and health-related economic benefits of anthropogenic emission reductions between 2002 and 2011. We estimate that the concomitant health benefits from the ozone reductions were significant for this anomalous month: 160-800 mortalities (95% confidence interval (CI): 70-1,010) were avoided in July 2011 in the Eastern U.S, saving an estimated $1.3-$6.6 billion (CI: $174 million-$15.5 billion). Additionally, we estimate that emission reductions resulted in 950 (CI: 90-2,350) less hospital admissions from respiratory symptoms, 370 (CI: 180-580) less hospital admissions for pneumonia, 570 (CI: 0-1650) less Emergency Room (ER) visits from asthma symptoms, 922,020 (CI: 469,960-1,370,050) less minor restricted activity days (MRADs), and 430,240 (CI: -280,350-963,190) less symptoms of asthma exacerbation during July 2011.Implications: We estimate the benefits of air pollution emission reductions on surface ozone concentrations and ozone-related impacts on human health and the economy between 2002 and 2011 during an extremely hot month, July 2011, in the eastern United States (US) using the CMAQ and BenMAP-CE models. Results suggest that, during July 2011, emission reductions prevented 10-15 ozone exceedance days in the Ohio River Valley and 5-10 ozone exceedance days in the Mid Atlantic; saved 160-800 lives in the Eastern US, saving $1.3 - $6.5 billion; and resulted in 950 less hospital admissions for respiratory symptoms, 370 less hospital admissions for pneumonia, 570 less Emergency Room visits for asthma symptoms, 922,020 less minor restricted activity days, and 430,240 less symptoms of asthma exacerbation.

TLR5 participates in the TLR4 receptor complex and promotes MyD88-dependent signaling in environmental lung injury

Lung disease causes significant morbidity and mortality, and is exacerbated by environmental injury, for example through lipopolysaccharide (LPS) or ozone (O3). Toll-like receptors (TLRs) orchestrate immune responses to injury by recognizing pathogen- or danger-associated molecular patterns. TLR4, the prototypic receptor for LPS, also mediates inflammation after O3, triggered by endogenous hyaluronan. Regulation of TLR4 signaling is incompletely understood. TLR5, the flagellin receptor, is expressed in alveolar macrophages, and regulates immune responses to environmental injury. Using in vivo animal models of TLR4-mediated inflammations (LPS, O3, hyaluronan), we show that TLR5 impacts the in vivo response to LPS, hyaluronan and O3. We demonstrate that immune cells of human carriers of a dominant negative TLR5 allele have decreased inflammatory response to O3 exposure ex vivo and LPS exposure in vitro. Using primary murine macrophages, we find that TLR5 physically associates with TLR4 and biases TLR4 signaling towards the MyD88 pathway. Our results suggest an updated paradigm for TLR4/TLR5 signaling.

A two decades study on ozone variability and trend over the main urban areas of the São Paulo state, Brazil

In this paper, we analyze the variability of the ozone concentration over São Paulo Macrometropolis, as well the factors, which determined the tendency observed in the last two decades. Time series of hourly ozone concentrations measured at 16 automated stations from an air quality network from 1996 to 2017 were analyzed. The temporal variability of ozone concentrations exhibits well-defined daily and seasonal patterns. Ozone presents a significant positive correlation between the number of cases (thresholds of 100-160 μg m^-3) and the fuel sales of gasohol and diesel. The ozone concentrations do not exhibit significant long-term trends, but some sites present positive trends that occurs in sites in the proximity of busy roads and negative trends that occurs in sites located in residential areas or next to trees. The effect of atmospheric process of transport and ozone formation was analyzed using a quantile regression model (QRM). This statistical model can deal with the nonlinearities that appear in the relationship of ozone and other variables and is applicable to time series with non-normal distribution. The resulting model explains 0.76% of the ozone concentration variability (with global coefficient of determination R¹ = 0.76) providing a better representation than an ordinary least square regression model (with coefficient of determination R² = 0.52); the effect of radiation and temperature are the most critical in determining the highest ozone quantiles.

Effect of O3, PM10 and PM2.5 on cardiovascular and respiratory diseases in cities of France, Iran and Italy

At present, both tropospheric ozone (O₃) and particulate matters (PM) are among the most threatening air pollutants for human health in cities. The air pollution effects over public health include increased risk of hospital admissions and mortality for respiratory and cardiovascular diseases even when air pollutant concentrations are below European and international standards. The aim of this study was to (i) estimate the burden of mortality and morbidity for cardiovascular and respiratory diseases attributed to PM_2.5, PM₁₀ and O₃ in nine selected cities in France, Iran and Italy in 2015 and 2016 and to (ii) compare estimated burdens at current O₃ and PM levels with pre-industrial levels. The selected Mediterranean cities are among the most affected by the air pollution in Europe, in particular by rising O₃ while the selected Iranian cities rank as the most polluted by PM in the world. The software AirQ+ was used to estimate the short-term health effects, in terms of mortality and morbidity by using in situ air quality data, city-specific relative risk values and baseline incidence. Compared to pre-industrial levels, long-term exposures to ambient PM_2.5, PM₁₀ and O₃ have substantially contributed to mortality and hospital admissions in selected cities: about 8200 deaths for non-accidental causes, 2400 deaths for cardiovascular diseases, 540 deaths for respiratory diseases, 220 deaths for chronic obstructive pulmonary diseases as well as 18,800 hospital admissions for cardiovascular diseases and 3400 for respiratory diseases were reported in 2015. The study supports the need of city-specific epidemiological data and urgent strategies to mitigate the health burden of air pollution.

Health impacts and cost-benefit analyses of surface O3 and PM2.5 over the U.S. under future climate and emission scenarios

Health impacts of surface ozone (O₃) and fine particulate matter (PM_2.5) are of major concern worldwide. In this work, the Environmental Benefits Mapping and Analysis Program tool is applied to estimate the health and economic impacts of projected changes in O₃ and PM_2.5 in the U.S. in future (2046-2055) decade relative to current (2001-2010) decade under the Representative Concentration Pathway (RCP) 4.5 and 8.5 climate scenarios. Future annual-mean O₃ reductions under RCP 4.5 prevent ~1,800 all-cause mortality, 761 respiratory hospital admissions (HA), and ~1.2 million school loss days annually, and result in economic benefits of ~16 billion, 29 million, and 132 million U.S. dollars (USD), respectively. By contrast, the projected future annual-mean O₃ increases under RCP8.5 cause ~2,400 mortality, 941 respiratory HA, and ~1.6 million school loss days annually and result in economic disbenefits of ~21 billion, 36 million, and 175 million USD, respectively. Health benefits of reduced O₃ double under RCP4.5 and health dis-benefits of increased O₃ increase by 1.5 times under RCP8.5 in future with 2050 population and baseline incidence rate. Because of the reduction in projected future PM_2.5 over CONUS under both scenarios, the annual avoided all-cause deaths, cardiovascular HA, respiratory HA, and work loss days are ~63,000 and ~83,000, ~5,300 and ~7,000, ~12,000 and ~15,000, and ~7.8 million and ~10 million, respectively, leading to economic benefits of ~560 and ~740 billion, ~240 and ~320 million, ~450 and ~590 million, and ~1,400 and ~1,900 million USD for RCP4.5 and 8.5, respectively. Health benefits of reduced PM_2.5 for future almost double under both scenarios with the largest benefits in urban areas. RCP8.5 projects larger health and economic benefits due to a greater reduction in PM_2.5 but with a warmer atmosphere and higher O₃ pollution than RCP4.5. RCP4.5 leads to multiple-benefit goals including reduced O₃ and PM_2.5, reduced mortality and morbidity, and saved costs. Greater reduction in future PM_2.5 under RCP4.5 should be considered to achieve larger multi-benefits.

Estimating the Health and Economic Impacts of Changes in Local Air Quality

OBJECTIVES

To demonstrate the benefits-mapping software Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE), which integrates local air quality data with previously published concentration-response and health-economic valuation functions to estimate the health effects of changes in air pollution levels and their economic consequences.

METHODS

We illustrate a local health impact assessment of ozone changes in the 10-county nonattainment area of the Dallas-Fort Worth region of Texas, estimating the short-term effects on mortality predicted by 2 scenarios for 3 years (2008, 2011, and 2013): an incremental rollback of the daily 8-hour maximum ozone levels of all area monitors by 10 parts per billion and a rollback-to-a-standard ambient level of 65 parts per billion at only monitors above that level.

RESULTS

Estimates of preventable premature deaths attributable to ozone air pollution obtained by the incremental rollback method varied little by year, whereas those obtained by the rollback-to-a-standard method varied by year and were sensitive to the choice of ordinality and the use of preloaded or imported data.

CONCLUSIONS

BenMAP-CE allows local and regional public health analysts to generate timely, evidence-based estimates of the health impacts and economic consequences of potential policy options in their communities.

Emerging investigator series: primary emissions, ozone reactivity, and byproduct emissions from building insulation materials

Building insulation materials can affect indoor air by (i) releasing primary volatile organic compounds (VOCs) from building enclosure cavities to the interior space, (ii) mitigating exposure to outdoor pollutants through reactive deposition (of oxidants, e.g., ozone) or filtration (of particles) in infiltration air, and (iii) generating secondary VOCs and other gas-phase byproducts resulting from oxidant reactions. This study reports primary VOC emission fluxes, ozone (O3) reaction probabilities (γ), and O3 reaction byproduct yields for eight common, commercially available insulation materials. Fluxes of primary VOCs from the materials, measured in a continuous flow reactor using proton transfer reaction-time of flight-mass spectrometry, ranged from 3 (polystyrene with thermal backing) to 61 (cellulose) μmol m-2 h-1 (with total VOC mass emission rates estimated to be between ∼0.3 and ∼3.3 mg m-2 h-1). Major primary VOC fluxes from cellulose were tentatively identified as compounds likely associated with cellulose chemical and thermal decomposition products. Ozone-material γ ranged from ∼1 × 10-6 to ∼30 × 10-6. Polystyrene with thermal backing and polyisocyanurate had the lowest γ, while cellulose and fiberglass had the highest. In the presence of O3, total observed volatile byproduct yields ranged from 0.25 (polystyrene) to 0.85 (recycled denim) moles of VOCs produced per mole of O3 consumed, or equivalent to secondary fluxes that range from 0.71 (polystyrene) to 10 (recycled denim) μmol m-2 h-1. Major emitted products in the presence of O3 were generally different from primary emissions and were characterized by yields of aldehydes and acetone. This work provides new data that can be used to evaluate and eventually model the impact of "hidden" materials (i.e., those present inside wall cavities) on indoor air quality. The data may also guide building enclosure material selection, especially for buildings in areas of high outdoor O3.

Occurrence and Coupling of Heat and Ozone Events and Their Relation to Mortality Rates in Berlin, Germany, between 2000 and 2014

Episodes of hot weather and poor air quality pose significant consequences for public health. In this study, these episodes are addressed by applying the observational data of daily air temperature and ozone concentrations in an event-based risk assessment approach in order to detect individual heat and ozone events, as well as events of their co-occurrence in Berlin, Germany, in the years 2000 to 2014. Various threshold values are explored so as to identify these events and to search for the appropriate regressions between the threshold exceedances and mortality rates. The events are further analyzed in terms of their event-specific mortality rates and their temporal occurrences. The results reveal that at least 40% of all heat events during the study period are accompanied by increased ozone concentrations in Berlin, particularly the most intense and longest heat events. While ozone events alone are only weakly associated with increased mortality rates, elevated ozone concentrations during heat events are found to amplify mortality rates. We conclude that elevated air temperatures during heat events are one major driver for increased mortality rates in Berlin, but simultaneously occurring elevated ozone concentrations act as an additional stressor, leading to an increased risk for the regional population.

The impact of air exchange rate on ambient air pollution exposure and inequalities across all residential parcels in Massachusetts

Individual housing characteristics can modify outdoor ambient air pollution infiltration through air exchange rate (AER). Time and labor-intensive methods needed to measure AER has hindered characterization of AER distributions across large geographic areas. Using publicly-available data and regression models associating AER with housing characteristics, we estimated AER for all Massachusetts residential parcels. We conducted an exposure disparities analysis, considering ambient PM_2.5 concentrations and residential AERs. Median AERs (h^-1) with closed windows for winter and summer were 0.74 (IQR: 0.47-1.09) and 0.36 (IQR: 0.23-0.57), respectively, with lower AERs for single family homes. Across residential parcels, variability of indoor PM_2.5 concentrations of ambient origin was twice that of ambient PM_2.5 concentrations. Housing parcels above the 90th percentile of both AER and ambient PM_2.5 (i.e., the leakiest homes in areas of highest ambient PM_2.5)-vs. below the 10 percentile-were located in neighborhoods with higher proportions of Hispanics (20.0% vs. 2.0%), households with an annual income of less than $20,000 (26.0% vs. 7.5%), and individuals with less than a high school degree (23.2% vs. 5.8%). Our approach can be applied in epidemiological studies to estimate exposure modifiers or to characterize exposure disparities that are not solely based on ambient concentrations.

Air Quality-Related Health Benefits of Energy Efficiency in the United States

While it is known that energy efficiency (EE) lowers power sector demand and emissions, study of the air quality and public health impacts of EE has been limited. Here, we quantify the air quality and mortality impacts of a 12% summertime (June, July, and August) reduction in baseload electricity demand. We use the AVoided Emissions and geneRation Tool (AVERT) to simulate plant-level generation and emissions, the Community Multiscale Air Quality (CMAQ) model to simulate air quality, and the Environmental Benefits Mapping and Analysis Program (BenMAP) to quantify mortality impacts. We find EE reduces emissions of NO _x by 13.2%, SO₂ by 12.6%, and CO₂ by 11.6%. On a nationwide, summer average basis, ambient PM_2.5 is reduced 0.55% and O₃ is reduced 0.45%. Reduced exposure to PM_2.5 avoids 300 premature deaths annually (95% CI: 60 to 580) valued at $2.8 billion ($0.13 billion to $9.3 billion), and reduced exposure to O₃ averts 175 deaths (101 to 244) valued at $1.6 billion ($0.15 billion to $4.5 billion). This translates into a health savings rate of $0.049/kWh ($0.031/kWh for PM_2.5 and $0.018/kWh for O₃). These results illustrate the importance of capturing the health benefits of EE and its potential as a strategy to achieve air standards.

Sensitivity of projected PM2.5- and O3-related health impacts to model inputs: A case study in mainland China

In China, fine particulate matter (PM_2.5) and ground-level ozone (O₃) are anticipated to continuously affect large populations in the coming decades. Simulations of the levels of these pollutants largely depend on emissions inputs, which are highly uncertain both in magnitude and spatial distribution. Our goal was to explore sensitivities of projected changes in PM_2.5- and O₃-related short-term health impacts in mainland China to emissions and other model inputs. We simulated winter PM_2.5 and summer O₃ concentrations using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem) for both 2008 and 2050. We used three emission inventories in 2008 and four emissions scenarios in 2050. The resulting air pollutant concentrations were combined with eight population projections and three concentration-response functions (CRFs) to estimate future PM_2.5- and O₃-related health impacts including total, cardiovascular, and respiratory mortalities in mainland China. Multivariate analysis of variance was used to apportion the uncertainty due to different model parameters. Combinations of different parameters produced a wide range of national PM_2.5- and O₃-related mortalities. CRFs and present emissions each contribute 38%-56% and 20%-28% of the total sum of squares for PM_2.5-related mortalities. Future emissions are the largest source of uncertainty in O₃-related mortality estimates, contributing 24%-48% of total sum of squares. Our results suggest that conducting more epidemiological studies and constraining the present day emissions are essential for projecting future air pollutant-related health impacts in mainland China.

Development of a large-scale computer-controlled ozone inhalation exposure system for rodents

Objective: Complete systems for laboratory-based inhalation toxicology studies are typically not commercially available; therefore, inhalation toxicologists utilize custom-made exposure systems. Here we report on the design, construction, testing, operation and maintenance of a newly developed in vivo rodent ozone inhalation exposure system. Materials and methods: Key design requirements for the system included large-capacity exposure chambers to facilitate studies with large sample sizes, automatic and precise control of chamber ozone concentrations, as well as automated data collection on airflow and environmental conditions. The exposure system contains two Hazelton H-1000 stainless steel and glass exposure chambers, each providing capacity for up to 180 mice or 96 rats. We developed an empirically tuned proportional-integral-derivative control loop that provides stable ozone concentrations throughout the exposure period (typically 3h), after a short ramp time (∼8 min), and across a tested concentration range of 0.2-2 ppm. Specific details on the combination of analog and digital input/output system for environmental data acquisition, control and safety systems are provided, and we outline the steps involved in maintenance and calibration of the system. Results: We show that the exposure system produces consistent ozone exposures both within and across experiments, as evidenced by low coefficients of variation in chamber ozone concentration and consistent biological responses (airway inflammation) in mice, respectively. Conclusion: Thus, we have created a large and robust ozone exposure system, facilitating future studies on the health effects of ozone in rodents.

Comparing apples to oranges: Interpreting ozone concentrations from observational studies in the context of the United States ozone regulatory standard

In 2015, the United States Environmental Protection Agency (US EPA) set the ozone National Ambient Air Quality Standards (NAAQS) at 0.070 parts per million (ppm), for an annual 4th highest daily 8-hour (h) maximum average concentration, averaged over three years, with compliance based on the monitor with the highest concentrations. Numerous epidemiological studies have evaluated associations between ozone and health effects, but how the ozone concentrations derived from those studies can be compared to the ozone NAAQS is not clear, because of the complexity of the standard. The purpose of the present work was to determine how ozone summary metrics used in key epidemiology studies compare to the metrics that comprise the ozone regulatory value. Evaluation of epidemiology studies used for quantitative risk assessment in the 2015 ozone NAAQS review demonstrated that the most commonly used summary metrics that differed from the NAAQS were: 1-h maximum or 24-h average concentrations; multiple-day averages from 2 to 30 days; and averaging of ozone concentrations across all monitors in an area and over different months of the year. Using different ozone summary metrics to calculate the ozone regulatory value in twelve US cities for 2000-2002 or 2013-2015 generated alternative ozone regulatory values that were often substantively different and that may or may not vary commensurate with the regulatory standard. Comparison of epidemiology study metrics to other countries' ozone standards or guideline levels produces similar challenges as described here for the NAAQS. In conclusion, many of the ozone concentration metrics used in epidemiology studies cannot be directly compared to the ozone NAAQS, and using simple conversion ratios adds substantial uncertainty to concentration estimates. These summary metrics must be reconciled to the regulatory value before any judgements are made as to the protectiveness of current and alternative standards based on epidemiology study results.

Inactivation of Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus in an open water system with ozone generated by a compact, atmospheric DBD plasma reactor

Ozone is a well-known disinfecting agent that is used as an alternative for chlorine in many applications, including water decontamination. However, the utility of ozone in water decontamination is limited by high electrical power consumption and expensive, bulky equipment associated with ozone generation. This study investigates the effectiveness of a lightweight, compact surface dielectric barrier discharge (SDBD) reactor as an ozone generator to inactivate Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) in an open water system. Experimental details are provided for ozone generation technique, mixing method, ozone concentrations in air and water, and input energy required to produce adequate ozone concentrations for bacterial inactivation in a contaminated, open water system. Specifically, an active plasma module (APM) reactor system of size 48 cubic centimeters, weighing 55 grams, with a maximum ozone yield of 68.6 g/KWh was used in atmospheric conditions as the source of ozone along with an air pump and a diffusion stone for mixing the ozone in water. Over 4-log reduction in P. aeruginosa concentration was achieved in 4 minutes with 0.1 mg/L ozone concentration in an open water system using 8.8 ± 1.48 J input energy. Also, over 5-log reduction in MRSA concentration was achieved in 2 minutes with 0.04 mg/L ozone concentration in an open water system using 4.4 ± 0.74 J input energy.

Does the air pollution model influence the evidence of socio-economic disparities in exposure and susceptibility?

Studies assessing socio-economic disparities in air pollution exposure and susceptibility are usually based on a single air pollution model. A time stratified case-crossover study was designed to assess the impact of the type of model on differential exposure and on the differential susceptibility in the relationship between ozone exposure and daily mortality by socio-economic strata (SES) in Montreal. Non-accidental deaths along with deaths from cardiovascular and respiratory causes on the island of Montreal for the period 1991-2002 were included as cases. Daily ozone concentration estimates at partictaipants' residence were obtained from the five following air pollution models: Average value (AV), Nearest station model (NS), Inverse-distance weighting interpolation (IDW), Land-use regression model with back-extrapolation (LUR-BE) and Bayesian maximum entropy model combined with a land-use regression (BME-LUR). The prevalence of a low household income (< 20,000/year) was used as socio-economic variable, divided into two categories as a proxy for deprivation. Multivariable conditional logistic regressions were used considering 3-day average concentrations. Multiplicative and additive interactions (using Relative Excess Risk due to Interaction) as well as Cochran's tests were calculated and results were compared across the different air pollution models. Heterogeneity of susceptibility and exposure according to socio-economic status (SES) were found. Ratio of exposure across SES groups means ranged from 0.75 [0.74-0.76] to 1.01 [1.00-1.02], respectively for the LUR-BE and the BME-LUR models. Ratio of mortality odds ratios ranged from 1.01 [0.96-1.05] to 1.02 [0.97-1.08], respectively for the IDW and LUR-BE models. Cochran's test of heterogeneity between the air pollution models showed important heterogeneity regarding the differential exposure by SES, but the air pollution model was not found to influence heterogeneity regarding the differential susceptibility. The study showed air pollution models can influence the assessment of disparities in exposure according to SES in Montreal but not that of disparities in susceptibility.

Human exposure to ozone in school and office indoor environments

BACKGROUND

Although it is recognized that ozone causes acute and chronic health effects and that even trace amounts of ozone are potentially deleterious to human health, information about global and local exposures to ozone in different indoor environments is limited. To synthesize the existing knowledge, this review analyzes the magnitude of and the trends in global and local exposure to ozone in schools and offices and the factors controlling the exposures.

METHODS

In conducting the literature review, Web of Science, SCOPUS, Google Scholar, and PubMed were searched using 38 search terms and their combinations to identify manuscripts, reports, and directives published between 1973 and 2018. The search was then extended to the reference lists of relevant articles.

RESULTS

The calculated median concentration of ozone both in school (8.50 μg/m³) and office (9.04 μg/m³) settings was well below the WHO guideline value of 100 μg/m³ as a maximum 8 h mean concentration. However, a large range of average concentrations of ozone was reported, from 0.8-114 μg/m³ and from 0 to 96.8 μg/m³ for school and office environments, respectively, indicating situations where the WHO values are exceeded. Outdoor ozone penetrating into the indoor environment is the main source of indoor ozone, with median I/O ratios of 0.21 and 0.29 in school and office environments, respectively. The absence of major indoor ozone sources and ozone sinks, including gas-phase reactions and deposition, are the reasons for lower indoor than outdoor ozone concentrations. However, there are indoor sources of ozone that are of significance in certain indoor environments, including printers, photocopiers, and many other devices and appliances designed for indoor use (e.g., air cleaners), that release ozone either intentionally or unintentionally. Due to significantly elevated outdoor ozone concentrations during summer, summer indoor concentrations are typically elevated. In addition, the age of a building and various housing aspects (carpeting, air conditioning, window fans, and window openings) have been significantly associated with indoor ozone levels.

CONCLUSIONS

The existing means for reducing ozone and ozone reaction products in school and office settings are as follows: 1) reduce penetration of outdoor ozone indoors by filtering ozone from the supply air; 2) limit the use of printers, photocopiers, and other devices and appliances that emit ozone indoors; 3) limit gas-phase reactions by limiting the use of materials and products (e.g. cleaning chemicals) the emissions of which react with ozone.

Assessment of Ozone-Induced Lung Injury in Mice

Ozone is a major pollutant in the air we breathe, and elevated levels lead to significant morbidity and mortality. As the climate warms, levels of ozone are predicted to increase. Accordingly, studies to assess the mechanisms of ozone-induced lung diseases are paramount. This chapter describes mouse models of ozone exposure and methods for assessing the effects of ozone in the lungs. These include bronchoalveolar lavage, necropsy, and measurement of lung function. Lavage allows for assessment of cell infiltration, cytokine production, tissue damage and capillary leakage in the airspaces. Necropsy provides tissue for gene expression, histology, and protein assessment in the whole lung. Lung physiology is used to assess airway hyperresponsiveness, tissue and total lung resistance, compliance, and elastance.

Air-quality-related health impacts from climate change and from adaptation of cooling demand for buildings in the eastern United States: An interdisciplinary modeling study

BACKGROUND

Climate change negatively impacts human health through heat stress and exposure to worsened air pollution, amongst other pathways. Indoor use of air conditioning can be an effective strategy to reduce heat exposure. However, increased air conditioning use increases emissions of air pollutants from power plants, in turn worsening air quality and human health impacts. We used an interdisciplinary linked model system to quantify the impacts of heat-driven adaptation through building cooling demand on air-quality-related health outcomes in a representative mid-century climate scenario.

METHODS AND FINDINGS

We used a modeling system that included downscaling historical and future climate data with the Weather Research and Forecasting (WRF) model, simulating building electricity demand using the Regional Building Energy Simulation System (RBESS), simulating power sector production and emissions using MyPower, simulating ambient air quality using the Community Multiscale Air Quality (CMAQ) model, and calculating the incidence of adverse health outcomes using the Environmental Benefits Mapping and Analysis Program (BenMAP). We performed simulations for a representative present-day climate scenario and 2 representative mid-century climate scenarios, with and without exacerbated power sector emissions from adaptation in building energy use. We find that by mid-century, climate change alone can increase fine particulate matter (PM2.5) concentrations by 58.6% (2.50 μg/m3) and ozone (O3) by 14.9% (8.06 parts per billion by volume [ppbv]) for the month of July. A larger change is found when comparing the present day to the combined impact of climate change and increased building energy use, where PM2.5 increases 61.1% (2.60 μg/m3) and O3 increases 15.9% (8.64 ppbv). Therefore, 3.8% of the total increase in PM2.5 and 6.7% of the total increase in O3 is attributable to adaptive behavior (extra air conditioning use). Health impacts assessment finds that for a mid-century climate change scenario (with adaptation), annual PM2.5-related adult mortality increases by 13,547 deaths (14 concentration-response functions with mean incidence range of 1,320 to 26,481, approximately US$126 billion cost) and annual O3-related adult mortality increases by 3,514 deaths (3 functions with mean incidence range of 2,175 to 4,920, approximately US$32.5 billion cost), calculated as a 3-month summer estimate based on July modeling. Air conditioning adaptation accounts for 654 (range of 87 to 1,245) of the PM2.5-related deaths (approximately US$6 billion cost, a 4.8% increase above climate change impacts alone) and 315 (range of 198 to 438) of the O3-related deaths (approximately US$3 billion cost, an 8.7% increase above climate change impacts alone). Limitations of this study include modeling only a single month, based on 1 model-year of future climate simulations. As a result, we do not project the future, but rather describe the potential damages from interactions arising between climate, energy use, and air quality.

CONCLUSIONS

This study examines the contribution of future air-pollution-related health damages that are caused by the power sector through heat-driven air conditioning adaptation in buildings. Results show that without intervention, approximately 5%-9% of exacerbated air-pollution-related mortality will be due to increases in power sector emissions from heat-driven building electricity demand. This analysis highlights the need for cleaner energy sources, energy efficiency, and energy conservation to meet our growing dependence on building cooling systems and simultaneously mitigate climate change.

Energy savings, emission reductions, and health co-benefits of the green building movement

Buildings consume nearly 40% of primary energy production globally. Certified green buildings substantially reduce energy consumption on a per square foot basis and they also focus on indoor environmental quality. However, the co-benefits to health through reductions in energy and concomitant reductions in air pollution have not been examined.We calculated year by year LEED (Leadership in Energy and Environmental Design) certification rates in six countries (the United States, China, India, Brazil, Germany, and Turkey) and then used data from the Green Building Information Gateway (GBIG) to estimate energy savings in each country each year. Of the green building rating schemes, LEED accounts for 32% of green-certified floor space and publically reports energy efficiency data. We employed Harvard's Co-BE Calculator to determine pollutant emissions reductions by country accounting for transient energy mixes and baseline energy use intensities. Co-BE applies the social cost of carbon and the social cost of atmospheric release to translate these reductions into health benefits. Based on modeled energy use, LEED-certified buildings saved $7.5B in energy costs and averted 33MT of CO₂, 51 kt of SO₂, 38 kt of NO_x, and 10 kt of PM_2.5 from entering the atmosphere, which amounts to $5.8B (lower limit = $2.3B, upper limit = $9.1B) in climate and health co-benefits from 2000 to 2016 in the six countries investigated. The U.S. health benefits derive from avoiding an estimated 172-405 premature deaths, 171 hospital admissions, 11,000 asthma exacerbations, 54,000 respiratory symptoms, 21,000 lost days of work, and 16,000 lost days of school. Because the climate and health benefits are nearly equivalent to the energy savings for green buildings in the United States, and up to 10 times higher in developing countries, they provide an important and previously unquantified societal value. Future analyses should consider these co-benefits when weighing policy decisions around energy-efficient buildings.

Pollution and respiratory disease: can diet or supplements help? A review

Pollution is known to cause and exacerbate a number of chronic respiratory diseases. The World Health Organisation has placed air pollution as the world's largest environmental health risk factor. There has been recent publicity about the role for diet and anti-oxidants in mitigating the effects of pollution, and this review assesses the evidence for alterations in diet, including vitamin supplementation in abrogating the effects of pollution on asthma and other chronic respiratory diseases. We found evidence to suggest that carotenoids, vitamin D and vitamin E help protect against pollution damage which can trigger asthma, COPD and lung cancer initiation. Vitamin C, curcumin, choline and omega-3 fatty acids may also play a role. The Mediterranean diet appears to be of benefit in patients with airways disease and there appears to be a beneficial effect in smokers however there is no direct evidence regarding protecting against air pollution. More studies investigating the effects of nutrition on rapidly rising air pollution are urgently required. However it is very difficult to design such studies due to the confounding factors of diet, obesity, co-morbid illness, medication and environmental exposure.

Ambient Air Pollution-related Mortality in Dairy Cattle: Does It Corroborate Human Findings?

BACKGROUND

Despite insights for humans, short-term associations of air pollution with mortality to our knowledge have never been studied in animals. We investigated the association between ambient air pollution and risk of mortality in dairy cows and assessed effect modification by season.

METHODS

We collected ozone (O3), particulate matter (PM10), and nitrogen dioxide (NO2) concentrations at the municipality level for 87,108 dairy cow deaths in Belgium from 2006 to 2009. We combined a case-crossover design with time-varying distributed lag models.

RESULTS

We found acute and delayed associations between air pollution and dairy cattle mortality during the warm season. The increase in mortality for a 10 μg/m increase in 2-day (lag 0-1) O3 was 1.2% (95% confidence interval [CI] = 0.3%, 2.1%), and the corresponding estimates for a 10 μg/m increase in same-day (lag 0) PM10 and NO2 were 1.6% (95% CI = 0.0%, 3.1%) and 9.2% (95% CI = 6.3%, 12%), respectively. Compared with the acute increases, the cumulative 26-day (lag 0-25) estimates were considerably larger for O3 (3.0%; 95% CI = 0.2%, 6.0%) and PM10 (3.2%; 95% CI = -0.6%, 7.2%), but not for NO2 (1.4%; 95% CI = -4.9%, 8.2%). In the cold season, we only observed increased mortality risks associated with same-day (lag 0) exposure to NO2 (1.4%; 95% CI = -0.1%, 3.1%) and with 26-day (lag 0-25) exposure to O3 (4.6%; 95% CI = 2.2%, 7.0%).

CONCLUSIONS

Our study adds to the epidemiologic findings in humans and reinforces the evidence on the plausibility of causal effects. Furthermore, our results indicate that air pollution associations go beyond short-term mortality displacement. (See video abstract at http://links.lww.com/EDE/B105.).

HTAP2 multi-model estimates of premature human mortality due to intercontinental transport of air pollution and emission sectors

Ambient air pollution from ozone and fine particulate matter is associated with premature mortality. As emissions from one continent influence air quality over others, changes in emissions can also influence human health on other continents. We estimate global air pollution-related premature mortality from exposure to PM_2.5 and ozone, and the avoided deaths from 20% anthropogenic emission reductions from six source regions, North America (NAM), Europe (EUR), South Asia (SAS), East Asia (EAS), Russia/Belarus/Ukraine (RBU) and the Middle East (MDE), three global emission sectors, Power and Industry (PIN), Ground Transportation (TRN) and Residential (RES) and one global domain (GLO), using an ensemble of global chemical transport model simulations coordinated by the second phase of the Task Force on Hemispheric Transport of Air Pollution (TF-HTAP2), and epidemiologically-derived concentration-response functions. We build on results from previous studies of the TF-HTAP by using improved atmospheric models driven by new estimates of 2010 anthropogenic emissions (excluding methane), with more source and receptor regions, new consideration of source sector impacts, and new epidemiological mortality functions. We estimate 290,000 (95% CI: 30,000, 600,000) premature O₃-related deaths and 2.8 million (0.5 million, 4.6 million) PM_2.5-related premature deaths globally for the baseline year 2010. While 20% emission reductions from one region generally lead to more avoided deaths within the source region than outside, reducing emissions from MDE and RBU can avoid more O₃-related deaths outside of these regions than within, and reducing MDE emissions also avoids more PM_2.5-related deaths outside of MDE than within. Our findings that most avoided O₃-related deaths from emission reductions in NAM and EUR occur outside of those regions contrast with those of previous studies, while estimates of PM_2.5-related deaths from NAM, EUR, SAS and EAS emission reductions agree well. In addition, EUR, MDE and RBU have more avoided O₃-related deaths from reducing foreign emissions than from domestic reductions. For six regional emission reductions, the total avoided extra-regional mortality is estimated as 6,000 (-3,400, 15,500) deaths/year and 25,100 (8,200, 35,800) deaths/year through changes in O₃ and PM_2.5, respectively. Interregional transport of air pollutants leads to more deaths through changes in PM_2.5 than in O₃, even though O₃ is transported more on interregional scales, since PM_2.5 has a stronger influence on mortality. For NAM and EUR, our estimates of avoided mortality from regional and extra-regional emission reductions are comparable to those estimated by regional models for these same experiments. In sectoral emission reductions, TRN emissions account for the greatest fraction (26-53% of global emission reduction) of O₃-related premature deaths in most regions, in agreement with previous studies, except for EAS (58%) and RBU (38%) where PIN emissions dominate. In contrast, PIN emission reductions have the greatest fraction (38-78% of global emission reduction) of PM_2.5-related deaths in most regions, except for SAS (45%) where RES emission dominates, which differs with previous studies in which RES emissions dominate global health impacts. The spread of air pollutant concentration changes across models contributes most to the overall uncertainty in estimated avoided deaths, highlighting the uncertainty in results based on a single model. Despite uncertainties, the health benefits of reduced intercontinental air pollution transport suggest that international cooperation may be desirable to mitigate pollution transported over long distances.

Association of Short-term Exposure to Air Pollution With Mortality in Older Adults

Importance

The US Environmental Protection Agency is required to reexamine its National Ambient Air Quality Standards (NAAQS) every 5 years, but evidence of mortality risk is lacking at air pollution levels below the current daily NAAQS in unmonitored areas and for sensitive subgroups.

Objective

To estimate the association between short-term exposures to ambient fine particulate matter (PM2.5) and ozone, and at levels below the current daily NAAQS, and mortality in the continental United States.

Design, Setting, and Participants

Case-crossover design and conditional logistic regression to estimate the association between short-term exposures to PM2.5 and ozone (mean of daily exposure on the same day of death and 1 day prior) and mortality in 2-pollutant models. The study included the entire Medicare population from January 1, 2000, to December 31, 2012, residing in 39 182 zip codes.

Exposures

Daily PM2.5 and ozone levels in a 1-km × 1-km grid were estimated using published and validated air pollution prediction models based on land use, chemical transport modeling, and satellite remote sensing data. From these gridded exposures, daily exposures were calculated for every zip code in the United States. Warm-season ozone was defined as ozone levels for the months April to September of each year.

Main Outcomes and Measures

All-cause mortality in the entire Medicare population from 2000 to 2012.

Results

During the study period, there were 22 433 862 million case days and 76 143 209 control days. Of all case and control days, 93.6% had PM2.5 levels below 25 μg/m3, during which 95.2% of deaths occurred (21 353 817 of 22 433 862), and 91.1% of days had ozone levels below 60 parts per billion, during which 93.4% of deaths occurred (20 955 387 of 22 433 862). The baseline daily mortality rates were 137.33 and 129.44 (per 1 million persons at risk per day) for the entire year and for the warm season, respectively. Each short-term increase of 10 μg/m3 in PM2.5 (adjusted by ozone) and 10 parts per billion (10-9) in warm-season ozone (adjusted by PM2.5) were statistically significantly associated with a relative increase of 1.05% (95% CI, 0.95%-1.15%) and 0.51% (95% CI, 0.41%-0.61%) in daily mortality rate, respectively. Absolute risk differences in daily mortality rate were 1.42 (95% CI, 1.29-1.56) and 0.66 (95% CI, 0.53-0.78) per 1 million persons at risk per day. There was no evidence of a threshold in the exposure-response relationship.

Conclusions and Relevance

In the US Medicare population from 2000 to 2012, short-term exposures to PM2.5 and warm-season ozone were significantly associated with increased risk of mortality. This risk occurred at levels below current national air quality standards, suggesting that these standards may need to be reevaluated.

TNF-stimulated gene 6 promotes formation of hyaluronan-inter-α-inhibitor heavy chain complexes necessary for ozone-induced airway hyperresponsiveness

Exposure to pollutants, such as ozone, exacerbates airway inflammation and hyperresponsiveness (AHR). TNF-stimulated gene 6 (TSG-6) is required to transfer inter-α-inhibitor heavy chains (HC) to hyaluronan (HA), facilitating HA receptor binding. TSG-6 is necessary for AHR in allergic asthma, because it facilitates the development of a pathological HA-HC matrix. However, the role of TSG-6 in acute airway inflammation is not well understood. Here, we hypothesized that TSG-6 is essential for the development of HA- and ozone-induced AHR. TSG-6-/- and TSG-6+/+ mice were exposed to ozone or short-fragment HA (sHA), and AHR was assayed via flexiVent. The AHR response to sHA was evaluated in the isolated tracheal ring assay in tracheal rings from TSG-6-/- or TSG-6+/+, with or without the addition of exogenous TSG-6, and with or without inhibitors of Rho-associated, coiled-coil-containing protein kinase (ROCK), ERK, or PI3K. Smooth-muscle cells from mouse tracheas were assayed in vitro for signaling pathways. We found that TSG-6 deficiency protects against AHR after ozone (in vivo) or sHA (in vitro and in vivo) exposure. Moreover, TSG-6-/- tracheal ring non-responsiveness to sHA was reversed by exogenous TSG-6 addition. sHA rapidly activated RhoA, ERK, and Akt in airway smooth-muscle cells, but only in the presence of TSG-6. Inhibition of ROCK, ERK, or PI3K/Akt blocked sHA/TSG-6-mediated AHR. In conclusion, TSG-6 is necessary for AHR in response to ozone or sHA, in part because it facilitates rapid formation of HA-HC complexes. The sHA/TSG-6 effect is mediated by RhoA, ERK, and PI3K/Akt signaling.

The impact of climate change and emissions control on future ozone levels: Implications for human health

Overwhelming evidence has shown that, from the Industrial Revolution to the present, human activities influence ground-level ozone (O3) concentrations. Past studies demonstrate links between O3 exposure and health. However, knowledge gaps remain in our understanding concerning the impacts of climate change mitigation policies on O3 concentrations and health. Using a hybrid downscaling approach, we evaluated the separate impact of climate change and emission control policies on O3 levels and associated excess mortality in the US in the 2050s under two Representative Concentration Pathways (RCPs). We show that, by the 2050s, under RCP4.5, increased O3 levels due to combined climate change and emission control policies, could contribute to an increase of approximately 50 premature deaths annually nationwide in the US. The biggest impact, however, is seen under RCP8.5, where rises in O3 concentrations are expected to result in over 2,200 additional premature deaths annually. The largest increases in O3 are seen in RCP8.5 in the Northeast, the Southeast, the Central, and the West regions of the US. Additionally, when O3 increases are examined by climate change and emissions contributions separately, the benefits of emissions mitigation efforts may significantly outweigh the effects of climate change mitigation policies on O3-related mortality.

Clinical effects of air pollution on the central nervous system; a review

The purpose of this review is to describe recent clinical and epidemiological studies examining the adverse effects of urban air pollution on the central nervous system (CNS). Air pollution and particulate matter (PM) are associated with neuroinflammation and reactive oxygen species (ROS). These processes affect multiple CNS pathways. The conceptual framework of this review focuses on adverse effects of air pollution with respect to neurocognition, white matter disease, stroke, and carotid artery disease. Both children and older individuals exposed to air pollution exhibit signs of cognitive dysfunction. However, evidence on middle-aged cohorts is lacking. White matter injury secondary to air pollution exposure is a putative mechanism for neurocognitive decline. Air pollution is associated with exacerbations of neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. Increases in stroke incidences and mortalities are seen in the setting of air pollution exposure and CNS pathology is robust. Large populations living in highly polluted environments are at risk. This review aims to outline current knowledge of air pollution exposure effects on neurological health.

Modeling variability in air pollution-related health damages from individual airport emissions

In this study, we modeled concentrations of fine particulate matter (PM_2.5) and ozone (O₃) attributable to precursor emissions from individual airports in the United States, developing airport-specific health damage functions (deaths per 1000t of precursor emissions) and physically-interpretable regression models to explain variability in these functions. We applied the Community Multiscale Air Quality model using the Decoupled Direct Method to isolate PM_2.5- or O₃-related contributions from precursor pollutants emitted by 66 individual airports. We linked airport- and pollutant-specific concentrations with population data and literature-based concentration-response functions to create health damage functions. Deaths per 1000t of primary PM_2.5 emissions ranged from 3 to 160 across airports, with variability explained by population patterns within 500km of the airport. Deaths per 1000t of precursors for secondary PM_2.5 varied across airports from 0.1 to 2.7 for NOx, 0.06 to 2.9 for SO₂, and 0.06 to 11 for VOCs, with variability explained by population patterns and ambient concentrations influencing particle formation. Deaths per 1000t of O₃ precursors ranged from -0.004 to 1.0 for NOx and 0.03 to 1.5 for VOCs, with strong seasonality and influence of ambient concentrations. Our findings reinforce the importance of location- and source-specific health damage functions in design of health-maximizing emissions control policies.

Assessing Spatial and Temporal Patterns of Observed Ground-level Ozone in China

Elevated ground-level ozone (O₃), which is an important aspect of air quality related to public health, has been causing increasing concern. This study investigated the spatiotemporal distribution of ground-level O₃ concentrations in China using a dataset from the Chinese national air quality monitoring network during 2013-2015. This research analyzed the diurnal, monthly and yearly variation of O₃ concentrations in both sparsely and densely populated regions. In particular, 6 major Chinese cities were selected to allow a discussion of variations in O₃ levels in detail, Beijing, Chengdu, Guangzhou, Lanzhou, Shanghai, and Urumchi, located on both sides of the Heihe-Tengchong line. Data showed that the nationwide 3-year MDA8 of ground-level O₃ was 80.26 μg/m³. Ground-level O₃ concentrations exhibited monthly variability peaking in summer and reaching the lowest levels in winter. The diurnal cycle reached a minimum in morning and peaked in the afternoon. Yearly average O₃ MDA8 concentrations in Beijing, Chengdu, Lanzhou, and Shanghai in 2015 increased 12%, 25%, 34%, 22%, respectively, when compared with those in 2013. Compared with World Health Organization O₃ guidelines, Beijing, Chengdu, Guangzhou, and Shanghai suffered O₃ pollution in excess of the 8-hour O₃ standard for more than 30% of the days in 2013 to 2015.

Is daily exposure to ozone associated with respiratory morbidity and lung function in a representative sample of schoolchildren? Results from a panel study in Greece

Previous time series or panel studies of asthmatics have reported respiratory health effects following short-term exposure to ozone (O₃). We followed 186 children aged 10 years old in Athens and Thessaloniki, Greece for 5 weeks during the academic year 2013-2014 and recorded daily their respiratory symptoms, absenteeism and peak expiratory flow (PEF). We applied mixed models controlling for various possible confounders to investigate the daily associations between O₃ exposure - derived from weekly personal and fixed school site measurements calibrated using daily values of the fixed monitoring site nearest to the child's school location - and PEF, presence of any symptom, cough and stuffy nose, as well as absenteeism. We tested the robustness of our findings to varying modeling assumptions and confounders and investigated effect modification patterns by medication use, time spent outdoors and prevalence of asthma. A 10 μg/m³ increase in O₃ personal exposure was associated with increased odds of any symptom (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.98, 1.44), largely attributed to the increase in the odds of stuffy nose (OR: 1.23, 95% CI: 1.00, 1.51). PEF and absenteeism were not related to O₃ exposure. Our results were robust to several sensitivity analyses. Effects were modified by medication use as presence of symptoms but also decreases in PEF were mainly reported among non-users, while our effect estimates were not driven by the asthmatic subgroup of children. Our findings indicate that short-term O₃ exposure may be associated with respiratory symptoms extending previously reported results for asthmatics to the general population.

Modeling to Evaluate Contribution of Oil and Gas Emissions to Air Pollution

Oil and gas production in the Western United States has increased considerably over the past 10 years. While many of the still limited oil and gas impact assessments have focused on potential human health impacts, the typically remote locations of production in the Intermountain West suggests that the impacts of oil and gas production on national parks and wilderness areas (Class I and II areas) could also be important. To evaluate this, we utilize the Comprehensive Air quality Model with Extensions (CAMx) with a year-long modeling episode representing the best available representation of 2011 meteorology and emissions for the Western United States. The model inputs for the 2011 episodes were generated as part of the Three State Air Quality Study (3SAQS). The study includes a detailed assessment of oil and gas (O&G) emissions in Western States. The year-long modeling episode was run both with and without emissions from O&G production. The difference between these two runs provides an estimate of the contribution of the O&G production to air quality. These data were used to assess the contribution of O&G to the 8 hour average ozone concentrations, daily and annual fine particulate concentrations, annual nitrogen deposition totals and visibility in the modeling domain. We present the results for the Class I and II areas in the Western United States. Modeling results suggest that emissions from O&G activity are having a negative impact on air quality and ecosystem health in our National Parks and Class I areas.

IMPLICATIONS

In this research, we use a modeling framework developed for oil and gas evaluation in the western United States to determine the modeled impacts of emissions associated with oil and gas production on air pollution metrics. We show that oil and gas production may have a significant negative impact on air quality and ecosystem health in some national parks and other Class I areas in the western United States. Our findings are of particular interest to federal land managers as well as regulators in states heavy in oil and gas production as they consider control strategies to reduce the impact of development.

Estimating State-Specific Contributions to PM2.5- and O3-Related Health Burden from Residential Combustion and Electricity Generating Unit Emissions in the United States

BACKGROUND

Residential combustion (RC) and electricity generating unit (EGU) emissions adversely impact air quality and human health by increasing ambient concentrations of fine particulate matter (PM_2.5) and ozone (O₃). Studies to date have not isolated contributing emissions by state of origin (source-state), which is necessary for policy makers to determine efficient strategies to decrease health impacts.

OBJECTIVES

In this study, we aimed to estimate health impacts (premature mortalities) attributable to PM_2.5 and O₃ from RC and EGU emissions by precursor species, source sector, and source-state in the continental United States for 2005.

METHODS

We used the Community Multiscale Air Quality model employing the decoupled direct method to quantify changes in air quality and epidemiological evidence to determine concentration-response functions to calculate associated health impacts.

RESULTS

We estimated 21,000 premature mortalities per year from EGU emissions, driven by sulfur dioxide emissions forming PM_2.5. More than half of EGU health impacts are attributable to emissions from eight states with significant coal combustion and large downwind populations. We estimate 10,000 premature mortalities per year from RC emissions, driven by primary PM_2.5 emissions. States with large populations and significant residential wood combustion dominate RC health impacts. Annual mortality risk per thousand tons of precursor emissions (health damage functions) varied significantly across source-states for both source sectors and all precursor pollutants.

CONCLUSIONS

Our findings reinforce the importance of pollutant-specific, location-specific, and source-specific models of health impacts in design of health-risk minimizing emissions control policies. Citation: Penn SL, Arunachalam S, Woody M, Heiger-Bernays W, Tripodis Y, Levy JI. 2017. Estimating state-specific contributions to PM_2.5- and O₃-related health burden from residential combustion and electricity generating unit emissions in the United States. Environ Health Perspect 125:324-332; http://dx.doi.org/10.1289/EHP550.

Human Health and Economic Impacts of Ozone Reductions by Income Group

Low-income households may be disproportionately affected by ozone pollution and ozone policy. We quantify how three factors affect the relative benefits of ozone policies with household income: (1) unequal ozone reductions; (2) policy delay; and (3) economic valuation methods. We model ozone concentrations under baseline and policy conditions across the full continental United States to estimate the distribution of ozone-related health impacts across nine income groups. We enhance an economic model to include these impacts across household income categories, and present its first application to evaluate the benefits of ozone reductions for low-income households. We find that mortality incidence rates decrease with increasing income. Modeled ozone levels yield a median of 11 deaths per 100 000 people in 2005. Proposed policy reduces these rates by 13%. Ozone reductions are highest among low-income households, which increases their relative welfare gains by up to 4% and decreases them for the rich by up to 8%. The median value of reductions in 2015 is either $30 billion (in 2006 U.S. dollars) or $1 billion if reduced mortality risks are valued with willingness-to-pay or as income from increased life expectancy. Ozone reductions were relatively twice as beneficial for the lowest- compared to the highest-income households. The valuation approach affected benefits more than a policy delay or differential ozone reductions with income.

Linking Air Quality and Human Health Effects Models: An Application to the Los Angeles Air Basin

Proposed emission control strategies for reducing ozone and particulate matter are evaluated better when air quality and health effects models are used together. The Community Multiscale Air Quality (CMAQ) model is the US Environmental Protection Agency's model for determining public policy and forecasting air quality. CMAQ was used to forecast air quality changes due to several emission control strategies that could be implemented between 2008 and 2030 for the South Coast Air Basin that includes Los Angeles. The Environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) was used to estimate health and economic impacts of the different emission control strategies based on CMAQ simulations. BenMAP-CE is a computer program based on epidemiologic studies that link human health and air quality. This modeling approach is better for determining optimum public policy than approaches that only examine concentration changes.