1
|
Cromar K, Gladson L, Gohlke J, Li Y, Tong D, Ewart G. Adverse Health Impacts of Outdoor Air Pollution, Including from Wildland Fires, in the United States: "Health of the Air," 2018-2020. Ann Am Thorac Soc 2024; 21:76-87. [PMID: 37906164 PMCID: PMC10867920 DOI: 10.1513/annalsats.202305-455oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
Rationale: Adverse health impacts from outdoor air pollution occur across the United States, but the magnitude of these impacts varies widely by geographic region. Ambient pollutant concentrations, emission sources, baseline health conditions, and population sizes and distributions are all important factors that need to be taken into account to quantify local health burdens. Objectives: To determine health impacts from ambient air pollution concentrations in the United States that exceed the levels recommended by the American Thoracic Society. Methods: Using a methodology that has been well established in previous "Health of the Air" reports, this study provides policy-relevant estimates for every monitored county and city in the United States for the adverse health impacts of outdoor pollution concentrations using U.S. Environmental Protection Agency design values for years 2018-2020. Additionally, for the first time, the report includes adverse birth outcomes as well as estimates of health impacts specifically attributable to wildland fires using an exposure dataset generated through Community Multiscale Air Quality simulations. Results: The adverse health burdens attributable to air pollution occur across the entire age spectrum, including adverse birth outcomes (10,660 preterm and/or low-weight births; 95% confidence interval [CI], 3,180-18,330), in addition to mortality impacts (21,300 avoidable deaths; 95% CI, 16,180-26,200), lung cancer incidence (3,000 new cases; 95% CI, 1,550-4,390), multiple types of cardiovascular and respiratory morbidity (748,660 events; 95% CI, 326,050-1,057,080), and adversely impacted days (52.4 million days; 95% CI, 7.9-92.4 million days). Two different estimates of mortality impacts from wildland fires were created based on assumptions regarding the underlying toxicity of particles from wildland fires (low estimate of 4,080 deaths, 95% CI, 240-7,890; middle estimate of 28,000 deaths, 95% CI, 27,300-28,700). Conclusions: This year's report identified sizable health benefits that would be expected to occur across the United States with compliance with more health-protective air quality standards such as those recommended by the American Thoracic Society. This study also indicates that a large number of excess deaths are attributable to emissions from wildland fires; air quality management strategies outside what is required by the Clean Air Act will be needed to best address this important source of air pollution and its associated health risks.
Collapse
Affiliation(s)
- Kevin Cromar
- Marron Institute of Urban Management, New York University, New York, New York
- New York University Grossman School of Medicine, New York, New York
| | - Laura Gladson
- Marron Institute of Urban Management, New York University, New York, New York
- New York University Grossman School of Medicine, New York, New York
| | | | - Yunyao Li
- Department of Atmospheric, Oceanic and Earth Sciences and
| | - Daniel Tong
- Department of Atmospheric, Oceanic and Earth Sciences and
- Center for Spatial Information Science and Systems, George Mason University, Fairfax, Virginia; and
| | - Gary Ewart
- American Thoracic Society, Washington, DC
| |
Collapse
|
2
|
Lanza K, Gohlke J, Wang S, Sheffield PE, Wilhelmi O. Climate change and physical activity: ambient temperature and urban trail use in Texas. Int J Biometeorol 2022; 66:1575-1588. [PMID: 35622168 PMCID: PMC9135991 DOI: 10.1007/s00484-022-02302-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/18/2022] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
Individuals in the USA are insufficiently active, increasing their chronic disease risk. Extreme temperatures may reduce physical activity due to thermal discomfort. Cooler climate studies have suggested climate change may have a net positive effect on physical activity, yet research gaps remain for warmer climates and within-day physical activity patterns. We determined the association between ambient temperatures (contemporary and projected) and urban trail use in a humid subtropical climate. At a trail in Austin, TX, five electronic counters recorded hourly pedestrian and cyclist counts in 2019. Weather data were acquired from World Weather Online. Generalized additive models estimated the association between temperature and trail counts. We then combined the estimated exposure-response relation with weather projections from climate models for intermediate (RCP4.5) and high (RCP8.5) emissions scenarios by NASA NEX-GDDP. From summer to autumn to spring to winter, hourly trail counts shifted from bimodal (mid-morning and early-evening peaks) to one mid-day peak. Pedestrians were more likely to use the trail between 7 and 27 °C (45-81°F) with peak use at 17 °C (63°F) and cyclists between 15 and 33 °C (59-91°F) with peak use at 27 °C (81°F) than at temperature extremes. A net decrease in trail use was estimated by 2041-2060 (RCP4.5: pedestrians = - 4.5%, cyclists = - 1.1%; RCP8.5: pedestrians = - 6.6%, cyclists = - 1.6%) and 2081-2100 (RCP4.5: pedestrians = - 7.5%, cyclists = - 1.9%; RCP8.5: pedestrians = - 16%, cyclists = - 4.5%). Results suggest climate change may reduce trail use. We recommend interventions for thermal comfort at settings for physical activity.
Collapse
Affiliation(s)
- Kevin Lanza
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health in Austin, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA.
| | - Julia Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, 205 Duck Pond Drive, Blacksburg, VA, 24061, USA
| | - Suwei Wang
- Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC, 27701, USA
| | - Perry E Sheffield
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, EMPH Box 1057, New York, NY, 10029, USA
| | - Olga Wilhelmi
- Research Applications Laboratory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO, 80307, USA
| |
Collapse
|
3
|
Kang X, Ranganathan S, Kang L, Gohlke J, Deng X. Bayesian auxiliary variable model for birth records data with qualitative and quantitative responses. J STAT COMPUT SIM 2022; 91:3283-3303. [PMID: 35001987 DOI: 10.1080/00949655.2021.1926459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Many applications involve data with qualitative and quantitative responses. When there is an association between the two responses, a joint model will produce improved results than fitting them separately. In this paper, a Bayesian method is proposed to jointly model such data. The joint model links the qualitative and quantitative responses and can assess their dependency strength via a latent variable. The posterior distributions of parameters are obtained through an efficient MCMC sampling algorithm. The simulation is conducted to show that the proposed method improves the prediction capacity for both responses. Further, the proposed joint model is applied to the birth records data acquired by the Virginia Department of Health for studying the mutual dependence between preterm birth of infants and their birth weights.
Collapse
Affiliation(s)
- Xiaoning Kang
- Institute of Supply Chain Analytics and International Business College, Dongbei University of Finance and Economics, China
| | - Shyam Ranganathan
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Lulu Kang
- Department of Applied Mathematics, Illinois Institute of Technology. Chicago, IL, USA
| | - Julia Gohlke
- Department of Population Health Sciences, Virginia Polytechnic Institute and State University, Blacksburg, USA
| | - Xinwei Deng
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, USA
| |
Collapse
|
4
|
Bukvic A, Gohlke J, Borate A, Suggs J. Aging in Flood-Prone Coastal Areas: Discerning the Health and Well-Being Risk for Older Residents. Int J Environ Res Public Health 2018; 15:ijerph15122900. [PMID: 30567352 PMCID: PMC6313428 DOI: 10.3390/ijerph15122900] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/06/2018] [Accepted: 12/10/2018] [Indexed: 01/15/2023]
Abstract
Coastal communities are increasingly exposed to more intense and frequent hurricanes, accelerated sea-level rise, and prolonged tidal inundation, yet they are often a preferred retirement destination for older adults vulnerable to flooding and extreme weather events. The unique physical and psychosocial challenges of older population age 65 and over may affect their level of preparedness, capacity to cope with, and ability to respond and recover from a hazard event. Despite the clear vulnerabilities of older residents living in high-risk areas when compared to younger coastal populations, there is a lack of empirical research on the integrated flood risks to this population group in the coastal context. This paper provides a holistic assessment of this emerging problem along the U.S. East Coast by measuring the exposure of older population to sea level rise and storm surge in coastal counties. It further evaluates how age-related vulnerabilities differ between rural and urban settings using the case study approach and geospatial and statistical analysis the paper also conducts a review of scientific literature to identify gaps in the current understanding of health and well-being risks to aging populations in coastal communities. The results show that older populations are unevenly distributed along the U.S. East Coast with some states and counties having significantly higher percent of residents age 65 and older living along the shoreline. Many places with larger older populations have other attributes that further shape the vulnerability of this age group such as older housing stock, disabilities, and lower income and that often differ between rural and urban settings. Lastly, our study found that vast majority of research on aging in high-risk coastal locations has been conducted in relation to major disasters and almost none on the recurrent nuisance flooding that is already affecting many coastal communities.
Collapse
Affiliation(s)
- Anamaria Bukvic
- Department of Geography, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Julia Gohlke
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA 24061, USA.
| | - Aishwarya Borate
- Urban Affairs and Planning, Virginia Tec h, Blacksburg, VA 24061, USA.
| | - Jessica Suggs
- Department of Statistics, Virginia Tech, Blacksburg, VA 24061, USA.
| |
Collapse
|
5
|
Scott AA, Misiani H, Okoth J, Jordan A, Gohlke J, Ouma G, Arrighi J, Zaitchik BF, Jjemba E, Verjee S, Waugh DW. Temperature and heat in informal settlements in Nairobi. PLoS One 2017; 12:e0187300. [PMID: 29107977 PMCID: PMC5673164 DOI: 10.1371/journal.pone.0187300] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/06/2017] [Indexed: 11/18/2022] Open
Abstract
Nairobi, Kenya exhibits a wide variety of micro-climates and heterogeneous surfaces. Paved roads and high-rise buildings interspersed with low vegetation typify the central business district, while large neighborhoods of informal settlements or "slums" are characterized by dense, tin housing, little vegetation, and limited access to public utilities and services. To investigate how heat varies within Nairobi, we deployed a high density observation network in 2015/2016 to examine summertime temperature and humidity. We show how temperature, humidity and heat index differ in several informal settlements, including in Kibera, the largest slum neighborhood in Africa, and find that temperature and a thermal comfort index known colloquially as the heat index regularly exceed measurements at the Dagoretti observation station by several degrees Celsius. These temperatures are within the range of temperatures previously associated with mortality increases of several percent in youth and elderly populations in informal settlements. We relate these changes to surface properties such as satellite-derived albedo, vegetation indices, and elevation.
Collapse
Affiliation(s)
- Anna A. Scott
- Department of Earth and Planetary Science, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail:
| | - Herbert Misiani
- IGAD Climate Prediction and Applications Centre (ICPAC), Intergovernmental Authority on Development (IGAD), Nairobi, Kenya
| | - Jerrim Okoth
- Department of Meteorology, University of Nairobi, Nairobi, Kenya
| | - Asha Jordan
- Department of Earth and Planetary Science, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Julia Gohlke
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, United States of America
| | - Gilbert Ouma
- Department of Meteorology, University of Nairobi, Nairobi, Kenya
| | - Julie Arrighi
- Red Cross Red Crescent Climate Centre, The Hague, Netherlands
- American Red Cross, Washington, D.C., United States of America
| | - Ben F. Zaitchik
- Department of Earth and Planetary Science, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Eddie Jjemba
- Red Cross Red Crescent Climate Centre, The Hague, Netherlands
| | | | - Darryn W. Waugh
- Department of Earth and Planetary Science, Johns Hopkins University, Baltimore, Maryland, United States of America
| |
Collapse
|
6
|
Krometis LA, Gohlke J, Kolivras K, Satterwhite E, Marmagas SW, Marr LC. Environmental health disparities in the Central Appalachian region of the United States. Rev Environ Health 2017; 32:253-266. [PMID: 28682789 DOI: 10.1515/reveh-2017-0012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/12/2017] [Indexed: 06/07/2023]
Abstract
Health disparities that cannot be fully explained by socio-behavioral factors persist in the Central Appalachian region of the United States. A review of available studies of environmental impacts on Appalachian health and analysis of recent public data indicates that while disparities exist, most studies of local environmental quality focus on the preservation of nonhuman biodiversity rather than on effects on human health. The limited public health studies available focus primarily on the impacts of coal mining and do not measure personal exposure, constraining the ability to identify causal relationships between environmental conditions and public health. Future efforts must engage community members in examining all potential sources of environmental health disparities to identify effective potential interventions.
Collapse
|
7
|
Sathiakumar N, Tipre M, Turner-Henson A, Chen L, Leader M, Gohlke J. Post-deepwater horizon blowout seafood consumption patterns and community-specific levels of concern for selected chemicals among children in Mobile County, Alabama. Int J Hyg Environ Health 2017; 220:1-7. [DOI: 10.1016/j.ijheh.2016.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/15/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
|
8
|
Berner A, Henkel J, Woodruff MA, Saifzadeh S, Kirby G, Zaiss S, Gohlke J, Reichert JC, Nerlich M, Schuetz MA, Hutmacher DW. Scaffold-cell bone engineering in a validated preclinical animal model: precursors vs differentiated cell source. J Tissue Eng Regen Med 2015; 11:2081-2089. [PMID: 26648044 DOI: 10.1002/term.2104] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/08/2015] [Accepted: 10/05/2015] [Indexed: 01/09/2023]
Abstract
The properties of osteoblasts (OBs) isolated from the axial skeleton (tOBs) differ from OBs of the orofacial skeleton (mOBs) due to the different embryological origins of the bones. The aim of the study was to assess and compare the regenerative potential of allogenic bone marrow-derived mesenchymal progenitor cells with allogenic tOBs and allogenic mOBs in combination with a mPCL-TCP scaffold in critical-sized segmental bone defects in sheep tibiae. After 6 months, the tibiae were explanted and underwent biomechanical testing, micro-computed tomography (microCT) and histological and immunohistochemical analyses. Allogenic MPCs demonstrated a trend towards a better outcome in biomechanical testing and the mean values of newly formed bone. Biomechanical, microCT and histological analysis showed no significant differences in the bone regeneration potential of tOBs and mOBs in our in vitro study, as well as in the bone regeneration potential of different cell types in vivo. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- A Berner
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Trauma Surgery, University of Regensburg, Germany
| | - J Henkel
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - M A Woodruff
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S Saifzadeh
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - G Kirby
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S Zaiss
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Trauma Surgery, University of Regensburg, Germany
| | - J Gohlke
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - J C Reichert
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Orthopaedics and Accident Surgery, Waldkrankenhaus Protestant Hospital, Berlin, Germany
| | - M Nerlich
- Department of Trauma Surgery, University of Regensburg, Germany
| | - M A Schuetz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - D W Hutmacher
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
9
|
Funk JA, Gohlke J, Kraft AD, McPherson CA, Collins JB, Harry GJ. Voluntary exercise protects hippocampal neurons from trimethyltin injury: possible role of interleukin-6 to modulate tumor necrosis factor receptor-mediated neurotoxicity. Brain Behav Immun 2011; 25:1063-77. [PMID: 21435392 PMCID: PMC3138904 DOI: 10.1016/j.bbi.2011.03.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 03/16/2011] [Accepted: 03/16/2011] [Indexed: 01/02/2023] Open
Abstract
In the periphery, exercise induces interleukin (IL)-6 to downregulate tumor necrosis factor (TNF), elevate interleukin-1 receptor antagonist (IL-1RA), decreasing inflammation. Exercise also offers neuroprotection and facilitates brain repair. IL-6 production in the hippocampus following exercise suggests the potential of a similar protective role as in the periphery to down-regulate TNFα and inflammation. Using a chemical-induced model of hippocampal dentate granule cell death (trimethyltin, TMT 2.4 mg/kg, ip) dependent upon TNF receptor signaling, we demonstrate neuroprotection in mice with 2 weeks access to running wheel. Exercise attenuated neuronal death and diminished elevations in TNFα, TNF receptor 1, myeloid differentiation primary response gene (MyD) 88, transforming growth factor β, chemokine (C-C motif) ligand 2 (CCL2), and CCL3. Elevated mRNA levels for IL-1α, IL-1RA, occurred with injury and protection. mRNA and protein levels of IL-6 and neuronal expression of IL-6 receptor α, were elevated with injury and protection. Microarray pathway analysis supported an up-regulation of TNFα cell death signaling pathways with TMT and inhibition by exercise. IL-6 pathway recruitment occurred in both conditions. IL-6 downstream signal events differed in the level of STAT3 activation. Exercise did not increase mRNA levels of brain derived neurotrophic factor, nerve growth factor, or glial derived neurotrophic factor. In IL-6 deficient mice, exercise did not attenuate TMT-induced tremor and a diminished level of neuroprotection was observed. These data suggest a contributory role for IL-6 induced by exercise for neuroprotection in the CNS similar to that seen in the periphery.
Collapse
Affiliation(s)
- Jason A. Funk
- Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC
| | - Julia Gohlke
- Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC,Department of Environmental Health Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Andrew D. Kraft
- Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC
| | - Christopher A. McPherson
- Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC
| | - Jennifer B. Collins
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC
| | - G. Jean Harry
- Laboratory of Toxicology and Pharmacology, National Institute of Environmental Health Sciences, National Institutes of Health, Dept of Health and Human Services, Research Triangle Park, NC,corresponding author: G. Jean Harry, National Institute of Environmental Health Sciences, P.O. Box 12233, MD C1-04, Research Triangle Park, NC 27709. Ph. (919) 541-0927, Fax. (919) 541-4634,
| |
Collapse
|
10
|
Faustman EM, Gohlke J, Judd NL, Lewandowski TA, Bartell SM, Griffith WC. Modeling developmental processes in animals: applications in neurodevelopmental toxicology. Environ Toxicol Pharmacol 2005; 19:615-624. [PMID: 21783534 DOI: 10.1016/j.etap.2004.12.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Biologically based dose-response models can provide a framework for incorporating mechanistic information into our assessments of neurotoxicity considering both kinetic and dynamic processes. We have constructed models for normal midbrain and neocortex development and we have extended these models to evaluate the neurodevelopmental toxicity of ethanol and methyl mercury. Using such modeling approaches, we have been able to test hypothesized modes of action for these neurodevelopmental toxicants. Specifically, we have compared ethanol's effects on neocortical neurogenesis and exacerbation of apoptosis during the synaptogenesis period. We have used methylmercury as an example of how one can link toxicokinetic and toxicodynamic models and also as an example of how mechanistic data on gene expression can support model development. In summary, using examples from our research group, this paper illustrates the need for models that evaluate both qualitative and quantitative kinetic and dynamic factors in order to understand the potential impacts of neurodevelopmental toxicants.
Collapse
Affiliation(s)
- Elaine M Faustman
- Center for Child Environmental Health Risks Research, Seattle, WA, USA; Institute for Risk Analysis and Risk Communication, Seattle, WA, USA; Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, #100, Seattle, WA, USA
| | | | | | | | | | | |
Collapse
|
11
|
Wong EY, Gohlke J, Griffith WC, Farrow S, Faustman EM. Assessing the health benefits of air pollution reduction for children. Environ Health Perspect 2004; 112:226-32. [PMID: 14754578 PMCID: PMC1241833 DOI: 10.1289/ehp.6299] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Benefit-cost analyses of environmental regulations are increasingly mandated in the United States. Evaluations of criteria air pollutants have focused on benefits and costs associated with adverse health effects. Children are significantly affected by the health benefits of improved air quality, yet key environmental health policy analyses have not previously focused specifically on children's effects. In this article we present a "meta-analysis" approach to child-specific health impacts derived from the U.S. Clean Air Act (CAA). On the basis of data from existing studies, reductions in criteria air pollutants predicted to occur by 2010 because of CAA regulations are estimated to produce the following impacts: 200 fewer expected cases of postneonatal mortality; 10,000 fewer asthma hospitalizations in children 1-16 years old, with estimated benefits ranging from 20 million U.S. dollars to 46 million U.S. dollars (1990 U.S. dollars); 40,000 fewer emergency department visits in children 1-16 years old, with estimated benefits ranging from 1.3 million U.S. dollars to 5.8 million U.S. dollars; 20 million school absences avoided by children 6-11 years old, with estimated benefits of 0.7-1.8 billion U.S. dollars; and 10,000 fewer infants of low birth weight, with estimated benefits of 230 million U.S. dollars. Inclusion of limited child-specific data on hospitalizations, emergency department visits, school absences, and low birth weight could be expected to add 1-2 billion U.S. dollars (1990 U.S. dollars) to the 8 billion U.S. dollars in health benefits currently estimated to result from decreased morbidity, and 600 million U.S. dollars to the 100 billion U.S. dollars estimated to result from decreased mortality. These estimates highlight the need for increased consideration of children's health effects. Key needs for environmental health policy analyses include improved information for children's health effects, additional life-stage-specific information, and improved health economics information specific for children.
Collapse
Affiliation(s)
- Eva Y Wong
- Institute for Risk Analysis and Risk Communication, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington 98105, USA
| | | | | | | | | |
Collapse
|
12
|
Schröder A, Gohlke J, Gross-Fengels W, Horstmann R. [Popliteal aneurysms--surgical management versus conservative procedure]. Langenbecks Arch Chir Suppl Kongressbd 1996; 113:857-63. [PMID: 9102006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
217 patients with 349 popliteal aneurysms (PA) were studied. 45% presented with symptomatic complications, mainly thrombosis (21% acute, 15% chronic) and embolisation (7%). The mean diameter was significantly larger in acutely thrombosed (2.69 cm) than in patent PA (2.15 cm). The amputation rate in patients requiring emergency treatment was 36.1% after 2 years. The difference to patients undergoing bypass surgery in an asymptomatic stage (4-year graft patency 89%, limb salvage 100%) is highly significant. Of 128 PA treated conservatively, 53% were free of complications after 5 years. We conclude that prophylactic surgery of PA is justified in cases at high risk of developing complications, but that characteristics of those cases are not yet well defined.
Collapse
Affiliation(s)
- A Schröder
- Allgemeines Krankenhaus Harburg, Hamburg
| | | | | | | |
Collapse
|