Eayh - Health Effects Of Air Pollutants (10/6/11)

Front 1

problems with air pollution

Back 1

a person inhales approximately 35 pounds of air per day (roughly 6 times more than food and drink consumed)

breathing is continuous and involuntary

air may be polluted both outdoors and indoors

lung disease is the 3rd leading cause of death in the US (~335,000 deaths/yr)

Front 2

chronic obstructive pulmonary disease (COPD)

Back 2

a major cause of disability
4th leading cause of death in the US

more than 12 million people are currently diagnosed with COPD

asthma is the most common chronic illness in children (leading cause of hospital admissions of children)

Front 3

lungs are used to exchange gasses

Back 3

inhaling oxygen

exhaling carbon dioxide

Front 4

the asthma epidemic exists particularly in...

Back 4

urban areas

Front 5

examples of catastrophic air pollution

Back 5

London (1911) - 1150 died form the effects of coal smoke (first time the mix of smoke and fog over london was called smog)

London (1952) - 4000 died from smog

Donora, PA (1948) - 20 died and 6000 were ill from smog from the community's steel mill, zinc smelter, and sulfuric acid plant

NYC (1963) - 300 people died from air pollution

Front 6

cost of air pollution (annual 1999 EPA report to congress)

Back 6

total cost - 71 billion
health - 68 billion (morbidity/mortality)
worker productivity - 460 million
agriculture - 45 million (many food products are more expensive to compensate for the cost of the crops lost due to air pollution)

Front 7

types of air pollutants

Back 7

natural (volcanic ash, pollen dust, smoke from fires)

man made
1. gaseous - derived from combustion processes, hydrocarbons, oxides of sulfur and nitrogen compounds

2. particulate matter - solid or aqueous particles

Front 8

particulate matter

Back 8

smallest (aerosols) can remain suspended

below ~2.5 micrometers are capable of penetrating all sites of the respiratory tract (carbonaceous, metallic oxides, salt or acids also have a porosity such that they absorb other gasses and liquids)

Front 9

the clean air act classified 2 broad classes of air pollutants

Back 9

"criteria" air pollutants and hazardous air pollutants

Front 10

criteria pollutants (CAPs)

Back 10

ubiquitous (wide spread)

not very toxic (not carcinogenic)

emitted from many large, diverse sources (including mobile and stationary sources)

omnipresent (therefore posing the greatest overall threat to human health)

presupposition - the adverse health effects are not cancerous and their dose response exhibits a threshhold

particulate matter (PM)
sulfur dioxide
nitrogen dioxide
ozone
carbon monoxide
lead (put into the environment when once used in gasoline)

Front 11

hazardous air pollutants (HAPs)

Back 11

sources may be limited and industry specific

considered more toxic and even carcinogenic

~188 chemicals (benzene, formaldehyde, cadmium, vinyl chlorine)

separate strategies exist for regulating the criteria and hazardous pollutants

Front 12

sources of primary air pollutans

Back 12

transportation 46%
fuel combustion (stationary sources) 29%
industrial processes 16%
miscellaneous 7%
solid waste disposal 2%

Front 13

emissions of primary air pollutants
(percentages)

Back 13

CO 48%
SO2 16%
NO2 16%
VOCs 15%
particulates 5%

Front 14

transformation and long-range transport of air pollutants

Back 14

sources - mobile, stationary, and natural

-->

primary pollutants - SO2, NO2, CO, PM

--> chemical transformation in atmosphere

secondarily formed pollutants (ozone, acid aerosols)

Front 15

transformation of air pollutants (secondary pollutants)

Back 15

hydrocarbons (VOCs) + NO2 -(sunlight)-> ozone

SO2 (gas) -(atmospheric oxidization)-> H2SO4 particle (droplet aerosols)

Front 16

concentration of gases in photo-chemical smog as a function of time

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cyclic

Front 17

coal mines in ohio pollute...

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the ohio river

Front 18

winds and geography play a role in the spread of air pollutants

Back 18

move across the US from west to east

Front 19

normal patterns of layers of air

Back 19

solar radiation
cooler air
cool air
warm air (on the ground)

Front 20

temperature inversion

Back 20

solar radiation
cool air
warm inversion layer (which traps pollution)
cool air (on the ground)

Front 21

areas in the us with the most unhealthy days due to pollution

Back 21

souther california is the worst
urban settings

(wind blows upward on the east coast giving them more good days)

Front 22

how do we communicate with the public

Back 22

color hazard chart
orange represents unhealthy for sensitive groups (e.g. children and people with lung disease)

Front 23

common symptoms of irritation from air pollution

Back 23

eye irritation
coughing
sore throat
shortness of breath
lung damage
airway constriction
nasal discharge
headaches/dizziness (in nasal passages you have a lot of nerves that go to your brain causing headaches)

Front 24

pulmonary responses to toxicants

Back 24

local irritation, which results in bronchial constriction and edema; secondary infection (bronchitis) frequently compounds the damage

damage to the cells of the airway which results in necrosis (cells die, leading to more types of damage)

fibrosis (stiffening of the lungs) and emphysema (destruction of airways)

airway constriction through allergic responses (asthma)

lung cancer (ozone may be a tumor promoter)

Front 25

health effects of particulate matter

Back 25

premature deaths of elderly

increased hospital use (emergency room visits and admissions)

aggravated asthma (many people end up in the OR)

acute symptoms including aggravated coughing and difficulties in breathing

decreased lung function (shortness of breath)

work and school absences

Front 26

the smaller the particulate ______

Back 26

the deeper in the lung it can go

Front 27

summary of ozone effects on acute exposure

Back 27

irritative symptoms

functional changes (including broncho-constriction)

temporary decrease in lung capacity and mild inflammation of the peripheral lung in moderately exercising subjects (breathe harder when you exercise)

increased risk of asthma attacks

Front 28

EPA health effects research laboratory (HERL) ozone clinical study protocol

Back 28

lab settings with ozone in the room and subject on the treadmill

Front 29

summary of ozone effects (long-term, related exposures)

Back 29

there is no definitive answer to this critical issue; possible to probable effects include:

impaired growth and development of the young lung (animal toxicology)

accelerated lung aging

contributes to the progression of underlying lung disease

Front 30

ozone

Back 30

sources - product of NO2 emissions from motor vehicles, power utilities, and industries burning fossil fuels, combined with hydrocarbons and sunlight in the atmosphere

health effects - causes difficulty breathing, irritation to mucous membranes, and increases risk to respiratory infections

welfare effects - corrodes rubber, paint, weakens fabric, produces leaf damage and retardation of plant growth

Front 31

carbon monoxide

Back 31

sources - incomplete combustion of fossil fuels as in vehicles, kerosene heaters, boilers, and furnaces

health effects - interferes with oxygen transport in blood by binding to hemoglobin, causes headaches, fatigue, and cardiovascular disease

welfare effects - effects on plants or material are not evident

Front 32

nitrogen dioxide

Back 32

sources - emitted from the combustion of fossil fuels in vehicles, industrial boilers, and electric generating utilities

health effects - increased risk of respiratory infections and aggravates symptoms in persons with asthma and chronic bronchitis

welfare effects - produces a reddish brown hue over cities which reduces horizon visibility, causes leaves to yellow, and is a precursor to acid deposition and tropospheric ozone

Front 33

sulfur dioxide

Back 33

sources - fossil fuel combustion especially in coal-burning electric power utilities, metal smelters, oil refineries and industrial boilers

health effects - causes irritation of the throat and lungs and aggravates symptoms in persons with asthma and chronic bronchitis

welfare effects - causes corrosion and deterioration of metals, brittleness of paper, point discoloration, damages textiles and leaves of plants, and is a precursor to acid disposition

Front 34

lead

Back 34

sources- histoirclaly emitted from vehicles burning leaded gasoline (emissions have been reduced by 98% since 1974, most exposures in the U.S. are not airborne)

health effects - damage to the CNS, blood forming tissues, kidneys, evidence of neurobehavioral disorders including learning disabilities and antisocial behavior

welfare effects - no known effect on vegetation materials

Front 35

clean air act (CAA)

Back 35

everybody should have the same degree of protection (establish UNIFORM national standards)

most susceptible subgroups of individuals (i.e. asthmatics, children) are to be protected

Front 36

regulation of criteria pollutants

Back 36

national ambient air quality standards (NAAQS)

level of protection - "adequate margin of safety"

Front 37

legislative background for NAAQS

Back 37

CAA directs EPA to identify air pollutants that may reasonably be anticipated to endanger public health

criteria are to reflect the latest scientific information used in indicating the kind and extent of all identifiable effects

the standard, in the judgement of the EPA administrator, allows for "an adequate margin of safety"

CAA requires periodic review and, if appropriate, revision of existing crieria and standards

CAA does not permit the EPA to consider costs in setting the NAAQS

Front 38

issues central to standard setting

Back 38

"all identifiable effects" are to be reviewed (the EPA is not free to define as adverse only those effects that are clearly harmful and about which there is medical consensus)

"adequate margin of safety" (the protect against effects that have not yet been uncovered by research, and effects whose medical significance is a matter of controversy and to be set low enough to protect the health of all susceptible groups within the population)

concept of threshold (assumption that a safe population dose exists)

Front 39

health bases for current NAAQ standards

Back 39

ozone - acute symptoms such as pain in breathing, irritative cough, and reduced vital capacity and FEV, etc.

NOx and VOCs - regulated largely on basis on controlling ozone formation via state and regional effects

PM - human mortality studies

CO - acute risk to people with cardiovascular disease

sulfur dioxide - control of acid rain is the major driver

lead - neurotoxicity to children

Front 40

how EPA standards are done

Back 40

scientific literature is the key to identification of adverse health effects

EPA must assess the potential that symptomatic effects are indicators of their more serious health effects

at the margin where effects are often subtle and reasonable scientists disagree about their importance, the EPA administrator must ultimately judge which effects should be regarded as "adverse" for standard-setting purposes

Front 41

hypersusceptibility

Back 41

an exaggerated response to a specific dose

pollutant specific

Front 42

criteria pollutants and their susceptible sub-populations

Back 42

SO2 - persons with increased airway reactivity (asthmatics)

CO - persons with arteriosclerotic disease affecting coronary vessels (angina patients)

Pb - fetus and children

PM10 - mortality (the elderly with cardiovascular and pulmonary disease), morbidity (children)

NO2 - children (respiratory illness)

O3 - active people, persons with pulmonary disease

Front 43

how were carbon monoxide settings created?

Back 43

doctor who used his patients with angina. put them on treadmills and drove them around los angeles.

Front 44

NAAQS ozone discussions

who benefits?

how many?

Back 44

who benefits?
construction workers, outdoor exercisers, those with impaired resistance to ozone

how many?
numbers based on risk analysis; will be hard to confirm epidemiologically

Front 45

the EPAs justification for proposed change (0.12 to 0.08 ppm)

Back 45

new scientific data show that ozone at levels below the previous standard causes significant adverse health effects

extend new health protection to 35 million, bringing to 113 million americans protected

Front 46

strategies for implementing standards

Back 46

technology driven control - best available technology on smokestacks, catalytic converters on cars

modify products - fuel additives (oxygenates - improve combustion)

restrict use - asbestos

ban - cholorofluorocarbons

disclose risk - california proposition 65 (seller must disclose risk of any known carcinogen or reproductive toxin contained in the product)

economic incentives - trade/sell pollutant emissions

Front 47

what else can be done (beyond standards)

Back 47

increased control of industrial activities and household activities that are known to contribute to air pollution

strategies to discourage automobile use and reduce the number of cars

stricter emission controls for automobiles

requirement for a certain number of zero-pollutant automobiles (electric cars)

improved public transportation and incentives for people to use it

mandatory car pooling

Front 48

copsa mica, romania

Back 48

67,000 tons of SO2, 500 tons of lead, 400 tons of zinc and 4 tins of cadmium released annually from two smelters

1989 - was one of the most polluted places in europe

highest infant mortality rate in europe

10% of population suffered "neuro-behavioral" problems

smelters shut down in 1993

Front 49

air pollution __(verb)__s

Back 49

travels

Front 50

hazardous pollutants (HAPs)

Back 50

1990 CAA amendment specified 188 pollutants or chemical groups

HAPs are more toxic than criteria pollutants

examples - heavy metals (chromium, mercury) and organics (benzene, perchloroethylene)

Front 51

air toxics sources

Back 51

point sources - 61%
(chemical plants, oil refineries, steel mills, aerospace manufacturers, marine tank vessel loading)

mobile sources - 21%
(gasoline has benzene in it --> amount increased when lead was removed form gasoline)

area sources - 18%
(dry cleaning operations, solvent cleaning, secondary lead smelters and chrome plating, commercial sterilizers)

Front 52

air toxics ambient air quality data

Back 52

release - 1993 ~8.1 million tons (national toxics release inventory)

no reliable network to measure ambient levels of air toxics

Front 53

health effects of air toxics

Back 53

little information available (most derived from experimental animal studies)

potential health effects (Cancer, neurological, cardiovascular, and respiratory effects; effects on liver, kidney, immune system, and reproductive system, and effects of fetal and child development)

about half of the HAPs have been classified as "known," "probable," or "possible" carcinogens

Front 54

method of control for air toxics

Back 54

because they may exhibit no threshold, and air quality standards would be inappropriate, site-specific emission standards are established instead (national toxic release inventory)

the emission standards must provide an ample (not simply adequate - as with the criteria pollutants) margin of safety

HAPs lack a monitoring system but the EPA does manage these inventories

Front 55

clean air act

Back 55

NAAQS - criteria pollutants
HAPs - old (now repealed approach) was health-based, the new approach is technology based with a "risk kicker" that applies to sources under technology standards

Front 56

HAPs technology based standards

Back 56

standards set according to what is available using available technology

"residual risks" are determined after the fact and perhaps more control applied at that point

Front 57

reasons for concern about indoor air pollution

Back 57

~75-90% of time is spent indoors

many air pollutants known to be hazardous to health are emitted indoors

indoor environments trap pollutants (levels may be 2 to 5 times higher than outside)

Front 58

air inside can be polluted as a result of...

Back 58

energy conservation measures (e.g. "air tightening" of buildings and lower ventilations standards)

building occupancy

human activities inside the structure

gas-off from synthetic building materials

forced air ventilation systems

biogenic pollutants (from biological organisms, e.g. fungi, aeropathogens, aeroallergens)

inflitration from outdoors

poor housing conditions (vermin and pets)

Front 59

air exchange rate

Back 59

rate at which air is replaced in the structure by external air - average from the american home is .7 to 1.0 changes per hour, tightly sealed homes without provisions for and exchange have ~0.2 air changes/hr

make-up air (from outside) - before 1973 - 15 CFM/person, after 1973 - 5.0 CFM/person

Front 60

health effects of indoor air pollutants

Back 60

irritation (eyes, nose, throat, upper airways, skin)

respiratory symptoms (wheezing couching, chest tightness, shortness of breath)

neurological symptoms (nausea, dizziness, headache, loss of coordination, tiredness, loss of concentration)

immunological reactions (inflammation, allergic reactions, delayed hypersensitivity)

asthma aggravation

increased susceptibility to respiratory infections

cancer

Front 61

major indoor air pollutants of concern

Back 61

combustion products
volatile chemicals and chemical mixtures
respirable particulates
biological pollutants
radon
odors

Front 62

sources of indoor air pollutants

Back 62

soil and groundwater - radon and radioactive progeny

building materials and furnishings - formaldehyde, asbestos, vinyl chloride, organic fumes

personal activities and hobbies - cigarette smoking, fireplace smoke

(more examples in slides)

Front 63

combustion products (scope of the problem)

Back 63

more than 1/2 of the world's population relies on dung, wood, crop waste, or coal to meet their most basic energy needs

cooking and heating with such solid fuels on open fired or stoves without chimneys leads to indoor air pollution

this indoor smoke contains a range of health-damaging pollutants including small soot or dust particles that are able to penetrate deep into the lungs

exposure is particularly high among women and children who spend most of their time near their domestic hearth

air pollution is responsible for one death every 20 seconds

Front 64

indoor smoke contains a variety of health-damaging pollutants

Back 64

particles (complex mixtures of chemicals in solid form droplets)

carbon monoxide

nitrous oxide

sulfur oxides (mainly from coal)

formaldehyde

carcinogens (chemical substances known to increase the risk of cancer)

Front 65

determinants of exposure to indoor air pollution

Back 65

the concentrations of pollutants in the indoor environment (mainly determined by the type of fuel and stove used, and the kitchen location)

the time that individuals spend in polluted environments

Front 66

disease issues

Back 66

pneumonia and other acute lower respiratory infections - globally they represent the single most important cause of death in children under 5 years (exposure to indoor air pollution more than doubles one's risk)

COPD - women exposed to indoor smoke are three times more likely to have COPD, the risk for men is doubled

lung cancer - exposure to smoke from coal fires doubles the risk for lung cancer

Front 67

wood burning emits high levels of

Back 67

particulate matter and CO

Front 68

role of biofuels in cooking and heating (developed vs. developing countries)

Back 68

developed - 3%

developing - 33%

Front 69

VOCs are taking in through what route?

Back 69

inhalation (volatile = gas)

Front 70

sources of VOCs in indoor air

Back 70

construction materials - foam insulation, carpet, glue, paint (emissions - methyl chloroform, formaldehyde, etc.)

structural components - vinyl tile, sheetrock (emissions - formaldehyde, benzene, etc.)

cleaners and solvent - liquid detergent, chlorine bleach, furniture wax (emissions - xylene, chloroform, benzene)

more examples on slides

Front 71

environmental tobacco smoke (ETS)

Back 71

non smokers will be exposed to smoke in the environment where there are other smokers

side stream - chemicals may be higher in concentration in the smoke coming off the tip of the cigarette than what the smoker is taking into their body

Front 72

ETS and children

Back 72

lower birth weights for infants of non-smoking mothers exposed to ETS during pregnancy

ETS exposure in pregnant women linked to growth retardation and congenital malformations in their babies

significant association - up to 40% increased risk of SIDS in infants exposed to ETS

extensive epidemiological evidence links ETS to an increased risk of lower respiratory tract illness such as bronchitis and pneumonia in children of parents who smoke

U.S. surgeon general report concluded that exposure to ETS can reduce lung infection in children

may contribute significantly to childhood asthma

Front 73

special environments

Back 73

airplanes (temperature, humidity, CO, ETS, infectious agents, pesticides on international fights)

others - xerox machine rooms, space heaters, public gathering places

Front 74

occupational environments

Back 74

with the onset of the energy crisis in the 1970s, buildigns in advanced countries were constructed to be energy efficient with less air exchange between the indoor air and the outdoor air. with this energy-efficient mindset, among the problems that arose in building were:

retention of higher temperatures

higher humidity levels

decreased ventilation

increased odor retention

Front 75

building related illness

Back 75

discrete, identifiable disease or illness
can be traced to a specific pollutant or sources within a building
cough, chest tightness, fever chills, muscle aches or more serious outcomes
legionaries disease, hypersensitivity pneumonitis, humidifier fever

Front 76

sick building syndrome (SBS)

Back 76

set of symptoms associated with time spent in building (respiratory tract irritation, skin irritation, headache, dizziness, nausea, fatigue, concentration problems)

symptoms diminish or cease when occupants leave the building

>20% of occupants report SBS

cannot be traced to specific pollutants or sources within the building

Front 77

regulatory jurisdictions

Back 77

outdoor air - EPA, clean air act

occupational air - OSHA

indoor air (apart from occupational air) - no specific federal laws, state and local jurisdictions regulate air quality in PUBLIC BUILDINGS (limit use of products that effect air quality, ventilation and air exchange standard rates, controlling activities)

private residence - must rely on education

Front 78

strategies to control indoor air pollution

Back 78

ventilation
source removal
source modification
air cleaning (pollutant removal)
education