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January 17, 2014

Air Pollution Blog Series

The ill-effects of air pollution

The American Cancer Society compared risk factor data for approximately 500,000 adults with the air pollution data from their respective metropolitan areas.  They combined this comparison data with vital status and cause-of-death data over a 16 year period (1982-1998).  Their findings:
Fine particulate and sulfur oxide–related pollution were associated with all-cause, lung cancer, and cardiopulmonary mortality. Each 10-µg/m3 elevation in fine particulate air pollution was associated with approximately a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer mortality, respectively. (1)
After controlling for smoking, education, marital status, BMI (body mass index), alcohol consumption, occupational exposure, regional differences, and diet variables the correlation remained between fine particulate air pollution and cardiopulmonary and lung cancer mortality. (1)
The risk imposed by exposure to fine particulate air pollution is obviously much smaller than the risk of cigarette smoking. (1)
Another famous study about 6 Massachusetts cities had similar findings plus it cited other studies that found:
Elevated levels of particulate air pollution have been associated with declines in lung function or with increases in respiratory symptoms such as cough, shortness of breath, wheezing, and asthma attacks. Other studies have found associations between particulate air pollution and rates of hospitalization, chronic obstructive pulmonary disease, and restricted activity due to illness. (2)

A European study, done in 2000, estimating the effects of pollution on public health in Austria, France and Switzerland found:

Air pollution caused 6% of total mortality or more than 40 000 attributable cases per year. About half of all mortality caused by air pollution was attributed to motorized traffic, accounting also for: more than 25 000 new cases of chronic bronchitis (adults); more than 290 000 episodes of bronchitis (children); more than 5 million asthma attacks; and more than 16 million person-days of restricted activities. (3)
Another study comparing air pollution, socio-economic, and asthma data determined that:
The effect of pollution is greater for children of lower socio-economic status (SES), indicating that pollution is one potential mechanism by which SES affects health. (4)

C. Arden Pope III, a nationally-notable atmospheric chemist and scholar on the health effects of pollution from BYU, did a review of many studies and articles on the health effects of air pollution in 2000 and concluded:

There is not a complete consensus of opinion about the human health effects of particulate air pollution.  Most reviewers, however, generally conclude that the overall epidemiologic evidence suggests that particulate air pollution, especially combustion-source pollution, common to many urban and industrial environments is an important risk factor for cardiopulmonary disease and mortality. (5) 
Recent daily time-series mortality studies...have also observed changes in daily death counts associated with short-term changes in particulate air pollution even at relatively low or moderate levels of air pollution...The relative risk of mortality increased with particulate concentrations in a near linear fashion....with no clear "threshold level" under which there are no effects...These (acute-response) studies often observed a lead-lag relationship between air pollution and mortality.  The results suggested that the increased mortality occurred concurrently or within 1-5 days following an increase in air pollution. (5)

The Utah Division of Air Quality warns that particle pollution has been associated with cardiac arrhythmias and heart attacks.  The NY Times has run articles correlating birth defects with air pollution in China.

The people most susceptible to the affects of air pollution are children, the elderly and those with chronic cardio-pulmonary diseases.  Most of the studies I read identified pm2.5 particulate pollution and sulfoxides as the culprits for the majority of adverse health effects. 

The case I'm trying to make here is that even for those skeptics who insist that correlation isn't causation, the body of evidence for health effects caused by particulate matter air pollution is pretty staggering.  Assuming that most people care about their health, I'd dare say that air pollution is a subject of concern for us all. 

Who's responsible?

Much of the particulate matter air pollution comes from combustion.  This could include electricity production by the burning of fossil fuels, burning of fuels to heat our homes and businesses, industrial processes such as oil refining or ore smelting, amongst other sources, but the majority of pollution in our area likely comes from our own vehicles' combustion.

The Division of Air Quality gives the estimated breakdown of pollution contribution: 57% from vehicles, 32% from houses, buildings and small businesses, and a final 11% coming from industry. 

Thus if you drive a vehicle or use public transportation, heat your house, use electricity or consume goods which require energy from production-related combustion, you're participating in the production of air pollution both directly and indirectly through consumption.  It's safe to say then that there's blame enough for everyone to get pegged--government, business, and people in general--even if it's by matter of degree.  This would imply a solution involving an adjustment in everyone's behavior.

What's being done about it?

Recently in Utah, Governor Herbert proposed a budget for the state government that includes funds for increased enforcement of no-burn days and to increase inspections of industry looking for violations such as gas or oil leaks.  It also provides funding to convert the school bus fleet to clean diesel or natural gas, as well as grants for small businesses who are known to be significant polluters to retrofit their operations.  Most of what the state government has done, however, involves asking people to voluntarily reduce their emissions, for instance by carpooling.  Considering, though, that as recently as New Year's Eve pm2.5 (particulate matter of 2.5 microns or less in size) reached high levels of over 80 ug/m3 in Salt Lake County, one has to wonder if voluntary measures, however valid they might be, will really be effective over the long term in reducing air pollution.  This is especially of concern when considering the ever growing population in Utah and the increasing density of population along the Wasatch Front where inversions are so prevalent. 
Many people have access to public transportation, but still choose to commute in their own vehicles.  Many people have access to electricity, natural gas or propane, but still choose to burn wood or coal to heat their homes.  Many people could buy more efficient vehicles, but still choose to buy less efficient vehicles.  Many could choose to lower their thermostat in winter and raise it in the summer, but don't because they don't like the discomfort.  The problem with voluntary recommendations is that many people choose what is most convenient for themselves.  More often than not to get people to do what is best for the community against self-interests you have to incentivize or regulate.

Governor Herbert has taken a mostly laissez-faire/recommendation-based stance on pollution regulation to promote economic growth in Utah.  Economic growth is a good thing for Utah.  It provides jobs, increases our standard of living and helps us keep pace with the demands of a growing population, but with some of the worst air quality in the United States and with knowledge of air pollution's negative impact on our health one has to question whether economic growth should take precedence over all other considerations.  I would advocate for a more balanced approach between economic growth and public health concerning pollution.  Besides, I doubt a choking haze will prove conducive to economic growth through tourism, prospective residents and prospective enterprises over the long-term anyhow. 

The growth and pollution paradox

Moving to a larger context, many of us want to see our standard of living increase over time.  We want, for ourselves and hopefully others, better access to education, healthcare, living conditions, food, fun, jobs, technologies, etc.  But there is a hidden paradox in the pursuit of a better quality of life......increased consumption of energy and thus, increased pollution. 

Hans Rosling, a Swedish medical doctor, academic, statistician and public speaker, has pointed out from UN gathered statistics about carbon dioxide emissions and the development of nations that as the economies of countries grow, so do their carbon dioxide emissions.  This is because developing a greater economy and modernizing a country requires a lot of energy, a lot of resources, and a lot of industry.  As technology stands today, the most reliable and readily usable sources for energy production are fossil fuels.  It may not always be the case, but so far no country has shaken the trend of better quality of life, higher consumption and higher pollution.  In fact, the top 3 billion economically well-off people on Earth use approximately 85% of the fossil fuel consumed each year.

In Utah, though we have reason to be concerned about the air pollution, one could always wonder about how much worse our pollution would be if we had to live with all of the consequences of our high-consumption lifestyles.  I wonder what the pollution would be like in Utah if all the products we consumed were manufactured and processed here rather than in China or India or any other country that we've outsourced our manufacturing and pollution to on our way to becoming a service-based economy?

What can be done?

Many things can be done and nealy everyone has a few ideas about how to improve the current state of affairs, but I'll give you some of my suggestions and other suggestions I've heard about here.  If you do have ideas for a solution, leave comments.

-According to Mark Clemens of the Utah branch of the Sierra Club, "Utah law is still stuck in the ridiculous position of specifically prohibiting state regulators from imposing air quality standards that are more stringent than those laid down by the federal government."  So a good first step would be for the Utah legislature to take away the barriers to legislative regulation of air quality standards.
-taking the necessary measures to comply with the current EPA standards which Utah has consistently failed to meet
-increase funding for retrofitting and renovating of businesses, homes and government buildings to boost energy efficiency
-updating infrastructure
-increase vehicle emission standards and increase MPG standards for new vehicles sold
-promoting innovations to improve traffic flow
-lower speed limits on high-speed highways and freeways 
-increase incentives for the use of more-efficient, less-polluting electricity, natural gas and propane for heating homes to further reduce the number of people who burn wood and coal
-reconsider 4 day workweeks for state employees
-stagger work hours of different industries to stagger rush hour traffic
-subsidizing solar, wind and other green-energy alternatives to supplement traditional energy sources
-invest in research and innovations for increasing efficiencies and reducing pollution across-the-board
-consider a pollution tax to disincentivize waste and to encourage alternatives to traditional energy sources
-offer tax credits or other incentives for people or businesses who buy newer, more-efficient vehicles and who invest in upgrading to more-efficient technologies
-redesigning our cities, suburbs and rural areas to reduce our commuter culture
-redesigning and upgrading homes and buildings
-continue to develop mass transit
-subsidize mass transit to make it a more affordable and attractive deal
-move away from "disposable" consumerism where it is easier to make cheap, disposable goods than quality, long-lasting goods
-promote environmental health and ecosystem services which help clean-up our messes
-invest in more and better air quality monitoring to be able to more accurately identify polluters who aren't meeting standards
-increase fines and taxes on those who can't bring their activities into compliance with the law
-anyone can help by reporting illegal wood burning to the Department of Air Quality on red-burn days, call: 801-536-4000

The creative possibilities at all levels of organization that could reduce air pollution are practically limitless as the imagination itself, but ideas aren't really what's lacking.  The implementation of ideas in government, business and private life is what's lacking here.
The forecast without substantial measures taken to curb air pollution is particularly bad considering that the population along the Wasatch Front is rapidly growing with no sign of leveling off.  Many want economic growth and realize the necessity of it to maintain our standard of living in a growing population, but money and progress are worthless gains without our health.  Perhaps to improve the quality of our air will require a slowing in the rate of economic growth, but ultimately I see no reason why economic growth and the promotion of public health must be seen as diametrically opposed.  Afterall, what good is the spirit of innovation if it can't solve pressing issues?

One last note

The burden of bad air pollution disproportionately affects the poor and those who already have bad health.  This is especially true for the poor or sickly who do not have health coverage.  While the governor has not yet ruled on whether to extend Medicaid benefits to the poor in Utah, it seems imperative for me to point out that right now the poor are twice negatively impacted by air pollution.  Once, for the ill-effects of air pollution and twice for not having funds to afford their own healthcare in the event bad air quality exacerbates a preexisting condition like asthma or creates a chronic condition like lung cancer or cardiopulmonary disease.

Knowing that air pollution results in so many short-term and long-term health effects and knowing that healthcare costs money for people, businesses and government, wouldn't it seem like good fiscal policy to invest in reducing air pollution?  Besides improving our health and reducing costs, many things that would improve air quality would also increase our overall quality of life and there's something even more basic about clean air, like the aesthetic beauty of the land and sky we've inherited and will leave to future generations.

-Seth Commichaux


1) Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution. 
C. Arden Pope III, PhD; Richard T. Burnett, PhD; Michael J. Thun, MD; Eugenia E. Calle, PhD; Daniel Krewski, PhD; Kazuhiko Ito, PhD; George D. Thurston, ScD
JAMA. 2002;287(9):1132-1141. doi:10.1001/jama.287.9.1132.

2) An Association between Air Pollution and Mortality in Six U.S. Cities.
Douglas W. Dockery, C. Arden Pope, Xiping Xu, John D. Spengler, James H. Ware, Martha E. Fay, Benjamin G. Ferris, Jr., and Frank E. Speizer
N Engl J Med 1993; 329:1753-1759December 9, 1993DOI: 10.1056/NEJM199312093292401

3) Public-health impact of outdoor and traffic-related air pollution: a European assessment. 

N Künzli MD a , R Kaiser MD b, S Medina MD b, M Studnicka MD c, O Chanel MD d, P Filliger PhD e, M Herry PhD f, F Horak MD g, V Puybonnieux-Texier MSc h, P Quénel MD b, J Schneider PhD i, R Seethaler MEc j, J-C Vergnaud PhD k, H Sommer PhD l

4) Air pollution, health, and socio-economic status: the effect of outdoor air quality on childhood asthma.
Matthew J. Neidell.  University of Chicago, CISES.

5) Review: Epidemiological Basis for Particulate Air Pollution Health Standards.

1 comment:

EnvironmentCare.in said...

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