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Healthy Air Matters:Health Effects of Air

Pollution

Janice NolenAssistant Vice President, National Policy

American Lung AssociationJanice.Nolen@Lung.org

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Air Pollution in the Past

1972 Birmingham

1966 New York City

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Air Pollution in the Past

“Separated here by only a narrow strip of water, the Four Corners Power Plan and a Navajo sheep herder represent two worlds.”

Four Corners Power Plant, May 1972

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November 3, 2010 at 11 AM from Clean Air Fairbanks

October 20, 2010 at 1:30 PM

Fairbanks, AK, haze from particulate matter

2010

Air Pollution in the Present

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Air Pollution in the Present

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Why tell people about air quality?

Someone in every family faces higher risk from air pollution

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Children, teens have growing lungs, spend more time outdoors, inhale more air per pound.

Children, teens face higher risk

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Aging brings a gradual decline in the body’s systems that makes us more vulnerable.

Older adults face higher risk

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Chronic diseases increase risk from air pollution

Having asthma or other lung diseases,cardiovascular disease or diabetes puts you at higher risk.

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Even healthy adults can face increased risk.

Working or exercising outdoors increases exposure, especially near highways.

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People with low incomes face increased risk.

Poorer people oftenlive closer to sources of pollution, may have higher incidence of disease, and less access to care.

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How does air pollution hurt us?

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Cause or Worsen Asthma

• Dust mites & cockroaches

• Mold & dampness

• Animal dander

• Tobacco smoke

• Traffic Pollution

• Nitrogen oxides

• Sulfur dioxide

• Ozone • Particulate Matter

• Pollen• Formaldehyde• Domestic birds• Fragrances• Wood burning

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Cause Cancer

• Radon (lung)

• Particulate matter (lung)

• Tobacco smoke (lung and others)

• Asbestos (lung cancer, mesothelioma)

• Formaldehyde

• Benzene and other VOCs

• Dioxins and Furans

• Arsenic (lung)

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Cause or Worsen Lung Disease

• Nitrogen oxides (risk of infection)

• Ozone and Particulate Matter (COPD)

• Tobacco Smoke

• Bacteria & viruses (pneumonia, influenza, colds, Legionella)

• Acid Gases

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Worsen Cardiovascular Disease

• Tobacco Smoke

• Particulate matter• Wood burning

• Ozone

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Harms or may harm central nervous system

• Carbon monoxide

• Pesticides

• Lead (learning impairment)

• Mercury

• Ozone

• Particulate Matter

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Harms reproduction or development

• Mercury• Particulate Matter• Carbon monoxide• Ozone• PAHs

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Kills people

• Carbon monoxide

• Particulate Matter

• Ozone

• Tobacco Smoke

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Our 16th Annual Report

• Puts air pollution into everyday language

• Gives public local information

• Focuses attention on ozone and particle pollution

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In 2011-2013, we found:

• Lower annual PM2.5 levels• 13 of the most polluted cities had

lowest ever

• Many more episodes of high PM2.5 24-hour

• Some cities had highest averages we’d seen

• Ozone mixed • Some better, some worse

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Reasons for improvement—Clean Air Act

The Clean Air Act tools at work:• New emissions control equipment on coal-fired power plants • Converting fleets of diesel trucks, buses,

trains, barges, tractors and heavy equipment to low-emissions vehicles

Clean Air Act

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• Warmer temperatures with climate change• Drought, wildfires, grassfires, dust• Warmer 2012 led to more ozone

• Ozone still better than 16 years ago• We’ve cleaned up a lot of raw ingredients for ozone

Heat

Reason for more particles and ozone?

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The News

In 2011-2013,

more than 4 people in 10

live in counties with an

F for ozone

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• Premature death• Coughing and wheezing• Asthma attacks• Worsening of COPD• Cardiovascular harm• May harm central nervous system• May increase risk of low birth weight

– US EPA, Integrated Science Assessment for Ozone and Related Photochemical Oxidants, 2013

Health effects of ozone

oxygen

oxygen

oxygen

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75 70 65 60

Current Standard High Range Mid-Range Low Range

EPA Staff recommended rangeEPA proposed range

Health and Medical

Community supports 60 ppb

CASAC preferred range

Options on the table

EPA taking comment on 60 ppb

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New findings show current standard needs to be stronger

Multiple chamber studies show ozone down to 60 ppb harms healthy adults. Adams (2002), Adams (2006), Brown et al (2008) and Kim et al (2011)

• Gold standard of testing—only ozone, only healthy adults, for 6.6 hours

• Solid evidence that concentrations >60 ppb risks many healthy adults, and most critically, susceptible populations

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New findings show current standard needs to be stronger

Epidemiological studies provide real-world evidence for the need for 60 ppb • 6 multi-city studies in the US and Canada• Looked at premature death and hospital/ ED

admissions• Increased risk shows up in most cities that would have

met a standard of 65 or 70 ppb.

Bell et al., 2006; Cakmak et al., 2006b; Dales et al., 2006; Katsouyanni et al., 2009, Mar and Koenig, 2009; Stieb et al, 2009

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Nationwide Benefits of Attaining Standard in 2025 Throughout the United States (except California)

Measure 60 ppb 65 ppb 70 ppb

Premature Deaths Avoided in 2025 7,900 4,300 1,440

Asthma Attacks Avoided in Children in 2025 1,800,000 960,000 320,000Respiratory Hospital Admissions Avoided in 2025 2,900 1,500 510

Asthma Emergency Department Visits Avoided in 2025 4,100 2,300 1,400

Missed School Days Avoided in 2025 1,900,000 1,000,000 330,000

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The more we look beyond

the lungs, the more risks we’re finding.

Here are a few.

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Uncovering newer risks from ozone

Ozone exposure likely causes cardiovascular harm

Human chamber studies suggest ozone causes heart rate variability.

Animal studies show evidence of harm in blood biomarkers.EPA ISA, 2013

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Uncovering newer risks from ozone

Evidence suggests that ozone exposure harms the central nervous system.

Studies in rats find similar impacts to the kinds shown in Alzheimer’s and Parkinson’s disease.

Human studies lacking here.

-EPA ISA 2013

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Uncovering newer risks from ozone

Stronger evidence of harm from long term exposure (30 days or longer)

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Uncovering newer risks from ozone

Long-term exposure to ozone is likely to cause respiratory harm.

Hospital admissions, ED visitsAsthma attacksNew onset asthma for people with specific genetic variants

EPA ISA 2013

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Uncovering newer risks from ozone

Evidence suggests that long term ozone exposure affects

-EPA ISA 2013

Cardiovascular harm

Reproduction and

Development

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Uncovering newer risks from ozone

Evidence suggests that long-term exposure to ozone causes:

Central nervous system harm

Premature death

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Push the White House to adopt stronger ozone standards

and a strong Clean Power Plan.

Outdoor air

Our Advocacy

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Our Advocacy

Bring

Healthy Air

Home

Reducing indoor

air pollution,

including radon

and smokefree

multifamily

housing

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Healthy Air is Core to our mission and vision

MissionTo save lives by

improving lung health and preventing lung

disease

VisionA world free of lung

disease

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Why do we fight for healthy air?

Millions of reasons

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Our Credo

We will breathe easier when the air in everyAmerican community is clean and healthy.

 We will breathe easier when people are free from the addictivegrip of tobacco and the debilitating effects of lung disease. 

We will breathe easier when the air in our public spaces andworkplaces is clear of secondhand smoke.

We will breathe easier when children no longerbattle airborne poisons or fear an asthma attack. 

Until then, we are fighting for air.