Air Quality Burden on Lung Health and Effective Strategies to...
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Maegan Weltzin, PhD Fairbanks Manager 907-891-7451 [email protected] Air Quality Burden on Lung Health and Effective Strategies to Improve Indoor Air Quality 1
Transcript of Air Quality Burden on Lung Health and Effective Strategies to...
Maegan Weltzin, PhD Fairbanks Manager
907-891-7451 [email protected]
Air Quality Burden on Lung Health and Effective Strategies to Improve Indoor Air Quality
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My Background
• PhD in Biochemistry and Molecular Biology • Ten years researching a receptor involved in nicotine addiction and
diseases • Ten peer-reviewed published manuscripts, two in preparation • Current Fairbanks office manager for the American Lung
Association Extracellular domain
Transmembrane domain
Intracellular domain
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Healthy Air, Healthy People, Healthy Communities The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease.
• Education • Advocacy • Research
Our vision is a world FREE OF LUNG DISEASE
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Our Vision: A World Free of Lung Disease
Lung Health Tobacco Control Healthy Air
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Why healthy air matters in Alaska • Asthma affects 1 in 10 families; it’s the #1 chronic illness keeping
kids home from school. • According to the ALA, in the FNSB currently: - Pediatric asthma: 2.2% - Adult Asthma: 6.0% - COPD: 3.0% (underdiagnosed)
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Why healthy air matters in Alaska • The State of AK Dept. of Health and Social Services reviewed FMH data and
FNSB PM2.5 air monitoring data - Determined that increases in PM2.5 concentrations were associated with
increased hospital visits for cardiac and respiratory conditions.
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CerebrovascularDisease Persons <
65 yrs
CerebrovascularDisease Persons >
65 yrs
Respiratory TractInfection Persons <
65 yrs
% In
crea
se a
fter a
10
ug/m
3 g
ain
in m
ean
24hr
[PM
2.5]
2003-2008 Increase in Next Day Hospital Visits
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Fairbanks needs healthy air!
State of the Air 2011-2016
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9 9 7
9 5 0
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2011 2012 2013 2014 2015 2016Ran
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etro
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State of the Air 24hr PM2.5 Rank
Not Ranked
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Not Ranked Not
Ranked
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0
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2011 2012 2013 2014 2015 2016
Ran
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Report Year
State of the Air Annual PM2.5 Rank
*Each time point is based on three years of data (ex. 2016 rank is derived from 2012, 2013 and 2014 data)
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Alaska’s Grades Alaska State of the Air 2016
For 24h Particle Pollution A Anchorage Municipality F Fairbanks North Star Borough C Juneau City And Borough F Matanuska-Susitna Borough
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Wildfire Season
Fire alerts indicate heat anomalies within a 1 km by 1 km area that are picked up by satellites, but do not measure the exact extent or intensity of the fire
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ber o
f Fire
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rts
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Wildfire Season
AK Division of Forestry
Fire northwest of Fairbanks, AK. Photo by USFS/Flickr
Year
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Western Montana PM2.5 Seasonal Trends Courthouse Annex-Libby
AIRS Code 300530018 POC 5 (ROUTINE)
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3/30
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9/11
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12/3
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2/23
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4/19
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6/13
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10/1
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11/2
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1/19
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3/14
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8/26
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12/1
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2/7/
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5/28
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7/22
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2/27
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4/23
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/07
Date
Conc
entra
tion
(µg/
m³)
PM2.5
24-hr National Ambient Air Quality Standards (NAAQS)
Annual NAAQS
Compliments of Marcy Ballman 11
Ambient/indoor comparison
Average indoor levels = 123.8 ± 27.3 μg/m3 Average outdoor levels = 169.1 ± 162.7 μg/m3
75% of ambient PM2.5 measured indoors.
Dylos Indoor Air Quality Monitor
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Indoor Air Quality (IAQ)
• People spend ~90% of time indoors
• Indoor air pollutants can cause allergic reactions, serious lung disease and even death
• Household burning of solid fuels is #4 risk factor for developing disease Radon
Asbestos
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Lin et al. (2012) The Lancet
Health Effects of Air Pollution General Irritation • Burning eyes • Nausea • Headaches Respiratory Issues • Coughing • Asthma attacks • Acute/Chronic bronchitis Cardiovascular Issues • Irregular heartbeat • Heart attack/Cardiac arrest
• Hospital and ER admissions • Premature death in people with lung or
heart issues 14
Asthma: A Randomized Trial of Indoor Smoke
Compliments of Marcy Ballman
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‘Placebo’ vs. Active Filters
Placebo Active
1-4 5-8 9-12 13-16 17-20 MERV Rating
Removes particles > 10.0 μm Pollen, dust mites, cockroach debris, sanding dust, spray paint dust, textile fibers, carpet fibers
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90% effective down to 0.3–1.0 μm Bacteria, cooking oil, smoke
~$4 ~$19
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IAQ and Wood Stove Changeouts
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1015202530354045
Wood Stove Filter Placebo
Pre-intervention Median
Post-intervention Median
PM
2.5 (
µg/m
3 )
-9%
-69%*
• Wood Stove Change out: - Expensive intervention
• $2,500- $4,500 per home - Not a huge impact in IAQ
PM2.5
• HEPA grade filters: - Big bang for your buck! - Cheap and significantly
reduced IAQ PM2.5.
Ward TJ et al., 2015
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Presenter
Presentation Notes
16 wood stove homes, 42 filter homes, 40 placebo homes
Active filter vs. Placebo to Reduce PM
02468
1012
Pre-intervention Post-intervention
Per
cent
Affe
ct
PM>2.5 PlaceboActive
0
5
10
15
20
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Pre Post
Per
cent
Affe
ct
PM2.5 PlaceboActive
PM>2.5 reduced by placebo filter (41%) and active filter (63%) PM2.5 reduced by active filter (70%) but not by placebo
Placebo filter reduces PM>2.5 but not PM2.5
Pre-intervention Post-intervention
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Bioaerosols • Mixture of solid or liquid particles in air
containing whole or parts of biological materials.
• Endotoxin- also known as Lipopolysaccharides (LPS) and are found on certain types of bacteria
• Endotoxin on coarse fraction particulate matter (PM>2.5= 2.5-10um) accounts for the majority of the ability of PM>2.5 to induce cytokine responses from alveolar macrophages.
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Presenter
Presentation Notes
Colony forming units (CFUs) PMx has 10x endotoxin than PM2.5
Bioaerosols and Respiratory Inflammation
• Healthy adult volunteers • Biological inactivation
reduces inflammatory potential of PM>2.5
Alexis NE et al., 2006
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Presenter
Presentation Notes
induced sputum was obtained 2 to 3 hours postinhalation for analysis of cellular and biochemical markers of inflammation and innate immune function Biological material on inhaled coarse fraction particulate matter activates airway phagocytes in vivo in healthy volunteers J Allergy and Clinical Immology (Alexis 2006) Neil E. Alexis, PhD,a John C. Lay, DVM, PhD,a Kirby Zeman, PhD,a William E. Bennett, PhD,a David B. Peden, MD, MS,a Joleen M. Soukup, MPH,b Robert B. Devlin, PhD,b and Susanne Becker, PhDb Chapel Hill, NC
Active filter vs. Placebo to Reduce Endotoxin
0100200300400500600
Pre-intervention Post-intervention
Endotoxin Found in Course Fraction
Placebo
Active
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Pre-intervention Post-intervention
Endotoxin Found in Air Sample
Placebo
Filter
Placebo filter reduces endotoxin 73% and 80% Active filter reduces endotoxin 90% and 92%
Both types of filters significantly reduce airborne endotoxin
EU
/mg
of P
Mc
mat
ter
EU
/m3 o
f air
sam
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Presenter
Presentation Notes
Active n=25 Placebo n=23 The endotoxin was collected using a filter-based sampler and the filter was then extracted in the lab to determine the endotoxin concentration. The sampler was connected to a little pump so it’s an airborne sample. It’s just a basic lab kit for determining the endotoxin concentration in the filter extract solution. Slide 25 has EU/mg and EU/m3, slight difference I know! EU stands for Endotoxin Units (it’s an standard scale made up by the companies that sell the analysis kits), so it is EU per mg of particulate matter collected (in this case, the coarse fraction), and the EU per volume (m3) of air sampled. It is commonly reported both ways, but it’s good to show that both measures are reduced at the same rate, indicating that it’s not just the coarse fraction particle mass that is being reduced but also the per mass content of endotoxin within the coarse fraction.
Summary of Air Filter Intervention
• Inexpensive filters reduce airborne endotoxin as significantly as HEPA-grade filters
• HEPA-grade filters are required to see significant reduction in PM2.5
• Publication pending in EHP
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Resources
Wood Stove Changeout Programs Air Filters
• Radon, mold, asbestoses testing, etc. • Look up Air Quality Index (airnow.gov) • http://fnsb.us/transportation/Pages/Air-Quality.aspx
http://fnsb.us/transportation/Pages/Air-Quality.aspx
Filtration systems
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What is ALAA doing to support clean air? Outdoor: • Involved in PM2.5 advocacy and education • Borough’s Air Pollution Control Commission
Indoor: • Educating on the harms of tobacco-smoke, e-cigarette vapor, radon
and wood smoke • Policy development for smoke-free
multi-unit housing • Spearheading efforts on statewide
smoke-free workplace campaign • Conducting survey of health care professionals
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Well-Known Health Effects of Secondhand Smoke • Contains more than 7,000 chemicals,
including >69 that cause cancer.
• Serious health hazard. • No risk-free level of secondhand smoke
exposure. • Non-smokers who are exposed to
secondhand smoke at home or work increase their heart disease and lung cancer risk up to 30 percent.
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Stroke
Why Smoke-Free Workplaces?
http://hlcc.pcccarson.org/
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Statewide Smoke-Free Workplace Law • Currently no statewide law in Alaska that prohibits smoking indoors
in public places, only local ordinances in some parts of the state.
Favor 69%
Oppose 28%
Unsure 3%
2016
Favored by margin of 2.5-to-1 Alaska Smoke-free Workplace Opinion Survey Dec 2015-Jan 2016
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Come Help Out!!
www.smokefreealaska.com
• Volunteer • Testify • Donate $
Maegan Weltzin, PhD Fairbanks Manager
529 6th Ave., Suite 203 Fairbanks, AK 99701
907-891-7451 [email protected]
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Oct. 4 and Nov. 1 at 5.30 FMH Cancer Treatment Center conference
