AIR POLLUTION AND HEALTH

AIR POLLUTION AND HEALTH MEDICAL EVIDENCE SUMMARY Clay Ballantine, M.D.

Medical Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of Death in U.S. ,[object Object],[object Object],[object Object]

Annual Deaths ,[object Object],[object Object],[object Object]

NC Medical Society Resolution ,[object Object]

4 Main Pollutants ,[object Object],[object Object],[object Object],[object Object]

Who is at Risk? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Health Problems ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Air Pollutants: Ground Level Ozone ,[object Object],[object Object],[object Object]

By 2010 vehicle use will grow 70% and electricity use 50%. By 2040 vehicle use will grow 170% and electricity 100%.

Air Pollutants: Ground Level Ozone ,[object Object],[object Object],[object Object],[object Object]

Ozone’s physiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Asthma Epidemic ,[object Object],[object Object]

Ozone and Asthma Attacks ,[object Object],[object Object],[object Object]

Ozone Reduces Lung Function BASELINE 2HR 4HR FEV1, % CHANGE -60 -40 -20 0 M-10

Asthma and Air Pollution ,[object Object],[object Object],Abt Associates report, 1999

North Carolina Summers ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ozone Causes Asthma ,[object Object],[object Object],McConnell, et al. Lancet 2002: 359: 386-91

Ozone: Asthma Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ozone: Other Effects ,[object Object],[object Object],[object Object],[object Object],[object Object]

Ozone Pollution Health Risks The ALA “Worst 25” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Air Pollutants: Particulates ,[object Object],[object Object],[object Object],[object Object]

Particulate Components ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Particulate Physiology ,[object Object],[object Object],[object Object]

Air Pollutants: Particulates ,[object Object],[object Object]

Two Different Immune System Responses ,[object Object],[object Object]

Diesel Exhaust Permanently Changes Immune Response ,[object Object],[object Object],[object Object],[object Object],[object Object],Nel, A.E., et al., J of Allergy and Clinical Immunology, 2001

Particulates and Asthma ,[object Object],[object Object]

PAH and Allergies ,[object Object],[object Object],Diaz-Sanchez J. All. Clin. Immun. Dec 2000 106

Particulates: Cardiac Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Particulates: Cardiac Effects ,[object Object]

Air Pollution and Next-Day Heart Attacks ,[object Object],[object Object],Increased Particulate Air Pollution and the Triggering of Myocardial Infarction Peters, et al.; Circulation, June 12, 2001, vol. 103

Traffic Emissions and Death ,[object Object],[object Object],[object Object],Hoek, G., et al. “Association between Mortality and Indicators of Traffic-related Air Pollution in the Netherlands: A Cohort Study” Lancet 360 (2002) 1203

Tunnel Workers Particulate Exposure Study ,[object Object],[object Object],[object Object],Bellander, T.,Dept. of Environmental Health, Sweden, WHO/HEI Conference March, 2001

Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution ,[object Object],[object Object],[object Object],[object Object],Pope, et al. JAMA 2002 ;287:1132-1141

Lung Cancer… (Pope, et al) ,[object Object],[object Object],[object Object],[object Object],Pope, et al. JAMA 2002 ;287:1132-1141

Lung Cancer… (Pope, et al) ,[object Object],[object Object],[object Object],Pope, et al. JAMA 2002 ;287:1132-1141

Air Pollution and Stroke Deaths ,[object Object],[object Object],[object Object],Effect of Air Pollutants on Acute Stroke Mortality. Hong, et al. Feb., 2002; Environmental Health Perspectives, v. 110. no.2

Long-term Effects of Particulate Pollution Exposure ,[object Object],[object Object],[object Object],[object Object],[object Object]

Lack of Threshold Effect: Nowhere to hide Daniels et al “NMMAPS” Am J Epidemiology v.152, no. 5. (2000)

Effects on Otherwise Healthy People ,[object Object],[object Object],[object Object],[object Object],[object Object]

Area Cities at Risk >15 mcg/m 3 PM 2.5 Weighted Annual Mean ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],EPA data 2000

WNC Health ,[object Object],[object Object],[object Object],[object Object],[object Object],NC State Center for Health Statistics, 1998

Effects on Children --A Generation at Risk-- ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Childhood asthma ,[object Object],[object Object],[object Object],[object Object],[object Object]

Asthma in Buncombe County ,[object Object],[object Object],[object Object],NC Dept. HHS-Div. Of Public Health, 2001

Air Pollution and Lung Function Growth-Part 1 ,[object Object],[object Object],[object Object],Association between Air Pollution and Lung Function Growth in Southern California Children. Gauderman, W., et al., Am J Respiratory and Critical Care Medicine, vol.166 (2002) pp.76-84 .

Air Pollution and Lung Function Growth-Part 2 ,[object Object],[object Object],The Effect of Air Pollution on Lung Development from 10 to 18 Years of Age Gauderman, W., et al., New England Journal of Medicine Vol. 351 (2004) pp 1057-1067

Results of Clean-up ,[object Object],[object Object],Friedman, M.S., et al. JAMA, V. 285, No. 7, 2001 Heinrich, J., et al., Am. J. Resp. and Crit. Care Med., V.161, 2000

Results of Clean-up ,[object Object],[object Object]

Air Pollution and Medical Care Costs ,[object Object],[object Object],[object Object],[object Object],Air Pollution and Medical Care Use by Older Americans: A Cross Area Analysis. Fuchs, Victor and Rosen, Sarah Health Affairs, vol. 21, no. 26 pp207-214

Air Pollution and Medical Care Costs ,[object Object],[object Object],Air Pollution and Medical Care Use by Older Americans: A Cross Area Analysis. Fuchs, Victor and Rosen, Sarah Health Affairs, vol. 21, no. 26 pp207-214

Air Pollution and Medical Care Costs ,[object Object],[object Object],[object Object],[object Object]

Annual Asthma Costs ,[object Object],[object Object],[object Object],[object Object],[object Object],NC Dept. HHS-Div. Of Public Health, 2001

Asthma in Buncombe County ,[object Object],[object Object],[object Object],[object Object],NC Dept. HHS-Div. Of Public Health, 2001

Cost Shifting-We all pay ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Southeast Region ,[object Object],[object Object],[object Object]

SAMI Data Independent analysis ,[object Object],[object Object]

Impaired Visibility = Particulates

5 Pieces to the Pollution Puzzle: ,[object Object],[object Object],[object Object],[object Object],[object Object]

5 Pieces to the Pollution Puzzle: ,[object Object],[object Object],[object Object],[object Object]

5 Pieces to the Pollution Puzzle: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

5 Pieces to the Pollution Puzzle: ,[object Object],[object Object],[object Object]

Final Points ,[object Object],[object Object],[object Object],[object Object],[object Object]

Web Sites ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

AIR POLLUTION AND HEALTH

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AIR POLLUTION AND HEALTH