Climate Change and Cardiovascular Health: A Systematic Review.

Importance: Climate change may increase the risk of adverse cardiovascular outcomes by causing direct physiologic changes, psychological distress, and disruption of health-related infrastructure. Yet, the association between numerous climate change-related environmental stressors and the incidence of adverse cardiovascular events has not been systematically reviewed. Objective: To review the current evidence on the association between climate change-related environmental stressors and adverse cardiovascular outcomes. Evidence Review: PubMed, Embase, Web of Science, and Cochrane Library were searched to identify peer-reviewed publications from January 1, 1970, through November 15, 2023, that evaluated associations between environmental exposures and cardiovascular mortality, acute cardiovascular events, and related health care utilization. Studies that examined only nonwildfire-sourced particulate air pollution were excluded. Two investigators independently screened 20 798 articles and selected 2564 for full-text review. Study quality was assessed using the Navigation Guide framework. Findings were qualitatively synthesized as substantial differences in study design precluded quantitative meta-analysis. Findings: Of 492 observational studies that met inclusion criteria, 182 examined extreme temperature, 210 ground-level ozone, 45 wildfire smoke, and 63 extreme weather events, such as hurricanes, dust storms, and droughts. These studies presented findings from 30 high-income countries, 17 middle-income countries, and 1 low-income country. The strength of evidence was rated as sufficient for extreme temperature; ground-level ozone; tropical storms, hurricanes, and cyclones; and dust storms. Evidence was limited for wildfire smoke and inadequate for drought and mudslides. Exposure to extreme temperature was associated with increased cardiovascular mortality and morbidity, but the magnitude varied with temperature and duration of exposure. Ground-level ozone amplified the risk associated with higher temperatures and vice versa. Extreme weather events, such as hurricanes, were associated with increased cardiovascular risk that persisted for many months after the initial event. Some studies noted a small increase in cardiovascular mortality, out-of-hospital cardiac arrests, and hospitalizations for ischemic heart disease after exposure to wildfire smoke, while others found no association. Older adults, racial and ethnic minoritized populations, and lower-wealth communities were disproportionately affected. Conclusions and Relevance: Several environmental stressors that are predicted to increase in frequency and intensity with climate change are associated with increased cardiovascular risk, but data on outcomes in low-income countries are lacking. Urgent action is needed to mitigate climate change-associated cardiovascular risk, particularly in vulnerable populations.

Improved biomass burning emissions from 1750 to 2010 using ice core records and inverse modeling.

Estimating fire emissions prior to the satellite era is challenging because observations are limited, leading to large uncertainties in the calculated aerosol climate forcing following the preindustrial era. This challenge further limits the ability of climate models to accurately project future climate change. Here, we reconstruct a gridded dataset of global biomass burning emissions from 1750 to 2010 using inverse analysis that leveraged a global array of 31 ice core records of black carbon deposition fluxes, two different historical emission inventories as a priori estimates, and emission-deposition sensitivities simulated by the atmospheric chemical transport model GEOS-Chem. The reconstructed emissions exhibit greater temporal variabilities which are more consistent with paleoclimate proxies. Our ice core constrained emissions reduced the uncertainties in simulated cloud condensation nuclei and aerosol radiative forcing associated with the discrepancy in preindustrial biomass burning emissions. The derived emissions can also be used in studies of ocean and terrestrial biogeochemistry.

Data-Driven Placement of PM2.5 Air Quality Sensors in the United States: An Approach to Target Urban Environmental Injustice.

In the United States, citizens and policymakers heavily rely upon Environmental Protection Agency mandated regulatory networks to monitor air pollution; increasingly they also depend on low-cost sensor networks to supplement spatial gaps in regulatory monitor networks coverage. Although these regulatory and low-cost networks in tandem provide enhanced spatiotemporal coverage in urban areas, low-cost sensors are located often in higher income, predominantly White areas. Such disparity in coverage may exacerbate existing inequalities and impact the ability of different communities to respond to the threat of air pollution. Here we present a study using cost-constrained multiresolution dynamic mode decomposition (mrDMDcc) to identify the optimal and equitable placement of fine particulate matter (PM2.5) sensors in four U.S. cities with histories of racial or income segregation: St. Louis, Houston, Boston, and Buffalo. This novel approach incorporates the variation of PM2.5 on timescales ranging from 1 day to over a decade to capture air pollution variability. We also introduce a cost function into the sensor placement optimization that represents the balance between our objectives of capturing PM2.5 extremes and increasing pollution monitoring in low-income and nonwhite areas. We find that the mrDMDcc algorithm places a greater number of sensors in historically low-income and nonwhite neighborhoods with known environmental pollution problems compared to networks using PM2.5 information alone. Our work provides a roadmap for the creation of equitable sensor networks in U.S. cities and offers a guide for democratizing air pollution data through increasing spatial coverage of low-cost sensors in less privileged communities.

Aerosol-Radiation Interactions in China in Winter: Competing Effects of Reduced Shortwave Radiation and Cloud-Snowfall-Albedo Feedbacks Under Rapidly Changing Emissions.

Since 2013, Chinese policies have dramatically reduced emissions of particulates and their gas-phase precursors, but the implications of these reductions for aerosol-radiation interactions are unknown. Using a global, coupled chemistry-climate model, we examine how the radiative impacts of Chinese air pollution in the winter months of 2012 and 2013 affect local meteorology and how these changes may, in turn, influence surface concentrations of PM2.5, particulate matter with diameter <2.5 µm. We then investigate how decreasing emissions through 2016 and 2017 alter this impact. We find that absorbing aerosols aloft in winter 2012 and 2013 heat the middle- and lower troposphere by ∼0.5-1 K, reducing cloud liquid water, snowfall, and snow cover. The subsequent decline in surface albedo appears to counteract the ∼15-20 W m-2 decrease in shortwave radiation reaching the surface due to attenuation by aerosols overhead. The net result of this novel cloud-snowfall-albedo feedback in winters 2012-2013 is a slight increase in surface temperature of ∼0.5-1 K in some regions and little change elsewhere. The aerosol heating aloft, however, stabilizes the atmosphere and decreases the seasonal mean planetary boundary layer (PBL) height by ∼50 m. In winter 2016 and 2017, the ∼20% decrease in mean PM2.5 weakens the cloud-snowfall-albedo feedback, though it is still evident in western China, where the feedback again warms the surface by ∼0.5-1 K. Regardless of emissions, we find that aerosol-radiation interactions enhance mean surface PM2.5 pollution by 10%-20% across much of China during all four winters examined, mainly though suppression of PBL heights.

Rapid rise in premature mortality due to anthropogenic air pollution in fast-growing tropical cities from 2005 to 2018.

Tropical cities are experiencing rapid growth but lack routine air pollution monitoring to develop prescient air quality policies. Here, we conduct targeted sampling of recent (2000s to 2010s) observations of air pollutants from space-based instruments over 46 fast-growing tropical cities. We quantify significant annual increases in nitrogen dioxide (NO2) (1 to 14%), ammonia (2 to 12%), and reactive volatile organic compounds (1 to 11%) in most cities, driven almost exclusively by emerging anthropogenic sources rather than traditional biomass burning. We estimate annual increases in urban population exposure to air pollutants of 1 to 18% for fine particles (PM2.5) and 2 to 23% for NO2 from 2005 to 2018 and attribute 180,000 (95% confidence interval: -230,000 to 590,000) additional premature deaths in 2018 (62% increase relative to 2005) to this increase in exposure. These cities are predicted to reach populations of up to 80 million people by 2100, so regulatory action targeting emerging anthropogenic sources is urgently needed.

Catalytic role of formaldehyde in particulate matter formation.

Formaldehyde (HCHO), the simplest and most abundant carbonyl in the atmosphere, contributes to particulate matter (PM) formation via two in-cloud processing pathways. First, in a catalytic pathway, HCHO reacts with hydrogen peroxide (H2O2) to form hydroxymethyl hydroperoxide (HMHP), which rapidly oxidizes dissolved sulfur dioxide (SO2,aq) to sulfate, regenerating HCHO. Second, HCHO reacts with dissolved SO2,aq to form hydroxymethanesulfonate (HMS), which upon oxidation with the hydroxyl radical (OH) forms sulfate and also reforms HCHO. Chemical transport model simulations using rate coefficients from laboratory studies of the reaction rate of HMHP with SO2,aq show that the HMHP pathways reduce the SO2 lifetime by up to a factor of 2 and contribute up to ∼18% of global sulfate. This contribution rises to >50% in isoprene-dominated regions such as the Amazon. Combined with recent results on HMS, this work demonstrates that the one-carbon molecules HMHP and HCHO contribute significantly to global PM, with HCHO playing a crucial catalytic role.

Estimating the health effects of environmental mixtures using principal stratification.

The control of ambient air quality in the United States has been a major public health success since the passing of the Clean Air Act, with particulate matter (PM) reductions resulting in an estimated 160 000 premature deaths prevented in 2010 alone. Currently, public policy is oriented around lowering the levels of individual pollutants and this focus has driven the nature of much epidemiological research. Recently, attention has been given to viewing air pollution as a complex mixture and to developing a multi-pollutant approach to controlling ambient concentrations. We present a statistical approach for estimating the health impacts of complex environmental mixtures using a mixture-altering contrast, which is any comparison, intervention, policy, or natural experiment that changes a mixture's composition. We combine the notion of mixture-altering contrasts with sliced inverse regression, propensity score matching, and principal stratification to assess the health effects of different air pollution chemical mixtures. We demonstrate the application of this approach in an analysis of the health effects of wildfire PM air pollution in the Western US.

Excess of COVID-19 cases and deaths due to fine particulate matter exposure during the 2020 wildfires in the United States.

The year 2020 brought unimaginable challenges in public health, with the confluence of the COVID-19 pandemic and wildfires across the western United States. Wildfires produce high levels of fine particulate matter (PM2.5). Recent studies reported that short-term exposure to PM2.5 is associated with increased risk of COVID-19 cases and deaths. We acquired and linked publicly available daily data on PM2.5, the number of COVID-19 cases and deaths, and other confounders for 92 western U.S. counties that were affected by the 2020 wildfires. We estimated the association between short-term exposure to PM2.5 during the wildfires and the epidemiological dynamics of COVID-19 cases and deaths. We adjusted for several time-varying confounding factors (e.g., weather, seasonality, long-term trends, mobility, and population size). We found strong evidence that wildfires amplified the effect of short-term exposure to PM2.5 on COVID-19 cases and deaths, although with substantial heterogeneity across counties.

Improved estimates of preindustrial biomass burning reduce the magnitude of aerosol climate forcing in the Southern Hemisphere.

Fire plays a pivotal role in shaping terrestrial ecosystems and the chemical composition of the atmosphere and thus influences Earth's climate. The trend and magnitude of fire activity over the past few centuries are controversial, which hinders understanding of preindustrial to present-day aerosol radiative forcing. Here, we present evidence from records of 14 Antarctic ice cores and 1 central Andean ice core, suggesting that historical fire activity in the Southern Hemisphere (SH) exceeded present-day levels. To understand this observation, we use a global fire model to show that overall SH fire emissions could have declined by 30% over the 20th century, possibly because of the rapid expansion of land use for agriculture and animal production in middle to high latitudes. Radiative forcing calculations suggest that the decreasing trend in SH fire emissions over the past century largely compensates for the cooling effect of increasing aerosols from fossil fuel and biofuel sources.

Global mortality from outdoor fine particle pollution generated by fossil fuel combustion: Results from GEOS-Chem.

The burning of fossil fuels - especially coal, petrol, and diesel - is a major source of airborne fine particulate matter (PM2.5), and a key contributor to the global burden of mortality and disease. Previous risk assessments have examined the health response to total PM2.5, not just PM2.5 from fossil fuel combustion, and have used a concentration-response function with limited support from the literature and data at both high and low concentrations. This assessment examines mortality associated with PM2.5 from only fossil fuel combustion, making use of a recent meta-analysis of newer studies with a wider range of exposure. We also estimated mortality due to lower respiratory infections (LRI) among children under the age of five in the Americas and Europe, regions for which we have reliable data on the relative risk of this health outcome from PM2.5 exposure. We used the chemical transport model GEOS-Chem to estimate global exposure levels to fossil-fuel related PM2.5 in 2012. Relative risks of mortality were modeled using functions that link long-term exposure to PM2.5 and mortality, incorporating nonlinearity in the concentration response. We estimate a global total of 10.2 (95% CI: -47.1 to 17.0) million premature deaths annually attributable to the fossil-fuel component of PM2.5. The greatest mortality impact is estimated over regions with substantial fossil fuel related PM2.5, notably China (3.9 million), India (2.5 million) and parts of eastern US, Europe and Southeast Asia. The estimate for China predates substantial decline in fossil fuel emissions and decreases to 2.4 million premature deaths due to 43.7% reduction in fossil fuel PM2.5 from 2012 to 2018 bringing the global total to 8.7 (95% CI: -1.8 to 14.0) million premature deaths. We also estimated excess annual deaths due to LRI in children (0-4 years old) of 876 in North America, 747 in South America, and 605 in Europe. This study demonstrates that the fossil fuel component of PM2.5 contributes a large mortality burden. The steeper concentration-response function slope at lower concentrations leads to larger estimates than previously found in Europe and North America, and the slower drop-off in slope at higher concentrations results in larger estimates in Asia. Fossil fuel combustion can be more readily controlled than other sources and precursors of PM2.5 such as dust or wildfire smoke, so this is a clear message to policymakers and stakeholders to further incentivize a shift to clean sources of energy.

Global Importance of Hydroxymethanesulfonate in Ambient Particulate Matter: Implications for Air Quality.

Sulfur compounds are an important constituent of particulate matter, with impacts on climate and public health. While most sulfur observed in particulate matter has been assumed to be sulfate, laboratory experiments reveal that hydroxymethanesulfonate (HMS), an adduct formed by aqueous phase chemical reaction of dissolved HCHO and SO2, may be easily misinterpreted in measurements as sulfate. Here we present observational and modeling evidence for a ubiquitous global presence of HMS. We find that filter samples collected in Shijiazhuang, China, and examined with ion chromatography within 9 days show as much as 7.6 µg m-3 of HMS, while samples from Singapore examined 9-18 months after collection reveal ~0.6 µg m-3 of HMS. The Shijiazhuang samples show only minor traces of HMS 4 months later, suggesting that HMS had decomposed over time during sample storage. In contrast, the Singapore samples do not clearly show a decline in HMS concentration over 2 months of monitoring. Measurements from over 150 sites, primarily derived from the IMPROVE network across the United States, suggest the ubiquitous presence of HMS in at least trace amounts as much as 60 days after collection. The degree of possible HMS decomposition in the IMPROVE observations is unknown. Using the GEOS-Chem chemical transport model, we estimate that HMS may account for 10% of global particulate sulfur in continental surface air and over 25% in many polluted regions. Our results suggest that reducing emissions of HCHO and other volatile organic compounds may have a co-benefit of decreasing particulate sulfur.

An Ensemble Learning Approach for Estimating High Spatiotemporal Resolution of Ground-Level Ozone in the Contiguous United States.

In this paper, we integrated multiple types of predictor variables and three types of machine learners (neural network, random forest, and gradient boosting) into a geographically weighted ensemble model to estimate the daily maximum 8 h O3 with high resolution over both space (at 1 km × 1 km grid cells covering the contiguous United States) and time (daily estimates between 2000 and 2016). We further quantify monthly model uncertainty for our 1 km × 1 km gridded domain. The results demonstrate high overall model performance with an average cross-validated R2 (coefficient of determination) against observations of 0.90 and 0.86 for annual averages. Overall, the model performance of the three machine learning algorithms was quite similar. The overall model performance from the ensemble model outperformed those from any single algorithm. The East North Central region of the United States had the highest R2, 0.93, and performance was weakest for the western mountainous regions (R2 of 0.86) and New England (R2 of 0.87). For the cross validation by season, our model had the best performance during summer with an R2 of 0.88. This study can be useful for the environmental health community to more accurately estimate the health impacts of O3 over space and time, especially in health studies at an intra-urban scale.

Air pollution from wildfires and human health vulnerability in Alaskan communities under climate change.

Alaskan wildfires are becoming more frequent and severe, but very little is known regarding exposure to wildfire smoke, a risk factor for respiratory and cardiovascular illnesses. We estimated long-term, present-day and future exposure to wildfire-related fine particulate matter (PM2.5) across Alaska for the general population and subpopulations to assess vulnerability using observed data for the present day (1997-2010), modelled estimates for the present day (1997-2001), and modelled estimates for the future (2047-2051). First, we assessed wildfire-PM2.5 exposure by estimating monthly-average wildfire-specific PM2.5 levels across 1997-2010 for 158 Alaskan census tracts, using atmospheric transport modelling based on observed area-burned data. Second, we estimated changes in future (2047-2051) wildfire-PM2.5 exposure compared to the present-day (1997-2001) by estimating the monthly-average wildfire-specific PM2.5 levels for 29 boroughs/census areas (county-equivalent areas), under the Intergovernmental Panel on Climate Change (IPCC) A1B scenario from an ensemble of 13 climate models. Subpopulation risks for present and future exposure levels were estimated by summing area-weighted exposure levels utilizing the 2000 Census and State of Alaska's population projections. We assessed vulnerability by several subpopulation characteristics (e.g. race/ethnicity, urbanicity). Wildfire-PM2.5 exposure levels during 1997-2010 were highest in interior Alaska during July. Among subpopulations, average summer (June-August) exposure levels for urban dwellers and African-American/Blacks were highest at 9.1 µg m-3 and 10 µg m-3, respectively. Estimated wildfire-PM2.5 varied by Native American tribe, ranging from average summer levels of 2.4 µg m-3 to 13 µg m-3 for Tlingit-Haida and Alaskan Athabascan tribes, respectively. Estimates indicate that by the mid-21st century, under climate change, almost all of Alaska could be exposed to increases of 100% or more in levels of wildfire-specific PM2.5 levels. Exposure to wildfire-PM2.5 likely presents a substantial public health burden in the present day for Alaska communities, with different impacts by subpopulation. Under climate change, wildfire smoke could pose an even greater public health risks for most Alaskans.

Assessing NO2 Concentration and Model Uncertainty with High Spatiotemporal Resolution across the Contiguous United States Using Ensemble Model Averaging.

NO2 is a combustion byproduct that has been associated with multiple adverse health outcomes. To assess NO2 levels with high accuracy, we propose the use of an ensemble model to integrate multiple machine learning algorithms, including neural network, random forest, and gradient boosting, with a variety of predictor variables, including chemical transport models. This NO2 model covers the entire contiguous U.S. with daily predictions on 1-km-level grid cells from 2000 to 2016. The ensemble produced a cross-validated R2 of 0.788 overall, a spatial R2 of 0.844, and a temporal R2 of 0.729. The relationship between daily monitored and predicted NO2 is almost linear. We also estimated the associated monthly uncertainty level for the predictions and address-specific NO2 levels. This NO2 estimation has a very high spatiotemporal resolution and allows the examination of the health effects of NO2 in unmonitored areas. We found the highest NO2 levels along highways and in cities. We also observed that nationwide NO2 levels declined in early years and stagnated after 2007, in contrast to the trend at monitoring sites in urban areas, where the decline continued. Our research indicates that the integration of different predictor variables and fitting algorithms can achieve an improved air pollution modeling framework.

Air Quality and Health Impact of Future Fossil Fuel Use for Electricity Generation and Transport in Africa.

Africa has ambitious plans to address energy deficits and sustain economic growth with fossil fueled power plants. The continent is also experiencing faster population growth than anywhere else in the world that will lead to proliferation of vehicles. Here, we estimate air pollutant emissions in Africa from future (2030) electricity generation and transport. We find that annual emissions of two precursors of fine particles (PM2.5) hazardous to health, sulfur dioxide (SO2) and nitrogen oxides (NOx), approximately double by 2030 relative to 2012, increasing from 2.5 to 5.5 Tg SO2 and 1.5 to 2.8 Tg NOx. We embed these emissions in the GEOS-Chem model nested over the African continent to simulate ambient concentrations of PM2.5 and determine the burden of disease (excess deaths) attributable to exposure to future fossil fuel use. We calculate 48000 avoidable deaths in 2030 (95% confidence interval: 6000-88000), mostly in South Africa (10400), Nigeria (7500), and Malawi (2400), with 3-times higher mortality rates from power plants than transport. Sensitivity of the burden of disease to either population growth or air quality varies regionally and suggests that emission mitigation strategies would be most effective in Southern Africa, whereas population growth is the main driver everywhere else.

Effects of Increasing Aridity on Ambient Dust and Public Health in the U.S. Southwest Under Climate Change.

The U.S. Southwest is projected to experience increasing aridity due to climate change. We quantify the resulting impacts on ambient dust levels and public health using methods consistent with the Environmental Protection Agency's Climate Change Impacts and Risk Analysis framework. We first demonstrate that U.S. Southwest fine (PM2.5) and coarse (PM2.5-10) dust levels are strongly sensitive to variability in the 2-month Standardized Precipitation-Evapotranspiration Index across southwestern North America. We then estimate potential changes in dust levels through 2099 by applying the observed sensitivities to downscaled meteorological output projected by six climate models following an intermediate (Representative Concentration Pathway 4.5, RCP4.5) and a high (RCP8.5) greenhouse gas concentration scenario. By 2080-2099 under RCP8.5 relative to 1986-2005 in the U.S. Southwest: (1) Fine dust levels could increase by 57%, and fine dust-attributable all-cause mortality and hospitalizations could increase by 230% and 360%, respectively; (2) coarse dust levels could increase by 38%, and coarse dust-attributable cardiovascular mortality and asthma emergency department visits could increase by 210% and 88%, respectively; (3) climate-driven changes in dust concentrations can account for 34-47% of these health impacts, with the rest due to increases in population and baseline incidence rates; and (4) economic damages of the health impacts could total $47 billion per year additional to the 1986-2005 value of $13 billion per year. Compared to national-scale climate impacts projected for other U.S. sectors using the Climate Change Impacts and Risk Analysis framework, dust-related mortality ranks fourth behind extreme temperature-related mortality, labor productivity decline, and coastal property loss.

An ensemble-based model of PM2.5 concentration across the contiguous United States with high spatiotemporal resolution.

Various approaches have been proposed to model PM2.5 in the recent decade, with satellite-derived aerosol optical depth, land-use variables, chemical transport model predictions, and several meteorological variables as major predictor variables. Our study used an ensemble model that integrated multiple machine learning algorithms and predictor variables to estimate daily PM2.5 at a resolution of 1 km × 1 km across the contiguous United States. We used a generalized additive model that accounted for geographic difference to combine PM2.5 estimates from neural network, random forest, and gradient boosting. The three machine learning algorithms were based on multiple predictor variables, including satellite data, meteorological variables, land-use variables, elevation, chemical transport model predictions, several reanalysis datasets, and others. The model training results from 2000 to 2015 indicated good model performance with a 10-fold cross-validated R2 of 0.86 for daily PM2.5 predictions. For annual PM2.5 estimates, the cross-validated R2 was 0.89. Our model demonstrated good performance up to 60 µg/m3. Using trained PM2.5 model and predictor variables, we predicted daily PM2.5 from 2000 to 2015 at every 1 km × 1 km grid cell in the contiguous United States. We also used localized land-use variables within 1 km × 1 km grids to downscale PM2.5 predictions to 100 m × 100 m grid cells. To characterize uncertainty, we used meteorological variables, land-use variables, and elevation to model the monthly standard deviation of the difference between daily monitored and predicted PM2.5 for every 1 km × 1 km grid cell. This PM2.5 prediction dataset, including the downscaled and uncertainty predictions, allows epidemiologists to accurately estimate the adverse health effect of PM2.5. Compared with model performance of individual base learners, an ensemble model would achieve a better overall estimation. It is worth exploring other ensemble model formats to synthesize estimations from different models or from different groups to improve overall performance.

Air pollution accountability of energy transitions: the relative importance of point source emissions and wind fields in exposure changes.

Recent studies have sought epidemiological evidence of the effectiveness of energy transitions. Such evidence often relies on so-called "natural experiments," wherein environmental and/or health outcomes are assessed before, during, and after the transition of interest. Often, these studies attribute air pollution exposure changes-either modeled or measured-directly to the transition. We formalize a framework for separating the fractions of a given exposure change attributable to meteorological variability and emissions changes. Using this framework, we quantify relative impacts of wind variability and emissions changes from coal-fired power plants on exposure to SO2 emissions across the United States under three unique combinations of spatial-temporal and source scales. We find that the large emissions reductions achieved by United States coal-fired power plants after 2005 dominated population exposure changes. In each of the three case studies, however, we identified periods and regions in which meteorology dampened or accentuated differences in total exposure relative to exposure change expected from emissions reductions alone. The results evidence a need for separating meteorology-induced variability in exposure when attributing health impacts to specific energy transitions.

Fires, Smoke Exposure, and Public Health: An Integrative Framework to Maximize Health Benefits From Peatland Restoration.

Emissions of particulate matter from fires associated with land management practices in Indonesia contribute to regional air pollution and mortality. We assess the public health benefits in Indonesia, Malaysia, and Singapore from policies to reduce fires by integrating information on fire emissions, atmospheric transport patterns, and population exposure to fine particulate matter (PM2.5). We use adjoint sensitivities to relate fire emissions to PM2.5 for a range of meteorological conditions and find that a Business-As-Usual scenario of land use change leads, on average, to 36,000 excess deaths per year into the foreseeable future (the next several decades) across the region. These deaths are largely preventable with fire reduction strategies, such as blocking fires in peatlands, industrial concessions, or protected areas, which reduce the health burden by 66, 45, and 14%, respectively. The effectiveness of these different strategies in mitigating human health impacts depends on the location of fires relative to the population distribution. For example, protecting peatlands through eliminating all fires on such lands would prevent on average 24,000 excess deaths per year into the foreseeable future across the region because, in addition to storing large amounts of fuel, many peatlands are located directly upwind of densely populated areas. We also demonstrate how this framework can be used to prioritize restoration locations for the Indonesian Peatland Restoration Agency based on their ability to reduce pollution exposure and health burden. This scientific framework is publicly available through an online decision support tool that allows stakeholders to readily determine the public health benefits of different land management strategies.

Strengthened scientific support for the Endangerment Finding for atmospheric greenhouse gases.

We assess scientific evidence that has emerged since the U.S. Environmental Protection Agency's 2009 Endangerment Finding for six well-mixed greenhouse gases and find that this new evidence lends increased support to the conclusion that these gases pose a danger to public health and welfare. Newly available evidence about a wide range of observed and projected impacts strengthens the association between the risk of some of these impacts and anthropogenic climate change, indicates that some impacts or combinations of impacts have the potential to be more severe than previously understood, and identifies substantial risk of additional impacts through processes and pathways not considered in the Endangerment Finding.