Health benefits of decreases in on-road transportation emissions in the United States from 2008 to 2017.

Decades of air pollution regulation have yielded enormous benefits in the United States, but vehicle emissions remain a climate and public health issue. Studies have quantified the vehicle-related fine particulate matter (PM2.5)-attributable mortality but lack the combination of proper counterfactual scenarios, latest epidemiological evidence, and detailed spatial resolution; all needed to assess the benefits of recent emission reductions. We use this combination to assess PM2.5-attributable health benefits and also assess the climate benefits of on-road emission reductions between 2008 and 2017. We estimate total benefits of $270 (190 to 480) billion in 2017. Vehicle-related PM2.5-attributable deaths decreased from 27,700 in 2008 to 19,800 in 2017; however, had per-mile emission factors remained at 2008 levels, 48,200 deaths would have occurred in 2017. The 74% increase from 27,700 to 48,200 PM2.5-attributable deaths with the same emission factors is due to lower baseline PM2.5 concentrations (+26%), more vehicle miles and fleet composition changes (+22%), higher baseline mortality (+13%), and interactions among these (+12%). Climate benefits were small (3 to 19% of the total). The percent reductions in emissions and PM2.5-attributable deaths were similar despite an opportunity to achieve disproportionately large health benefits by reducing high-impact emissions of passenger light-duty vehicles in urban areas. Increasingly large vehicles and an aging population, increasing mortality, suggest large health benefits in urban areas require more stringent policies. Local policies can be effective because high-impact primary PM2.5 and NH3 emissions disperse little outside metropolitan areas. Complementary national-level policies for NOx are merited because of its substantial impacts-with little spatial variability-and dispersion across states and metropolitan areas.

Health Benefits from Upgrading Public Buses for Cleaner Air: A Case Study of Clark County, Nevada and the United States.

Public transit buses, which move more than 5 billion passengers annually in the United States (U.S.), can contribute substantially to the environmental health burden through emitted air pollutants. As a leader in transforming to cleaner bus fleets, the Regional Transport Commission of Southern Nevada (RTC) has been transitioning from diesel to compressed natural gas (CNG) transit buses since 1999. By 2017, ~75% of RTC's buses operating in Clark County, Nevada were CNG-powered. This study assesses the health benefits of the venture using the US Environmental Protection Agency's (EPA) Co-Benefits Risk Assessment (COBRA) model, considering the emission and exposure changes from the 2017 baseline for two hypothetical scenarios: (1) no transition (CC_D) and (2) complete transition (CC_N). The CC_D scenario shows realized health benefits, mostly due to avoided mortality, of $0.79⁻8.21 million per year for 2017 alone, while CC_N suggests an additional $0.88⁻2.24 million annually that could be achieved by completing the transition. The wide range of estimates partly reflects uncertainties in determining diesel bus emissions under business-as-usual. These health benefits were not limited locally, with ~70% going to other counties. Two national-scale scenarios, US_D and US_N, were also constructed to explore the health impact of transitioning from diesel to CNG buses across the U.S. As of 2017, with CNG powering only ~20% of transit bus mileages nationwide, there could be massive unrealized health benefits of $0.98⁻2.48 billion per year including 114⁻258 avoided premature deaths and >5000 avoided respiratory and cardiovascular illnesses. Taking into account the health benefits, economic costs, and the inter-state nature of air pollution, expanding federal assistances to accelerate a nationwide transition to cleaner bus fleets is highly recommended.

Including intangible costs into the cost-of-illness approach: a method refinement illustrated based on the PM2.5 economic burden in China.

The concentrations of particulate matter with aerodynamic diameters less than 2.5 µm (PM2.5) and 10 µm (PM10) is a widespread concern and has been demonstrated for 103 countries. During the past few years, the exposure-response function (ERf) has been widely used to estimate the health effects of air pollution. However, past studies are either based on the cost-of-illness or the willingness-to-pay approach, and therefore, either do not cover intangible costs or costs due to the absence of work. To address this limitation, a hybrid health effect and economic loss model is developed in this study. This novel approach is applied to a sample of environmental and cost data in China. First, the ERf is used to link PM2.5 concentrations to health endpoints of chronic mortality, acute mortality, respiratory hospital admission, cardiovascular hospital admission, outpatient visits-internal medicine, outpatient visits-pediatrics, asthma attack, acute bronchitis, and chronic bronchitis. Second, the health effect of PM2.5 is monetized into the economic loss. The mean economic loss due to PM2.5 was much heavier in the North than the South of China. Furthermore, the empirical results from 76 cities in China show that the health effects and economic losses were over 4.98 million cases and 382.30 billion-yuan in 2014 and decreased dramatically compared with those in 2013.

Air pollution and respiratory diseases: ecological time series.

CONTEXT AND OBJECTIVE: Exposure to air pollutants is one of the factors responsible for hospitalizations due to respiratory diseases. The objective here was to estimate the effect of exposure to particulate matter (such as PM2.5) on hospitalizations due to certain respiratory diseases among residents in Volta Redonda (RJ). DESIGN AND SETTING: Ecological time series study using data from Volta Redonda (RJ). METHODS: Data on hospital admissions among residents of Volta Redonda (RJ), between January 1, 2012, and December 31, 2012, due to pneumonia, acute bronchitis, bronchiolitis and asthma, were analyzed. Daily data on PM2.5 concentrations were estimated through the CCATT-BRAMS model. The generalized additive Poisson regression model was used, taking the daily number of hospitalizations to be the dependent variable and the PM2.5 concentration to be the independent variable, with adjustment for temperature, relative humidity, seasonality and day of the week, and using lags of zero to seven days. Excess hospitalization and its cost were calculated in accordance with increases in PM2.5 concentration of 5 µg/m3. RESULTS: There were 752 hospitalizations in 2012; the average concentration of PM2.5 was 17.2 µg/m3; the effects of exposure were significant at lag 2 (RR = 1.017), lag 5 (RR = 1.022) and lag 7 (RR = 1,020). A decrease in PM2.5 concentration of 5 µg/m3 could reduce admissions by up to 76 cases, with a decrease in spending of R$ 84,000 a year. CONCLUSION: The findings from this study provide support for implementing public health policies in this municipality, which is an important steelmaking center.

Air pollution and respiratory diseases: ecological time series / Poluição do ar e doenças respiratórias: estudo ecológico de série temporal

ABSTRACT CONTEXT AND OBJECTIVE: Exposure to air pollutants is one of the factors responsible for hospitalizations due to respiratory diseases. The objective here was to estimate the effect of exposure to particulate matter (such as PM2.5) on hospitalizations due to certain respiratory diseases among residents in Volta Redonda (RJ). DESIGN AND SETTING: Ecological time series study using data from Volta Redonda (RJ). METHODS: Data on hospital admissions among residents of Volta Redonda (RJ), between January 1, 2012, and December 31, 2012, due to pneumonia, acute bronchitis, bronchiolitis and asthma, were analyzed. Daily data on PM2.5 concentrations were estimated through the CCATT-BRAMS model. The generalized additive Poisson regression model was used, taking the daily number of hospitalizations to be the dependent variable and the PM2.5 concentration to be the independent variable, with adjustment for temperature, relative humidity, seasonality and day of the week, and using lags of zero to seven days. Excess hospitalization and its cost were calculated in accordance with increases in PM2.5 concentration of 5 µg/m3. RESULTS: There were 752 hospitalizations in 2012; the average concentration of PM2.5 was 17.2 µg/m3; the effects of exposure were significant at lag 2 (RR = 1.017), lag 5 (RR = 1.022) and lag 7 (RR = 1,020). A decrease in PM2.5 concentration of 5 µg/m3 could reduce admissions by up to 76 cases, with a decrease in spending of R$ 84,000 a year. CONCLUSION: The findings from this study provide support for implementing public health policies in this municipality, which is an important steelmaking center.

RESUMO CONTEXTO E OBJETIVO: A exposição aos poluentes do ar é um dos fatores responsáveis por internações por doenças respiratórias; o objetivo foi estimar o efeito da exposição a material particulado (como PM2,5) sobre as hospitalizações devido a certas doenças respiratórias em moradores de Volta Redonda (RJ). TIPO DE ESTUDO E LOCAL: Estudo ecológico de séries temporais utilizando dados de Volta Redonda (RJ). MÉTODOS: Foram analisados dados de internação hospitalar, entre 1 de janeiro de 2012 e 31 de dezembro de 2012, devida a pneumonia, bronquite aguda, bronquiolite e asma, em residentes em Volta Redonda (RJ), e dados diários das concentrações de PM2,5 obtidos a partir do modelo CCATT-BRAMS. Utilizou-se o modelo aditivo generalizado de regressão de Poisson, sendo o número diário de internações a variável dependente e a concentração PM2,5 a variável independente, ajustado para temperatura, umidade relativa, sazonalidade e dia da semana e defasagens entre zero e sete dias. Excesso de internação hospitalar e seu custo, de acordo com o aumento de 5 ug/m3 na concentração de PM2,5, foram calculados. RESULTADOS: Ocorreram 752 internações em 2012; a concentração média de PM2,5 foi de 17,2 ug/m3; os efeitos da exposição foram significativos em lag 2 (RR = 1,017), lag 5 (RR = 1,022) e lag 7 (RR = 1,020). A redução em 5 ug/m3 na concentração de PM2,5 poderia reduzir até 76 casos as internações com diminuição nos gastos de R$ 84 mil/ano. CONCLUSÃO: Os achados deste estudo fornecem subsídios para implantar políticas públicas de saúde neste município, que é importante polo siderúrgico.

The global reorganization and revitalization of the asbestos industry, 1970-2007.

The intent of this essay is to highlight the global reorganization of the asbestos industry over the period 1970-2007. Descriptive analysis illustrates that asbestos consumption in the industrialized countries declined precipitously over this period, in juxtaposition to a notable increase in consumption in the developing countries. In 2007, asbestos consumption in the developing countries was more than two million metric tons but negligible elsewhere in the world economy. The author argues that as asbestos increasingly became the focus of government oversight in the industrialized countries, continued capital accumulation efforts necessitated displacement of risk to the developing countries. The global revitalization of asbestos production and consumption over the period 1970-2007 presents numerous challenges in terms of occupational and environmental health hazards in the developing countries. It has the potential, moreover, to prefigure a significant expansion of asbestos-related disease into the 21st century, absent a global ban on asbestos use.

The costs of respiratory illnesses arising from Florida gulf coast Karenia brevis blooms.

BACKGROUND: Algal blooms of Karenia brevis, a harmful marine algae, occur almost annually off the west coast of Florida. At high concentrations, K. brevis blooms can cause harm through the release of potent toxins, known as brevetoxins, to the atmosphere. Epidemiologic studies suggest that aerosolized brevetoxins are linked to respiratory illnesses in humans. OBJECTIVES: We hypothesized a relationship between K. brevis blooms and respiratory illness visits to hospital emergency departments (EDs) while controlling for environmental factors, disease, and tourism. We sought to use this relationship to estimate the costs of illness associated with aerosolized brevetoxins. METHODS: We developed a statistical exposure-response model to express hypotheses about the relationship between respiratory illnesses and bloom events. We estimated the model with data on ED visits, K. brevis cell densities, and measures of pollen, pollutants, respiratory disease, and intra-annual population changes. RESULTS: We found that lagged K. brevis cell counts, low air temperatures, influenza outbreaks, high pollen counts, and tourist visits helped explain the number of respiratory-specific ED diagnoses. The capitalized estimated marginal costs of illness for ED respiratory illnesses associated with K. brevis blooms in Sarasota County, Florida, alone ranged from $0.5 to $4 million, depending on bloom severity. CONCLUSIONS: Blooms of K. brevis lead to significant economic impacts. The costs of illness of ED visits are a conservative estimate of the total economic impacts. It will become increasingly necessary to understand the scale of the economic losses associated with K. brevis blooms to make rational choices about appropriate mitigation.

The cost effectiveness of occupational health interventions: prevention of silicosis.

BACKGROUND: The failure to recognize occupational health as an economic phenomenon limits the effectiveness of interventions ostensibly designed to prevent disease and injury. Hence, consideration of economic efficiency is essential in the evaluations of interventions to reduce hazardous working conditions. In this paper, we present an analysis of the cost effectiveness of alternative means of preventing silicosis. METHODS: To evaluate the cost effectiveness of specific interventions for the prevention of occupationally induced silicosis, we have used the simulation models based on the generalized cost-effectiveness analysis (GCEA) developed by the WHO-CHOICE initiative for two representative subregions namely AMROA (Canada, United States of America), and WPROB1 (China, Korea, Mongolia). RESULTS: In both of the two subregions, engineering controls are the most cost effective with ratios varying from 105.89 dollars per healthy year or disability adjusted life year saved in AMROA to approximately 109 dollars in WPROB1. In the two subregions, the incremental cost-effectiveness ratio of engineering controls (EC) looks most attractive. Although dust masks (DM) look attractive in terms of cost, the total efficacy is extremely limited. CONCLUSIONS: To the extent that this analysis can be generalized across other subregions, it suggests that engineering control programs would be cost effective in both developed and developing countries for reducing silica exposure to save lives. Note that this analysis understates health benefits since only silicosis and not all silica-related diseases are considered.