Johnson - Measuring the Public Health Impacts of Air Pollution in Minnesota


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  • Over the past several decades, thousands of epidemiological studies have looked at the health impacts of air pollution.These studies have made a case for the conclusion that: these health impacts are indeed measurable, and exposure to PM2.5 has an impact on respiratory and cardiovascular health on a population level, even at low concentrations of PM2.5. The body of evidence for PM2.5 encompasses studies that look at long-term, cumulative exposures to particle pollution – they find increased risks for mortality, CVD disease, and other health outcomes due to levels of PM2.5 in the air.There are also studies that look at how short-term exposures can affect health…these studies have also consistently found associations with PM2.5 and the triggering or exacerbation of health events.
  • The take-home message from all of these epidemiology studies is that everyone is exposed to some amount of air pollution .But some people are more susceptible to the effects of pollution than others….this population group is growing in MN as well as nationwide.[The figures show the prevalence of obesity among adults in MN – growing prevalence.]Baseline incidence of disease is not uniform across the population but has geographic variability, thus health impact analysis will reflect geographic variation in underlying population vulnerabilities. (geographic distribution of disease not even….pockets of susceptible populations)[A “double whammy” – there are increasing rates of diabetes, obesity…and these populations are already at risk of heart disease because of those conditions. On top of that, these populations are even further at risk of adverse health because of their exposure to air pollution.]
  • This chart shows the number of days in a year that the Air Quality Index was above 100 in various regions in MN. An AQI of above 100 means that the PM2.5 or ozone concentration is harmful for sensitive groups (such as people with respiratory or heart disease, the elderly, and active children).In general, the Twin Cities experiences the highest number of unhealthy air quality days. However, all regions of the state can experience poor air quality.
  • Most recently, CDC’s Environmental Public Health Tracking Program piloted a health impact assessment approach to model the estimated number of deaths prevented given improvements in air quality. They used this to model predictions for every county in the US, and here you see the scenario using 2006 data for MN counties. These are the estimated number of deaths prevented in 2006 in a scenario where the PM2.5 concentrations are reduced by 10%.[Keep in mind that the model uses many, many assumptions…]Yellow = 0Green = more than 0 to 1Light blue = more than 1 to 2Blue = more than 2[This is based on a model that is making predictions…..different approach from what we used.]Estimated mortality = (change in PM2.5 concentration) x (concentration-response function) x (baseline death incidence rate) x (population)
  • Johnson - Measuring the Public Health Impacts of Air Pollution in Minnesota

    1. 1. Measuring the Public Health Impacts of AirPollution in Minnesota Jean Johnson, PhD Minnesota Department of Health Chronic Disease and Environmental Epidemiology Environmental Public Health Tracking and Biomonitoring
    2. 2. Fine particle pollution: PM2.5
    3. 3. PM2.5 pyramid of health effects Death Hospital admissions Emergency room visits Doctor visits Asthma attacks, medication use, symptoms Lung function changes, immune cell responses, heart rate variability responses
    4. 4. Increased life expectancy Source: NEJM 2009 Air pollution controls during 1970-2000  improved health  51 metropolitan areas  15% increase in life expectancy due to pollution reduction  Reducing PM2.5 (10µg/m3) added 7 months of life
    5. 5. Air pollution epidemiology studies Health impacts are measurable Large body of evidence – PM2.5 Respiratory and cardiovascular effects Long-term effects  increased risk Short-term effects  triggering/exacerbations Effects observed even at low concentrations
    6. 6. Air pollution affects entire populations Susceptible population is growing 2004  Aging population  Increasing obesity, diabetes rates Effects observed in children  Lung development 2009  Asthma exacerbations Even very small increases associated with disease and death Obesity in MN
    7. 7. AQI: Number of unhealthy air days in MN Source: MN Pollution Control Agency
    8. 8. Improving air, preventing deaths Air quality MN (2006) improvement scenarios 5 Estimated number of prevented deaths 10% reduction PM2.5 78 concentrations (MSP metro) BenMAP software 4 Source: CDC Environmental Public Health Tracking
    9. 9. Air pollution and health research at MDH Purpose: method/indicator development  Local area analyses  Using local sources of data Track health effects associated with changes in air quality in MSP and Olmsted during 2003- 2009  Fine particulate matter pollution (PM2.5)  Hospitalizations and mortality  Respiratory , cardiovascular
    10. 10. MN air initiatives timeline Heavy Duty Diesel Rule 2007 Ultra Low Sulfur Fuel late 2006 24-hr PM2.5 NAAQS revisionClean Air Interstate RuleAdopted 2005; remanded 2008 2003 2004 2005 2006 2007 2008 2009 Baseline Period Early Implementation Implementation MERP: Riverside coal to natural gas MERP: High Bridge coal to natural gas MERP: Allen S. King emissions controls Project Green Fleet retrofits 2005-2009 continuous
    11. 11. Measuring impacts using local area data Reductions in Reductions in Regulatory Population Adverse or Policy Exposures Health Changes Outcomes • PM2.5 • Respiratory diseases • Cardiovascular disease • Hospitalizations and Deaths
    12. 12. Source: MN Pollution Control Agency
    13. 13. Air pollution and health research: Results Associations found in the MSP metro for PM2.5 and respiratory hospitalizationsHospitalizations Amount attributable to PM2.5 in 2003-2009 Percent # hosp. per yearTotal respiratory 1.9% 224COPD + asthma 2.3% 110Asthma 2.3% 54
    14. 14. MN air pollution health impacts over time Amount attributable to PM2.5Hospitalizations Time period Percent # hosp./yrTotal respiratory 2003-2005 3.0% 354 2006-2007 2.6% 309 2008-2009 -- --COPD + asthma 2003-2005 3.3% 154 2006-2007 2.9% 140 2008-2009 -- --Asthma 2003-2005 3.8% 92 2006-2007 -- -- 2008-2009 -- --
    15. 15. Summary Air pollution affects health even at low levels Air pollution affects entire populations  Impact on a growing number of susceptible people All regions of MN experience poor air quality daysBUT… MN has been making improvements in air quality Continued efforts will lead to a healthier MN
    16. 16. Project TeamMN Dept. of Health MN Pollution Control Agency Olmsted Medical Center Jean Johnson Greg Pratt Barbara Yawn Chuck Stroebel Kari Palmer Peter Wollan Allan Williams Margaret McCourtney Naomi Shinoda Cassie McMahon Wendy Brunner Lisa Herschberger Paula Lindgren Measuring the Impact of Fine Particles: