Air Pollution Episodes Especially Harmful to Athletes and Outdoor Workers

Health effects include respiratory problems, DNA damage

Staff fom the ARB have recently presented research to the California Air Resources Board that links air pollution episodes to adverse health effects for athletes and those who must work outdoors.

Scientists have found that outdoor exercise during high levels of smog or particulate matter may cause otherwise healthy individuals to experience lung function decrease, exacerbation of asthma, and even DNA damage. For those with pre-existing respiratory or heart ailments, the danger is even greater.

"This report once again shows that an active person's zeal for fitness may sometimes do more harm than good when air quality is suffering," said ARB Chairman Mary Nichols. "People should be aware of air quality in their region and take precautions to protect their health when pollution spikes occur. For example, we are surprised and alarmed to find many people out exercising during the recent rash of wildfires that have blanketed much of the state in smoke."

The findings from the studies include:
* A three-fold decrease in lung function after walking near diesel traffic compared to walking in a park with no traffic;

* A four-fold increase in DNA damage after cycling in traffic;

* A 10 percent reduction in lung function after cycling with ozone exposure;

* Delivery of oxygen to the heart may drop by three times when exercising while exposed to diesel exhaust; and,

* A three-fold increase in asthma development for children who played multiple sports in high ozone areas.

Research shows that during exercise, people breathe faster; a greater proportion of air is inhaled through the mouth, bypassing nasal filtration, and pollutants are carried more deeply into the lungs. And, greater volumes of air are exchanged during exercise -- up to 10 or 20 times more air compared to when at rest.

As breathing rates increase so does the quantity of pollutants inhaled. Anyone exercising outdoors during times of high pollution should remember they will receive a greater dose of pollutants. Additionally, research studies found that people who exercise near roadways such as joggers, cyclists and pedestrians experience increased risk because not only are they exposed to outdoor air pollution but traffic-related pollution as well.

For people who already have compromised lung function or heart disease, these risks are amplified.

It is well established that exercise promotes health and fitness. Regular exercise can help counteract the negative effects of air pollution. For example, regular activity may improve removal of inhaled particles from the lungs and can strengthen immune defenses. Prior to exercise outdoors, people can protect themselves by heeding air quality advisories, available in local newspapers, television weather reports, and through local health agencies, air districts and U.S.

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Air Now EPA

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Is Air Pollution Associated with Ventricular Arrhythmia?

Introduction: Premature ventricular complexes are a normal finding in healthy individuals and the prevalence increases with age and is more common in men. Premature ventricular complexes can occur in association with a variety of stimuli, and a lesser known cause is the association between air pollution and ventricular arrhythmias.

Case presentation: A previously healthy man started to ride a lightweight motorbike in heavy traffic.

A few weeks later he was admitted to hospital with premature ventricular complexes in bigeminy, which decreased after a few days when he was not exposed to exhaust fumes. A few weeks later he started using the motorbike again and the same symptoms developed once more, only to subside when he stopped riding in heavy traffic.

Conclusions: Studies have shown an association between air pollution and premature ventricular complexes and other kinds of arrhythmias.

The mechanism may be changes in cardiac autonomic function, including heart rate and heart rate variability. Air pollution should be considered when patients present with arrhythmias and no other causes are found.

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Journal of Medical Case Reports

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When it Comes to Air Pollution, What You Can't See Can Hurt You

Research presented at American Society of Hypertension's Twenty Third Annual Scientific Meeting and Exposition (ASH 2008) shows that even a few hours of exposure to particulate matter (PM), which is not ozone but a component of air pollution emitted from power plants, factories and motor vehicles, among other sources, is responsible for rapidly raising blood pressure and can impair blood vessel function in certain situations within 24 hours. These effects may explain why air pollution can trigger a large host of CV events including heart attack, heart failure and stroke.

"Not everyone is equally at risk to the effects of poor air quality," said Robert Brook, Assistant Professor of Medicine of the Division of Cardiovascular Medicine at the University of Michigan. "Yet, as traffic worsens and millions of vulnerable people are exposed to PM, it is incumbent upon us to understand how and why people are affected so that we can take steps to limit our personal exposure – and consider making broader changes to the public agenda to control air pollution."

PM is the 13th cause of mortality worldwide, but until now, the explanation underlying this association remains incompletely understood.

In their study, researchers designed two randomized, double-blind exposure experiments – one in downtown Toronto and one in Ann Arbor, Michigan – to investigate how PM raises blood pressure in healthy adults, aged 18 to 50, and what air pollution constituents are responsible. In Toronto, researchers compared the effect on blood pressure and blood vessel functions among 30 adults for two hours in four different exposure situations: concentrated ambient PM (CAPS alone), CAPS and ozone, ozone alone or filtered air. Results showed that short term exposure to air pollution that contains PM (CAP or CAP and ozone) – but not ozone alone – significantly raised diastolic blood pressure by 3.6 mm Hg on average (a significant difference from filtered air), and only during the exposure period of two hours. Blood vessel function was impaired 24 hours after all exposures containing PM, but not ozone alone, and not immediately after any exposure type (within five minutes).

In Ann Arbor, researchers compared the effect of CAP and ozone in 50 adults pre-treated with the anti-oxidant vitamin C, a blocker of the vasoconstrictor hormone endothelin (bosentan) and placebo. Diastolic blood pressure increased to a similar degree, between 2.5 and 4.0 mm Hg, during all exposure types. Blood vessel function was not impaired at any time point after all exposures, and blood pressure returned to normal within 10 minutes after exposure.

Results confirm that it is PM and not ozone that is responsible for the rapid raise in diastolic blood pressure and that the pro-hypertensive response occurs only during the actual inhalation of the particles. The very rapid and transient nature of the increase in blood pressure, and the fact that pre-treatment with vitamin C did not block the response, suggest that a sudden increased in sympathetic nervous system activity is the most like cause.

Additionally, the study confirmed that PM does impair blood vessel function one day following exposure. But since this response occurred only in Toronto, the composition of PM or its source may likely play a role in determining the health response.

"These findings are a springboard for further study that will specifically determine how the sympathetic nervous system responds and to what types of particles in air pollution," said Dr. Brook. "But this glimpse helps us determine the triggers behind a range of CV events – some deadly. Learning how this dangerous cascade starts can help the medical and public health community make advances toward limiting their impact in the future."

About the American Society of HypertensionThe American Society of Hypertension (ASH) is the largest U.S. professional organization of scientific investigators and healthcare professionals committed to eliminating hypertension and its consequences. ASH is dedicated to promoting strategies to prevent hypertension and to improving the care of patients with hypertension and associated disorders. The Society serves as a scientific forum that bridges current hypertension research with effective clinical treatment strategies for patients.

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NewsWise

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Particulate Pollution May Trigger Heart Attacks/Strokes by Spurring Blood Clots

It was a murder mystery playing out in major cities across the country and perplexing scientists. Thousands of people were dying from strokes and heart attacks within 24 hours of a spike in microscopic pollution -- tiny particles that spew from the exhaust of diesel trucks, buses and coal-burning factories.

But scientists didn't have a smoking gun. They couldn't figure out why the pollution was triggering the deaths. All they had to go on was a vague lead: the particles -- too small to be filtered by the nose or mouth -- caused inflammation of the lungs. But what was the link between particles trapped in the lungs to the strokes and heart attacks?

New research from the gumshoes at Northwestern University's Feinberg School of Medicine has solved a key piece of the mystery. The study identifies how these tiny pieces of soot -- called particulate matter air pollution -- kill people at risk and tells how they can protect themselves from these pollution-related strokes and heart attacks.

Northwestern researchers have discovered that this microscopic air pollution - smaller than 10 microns or less than one-tenth of the diameter of a human hair -- spurs hyperclotting of the blood. The study found that lungs inflamed by the pollution secrete a substance, interleukin-6, which causes an increased tendency for blood to coagulate or clot. This raises the risk of a fatal heart attack or stroke in people with cardiovascular disease such as coronary artery disease, congestive heart failure or a history of stroke.

Previous epidemiological research has linked the pollution to cardiovascular death and disease, but this is the first study to show how it actually happens in an animal model.

"This is a critical missing piece of the puzzle that has eluded scientists for decades," said Gokhan Mutlu, M.D., lead author of the study and assistant professor of pulmonary and critical care medicine at the Feinberg School, and a physician at Northwestern Memorial Hospital. "Now we know how the inflammation in the lungs caused by air pollutants leads to death from cardiovascular disease."

People at risk can probably help protect themselves by taking low-dose aspirin to keep their blood thin, Mutlu said.

Mutlu collaborated on the study with co-authors Scott Budinger, M.D. associate professor of pulmonary and critical care medicine, and David Green, M.D., professor of hematology and oncology, both at the Feinberg School and physicians at Northwestern Memorial Hospital.

The paper will appear on-line Sept. 20 in the Journal of Clinical Investigation and will be published in the print issue Oct. 1.

In the study, researchers used particles of pollution collected by the United States Environmental Protection Agency, mixed them into a saline solution and injected the pollution cocktail into the lungs of mice. The blood of the mice exposed to the pollution clotted faster than mice not exposed. Researchers observed a 15-fold increase in interleukin-6 24 hours after the mice were exposed to the pollution.

In people, interleukin-6 also raises the levels of a substance called CRP, which is correlated with death from cardiovascular disease.

Particulate matter pollution is highest near expressways or truck routes. It's hard for commuters to escape. People are exposed to the pollution inside a car (even with the windows rolled up), a train or walking outdoors, Mutlu said. The only safe location with lower levels is indoors.

People with previous blockages in the coronary or carotid arteries are at the highest risk. "It's important to get screened to see if you have one of these conditions. If so, when there are high levels of particulate matter, you should try to stay indoors and limit your exposure to the outside air," Budinger said.

Exercising hikes the risk because it floods the lungs with more polluted air. "If you're sitting down, the amount of air you get into your lungs is about five to six liters per minute, but if you're running the amount is 20 to 25 liters," Mutlu noted. "If you're close to an expressway, you're actually breathing more particulate matter into your lungs."

The doctors also warned that heart attacks and strokes occur at relatively low levels of particulate matter pollution. "We haven't found a safe level yet," Mutlu said. He hopes the study helps encourages the EPA and local regulators to reduce the limits on particulate matter levels.

The American Lung Association State of the Air: 2007 report said the most "ominous trend" in air pollution is the increase in particle pollution, particularly in the eastern United States. Among the metropolitan areas, Los Angeles has the most year-round particle pollution. Chicago ranks 11; New York, 17 and Washington D.C., 20. All received an "F" or failing grade for their pollution , which was in excess of the EPA annual average limit of 15 micrograms per cubic meter.

The risk of dying from a heart attack or ischemic stroke jumps a whopping 30 percent with each additional 10 micrograms of pollution.

While the current Northwestern study looked at the acute effects of this microscopic pollution, Mutlu also has begun to research its long-term exposure on cardiovascular health. He is piping air on the street from Huron and Lake Shore Drive in downtown Chicago into a chamber with mice. Over the next several years, he will examine the effect of breathing this air on the mice's cardiovascular health.

The National Institute of Environmental Health Sciences supported the study.

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Northwestern University

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Air Pollution Linked to Cardiovascular Risk in Healthy Young Adults

Researchers in Taiwan have demonstrated for the first time that urban air pollution simultaneously affects key indicators of cardiovascular risk in young adults: inflammation, oxidative stress, coagulation and autonomic dysfunction.

The study, which appeared in the second issue for August of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society, investigated the effect of common urban air pollutants on biological markers for inflammation, oxidative stress, coagulation and autonomic dysfunction in 76 healthy Taiwanese college students.

The researchers collected blood samples and performed electrocardiograms on each subject approximately every 30 days for the months of April, May and June in either 2004 or 2005. They then correlated the sample dates and time with monitoring data from a fixed-site air monitoring station on the students’ campus. The concentrations of common urban air pollutants were averaged over 24, 48 and 72 hours.

They found significant increases in all indices of cardiovascular risk were associated with increased exposure to common pollutants. “This study provides evidence that urban air pollution is associated with systemic inflammation/oxidative stress, impairment of the fibrinogenic system, activation of blood coagulation and alterations in the autonomic nervous system in young, healthy humans,” wrote the study’s lead author Chang-Chuan Chan, Sc.D., of National Taiwan University’s College of Public Health.

“Most pollution literature has shown affects in elderly people, and although there have been experiments in young subjects, epidemiological research has not found such significant effects in young people as with these students in Taiwan,” said Benoit Nemery, M.D., Ph.D., professor in the division of pneumonology at the Catholic University of Leuvin in Belgium, who was not involved in the research.

“Further studies with more detailed measurements of cardiovascular endpoints over time are still needed to elucidate the time sequence of pollution effects on cardiovascular endpoints in humans,” wrote Dr. Chang-Chuan Chan.

“Many questions remain to be answered,” wrote Joel Kaufman, M.D., M.P. H., in the accompanying editorial, “[But] these questions should by no means slow the important efforts to reduce exposures and benefit global public health.”

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Newswise

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Air Pollution Linked to Clogged Arteries

Got high cholesterol? You might want to stay away from air pollution.

That’s the message of a new UCLA study linking diesel exhaust to atherosclerosis, or hardening of the arteries, which significantly increases one’s risk for heart attack and stroke. Published in the July 26 edition of the online journal Genome Biology, the findings are the first to explain how fine particles in air pollution conspire with artery-clogging fats to switch on the genes that cause blood vessel inflammation and lead to cardiovascular disease.

“When you add one plus one, it normally totals two,” said principal investigator Dr. André Nel, chief of nanomedicine at the David Geffen School of Medicine at UCLA and a researcher at UCLA’s California NanoSystems Institute. “But we found that adding diesel particles to cholesterol fats equals three. Their combination creates a dangerous synergy that wreaks cardiovascular havoc far beyond what’s caused by the diesel or cholesterol alone.”

The researchers set up a scenario to investigate the interaction between diesel exhaust particles and the fatty acids found in low-density lipoprotein (LDL) cholesterol — the “bad” type of cholesterol that leads to artery blockage.

In particular, the team was interested in how oxidation — cell and tissue damage resulting from exposure to molecules known as free radicals — contributes to inflammation and artery disease. Free radicals enter the body through small particles present in polluted air and are also byproducts of normal processes, such as the metabolic conversion of food into energy.

“Diesel particles are coated in chemicals containing free radicals, and the fatty acids in LDL cholesterol generate free radicals during metabolism in the cells,” said first author Ke Wei Gong, a UCLA cardiology researcher. “We wanted to measure what happens when these two sources of oxidation come into contact.”

The scientists combined the pollutants and oxidized fats and cultured them with cells from the inner lining of human blood vessels. A few hours later, the team extracted DNA from the cells for genetic analysis.

“We saw that the diesel particles and oxidized fats had worked in tandem to activate the genes that promote cellular inflammation — a major risk factor for atherosclerosis,” said Dr. Jesus Araujo, UCLA assistant professor of medicine and director of environmental cardiology at the Geffen School of Medicine.

“The interaction left a genetic footprint that reveals how interaction between the particles and cholesterol accelerates the narrowing and blockage of the blood vessels,” Araujo noted.

To duplicate these findings in living cells, the UCLA team exposed mice with high cholesterol to the diesel particles and saw activation of some of the same gene groups in the animals’ tissue.

“Exactly how air pollutants cause cardiovascular injury is poorly understood,” Nel said.

“But we do know that these particles are coated with chemicals that damage tissue and cause inflammation of the nose and lungs. Vascular inflammation in turn leads to cholesterol deposits and clogged arteries, which can give rise to blood clots that trigger heart attack or stroke.”

The researchers’ next step will be to convert the genes’ responses to the pollutant-cholesterol combination into a biomarker that will enable physicians to easily evaluate air pollution’s effect on health, especially cardiovascular disease.

“Once a biomarker is developed, we’d simply need to test a blood sample in order to measure a person’s exposure to particulate matter and determine whether it has reached levels that require medical intervention,” Araujo said.

The American Cancer Society has reported a 6 percent increase in heart- and lung-related deaths for every 10 micrograms per cubic meter rise in particulates.

“Our results emphasize the importance of controlling air pollution as another tool for preventing cardiovascular disease,” Gong said.

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Newswise

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International Conference on Asthma - Impacts of Air Pollution

The South Coast Air Quality Management District will be co-sponsoring “Asthma Is a Small World, International Conference on the Asthma Impacts of Air Pollution”, to be held Thursday - Friday, April 26 - 27, 2007, in Anaheim, California, USA.

Internationally recognized scientists, physicians, public health professionals, political and policy individuals from countries around the world will address accelerating policy and technology solutions to improve the conditions of the air that we breathe, and reduce the alarming increase in the incidence of asthma

Featured sessions include: Health Effects of Air Pollution; Heath Tracking and Management Guidelines; Legislative and Policy Approaches; and Current Concepts in Asthma and Respiratory Diseases. Other highlights include esteemed researchers, scientists, community-organization leaders and policy makers exploring the health effects of traffic emissions, pollution exposure and the development of asthma, impacts of goods movement to respiratory illness, socioeconomic influences on respiratory disease, a global initiative for asthma, and the global warming connection.

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SCAQMD

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How to decrease fine particulate matter pollution that contributes to asthma by using diesel particulate filters

EPA Announces New Human Health Research Web Site

EPA's Human Health Research Program launched a new Web site on the latest information on its research to protect public health. The program's science looks at such questions as why some people are more sensitive to pollution and how exposure to chemicals affects people's health. The site is designed for the general public as well as for the scientific community.

"The best decisions are informed decisions," said George Gray, assistant administrator for the Office of Research and Development. "The site provides easy access to research and results on methods, tools, and data needed to improve risk assessments to protect the public."

Visitors to the site will find an overview of the research, information on how research has contributed to decision making, resource materials available in journal publications and reports, and a listing of meetings and conferences.

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EPA – Human Health Research Program

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The health impact of pollution caused by diesel emissions

Diesel Fumes Pose Major Health Risk to Commuters

Washington, D.C. -- February 28, 2007 -- Diesel fumes pose a major health risk to commuters, according to a new report by the non-profit Clean Air Task Force.

The Boston-based environmental research group reported today that even though we spend only a tiny portion of our day commuting, it’s during the commute that we receive more than half our overall exposure to deadly fine particle pollution.

“Exposure to diesel exhaust during commutes poses a serious public health risk that needs to be addressed,” said George Thurston, Professor of Environmental Medicine at New York University’s School of Medicine, who wrote the foreword to the report.

Fine particle pollution, including diesel exhaust, can cause lung cancer, stroke, heart attack and infant death. It also triggers asthma attacks and makes people more likely to become allergic.

Some health researchers have estimated that such fine particles are responsible for shortening the lives of at least 70,000 Americans each year.

The Task Force specifically investigated diesel exhaust levels during commutes in New York NY, Boston MA, Austin TX and Columbus OH. The Task Force documented diesel particle levels four to eight times higher inside commuter cars, buses, and trains than in the ambient outdoor air in those cities. These are examples of likely results during a commute anywhere in the country where there is significant diesel traffic.

“Our investigation demonstrated that you may be exposed to high levels of diesel particles – four to eight times the levels in the outdoor air -- whether you commute by car, bus, ferry, train, or on foot,” said Bruce Hill, Senior Scientist with CATF.

By contrast, Hill noted, pollution levels were negligible for commuters in and near vehicles equipped with modern pollution controls or those that run on lower-polluting fuels such as natural gas.

“The problem is that there are 13 million diesel engines in service today, and virtually all are exempt from modern pollution controls,” said Conrad Schneider, Advocacy Director for the Task Force. “However, our study showed that simply replacing the muffler of trucks or buses with a diesel particle filter can reduce commuter exposure substantially,” he said. By EPA regulation, the Ultra-Low Sulfur Diesel (ULSD) fuel that is necessary to keep these diesel particle filters operating optimally became available nationwide late last year.

The Task Force called on federal and state agencies to increase funding to clean up highly polluting buses and other existing diesel engines. It urged the U.S. Environmental Protection Agency to require that long-haul trucks clean up when their engines are rebuilt. It also urged the EPA to move ahead with plans to set new pollution standards for diesel trains and diesel-powered boats, including commuter ferries.

The new report can be found online at www.catf.us/goto/noescape
For information about diesel risk in specific communities, go to: www.catf.us/projects/diesel/dieselhealth

Founded in 1996, the Clean Air Task Force (CATF) (www.catf.us) is a nonprofit organization dedicated to restoring clean air and healthy environments through scientific research, public education, and legal advocacy. CATF’s staff includes scientists, engineers, economists, MBAs and lawyers. The organization works closely with more than 40 state, local, regional and national groups to educate the public, media, industry and public decision makers on the science and economics of clean air policies through fact-based and locally appropriate advocacy.

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Clean Air Task Force

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NERAM Launches Plan to Fight Air Pollution

WATERLOO, Ont. -- February 7, 2007 -- A University of Waterloo-based research network says scientific evidence of the effects of air pollution on human health and the environment is clear enough to support global efforts to continue reducing outdoor levels.

The Network for Risk Assessment and Management (NERAM) has developed with international experts a 12-point plan -- parts of which have been adopted in Europe -- to fight air pollution and improve public health. The plan, a policy guidance document on air quality management for local, regional and national policy-makers, is the result of a five-year NERAM colloquium series.

"It is now universally recognized that poor air quality has adverse impacts on human health and research confirms that residents in Southern Ontario and other parts of Canada are exposed to levels of air pollutants associated with morbidity and mortality," says UW professor emeritus John Shortreed, executive director of both NERAM and UW's Institute for Risk Research.

"The University of Waterloo has done five years of work in translating research from around the world for use in policies to improve health. We are ready to battle the No. 1 environmental killer -- air pollution."

The plan reflects the latest thinking of policy-makers and health researchers from around the world. The fifth and final colloquium was held in October in Vancouver.

Research shows that both short-term and long-term exposures to particulate matter and other air pollutants are statistically associated with serious human health effects, including premature death, heart-and breathing-related hospital admissions and emergency room visits, together with a worsening of asthma conditions.

"Scientific evidence of the effects of air pollutant exposure on human health and on the environment is strong enough to justify global efforts to continue to reduce outdoor concentrations, even in locations that meet air pollutant standards," Shortreed says.

He adds that Europe and Britain are already implementing the interim policies proposed by the NERAM colloquium series held in Rome in 2003 and in Mexico in 2005 to deal with hot spots, such as high traffic areas in cities like Toronto.

"They are using an innovative approach to regulations that actually allow some locations to exceed air quality standards, while imposing area-wide reductions that have many more health benefits -- the result is more health outcomes for existing regulatory resources."

Shortreed says that air pollution typically causes a white, yellow or brown haze that reduces visual range, affecting people's ability to enjoy their surroundings. In places like Hong Kong, for instance, the impaired visibility caused by haze or smog is used as a means to show the public the link between high air pollution concentrations and increased health costs.

Topics covered in the NERAM document include air quality and human health, emission inventories, air quality management approaches and evidence of effectiveness, as well as challenges and opportunities in air quality management.

The plan includes the following strategic policy directions for air quality management:
1. Communication of health effects is key to increasing public awareness and demand for air quality management policies.
2. Increase awareness of linkages between air quality and climate change.
3. Cross-sectoral policies in energy, environment, climate, transport, agriculture and health.
4. Exposure reduction and continuous improvement policies are important extensions to ambient air quality standards.
5. Reducing exposure to combustion-generated particles should be a priority, such fossil fuels and biomass.
6. Evidence is sufficient to justify policies to reduce traffic exposures.
7. Prioritize pollutants and sources based on the potential for exposure.
8. Policies focused on improving visibility may gain greater support than those focused solely on health.
9. International harmonization of measurements and metrics, emission inventories, modelling tools, assessment of health effects literature and health-related guidelines.
10. More research on toxicity-determining characteristics of particulate matter and more evaluation of local, regional and global policies.

Shortreed says there are many epidemiological (human population) studies carried out in North America and Europe that have demonstrated statistically significant ties between ambient levels of particulate matter and other air pollutants and a variety of human health problems, including death and hospital admissions for cardiovascular and respiratory diseases.

NERAM has already started a regional initiative in the Greater Toronto Area along with Pollution Probe to apply some of the research results in order to tackle the thousands of premature deaths every year in Ontario.

The main goal of NERAM is to integrate the scientific knowledge and expertise that exists across many diverse disciplines in Canada, thereby providing a comprehensive approach to environmental risk assessment and risk management. As a result, there will be more effective and efficient environmental protection practices.

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Network for Environmental Risk Assessment and Management

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Code Green: Stanford Medicine Explores Health Impacts of Climate Change

STANFORD, Calif.--(BUSINESS WIRE)--Until recently, few scientists investigated the impact of global warming on health. Aside from the World Health Organization and the United Nations, only a handful of institutions focused on the coming crisis — or the other planetary systems at risk. In addition to the climate, humans have altered atmospheric ozone, biodiversity, food production on land and sea, and water cycles in ways that harm health.

But change is in the air. Environmental researchers are beginning to find common ground with physicians, as exemplified by collaborations among researchers at Stanford University’s new Woods Institute for the Environment. And in January, the federal Centers for Disease Control and Prevention announced its intention to tackle health threats posed by climate change.

The spring issue of Stanford Medicine magazine, which is produced by the Stanford School of Medicine, contains a special report on the health impacts of the global environmental crisis, from climate change to sewage-filled seas. Among the stories:

The heat wave that hit California last summer, killing 138
- An account of one man’s education about his own body’s inventory of environmental toxins
- A peek at the future health impacts of climate change in the United States
- A beginner’s guide to reducing carbon emissions
- A look at what cholera can teach us about climate change, and what climate studies can teach us about preventing cholera
- The growing problem of disease-causing microbes in the surf

The magazine is available online at http://mednews.stanford.edu/stanmed/. Bonus content on the magazine’s Web site includes a video interview with writer David Duncan Ewing on the reporting of the story on his chemical inventory, and a podcast on writer Tracie White’s trip to Fresno to report on the heat wave.

To request the print version of the magazine, call (650) 723-6911.

Stanford University Medical Center integrates research, medical education and patient care at its three institutions — Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children’s Hospital at Stanford.

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MedNews

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Exploring the Effects of Diesel Exposure on School Children

Millions of children rely on school buses for transportation. According to Clarkson University researcher Peter Jaques, "Those who commute in non-retrofitted, diesel-operated buses can be exposed to potentially harmful agents emitted from the exhaust, including carbonaceous ultrafine particles and diesel particulate matter (DPM), which have been linked to increases in upper-respiratory illnesses."

Jaques, assistant professor of biology; Alan Rossner, assistant professor and director of Clarkson's Environmental Health Science Program; Andrea Ferro, assistant professor of civil and environmental engineering; and Stephanie Schuckers, associate professor of electrical and computer engineering, are working to characterize diesel exposure in school buses and develop methods for measuring lung function and cardiopulmonary effects in children. Their pilot study, led by Jaques, is being funded with a grant from the Collaborative Activities for Research and Technology Information (CARTI) of the Center of Excellence (CoE) at Syracuse University.

In one part of the study the team is measuring the distribution of DPM throughout three empty buses during different modes of operation and under various conditions. The researchers expect the concentration levels to vary depending on such circumstances as seat location, whether windows are open or closed and if the bus is idling or in motion.

Additionally, the team is measuring the heart rate and respiration of 20 different third- and fourth-grade students on school buses throughout the day. Each student wears a LifeShirt TM, an elastic shirt worn under clothing that measures heart and respiratory rates and breathes into respiratory monitors that indicate lung inflammation.

"This gives us data we can later organize and analyze computationally," Rossner said. "We evaluate respiratory inflammation by measuring nitric oxide from exhaled breath at specific intervals, including before and after bus rides. Students also wear personal exposure monitors the size of a small backpack throughout the day."

The goal of this study is to develop techniques and a sufficient exposure database to use later in a more extensive study. The researchers hope their work will improve understanding of diesel exposure-related effects in children. They also hope to strengthen knowledge of the risks associated with exposure to DPM in buses, especially for children with asthma.

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Clarkson University

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How to reduce diesel particulate matter using particulate filters

Long-term Exposure to Air Pollution Hardens Arteries

Study in Environmental Health Perspectives Finds women most vulnerable to atherosclerosis

Long-term exposure to air pollution may lead to the development of atherosclerosis, a form of cardiovascular disease in which fatty deposits cause artery walls to thicken and harden, according to a study published today in the February issue of Environmental Health Perspectives. The study adds to the growing body of literature linking air pollution with cardiovascular disease and provides the first epidemiologic evidence linking atherosclerosis with exposure to fine particulate matter.

Researchers evaluated 798 healthy Los Angeles-area men and women over the age of 40 who showed some signs of increased risk of cardiovascular disease. They used data from 23 monitoring stations to estimate annual average concentrations of particulate matter in residential zip codes throughout the Los Angeles area. Beginning with data from 2000, researchers found concentrations of particulate matter ranging from 5.2 to 26.9 micrograms per cubic meter.

Overall, the more polluted the air to which subjects were exposed, the thicker the inner layers of their carotid artery, which transports blood to the head and neck. The most-exposed study participants experienced about 8% more artery thickening than the least-exposed participants, after accounting for such factors as diet, use of vitamin supplements and hormone-replacement drugs, physical activity, blood pressure, education, and income.

Women over the age of 60 experienced artery thickening at a rate almost four times higher than the overall population. In general, women were much more vulnerable than men, and nonsmokers and people taking drugs to reduce cholesterol also proved to be more vulnerable than average.

"From a biologic perspective, our results support the hypothesis that long-term exposure to ambient particulate matter contributes to systemic inflammatory pathways, which are a relevant aspect of atherogenesis," the study authors write. "The findings indicate a biologically plausible link between the observed acute effects of ambient air pollution on systemic inflammation and the long-term consequences of sustained vascular inflammation leading to increased atherosclerosis and, ultimately, cardiovascular death."

"We've known for some time that air pollution leads to lung damage, but this study also emphasizes the role air pollution plays on the arteries. Heart disease is a primary cause of death in the western world, so more research, perhaps focusing on those at highest risk, is important," says Dr. Jim Burkhart, science editor for EHP.

The lead author of the study was Nino Künzli of the University of Southern California Keck School of Medicine. Other authors included M. Jerrett, W.J. Mack, B. Beckerman, L. LaBree, F. Gilliland, D. Thomas, J. Peters, and H.N. Hodis. The article is available free of charge at http://ehp.niehs.nih.gov/members/2004/7523/7523.html.

The study was supported in part by the National Institute on Aging, the National Institute of Environmental Health Sciences, the Wright Foundation, the Hastings Foundation, and the Health Effects Institute.

EHP is published by the National Institute of Environmental Health Sciences, part of the U.S. Department of Health and Human Services. EHP is an Open Access journal.

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Environmental Health Perpectives

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How diesel particulate filters can reduce fine particulate matter.

Long-Term Exposure to Fine Particulate Matter Increases Risk of Heart Attack and Stroke

In a recent study by The New England Journal of Medicine findings link long-term exposure to fine particulate matter (soot) found in air pollution, to cardiovascular disease. The study targeted postmenopausal women living in 36 US metropolitan areas during the years of 1994 to 1998, with a median follow-up 6 years later. The study included 65,893 women. Air pollution levels and assessed exposure were taken using the closes monitor located near each woman’s residence. Key sources of particulates include internal combustion engines (such as diesel-powered vehicles and stationary generators) and coal-fired powered plants.

The results showed 1816 women had “one or more fatal or nonfatal cardiovascular events, as confirmed by a review of medical records, including death from coronary heart disease or cerebrovascular disease, coronary revascularization, myocardial infarction, and stroke” during the study. The study showed that in increased exposure to fine particulate pollution was associated with an increase risk of heart attack, stroke and death.

The conclusion was “long-term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women. Exposure differences within cities are associated with the risk of cardiovascular disease.”

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The New England Journal of Medicine

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About the environmental and health impact of fine particulate matter.

PennFuture, EIP Reach Agreement with Allegheny Power to Clean Up Hatfield's Ferry Plant in PA

PennFuture and the Environmental Integrity Project announced a settlement of its lawsuit against Allegheny Power for violation of soot and particulate matter standards at the Hatfield's Ferry Plant in western Pennsylvania. The agreement requires immediate steps to reduce sooty discharges through flue gas conditioning and other measures, and will further reduce particulate matter through installation of a scrubber no later than June 30, 2010. The settlement is expected to ultimately save over 200 lives and $1.2 billion in health costs annually by reducing exposure to fine particle pollution that triggers asthma attacks and premature death from heart disease

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The Environmental Integrity Project
PennFuture

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How to reduce soot and particulate pollution using the CleanAIR PERMIT Filter.

Cancer Risk in Texas

A recent study by the University of Texas School of Public Health has found a possible association between air pollution and high cancer rates for children living in Harris County, TX. The researchers found children living within a 2 mile radius of the Houston Ship Channel had a 56 percent higher risk of developing acute lymphocytic leukemia. And those living near increased emissions of 1.3-butadiene, a known carcinogen, were at a higher risk for leukemia.

Investigators stress the preliminary study establishes only an “association” and not proof that these pollutants are connected to an increase in certain diseases.

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Science Daily

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About the health impact of emissions that cause air pollution.

Legal Action Filed to Halt 'Fast-Tracking' of Texas Coal-Fired Power Plants

Major New Challenge to Governor's Attempt to Short-Circuit Full Public Review of Health, Environmental, and Pollution Control Issues in the Permitting Process

AUSTIN, Texas, Dec. 27 -- The Sierra Club, represented by the Austin office of Environmental Integrity Project (EIP), took legal action today to stop the "unprecedented, unreasonable, and ...illegal" plan by Governor Rick Perry to "fast track" administrative hearings for construction of up to 18 dirty coal-fired power plants in the state. Most of the plants in question are being proposed by the Dallas-based utility giant TXU.

EIP Austin Office Counsel Ilan Levin filed the petition on behalf of the Sierra Club to intervene in a state district lawsuit originally brought by Environmental Defense over the processing of coal plant permits. Today's legal action by Sierra Club stems from a recent state agency decision to consolidate six proposed TXU coal plant permits into one hearing, and to set those permits for a speedy decision. The lawsuit seeks to halt Perry's controversial executive order of October 27, 2005, directing the Texas Commission on Environmental Quality (TCEQ) to accelerate consideration of permit applications and the Texas State Office of Administrative Hearings (SOAH) to issue unusually fast decisions on air pollution permits for new electric power plants.

EIP Austin Office Counsel Ilan Levin said: "Today, Sierra Club is asking a judge to overturn a Governor's executive order that imposes unfair burdens on regular people simply trying to avail themselves of the common-sense environmental protections built into state and federal laws. We're saying that speeding up the required decision process for major new sources of smog and other air pollution is illegal and unfair, especially to citizens trying to participate."

Rita Beving, Conservation Co-Chair for the Dallas Sierra Club Group, whose area's air quality would be impacted by coal plant emissions, said: "This legal action is a critical step in the fight by Texas citizens to assert their rights to protect their health and environment from an ill-considered rush to permit these polluting coal-fired power plants, whether we need them or not. The tragedy is that we could meet our energy needs through greater efficiency and renewable energy, without subjecting our cities to further air pollution from coal plants."

The lawsuit notes: "The executive order imposes an unreasonable schedule to thoroughly develop the required technical and legal issues for one major air permit of the type being considered, let alone six of them ... The Governor's Executive Order RP 49 infringes on the rights of Texas citizens to participate meaningfully in the environmental permitting arena.

The right of any affected party to participate in agency permitting decisions is rooted in the constitutional right to due process. The Governor lacks authority to unilaterally alter this system. Further, the Governor lacks the authority to dictate to an administrative law judge exactly how much time is allowed for a judicial administrative decision, and to do so violates the doctrine of separation of powers."

The Perry fast-tracking scheme has huge consequences. The Sierra Club petition notes: "To put the magnitude of the six TXU permits in context, it is worth noting the additional greenhouse gases associated with these new coal plants. While not addressed in the permits, the new units will emit an additional estimated 51 million tons of carbon dioxide per year into Texas skies. In 2005, all existing Texas power plants emitted 255.4 million tons of carbon dioxide."

The Sierra Club contends that a full and deliberate hearing process on each of the power plant applications is crucial due to the serious health and environmental consequences associated with coal-fired power plants, such as increased sulfur dioxide, nitrogen oxides and mercury pollution.

For example, the legal filing points out: "Sulfur dioxide ... interacts with nitrogen oxides to form nitric and sulfuric acids, commonly known as acid rain, which damages forests and acidifies soil and waterways. Harvard School of Public Health studies have shown that SO2 emissions from power plants significantly harm the cardiovascular and respiratory health of people who live near the plants. According to U.S. EPA studies, fine particle pollution from power plants causes more than 20,000 premature deaths a year."

On the topic of mercury pollution, the EIP/Sierra Club petition notes: "Coal-fired power plants are the single largest source of mercury air pollution, accounting for roughly 40 percent of all mercury emissions nationwide. Mercury is a highly toxic metal that, once released into the atmosphere, settles in lakes and rivers, where it moves up the food chain to humans. The Centers for Disease Control has found that roughly 10 percent of American women carry mercury concentrations at levels considered to put a fetus at risk of neurological damage."

Another major pollutant -- nitrogen oxide -- is a major contributor to ozone smog-forming pollution, which has been a major problem for ambient air quality in the Dallas/Fort Worth and Austin areas.

Usually each power plant application would be considered separately with a full review of the risks associated with its additional pollution impact. The new plants also would be examined to verify that that are using the best available technology in order to not degrade air quality.

ABOUT THE GROUPS
Sierra Club is one of the oldest and largest grassroots environmental organizations in the country. The Club has more than 700,000 members nationwide, and roughly 23,000 Texas members. The Sierra Club is dedicated to preserving and enhancing the natural environment and protecting public health, among other goals. The Sierra Club has the specific goal of improving outdoor air quality. The Sierra Club is a party in administrative proceedings that are at issue in this litigation.

With offices in Washington, D.C. and Austin, Texas, the Environmental Integrity Project (http://www.environmentalintegrity.org/) is a nonpartisan, nonprofit organization established in March of 2002 to advocate for more effective enforcement of environmental laws. EIP was founded by Eric Schaeffer, who was director of the U.S. Environmental Protection Agency's Office of Regulatory Enforcement. He resigned in 2002 after publicly expressing his frustration with efforts of the Bush Administration to weaken enforcement of the Clean Air Act and other laws.

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About selective catalytic reduction to reduce emissions of NOx.

Smog Kills Thousands in Iran

The BBC reports an estimated 10,000 people died in Tehran during a one-year period due to air pollution. The deaths are attributed to heart attacks, strokes, pneumonia and other respiratory problems as a result of living in a smog-congested area.

Cheap fuel and an abundance of cars, many of which do not meet global emissions standards, are causing a sharp increase in pollution levels and pollution-related deaths within the capital city.

EPA Violates Clean Air Act

On December 22nd the US Court of Appeals for the District of Columbia ordered the EPA to deliver a new plan for reducing smog. The court said the EPA was “backsliding” when it came to improving air quality by weakening smog standards set before 2004 to reduce ozone in 474 counties, affecting 159 million residents.

The Bush administration claims the EPA doesn’t have the authority to limit greenhouse emissions under the Clean Air Act due to the fact that global warming was not a recognizable threat 36 years ago at the time President Nixon signed it into law. However, Congress has directed the EPA in the past to “regulate air pollution based on new and changing scientific information.”

The Court was unanimous in their decision that the EPA had violated the Clean Air Act by relaxing limits on smog-forming emissions generated by power plants, factories, vehicle exhaust and other sources.

Short-Term Air Pollution Increases Risk of Heart Attack for Those With Clogged Arteries

A new Brigham Young University study published in the world's top heart journal shows that a one- or two-day rise in air pollution causes a significant increase in the risk of unstable angina and heart attacks in the millions of Americans who have significant coronary artery blockage.

"For people who have blockage in their arteries -- whether they know it or not -- relatively modest increases in air pollution are associated with measurable and significant increases in one of these heart disease events," said C. Arden Pope, a BYU epidemiologist and lead author on the study appearing in the new issue of Circulation. He has also published several landmark studies on the health effects of air pollution over the past two decades.

For this study, the researchers linked detailed daily measures of air pollution gathered from monitoring sites in northern Utah with a registry of more than 12,000 heart patients painstakingly built over 12 years by cardiologists at LDS Hospital in Salt Lake City. Pope and his co-authors from the hospital were able to compare levels of pollution on the days preceding the patients' hospital visits with their personal health characteristics. This approach eliminated the impact of other risk factors such as smoking or obesity. The level of detail considered by the study allows cardiologists like study co-author Dr. Jeffrey L. Anderson to make specific recommendations for their patients.

"For those of us with patients who have significant coronary artery disease, the message is that they probably shouldn't be out and about during periods of air pollution," said Anderson, associate chief of cardiology at LDS Hospital as well as professor of internal medicine at the University of Utah School of Medicine. "We have wide fluctuations in the degree of fine particulate pollution along the Wasatch Front. At times our area is wonderfully clean, and other times it's really awful."

The type of pollution linked to the heart attacks is fine pieces of soot smaller than 2.5 microns, or less than five one-hundredths the width of a human hair. Such particulate matter is generated by combustion, most commonly by automobiles, manufacturing and coal-fired power plants. The Environmental Protection Agency has declared that the annual average level of such particles in the air should not exceed 15 micrograms per cubic meter. Pope's study showed that a daily increase of 10 micrograms per cubic meter in fine particulate air pollution is accompanied by a 4.5 percent increased risk of having unstable angina or a heart attack. During winter inversions, Utah can see levels as high as 100 micrograms per cubic meter, Pope said.

Although the effect may seem small, the findings have significant public health impact because exposure to fine particulate matter is widespread in urban environments and essentially involuntary, Pope said. "We all have to breathe the air."

In further explanation of the broad application of these findings, study co-author Benjamin D. Horne pointed out that coronary disease is very common. "Although some people have advance warning through chest pain and other indications, unfortunately about half of people who are at the greatest risk from air pollution's effects actually have silent, undiagnosed coronary disease, and their first sign or symptom of disease is an acute event such as a heart attack," said Horne, director of cardiovascular epidemiology at LDS Hospital.

Horne suggested preventive measures such as improving public air quality warning systems, educating the public about the American Heart Association's recommendations for activity restrictions for those at higher risk and educating the public about improving filtration of their indoor air. He also pointed out that any efforts to improve air quality would be beneficial.

Other co-authors on the study were Dr. Joseph B. Muhlestein and Dr. Dale G. Renlund, who both have joint appointments at LDS Hospital and the University of Utah, and Heidi T. May of LDS Hospital.

NIWA Expands Urban Air Quality Team

NIWA Media Release 8 January 2007

NIWA expands team to meet challenge of poor urban air quality

For a country with a relatively low population density, New Zealand’s air quality can be very poor. The most significant concern is wintertime air pollution in urban centres, where emissions from domestic solid fuel heaters generate high ambient concentrations of PM10 (Particulate Matter with a diameter of ten micrometres or less). Vehicle pollution is also an important source in the larger cities. Recent research has estimated that as many as 900 people may die prematurely each year in New Zealand from the effects of air pollution and that the cost to the New Zealand taxpayer of the health effects of air pollution is greater than six hundred million dollars per year.

The National Institute of Water & Atmospheric Research (NIWA) is expanding its urban air quality team. The group carries out research into the processes controlling air pollution in urban environments and investigates methods of managing or mitigating its effects. We also provide air quality monitoring and consultancy services to government and industry throughout NZ.

Group manager, Dr Guy Coulson, says three new staff will substantially boost NIWA’s capacity to conduct scientific research and commercial consultancy work. The group will now have six scientists based in Auckland, Wellington, and Christchurch, supported by a three-person strong technical team based in Auckland. The team is Jeff Bluett, Tom Clarkson, and Guy Coulson with newcomers Perry Davy, Ian Longley, and Gustavo Olivares, supported by Lou Reddish, Sally Gray, and Jeremy Hunt.