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Air Pollution and Public Health
in California
Wendy Ring MD, MPH
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Agenda
California's air quality problemHealth effectsVulnerable populationsCalifornia research studiesLocal air quality issuesFuture trendsActions
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Selma, CA
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Real time Air Advisory Network App
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State of the Air 2016
(American Lung Association, 2016)
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654321
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CALIFORNIA'S MAJOR AIR POLLUTANTS
TOXICBlack CarbonDiesel ParticulatesDioxinsAromatic Hydrocarbons
CRITERIAParticulatesOzoneNitrogen Oxides
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MAJOR SOURCES
Motor vehiclesWood stovesWildfiresDustPower plantsOil Wells and refineriesAsia
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HEALTH EFFECTS
Well established
Premature death
CVD
Asthma/COPD exacerbations
Impaired lung development
Cancer
Prematurity
Low Birth Weight
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Significant morbidity and mortality
Statewide 7,000 CA CVD deaths/year (CARB, 2015)
10,000 hospital/ER visits and $60 million/year (Romley, 2010)
LA County1 in 10 deaths (EPA, 2015)
27,000 cases of childhood asthma (CARB)
11% of ER visits and 20% of hospitalizations for ped asthma (Brandt, 2014)
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SUSPECTED HEALTH EFFECTS (evidence accumulating)
Neurotoxicity– Cognitive
• Alzheimers• Child Development
– Behavioral• ADD• Autism
Endocrine Disruption– Diabetes– Obesity
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EPIDEMIOLOGY
Study DesignCohortCross Sectional Community
Measured Exposurepersonal air monitoringcommunity air monitoring
Markers for exposure:PAH adductsproximity to known source
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USC Children's Health Study
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STUDY FINDINGS
Exposure to air pollution increases:New onset asthma
Bronchitis symptoms
School absences from respiratory infections
Proportion of non asthmatics with subnormal lung development
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Percent of cohort with reduced FEV1 decreasing over time
(Guaderman, 2015)
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Children's Health and Air Pollution Study
StanfordUCSF FresnoUC Berkeley
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Epigenetic effect of pollutants
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Effect of PAH exposure on major mediator of T cell regulation
(Nadeau, 2010)
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Fresno vs Palo Alto
(Nadeau, 2010)
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(McConnell, 2014)
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Near road pollution exposure and BMI at age 18
(Jarrett, 2010)
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Columbia Center for Children's Environmental Health
Highest quintile of prenatal PAH exposure doubled risk of obesity at age 7
(Rundle, 2012)
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Biomonitoring California PAH
(CDPH, OEHHA, 2016)
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USC Child Obesity Research CenterStudy of Latino Adolescents at Risk of Type 2
Diabetes (SOLAR) study
Cohort of overweight and obese Latino teens
At age 18, interval exposure to PM2.5 and NOx linked to:
Increased BMI
Decreased insulin sensitivity
Decreased beta cell function
(Goran, 2017)
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DIFFERENTIAL VULNERABILITY
DemographicFetusesChildrenElderlyWomenLow incomePeople of color
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Health Status
Cardiovascular diseaseChronic lung diseaseDiabetes
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(Ferrar, 2016)
Proximity
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Topography
MARINE INVERSION
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Wind DirectionEast Bay Children's Respiratory Health Study
(Kim, 2008)
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Environmental JusticeCal Enviro Screen
(OEHA, 2015)
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Local Air Quality Issues
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Wildfire pm2.5
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Wildfire contribution to ozone
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Biomass from wood waste
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TONS EMITTED PER YEAR
Local Biomass PGE natural gas
CO 2808 8NOx 472 15PM 2.5 95 1
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EPA permitted emission rates (in lb/ MMBtu)
Local Biomass Coal (past decade) NOx 0.15 - 0.26 .088
CO 0.50 - 4.0 .144
PM 0.02 - 0.04 .017
(EPA and NCUAQMD)
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TransPacific pollutant transport
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TransPacific pollutant transport
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(Hadley, 2007)
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Ozone
(Zhang, 2008)
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Serpentine soil and asbestos
(USGS, 2015)
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Future Trends
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But recent uptick due to climate change(Gauderman, 2015)
Air quality has improved dramatically
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Temperature related increases in OZONE
(Fann, 2014)
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Cal Adapt projected increase in burned area
Frequency of large fires has nearly doubled
Fire season is 2 months longer
Cal-adapt.org
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Recommendations
Appreciate.
Anticipate.
Advocate.
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HOW TO GET INVOLVED
Health Professionals for Clean AirDoctors for Climate Health [email protected] Climate 911 www.climate911.org
PSR www.psr.org