Air Pollution Exposure: Particulate Matter

Final Paper Term

Sonia Donaires

December 10, 2015

MPH 584, Community Health

Dr. Kelly Wheeler

Introduction

Today, air pollution is one of the contaminants that are a concern for authorities

worldwide and is one of the factors that cause diseases in humans and living organisms such as

food and crops in natural or built environment. Air pollution is the presence of particles,

biological molecules or other toxic materials into the earth’s atmosphere that affect entire

communities. The Centers for Disease and Control and Prevention (CDC) identifies six

pollutants presents in the environment: carbon monoxide, lead, nitrogen oxides, ground-level

ozone, particle pollution (Particulate Matter), and sulfur oxides (CDC, 2015). Also, monitor

emissions of Particulate Matter (PM) and measure air quality in the environment.

The identification of primary sites of contamination of Particulate Matter are useful to

collect statistical information that will be crucial to understanding the prevalence of diseases

caused by air pollution. Private and federal agencies and the participation of stakeholders are

critical to implementing a solution for air pollution. The Framework for Program Evaluation in

Public health will be utilized as the most efficient and useful tool to evaluate the planning

process, implementation, and intervention program.

Develop a VIMOSA

Vision Statement:

The intent of this research is to disclosure the risk factors caused by air pollution and the

awareness of people about the health problems associated with Particulate Matter.

Objectives:

Identify the risk factors for articulate matter exposure into the atmosphere in the United

States

Identify the health effects of particulate matter exposure into the air in the United States

Reduce the prevalence of diseases related to exposure to particulate matter exposure into

the air in the United States

Strategies

Setting control strategies for the project Air Pollution Exposure: Particulate Matter is

crucial to identify concrete measures to implement with the purpose to to reduce PM in the air.

As part of the control strategy of PM is important also, to assess the costs and benefits of the

method used in the project. The fundamental key pieces for a successful campaign is to develop

a multi-step strategy with the following components:

Organization of a committee or team for each step of the development of the process.

Establish realistic goals that can be achievable during the progress of the campaign.

Identification of the target population based on the evidence or facts provided by the

experts in PM.

Identify needs and resources and establish a realistic timeline and deadlines in each step

of the process of the program. Besides, to determine the budget and identify external and

internal resources that might be monetary contributors.

Prepare outreach materials based on the needs of the audience to inform about Particulate

Matter and expose the impact on the health of communities. Also, informing about

resources and websites to obtain more information of what to do to advocate for their

community.

Implement strategies to monitor results and make adjustments as needed (EPA, 2015).

Outreach strategies will help to build lessons learned during the process of planning.

Assessment of the process of planning, implementation, and intervention and to evaluate

final outcomes

Plan action

Problem Definition

Particulate Matter (PM) is an outdoor contaminant in the form of dust, mist, and smoke

that is suspended in the atmosphere. PM is one of the major environmental risk factors that

impact in the health of individuals, plants, and animals. The primary sources that contribute the

emission of PM are the rapid industrialization, fast urbanization, rapid growth in population,

grows of vehicles on the roads and human-made sites, affects the natural balance of the

atmosphere. The sources of PM pollution are two types: 1) Natural sources are caused for a

natural phenomenon such as volcanic eruptions, forest fires, biological decay, pollen grains,

marshes, and radioactive materials; and 2) Artificial sources man-made such as burning coal in

power and industrial units, vehicular combustion, agricultural activities, unpaved roads,

construction, and others (EPA, 2015).

According to World Health Organization (WHO), Particulate Matter causes diseases that

compromise the respiratory system, cardiovascular, and cancer. Word Health Organization

(WHO) reported that 80% of premature deaths are caused by air pollution due to ischaemic heart

disease and strokes; 14% of deaths due to chronic obstructive pulmonary disease or acute lower

respiratory infections; and 6% of deaths of lung cancer. Additionally, researchers from the

International Agency for Research on Cancer (IARC) reported that Particulate Matter is a risk

factor for the increase of the prevalence of carcinogenic to humans or cancer of the lung and

cancer of the urinary tract/bladder. Premature Death caused by outdoor pollution in rural and

urban zones estimate 3.7 million worldwide in 2012 (WHO, 2015). The plan will be based on the

established laws and policies by the federal-enforceable plan for reducing air pollution. Also, the

National Ambient Air Quality standards (NAAQS) set forth in the Clean Air Act (CAA) (EPA,

2015) will be another useful resource for the project.

Conducted a capacity /Inputs/Gaps Inventory

Particulate Matter Air Pollution is a problem that affect people in develop and developing

countries. The target audience for this program would be the most vulnerable population affected

by air pollution: children, elderly and minorities. The intervention of local government in

conjunction with the federal regulations for PM is necessary to decrease the prevalence of health

issues in the target population. Additionally, different levels of government will measure the

development of control strategy, from local to provincial and state level to national. Also, the

established objectives will be based on the realistic and significant emission of PM that impacts

the health of the target audience (Environmental Protection Agency, 2015). Another relevant

point is the collecting of data about the prevalence of diseases in the area selected after the

intervention to measure final outcomes. A principal resource that would benefit the project is

those agencies that already have regulated the PM at the federal level.

The primary sources mention below are useful to obtain statistical information for this

study are crucial to understanding the prevalence of diseases caused by air pollution.

- The Centers for Diseases Control and Prevention (CDC)

- Occupational Safety and Health Administration (OSHA)

- World Health Organization (WHO)

- Agency for Toxic Substances and Disease Registry (ATSDR) from US government, and

Medical reports

- Food and Drug Administration (FDA)

- Other sources such as medical magazines, news, documentaries, etc.

Another agencies that are useful in implementing a solution to the contaminants of air

pollution. It will provide examples and models used in an intervention to evaluate effectiveness

in the project:

- The Centers for Diseases Control and Prevention (CDC): CDCynergy

- Agency for Toxic Substances and Disease Registry (ATSDR) from US government, and

Medical reports

- The Guide to Community Preventive Services

- US Environmental Protection Agency (EPA)

- Natural Resources Defense Council (NRDC)

The project Air Pollution: Particulate Matter needs to take into consideration the

participation of multiple partners agencies with the purpose to develop strategic activities and

establish a climate and clean air policies. The involvement of organizations that are the primary

contributors of PM will the other target population. The awareness of this industries and the

agreement to try new alternative solutions will ensure the success of implementing a program to

reduce emissions of PM. The collaboration of federal agencies is crucial to achieving goals. The

participation of professionals from multiple organizations will help to identify and access of

other existing programs, resource, and tools developed by another team that might be suitable in

the process of planning (state agencies, legislatures, universities, and the private sector).

The plan of substitution of clean energy to reduce the emissions of greenhouses gas and

automobils is one of the purposes that all agencies altogether should consider to achieve the

objectives. The key people that should contribute in this matter are:

The governor of a state can provide leadership and ensure the follow-through of the

implementation.

State legislatures are those that can oversight the policies and legislative to take action in

the matter.

State agencies are crucial to maintaining government data and have an "analytical

capacity, policy making authority, and/or implementation of jurisdiction in sectors of

interest" (EPA, n.d.).

Universities will provide expertise, analytical support, and neutral forum to convince

stakeholders meetings (Environmental Protection Agency, 2015).

Additionally, the importance of identifying other significant stakeholders from outside of

the targeted area can assure the process of the project:

Automobiles industries

Private business that are Independent system operators (ISOs) and regional

transmission organizations (RTOs) that are important pieces for clean energy

policies.

Independent power producers, transmissions owners, energy suppliers and electricity

markets.

Environmental and consumer organizations will track data, analysis, and provide

feedback.

While it is true that the support of local government and legislature and state agencies are

relevant for an efficient implementation of a campaign, also, the involvement of target audience

is essential for the success of the project (EPA, 2015, July 8)

If …..THEN….Process

If we achieve that stakeholder at local, state, and national level hear us, then the coalition

will be formed to take action.

If we organized a committee, then they will develop a Program to reduce the levels of

Particulate Matter plan.

If we increase education about the sources that contribute the rise of levels of PM in the

target community then the vulnerable population children, elderly and minorities will

reduce health effects.

If we identify specific source contributors of PM emissions, then health professionales

will show evidence to take action.

If we identify diseases related PM exposure in the target community, then the federal

government will intervene in the development of a program for implementation.

If we develop a program to inform about sites, primary sources of PM emissions, and

diseases related to PM exposure, then we can advocate for the well-being of our

communities.

If we develop a plan demonstrating how to substitute of fix the release of PM, then we

will succeed reducing PM in our environment.

Logic Model Narrative

The fact that people knew little about Particulate matter in air pollution make impossible

that people identify other risk factors for lung cancer. PM, which in essence is the same as

cigarette smoke, is another risk factor for the prevalence of lung cancer. Therefore, the first step

to reducing the PM is to develop a series of propaganda to warn people about the risks of PM.

Printed materials will help to inform about the health issues related PM, the use of mass media

will make aware people about their risks of exposure to PM. Furthermore, in this campaign the

intervention of physicians are relevant because they are the primary professional to advocate for

the health of their patients that are affected with symptoms of exposure to PM. Besides, is

important to know that PM has been linked no just to lung cancer or respiratory problems. It is

also related to the increase in the prevalence of heart attack and stroke and thus the rise of

mortality rates (Moench, 2015).

Inputs:

Key people from the community such as teachers, police officers, or other concern

citizenships.

Physicians that are aware of the impact on health issues in the commonwealth.

Researchers such as epidemiologists and professionals of Public Health that come from

outside of the community or can be local agencies that have a concern about the impact

of the PM in the public health.

Data analysis to determine the prevalence of the exposure to the PM.

Gaining entry into the community, a gatekeeper that can be representative of

intermediary organizations such as church and school. Politicians, leaders of activists

groups, business and education leaders, ad clergy and others (McKenzie & Pinger, 2015).

Ensure the support of a variaty of organizations to obtain funds for the project

Coallition

Organize a coalition with the only top people expertise in air quality management.

Significant representatives from the public and private sector. Participation of community

through universities, colleges, higher education, public research institutions, Media, and

professionals of health care.

Organization of committee to gain support and participation of stakeholders in the

process of the program

The involvement of a broad of stakeholders is essential to the success of air quality

management.

Stakeholders also should be involved at all stages of the process or organization,

planning, information collection and analysis, implementation, intervention, and

assessment (United Nations Environment Programme, n.d.).

Surveillance system

Professionals experts in PM will be the first monitors to disclosure the exposure of sites

that contributing with Suspended Particulate Matter.

Public Health personnel will be the collecting samples to detect levels of PM exposure

The feasibility of Conducting exposure monitoring in the areas suspected (National

Research Council of the National Academes, n.d.).

Citizens concern about PM should request Sampling sites to be collected to represent

areas of potential exposure of PM

Surveillance system in the public hospitals will be one of the ways the impact of PM in

the community.

Funidng/support

Laws and policies stated by federal agencies will be one of the support of the project to

have available found.

Ensuring the availability of funding are important to continue with the development of

the program.

Gaining the support of potential stakeholders that might ensure monetary contributions to

implement the campaign.

Activities

Surveillance data

Research of the impact of PM and related diseases in the target area

Organization of a coalition between stakeholders, team members and other partners

will ensure the progress of the project.

Development of a plan that focuses on achieving the objective set.

Implement and intervene to control PM

Assessment and evaluation

Products

Monitoring the exposure of PM every year to establish the increase or reduction of PM is

important.

Monitoring health issues related PM every year in hospitals

Intermediate Outcomes

Data collected to measure the success of strategies used in the program

Assessment and feedback of evaluators during the development of the project.

Feedback of stakeholders and policymaker about the success of the program (Funnell &

Rogers, 2011).

Distal Outcomes

Reduction the suspended Particulate Matter in the air

Reduction of health issues related PM

Increase of quality air

Review of the related resources

Particulate matter (PM) is a mixture of solid particles and liquid droplets found in the air

(NJSHAD - Indicator Profile View – Fine Particulate Matter in Outdoor Air, n.d.). Some

examples or this particulate are located in the dust, dirt, soot, or smoke. A particulate matter has

different sizes and shapes and is made up of hundreds of various chemicals. Some of them are

larger or dark that can be seen with the eye; others are minuscule that cannot be detected.

“Inhalable coarse particles have a diameter of 2.5 micrometers and smallest that 10 microns. In

comparison with hair, that has a diameter of 70 microns making 30 times larger that the largest

fine particle. (The United States Environmental Protection Agency, 2015). PM emissions are

classified in anthropogenic and non-anthropogenic, what it means is that anthropogenic is PM

that is man-made such as construction sites, unpaved roads, fields, smokestacks fires, and natural

sources like windblown, wildfires, and dust, also, it is called primary emissions. And non-

anthropogenic comes from natural sources that include SOx, NOx, VOCs, and ammonia (San

Joaquin Valley Air Pollution control District, n.d.). The “fine particulate” are emitted directly

into the air from forest fires, gasses emitted from power plants, industries, and automobiles react

(The United States Environmental Protection Agency, 2015).

The danger of particulate matter is because it is the tiniest particle (measures 3 microns in

diameter) in the air and can be inhaled. When people breathe this microscopic particle, it enters

the nose and through the throat arrive at the lungs where irritates the lung capillaries causing

breathing problems. So, PM is one of the risk factors in human that cause deficiencies in the lung

functions increasing the respiratory morbidity. PM also produce a high risk of lung cancer,

emphysema in the urban population. (United Nations Environment Program, n.d.)

The effects of PM and other pollutants vary in corrosion of buildings and effects in

human, animals, and plants. PM can produce accelerated corrosion of metals, damage paints,

sculptures, surfaces of structures. PM also impact climate through the formation of clouds and

snow and “contribute to acid deposition and may absorb solar radiation and impair/reduce

visibility” (United Nations Environment Program, n.d.)

The impact on the health of public health linked to particulate matter pollution includes

premature death in people with heart or lung disease, nonfatal heart attacks, irregular heartbeat,

aggravated asthma, decreased lung function, and respiratory problems: irritation of the airways,

coughing or difficulty breathing. The populations most affected are children, infants, elderly and

minorities. PM also, produce premature death in individuals, decreasing the life expectancy in

communities (The United States Environmental Protection Agency, 2015).

Particulate matter does not dissipate from the environment, it remains suspended in the

air and travel long distances and can damage the environment. "PM settles on soil and water and

harms the environment by changing the nutrient and chemical balance" (United States

Environmental Protection Agency, 2015). According to the EPA under the Clean Air Act sets

and review national air quality standards for Particulate Matter. EPA monitors air quality and

measures the concentration of PM nationwide. EPA main purpose of these measurements is to

ensure that PM pollution in the atmosphere has the minimum levels that reduce public health and

the environment issues. The picture below shows that Particulate Matter has been decreasing in

the last years (Environment Protection Agency 2015, September 24).

Source: http://www3.epa.gov/airtrends/pm.html

The National Ambient Air Quality Standards (NAAQS) under the Clean Air Act

measures the levels of PM in the environment considered harmful or toxic to the public health.

There are two types of national ambient air quality standards: 1) Primary standards that main

purpose is to protect the health of sensitive populations such as asthmatics, children, and the

elderly. 2) Secondary standards protects against visibility and damage to animals, crops,

vegetation, and buildings (The United States Environmental Protection Agency, 2015, October

6). The Particulate Matter is one of the six principal pollutants: the "criteria" unit of measuring

"the standards are parts per million (ppm) by volume, parts per billion (ppb) by volume and

micrograms per cubic meter of air (ug/m3)" (EPA National Ambient Air Quality Standards

(NAAQS), n.d.).

Particulate Matter Standards

Pollutant

[Final Rule Cite]

Primary/

Secondary

Average

Time

Level Form

Particulate

Pollution

Dec. 14, 2012

: PM 2.5

Primary Annual 12 ug/m3 Annual mean, average over 3 years

Secondary Annual 15 ug/m3 Annual mean, average over 3 years

Primary

and

secondary

24 - hours 150 ug/m3 98th percentile, average over 3 years

PM 10 Primary

and

Secondary

24 - hours 150 ug/m3 Not to be exceeded more than once

per year on average over 3 years

Source: http://www3.epa.gov/ttn/naaqs/criteria.html

Formative and Process Evaluation

Exposure Air pollution Exposure: Particulate Matter program will determine the achievement of

objectives using the CDC’s framework of the six steps for the evaluation process.

1. Engaging stakeholders are not enough to achieve the objectives of Particulate

Matter program. The involvement of a broad private and public sectors and the engagement of

the target audience are necessary to make successful the Air Pollution Exposure: Particulate

Matter. So, the evaluation and feedback of all organizations and participants will determine the

changes necessary in the process of planning and implementation (CDC’s Healthy Communities

Program, n.d.).

2. The description of the program will identify the strengths and weaknesses of the

program and will help planners to decide what is worth monitoring in the program.

3. Focus the evaluation design increases the chances that the assessment will

succeed by identifying procedures that are practical, politically viable, and cost effective. This

step develops basic evaluation questions that planners can measure: the awareness of the target

community about PM; responses of stakeholders and policy makers; and the impact of the

campaign in the commonwealth.

4. Gather credible evidence will enhance the evaluation, promotes the collection of

valid, reliable and complete information that is the foundation of any accurate assessment

(CDC’s Healthy Communities Program, n.d.). Evidence is a fact that expert professionals will

gather from a collection of sample test of air.

5. Justify conclusions reinforce findings to the evaluation, involves clarification,

qualitative and quantitative data analysis and synthesis, logical interpretation and appropriate

comparison against relevant standards for judgment (CDC’s Healthy Communities Program,

n.d.). During this step, planners will determine how the data will be analyzed and how the results

will be summarized, interpreted, disseminated and used to improve program implementation

(CDC, 1999, 2008). Once the data is analyzed, the evaluator will develop a report of the results.

Then, it will be distributed to the program managers, as well as to all partners and stakeholders.

The feedback from the stakeholders should lead planners to decide if the program needs to

change the strategies, message, and intervention to improve the program (CDC, n.d).

6. Ensure the use and share lessons learned, this step’s primary purpose is to

evaluate goals and objectives of the program. In this step, stakeholder’s feedback will revel the

strengths and weakness of the program with the purpose of change, continue or discontinue,

improve or eliminate ineffective parts of the program (CDC’s Healthy Communities Program,

n.d.).

The use of formative and summative evaluation is necessary for the assessment processes

of the Air Pollution Exposure: Particulate Matter will benefit from the qualitative and

quantitative method with the purpose to compensate the weaknesses of one method for the

strengths of the others (Mackenzie et al, 2013).

Formative evaluation will be conducted during the development and implementation of

the program. Once the needs assessment is defined, the formative evaluation will measure the

participation of the target audience. It involves engagement of the target community. The

process evaluation will measure how much was accomplished during the campaign. It will

measure the results of the response of the industries and manufacturers that contribute with PM

pollution. Also, the evaluation process will measure whether the implementation is operating as

planned. The assessment is conducted during the process of planning until the end of the

program.

Summative evaluations should be completed once a program is vested (CDC’s Healthy

Communities Program, n.d.) The purpose of a summative evaluation is to identify to what extent

the intervention is reached. It also evaluates the results responses of the industries related with

PM will determine the success or failure of the program and to see if regulations from federal

agencies are respected. Outcomes will be based long-term results of the reduction of PM.

Additionally; the summative evaluation will evaluate awareness, and attitude of the individuals

about the impact of PM on their health (Department of Health & Human Services, 1999).

Innovation 

Air Pollution Exposure: Particulate Matter program most innovative intervention is the use of

multiple partners at local, State and National level. PM is a problem that is not just a concern of

one community, is a concern of every country worldwide. So, engaging the participation of

professionals’ experts in PM will be crucial to gain collaboration of all sectors and input of the

target community. The purpose of this research is to suggest alternative solutions to reduce the

increase of PM to the industries of the automobile and other anthropogenic contributors of PM

and lessen the impact of public health. Possible innovative strategies might be on the way to be

invented.

Limitations 

Planners do not have control of industries that contribute or increase of PM. Regulation and

policies are already set by the U.S. Environmental Protection Agency (EPA). EPA also establish

the authorization to establish National Ambient Air Quality Standards (NAAQS) that main

purpose is to protect human health and the second purpose is oversee the effects in the structure

of cities . Air Pollution Exposure: Particulate Matter, do not have the control to reduce the

mortality with prevention programs in behavior change of individuals; it is responsibility of all

those manufacturers and industries that pollute the environment (Phalen, 2004).

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