LIVING AND DYING IN PARTICULATE AIR POLLUTION Robert

LIVING AND DYING IN PARTICULATE AIR POLLUTION Robert F. Phalen, Ph. D. University of California, Irvine Professor: Dept. of Medicine, Faculty: Center for Occupational and Environmental Medicine Co-Director: Air Pollution Health Effects Laboratory America First Energy Conference | The Heartland Institute Houston Texas, November 9, 2017

OUTLINE 1. What is PM? 2. The Death of John Doe 3. PM as an Air Pollutant 4. Remarks 2

MY BACKGROUND • • • Tulsa – The Former Oil Capital of the World San Diego State U. of Rochester, Lovelace U. C. Irvine – The Oil Embargo and ARB 200 + Particle and Gas Toxicology Studies International Conferences on PM and Human Health Committees – NRC, NIH, NIOSH, EPA, IRB, etc. 3

WHAT IS PM? • • NAAQS Criteria Pollutant Particulate Matter (Mass) Weight Below Either 10 or 2. 5 m Diam. Cutoff Composition Not Considered Variable in Space, Time, & Composition Mixed Natural and Anthropogenic Material 25% Deposits in Lung 4

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JOHN DOE 7

JOHN DOE’S RISK FACTORS • • • Age, overweight, older adult Cardiovascular disease, diabetic URT infection Anxiety, unemployed Poor physical/mental status Heat wave inversion, no AC 8

THE DAY JOHN DIED • • • Truck drove by Dog chased truck John chased dog uphill John collapsed and Died in ER, MI 9

WHAT KILLED JOHN? • • PM 2. 5 URT infection cigarettes pollen Obesity, CVD, and exertion Diabetes Anxiety, stress Low socioeconomic status etc. 10

PREVENTING HIS DEATH? • • • Tighten air Quality Standards Re-route traffic Improve John’s general health Reduce cost of air conditioning Improve John’s socioeconomic status etc. 11

PM AS A METRIC - 1 • • Not chemically defined Not stable in time or place Mixed man-made and natural pollutants Doses are miniscule 12

PM AS A METRIC - 2 • • Several no-effect epi studies Very expensive to meet regulations Controls have public health tradeoffs Controls can have unpredictable effects on air chemistry 13

REMARKS • PM is a poor metric • PM 2. 5 alone didn’t kill John • Do risk analysis on decisions, not a single pollutant • Consider all consequences of a decision 14

References: Enstrom, J. E. , (2017), Fine Particulate Matter and Total Mortality in Cancer Prevention Study Cohort Reanalysis, Dose-Response, 15(1), DOI: 10. 1177/1559325817693345. Graham, J. D. , and Wiener, J. B. , editors, (1995), Risk vs Risk: Tradeoffs in Protecting Health and the Environment, Harvard University Press, Cambridge, MA. Hiatt, R. A. , et. al. , Controlled Human Inhalation – Exposure Studies at EPA, National Academies Press, Washington, DC, 2017. National Research Council of the National Academies, (2009), Science and Decisions: Advancing Risk Assessment, National Academies Press, Washington, DC. Phalen, R. F. , (2002), The Particulate Air Pollution Controversy: A Case Study and Lessons Learned, Kluwer Academic Publishers, Boston, MA. Phalen, R. F. , (2009), Inhalation Studies: Foundations and Techniques, 2 nd Edn, Informa, New York, NY. Phalen, R. F. , and Phalen, R. N. , (2013), Introduction to Air Pollution Science: A Public Health Perspective, Jones and Bartlett Learning, Burlington, MA. Phalen, R. F. , (2017), Core Ethics for Health Professionals: Principles, Issues, and Compliance, Springer Publishing Company, New York, NY. 15