Furthering a partnership: Air quality modeling and improving public health.

Air pollution is one of the top five risk factors for population health globally. In recent years, advances in air pollution data and modeling have occurred simultaneously with advances in data and methods available for health studies. To realize the potential of such advances, the air quality modeling and public health communities should continue to strengthen their engagements and build effective interdisciplinary teams. These partnerships recognize the tight coupling between air quality and health data and methods and the value of expertise from multiple fields to ensure that this information is applied appropriately with a deep understanding of its capabilities and limitations. Building effective multidisciplinary teams takes a sustained commitment to engage with partners with different expertise to establish working partnerships and collaborations to better address public exposures to air pollution. Effective partnerships enable better targeting of research resources to answer important questions and provide essential information to protect public health.Implications: Air quality models are an effective tool that can be used to estimate air pollution exposure in epidemiologic studies and risk assessments. Working together in collaborative multidisciplinary teams will lead to greater advancements in understanding of air pollution impacts and in useful information informing actions to improve public health.

Estimating the national public health burden associated with exposure to ambient PM2.5 and ozone.

Ground-level ozone (O(3)) and fine particulate matter (PM(2.5)) are associated with increased risk of mortality. We quantify the burden of modeled 2005 concentrations of O(3) and PM(2.5) on health in the United States. We use the photochemical Community Multiscale Air Quality (CMAQ) model in conjunction with ambient monitored data to create fused surfaces of summer season average 8-hour ozone and annual mean PM(2.5) levels at a 12 km grid resolution across the continental United States. Employing spatially resolved demographic and concentration data, we assess the spatial and age distribution of air-pollution-related mortality and morbidity. For both PM(2.5) and O(3) we also estimate: the percentage of total deaths due to each pollutant; the reduction in life years and life expectancy; and the deaths avoided according to hypothetical air quality improvements. Using PM(2.5) and O(3) mortality risk coefficients drawn from the long-term American Cancer Society (ACS) cohort study and National Mortality and Morbidity Air Pollution Study (NMMAPS), respectively, we estimate 130,000 PM(2.5) -related deaths and 4,700 ozone-related deaths to result from 2005 air quality levels. Among populations aged 65-99, we estimate nearly 1.1 million life years lost from PM(2.5) exposure and approximately 36,000 life years lost from ozone exposure. Among the 10 most populous counties, the percentage of deaths attributable to PM(2.5) and ozone ranges from 3.5% in San Jose to 10% in Los Angeles. These results show that despite significant improvements in air quality in recent decades, recent levels of PM(2.5) and ozone still pose a nontrivial risk to public health.

Maximizing health benefits and minimizing inequality: incorporating local-scale data in the design and evaluation of air quality policies.

The U.S. Environmental Protection Agency undertook a case study in the Detroit metropolitan area to test the viability of a new multipollutant risk-based (MP/RB) approach to air quality management, informed by spatially resolved air quality, population, and baseline health data. The case study demonstrated that the MP/RB approach approximately doubled the human health benefits achieved by the traditional approach while increasing cost less than 20%--moving closer to the objective of Executive Order 12866 to maximize net benefits. Less well understood is how the distribution of health benefits from the MP/RB and traditional strategies affect the existing inequalities in air-pollution-related risks in Detroit. In this article, we identify Detroit populations that may be both most susceptible to air pollution health impacts (based on local-scale baseline health data) and most vulnerable to air pollution (based on fine-scale PM(2.5) air quality modeling and socioeconomic characteristics). Using these susceptible/vulnerable subpopulation profiles, we assess the relative impacts of each control strategy on risk inequality, applying the Atkinson Index (AI) to quantify health risk inequality at baseline and with either risk management approach. We find that the MP/RB approach delivers greater air quality improvements among these subpopulations while also generating substantial benefits among lower-risk populations. Applying the AI, we confirm that the MP/RB strategy yields less PM(2.5) mortality and asthma hospitalization risk inequality than the traditional approach. We demonstrate the value of this approach to policymakers as they develop cost-effective air quality management plans that maximize risk reduction while minimizing health inequality.

Sun protection education in the United States: what we know and what needs to be taught.

The incidence of skin cancers in the United States is rising. This has correlated with a life-time of sun exposure and cumulative damage of repetitive sun-related injuries such as tanning and sunburning. It is estimated that 80% of sun damage occurs before the age of 18 years. This relates to excessive tanning, blistering sunburns, and ineffective sun protection. It has been demonstrated that children can be taught to protect themselves from the sun. However, teaching of sun protection needs to begin at an early age. Such education requires that parents enforce protection in the household and through their actions in sunny situations. It has become apparent from the literature in the United States that we have made strides in sun education, but we have not yet instituted an effective nationwide education plan. This article reviews the data we have in the United States on sun protection, with a focus toward helping to design better education programs for the future. Based on the literature, it would seem that sun education should combine teaching mothers about sun protection in the nursery and teaching schools how to educate youngsters on the need for sun protection, beginning in nursery school. Improvements in education will have a latency of many years for reducing skin cancer incidence but will be an excellent investment in the future cutaneous health of today's children.