As the amount of PM 2.5 increased between the days analyzed, so did the hospital admission rate connected to those disease groups. Further, the link between exposure to fine particulate matter and hospitalizations was still evident even when the daily air pollution levels were lower than current World Health Organization guidelines and the less-stringent U.S. regulatory standards. “The study shows that the health dangers and economic impacts of air pollution are significantly larger than previously understood,” said Yaguang Wei, the study’s lead author and a doctoral student at the Chan School.
While air pollution health damage can be permanent and even cause death, Reductions in air pollution yielded fast and dramatic impacts on health-outcomes, as well as decreases in all-cause morbidity, according to findings in “Health Benefits of Air Pollution Reduction,” new research published in the American Thoracic Society’s journal, Annals of the American Thoracic Society. (See second article below)
Air pollution is largely an avoidable health risk that affects everyone. Urban growth, expanding industrialization, global warming, and new knowledge of the harm of air pollution raise the degree of urgency for pollution control and stress the consequences of inaction,” he says. “Fortunately, reducing air pollution can result in prompt and substantial health gains. Sweeping policies affecting a whole country can reduce all-cause mortality within weeks.
Neela Banerjee, Inside Climate News, NOV 27, 2019
A new Harvard University study for the first time links hospitalizations for common blood, skin and kidney ailments to short-term exposure to fine particulate matter from fossil fuel combustion and wildfires.
The findings widen the population of older Americans considered especially vulnerable to threats from the air pollutant even when exposed to it over short periods.
Led by researchers at Harvard University’s T.H. Chan School of Public Health, the study published Wednesday in the British medical journal BMJ found that short-term exposure to fine particulate matter led to higher levels of hospitalization for people with illnesses such as septicemia, or blood poisoning, kidney failure, urinary tract infections, skin and other tissue infections and electrolyte disorders often brought on by loss of fluids from vomiting or diarrhea.
Researchers defined “short-term” as exposure on the day of hospitalization and compared the pollution levels to the day before. The population studied was Americans over the age of 65, through a vast analysis of Medicare records for the 48 continental states.
As the amount of PM 2.5 increased between the days analyzed, so did the hospital admission rate connected to those disease groups. Further, the link between exposure to fine particulate matter and hospitalizations was still evident even when the daily air pollution levels were lower than current World Health Organization guidelines and the less-stringent U.S. regulatory standards.
The researchers studied a microscopic pollutant known as PM 2.5, which is generated by fossil fuel combustion in power plants and vehicles and by wildfires.
The tiny particles infiltrate the lungs, contributing to heart disease and worsening respiratory conditions such as asthma over the long-term, studies have shown. A 2015 study by the World Health Organization estimated that regular exposure to outdoor PM 2.5 pollution caused 3.7 million premature deaths worldwide each year. Previous studies showed that exposure to PM 2.5 heightened the risk of hospitalization largely for cardiovascular and respiratory illnesses, diabetes and Parkinson’s disease.
The new study indicates that people with diseases other than those with a clear link to heart or lung problems are also harmed by even short-term exposure to PM 2.5.
“The study shows that the health dangers and economic impacts of air pollution are significantly larger than previously understood,” said Yaguang Wei, the study’s lead author and a doctoral student at the Chan School.
Trump EPA Moves to Suppress Science on PM 2.5
The study’s focus on a broader public vulnerability to PM 2.5 comes as the Trump administration prepares to adopt a regulation that would severely curtail the use of scientific research to support public health standards, a major step in its efforts to undo pollution rules.
Environmental Protection Agency Administrator Andrew Wheeler, a former coal industry lobbyist, has described the proposed rule as an effort to improve “transparency.” But it has been widely criticized as an attempt to protect polluters by preventing policymakers from considering decades of well-established scientific research that connects air pollution to premature death.
The draft rule would prevent the use of studies based on confidential health data, which is often necessary to get a wide swath of participants and sensitive details. If it is also applied retroactively, that could lead to the regulator’s rejection of a seminal 1993 Harvard study that showed the threat that air pollution, including PM 2.5, poses to human health.
That has triggered a backlash in the medical and scientific communities, which say the result would be increased harm to human health. On Tuesday, the executive editors of some of the world’s most prestigious scientific journals, including Nature, Science and The Lancet, published a rare joint statement condemning the proposed rule. Scientists and health experts have been fighting it for over a year, raising alarms that it could be used to suppress scientific evidence critical for health regulations by preventing the use of studies useful for drug development or understanding asthma and pollution impacts. If such scientific evidence is dismissed by EPA under the new rule, “that would be a catastrophe,” they wrote.
Francesca Dominici, a professor of biostatistics at the Chan school and the new study’s principal investigator, described the proposed rule as “clearly an attack against science.”
Understanding the Connections
The new Harvard PM 2.5 study has transparency built into its design—it used government data from Medicare which is accessible to others who might want to replicate or build off the research.
The study was partly funded by the EPA and arrives as the agency should start a process to review and finalize the National Ambient Air Quality standards, including on fine particulates, by the end of 2020. EPA staff have reached a preliminary conclusion that the current PM 2.5 standard is too weak, but the agency’s Trump administration-appointed science advisers disagreed. The final decision will be Wheeler’s.
For the study, researchers analyzed hospital admissions data from 2000 to 2012 for 95 million inpatient claims on Medicare.
They classified the illnesses that landed people in the hospital into 214 groups, based on codes Medicare uses. To estimate the daily PM 2.5 levels over the same period, the researchers relied on satellite-based pollution measurements and a computer model of air pollution. Then they matched the PM 2.5 estimates with the zip codes of those people hospitalized.
The study did not seek to determine how PM 2.5 worsens the illnesses for which people were hospitalized. Wei, the lead author, said that many studies have shown that exposure to fine particulate matter can induce inflammation. But for some of the diseases found to be aggravated by PM 2.5, the underlying mechanism of how exposure worsens illness wasn’t clear and warranted further research.
“Now that we have reported on these new sets of diseases, it will allow others to look into the physiology of the diseases,” Dominici said. “It will open up a better understanding of how this is happening and that will allow us to prevent these hospitalizations.”
InsideClimate News reporter Marianne Lavelle contributed to this story.
**
Reductions in air pollution yielded fast and dramatic impacts on health-outcomes, as well as decreases in all-cause morbidity, according to findings in “Health Benefits of Air Pollution Reduction,” new research published in the American Thoracic Society’s journal, Annals of the American Thoracic Society.
The study by the Environmental Committee of the Forum of International Respiratory Societies (FIRS) reviewed interventions that have reduced air pollution at its source. It looked for outcomes and time to achieve those outcomes in several settings, finding that the improvements in health were striking. Starting at week one of a ban on smoking in Ireland, for example, there was a 13 percent drop in all-cause mortality, a 26 percent reduction in ischemic heart disease, a 32 percent reduction in stroke, and a 38 percent reduction in chronic obstructive pulmonary disease (COPD). Interestingly, the greatest benefits in that case occurred among non-smokers.
“We knew there were benefits from pollution control, but the magnitude and relatively short time duration to accomplish them were impressive,” said lead author of the report, Dean Schraufnagel, MD, ATSF. “Our findings indicate almost immediate and substantial effects on health outcomes followed reduced exposure to air pollution. It’s critical that governments adopt and enforce WHO guidelines for air pollution immediately.”
In the United States, a 13-month closure of a steel mill in Utah resulted in reducing hospitalizations for pneumonia, pleurisy, bronchitis and asthma by half. School absenteeism decreased by 40 percent, and daily mortality fell by 16 percent for every 100 ?g/m3 PM10 decrease. Women who were pregnant during the mill closing were less likely to have premature births.
A 17-day “transportation strategy,” in Atlanta, Georgia during the 1996 Olympic Games involved closing parts of the city to help athletes make it to their events on time, but also greatly decreased air pollution. In the following four weeks, children’s visits for asthma to clinics dropped by more than 40 percent and trips to emergency departments by 11 percent. Hospitalizations for asthma decreased by 19 percent. Similarly, when China imposed factory and travel restrictions for the Beijing Olympics, lung function improved within two months, with fewer asthma-related physician visits and less cardiovascular mortality.
In addition to city-wide polices, reducing air pollution within the home also led to health benefits. In Nigeria, families who had clean cook stoves that reduced indoor air pollution during a nine-month pregnancy term saw higher birthweights, greater gestational age at delivery, and less perinatal mortality.
The report also examines the impact of environmental policies economically. It highlights that 25 years after enactment of the Clean Air Act, the U.S. EPA estimated that the health benefits exceeded the cost by 32:1, saving 2 trillion dollars, and has been heralded as one of the most effective public health policies of all time in the United States. Emissions of the major pollutants (particulate matter [PM], sulfur oxides, nitrogen oxides, carbon monoxide, volatile organic compounds, and lead) were reduced by 73 percent between 1990 and 2015 while the U.S. gross domestic product grew by more than 250 percent.
Given these findings, Dr. Schraufnagel has hope. “Air pollution is largely an avoidable health risk that affects everyone. Urban growth, expanding industrialization, global warming, and new knowledge of the harm of air pollution raise the degree of urgency for pollution control and stress the consequences of inaction,” he says. “Fortunately, reducing air pollution can result in prompt and substantial health gains. Sweeping policies affecting a whole country can reduce all-cause mortality within weeks. Local programs, such as reducing traffic, have also promptly improved many health measures.”
Materials provided by American Thoracic Society. Note: Content may be edited for style and length.
Dean E. Schraufnagel, John R. Balmes, Sara De Matteis, Barbara Hoffman, Woo Jin Kim, Rogelio Perez-Padilla, Mary Rice, Akshay Sood, Aneesa Vanker, Donald J. Wuebbles. Health Benefits of Air Pollution Reduction. Annals of the American Thoracic Society, 2019; 16 (12): 1478 DOI: 10.1513/AnnalsATS.201907-538CME
American Thoracic Society. “Dramatic health benefits following air pollution reduction.” ScienceDaily. ScienceDaily, 6 December 2019. <www.sciencedaily.com/releases/2019/12/191206173634.htm>. Nov. 11, 2019
Particulate Matter Policy Assessment for the National Ambient Air Quality Standards (NAAQS)
| EPA Designated Federal Officer (DFO): | Aaron Yeow 202-564-2050 yeow.aaron@epa.gov |
| Responsible Committee/Panel: | CASAC |
See EPA’s PDF page to learn more about PDF files.
| BACKGROUNDPROCESS FOR COMMITTEE/PANEL FORMATIONADVISORY MEETINGS AND REPORT DEVELOPMENTUnder the Clean Air Act, EPA is required to carry out a periodic review and revision, as appropriate, of the air quality criteria and the primary and secondary standards for six criteria air pollutants, which include particulate matter. EPA is currently reviewing the NAAQS for particulate matter. Primary standards set limits to protect public health, including the health of “sensitive” populations such as asthmatics, children, and the elderly. Secondary standards set limits to protect public welfare, including protection against decreased visibility, damage to animals, crops, vegetation, and buildings. As part of the NAAQS review process, EPA’s Office of Air and Radiation has requested CASAC review of the draft Policy Assessment. Agency Charge . (PDF, 5 pp., 173,746 bytes) Agency Review Document(s): PDF for Policy Assessment for the Review of the National Ambient Air Quality Standards for Particulate Matter (External Review Draft – September 2019). (PDF, 457 pp., 15,904,295 bytes) |
NYT, Nov 2019
WASHINGTON — The Trump administration is preparing to significantly limit the scientific and medical research that the government can use to determine public health regulations, overriding protests from scientists and physicians who say the new rule would undermine the scientific underpinnings of government policymaking.
A new draft of the Environmental Protection Agency proposal, titled Strengthening Transparency in Regulatory Science, would require that scientists disclose all of their raw data, including confidential medical records, before the agency could consider an academic study’s conclusions. E.P.A. officials called the plan a step toward transparency and said the disclosure of raw data would allow conclusions to be verified independently.
“We are committed to the highest quality science,” Andrew Wheeler, the E.P.A. administrator, told a congressional committee in September. “Good science is science that can be replicated and independently validated, science that can hold up to scrutiny. That is why we’re moving forward to ensure that the science supporting agency decisions is transparent and available for evaluation by the public and stakeholders.”
The measure would make it more difficult to enact new clean air and water rules because many studies detailing the links between pollution and disease rely on personal health information gathered under confidentiality agreements. And, unlike a version of the proposal that surfaced in early 2018, this one could apply retroactively to public health regulations already in place.
“This means the E.P.A. can justify rolling back rules or failing to update rules based on the best information to protect public health and the environment, which means more dirty air and more premature deaths,” said Paul Billings, senior vice president for advocacy at the American Lung Association.
Public health experts warned that studies that have been used for decades — to show, for example, that mercury from power plants impairs brain development, or that lead in paint dust is tied to behavioral disorders in children — might be inadmissible when existing regulations come up for renewal.
For instance, a groundbreaking 1993 Harvard University project that definitively linked polluted air to premature deaths, currently the foundation of the nation’s air-quality laws, could become inadmissible. When gathering data for their research, known as the Six Cities study, scientists signed confidentiality agreements to track the private medical and occupational histories of more than 22,000 people in six cities. They combined that personal data with home air-quality data to study the link between chronic exposure to air pollution and mortality.
But the fossil fuel industry and some Republican lawmakers have long criticized the analysis and a similar study by the American Cancer Society, saying the underlying data sets of both were never made public, preventing independent analysis of the conclusions.
The change is part of a broader administration effort to weaken the scientific underpinnings of policymaking. Senior administration officials have tried to water down the testimony of government scientists, publicly chastised scientists who have dissented from President Trump’s positions and blocked government researchers from traveling to conferences to present their work.
In this case, the administration is taking aim at public health studies conducted outside the government that could justify tightening regulations on smog in the air, mercury in water, lead in paint and other potential threats to human health.
Scott Pruitt, the former administrator of the E.P.A., had made publication of underlying scientific data a top priority and tried to rush a proposal through the regulatory system in 2018. Mr. Pruitt resigned that July, and his successor, Mr. Wheeler, delayed the transparency rule and suggested the E.P.A. needed time to address the chorus of opposition from environmental and public health groups.
But a draft of the revised regulation headed for White House review and obtained by The New York Times shows that the administration intends to widen its scope, not narrow it.
The previous version of the regulation would have applied only to a certain type of research, “dose-response” studies in which levels of toxicity are studied in animals or humans. The new proposal would require access to the raw data for virtually every study that the E.P.A. considers.
“E.P.A. is proposing a broader applicability,” the new regulation states, saying that open data should not be limited to certain types of studies.
Most significantly, the new proposal would apply retroactively. A separate internal E.P.A. memo viewed by The New York Times shows that the agency had considered, but ultimately rejected, an option that might have allowed foundational studies like Harvard’s Six Cities study to continue to be used.
An E.P.A. spokeswoman said in an emailed statement, “The agency does not discuss draft, deliberative documents or actions still under internal and interagency review.”
On Wednesday, the House Committee on Science, Space and Technology will hold a hearing on the E.P.A.’s efforts. A top pulmonary specialist and a representative of the country’s largest nonprofit funder of research on Parkinson’s disease, the Michael J. Fox Foundation, are expected to testify that the E.P.A.’s proposed rule would eliminate the use of valuable research showing the dangers of pollution to human health.
Mr. Pruitt’s original proposal drew nearly 600,000 comments, the vast majority of them in opposition. Among them were leading public health groups and some of the country’s top scientific organizations like the American Association for the Advancement of Science.
The National Association of Pediatric Nurse Practitioners said it was “deeply concerned” that the rule would lead to the exclusion of studies, “ultimately resulting in weaker environmental and health protections and greater risks to children’s health.” The National Center for Science Education said ruling out studies that do not use open data “would send a deeply misleading message, ignoring the thoughtful processes that scientists use to ensure that all relevant evidence is considered.” The Medical Library Association and the Association of Academic Health Science Libraries said the proposal “contradicts our core values.”
Industry groups said the rule would ensure greater public understanding of the science behind regulations that cost consumers money.
“Transparency, reproducibility and application of current scientific knowledge are paramount to providing the foundation required for sound regulations,” the American Chemistry Council wrote to the E.P.A. in support of the plan.
The new version does not appear to have taken any of the opposition into consideration. At a meeting of the agency’s independent science advisory board this summer, Mr. Wheeler said he was “a little shocked” at the amount of opposition to the proposal, but he was committed to finalizing it. Beyond retroactivity, the latest version stipulates that all data and models used in studies under consideration at the E.P.A. would have to be made available to the agency so it can reanalyze research itself. The politically appointed agency administrator would have wide-ranging discretion over which studies to accept or reject.
“It was hard to imagine that they could have made this worse, but they did,” said Michael Halpern, deputy director for the Center for Science and Democracy at the Union of Concerned Scientists, a nonprofit advocacy group. He added, “This is a wholesale politicization of the process.”
Academics are not typically required to turn over private data when submitting studies for peer review by other specialists in the field, or for publication in scientific journals, the traditional ways scientific research is evaluated. If academics were to turn over the raw data to be made available for public review, the E.P.A. would have to spend hundreds of millions of dollars to redact private information, according to one federal estimate.
The Six Cities study and a 1995 American Cancer Society analysis of 1.2 million people that confirmed the Harvard findings appear to be the inspiration of the regulation.
The proposal gives the public 30 days to offer comments on the changes to the E.P.A.’s plan. Agency officials have said they hope to finalize the measure in 2020.
“The original goal was to stop E.P.A. from relying on these two studies unless the data is made public,” said Steven J. Milloy, a member of Mr. Trump’s E.P.A. transition team who runs Junkscience.org, a website that questions established climate change science and contends particulate matter in smog does not harm human health.
He dismissed concerns that the new rule could be used to unravel existing regulations, but he said he did expect it to prevent pollution rules from getting tougher.
“The reality is, standards are not going to be tightened as long as there’s a Republican in office,” he said.
**
Joint statement on EPA proposed rule and public availability of data (2019)
- H. Holden Thorp1,*,
- Magdalena Skipper2,
- Veronique Kiermer3,
- May Berenbaum4,
- Deborah Sweet5,
- Richard Horton6
See all authors and affiliations Science 06 Dec 2019: Vol. 366, Issue 6470, eaba3197 DOI: 10.1126/science.aba3197
Eighteen months after articulating our concerns (1) regarding the 2018 “Strengthening Transparency in Regulatory Science” rule proposed by the Environmental Protection Agency (EPA) (2), we have become more concerned in response to recent media coverage and a 13 November hearing on the role of science in decision-making at the EPA. These events suggest that the proposed rule is now moving toward implementation; whether it includes amendments sufficient to address the concerns raised by us and many others remains a question.
Our previous statement on the proposed rule, authored and published by the editors-in-chief of five major scientific journals in May 2018, reflected alarm that the proposal’s push for “transparency” would be used as a mechanism for suppressing the use of relevant scientific evidence in policy-making, including public health regulations. After the public comment period for the proposed rule closed, the EPA reported more than 590,000 comments from individuals and scientific, medical, and legal groups, many of which articulated similar concerns (3).
As leaders of peer-reviewed journals, we support open sharing of research data, but we also recognize the validity of scientific studies that, for confidentiality reasons, cannot indiscriminately share absolutely all data. Datasets featuring personal identifiers—including studies evaluating genomes of thousands of people to characterize medically relevant genetic variants—are but one example. Such data may be critical to developing new drugs or diagnostic tools but cannot be shared openly; even anonymized personal data can be subject to re-identification, and it has been a longstanding practice for agencies and journals to acknowledge the value of data privacy adjustments. The principles of careful data management, as they inform medicine, are just as applicable to data regarding environmental influences on public health. Discounting evidence from the decision-making process on the basis that some data are confidential runs counter to the EPA stated mission “to reduce environmental risks…based on the best available scientific information” (4).
We are also concerned about how the agency plans to consider options related to existing regulations. Even if a new standard is not applied retroactively, the standard could apply when a regulation is updated; thus, foundational science from years past—research on air quality and asthma, for example, or water quality and human health—could be deemed by the EPA to be insufficient for informing our most significant public health issues. That would be a catastrophe.
We urge the EPA to continue to adopt an approach that ensures the data used in decision-making are the best available, which will at times require consideration of peer-reviewed scientific data, not all of which may be open to all members of the public. The most relevant science, vetted through peer review, should inform public policy. Anything less will harm decision-making that claims to protect our health.
We hope that in the end, decisions that are made to inform the proposed EPA rule will rise above any form of politics, focusing on what’s best for our communities. We encourage anyone with concerns or opinions about this issue to express their views through relevant legislative channels. Whether submitting public comments to the EPA or communicating with lawmakers in Congress, it is important to emphasize that decision-making that affects us all should be informed by nothing less than the full suite of relevant science vetted through peer review.
- ↵
- J. Berg,
- P. Campbell,
- V. Kiermer,
- N. Raikhel,
- D. Sweet
- ↵U.S. Environmental Protection Agency, News Releases, “EPA Administrator Pruitt proposes rule to strengthen science used In EPA regulations” (2018); www.epa.gov/newsreleases/epa-administrator-pruitt-proposes-rule-strengthen-science-used-epa-regulations.Google Scholar
- ↵U.S. Environmental Protection Agency, Science Advisor Programs, “Strengthening transparency in regulatory science” (2018); www.epa.gov/osa/strengthening-transparency-regulatory-science.Google Scholar
- ↵U.S. Environmental Protection Agency, “Our mission and what we do” (2018); www.epa.gov/aboutepa/our-mission-and-what-we-do.Google Scholar
Recommended articles from TrendMD
- Getting the EPA back on trackMarie Lynn Miranda, Science, 2019
- Whose science? A new era in regulatory “science wars”Wendy Wagner et al., Science, 2018
- Critics see hidden goal in EPA data access ruleWarren Cornwall, Science, 2018
- Obfuscating with transparencyJeremy Berg, Science, 2018
- White House Softens Disputed Peer-Review PlanJocelyn Kaiser, Science, 2004
- New EPA rule may hinder health researchMDLinx, 2019
- Will research preprints improve healthcare for patients?Harlan M Krumholz et al., The BMJ, 2018
- Data sharing statements for clinical trialsLaragh Gollogly et al., The BMJ, 2017
- PulmCCM Journal Launches: Your Submissions WelcomePulmCCM, PulmCCM
- Does the Anonymous Voice Have a Place in Scholarly Publishing?Jaime A Teixeira da Silva et al., Plant Physiol, 2016
