# Presentation: 324901

## PARTICULATE MATTER HEALTH EFFECTS

**Social/Behavioral**
**Factors**** **

**Genetics**

**Environment**

**National Air Quality Conference**
**February 5, 2002**

**PARTICULATE MATTER HEALTH EFFECTS**

**Cal/EPA Children’s Environmental Health Center**

## OVERVIEW

**Particulate Matter:**
**	****A Pollutant with Multiple Personalities**
**	****Health Effects**
**	****Exposure Considerations**
**	****How Can PM Cause Adverse Health Effects?**
** ****	****Take-Home Messages        **

## A Pollutant with Multiple Personalities

**Secondary Pollutants**
**HC + NO****X**** ******** Oxidants (O****3****, PAN)**
**O****3**** + NO ******** NO****2**
**O****3**** + NO****2**** ******** NO****3**** (Particles)**
**O****3**** + SO****2**** ******** SO****4**** (Particles)**

**Primary Pollutants = PM, HC, NO****X  ****CO, Pb, SO****2**

**Earth’s Protective Ozone Layer**

***The air we breathe...***

**~ 10-15 km**

**~ 15-50 km**

***UV***

***UV***

***UV***

***UV***

***UV***

**A Pollutant with Multiple Personalities**

## A Pollutant with Multiple Personalities: PM10  Size and Composition

**A Pollutant with Multiple Personalities: ****PM****10****  Size and Composition**

**Notes:**
1.  If you look at a sample of urban PM10--PM10 from a populated area with a wide mix of sources contributing to the PM problem-- and you sort the kinds of particles out by their relative size, you’ll get a picture very much like this here.  
2.  You will typically get a fair amount of the total mass ending up in what is called the “coarse” fraction of PM10.  These particles are bigger than 2.5 microns but smaller than 10 microns.  Here you’ll find such things as soil, dust, pollen pieces, salts and even rubber.  Ever wonder what happens to the tread that wears off your tires? 
3.  You’ll also get a significant amount of particles in what is called the “fine” fraction.  These are smaller than 2.5 microns in size.  Really really small stuff.  This is where you will find what many believe intuitively (although the science does not yet exist to conclusively prove this) might be the “real culprits” in causing some of the most serious health effects, in particular premature death. Things such as sulfates, nitrates, ammonia, heavy metals such as lead, all kinds of organics, along with carbon and soot.  This is why many people feel PM2.5 might be especially harmful.
4.  It is important to note that particles in the coarse range of PM10 are also harmful, although they are likely responsible for different kinds of health effects than those that may be found for PM2.5 exposure.
5.  Whatever the size cut, whatever the health effects observed, it is obvious that researchers have a great deal more work to do before we can understand how PM air pollution causes health effects.

## Pollens
Mold & Fungal Spores
Latex from Tire Wear
Agricultural Product Dusts

**Mold & Fungal Spores**
**Latex from Tire Wear**
**Agricultural Product Dusts**

**Particulates & Allergens Interact**
**Diesel & Pollens**
**PM10 & Endotoxin**

**A Pollutant with Multiple Personalities: ****Allergenic Constituents**

## Health Effects: Historical PM Episodes

**Increased Mortality**
**Most deaths due to respiratory or cardiovascular causes**
**Most in elderly and those already ill**
**PM Episodes**
**	****1930****	****Meuse Valley, Belgium****	**
**	****1948****	****Donora, Pennsylvania**
**	****1952****	****London, England**
**4 days before episode  193 deaths/day**
**4 days during episode  406 deaths/day **
** ****> 1995 ug/m****3**** British Smoke**

## Hazards from atmospheric pollutants have been demonstrated most vividly in episodes of acute exposure. ...A few community catastrophes have resulted from combinations of fog, temperature inversion, and air stagnation, coupled with unusually large amounts of ordinary combustion-produced atmospheric pollutants.  In these rare but tragic episodes, fatalities occurred predominantly among the elderly and those with pre-existing cardiac or pulmonary disease.”

_**Restoring the Quality of Our Environment**_
**Report of The Environmental Pollution Panel**
**President’s Science Advisory Committee**
**The White House**
**November 1965**

***“******Excessive air pollution for short periods (acute episodes)--***

## Health Effects: At Current Ambient Levels

**Acute Mortality:**** Short-term (day(s)) Exposures**
**    ****Daily Time-Series Studies relate the temporal distribution of PM & deaths in large populations **
**All-Cause, ****	****	****	****	****	****Respiratory, Cardiovascular Causes**
**Elderly,  people with pre-existing disease,    neonates & infants**
**Similar effects observed in wide range of locations, populations**
**Near linear increase in death counts corresponding to increasing PM levels**

## Health Effects: At Current Ambient Levels

**Acute Mortality:**** Short-term(day(s)) Exposures**
**Excess Mortality ****(Daily Time-Series Studies)**
**   ****Percent Change in Mortality**
**All-Cause**
**0.5% -to-1.6% per 10 ug/m****3**** PM10**
**1.0% -to-2.5% per 10 ug/m****3**** PM2.5**
**Respiratory Causes**
**1.3% -to- 3.7% per 10 ug/m****3**** PM10**
**Cardiovascular Causes**
**0.8% -to- 1.8% per 10 ug/m****3**** PM10**

## Health Effects: At Current Ambient Levels

**[Chronic] Mortality: ****Long-Term Exposures**
**    ****Effects may result from repeated exposures to elevated levels of PM and/or persistent exposure to low-to-moderate levels of PM. **
**Available studies compare mortality [or morbidity] among communities with different levels of PM.**
**Population-Based or Prospective Cohort **
**Use longer-term PM averages: 1+ years**

## Health Effects: At Current Ambient Levels

**[Chronic] Mortality: ****Long-Term Exposures**
**    ****Prospective Cohort Studies: Harvard 6-City, ACS **
**Percent Change in Mortality *******
**(After adjusting for individual risk factors)**
**Total (“all-cause”)**
**3% -to-9% per 10 ug/m****3**** PM10**
**Cardiopulmonary Causes**
**5% -to- 9% per 10 ug/m****3**** PM10**
*** ****Source: Wilson, Spengler. 1996. Particles in Our Air.**

## Health Effects: At Current Ambient Levels

**Morbidity:**** Short-term (daily) Exposures**
**Excess Morbidity ****(Daily Time-series Studies)**
**	****     ****Hospital Admissions: **
**	****	****Respiratory, pneumonia, COPD, asthma.**
**	****	****Cardiovascular, ischemic heart disease.**
**	****     ****Other Markers of Acute Illness:**
**	****	****School absences, work days lost, **
**	****	****	****reduced activity days,**
**	****	****	****medications usage. **

## Health Effects: At Current Ambient Levels

**Morbidity or Physiologic Responses:**
**    ****Short-term (daily, multi-day) Exposures**
**Acute Illness ****(Cohort, Panel Studies)**
**Aggravation of asthma, bronchitis**
**Increased risk of acute respiratory infection**
**Physiologic Responses ****(Cohort, Panel Studies)**
**Increased heart rate, pulse rate**
**Decreased heart rate variability**
**Increased plasma viscosity**
**Decreased lung function (transient?)**
**Irritation of respiratory tract **

## Health Effects: At Current Ambient Levels

**Morbidity or Physiologic Responses:**
**    ****Long-term (months, years) Exposures**
**Slowed lung function growth (children)**
**Accelerated lung function decline (adults)**
**Increased occurrence of respiratory disease or symptoms**
**Elevated risk of bronchitis or chronic cough**

## Health Effects:  Who Is Vulnerable?

**Short-Term**
**Children (all ages)**
**pre - & post-natal**
**Elderly People**
**Heart Disease Patients**
**Chronic Respiratory Disease Patients**
**Asthmatics**
**People with Bronchitis**
**Long-Term**
**Everyone**

## Exposure Considerations:Air Pollution -- From Source to Effects

**Sources**

**Transport**
**Local Air**
**Concentration**

**Exposure**

**Dose**

**Effects**

## Exposure Considerations:Particulate Matter Temporal Variation

## Exposure Considerations:Within Community Spatial Variation

- Source: T. Haste (Sonoma Technology, Inc)

## Ultrafine particle counts drop with distance from highway

**Source:****  ****Westerdahl, Bowers, Taylor: Presented at AAAR October 18, 2001****Data Source:Sioutas with permission, unpublished data**

**Exposure Considerations:****Within-Community Spatial Variation**

## Exposure Considerations:Association Between Lung Function of Children Living <300 Meters From Motorway and Intensity of Cargo Traffic

**FEV1 (Liters)**

**Source:****  ****Westerdahl, Bowers, Taylor: Presented at AAAR October 18, 2001****Source: Brunekreef B, et al,  Air Pollution from truck traffic and lung function in children living near motorways**

## How can particulate matter cause adverse effects? 

**How can particulate matter cause adverse effects?**** **

## How can particulate matter cause adverse effects? 

**How can particulate matter cause adverse effects?**** **

## How can particulate matter cause adverse effects? 

**Alterations in Mucociliary Clearance: PM alone & in combination**

**How can particulate matter cause adverse effects?**** **

**Cilia pre-NO****2**** Exposure**

**Cilia post-NO****2**** Exposure**

## How can particulate matter cause adverse effects? 

**How can particulate matter cause adverse effects?**** **

## How can particulate matter cause adverse effects? 

**How can particulate matter cause adverse effects?**** **

## How can particulate matter cause adverse effects? 

**How can particulate matter cause adverse effects?**** **

## How can particulate matter cause adverse effects? 

**How can particulate matter cause adverse effects?**** **

## Take-Home Messages: The Pieces of the Puzzle Fit

** ****The Evidence is Consistent:**
**Similar effects observed in numerous studies with**
**diverse populations, environments, pollutant mixes.**
** ****The Evidence is Coherent:**
**Physiologic Responses********Acute Illness ********Hospitalizations ********Death**
** ****The Effects are Plausible:**
**Changes in physiologic & other biological measures are consistent with observed health effects --**
**including morbidity and mortality**
**from respiratory and cardiovascular causes.**

## Take-Home Messages

**  ****Public Health is Severely Impacted by PM**
**    ****Both morbidity & mortality risk increases.**
**    ****Everyone is vulnerable...**
**    ****Degrees of vulnerability depend on**
**	****biological susceptibility,**
**	****exposure and dose.  **
** ****There are safe levels below which **
**    ****no adverse health effects occur... **
**    ****...but stay tuned.**

## Collectively we can achieve sufficient reductions in particulate matter  to protect public health.

Until then...
    we can limit exposure,
	especially of susceptible populations --
		the elderly, children of all ages, 
    	patients with chronic illness.

**Until then...**
**    ****we can limit exposure,**
**	****especially of susceptible populations --**
**	****	****the elderly, children of all ages, **
**    ****	****patients with chronic illness.**

**Take-Home Messages**

## Thank You!

***Thank You!***

**Contact Information:**
**Helene Margolis   **
***hmargoli@calepa.ca.gov***
***hmargoli@ arb.ca.gov***
**Children’s Environmental Health Center**
**California Environmental Protection Agency**
**Office of the Secretary**
**1001 ****  I****   Street**
**Sacramento, CA 95814**