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Geographies of uncertainty in the health benefits of air quality improvements

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Abstract

Assessing the long-term benefits of marginal improvements in air quality from regulatory intervention is methodologically challenging. In this study, we explore how the relative risks (RRs) of mortality from air pollution exposure change over time and whether patterns in the RRs can be attributed to air quality improvements. We employed two-stage multilevel Cox models to describe the association between air pollution and mortality for 51 cities with data from the American Cancer Society (ACS) cohort (N = 264,299, deaths = 69,819). New pollution data were computed through models that predict yearly average fine particle (PM2.5) concentrations throughout the follow-up (1982–2000). Average PM2.5 concentrations from 1999 to 2000 and sulfate concentrations from 1980 were also examined. We estimated the RRs of mortality associated with air pollution separately for five time periods (1982–1986, 1987–1990, 1991–1994, 1995–1998, and 1999–2000). Mobility models were implemented with a sub-sample of 100,557 subjects to assist with interpreting the RR estimates. Sulfate RRs exhibit a large decline from the 1980s to the 1990s. In contrast, PM2.5 RRs follow the opposite pattern, with larger RRs later in the 1990s. The reduction in sulfate RR may have resulted from air quality improvements that occurred through the 1980s and 1990s in response to the acid rain control program. PM2.5 concentrations also declined in many places, but toxic mobile sources are now the largest contributors to PM in urban areas. This may account for the heightened RR of mortality associated with PM2.5 in the 1990s. The paper concludes with a three alternative explanations for the temporal pattern of RRs, each emphasizing the uncertainty in ascribing health benefits to air quality improvements.

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Abbreviations

NRC:

National Research Council

ACS:

American Cancer Society

TSP:

Total suspended particulate

PM10 :

Particles less than or equal to 10 μm in diameter

PM2.5 :

Particles less than or equal to 2.5 μm in diameter

RR:

Relative risk

CR:

Concentration-response

MSAs:

Metropolitan statistical areas

CVD:

Cardiovascular disease

GAM:

Generalized additive model

SO4 :

Sulfate

EPA:

Environmental Protection Agency

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Acknowledgments

We are grateful to the Health Effects Institute, the National Institute of Environmental Health Science (Grants 5 R01 ES 09560, 5P30 ES07048, 5PO1ES011627), and the Verna Richter Chair in Cancer Research for financial support. D. Krewski is the NSERC/SSHRC/McLaughlin Chair in Population Health Risk Assessment at the University of Ottawa. We thank Yuanli Shi, Dan Crouse, Bernie Beckerman, Karen King, and Richard Hamilton for assistance with the statistical analyses, cartography, and graphic design.

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Authors and Affiliations

  1. Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, 94720-7360, USA

    M. Jerrett

  2. McMaster University, Hamilton, ON, Canada, L8S 4L8

    K. B. Newbold

  3. Health Canada, Ottawa, ON, Canada

    R. T. Burnett

  4. New York University, New York, NY, USA

    G. Thurston & R. Lall

  5. Brigham Young University, Provo, UT, USA

    C. A. Pope III

  6. University of New Brunswick, Fredericton, NB, Canada

    R. Ma

  7. School of Geography and Earth Science, McMaster University, Hamilton, Canada

    P. De Luca

  8. American Cancer Society, Atlanta, GA, USA

    M. Thun & J. Calle

  9. University of Ottawa, Ottawa, ON, Canada, K1N 6N5

    D. Krewski

Authors
  1. M. Jerrett
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  2. K. B. Newbold
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  3. R. T. Burnett
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  4. G. Thurston
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  5. R. Lall
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  6. C. A. Pope III
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  7. R. Ma
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  8. P. De Luca
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  9. M. Thun
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  10. J. Calle
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  11. D. Krewski
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Correspondence to M. Jerrett.

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Jerrett, M., Newbold, K.B., Burnett, R.T. et al. Geographies of uncertainty in the health benefits of air quality improvements. Stoch Environ Res Risk Assess 21, 511–522 (2007). https://doi.org/10.1007/s00477-007-0133-2

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  • DOI: https://doi.org/10.1007/s00477-007-0133-2

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