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      Climate Change, Tropospheric Ozone and Particulate Matter, and Health Impacts

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          Abstract

          Objective

          Because the state of the atmosphere determines the development, transport, dispersion, and deposition of air pollutants, there is concern that climate change could affect morbidity and mortality associated with elevated concentrations of these gases and fine particles. We review how climate change could affect future concentrations of tropospheric ozone and particulate matter (PM), and what changing concentrations could mean for population health.

          Data sources

          We review studies projecting the impacts of climate change on air quality and studies projecting the impacts of these changes on morbidity and mortality.

          Data synthesis

          Climate change could affect local to regional air quality through changes in chemical reaction rates, boundary layer heights that affect vertical mixing of pollutants, and changes in synoptic airflow patterns that govern pollutant transport. Sources of uncertainty include the degree of future climate change, future emissions of air pollutants and their precursors, and how population vulnerability may change in the future. Given these uncertainties, projections suggest that climate change will increase concentrations of tropospheric ozone, at least in high-income countries when precursor emissions are held constant, which would increase morbidity and mortality. Few projections are available for low- and middle-income countries. The evidence is less robust for PM, primarily because few studies have been conducted.

          Conclusions

          Additional research is needed to better understand the possible impacts of climate change on air pollution–related health impacts. If improved models continue to project higher ozone concentrations with climate change, then reducing greenhouse gas emissions would enhance the health of current and future generations.

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          Most cited references110

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          Ozone and short-term mortality in 95 US urban communities, 1987-2000.

          Ozone has been associated with various adverse health effects, including increased rates of hospital admissions and exacerbation of respiratory illnesses. Although numerous time-series studies have estimated associations between day-to-day variation in ozone levels and mortality counts, results have been inconclusive. To investigate whether short-term (daily and weekly) exposure to ambient ozone is associated with mortality in the United States. Using analytical methods and databases developed for the National Morbidity, Mortality, and Air Pollution Study, we estimated a national average relative rate of mortality associated with short-term exposure to ambient ozone for 95 large US urban communities from 1987-2000. We used distributed-lag models for estimating community-specific relative rates of mortality adjusted for time-varying confounders (particulate matter, weather, seasonality, and long-term trends) and hierarchical models for combining relative rates across communities to estimate a national average relative rate, taking into account spatial heterogeneity. Daily counts of total non-injury-related mortality and cardiovascular and respiratory mortality in 95 large US communities during a 14-year period. A 10-ppb increase in the previous week's ozone was associated with a 0.52% increase in daily mortality (95% posterior interval [PI], 0.27%-0.77%) and a 0.64% increase in cardiovascular and respiratory mortality (95% PI, 0.31%-0.98%). Effect estimates for aggregate ozone during the previous week were larger than for models considering only a single day's exposure. Results were robust to adjustment for particulate matter, weather, seasonality, and long-term trends. These results indicate a statistically significant association between short-term changes in ozone and mortality on average for 95 large US urban communities, which include about 40% of the total US population. The findings indicate that this widespread pollutant adversely affects public health.
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            Epidemiological evidence on health effects of ultrafine particles.

            Evidence from epidemiologic studies linking ambient concentrations of particulate matter to morbidity and mortality influenced the guidelines for air quality standards worldwide. With the improvement of measurement techniques, clearer effects were observed with smaller particle sizes. Based on these effects and results from animal studies on the potential toxicity of ultrafine particles, recent epidemiologic studies focus on the health effects of particles which are less than 100nm in diameter. However, most of the studies are ongoing and only few results have been available so far. Six panel studies with patients suffering from chronic pulmonary diseases have been performed in Germany, Finland and the United Kingdom. Overall, a decrease of peak expiratory flow (PEF) and an increase of daily symptoms and medication use was found for elevated daily particle concentrations. Effects were seen with both fine and ultrafine particles. One large study on daily mortality from Germany showed comparable effects of fine and ultrafine particles in all size classes considered. However, fine particles showed more immediate effects while ultrafine particles showed more delayed effects on mortality. The limited number of epidemiological studies suggest that there are health effects of fine and ultrafine particles which might be independent of each other. If these effects are confirmed by ongoing research, monitoring and regulation of particulate air pollution may need to be revised.
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              Health effects of particles in ambient air.

              A summary of a critical review by a working group of the German commission on Air Pollution Prevention of VDI and DIN of the actual data on exposure and health effects (excluding cancer) of fine particulate air pollution is presented. Typical ambient particle concentrations for PM10 (PM2.5) in Germany are in the range of 10-45 (10-30) microg/m3 as annual mean and 50-200 (40-150) microg/m3 as maximum daily mean. The ratio of PM2.5/PM10 generally amounts between 0.7 and 0.9. During the past 10 years many new epidemiological and toxicological studies on health effects of particulate matter (PM) have been published. In summary, long-term exposure against PM for years or decades is associated with elevated total, cardiovascular, and infant mortality. With respect to morbidity, respiratory symptoms, lung growth, and function of the immune system are affected. Short-term studies show consistant associations of exposure to daily concentrations of PM with mortality and morbidity on the same day or the subsequent days. Patients with asthma, COPD, pneumonia, and other respiratory diseases as well as patients with cardio-vascular diseases and diabetes are especially affected. The strongest associations are found for PM2.5 followed by PM10, with no indication of a threshold value for the health effects. The data base for ultra fine particles is too small for final conclusions. The available toxicological data support the epidemiological findings and give hints as to the mechanisms of the effects. The working group concludes that a further reduction of the limit values proposed for 2005 will substantially reduce health risks due to particulate air pollution. Because of the strong correlation of PM10 with PM2.5 at most German sites there is no specific need for limit values of PM2.5 for Germany in addition to those of PM10.
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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                1552-9924
                November 2008
                10 July 2008
                : 116
                : 11
                : 1449-1455
                Affiliations
                [1 ] ESS, LLC, Alexandria, Virginia, USA
                [2 ] The University of Auckland, Auckland, New Zealand
                Author notes
                Address correspondence to K.L. Ebi, ESS, LLC, 5249 Tancreti Lane, Alexandria, VA 22034 USA. Telephone: (703) 304-6126. E-mail: krisebi@ 123456essllc.org

                The authors declare they have no competing financial interests.

                Article
                ehp-116-1449
                10.1289/ehp.11463
                2592262
                19057695
                a3c18542-5c22-4cd2-8e87-72b475d02e91
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                History
                : 7 March 2008
                : 9 July 2008
                Categories
                Review

                Public health
                health impacts,ozone,air pollution,particulate matter,climate change
                Public health
                health impacts, ozone, air pollution, particulate matter, climate change

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