Adverse Health Impacts of Outdoor Air Pollution

in the United States: "Health of the Air," 2018-2020

+ Kevin Cromar, Laura Gladson, Gary Ewart


Rationale: Adverse health impacts from outdoor air pollution occur across the U.S., but the magnitude of these impacts varies widely by geographic region. Ambient pollutant concentrations, emission sources, baseline health conditions, and population sizes and distributions are all important factors that need to be taken into account to quantify local health burdens. Objective: To determine health impacts from ambient air pollution concentrations in the U.S. that exceed recommended levels from the American Thoracic Society (ATS). Methods: Using a methodology that has been well established in previous “Health of the Air” reports, this study provides policy-relevant estimates for every monitored county and city in the U.S. for the adverse health impacts of outdoor pollution concentrations, using Environmental Protection Agency (EPA) design values for years 2018–2020. Additionally, for the first time, the report includes adverse birth outcomes as well as estimates of health impacts specifically attributable to wildland fires using an exposure dataset generated through Community Multi-scale Air Quality (CMAQ) simulations. Results: The adverse health burdens attributable to air pollution occur across the entire age spectrum, including adverse birth outcomes (10,660 preterm and/or low weight births; 95% CI: 3,180–18,330), in addition to mortality impacts (21,300 avoidable deaths; 95% CI: 16,150–26,200), lung cancer incidence (3,000 new cases; 95% CI: 1,550–4,390), multiple types of cardiovascular and respiratory morbidity (748,660 events; 95% CI: 326,050–1,057,080), and adversely impacted days (52.4 million days; 95% CI: 7.9–92.4 million). Two different estimates of mortality impacts from wildland fires were estimated based on assumptions regarding the underlying toxicity of particles from wildland fires (low estimate of 4,080 deaths, 95% CI: 240–7,890; middle estimate of 28,000 deaths, 95% CI: 27,300–28,700). Conclusions – This year’s report identified sizable health benefits that are expected to occur across the U.S. from meeting more health-protective air quality standards such as those recommended by ATS. This study also indicates that a large number of excess deaths are attributable to emissions from wildland fires; air quality management strategies outside what is required by the Clean Air Act will be needed to best address this important source of air pollution and its associated health risks. Primary Source of Funding: National Aeronautics and Space Administration, Environmental Defense Fund

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Kevin Cromar, Ph.D., is a program director at the Marron Institute of Urban Management and a Clinical Associate Professor of Environmental Medicine and Population Health at New York University Grossman School of Medicine.

Laura Gladson (M.S.) is a Ph.D. candidate in New York University's Environmental Health Sciences department and a researcher with the Health, Environment, and Policy program at the NYU Marron Institute of Urban Management.

Gary Ewart is the Cheif of Advocacy and Government Relations at the American Thoracic Society.

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