Measuring the Public Health Impacts of Air Pollution in Minnesota

Jean Johnson, PhDMinnesota Department of HealthChronic Disease and Environmental Epidemiology

Environmental Public Health Tracking and Biomonitoring

Fine particle pollution: PM2.5

PM2.5 pyramid of health effects

Death

Hospital admissions

Emergency room visits

Doctor visits

Asthma attacks, medication use, symptoms

Lung function changes, immune cell responses, heart rate variability

responses

Increased life expectancy

Air pollution controls during 1970-2000 improved health

51 metropolitan areas

15% increase in life expectancy due to pollution reduction

Reducing PM2.5 (10µg/m3) added 7 months of life

Source: NEJM 2009

Air pollution epidemiology studies

Health impacts are measurable

Large body of evidence – PM2.5

Respiratory and cardiovascular effects

Long-term effects increased risk

Short-term effects triggering/exacerbations

Effects observed even at low concentrations

Air pollution affects entire populations

Susceptible population is growing

Aging population

Increasing obesity, diabetes rates

Effects observed in children

Lung development

Asthma exacerbations

Even very small increases associated

with disease and death

2004

2009

Obesity in MN

Source: MN Pollution Control Agency

AQI: Number of unhealthy air days in MN

Improving air, preventing deaths

Air quality improvement scenarios

Estimated number of prevented deaths

10% reduction PM2.5

concentrations

BenMAP software

5

4

78 (MSP metro)

MN (2006)

Source: CDC Environmental Public Health Tracking

Air pollution and health research at MDH

Purpose: method/indicator development

Track health effects associated with changes in air quality in MSP and Olmsted during 2003-2009

Purpose: method/indicator development

Local area analyses

Using local sources of data

Track health effects associated with changes in air quality in MSP and Olmsted during 2003-2009

Fine particulate matter pollution (PM2.5)

Hospitalizations and mortality

Respiratory , cardiovascular

MN air initiatives timeline

2003 2004 2005 2006 2007 2008 2009Early Implementation Implementation

Project Green Fleet retrofits

Baseline Period

2005-2009 continuous

Heavy Duty Diesel Rule

late 2006

Ultra Low Sulfur Fuel

2007

Clean Air Interstate RuleAdopted 2005; remanded 2008

MERP: Allen S. Kingemissions controls

coal to natural gas

MERP: High Bridge

MERP: Riversidecoal to natural gas

24-hr PM2.5 NAAQS revision

Measuring impacts using local area data

Regulatory or Policy Changes

Reductions in Population Exposures

Reductions in AdverseHealth

Outcomes

• PM2.5 • Respiratory diseases

• Cardiovascular disease

• Hospitalizations and Deaths

Source: MN Pollution Control Agency

Air pollution and health research: Results

Hospitalizations Amount attributable to PM2.5 in 2003-2009

Percent # hosp. per year

Total respiratory 1.9% 224

COPD + asthma 2.3% 110

Asthma 2.3% 54

Associations found in the MSP metro for PM2.5 and respiratory hospitalizations

MN air pollution health impacts over time

Hospitalizations Time periodAmount attributable to PM2.5

Percent # hosp./yr

Total respiratory 2003-20052006-20072008-2009

3.0%2.6%

--

354309

--

COPD + asthma 2003-20052006-20072008-2009

3.3%2.9%

--

154140

--

Asthma 2003-20052006-20072008-2009

3.8%----

92----

Summary

Air pollution affects health even at low levels

Air pollution affects entire populations

Impact on a growing number of susceptible people

All regions of MN experience poor air quality days

BUT…

MN has been making improvements in air quality

Continued efforts will lead to a healthier MN

Project Team

MN Pollution Control Agency

Greg Pratt

Kari Palmer

Margaret McCourtney

Cassie McMahon

Lisa Herschberger

Olmsted Medical Center

Barbara Yawn

Peter Wollan

Measuring the Impact of Fine Particles:http://www.health.state.mn.us/divs/hpcd/cdee/airquality.html

MN Dept. of Health

Jean Johnson

Chuck Stroebel

Allan Williams

Naomi Shinoda

Wendy Brunner

Paula Lindgren