ATS Report: Air Pollution in US Linked to Substantial Adverse Health Outcomes

Ambient air pollution concentrations above recommended levels in the US resulted in a substantial number of adverse health outcomes and deaths from 2018 to 2020, according to findings published in the Annals of the American Thoracic Society.

The findings were reported in the fifth “Health of the Air” report, a joint effort of environmental health researchers at New York University’s Marron Institute of Urban Management and the American Thoracic Society (ATS), which created the pollution concentration recommendations.

The report details adverse health effects for various health endpoints from ambient pollution concentrations greater than recommended by the ATS (8 μg/m³ for long-term particulate matter 2.5 [PM_2.5], 25 μg/m³ for short-term PM_2.5, and 60 ppb for ozone [O₃]). The new edition of the report also includes health estimates attributable to wildland fire emissions in the US as well as preterm birth and low birthweight outcomes.

Daily PM_2.5 and O₃ concentrations were obtained from the Environmental Protection Agency (EPA) Air Quality System (AQS) for all monitored US counties for 2018 to 2020.

Among 3144 total counties in the contiguous US, 515 counties had valid PM_2.5 monitoring data. Of these counties, 210 exceeded the ATS recommendation for long-term PM_2.5 (8 μg/m³), 101 exceeded the recommendation for short-term PM_2.5 (25 μg/m³), and 75 counties exceeded both. Among the 693 counties with valid O₃ data, 487 exceeded the ATS recommendation (60 ppb).

Preventable national annual health outcomes associated with PM_2.5 and O₃ greater than ATS recommended levels in the monitored counties include 13,900 deaths (95% CI, 13,500-14,300) for PM_2.5 and 7400 deaths (95% CI, 2650-11,900) for O₃; 3000 new cases of lung cancer (95% CI, 1550-4390) attributable to PM_2.5; 748,660 (95% CI, 326,050-1,057,080) cardiovascular and respiratory morbidities combined for PM_2.5 and O₃; 52.4 million (95% CI, 7.9-92.4 million) adversely affected days combined for PM_2.5 and O₃; and 10,660 (95% CI: 3,180-18,330) adverse birth outcomes. These estimates represented outcomes that could have been prevented if all counties had met ATS recommendations between 2018 and 2020.

A total of 4400 preterm (95% CI, 1590-7410) and 6270 (95% CI, 1590-10,930) low weight births each year were associated with air pollution levels higher than the ATS recommendations.

Los Angeles had the greatest adverse health effects from air pollution among cities, with about 3300 (95% CI, 2470-4080) mortalities per year, followed by Riverside, CA (1900; 95% CI, 1460-2310); Chicago, IL, (985; 95% CI, 759-1200); and Phoenix, AZ, (802; 95% CI, 581-1200).

Preventable national annual health outcomes in 2019 associated with wildland fire PM_2.5 and O₃ in all contiguous US counties included 28,000 deaths (95% CI, 27,300-28,700) for PM_2.5 and 828 deaths (95% CI, 295-1340) for O₃. The estimate for mortality outcomes from wildland fire PM_2.5 is different when using standard health functions compared with wildland fire-specific health functions (4080 deaths; 95% CI, 242-7890).

“While we will never fully eliminate outdoor air pollution, the large magnitude of adverse health impacts estimated in this report can be avoided through the policy framework that already exists under the Clean Air Act if more health protective standards were adopted by the US EPA,” the study authors stated.

This article originally appeared on Pulmonology Advisor