Health Effects of Air Pollution: A Brief Review – Dust Control and Soil Stabilization for Arid Regions ASU (TPD1702041)

 Did you know:

• An average per s,on breathes 7 to 8 l1t ,ers of

air/minute (approximately 2 ga, ll ons)

• This equates to  about 11,,QQ0 liters air/day

(2,905 gai ll ons/ day or 3,88 cu bi,c feet / diay.)

Source: Discovery Health – online

Maricopa County

Susceptible Populations

• Children

–     Spend more time outdoors

–     Have developing lungs (fewer alveoli) and immune systems

–     Have a larger lung surface area per kg of body wt.

–     Breathe 50% more air per kg of body wt.

• People with heart and lung diseases

–     Asthmatics and other COPD patients

–     Coronary artery and congestive heart failure

• Older adults
• Outdoor workers

Criteria Pollutants

• EPA websites have lots of information on different types of pollutantshttps://www.epa.gov/environmental-topics/air-topics

• EPA has set national standards for six air pollutants (called criteria pollutants). Standards are called National Ambient Air Quality Standards (NAAQS).                             See:https://www.epa.gov/criteria–air–pollutants

• The six criteria pollutants are CO, NO2, SO2, ozone, particulate matter, and lead

Source: httSpcs:h//owowlswe3f.eEpna.ggoinv/ecegir-ibning/broker?polchoice=CO&_debug=0&_service=data&_program=dataprog.national_1.sas

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

Health Effects of CO

• CO affects humans by competing with O2 for binding to Fe2+ in hemoglobin (Hb).

HbFe  + CO  ⇄  HbFeCO

HbFe  +  O2   ⇄    HbFeO2

–     Equilibrium constant for HbFeCO binding is 240 times as large as for HbFeO2.

–     Thus, even a small amount of CO can be deadly because it blocks active site of Hb.

• Lethal concentrations > 750 ppm
• Concentrations of 100 ppm causes dizziness and headaches
• Exposure to 50 ppm over 8 hour period impairs psychomotor performance
• 6 weeks exposure can cause structural changes in heart and brain of animals

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

https://www3.epa.gov/cgi-bin/broker?polchoice=SO2&_debug=0&_service=data&_program=dataprog.national_1.sas    _TPD1702041

Sulfur compounds

• Unlike CO, which is only a concern for health effects, SOx not only affects human health, but damages crops and changes chemistry of soils, causes acid rain, and contributes to visibility impairment. So it’s environmental effects are much greater than CO.
• Aerosols of sulfuric acid and other sulfates make up 5- 20% of total suspended particulate matter in urban air. Causes significant reduction of visibility as part of atmospheric haze.
  • Human response to sulfur dioxide is bronchoconstriction and asthma. Sensitive individuals can respond to as low as 1 ppm.
  • Other Forms of Sulfur

–     Sulfur compounds are generated naturally by biological processes (such as anaerobic microbial degradation)

–     As much as 90% of sulfur in humid regions occurs as organosulfur compounds.

ARIZONA STATE UNIVERSITY

https://www3.epa.gov/cgi-bin/broker?polchoice=NOX&_debug=0&_service=data&_program=dataprog.national_1.sas                                                                                                                                                      

Major Findings from 2016 NO2 ISA

Source: U.S. EPA 2016 Integrated Science Assessment for Oxides of Nitrogen – Health Criteria

Ozone

• Ozone is O3

–     Distinguish ozone from O2 which is the stable form of oxygen in atmosphere.

O-O=O or O=O-O     vs      O=O

–     O3 has weaker bonds than O2 and is much more reactive.          Strong oxidizing agent.     Attacks rubber, cellulose, and other materials.

–     O3 is a secondary, not a primary pollutant. It is produced through photochemical reactions in atmosphere.  Thus, without sunlight, no ozone.

–     We can’t regulate ozone directly. Instead we regulate its precursors which are VOCs and NOx emissions. So we are concerned about NOx for its own health effects, but also because it is a precursor to ozone.

Bogenics Fires

ARIZONA STATE UNIVERSITY

ARIZONA STATE UNIVERSITY

https://www3.epa.gov/cgi-bin/broker?polchoice=NOX&_debug=0&_service=data&_program=dataprog.national_1.sas

TPD1702041

Short Term Exposure

Schools  ef Engineering

ARIZONA    STATE  UNIVERSITY

EPA 2013 ISA for Ozone and

Related Photochemical Oxidants

engineering.asu.edu

EPA 2013 ISA for Ozone and Related Photochemical Oxidants

2006 ISA                                                                2013 ISA

Healtheffectsofgroun,d-levell•OZ•one

The science shows that ozone:

• llnflames and damages the airways
• Aggravates lung disease, including asthma , emphysema and bronchitis
• Increases the frequency and severity of asthma attacks
  • Reduces lung function, making it harder to

breathe as deeply as normal

• Causes coughing and sore throat or burning sensation in airways

Ira A. Fulton

Schools ef Engineering

ARIZONA    STATE  UNIVERSITY

EPA Proposed NAAQS for O3 December, 2014

engineering.asu.edu

Benefits and Costs of Meeting the Proposed Standards

• EPA estimates that meeting the standards in 2025 will yielid an nual health benefits of:
  • $6.4 to $13 billion for a standard of 70 ppb
  • $19 to $38 billion for a standard or 65 ppb
  • This includes the value of preventing significant health effects in chil:dr  en and adults.
    • EPA estimates that annual costs would be:
      • $3.9 billion for a standard of 70 ppb
      • $15 billion for a sta ndard of ’65 ppb

N ote : These numbers do not include Ca lifornia which was

analy zed separately                                                                                                                         18

Ira A. Fulton

Schools ef Engineering

EPA Proposed NAAQS for O3

December, 2014; Final Rule October 2015

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

Summary of Health Effects from ozone

• •           Short-term exposure to excessive ozone have a causal relationship with respiratory disease and a likely causal relationship for premature death
  • Long-term exposure to excessive ozone have a likely causal relationship with respiratory disease and a suggestive causal relationship for cardiovascular, reproductive, nervous system diseases; and premature death

Particulate Matter

• “PM is the generic term for a broad class of chemically and physically diverse substances that exist as discrete particles (liquid droplets or solids) over a wide range of sizes” (ISA, Sec. 1.2).
• PM can be dispersed airborne solid or liquid particles, or solid cores surrounded by liquid.
  • Aerosols

–     Can be liquid or solids. Suspended solid aerosols include fumes or smoke formed by condensation, sublimation or chemical reactions.

–     Mists are condensed liquid particles. Generally mist particles are larger than fumes.

• Categories:

Classification of PM

–     PM10 refers to particulate matter ≤ 10 μm

–     PM2.5 refers to particulate matter ≤ 2.5 μm

• Fractions

–     Ultra-fines are less than 0.1 μm.                                                 No current U.S. regulations for PM0.1.

–     PM2.5 particles called fine fraction. Atmospheric lifetimes of days to weeks.                    Can travel thousands of kilometers. Higher concentration of organics. Poorly characterized compared to PM10.           Mostly from combustion sources.

–    Coarse fraction refers to inhalable PM10 from which the fine fraction has been removed (i.e. PM2.5-10 fraction.                          Atmospheric lifetimes of minutes to hours.   Travel less than 10 km.

Particulate Matter: What is It?

Acomplexmixture,ofextremelysm1all particlesandliquiddroplets

Agriculture Fires

Industrial Ftocess es rvk:bile

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Fire;

Agriculture Fuel Can bustien Miscellaiecus

rvt:bile Industrial  A”oce;se;

Sdvent

LJnks              Agriculture Fires

Short Tens

DJst

Fue Can bustien

ARIZONA STATE UNIVERSITY

Industrial Froce;s e; rvt:bile

Mscellaneous

Sdvent

 I      I        111 1111 .u u.ed u

https://www3.epa.gov/cgi                    -bin/broker?polchoice=PM&_debug=0&_service=data&_program=dataprog.national_1.^Ts^Pa^Ds ^1702041

July 5, 2011 Haboob

Photo Courtesy: Daniel Bryant

ARIZONA STATE

From J. Colls, Air Pollution (2002), SpoennPgreisnseering.asu.edu

Donora, PA 1948

PM 2.5 Exceedance Day

Source: ADEQ Monthly Air Quality Report; December 2012

Toxic Effects of Particulate Matter

• See next slides for view of lungs.

–     Air pathway becomes progressively smaller: Trachea à Bronchi à Bronchioles à Alveoli

–     In alveolar sac there is only one cell thickness between air and bloodstream.                       Gaseous molecules can diffuse across.

• Respiratory tract divided into 3 regions:

–     Extrathoracic (ET) consists of nasal and oral passages through the larynx

–     Tracheobronchial (TB) consists of trachea, bronchi, and conducting bronchioles

–     Alveolar (A) consists of respiratory bronchioles alveoli

Incredible Machine,

National Geographic Society, 1986

Incredible Machine, National Geographic Society, 1986

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

Deposition of PM in Respiratory System

• Penetration and deposition of PM in lungs depends upon size.                          Actually kind of a U shaped curve (ISA, p. 4-8).
• Above 10 μm almost all inhaled particles are deposited in upper respiratory particles (Extrathoracic region) by sedimentation and impaction on sides of respiratory tract.

–     For 10 μm particles, deposition is about 90% in nasal region (very few large particles make it through nasal passage)

–     Nasal breathing is more effective in removing particulates than oral breathing.                            Children tend to breathe more orally, thus might be more impacted by particulates.

Sites of Deposition

• From Fig 4-3 in ISA (next slide) we can see that particles from 5 – 10 μm are deposited quite efficiently in the ET range and there is some increase in deposition in the ET as particle size decreases below 0.1 μm.
  • As particle size decreases to 1 μm, deposition in ET reaches a minimum.
  • Little PM above 5 μm makes it to the TB or A regions. But between 1 – 5 μm, there is deposition in both TB and A.
  • As particle size decreases below 0.1 μm, deposition in both TB and A increase. Alveolar deposition reaches minimum between 0.1 and 1 μm.

Clearance of PM

• Clearance of PM (ISA, p. 4-17).

–     Particles in mouth can be swallowed or expectorated.  In nose, can be cleared by sneezing, wiping, or blowing nose.

–     Mucociliary clearance in TB originally thought to take 24-48 hrs.               Series of “escalators.”       Now thought to be a slower clearance for smaller particles (up to 100 days for UFP).

• Clearance in alveolar region much more difficult. Involves macrophage phagocytosis (p. 4.-19).

–     Macrophages originate in bone marrow, circulate in blood and envelop a deposited particle.

–     Some deposited particles can translocate (move across cell membranes, into blood and circulate through body.

ing.asu.edu

Toxicological Effects of PM-2.5

• Airborne PM-2.5 associated with shortened lifespans. All-cause mortality rates, cardiopulmonary mortality and lung cancer mortality are all associated with increases in PM- 2.5.
• People with heart or lung disease, children and elderly are most affected.
• See article by Pope.

–  Each 10 mg/m3 increase in PM2.5 is associated with a 4% increase in total mortality; 6% increase in cardiovascular mortality; and 8% increase in lung cancer mortality.                           No consistent associations with coarse PM.

Source: U.S. EPA, 2012, Provisional Assessment

of Recent Studies on Health Effects of Particulate Matter Exposure                                                                                                                  

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

Results and Conclusions

• Diabetes prevalence increases with increasing PM2.5 concentrations
• A 1% increase in prevalence associated with a 10 µg/m³ PM2.5 exposure
  • A >20% increase in prevalence for counties with highest

PM2.5

• The study controlled for diabetes risk factors
• Additional studies are needed to understand the role of PM2.5 in the inflammatory pathway giving rise to diabetes

Ultrafine PM and PM 2.5 in Blood and CNS

• Ultrafine PM can enter capillaries in the alveoli
• PM 2.5 can include neurotoxins that have been adsorbed onto the particles
• PM 2.5 can cause inflammation of lungs, olfactory nerves, and eventually the brain
• PM 2.5 triggers biochemical changes that can cause heart attacks and arrhythmia

Source: U.S. EPA, 2004, Air Quality Criteria for Particulate Matter

U.S. EPA, 2009, Integrated Science Assessment for Particulate Matter, Final Report,

Summary of PM Health Effects

• •        Short-term  and long-term exposures to excessive PM-2.5 have a causal effect on cardiovascular disease and premature death
  • Short-term exposure to excessive PM-10 are suggestive of cardiovascular disease and premature death

• •       Health and visibility benefits of Revised 24-hr PM2.5 standards range from $9 bil to $75 bil a year by 2020
  • These benefits are in addition to benefits of meeting the 1997 standards
  • •       Cost is estimated at $5.4 bil per year in 2020

ftE  AIA EUnnvlnilmma a¹¹I-^BRI Pi’ote   lc11

Agenc:y

Be,

nefits and Cos-ts

Otti.ee ol Ah OLJality Plarmlng 2md Siandards

• T, lhe benefits of 1m1e,etingthe revised 24-hour PM2_5

standa.rds incllude the value of estimated annuall reductions of:

–            11   200 to 13 000 premature deaths in people with heart or lung disease;

–

2 600 cases of chronic bronchitis

–   5,000 nonfatal heart attacks·

–      11   6  30 hospital admissions far cardiovascular or respiratory symptoms;

–          1200 emergency room visits for asthma;

–          7,300 cases of acute bron chitis;

–

97 000 cases of upper and lower respiratory symptoms;

–           51,000 cases of aggravated asthma;

–

350 000 days when people miss worik or school; and

–           2 million days when people must restrict their activities because of

partic le pollution-related symptoms.

19

Lead

• Lead is the only metal listed as a criteria pollutant (others, such as Cr, are listed as a HAP).                                           Attacks liver, kidneys, brain and other vital organs.                                          Disrupts reproductive and immunological functions.

–     Historically lead used in gasoline, paints, piping, radioactive shielding, etc. Also natural sources from soils.

–     Due to use of unleaded gasoline, emissions decreased 99% from 1970 to 1995 (all leaded gasoline banned in

U.S. on Dec 31, 1995).  Now also banned in paints, and solder.

–     Main sources now from piston engine aircraft and metal smelting.            Following slides show dramatic differences in total lead emissions and sources.

ARIZONA STATE UNIVERSITY

https://www3.epa.gov/cgi-bin/broker?polchoice=Pb&_debug=0&_service=data&_program=dataprog.national_1.sas

Hazardous Air Pollutants

• 187 Listed HAPs
• The most common include:

–     Asbestos

–     Benzene

–     Perchloroethlyene

–     Toluene

–     1,3 Butadiene

–     Formaldehyde

HAPs are not routinely monitored by air quality regulatory agencies

Mobile Source Air Toxics

• •           Diesel particulate matter (diesel PM)
  • Formaldehyde
  • •          Benzene
    • 1,3-butadiene
    • •          Napthalene
      • Acrolein
      • •          Polycyclic organic matter (POM)

• Ira A. Fulton

Schools ef Engineering

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

What is In Diesel Exhaust?

• Nitrogen oxides
  • Carbon monoxide
  • Diesel particulate matter (mostly PM-2.5)
    • Black carbon
    • Aldehydes
      • Polycyclic aromatic hydrocarbons
      • 1,3-butadiene
        • Sulfates
        • Metals, including arsenic

Bio aerosols

Please note that these pollutants are NOT regulated

• Seasonal influenza and pandemic influenza
• Bacillus anthracis (Anthrax)
• Francisella tularensis (Tularemia)
• Brucella species (Brucellosis)
• Staphylococcus aureus (MRSA)
• Pollens
• Coccidioides sp. (Valley Fever: Coccidioidomycosis)
• Other fungal

–        Stachybotrys chartarum

–        Histoplasma capsulatum

–        Aspergillus fumigatus

–        Aspergillus clavatus

Pollutant

Indoor Air Pollutants

Source

• Tobacco smoke
• Carbon monoxide
• Formaldehyde
• Asbestos
• Radon
• Mold and other biologicals

• Volatile organic compounds
  • Smokers in the household
  • Gas stove, furnace, broken exhaust vents
  • Furniture, carpeting
  • Insulation, wall texture
  • Cracks in the slab
  • Plumbing leaks, unsanitary premises
    • Paints, solvents, cleaners

Pollutant

Indoor Air Pollutants continued

Source

• Pesticides
• Particulates

• Nitrogen dioxide

• Carbon dioxide
• Hydrogen sulfide
• Methane
• Insect parts and waste
  • Any application of pesticides
    • Wood, fuel oil burning, remodeling, open windows
    • Wood, fuel oil burning, gas stove, furnace
    • Poor ventilation
    • Sewer gas (floor drains)
    • Sewer gas (floor drains)
    • Cockroach and cricket infestation

Source: http://www.epa.gov/iaq/ia–intro.html                                                                                                                  TPD1702041

EPA Map of Radon Zones

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

Gabrielson, D., 2011, Pinal County DEQ

Hazards,toTransportationAre

Hl azards toP’ublic1

• 7 dea ,d in dust storm on 1-10

–           May 1971, Casa Grande, Ariizona

Hl ealth

–         http://casagrandepl.newspaperarchive.com/ PdN iewer.aspx?pubdateid=15048836&src=browse

–        lhttp://casagrandepl.newsp aper arch ive .com/PdN,

• 14 ,dead  in dust storm ,on 1-5

iiewer.aspx? pubdateiid=15049552&s rc=bro wse

–        Dece1mber 199’1 , C oa l inga, California

–         http://articles.latimes.com/1991-12-01/news/mn-917     1 dust-storm

• 2 dea ,d in dust storm on 1-8

–      , February 2006, Stanfield, Arizona

–         http:/fcasagrandepl.newspaperarchive.com/PdNiewer.aspx?pubdateid=14949 117&src=browse

• 3 dea ,d in dust storm on 1-10

–        Dece1mber 2009, Casa Grande, Arizona

–         http://www.azcentral.com/community/p  inal/articles/2009/12/22/20091222pc-accident22-0 N.html

• And so on.

ARIZONA

GSTaAbTrEieUlsNoInVE,RDS.,IT2Y011, Pinal County DEQ

engineering.asu.eau

“…The Panel concluded that the evidence is sufficient to support a causal relationship between exposure to traffic-related air pollution and exacerbation of asthma. It also found suggestive evidence of a causal relationship with onset of childhood asthma, nonasthma respiratory symptoms, impaired lung function, total and cardiovascular mortality, and cardiovascular morbidity, although the data are not sufficient to fully support causality.”

On average, vehicles emit one pound of pollutants per mile driven

“Local exposure to traffic on a freeway has adverse effects on children’s lung development, which are independent of regional air quality, and which could result in important deficits in attained lung function in later life.”

Diabetes and Air Pollution?

“Traffic-related air pollution is associated with incident type 2 diabetes among elderly women. Subclinical inflammation may be a mechanism linking air pollution with type 2 diabetes.”

Kramer, U., et. al., 2010, Environmental Health Perspectives                                                                                                               TPD1702041

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ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

Elementary School

ARIZONA    STATE    UNIVERSITY                                                                                                                              engineering.asu.edu

• Ira A. Fulton

   Schools ef Engineering

ARIZONA    STATE  UNIVERSITY

Localized highly unhealthful air pollution

engineering.asu.edu

• Ira A. Fulton

   Schools ef Engineering

ARIZONA    STATE  UNIVERSITY

Localized highly unhealthful air pollution

engineering.asu.edu

How can I Reduce Air Pollution?

• •           Drive less; slow down
  • Educate others; be a champion
  • •           Do not use a leaf blower
    • Comply with “no burn day” requirements
    • •           Refuel after sunset in the hot months
      • Reduce speed on unpaved roads
      • •           Use only high gas mileage vehicles

How Can I Protect Myself and My Family

• Maintain clean household, school and workplace environments
• Stay indoors during high pollution episodes and reduce strenuous activity
  • Do not exercise outdoors during high pollution episodes; avoid exercising near arterial roadways
  • Do not live within 500 M of a freeway
  • Educate others; lead by example
  • Sign up for high air pollution advisory notices:

http://cleanairmakemore.com/make-the-commitment/

SDS Highlights for Gorilla-Snot®

• Chemical Family: Synthetic Copolymer Dispersion
• GHS: Not a hazardous substance or mixture
• HMIS and NFPA 0-0-0-No special hazard under normal use
  • Active ingredient: Synthetic Vinyl Copolymer Dispersion; 20-60%
  • Carcinogenicity: Not listed as carcinogenic
  • Reproductive & Developmental Toxicity: Not expected to be a hazard
  • DOT: Not regulated
  • IATA: Not regulated
  • RCRA: Not hazardous waste when disposed
  • CERCLA/SARA: Does not contain chemicals with reportable quantities
  • CAA: Does not contain a HAP
  • OSHA: No PELs; avoid repetitive skin contact and inhalation of mist

/media/101960/sgs1507021-gorilla-snot-safety-data-sheet.pdf

Current Developments in Re-Designation to

Attainment

• June 10, 2014

–     EPA Publishes Final Rule Approving 2012 SIP

• July 29, 2014

–     Petitioners (Sandy Bahr & David Matusow) file a Petition for Review, challenging the following portions of EPA’s approval of the 2012 SIP

• Attainment Demonstration
• 5% Demonstration
• Contingency Measures

9^th Circuit Decision On Petition

• Nonattainment Demonstration

–     Upholds EPA’s determination

–     Agrees that the 135 exceedances were exceptional events

• 5% Demonstration

–     Upholds EPA’s determination

–     Agrees that Control Measures do not need to be updated

• Contingency Measures

–     Remands to EPA the contingency measures portion for further consideration

Next Steps

• EPA must decide how to move forward

–     Appeal 9^th Circuit Opinion

–     Request AZ to revise Contingency Measures

• AZ must decide how to move forward

–     Wait for EPA while remaining in serious nonattainment

–     Prepare a Maintenance Plan and seek Redesignation from nonattainment to attainment

Don’t Become Complacent

• Unpermitted regulated sources like property owners with unstabilized land areas must comply with the Dust Action Plan General Permit
• Agricultural sources must comply with Agricultural BMPs
• Continue working with GRIC, PMSRIC and Pinal County on minimizing dust transport into the Maricopa County nonattainment area
  • All permitted sources must maintain their high degree of compliance with existing MCAQD Air Pollution Control rules, especially Rules 310 and 316
  • Continue high quality and complete petitions to EPA for exceptional event determinations

Do Not Become Complacent

References

Arizona Department of Environmental Quality (ADEQ) 2012, Air Monitoring Network Plan for 2012, http://www.azdeq.gov/environ/air/assessment/download/networkplan_2012.pdf

ADEQ Air Quality Forecasts, 2012,

http://www.azdeq.gov/function/forms/docs.html#month

Gauderman, W. J. et. al, (2007), Effect of exposure to traffic on lung development from 10 to 18 years of age: a cohort study, The Lancet, Volume 369, Issue 9561, 17– 23 February 2007, Pages 571-577, ISSN 0140-6736, 10.1016/S0140-6736(07)60037-

3.

http://www.sciencedirect.com/science/article/pii/S0140673607600373

HEI Panel on the Health Effects of Traffic-Related Air Pollution. 2010. Traffic-Related Air Pollution: A Critical Review of the Literature on Emissions, Exposure, and Health Effects. HEI Special Report 17.

Health Effects Institute, Boston, MA.

References Continued

Jerrett, M. et al., 2009, Long-term ozone exposure and mortality, The New England Journal of Medicine, V. 360

Kramer, U. et. al., 2010, Traffic related pollution and incident Type 2 diabetes: results from the SALIA cohort study, Environmental Heath Perspectives, http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.0901689

Kyle, A.D., Wright, C.C. Caldwell, J.C., Buffler, P.A., 2001,Evaluating the heath significance of hazardous air pollutants using monitoring data. Public Health Reports 2001; 116:32-44

References Continued

Narayan, M., 2013, Coffelt-Lamoreaux Public Housing Redevelopment: Health Impact Assessment Report

Pearson, J. F., et al., 2010, Association between fine particulate matter and diabetes prevalence in the U.S., Diabetes Care, Vol 33, No. 10.

Pope, C.A., et al., 2009, Fine-particulate air pollution and life expectancy in the United States, New England Journal of Medicine, Vol 360

Samet, J.M., et al. Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994. New England Journal of Medicine, 2000; 343:1742-1749

Schwartz, J., Air pollution and children’s health. Pediatrics 2004; 113:1037- 1043

References continued

U.S. Environmental Protection Agency (U.S. EPA), 2013, Integrated Science Assessment for Ozone and Related Photochemical Oxidants,

http://www.epa.gov/air/airpollutants.html

U.S. EPA, 2013, Indoor Air Quality, http://www.epa.gov/iaq/ia-intro.html

U.S. EPA, 2012, Provisional Assessment of Recent Studies on Health Effects of Particulate Matter Exposure, http://www.epa.gov/air/airpollutants.html

U.S. EPA, 2012, New Annual PM 2.5 Standard, Press Release,

http://yosemite.epa.gov/opa/admpress.nsf/bd4379a92ceceeac8525735900400c27/a7446ca9e228622b852 57ad400644d82!OpenDocument

U.S. EPA, 2012, NAAQS page, http://epa.gov/air/criteria.html

U.S. EPA, 2009, Integrated Science Assessment for Particulate Matter, Final Report,

http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=216546

References continued

U.S. EPA, 2008, Integrated Science Assessment for Oxides of Nitrogen,

http://www.epa.gov/air/airpollutants.html

U.S. EPA AirNow Website;

http://airnow.gov/index.cfm?action=airnow.displaymaps&pollutant=OZONE&StateID=3&domain=phnx&mon=11&dayofmon= 1&yr=2007

U. S. EPA, Air quality overview pages,

http://www.epa.gov/air/basic.html

U.S. EPA, 2006, Air quality criteria for ozone and related photochemical oxidants; EPA 600/R-05/004aF.

U. S. EPA, Health Providers Fact Sheets page,

http://www.airnow.gov/index.cfm?action=health_prof.main

References continued

U. S. EPA, Ozone Rule Slides, 2008,

http://www.epa.gov/groundlevelozone/pdfs/2008_03_text_slides.pdf

U.S. EPA, Mobile Source Air Toxics, Final Rule, February 2007,

http://www.epa.gov/otaq/regs/toxics/420f07017.htm

U.S. EPA, September 2006 Revisions to the National Ambient Air Quality Standards for Particle Pollution, Overview 9-06,

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