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Climate change is already adversely affecting human health and health systems, 1,2 and projected climate change is expected to alter the geographic range and burden of a variety of climate-sensitive health outcomes and to affect the functioning of public health and health care systems. If no additional actions are taken, then over the coming decades, substantial increases in morbidity and mortality are expected in association with a range of health outcomes, including heat-related illnesses, illnesses caused by poor air quality, undernutrition from reduced food quality and security, and selected vectorborne diseases in some locations; at the same time, worker productivity is expected to decrease, particularly at low latitudes. 3,4 Vulnerable populations and regions will be differentially affected, with expected increases in poverty and inequities as a consequence of climate change. Investments in and policies to promote proactive and effective adaptation and reductions in greenhouse-gas emissions (mitigation) would decrease the magnitude and pattern of health risks, particularly in the medium-to-long term.

Published Jan 1, 2019

Haines, A., & Ebi, K. (2019). The imperative for climate action to protect health. New England Journal of Medicine, 380(3), 263–273. https://doi.org/10.1056/NEJMra1807873

Considerations for electrifying school buses are presented with an analysis of battery sizing to match bus-driving requirements. The charging and vehicle-to-building dispatch of the electric school buses were optimized to evaluate the potential to reduce the impact of the bus charging on the school's electric utility bill. Distributed energy resources and flexible building loads were also considered with the school bus electrification to evaluate the further reductions in energy costs with enhanced systems integration and optimized dispatch. The effect of degradation on the school bus batteries was analyzed to determine if the smart-charging and vehicle-to-building battery operation decreases the life of the battery. The results show that there is an opportunity to mitigate the increase in electric utility bill with improved charging controls and bi-directionally operating the school bus batteries. The battery degradation analysis using dispatch with optimized charging and discharging shows that acceptable battery life remains.

Published Jan 1, 2019

Becker, W., Miller, E., Mishra, P. P., Jain, R., Olis, D., & Li, X. (2019, October 1). Cost Reduction of School Bus Fleet Electrification with Optimized Charging and Distributed Energy Resources. 51st North American Power Symposium, NAPS 2019. https://doi.org/10.1109/NAPS46351.2019.9000330

The effect of acute and long-term exposures to outdoor particulate air pollution on lung function in healthy adults is not well established. The objective of this study was to conduct a systematic literature review and meta-analysis of studies that assessed the relationship of outdoor particulate air pollution and lung function in healthy adults. Studies that contained data on outdoor air particulate matter levels (PM 10 or PM 2.5) and forced expiratory volume in 1 s (FEV 1) in healthy adults were eligible for inclusion. Effect estimates, in relation to long-term and acute exposures, were quantified separately using random effects models. A total of 27 effect estimates from 23 studies were included in this review. Acute exposures were typically assessed with PM 2.5, while long-term exposures were predominantly represented by PM 10. A 10 μg/m3 increase in short-term PM 2.5 exposure (days) was associated with a -7.02 mL (95% CI -11.75 to -2.29) change in FEV 1. A 10 μg/m 3 difference in long-term PM 10 exposure was associated with a -8.72 mL (95% CI -15.39 to -2.07) annual change in FEV 1 and an absolute difference in FEV 1 of -71.36 mL (95% CI -134.47 to -8.24). This study provides evidence that acute and long-term exposure to outdoor particulate air pollution are associated with decreased FEV 1 in healthy adults. Residual confounding from other risk factors, such as smoking, may explain some of the effect for long-term exposures. More studies are required to determine the relationship of long-term exposure to PM 2.5 and short-term exposure to PM 10, which may have different biologic mechanisms.

Published Jan 1, 2019

Edginton, S., O’sullivan, D. E., King, W., & Lougheed, M. D. (2019). Effect of outdoor particulate air pollution on FEV 1 in healthy adults: a systematic review and meta-analysis. Occupational and Environmental Medicine, 76(8), 583–591. https://doi.org/10.1136/oemed-2018-105420

We examine the effect of school traffic pollution on student outcomes by leveraging variation in wind patterns for schools the same distance from major highways. We compare within-student achievement for students transitioning between schools near highways, where one school has had greater levels of pollution because it is downwind of a highway. Students who move from an elementary/middle school that feeds into a “downwind” middle/high school in the same zip code experience decreases in test scores, more behavioral incidents, and more absences, relative to when they transition to an upwind school. Even within zip codes, microclimates can contribute to inequality.

Published Jan 1, 2019

Heissel, J., Persico, C., & Simon, D. (2019). Does pollution drive achievement? The effect of traffic pollution on academic performance. doi:10.3386/w25489

We investigate the effect of pollution on worker productivity in the service sector by focusing on two call centers in China. Using precise measures of each worker's daily output linked to daily measures of pollution and meteorology, we find that higher levels of air pollution decrease worker productivity. These results manifest themselves at levels of pollution commonly found in large cities throughout the developing and developed world.

Published Jan 1, 2019

Chang, T. Y., Zivin, J. G., Gross, T., & Neidell, M. (2019). The effect of pollution on worker productivity: Evidence from call center workers in China. American Economic Journal: Applied Economics, 11(1), 151–172. https://doi.org/10.1257/app.20160436

Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (particulate matter with an aerodynamic diameter 103 million disability-adjusted life years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body. It can cause, complicate, or exacerbate many adverse health conditions. Tissue damage may result directly from pollutant toxicity because fine and ultrafine particles can gain access to organs, or indirectly through systemic inflammatory processes. Susceptibility is partly under genetic and epigenetic regulation. Although air pollution affects people of all regions, ages, and social groups, it is likely to cause greater illness in those with heavy exposure and greater susceptibility. Persons are more vulnerable to air pollution if they have other illnesses or less social support. Harmful effects occur on a continuum of dosage and even at levels below air quality standards previously considered to be safe.

Published Jan 1, 2019

Schraufnagel, D. E., Balmes, J. R., Cowl, C. T., De Matteis, S., Jung, S. H., Mortimer, K., Perez-Padilla, R., Rice, M. B., Riojas-Rodriguez, H., Sood, A., Thurston, G. D., To, T., Vanker, A., & Wuebbles, D. J. (2019). Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies’ Environmental Committee, Part 1: The Damaging Effects of Air Pollution. Chest, 155(2), 409–416. https://doi.org/10.1016/j.chest.2018.10.042

The transportation sector is now the leading emitter of greenhouse gases ("GHGs") in the United States, emitting more GHGs than the power sector. In order to reach greenhouse gas emission reduction goals to mitigate the effects of climate change, transit authorities must transition to zero-emission vehicle ('"EV") bus fleets. The average life span of a diesel bus is twelve years; therefore, it is imperative that transit authorities act quickly and stop buying additional diesel buses. However, one significant barrier to shifting to ZEVs is the upfront cost. Although electric buses have or will soon reach cost parity with their diesel counterparts over time, they are more expensive to purchase. Currently, many states are using limited federal funding and the VW Settlement Fund, but those are finite resources that are already spread too thin. This Note argues that transit authorities should consider a Pay-As- You Save ("PAYS") financing structure to cover the initial increased cost. Through PAYS, electric companies bear the additional upfront cost in pur- chasing electric buses and charge the transit authorities a fixed tariff on their electric bill. Utilities supply the additional electricity to power the buses and PAYS will allow transit authorities to leverage the limited public funds, so they can buy more electric buses. This will allow them to transition to a zero- emission fleet faster. This Note examines the VW Consent Decree, a selection of state VW Mitigation Beneficiary Plans, as well as the Low-No Emissions federal grant, none of which pose a legal barrier for leveraging VW funds through PAYS. Although there is additional coordination to set up PAYS and there is more administration than simply using federal grants or VWfunding, PAYS financing will allow transit authorities to scale their bus electrification while we are run- ning out of time to prevent meaningful effects of climate change.

Published Jan 1, 2019

Strauss, R. (2019). Electric Buses and Clean Energy Financing: How Transit Authorities Can Leverage State and Federal Funds to Buy More Zero-Emission Buses. Georgetown Environmental Law Review, 32. https://heinonline.org/HOL/LandingPage?handle=hein.journals/gintenlr32&div=10&id=&page=

Walking School Buses (WSBs), organized groups for children to walk to school under the supervision of adults, help reduce traffic congestion and contribute towards exercise. Routes are based largely on need, traffic safety and travel time, with exposure to air pollution not generally considered. This paper explores whether reductions in exposure can be achieved based on the side of the road travelled using data collected in Auckland, New Zealand. Exposure to air pollution was measured for a 25-min commute consisting of a 10-min segment along a quiet cul-de-sac and a 15-min segment along a main arterial road with traffic congestion heavier in one direction. Two participants were each equipped with a portable P-Trak ultrafine particle monitor and a portable Langan carbon monoxide monitor, and walked the route on opposite sides of the road simultaneously, for both morning and afternoon, logging 10-s data. The results suggest that pedestrians travelling on the footpath next to the less congested side of the road in the morning avoid many short-term peaks in concentration and experience significantly lower mean exposures than those travelling on the footpath next to the more congested side. Significant reductions in air pollution exposure could be made for children by taking into account the side of the road in WSB route design.

Published Dec 6, 2018

Dirks, K., Salmond, J., & Talbot, N. (2018). Air Pollution Exposure in Walking School Bus Routes: A New Zealand Case Study. International Journal of Environmental Research and Public Health, 15(12), 2802. https://doi.org/10.3390/ijerph15122802

Environmental burdens such as air pollution are inequitably distributed with groups of lower socioeconomic statuses, which tend to comprise of large proportions of racial minorities, typically bearing greater exposure. Such groups have also been shown to present more severe health outcomes which can be related to adverse pollution exposure. Air pollution exposure, especially in urban areas, is usually impacted by the built environment, such as major roadways, which can be a significant source of air pollution. This study aims to examine inequities in prevalence of cardiovascular and respiratory diseases in the Atlanta metropolitan region as they relate to exposure to air pollution and characteristics of the built environment. Census tract level data were obtained from multiple sources to model health outcomes (asthma, chronic obstructive pulmonary disease, coronary heart disease, and stroke), pollution exposure (particulate matter and nitrogen oxides), demographics (ethnicity and proportion of elderly residents), and infrastructure characteristics (tree canopy cover, access to green space, and road intersection density). Conditional autoregressive models were fit to the data to account for spatial autocorrelation among census tracts. The statistical model showed areas with majority African-American populations had significantly higher exposure to both air pollutants and higher prevalence of each disease. When considering univariate associations between pollution and health outcomes, the only significant association existed between nitrogen oxides and COPD being negatively correlated. Greater percent tree canopy cover and green space access were associated with higher prevalence of COPD, CHD, and stroke. Overall, in considering health outcomes in connection with pollution exposure infrastructure and ethnic demographics, demographics remained the most significant explanatory variable.

Published Nov 26, 2018

Servadio, J. L., Lawal, A. S., Davis, T., Bates, J., Russell, A. G., Ramaswami, A., Convertino, M., & Botchwey, N. (2019). Demographic Inequities in Health Outcomes and Air Pollution Exposure in the Atlanta Area and its Relationship to Urban Infrastructure. Journal of Urban Health, 96(2), 219–234. https://doi.org/10.1007/s11524-018-0318-7

Asthma is the most prevalent chronic respiratory disease worldwide, affecting 358 million people in 2015. Ambient air pollution exacerbates asthma among populations around the world and may also contribute to new-onset asthma.

Published Oct 24, 2018

Anenberg, S. C., Henze, D. K., Tinney, V., Kinney, P. L., Raich, W., Fann, N., Malley, C. S., Roman, H., Lamsal, L., Duncan, B., Martin, R. V., van Donkelaar, A., Brauer, M., Doherty, R., Jonson, J. E., Davila, Y., Sudo, K., & Kuylenstierna, J. C. I. (2018). Estimates of the Global Burden of Ambient, Ozone, and Asthma Incidence on Emergency Room Visits. Environmental Health Perspectives, 126(10), 107004. https://doi.org/10.1289/EHP3766