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The United States has one of the world’s largest oil and gas (O&G) industries, yet the health impacts and inequities from pollutants produced along the O&G lifecycle remain poorly characterized. Here, we model the contribution of major lifecycle stages (upstream, midstream, downstream, and end-use) to air pollution and estimate the associated chronic health outcomes and racial-ethnic disparities across the contiguous US in 2017. We estimate lifecycle annual burdens of 91,000 premature deaths attributable to fine particles (PM2.5), nitrogen dioxide (NO2), and ozone, 10,350 PM2.5-attributable preterm births, 216,000 incidences of NO2-attributable childhood-onset asthma, and 1610 lifetime cancers attributable to hazardous air pollutants (HAPs). Racial-ethnic minorities experience the greatest disparities in exposure and health burdens across almost all lifecycle stages. The greatest absolute disparities occur for Black and Asian populations from PM2.5 and ozone, and the Asian population from NO2 and HAPs. Relative inequities are most extreme from downstream activities, especially in Louisiana and Texas.

Published Aug 22, 2025

Vohra, K., Marais, E. A., Achakulwisut, P., Anenberg, S., & Harkins, C. (2025). The health burden and racial-ethnic disparities of air pollution from the major oil and gas lifecycle stages in the United States. Science Advances , 11(34), 2241. https://doi.org/10.1126/sciadv.adu2241

Rationale: Abrupt air quality improvements have followed the closure or dramatic emission control of large air pollution sources. These “natural experiments” provide ideal opportunities to assess the real-world health benefits of air quality improvements. The shutdown of the Shenango coking plant, a significant fossil-fuel pollution source located on an island in the Ohio River near Pittsburgh, PA, presented such an opportunity to test for changes in respiratory health in the local community following the closure. Objectives: To identify and quantify the immediate and/or longer-term changes in respiratory hospitalizations and emergency department (ED) visits among the population residing near the Shenango coke plant at the time of its closure. Methods: We acquired data for respiratory hospitalizations and ED visit counts by residents living in zip codes surrounding the plant, as well as at comparison control sites, three years before and after the shutdown date. The immediate and longer-term changes of respiratory health outcomes were tested with an interrupted time series model, and compared with external control sites and internal control outcomes. Measurements and Main Results: We found the closure of the Shenango plant was associated with an immediate 20.5% (95% CI: 12.8%-27.6%) decrease for weekly respiratory ED visits, and an immediate 41.2% (95% CI: 14.4%-59.9%) decrease in pediatric asthma ED visits, followed by an additional 4% per month longer-term downward trend. Longer-term reductions, as compared to pre-closure trends, were also observed for chronic obstructive pulmonary disease hospitalizations. Conclusions: Our study provides strong confirmation that reductions in fossil-fuel-related air pollution produce both short and longer-term respiratory health benefits.

Published Jul 21, 2025

Yu, W., & Thurston, G. D. (2025). Reductions in Respiratory Hospital Visits after a Coal Coking Plant Closure: A Natural Experiment. Https://Doi.Org/10.1164/Rccm.202410-2005OC. https://doi.org/10.1164/RCCM.202410-2005OC

Background: Heat exposure poses a substantial public health threat. Increasing greenness has been suggested as a mitigation strategy due to its cooling effect and potential to modify the heat–mortality association. This study aimed to comprehensively estimate the effects of increased greenness on heat-related deaths.
Methods: We applied a multistage meta-analytical approach to estimate the potential reduction in global heat-related deaths by increasing greenness in the warm season in 2000–19 in 11 534 urban areas. We used the enhanced vegetation index (EVI) to indicate greenness and a random forest model to predict daily temperatures in counterfactual EVI scenarios. In the factual EVI scenarios, daily mortality and weather variables from 830 locations in 53 countries were extracted from the Multi-Country Multi-City Collaborative Research Network and used to assess heat–mortality associations. These associations were then extrapolated to each urban area under both factual and counterfactual EVI scenarios based on meta-regression models.
Findings: We estimated that EVI increased by 10% would decrease the global population-weighted warm-season mean temperature by 0·08°C, EVI increased by 20% would decrease temperature by 0·14°C, and EVI increased by 30% would decrease temperature by 0·19°C. In the factual scenario, 3 153225 (2·48%) of 127 179 341 total deaths could be attributed to heat exposure. The attributable fraction of heat-related deaths (as a fraction of total deaths) in 2000–19 would decrease by 0·67 (95% empirical CI 0·53–0·82) percentage points in the 10% scenario, 0·80 (0·63–0·97) percentage points in the 20% scenario, and 0·91 (0·72–1·10) percentage points in the 30% scenario, compared with the factual scenario. South Europe was modelled to have the largest decrease in attributable fraction of heat-related mortality.
Interpretation: This modelling study suggests that increased greenness could substantially reduce the heat-related mortality burden. Preserving and expanding greenness might be potential strategies to lower ambient temperature and reduce the health impacts of heat exposure.

Published Jul 1, 2025

Wu, Y., Wen, B., Ye, T., Huang, W., Liu, Y., Guo, Y., Li, S., Gasparrini, A., Wu, Y., Wen, B., Ye, T., Huang, W., Liu, Y., Gasparrini, A., Sera, F., Tong, S., Lavigne, E., Roye, D., Achilleos, S., … Li, S. (2025). Estimating the urban heat-related mortality burden due to greenness: a global modelling study. The Lancet Planetary Health, 9, 101235. https://doi.org/10.1016/S2542-5196(25)00062-2

Background
The associations of PM2.5 mass and various adverse health outcomes have been widely investigated. However, fewer studies focused on the potential health impacts of PM2.5 components, especially for dementia and Alzheimer’s diseases (AD).
Methods
We constructed a nationwide population-based open cohort study among Medicare beneficiaries aged 65 or older during 2000–2018. This dataset was linked with the predicted levels of 15 PM2.5 components, including 5 major mass contributors (EC, OC, NH4+, NO3–, SO42-) and 10 trace elements (Br, Ca, Cu, Fe, K, Ni, Pb, Si, V, Zn) across contiguous U.S. territory. Data were aggregated by ZIP code, calendar year and individual level demographics. Two mixture analysis methods, weighted quantile sum regression (WQS) and quantile g-computation (qgcomp), were used with quasi-Poisson models to analyze the health effects of the total mixture of PM2.5 components on dementia and AD, as well as the relative contribution of individual components.
Results
Exposure to PM2.5 components over the previous 5 years was significantly associated with increased risks of both dementia and AD, with stronger associations observed for AD. SO42-, OC, Cu were identified as major contributors to the combined positive association of the mixture from both WQS and qgcomp models.
Conclusion
We found positive associations between the 15 PM2.5 components and the incidence of dementia and AD. Our findings suggest that reducing PM2.5 emissions from traffic and fossil fuel combustion could help mitigate the growing burden of dementia and Alzheimer’s disease.

Published Jun 1, 2025

Zhang, H., Wang, Y., Li, H., Zhu, Q., Ma, T., Liu, Y., & Steenland, K. (2025). The role of the components of PM2.5 in the incidence of Alzheimer’s disease and related disorders. Environment International, 200(7), 109539. https://doi.org/10.1016/j.envint.2025.109539

Air pollution poses a global concern due to its detrimental effects on climate, healthcare, and human capital accumulation. However, there is limited evidence on the health and human capital impacts of clean air transport policies. This study investigates the effects of London’s Low Emission Zone (LEZ) and Ultra-Low Emission Zone (ULEZ) on air quality, sick leave, well-being, and physical health. By exploiting the temporal and spatial variations of these policies – implemented in Greater London (LEZ) in 2008 and Central London (ULEZ) in 2019 – we implement a difference-in-differences approach utilising linked survey and administrative data. We show that the LEZ and ULEZ policies significantly reduced PM10 and NO2 levels. Consequently, we observe substantial improvements in labour productivity, with sick leave reduced by 18.5% from pre-LEZ levels. The ULEZ contributed to enhanced mental well-being, as evidenced by increased feelings of happiness, worthiness and satisfaction, along with a reduction in anxiety. These effects are further supported by improvements in physical health, with the LEZ reducing the incidence of long-term health conditions by 6.8% and respiratory issues by 10.2%. A back-of-the-envelope cost–benefit analysis suggests that the policies generated savings exceeding £37 million per year for the overall population.

Published Jun 1, 2025

Beshir, H. A., & Fichera, E. (2025). “And Breathe Normally”: Impacts of low emission zones on sick leave and mental well-being. Journal of Economic Behavior & Organization, 234, 106994. https://doi.org/10.1016/J.JEBO.2025.106994

The co-occurrence of fine particulate matter (PM2.5) and ozone has emerged as a critical environmental challenge in recent years. The individual harmful impacts of PM2.5 and ozone exposure have been well studied; however, their combined toxicity under co-exposure conditions remains mechanistically undefined. This paper provides an extensive evaluation of the current pollution levels, epidemiological investigation, and new findings on the toxicological mechanisms of combined exposure to PM2.5 and ozone. The synergistic toxicity of PM2.5 and ozone depends on different factors, including the physicochemical properties of PM2.5, the dose and duration of exposure, and the specific target organs. Through extensive research, we identified the main targets of toxic responses to PM2.5 and ozone exposure and summarized their synergistic toxic mechanisms. Given the current research priorities, there is an urgent need to improve scientific research regarding PM2.5 and ozone co-exposure with priority given to characterizing their properties and toxicological responses while updating relevant guidelines and standards.

Published Mar 24, 2025

He, J., Wang, T., Li, H., Zhou, Y., Liu, Y., & Xu, A. (2025). Synergistic Toxicity of Fine Particulate Matter and Ozone and Their Underlying Mechanisms. Toxics 2025, Vol. 13, Page 236, 13(4), 236. https://doi.org/10.3390/toxics13040236

Background
Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) are prevalent neurodegenerative disorders, posing a critical worldwide public health challenge. Ambient air pollution has been identified as a potential risk factor for AD progression based on toxicological and epidemiological studies. We aimed to evaluate the impacts of air pollution—including fine particulate matter (PM2·5), nitrogen dioxide (NO2), summer ozone (O3), and oxidant—on readmission or death among Medicare enrollees previously hospitalised with an AD/ADRD diagnosis code.
Methods
We constructed a population-based nationwide retrospective cohort including all Medicare fee-for-service beneficiaries (aged ≥65 years) in the contiguous USA (2000–16) hospitalised with AD/ADRD, and followed them up from the year after their first hospitalisation until (1) year of death (mortality cohort) and (2) year of second hospitalisation for any cause (readmission cohort). We calculated annual average PM2·5, NO2, summer O3, and oxidant concentrations for each individual at their residential ZIP code in each year after their first hospitalisation with AD/ADRD. We applied Cox proportional hazard models for the mortality and readmission cohorts stratifying on individual risk factors and adjusting for socioeconomic status, seasonal temperatures, and relative humidity.
Findings
Our cohort consisted of 5 544 118 individuals, of whom 4 543 759 (82·0%) died and 3 880 894 (70·0%) were readmitted to the hospital during the study period. The average follow-up times were 3·34 years (SD 2·60) for the mortality cohort and 1·98 years (SD 1·65) for the readmission cohort. In both the mortality and readmission cohorts we found significant associations with each pollutant. For an IQR increase in NO2, we found a hazard ratio (HR) for mortality of 1·012 (95% CI 1·009–1·015) and an HR for readmission of 1·110 (1·104–1·117). In the readmission cohort, we found an HR of 1·084 (1·079–1·089) for an IQR increase (3·87 μg/m3) in PM2·5. The results slightly decreased in multi-pollutant models. The results of effect modification for mortality and readmission varied by pollutant, but higher risks were found among Black males and among those eligible for Medicaid in general.

Published Feb 1, 2025

Dong, S., Braun, D., Wu, X., Yitshak-Sade, M., Blacker, D., Kioumourtzoglou, M. A., Schwartz, J., Mork, D., Dominici, F., & Zanobetti, A. (2025). The impacts of air pollution on mortality and hospital readmission among Medicare beneficiaries with Alzheimer’s disease and Alzheimer’s disease-related dementias: a national retrospective cohort study in the USA. The Lancet Planetary Health, 9(2), e114–e123. https://doi.org/10.1016/S2542-5196(25)00001-4

Climate change and extreme weather events are particularly concerning for pregnant and postpartum women and have been related to negative birth outcomes. However, the impact of climate change on perinatal mental health outcomes is not well studied. Mood and anxiety disorders are among the leading comorbidities during pregnancy and the postpartum period, and they are associated with significant familial and societal burdens. It is crucial to include environmental factors in the risk profile of perinatal mental illness to optimize prevention and early intervention strategies. In the clinical experience of one of the authors, new mothers can feel particularly concerned about their baby’s physical health when faced with extreme heat or may present as agitated due to heat-related sleep deprivation. This is in line with qualitative research showing maternal worrying about a baby’s thermal dysregulation as one of the emerging themes. With extreme weather events becoming more frequent, clinicians have a role in advocating for climate adaptation in healthcare settings. Climate inequalities need to be addressed alongside health and social inequalities.

Published Jan 20, 2025

Barkin, J. L., van Rhijn, S., & Johnson, C. M. (2024). The connection between climate change and perinatal mental health. Frontiers in Psychiatry, 15, 1515895. https://doi.org/10.3389/FPSYT.2024.1515895/BIBTEX

In the United States (US), neonatal intensive care units (NICUs) monitor and treat newborns for a variety of adverse health concerns including preterm status, respiratory distress and restricted growth. As such, NICU admission is an integrated measure of neonatal risk. We linked 2018 US national birth registry NICU admission data among singleton births with satellite and modelled air pollution levels for the month prior to birth to examine whether late-pregnancy exposure to ambient air pollutants is associated with adverse neonatal health outcomes. Regardless of season, higher ambient levels of nitrogen dioxide (NO2) and fine particulate matter < 2.5 microns (PM2.5) increased the likelihood of NICU admission 30–35% for NO2 and 11–22% for PM2.5 even after adjustment for parental characteristics. Results for ozone exposure were inconsistent with largely null or reduced risk except for summer months. Despite the relatively low-moderate US exposure levels, traffic-related pollutants near the end of pregnancy appear to increase overall adverse health risks for newborns, underscoring the need to reduce prenatal exposure to ambient pollutants.

Published Jan 2, 2025

Phiri, Y. V. A., Canty, T., Nobles, C., Ring, A. M., Nie, J., & Mendola, P. (2025). Neonatal intensive care admissions and exposure to satellite-derived air pollutants in the United States, 2018. Scientific Reports 2024 15:1, 15(1), 420-. https://doi.org/10.1038/s41598-024-84755-9

Background
A growing body of epidemiologic and toxicologic literature indicates that fine airborne particulate matter (PM2.5) pollution is neurotoxic and threatens children’s neurobehavioral development, resulting in reduced cognitive function. Understanding the magnitude of this effect is critical for establishing public health policies that will protect children’s health, preserve human capital, and support societal progress.

Objective
To quantify the association between ambient PM2.5 air pollution and loss of cognitive function in children, as measured by Intelligence Quotient (IQ) scores, through a systematic literature review and meta-analysis.

Methods
Following PRISMA guidelines, we conducted a systematic literature search across seven databases: Agricultural and Environmental Science, BIOSIS Citation Index, Embase, GreenFILE, PubMed, Scopus, and Web of Science to identify original scientific studies that investigated the impact of PM2.5 exposure during pre-and postnatal periods on IQ loss during childhood. Using data from studies included for final review, we conducted a meta-analysis, using a random effects model to compute a beta coefficient that quantifies the overall effect of PM2.5 exposure on Full-Scale IQ (FSIQ), Performance IQ (PIQ), and Verbal IQ (VIQ).

Findings
Of the 1,107 unique publications identified, six studies met the inclusion criteria for final review, representing 4,860 children across three continents (North America, Europe, and Asia). The mean PM2.5 concentration across all studies was 30.4 ± 24.4 µg/m3. Exposure timing ranged from the prenatal period to mid-childhood. Children were an average of 8.9 years old at the time of cognitive testing. We found that each 1 µg/m3 increase in PM2.5 concentration is associated with a -0.27 point change in FSIQ (p < 0.001), 0.39 point change in PIQ (p = 0.003), and -0.24 point change in VIQ (p = 0.021). Conclusion Through a systematic review and meta-analysis, we identified a statistically significant relationship between increased exposure to PM2.5 air pollution and reduced cognitive function in children, with the most pronounced impact on PIQ. This analysis will enable estimation of the burden of adverse neurobehavioral development attributable to PM2.5 in pediatric populations and will inform local and global strategies for exposure prevention.

Published Dec 1, 2024

Alter, N. C., Whitman, E. M., Bellinger, D. C., & Landrigan, P. J. (2024). Quantifying the association between PM2.5 air pollution and IQ loss in children: a systematic review and meta-analysis. Environmental Health: A Global Access Science Source, 23(1), 1–17. https://doi.org/10.1186/S12940-024-01122-X/TABLES/8