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The combustion of fossil fuels (coal, petroleum [oil], and natural gas) is the major source of both air pollution and the greenhouse-gas emissions driving climate change. The fetus, infant, and child are especially vulnerable to exposure to air pollution and climate change, which are already taking a major toll on the physical and mental health of children. Given the frequent co-occurrence of various fossil-fuel exposures, their interactions and cumulative environmental impacts are a growing concern. All children are at risk, but the greatest burden falls on those who are socially and economically disadvantaged. Protection of children’s health requires that health professionals understand the multiple harms to children from climate change and air pollution and use available strategies to reduce these harms.

Published Jun 15, 2022

Perera, F., & Nadeau, K. (2022). Climate Change, Fossil-Fuel Pollution, and Children’s Health. New England Journal of Medicine, 386(24), 2303–2314. https://doi.org/10.1056/NEJMRA2117706

In this paper we study the effects of three large, nearly-simultaneous coal-fired power plant closures on school absences in Chicago. We find that the closures resulted in a 6 percent reduction in absenteeism in nearby schools relative to those farther away following the closures. For the typical elementary school in our sample, this translates into around 363 fewer absence-days per year in the aggregate, or 0.66 fewer annual absences per student. To explore potential mechanisms responsible for these absence reductions, we investigate the effects of the closures on endogenous migration to neighborhoods near the plants (mediated through housing prices) and emergency department visits for asthma-related conditions among school-age children. We do not find strong evidence of endogenous migration into neighborhoods near the coal-fired power plants following the closures but do find declines in rates of emergency department visits in areas near the three plants. Given inequalities in exposure to operational coal-fired power plants and other large, industrial polluters, our findings suggest that transitions towards alternative energy sources could play an important role in addressing educational inequality.

Published Mar 1, 2022

Komisarow, S., & Pakhtigian, E. L. (2022). Are power plant closures a breath of fresh air? Local air quality and school absences. Journal of Environmental Economics and Management, 112, 102569. https://doi.org/10.1016/J.JEEM.2021.102569

We used a large national cohort in Canada to assess the incidence of acute myocardial infarction (AMI) and stroke hospitalizations in association with long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3). The study population comprised 2.7 million respondents from the 2006 Canadian Census Health and Environment Cohort (CanCHEC), followed for incident hospitalizations of AMI or stroke between 2006 and 2016. We estimated 10-year moving average estimates of PM2.5, NO2, and O3, annually. We used Cox proportional hazards models to examine the associations adjusting for various covariates. For AMI, each interquartile range (IQR) increase in exposure was found to be associated with a hazard ratio of 1.026 (95% CI: 1.007–1.046) for PM2.5, 1.025 (95% CI: 1.001–1.050) for NO2, and 1.062 (95% CI: 1.041–1.084) for O3, respectively. Similarly, for stroke, an IQR increase in exposure was associated with a hazard ratio of 1.078 (95% CI: 1.052–1.105) for PM2.5, 0.995 (95% CI: 0.965–1.030) for NO2, and 1.055 (95% CI: 1.028–1.082) for O3, respectively. We found consistent evidence of positive associations between long-term exposures to PM2.5, and O3, and to a lesser degree NO2, with incident AMI and stroke hospitalizations.

Published Mar 1, 2022

Olaniyan, T., Pinault, L., Li, C., van Donkelaar, A., Meng, J., Martin, R. v., Hystad, P., Robichaud, A., Ménard, R., Tjepkema, M., Bai, L., Kwong, J. C., Lavigne, E., Burnett, R. T., & Chen, H. (2022). Ambient air pollution and the risk of acute myocardial infarction and stroke: A national cohort study. Environmental Research, 204, 111975. https://doi.org/10.1016/j.envres.2021.111975

Communities of color in the United States are systematically exposed to higher levels of air pollution. We explore here how redlining, a discriminatory mortgage appraisal practice from the 1930s by the federal Home Owners’ Loan Corporation (HOLC), relates to present-day intraurban air pollution disparities in 202 U.S. cities. In each city, we integrated three sources of data: (1) detailed HOLC security maps of investment risk grades [A (“best”), B, C, and D (“hazardous”, i.e., redlined)], (2) year-2010 estimates of NO2 and PM2.5 air pollution levels, and (3) demographic information from the 2010 U.S. census. We find that pollution levels have a consistent and nearly monotonic association with HOLC grade, with especially pronounced (>50%) increments in NO2 levels between the most (grade A) and least (grade D) preferentially graded neighborhoods. On a national basis, intraurban disparities for NO2 and PM2.5 are substantially larger by historical HOLC grade than they are by race and ethnicity. However, within each HOLC grade, racial and ethnic air pollution exposure disparities persist, indicating that redlining was only one of the many racially discriminatory policies that impacted communities. Our findings illustrate how redlining, a nearly 80-year-old racially discriminatory policy, continues to shape systemic environmental exposure disparities in the United States.

Published Feb 15, 2022

Lane, H. M., Morello-Frosch, R., Marshall, J. D., & Apte, J. S. (2022). Historical Redlining Is Associated with Present-Day Air Pollution Disparities in U.S. Cities. Environmental Science & Technology Letters, 9(4), 345–350. https://doi.org/10.1021/ACS.ESTLETT.1C01012

Natural gas stoves in >40 million U.S. residences release methane (CH4)─a potent greenhouse gas─through post-meter leaks and incomplete combustion. We quantified methane released in 53 homes during all phases of stove use: steady-state-off (appliance not in use), steady-state-on (during combustion), and transitory periods of ignition and extinguishment. We estimated that natural gas stoves emit 0.8–1.3% of the gas they use as unburned methane and that total U.S. stove emissions are 28.1 [95% confidence interval: 18.5, 41.2] Gg CH4 year–1. More than three-quarters of methane emissions we measured originated during steady-state-off. Using a 20-year timeframe for methane, annual methane emissions from all gas stoves in U.S. homes have a climate impact comparable to the annual carbon dioxide emissions of 500 000 cars. In addition to methane emissions, co-emitted health-damaging air pollutants such as nitrogen oxides (NOx) are released into home air and can trigger respiratory diseases. In 32 homes, we measured NOx (NO and NO2) emissions and found them to be linearly related to the amount of natural gas burned (r2 = 0.76; p ≪ 0.01). Emissions averaged 21.7 [20.5, 22.9] ng NOx J–1, comprised of 7.8 [7.1, 8.4] ng NO2 J–1 and 14.0 [12.8, 15.1] ng NO J–1. Our data suggest that families who don’t use their range hoods or who have poor ventilation can surpass the 1-h national standard of NO2 (100 ppb) within a few minutes of stove usage, particularly in smaller kitchens.

Published Jan 27, 2022

Lebel, E. D., Finnegan, C. J., Ouyang, Z., & Jackson, R. B. (2022). Methane and NOx Emissions from Natural Gas Stoves, Cooktops, and Ovens in Residential Homes. Environmental Science & Technology, 56(4), 2529–2539. https://doi.org/10.1021/ACS.EST.1C04707

Background
Combustion-related nitrogen dioxide (NO2) air pollution is associated with paediatric asthma incidence. We aimed to estimate global surface NO2 concentrations consistent with the Global Burden of Disease study for 1990–2019 at a 1 km resolution, and the concentrations and attributable paediatric asthma incidence trends in 13 189 cities from 2000 to 2019.

Methods
We scaled an existing annual average NO2 concentration dataset for 2010–12 from a land use regression model (based on 5220 NO2 monitors in 58 countries and land use variables) to other years using NO2 column densities from satellite and reanalysis datasets. We applied these concentrations in an epidemiologically derived concentration–response function with population and baseline asthma rates to estimate NO2-attributable paediatric asthma incidence.

Findings
We estimated that 1·85 million (95% uncertainty interval [UI] 0·93–2·80 million) new paediatric asthma cases were attributable to NO2 globally in 2019, two thirds of which occurred in urban areas (1·22 million cases; 95% UI 0·60–1·8 million). The proportion of paediatric asthma incidence that is attributable to NO2 in urban areas declined from 19·8% (1·22 million attributable cases of 6·14 million total cases) in 2000 to 16·0% (1·24 million attributable cases of 7·73 million total cases) in 2019. Urban attributable fractions dropped in high-income countries (–41%), Latin America and the Caribbean (–16%), central Europe, eastern Europe, and central Asia (–13%), and southeast Asia, east Asia, and Oceania (–6%), and rose in south Asia (+23%), sub-Saharan Africa (+11%), and north Africa and the Middle East (+5%). The contribution of NO2 concentrations, paediatric population size, and asthma incidence rates to the change in NO2-attributable paediatric asthma incidence differed regionally.

Interpretation
Despite improvements in some regions, combustion-related NO2 pollution continues to be an important contributor to paediatric asthma incidence globally, particularly in cities. Mitigating air pollution should be a crucial element of public health strategies for children.

Published Jan 1, 2022

Anenberg, S. C., Mohegh, A., Goldberg, D. L., Kerr, G. H., Brauer, M., Burkart, K., Hystad, P., Larkin, A., Wozniak, S., & Lamsal, L. (2022). Long-term trends in urban NO2 concentrations and associated paediatric asthma incidence: estimates from global datasets. The Lancet Planetary Health, 6(1), e49–e58. https://doi.org/10.1016/S2542-5196(21)00255-2

Background: Growing evidence suggests that air pollution exposure may adversely affect the brain and increase risk for psychiatric disorders such as schizophrenia and depression. However, little is known about the potential role of air pollution in severity and relapse following illness onset.

Aims: To examine the longitudinal association between residential air pollution exposure and mental health service use (an indicator of illness severity and relapse) among individuals with first presentations of psychotic and mood disorders.

Method: We identified individuals aged ≥15 years who had first contact with the South London and Maudsley NHS Foundation Trust for psychotic and mood disorders in 2008-2012 (n = 13 887). High-resolution (20 × 20 m) estimates of nitrogen dioxide (NO2), nitrogen oxides (NOx) and particulate matter (PM2.5 and PM10) levels in ambient air were linked to residential addresses. In-patient days and community mental health service (CMHS) events were recorded over 1-year and 7-year follow-up periods.

Results: Following covariate adjustment, interquartile range increases in NO2, NOx and PM2.5 were associated with 18% (95% CI 5-34%), 18% (95% CI 5-34%) and 11% (95% CI 3-19%) increased risk for in-patient days after 1 year. Similarly, interquartile range increases in NO2, NOx, PM2.5 and PM10 were associated with 32% (95% CI 25-38%), 31% (95% CI 24-37%), 7% (95% CI 4-11%) and 9% (95% CI 5-14%) increased risk for CMHS events after 1 year. Associations persisted after 7 years.

Conclusions: Residential air pollution exposure is associated with increased mental health service use among people recently diagnosed with psychotic and mood disorders. Assuming causality, interventions to reduce air pollution exposure could improve mental health prognoses and reduce healthcare costs.

Published Dec 18, 2021

Newbury, J. B., Stewart, R., Fisher, H. L., Beevers, S., Dajnak, D., Broadbent, M., Pritchard, M., Shiode, N., Heslin, M., Hammoud, R., Hotopf, M., Hatch, S. L., Mudway, I. S., & Bakolis, I. (2021). Association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders: retrospective cohort study. The British Journal of Psychiatry : The Journal of Mental Science, 219(6), 678–685. https://doi.org/10.1192/BJP.2021.119

Decades of air pollution regulation have yielded enormous benefits in the United States, but vehicle emissions remain a climate and public health issue. Studies have quantified the vehicle-related fine particulate matter (PM2.5)-attributable mortality but lack the combination of proper counterfactual scenarios, latest epidemiological evidence, and detailed spatial resolution; all needed to assess the benefits of recent emission reductions. We use this combination to assess PM2.5-attributable health benefits and also assess the climate benefits of on-road emission reductions between 2008 and 2017. We estimate total benefits of $270 (190 to 480) billion in 2017. Vehicle-related PM2.5-attributable deaths decreased from 27,700 in 2008 to 19,800 in 2017; however, had per-mile emission factors remained at 2008 levels, 48,200 deaths would have occurred in 2017. The 74% increase from 27,700 to 48,200 PM2.5-attributable deaths with the same emission factors is due to lower baseline PM2.5 concentrations (+26%), more vehicle miles and fleet composition changes (+22%), higher baseline mortality (+13%), and interactions among these (+12%). Climate benefits were small (3 to 19% of the total). The percent reductions in emissions and PM2.5-attributable deaths were similar despite an opportunity to achieve disproportionately large health benefits by reducing high-impact emissions of passenger light-duty vehicles in urban areas. Increasingly large vehicles and an aging population, increasing mortality, suggest large health benefits in urban areas require more stringent policies. Local policies can be effective because high-impact primary PM2.5 and NH3 emissions disperse little outside metropolitan areas. Complementary national-level policies for NOx are merited because of its substantial impacts—with little spatial variability—and dispersion across states and metropolitan areas.

Published Dec 13, 2021

Choma, E. F., Evans, J. S., Gomez-Ibañez, J. A., Di, Q., Schwartz, J. D., Hammitt, J. K., & Spengler, J. D. (2021). Health benefits of decreases in on-road transportation emissions in the United States from 2008 to 2017. Proceedings of the National Academy of Sciences of the United States of America, 118(51), e2107402118. https://doi.org/10.1073/PNAS.2107402118/SUPPL_FILE/PNAS.2107402118.SD05.CSV

Background:
Emerging evidence links ambient air pollution with coronavirus 2019 (COVID-19) disease, an association that is methodologically challenging to investigate.

Objectives:
We examined the association between long-term exposure to air pollution with SARS-CoV-2 infection measured through antibody response, level of antibody response among those infected, and COVID-19 disease.

Methods:
We contacted 9,605 adult participants from a population-based cohort study in Catalonia between June and November 2020; most participants were between 40 and 65 years of age. We drew blood samples from 4,103 participants and measured immunoglobulin M (IgM), IgA, and IgG antibodies against five viral target antigens to establish infection to the virus and levels of antibody response among those infected. We defined COVID-19 disease using self-reported hospital admission, prior positive diagnostic test, or more than three self-reported COVID-19 symptoms after contact with a COVID-19 case. We estimated prepandemic (2018–2019) exposure to fine particulate matter [PM with an aerodynamic diameter of ≤2.5μ⁢m (PM2.5)], nitrogen dioxide (NO2), black carbon (BC), and ozone (O3) at the residential address using hybrid land-use regression models. We calculated log-binomial risk ratios (RRs), adjusting for individual- and area-level covariates.

Results:
Among those tested for SARS-CoV-2 antibodies, 743 (18.1%) were seropositive. Air pollution levels were not statistically significantly associated with SARS-CoV-2 infection: Adjusted RRs per interquartile range were 1.07 (95% CI: 0.97, 1.18) for NO2, 1.04 (95% CI: 0.94, 1.14) for PM2.5, 1.00 (95% CI: 0.92, 1.09) for BC, and 0.97 (95% CI: 0.89, 1.06) for O3. Among infected participants, exposure to NO2 and PM2.5 were positively associated with IgG levels for all viral target antigens. Among all participants, 481 (5.0%) had COVID-19 disease. Air pollution levels were associated with COVID-19 disease: adjusted RRs=1.14 (95% CI: 1.00, 1.29) for NO2 and 1.17 (95% CI: 1.03, 1.32) for PM2.5. Exposure to O3 was associated with a slightly decreased risk (RR=0.92; 95% CI: 0.83, 1.03). Associations of air pollution with COVID-19 disease were more pronounced for severe COVID-19, with RRs=1.26 (95% CI: 0.89, 1.79) for NO2 and 1.51 (95% CI: 1.06, 2.16) for PM2.5.

Discussion:
Exposure to air pollution was associated with a higher risk of COVID-19 disease and level of antibody response among infected but not with SARS-CoV-2 infection.

Published Nov 17, 2021

Kogevinas, M., Castaño-Vinyals, G., Karachaliou, M., Espinosa, A., de Cid, R., Garcia-Aymerich, J., Carreras, A., Cortés, B., Pleguezuelos, V., Jiménez, A., Vidal, M., O’callaghan-Gordo, C., Cirach, M., Santano, R., Barrios, D., Puyol, L., Rubio, R., Izquierdo, L., Nieuwenhuijsen, M., … Tonne, C. (2021). Ambient Air Pollution in Relation to SARS-CoV-2 Infection, Antibody Response, and COVID-19 Disease: A Cohort Study in Catalonia, Spain (COVICAT Study). Environmental Health Perspectives, 129(11). https://doi.org/10.1289/EHP9726

BACKGROUND AND AIM: Research supports the adverse effect of air pollution exposures on child cognitive performance and behavior, but few studies have utilized spatiotemporally resolved pollution predictions. METHODS: We investigated these associations in 1,894 mother-child dyads from three U.S. pregnancy cohorts (CANDLE, TIDES, GAPPS) in the ECHO-PATHWAYS Consortium. Child cognition was assessed using cohort-specific intelligence scales and quantified as the Full-Scale Intelligence Quotient (IQ). Child behavior was reported using the Child Behavior Checklist and quantified as the total problems raw score. Pre- and postnatal nitrogen dioxide (NO2) and particulate matter ≤2.5μm in aerodynamic diameter (PM2.5) were derived from an advanced spatiotemporal model. We fit multivariate linear regressions, adjusted for sociodemographic, behavioral, and psychological factors, to measure associations per 2-unit increase in pollutant in each window, and examined modification by child sex using interaction models. RESULTS: Mean PM2.5 and NO2 ranged from 8.4-9.1 µg/m3 and 8.4-9.0 ppb, respectively, across pre-and postnatal windows. Average child IQ and total problems raw score at 4-6 years were 102.7 (SD:15.3) and 22.6 (SD:18.3). Children with a higher 3rd trimester NO2 exposure had a lower IQ (β=-0.44, 95%CI: -0.81, -0.07). Each 2-ppb increase of NO2 in the 2nd trimester and averaged over pregnancy was associated with a 0.68 (95%CI: 0.09, 1.27) and a 0.85 (95%CI: 0.09, 1.61) higher total problems raw score, respectively. Prenatal PM2.5 was only associated with a higher total problems score (β=1.94, 95%CI: 0.11, 3.76), while PM2.5 at 2-4 years was associated with both outcomes (IQ: β=-2.30, 95%CI: -4.53, 0.08; Total problems: β=3.00, 95%CI: 0.21, 5.78). Other associations were null. No modification by child sex was suggested. CONCLUSIONS: The findings build on the current literature on air pollution and child neurodevelopment by using more refined exposure assessments across several pre- and postnatal windows in settings with modest air pollution levels.

Published Aug 23, 2021

Ni, Y., Loftus, C. T., Szpiro, A. A., Young, M. T., Hazlehurst, M. F., Murphy, L. E., Tylavsky, F. A., Mason, A. W., Lewinn, K. Z., Sathyanarayana, S., Barrett, E. S., Bush, N. R., & Karr, C. J. (2021). Associations of Pre- and Postnatal Air Pollution Exposures with Child Cognitive Performance and Behavior: A Multi-cohort Study. ISEE Conference Abstracts, 2021(1). https://doi.org/10.1289/ISEE.2021.P-492