Goods Movement Conference: Public Health Implications for the Mid-Atlantic Region University of...
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Goods Movement Conference: Public Health Implications for the Mid-Atlantic Region
University of PennsylvaniaHouston Hall – Bodek Lounge
Philadelphia, Pennsylvania
Friday, September 23, 2011
Diesel Pollution Cancer and Other Health Risks
Kevin M. Stewart
Director of Environmental Health
American Lung Association of the Mid-Atlantic
Outline• Diesel Exhaust Composition• Diesel Health Effects Overview• Diesel Emissions as a Carcinogen• Some Factors Associated with Goods Movement
Influencing Health Outcomes• Conclusion
Composition of Diesel Exhaust
• Complex mixture of thousands of
chemicals• Gases and fine particles• Over forty air contaminants recognized as
toxins, carcinogens, reproductive and developmental hazards, endocrine disruptors
Composition of Diesel Exhaust
• Gas phaseOxygen Carbon dioxideNitrogen Carbon monoxideWater vaporNitrogen Oxides (especially NO)Sulfur Compounds
(especially Sulfur Oxides)Volatile Organic CompoundsLow MW Hydrocarbons…
Composition of Diesel Exhaust
• Gas phase components of toxicological significance
Aldehydes (formaldehyde, acetaldehyde, acrolein)
Benzene1,3-butadienenitrosaminespolycyclic aromatic hydrocarbons (PAHs)nitro-PAHs
Composition of Diesel Exhaust
• Particulate phase– Mostly elemental carbon (soot)
– About 20% to 40% adsorbed
organic compounds
– Also sulfate, nitrate, metals,
other trace elements
– The most toxicologically relevant adsorbed
compounds (less than 1% of PM by mass):
- PAHs - Nitro-PAHs - Oxidized PAH derivatives
– 92% of mass is in particles smaller than 1 micron
Diesel Exhaust Particles
Health Effects Institute, 1995
Elemental Carbon (EC)
PAHs ...
UnburnedFuel
Dr. John Froines, Director, UCLA Southern California Particulate Center and Supersite
How small are these particles?
Human Hair(50-100 m diameter)
PM10
(10 m)PM2.5
(2.5 m)
Hair cross section (50-100 m)
PM0.1
(0.1 m)
• Nose and Throat Remove Particles > 10 m
• Trachea and Upper Bronchi remove Particles < 10 m and > 2.5 m
• Particles < 2.5 m and >0.1 m are deposited in Bronchioles and Alveoli
• Ultrafine particles (<0.1 m) reach all areas of lung and to some degree diffuse into body tissues
Where they go
Substances in Diesel Exhaust Listed by the California Air Resources Board as Toxic Air Contaminantsacetaldehyde cobalt compounds nickel
acrolein cresol isomers 4-nitrobiphenyl
aniline cyanide compounds phenol
antimony compounds dibutylphthalate phosphorus
arsenic dioxins and dibenzofurans POM, including PAHs
benzene ethyl benzene and their derivatives
beryllium compounds formaldehyde propionaldehyde
biphenyl hexane selenium compounds
bis[2-ethylhexyl]phthalate lead (inorganic) styrene
1,3-butadiene manganese compounds toluene
cadmium mercury compounds xylene isomers, mixtures
chlorine methanol o-xylenes
chlorobenzene methyl ethyl ketone m-xylenes
chromium compounds naphthalene p-xylenes
Diesel Exhaust is a “Quadruple Whammy” for
Public Health
• Carcinogens• Toxins • Fine Particulate Matter• Nitrogen Oxides
Whammies 1 and 2• Carcinogens
– Lung– Bladder
• Toxins– Nervous – Endocrine– Reproductive– Immune– Developmental– Liver – Kidney
Whammy 3• Fine Particulate Matter
– Premature death from respiratory and cardiovascular causes, as well as stroke
– Increased hospitalization and emergency visits for heart attacks, strokes, and acute respiratory illnesses
– Exacerbation of asthma • Increased frequency, severity, and duration of
episodes/attacks • Increased symptom days and absenteeism• Increased emergency visits and hospitalizations
Whammy 4• Nitrogen Oxides
– Ozone precursor …• Premature death• Increased asthma attacks/episodes• Increased need for medical treatment, emergency
visit, and hospitalization for persons with chronic lung disease
– Increased susceptibility to respiratory infections
– Decrease in lung function growth
Estimated Cancers from Diesel Particulate
State and Territorial Air Pollution Program Administrators
and Association of Local Air Pollution Control Officials
(STAPPA/ALAPCO, now NACAA) Cancer Risk from Diesel Particulate: National and
Metropolitan Area Estimates for the United States,
March 15, 2000.
Estimated Cancers from Diesel ParticulateENTIRE UNITED STATES 125,110 20 Largest Metropolitan AreasMetropolitan Area CancersLos Angeles 16,250New York 10,360Chicago 4,535Washington/Baltimore 3,750San Francisco 3,510Philadelphia 3,085Boston 2,900Detroit 2,810Dallas/Fort Worth 2,470
- continued...
Estimated Cancers fromDiesel Particulate 20 Largest Metropolitan Areas - continuedMetropolitan Area CancersHouston 2,270Atlanta 1,930Miami/Fort Lauderdale 1,880Seattle 1,765Phoenix 1,510Cleveland 1,500Minneapolis 1,460San Diego 1,430St. Louis 1,320Denver 1,220Pittsburgh 1,210
Cancer Risk Assessments of Diesel Exhaust
ORGANIZATION YEARCONCLUSION
National Institute for Occupational Safety and Health 1988 potential occupational carcinogen
International Agency for Research on Cancer (WHO) 1989 probable human carcinogen
State of California 1990 known to cause cancer
Health Effects Institute 1995& World Health Organization 1996
consistency in showing weak association between exposure to diesel exhaust and lung cancer
Cancer Risk Assessments of Diesel Exhaust
ORGANIZATION YEAR CONCLUSION
California EPA (Staff Recommendation) 1998 “may cause an increase in the likelihood of cancer”
California Air Resources Board 1998 diesel particulate emissions are a toxic air contaminant
National Toxicology Program 1998 “diesel exhaust particulate is reasonably anticipated to be a human carcinogen”
U.S. Environmental Protection Agency 2002 likely to be carcinogenic to humans by inhalation at environmental levels of exposure
Cancer Risk Assessments of Diesel Exhaust
• In a presentation to the Mid-Atlantic Clean Diesel Collaborative in 2010, EPA’s Rich Cook noted:– Strong desire among many stakeholders to develop
a cancer Unit Risk Estimate for diesel exhaust.– Most recent request from National Environmental
Justice Advisory Committee (NEJAC)– EPA Response: Data still inadequate to develop unit
risk estimate.• Issue is [wide variation in] dose response relationships in
epidemiology studies• However, EPA will continue to control emissions to the
maximum extent possible.
Cancer Risk Assessments of Diesel Exhaust
• California Office of Environmental Health Hazard Assessment has made estimates of risk:– Estimated range of lung cancer risk (upper 95% confidence
interval) based on human epidemiological data is 1.3 x 10-4 to 2.4 x 10-3 per µg/m3.
– Overall, after considering the results of the meta-analysis of human studies, as well as the detailed analysis of railroad workers, the Scientific Review Panel concluded that 3 x 10-4 per µg/m3 is a reasonable estimate of unit risk expressed in terms of diesel particulate.
Carcinogenic Potentialof Diesel Emissions • Carcinogens in vapor phase
– Benzene– Formaldehyde– 1,3-butadiene– Ethylene dibromide
• Adsorbed onto particles– 3 PAHs (including BAP) classified as
probably carcinogenic to humans – At least 16 hydrocarbons classified as
possibly carcinogenic to humans• These do not account for all of the cancer risk associated with diesel exhaust.
Carcinogenic Potential of Diesel Emissions
• Meta-analysis by California Office of Environmental Health Hazard Assessment on diesel exhaust and lung cancer:– Clear positive relationship between occupational
diesel exhaust and lung cancer– Cigarette smoking removed as confounder– Consistent with causal relationship– Association with 40% increase in relative risk
Carcinogenic Potential of Diesel Emissions
• Over thirty studies have investigated the exposure of bus and truck drivers, railroad and shipyard workers to diesel exhaust.
• A meta-analysis on diesel exhaust and bladder cancer (January, 2001 by Boffetta and Silverman in Epidemiology):– Found an increased risk of between 18% and
76% among occupationally exposed individuals.
Carcinogenic Potential of Diesel Emissions • People are exposed to hundreds of times the
amount of carcinogens the EnvironmentalProtection Agency recognizes as reasonablyallowable (levels yielding a one-in-a-millionrisk):– In 1996 the national average lifetime cancer
risk from breathing outdoor hazardous pollutants was 1 in 2,100.
– Mobile sources: 93% of this risk– Diesel emissions: over 95% of the mobile
sources’ contribution (89% of the total)
Carcinogenic Potential of Diesel Emissions • In 2005, Clean Air Task Force estimated:
– Average lifetime nationwide cancer risk due to diesel exhaust is over 350 in a million.
– Residents from more than two-thirds of all U.S. counties face a cancer risk from diesel exhaust greater than 100 deaths per million population.
– People living in eleven urban counties face diesel cancer risks greater than 1,000 in a million.
– The risk of lung cancer from diesel exhaust for people living in urban areas is three times that for those living in rural areas.
Nature of Fuels
• Finally, where
highway diesel
has needed to
be at 15 ppm,
other diesel fuel has been at 500 ppm sulfur. (Clean Diesel Fuel Alliance)
• Fuels used in shipping, where emissions have been virtually unregulated, run from 1 – 5 percent sulfur.
Proximity
“If we have diesel sources, the best thing we can do is to keep them 500 meters away from people.”
(Mike Nazemi, SCAQMD, Presentation, Mira Loma, CA, 2002)
Proximity as a Consequence
• Behavioral factors influenced by that highly populous environment:
“Findings in published, peer-reviewed health research estimate that, although we spend only about six percent of our day commuting to and from work, over half of our exposure to these particles may occur during that travel time.”
- George D. Thurston, Sc.D., NYU Sch. of Med.
Populations at Risk
Delaware Maryland New Jersey Pennsylvania
Total Population 873,092 5,633,597 8,682,661 12,448,279
Under 18 206,229 1,340,583 2,047,582 2,762,004
65 and Above 121,688 679,565 1,150,941 1,910,571
Pediatric Asthma 19,414 126,197 192,753 260,003
Adult Asthma 63,267 402,170 568,274 891,605
Chronic Bronchitis 29,411 187,490 292,135 432,231
Emphysema 11,836 71,392 115,440 180,491
Cardiovascular Disease 249,813 1,553,040 2,461,401 3,737,863
Diabetes 56,460 375,211 564,620 859,063
Poverty 87,978 448,789 740,070 1,454,240
Environmental Justice Concerns
• Racial and Ethnic
Disparities• Socioeconomic
Disparities (Poverty)• Disparities in Access to
& Quality of Medical Care
Concluding Remarks
Observation
PM2.5 levels in traffic, Austin, TX (CATF, 2007)
Cars only (MOPAC) With trucks (I-35)
We will breathe easier when the air in everyAmerican community is clean and healthy.
We will breathe easier when people are free from the addictivegrip of cigarettes and the debilitating effects of lung disease.
We will breathe easier when the air in our public spaces andworkplaces is clear of secondhand smoke.
We will breathe easier when children no longerbattle airborne poisons or fear an asthma attack.
Until then, we are fighting for air.