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Research on Health Effects from Air Pollution

Visualization of human heart and lungs in the body

Decades of research have shown that air pollutants such as ozone and particulate matter (PM) increase the amount and seriousness of lung and heart disease and other health problems. More investigation is needed to further understand the role poor air quality plays in causing  detrimental efffects to health and increased disease, especially in vulnerable populations. Children, the elderly, and  people living in areas with high levels of air pollution are especially susceptible.

Results from these investigations are used to support the nation's air quality standards under the Clean Air Act and contribute to improvements in public health.

Research is being conducted in the following areas:

Health Effects of Air Pollutants on Vulnerable Populations

An adult helping a child use an inhalerResearch has shown that some people are more susceptible than others to air pollutants. These groups include children, pregnant women, older adults, and individuals with pre-existing heart and lung disease. People in low socioeconomic neighborhoods and communities may be more vulnerable to air pollution because of many factors. Proximity to industrial sources of air pollution, underlying health problems, poor nutrition, stress, and other factors can contribute to increased health impacts in these communities.

There is a need for greater understanding of the factors that may influence whether a population or age group is at increased risk of health effects from air pollution. In addition, advances to analytical approaches used to study the health effects from air pollution will improve exposure estimates for healthy and at-risk groups.

The research by EPA scientists and others inform the required reviews of the primary National Ambient Air Quality Standards (NAAQS), which is done with the development of Integrated Science Assessments (ISAs). These ISAs are mandated by Congress every five years to assess the current state of the science on criteria air pollutants and determine if the standards provide adequate protection to public health. 

Research is focused on addressing four areas:

  • Identifying and characterizing whether there are key reproductive factors and critical stages of development that are impacted by air pollution exposures;
  • Determining the role of acute and chronic sociodemographic factors in air pollution health disparities;
  • Understanding how diet modifies responses to air pollution;
  • Evaluating long-term lifestyle and chronic disease effects on air pollution-induced respiratory and cardiovascular responses

A multi-disciplinary team of investigators is coordinating epidemiological, human observational, and basic toxicological research to assess the effects of air pollution in at-risk populations and develop strategies to protect these populations, particularly those with pre-existing disease. The results from these products will improve risk assessments by clarifying the role of modifying factors such as psychosocial stress (e.g. noise) and diet, and determining the impact of individual susceptibility on the relationship between air pollutant exposures and health.

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Long-Term and Short-Term Effects from Exposure to Air Pollutants

A plume of emissions rises from a factory smokestack near an empty playgroundPeople can experience exposure to varying concentrations of air pollution. Poor air quality can impact individuals for a short period of time during the day, or more frequently during a given day. Exposure to pollutants can also occur over multiple days, weeks or months due to seasonal air pollution, such as increased ozone during the summer or particulate matter from woodstoves during the winter.

The health impact of air pollution exposure depends on the duration and concentrations, and the health status of the affected populations. Studies are needed to increase knowledge of the exposure duration and the possible cumulative increase in risk.

The research is focused on three main areas: 

  • Short-term peak exposures, such as wildfires, traffic-related sources, or other episodic events;
  • Intermittent and cumulative exposures;
  •  Mechanisms underlying the exposure risks

Researchers are evaluating the health responses of intermittent multiple days versus one-day air pollution exposure in controlled human exposure, animal, and in vitro models and associated cellular and molecular mechanisms. They are employing population-based models and electronic health records to assess the health effects of short-term and long-term exposures and identifying populations at greatest risk of health effects. The work is improving our understanding of the possible cumulative effects of multiple short-term peak exposures and the relationship of these exposures to longer-term exposures and risks.

Multipollutant Exposures and Changes in Environmental Conditions  

A sunrise over the Cincinnati skyline and riverEPA research is providing information to understand how individuals may respond to two or more pollutants or mixtures and how environmental conditions may impact air quality. While risk estimates for exposure to individual criteria air pollutants such as PM and ozone are well established, the acute and cumulative effects of combinations of pollutants is not well understood. In addition, research is needed to determine how changes in the environment affect both pollutant formation and subsequent responsiveness to exposures in healthy and susceptible individuals.

The research is focused on three specific questions: 

  • What is the role of temperature and photochemical aging on the health impact of wildfire smoke and air pollution mixtures?
  • What is the effect of changing environmental conditions (i.e., temperature and humidity) on responsiveness to air pollution?
  • Does prior pollutant exposure modify responsiveness to subsequent exposures?

The integrated, multi-disciplinary research includes:

  • Epidemiologic analyses of environmental influences on morbidity and mortality in populations,
  • Simulations of changing environmental conditions in multi-pollutant formation in atmospheric chamber studies coupled with clinical and toxicological assessments in healthy and at-risk populations,
  • Evaluation of pre-exposure as a modifying effect on subsequent exposures

The results are revealing how changes in environmental conditions affect pollutant formation and subsequent health impact in at-risk populations. The research findings are informing EPA’s Integrated Science  Assessments for criteria air pollutants and assisting with future regulatory decisions on the National Ambient Air Quality Standards (NAAQS).

Leveraging Big Data for Innovations in Health Science  

Lines of binary code against a blue backgroundEPA is at the cutting edge of health science, using electronic health records, novel data systems, tissue-like advanced cellular models, molecular approaches, and animal models to evaluate the health impacts of air pollution.  Researchers are using these powerful new techniques to identify factors that may increase sensitivity and vulnerability to air pollution effects. 

The research is building capacity for future risk assessment and regulatory analyses that go beyond traditional lines of evidence to more clearly define populations and lifestages at increased risk of health effects from air pollution.

To continue to protect public health from poor air quality, researchers must consider new epidemiological, toxicological and clinical approaches to understand the health risks of poor air quality and the biological mechanisms responsible for these risks. At the center of these new research approaches is an explosion of data availability and methodological approaches for handling large clinical and molecular datasets, also known as "big data."

While data of increasing size, depth, and complexity have accelerated research for many industries and scientific fields, big data is sometimes less recognized for the impacts it is having on environmental health studies. Increasingly, researchers are able to examine vulnerable populations with unprecedented precision and detail while also evaluating hundreds of thousands of molecular biomarkers in order to understand biological mechanisms associated with exposure.

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Health Effects of Wildfire Smoke

Smoke from a wildfire rising behind homes in a neighborhoodLarger and more intense wildfires are creating the potential for greater smoke production and chronic exposures in the United States, particularly in the West. Wildfires increase air pollution in surrounding areas and can affect regional air quality.

The health effects of wildfire smoke can range from eye and respiratory tract irritation to more serious disorders, including reduced lung function, exacerbation of asthma and heart failure, and premature death. Children, pregnant women, and the elderly are especially vulnerable to smoke exposure. Emissions from wildfires are known to cause increased visits to hospitals and clinics by those exposed to smoke.

It is important to more fully understand the human health effects associated with short- and long-term exposures to smoke from wildfires as well as prescribed fires, together referred to as wildland fires. EPA is conducting research to advance understanding of the health effects from different types of fires as well as combustion phases. Researchers want to know:

  • What is the full extent of health effects from smoke exposure?
  • Who is most at risk?
  • Are there differences in health effects from different wildfire fuel types or combustion phases (burning versus flaming)?
  • What strategies and approaches are most effective in protecting public health?
  • What are the environmental, social and economic impacts of wildfire emissions?

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Public Health Intervention and Communications Strategies

A female doctor speaks with an elderly patient while holding a tabletMany communities throughout the United States face challenges in providing advice to residents about how best to protect their health when they are exposed to elevated concentrations of air pollutants from motor vehicle and industrial emissions and other sources of combustion, including wildland fire smoke.

Researchers are studying intervention strategies to reduce the health impacts from exposure to air pollution as well as ways to effectively communicate these health risks. To translate the science for use in public health communication and community empowerment, EPA is collaborating with other federal agencies, such as the Centers for Disease Control and Prevention (CDC) and the National Heart, Lung, and Blood Institute (NHLBI), and state and local agencies and tribes. The objectives are to identify ways to lower air pollution exposure or mitigate the biological responses at individual, community or ecosystem levels, and ultimately evaluate whether such interventions have benefits as measured by indicators of health, well-being or economics.

Studies are evaluating the interactions between behavior and social and economic factors to more thoroughly understand how these factors may influence health and well-being outcomes, which can inform effective and consistent health risk messaging. 

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Integrated Science Assessments for Air Pollutants

A city skyline enveloped by smogEPA sets National Ambient Air Quality Standards (NAAQS) for six principal criteria air pollutants—nitrogen oxides, sulfur oxides, particulate matter, carbon monoxide, ozone and lead—all of which have been shown to be harmful to public health and the environment.

The Agency’s Integrated Science Assessments (ISAs) form the scientific foundation for the review of the NAAQS standards by providing the primary (human health-based) assessments and secondary (welfare-based, e.g. ecology, visibility, materials) assessments. The ISAs are assessments of the state of the science on the criteria pollutants. They are conducted as mandated under the Clean Air Act.

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