Health Impacts from PM 2.5 Particle Pollution

Unless you have an effective home air filter, the ambient (outside) level of pollution comes inside your house, office, church, store, daycare, or school. A growing body of scientific evidence shows that exposure to increased small particle pollution (PM 2.5) causes increased health consequences, short-term and long-term.

Following is a selection of health studies and reports on the consequences of fine particle pollution, called PM 2.5, in wood and coal smoke.

The American Lung Association has noted that “short-term exposure to particle pollution can kill.” This sobering statement puts our high PM 2.5 levels in context. From their 2010 State of the Air report:

Deaths can occur on the very day that particle levels are high, or within one to two months afterward. Particle pollution does not just make people die a few days earlier than they might otherwise—these are deaths that would not have occurred if the air were cleaner.

Particle pollution also diminishes lung function, causes greater use of asthma medications and increased rates of school absenteeism, emergency room visits and hospital admissions. Other adverse effects can be coughing, wheezing, cardiac arrhythmias and heart attacks. According to the findings from some of the latest studies, short-term increases in particle pollution have been linked to:

• death from respiratory and cardiovascular causes, including strokes;
• mortality in infants and young children;
• increased numbers of heart attacks, especially among the elderly and in people with heart conditions;
• inflammation of lung tissue in young, healthy adults;
• increased hospitalization for cardiovascular disease, including strokes and congestive heart failure;
• increased emergency room visits for patients suffering from acute respiratory ailments;
• increased hospitalization for asthma among children; and
• increased severity of asthma attacks in children.

Minnesota Pollution Control Agency “Health Effects of Wood Smoke” covers this topic clearly and with an excellent graphic. Fine particles, called PM 2.5, travel deep into the lungs and beyond into the body, carrying toxic contaminants on a deadly journey inside us.

Some of the smallest fine particles can go deep into the lungs and can even pass through the lungs into the bloodstream. They can trigger respiratory problems such as asthma attacks and even heart problems. Fine particles are considered especially dangerous for young children with developing lungs, and people of all ages who have asthma, bronchitis, other respiratory problems, and or cardiovascular disease.

“Woodsmoke health effects: a review” Naeher, et al (2007), recommends woodsmoke be regulated along with other ambient fine particle pollutants:

The sentiment that woodsmoke, being a natural substance, must be benign to humans is still sometimes heard. It is now well established, however, that wood-burning stoves and fireplaces as well as wildland and agricultural fires emit significant quantities of known health-damaging pollutants, including several carcinogenic compounds.

Critical Review of the Health Effects of Woodsmoke by Naeher PhD et al, 3/2005 provides a comprehensive coverage of its many health effects.

Wood Smoke Risk Assessment: Defining the Questions, Morandi, et al (2009), page 2:

(T)here is a growing body of evidence from animal and human studies that exposure to wood smoke poses a risk to human health at environmentally relevant concentrations. These adverse health effects range from irritancy to serious respiratory diseases, including chronic obstructive airway disease and lung cancer.

Globally, the 1.4 million premature deaths from biomass fuels (indoor smoke from solid fuels) annually rivals those from malaria. Source: “Wood: The Fuel that Warms You Thrice” Kirk R. Smith, MPH, PhD (2008), Figure 5.1. Smith has a new take on the old New England expression, “Wood is the fuel that warms you twice. Once when chopping, and once when burning.” Smith writes that:

Wood seems to have the potential to generate heat a third time because the smoke from its burning is a major risk factor for respiratory infections and the fever that often accompanies them.

Other woodsmoke and PM 2.5 particulate studies are available on the National Institutes of Health PubMed publication search site.

The State of Alaska Epidemiology bulletin identified an association between PM 2.5 and Fairbanks hospital admissions 8/30/2010. See also the State of Alaska Department of Health and Human Services fact sheeton the 8/2010 bulletin. Also, see the FDNM article on the 8/2010 on the State of Alaska Epidemiology study.

Examine this list of scientific studies from 1984 to 2004 on the health effects of woodsmoke and particulate matter air pollution.

Woodsmoke triggers asthma attacks. Read more on the Center for Disease Control, Asthma pages, and asthma trigger page. See also the NIH National Library of Medicine “Breath of Life” asthma publication to better understand this complex disease.

A Johns Hopkins study from 1998-2003 found a direct correlation in increased PM 2.5 levels in indoor air and asthma symptoms and medication use. According to the study, a rise in indoor PM 2.5 by 10 μg/m³ increases the number of days children were wheezing severely enough to limit their speech by 7% and the number of days children used rescue medication by 4%. 

Jane Q. Koenig, PhD, MS Professor Emeritus of the University of Washington and Koenig’s faculty profile, has a number of relevant publications including: “Indoor- and Outdoor-Generated Particles” Koenig et al 2005 and “Effect of Particulate Air Pollution on Lung Function in Adult and Pediatric Subjects in a Seattle Panel Study” Carol A. Trenga, PhD, Koenig, et al 2005.

PM 2.5 air pollution has harmful cardiovascular effects according to a growing body of evidence, according to “Growing evidence linking air pollution with cardiovascular disease: AHA” by Michael O’Riordan on RD Brook, 2010:

PM2.5 generally has been associated with increased risks of myocardial infarction, stroke, arrhythmia, and heart-failure exacerbation within hours to days of exposure in susceptible individuals. Several new studies have also demonstrated that residing in locations with higher long-term average PM levels elevates the risk for cardiovascular morbidity and mortality.

Sunday newspaper insert Parade published an article “The Surprising Link Between Air Pollution & Diabetes” 11/7/2010. The article refers to a study published in Diabetes Care which found “a strong association between PM2.5 exposure and diabetes prevalence, suggesting that ambient air pollution may contribute to the increased prevalence of diabetes in the adult U.S. population.” This conclusion was published in “Association Between Fine Particulate Matter and Diabetes Prevalence in the U.S.” by John F. Pearson, BS, et al in Diabetes Care, 10/2010.

Given a hypothetical population of 1,000,000 people, our model suggests that for every 10 μg/cubic meter increase of PM2.5, there could be a resulting increase of ∼10,000 diagnosed cases of diabetes or an overall increase in diabetes prevalence of ∼1%/10 μg/cubic meter.

According to the 2009 US Census Bureau, the Fairbanks North Star Borough population estimate was 98,660, with 8.4% under the age of 5 and 26% under 18. In our community a 10 microgram increase in the annual average PM 2.5 level would be expected to result in an additional 900 to 1,000 individuals developing diabetes. Pearson’s article concludes:

…(E)vidence based on this study and others suggests that current limits [EPA annual limit of 15 μg/cubic meter] on particulate matter exposure may not adequately mitigate the public health consequences.

The Indo-US Collaboration on Environmental and Occupational Health, recommendations and abstracts, 2008 grimly portrays the effects of air pollution. One study, on page 32, lists the common short-term air pollution exposure effects [and symptom(s) associated with that effect]:

• mortality (cardio-respiratory)
• hospital admissions (cardio-respiratory)
• emergency room attendees (cardio-respiratory)
• primary care visits (upper and lower respiratory)
• respiratory symptoms (cough, phlegm, wheeze)
• use of medications (asthma drugs)
• lung function (restrictive and obstructive)
• blood (increased viscosity, fibrinogen)
• heart (increased heart rate variability, arrhythmia)

Another abstract in the Indo-US publication goes beyond the short-term effects, see page 53-54:

(The) WHO estimates 1.6 million premature deaths from indoor air pollution (twice that from outdoor air pollution) [800 thousand]…. Chronic exposure to biomass smoke causes genetic damage, cardiovascular disease and stroke.

Brains as well as bodies are put at risk. A recent US study found lower IQ in children of mothers exposed to higher levels of Polycyclic Aromatic Hydrocarbons (PAHs), the main toxins in woodsmoke. After controlling for variables, IQ was 5 points lower, about 4%, than children of mothers with lower PAH exposure. Study: Prenatal Airborne Polycyclic Aromatic Hydrocarbon Exposure and Child IQ at Age 5 Years published in Pediatrics7/2009.

A current study found an association between childhood autism and residence proximity, during pregnancy and near the time of delivery, to freeways and major roadways as a surrogate for air pollution exposure. The study was published in the journal Environmental Health Perspectives “Residential Proximity to Freeways and Autism in the CHARGE study” 12/16/2011 and also summarized in the LA Times “Proximity to freeways increases autism risk, study finds” 12/16/2011.

The New South Wales (Australia) Government’s “Action for Air” 2009 acknowledges PM 2.5 particles are particularly dangerous and that there is no safe exposure level:

Health research identifies particles of less than 2.5 micrograms (PM2.5) as a particular concern because their smaller size means they can be inhaled deeper into the lungs, and because there is no safe threshold level to use for setting standards.

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School District Regs on Unhealthy Particulate Levels

Update to Post – School district improved guidelines 11/2010, but not nearly enough protection for children: Newly revised School District regulation 960.1 allows healthy children to play outside at recess until particulate levels reach 176 micrograms/cubic meter. If this “guideline” is based on 24-hour particulate levels, it is much too high. If it is based on one-hour particulate levels, those measurements are not currently available to parents, nurses, principals, or even the Superintendent.

Listen to KUAC’s radio news story 12/14/2010 on the School District’s decision to revise the guidelines from 200 to 176 micrograms/cubic meter and the district’s challenge to ensure indoor air is clean.

960.1 was updated 11/2010, noted above. FNSB School District has regulations and guidelines for activities during unhealthy particulate levels, called Administrative Regulations 960.1 Guidelines for Student Activity in Adverse Conditions. These regulations are as follows:

A. Air Quality

1. The health and safety of students must be considered when particulate levels reach unhealthy levels due to smoke and forest fires, vehicle emissions, or volcanic eruptions. The school district shall rely upon the Fairbanks North Star Borough (FNSB) Air Quality Program standards to guide decision-making.

2. Guidelines for Activities in Adverse Air Quality Conditions

Particulate Levels	Elementary Recess or Other Outdoor Activity	Athletic Practices	Athletic Competitions
a. 100-199 micrograms per cubic meter	Reduce prolonged or heavy exertion	Be aware of potential health dangers. Allow extra recovery time for athletes. Have extra water available. Have cell phone available.	Be aware of potential health dangers. Allow extra recovery time for athletes. Have extra water available. Have cell phone available.
b. 200-300 micrograms per cubic meter	Move indoors.	Move all practices indoors. Student athletes with asthma or other respiratory disorders should be informed and have medications available.	Allowed outdoors with extra precautions. Student athletes with asthma or other respiratory disorders should be informed and have medications available.
c. Above 300 micrograms per cubic meter	Cancel or move indoors.	Postpone or cancel. Postpone	Postpone or cancel.

3. The district will consult with FNSB Air Quality personnel and make decisions concerning competitions scheduled for Friday by 9:00 p.m. on Wednesday night and by 9:00 p.m. on Thursday evening for competitions scheduled on the weekend.

4. Principals and activity coordinators will be notified via fax and email if the air quality warrants cancellation of recess, field trips, athletic practices or competitions, or other outdoor activities.

Please notice the particulate levels which trigger School District action: 100 to 199 micrograms/cubic meter of air. The FNSB Air Quality Index and especially Judging Particulate Levels in Your Area chart may be used to compare to the guidelines with recommendations for the various groups. It is not clear whether the school district guidelines chart refers to one hour PM 2.5 levels, 24-hour levels, or EPA’s Air Quality Index Values. (Convert PM 2.5 pollution concentration to AIQ values at AIRNow.) With the most lenient average (one hour particulate levels), 100 micrograms/cubic meter falls within the “Unhealthy for Sensitive Groups” category, which includes all children. If the 24-hour levels are used, 100 micrograms/cubic meter falls within the “Unhealthy” category.

Questions Parents and Grandparents Want Answered:

1. Are these guidelines sufficient to protect children? Every healthy child is included in the “sensitive groups” category. Children with lung problems, such as asthma, or heart problems are at even greater risk from PM 2.5.
2. According to the Air Quality Index chart, the “Unhealthy for Sensitive Groups” category starts at 35.5 micrograms/cubic meter of air. Why are children being let out to recess at higher levels?
3. Recess and exercise are vital for child development and learning. What can be done to safeguard recess so children can exercise without risking permanent damage?
4. According to Jim Conner, FNSB Air Quality Specialist, air quality at the schools “can be as bad inside as out.” Canceling outdoor recess in favor of indoor recess, if in smoke-filled gyms or halls, is not sufficient. What is being done to safeguard students & staff inside the school building?
5. Would the School District conduct a feasibility study for installing HEPA filtration for schools where ambient levels of outdoor PM 2.5 pollution are in excess of 35.5 micrograms/cubic meter of air?
6. The School District collects forms from students who require an inhaler to control their asthma. How many students at each school have submitted these forms and has this number grown over the past 4 years?
7. Why are our children being allowed to be exposed to particulates at such high levels? Many studies show that children are more susceptible to elevated particulate levels because they breathe more air per body weight than adults, they tend to be active, they mouth-breathe when active (i.e., crying), and their lungs are still developing. An additional concern is that their immune and brain defenses are not fully formed. Dr. Lori Verbrugge, Alaska Division of Public Health, cited over 20 separate studies that consistently showed a 6–17% increase in relative mortality with each 10 μg/m3 of long-term particulate exposure. Dr. Verbrugge said the available data showed there is increased mortality with short-term exposure to PM 2.5 concentrations that are less than 20 μg/m3, which is considerably below the “health-based” 24-hour standard of 35 μg/m3. [Don’t miss the full summary of the FNSB symposium presentation by Dr. Verbrugge, 2009]

 

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Fairbanks Community Links

Much is going on locally to better understand and improve our air pollution problem:

Fairbanks Home Heating Survey 6/21/2010 prepared for the Alaska Department of Environmental Conservation. The table on page 32 of the survey shows there are approximately 8,000 cordwood using woodstoves, 600 fireplaces with inserts, 350 pellet stoves, and 90 outdoor wood boilers in the nonattainment area. Of the approximately 8,600 cordwood burners (woodstoves & inserts), 5,600 are certified and the rest, nearly 3,000, are uncertified. Also see this FDNM article on the Fairbanks Home Heating Survey 7/2010.

What is the PM 2.5 nonattainment area? View the FNSB PM 2.5 nonattainment area map. The effective date of this nonattainment designation was Nov 2009. The Alaska Department of Environmental Conservation has a comprehensive site covering all the PM 2.5 non-attainment documents, including the recommendation for nonattainment by then Governor Palin. Nonattainment is the US Environmental Protection Agency’s designation for an area which exceeds current Clean Air Act regulations for PM 2.5 or other priority pollutants.

Exposure limits set under the Clean Air Act for PM 2.5 are: the 24-hour average exposure limit is 35 micrograms per cubic meter of air (which we often violate) and the annual average limit is 15 micrograms per cubic meter. In 2006, the federal regulations lowered the 24-hour limit from 65 to the current 35. State air quality PM 2.5 regulations for the ambient air quality standards concur with the federal limits for the 24-hr average and the annual average, see page 3 Alaska Air Quality Control Regulations, 18 AAC 50.010(B). In 2013, EPA lowered the annual limit to 12 micrograms per cubic meter.

Don’t miss the Air Quality Fairbanks site run by the FNSB. Lots of good links and helpful, if dated.

Daily reports of air quality sampling are available on the FNSB Air Quality Program site which gives the current Air Quality Index for PM 2.5 and carbon monoxide (CO), updated Monday-Friday during the winter. Especially helpful for understanding the PM 2.5 problem in the borough are two documents linked from the same page, the 2009 Symposium Summary and the 2009 Symposium Presentations.

In July 2009, the FNSB hosted a symposium on the local PM 2.5 problem. Their 2009 Symposium Summary covers vital background information on establishing the non-attainment area, PM 2.5 timeline, agency jurisdictions, health effects, graph of 24-hr measurements, fixed monitoring locations, temporary monitoring stations locations (including Woodriver and Hunter Elementary Schools), and routes covered by the instrumented monitoring “sniffer” vehicle. It includes a chart (Figure 5) which “shows that the Borough exceeded the 24-hour standard 41 out of 123 days in the period presented (i.e., exceedances were recorded on fully one-third of the days at multiple locations).” (pg 10) The period presented was from 10/29/2008 to 2/16/2009. Listen to KUAC’s radio news story 7/17/2009 on the Symposium.

On the interactive 2009 Symposium Presentations document, multiple presentations can be reviewed simply by clicking on the highlighted text. For example, on July 15, 2009 Session 3, Jim Conner, Borough Air Quality Specialist, presented “Fixed Site Trends.” This presentation on 24-hour average PM 2.5 particle concentrations and hourly concentrations measured at the downtown monitoring station in Jan. 2008. Peaks reached 170 micrograms/cubic meter of air. The winter 5-year comparison chart “Particulate Matter in the FNSB” from 2003/2004 to 2007/2008 records the largest number of days exceeding the 35 micrograms/cubic meter standard was 30. In 2008/2009, according to Figure 5 provided in the Symposium Presentation (described above), the number of days jumped to 41. No data from the winter of 2009/2010 has been made available.

In addition Jim Conner’s presentation (2009 Symposium Presentations, “Fixed Site Trends”) includes a map of “Topography & Drainage Flows in Fairbanks Area.” By this map, it is clear to see that any pollution generated in North Pole drifts into the City of Fairbanks and surrounding populated areas. This map appears to contradict the following quote from the 2009 Symposium Summary (pg 14), although it may be a failure to differentiate between “Fairbanks” and North Pole as separate locations within the “local” nonattainment area:

Transport is not a significant contributor to the Fairbanks PM 2.5 problem. This means local emissions are the cause of Fairbanks’ elevated PM2.5 concentrations.”

The FDNM article on “Wood-burning coalition offers many fixes for Fairbanks pollution” 12/2009 presents the efforts of the Fairbanks Area Wood Smoke Local Action Coalition to identify strategies for reducing PM 2.5. The full report may be downloaded from the Northern Alaska Environmental Center’s site at their air quality action committee link: Fairbanks Area Wood Smoke Local Action Coalition draft. This document espouses the most extreme pro-wood burning position available locally.

Review the Fairbanks North Star Borough codes on air pollution: Chapter 8.04 Air Pollution and also Chapter 8.21 PM 2.5 Air Quality Control Program. Included is the nuisance subsection (FNSB code 8.21.020 E.):

No person shall cause or allow emissions of a solid fuel burning appliance that are injurious to human life or to property or that unreasonably interfere with the comfortable enjoyment of life or property. No person shall operate a solid fuel burning appliance in a manner so as to create a public or private nuisance. A violation of a provision of this chapter is hereby declared to be a nuisance.”

Also included in Borough code is the solid fuel stove change-out program (FNSB code 8.21.030). The change-out program was featured in this FDNM article 9/21/2010, which highlights one resident’s enslavement to his 30-cord/winter outdoor wood burner (now voluntarily removed). The Borough offers residents payments and/or municipal tax credits to remove or replace hydronic heaters (outdoor wood burner/boiler), woodstoves, or chimneys.

FNSB Mayor Luke Hopkins wrote an opinion article published in the FDNM 6/2010 calling for local control of PM 2.5 pollution.

Columnist Dermot Cole for the Fairbanks Daily News-Miner has reported on local air pollution and the Air Quality Ordinance in his columns: “Borough needs nuisance standard, fines to protect health, property values and property rights“ 6/2010, “Assembly sets wood smoke fines far below other borough penalties“ 6/2010, and “Private property rights extend to the air“ 8/2010.

Cold Climate Housing Research Center (CCHRC) home, has heating systems information and has contracted with the FNSB to conduct a study to monitor wood usage and moisture content and heating oil used for home heating in Fairbanks during the winter (Fairbanks Home Heating Survey 6/21/2010, pages 13 and A-12). Read CCHRC 2009 studyof the various PM 2.5 emission sources in Fairbanks and how to achieve the greatest reductions. Graph 3 of this study shows the greatest PM 2.5 reductions from household sources could be achieved through measures to reduce emissions from wood-fired hydronic heaters, pg 14. Graph 4 of the study shows residential coal-fired heating appliances are second only to hydronic heaters in their contribution of PM 2.5 per household, pg 15. Increasing oil prices will lead to more burning of coal unless action is taken.

At the Winter Expo at the Carlson Center on 9/26/2010, Richard and Felicia Musick of Ventilation Solutions were on hand offering home air filtration systems (nearly HEPA standard) and heat recovery ventilation systems. Without making any recommendation or looking at their competitors, it makes perfect sense to protect your family’s health by filtering the air in your home.

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FNSB Air Sampling Results

Results of air quality sampling are available on the FNSB Air Quality Program site which gives the current Air Quality Index for PM 2.5 and carbon monoxide (CO), updated Monday-Friday. Especially helpful for understanding the PM 2.5 problem in the borough are two documents linked from the same page, the 2009 Symposium Summary and the 2009 Symposium Presentations.

In July 2009, the FNSB hosted a symposium on the local PM 2.5 problem. Their 2009 Symposium Summary covers vital background information on establishing the non-attainment area, PM 2.5 timeline, agency jurisdictions, health effects, graph of 24-hr measurements, fixed monitoring locations, temporary monitoring stations locations (including Woodriver and Hunter Elementary Schools), and routes covered by the mobile monitoring. It includes a chart (Figure 5) which “shows that the Borough exceeded the 24-hour standard 41 out of 123 days in the period presented (i.e., exceedances were recorded on fully one-third of the days at multiple locations).”  (pg 10) The period presented was from 10/29/2008 to 2/16/2009.

On the interactive 2009 Symposium Presentations document, multiple presentations can be reviewed simply by clicking on the highlighted text. For example, on July 15, 2009 Session 3, Jim Conner, Borough Air Quality Specialist, presented “Fixed Site Trends.” This presentation covered 24-hour average PM 2.5 particle concentrations as well as hourly data; at the downtown monitoring station in 1/2008, peaks reach 170 micrograms/cubic meter of air. The winter 5-year comparison chart “Particulate Matter in the FNSB” from 2003-04 to 2007-08 records the largest number of days exceeding the 35 micrograms/cubic meter standard was 30. In 2008-09, according to Figure 5 provided in the Symposium Summary (described above), the number of days jumped to 41. No data from the winter of 2009-10 has been made available.

In addition Jim Conner’s presentation (2009 Symposium Presentations, “Fixed Site Trends”) includes a map of “Topography & Drainage Flows in Fairbanks Area.” By this map, it is clear to see that any pollution generated in North Pole drifts into the City of Fairbanks and surrounding populated areas. This map appears to contradict the following quote from the 2009 Symposium Summary (pg 14), although it may be a failure to differentiate between “Fairbanks” and North Pole as separate locations within the “local” nonattainment area:

Transport is not a significant contributor to the Fairbanks PM 2.5 problem. This means local emissions are the cause of Fairbanks’ elevated PM2.5 concentrations.

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