U.S. air- -quality standards are designed to restrict quality standards are designed to restrict U.S. air ambient pollutant concentrations in and effort to ambient pollutant concentrations in and effort to protect human health. protect human health. Do improvements in air quality Do improvements in air quality result in measurable result in measurable improvements in human improvements in human health and longevity? health and longevity?
Fine- -Particle Air Pollution Particle Air Pollution Fine and Life Expectancy in the and Life Expectancy in the United States United States New England Journal of New England Journal of Medicine Medicine January 22 2009 January 22 2009
Fine Particle Air Pollution and Life Fine Particle Air Pollution and Life Expectancy in the United States Expectancy in the United States New England Journal of Medicine New England Journal of Medicine January 22, 2009 January 22, 2009 Methods Methods Evaluated the changes in life expectancy Evaluated the changes in life expectancy associated with differential changes in PM2.5 associated with differential changes in PM2.5 concentration that occurred in 51 U.S. concentration that occurred in 51 U.S. Metropolitan Areas between late 1970s and Metropolitan Areas between late 1970s and early 1980s and late 1990s and early 2000s early 1980s and late 1990s and early 2000s adjusted for changes in socioeconomic and adjusted for changes in socioeconomic and demographic variables and in proxy indicators demographic variables and in proxy indicators for the prevalence of cigarette smoking. for the prevalence of cigarette smoking. . .
Distribution of Study Areas Pope C et al. N Engl J Med 2009;360:376-386
Cross-Sectional Life Expectancies for 1978-1982, Plotted against PM2.5 Concentrations for 1979- 1983 Pope C et al. N Engl J Med 2009;360:376-386
Cross-Sectional Life Expectancies for 1997-2001, Plotted against PM2.5 Concentrations for 1999- 2000 Pope C et al. N Engl J Med 2009;360:376-386
Changes in Life Expectancy for the 1980s-1990s, Plotted against Reductions in PM2.5 Concentrations for 1980-2000 Pope C et al. N Engl J Med 2009;360:376-386
Fine- -Particulate Air Pollution and Life Particulate Air Pollution and Life Fine Expectancy in the United States Expectancy in the United States New England Journal of Medicine New England Journal of Medicine January 22, 2009 January 22, 2009 Results: Results: � Average reduction in PM 2.5 was � Average reduction in PM 2.5 was 6.52ug per cubic meter per cubic meter 6.52ug � Average increase in life expectancy � Average increase in life expectancy 2.72 2.72 years years � A decrease in PM2.5 by 10ug per cubic � A decrease in PM2.5 by 10ug per cubic meter was associated with a gain in life meter was associated with a gain in life expectance of 0.61 years 0.61 years. . expectance of
Change in Life expectance Associated Change in Life expectance Associated with change in PM 2.5 with change in PM 2.5 California Cities Decrease in Gain in life Life expectancy California Cities Decrease in Gain in life Life expectancy expectance (years) expectance (years) PM 2.5 PM 2.5 (months.) (months.) San Jose 3.2 4.2 80.3 San Jose 3.2 4.2 80.3 San Diego 3.2 2.3 78.5 San Diego 3.2 2.3 78.5 Los Angeles Los Angeles 6.6 6.6 4.1 4.1 78.1 78.1 San Francisco 3.9 4.5 77.9 San Francisco 3.9 4.5 77.9
Gains in Life expectancy with Preventative Interventions Gains in Life expectancy with Preventative Interventions Disease and Intervention Gain in Life Expectancy Disease and Intervention Gain in Life Expectancy (in months ) ) (in months Men Women Men Women Cardiovascular disease Cardiovascular disease 10.2 7.9 10.2 7.9 Statin Statin for low LDL/ high CRP for low LDL/ high CRP 5.5 6.7 5.5 6.7 Achievement 20% cessation rate in Achievement 20% cessation rate in smokers smokers Reduction of diastolic BP to 88 Reduction of diastolic BP to 88 13.2 10.8 13.2 10.8 if 90 - -94 94 if 90 Reduction of total cholesterol to Reduction of total cholesterol to 200mg/dl If 200 to 239 mg/dl 200mg/dl If 200 to 239 mg/dl 6.0 4.8 6.0 4.8 200mg/dl if 240 to 299 mg/dl 200mg/dl if 240 to 299 mg/dl 20.4 18.0 20.4 18.0 Cancer prevention Cancer prevention 10 years of biannual 10 years of biannual 0.8 0.8 mammography for 50y/o women mammography for 50y/o women Pap smear every 3 years for 55 Pap smear every 3 years for 55 3.1 3.1 years for 20 y/o y/o women women years for 20 Colonoscopy every 5 years for 25 Colonoscopy every 5 years for 25 2.5 2.2 2.5 2.2 years in 50 year olds. years in 50 year olds.
Summary Characteristics of the 217 Counties Analyzed Pope C et al. N Engl J Med 2009;360:376-386
Results of Selected Regression Models, Including Estimates of the Increase in Life Expectancy Associated with a Reduction in PM2.5 of 10 {micro}g per Cubic Meter, Adjusted for Socioeconomic, Demographic, and Proxy Indicators for Prevalence of Smoking Pope C et al. N Engl J Med 2009;360:376-386
Estimates of Increased Mortality Associated with an Increase in PM2.5 Concentrations of 10 {micro}g per Cubic Meter Based on Extended Follow-up of the American Cancer Society Cancer Prevention Study II Krewski D. N Engl J Med 2009;360:413-415
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