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Health Effects of Diesel Exhaust. Kevin M. Stewart Director of Environmental Health American Lung Association of Pennsylvania. Outline. Diesel Exhaust Composition Diesel Exhaust Health Effects Overview Specifics, notably cancer Populations at Risk Key Steps / Conclusion.

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health effects of diesel exhaust

Health Effects of Diesel Exhaust

Kevin M. Stewart

Director of Environmental Health

American Lung Association of Pennsylvania

American Lung Association of Pennsylvania

outline
Outline
  • Diesel Exhaust Composition
  • Diesel Exhaust Health Effects
    • Overview
    • Specifics, notably cancer
    • Populations at Risk
  • Key Steps / Conclusion

American Lung Association of Pennsylvania

what is diesel exhaust
What is Diesel Exhaust?

American Lung Association of Pennsylvania

composition of diesel exhaust
Composition of Diesel Exhaust
  • Complex mixture of thousands of

chemicals

  • Gases and fine particles
  • Over forty air contaminants

recognized as toxicants,

carcinogens, reproductive

and developmental hazards,

endocrine disruptors

American Lung Association of Pennsylvania

composition of diesel exhaust5
Composition of Diesel Exhaust
  • Gas phase

Oxygen Carbon dioxide

Nitrogen Carbon monoxide

Water vapor

Nitrogen Oxides (especially NO)

Sulfur Compounds

(especially Sulfur Oxides)

Volatile Organic Compounds

Low MW Hydrocarbons

American Lung Association of Pennsylvania

composition of diesel exhaust6
Composition of Diesel Exhaust
  • Gas phase components of toxicological significance

Aldehydes (formaldehyde, acetaldehyde, acrolein)

Benzene

1,3-butadiene

nitrosamines

polycyclic aromatic hydrocarbons (PAHs)

nitro-PAHs

American Lung Association of Pennsylvania

composition of diesel exhaust7
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

American Lung Association of Pennsylvania

substances in diesel exhaust listed by the california air resources board as toxic air contaminants
Substances in Diesel Exhaust Listed by the California Air Resources Board as Toxic Air Contaminants

acetaldehyde 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

American Lung Association of Pennsylvania

diesel emissions inventory
Diesel Emissions Inventory
  • Nationwide, 2001 data show diesel emissions at ~ 4% of PM2.5 inventory. (~11% excluding natural and

miscellaneous sources)

  • Urban Centers

Diesel PM estimated up to 10% to 36% in some western cities.

  • Nitrogen Oxides – nearly one third!
  • Over decades, nonroad diesel has over- taken decreasing onroad diesel emissions.
  • Recent diesel emissions trends have been relatively stagnant.

American Lung Association of Pennsylvania

estimating exposure to diesel exhaust
Estimating Exposure to Diesel Exhaust
  • Use of particulate phase as surrogate for all:
  • Typical indoor level about half of higher risk areas
  • Near-highway exposures up to about 5 times average outdoor levels
  • On school buses, average PM2.5 concentrations often 5 to 10 times higher than ambient, especially when buses are queued and idling.
  • PM10 concentrations average ~ 2 mcg/m3 but has been detected at 125 mcg/m3 above background (w/ windows closed) following an urban transit bus

American Lung Association of Pennsylvania

diesel health effects overview
Diesel Health Effects Overview

American Lung Association of Pennsylvania

weight of evidence approach to understanding risk
Weight of Evidence Approach to Understanding Risk
  • biological plausibility
  • supporting evidence from animal studies, genotoxicity
  • consistency of response
  • broad-based evidence
  • upward trend in exposure-response
  • detectable association at environmental levels
  • effects remain after adjusting for potential bias
  • strong association for highest exposure groups
  • confounding cannot explain association

American Lung Association of Pennsylvania

diesel exhaust is a quadruple whammy for public health
Diesel Exhaust is a “Quadruple Whammy” for Public Health
  • Carcinogens
  • Toxins
  • Fine Particulate Matter
  • Nitrogen oxides

American Lung Association of Pennsylvania

whammies 1 and 2
Whammies 1 and 2
  • Carcinogens
    • Lung
    • Bladder
  • Toxins
    • Nervous
    • Endocrine
    • Reproductive
    • Immune
    • Developmental
    • Liver
    • Kidney

American Lung Association of Pennsylvania

whammy 3
Whammy 3
  • Fine Particulate Matter
    • Premature death
    • Increase respiratory illnesses
    • Exacerbate asthma
      • Symptom days
      • Attacks
      • ER visits
      • Hospitalization

American Lung Association of Pennsylvania

whammy 4
Whammy 4
  • Nitrogen oxides
    • Ozone precursor …
    • Increase in respiratory illnesses
    • Decrease in lung function growth

American Lung Association of Pennsylvania

specific health effects
Specific Health Effects

American Lung Association of Pennsylvania

specific highlights
Specific Highlights
  • Diesel emissions are a significant source of the fine

particulate matter that may be responsible for about

50,000 premature deaths in the U. S. every year.

  • Nationwide, expected lifetime cancers from diesel

particulate in the U. S. population have been

conservatively estimated at about 125,000.

  • EPA has estimated that the diesel engine and fuel rule

approved in February of 2001 will prevent 8,300

premature deaths, 360,000 asthma attacks, and

1.5 million lost work days annually.

American Lung Association of Pennsylvania

specific highlights19
Specific Highlights

STAPPA and ALAPCO estimated in 2002 that if EPA

were to adopt and implement a NONROAD heavy duty

diesel rule consistent with those organizations’

recommendations:

  • Approximately 8,500 premature deaths per year could be

avoided.

  • In 2030 the total annual monetized health-related

benefits associated with reductions in particulate

matter emissions reductions would be more than

$67 billion (1999 dollars).

American Lung Association of Pennsylvania

non cancer health effects from short term exposure
Non-cancer Health Effects from Short-term Exposure
  • Acute irritation
  • Respiratory symptoms (e.g., cough)
  • Neurophysiological symptoms (e.g., nausea)
  • Compromised pulmonary function
  • Increase in biochemical markers associated with allergy
  • Asthma exacerbation
  • Insufficient data for specifying “guidance” level

American Lung Association of Pennsylvania

non cancer health effects from long term exposure
Non-cancer Health Effects from Long-term Exposure
  • Greater cough and phlegm
  • Asthma induction
  • Animals also show decreased resistance to infection, increased chronic lung inflammation and tissue changes
  • Insufficient human data for specifying “guidance” level, but US EPA has set Reference Concentration at 5 micrograms/m3

American Lung Association of Pennsylvania

diesel emissions as a carcinogen
Diesel Emissions as a Carcinogen

American Lung Association of Pennsylvania

estimated cancers from diesel particulate
Estimated Cancers from Diesel Particulate

State and Territorial Air Pollution Program Administrators

and Association of Local Air Pollution Control Officials

(STAPPA/ALAPCO)

Cancer Risk from Diesel Particulate: National and

Metropolitan Area Estimates for the United States,

March 15, 2000.

American Lung Association of Pennsylvania

estimated cancers from diesel particulate24
Estimated Cancers from Diesel Particulate

ENTIRE UNITED STATES 125,110

20 Largest Metropolitan Areas

Metropolitan Area Cancers

Los Angeles 16,250

New York 10,360

Chicago 4,535

Washington/Baltimore 3,750

San Francisco 3,510

Philadelphia 3,085

Boston 2,900

Detroit 2,810

Dallas/Fort Worth 2,470

- continued

American Lung Association of Pennsylvania

estimated cancers from diesel particulate25
Estimated Cancers from Diesel Particulate

20 Largest Metropolitan Areas - continued

Metropolitan Area Cancers

Houston 2,270

Atlanta 1,930

Miami/Fort Lauderdale 1,880

Seattle 1,765

Phoenix 1,510

Cleveland 1,500

Minneapolis 1,460

San Diego 1,430

St. Louis 1,320

Denver 1,220

Pittsburgh 1,210

American Lung Association of Pennsylvania

cancer risk assessments of diesel exhaust
Cancer Risk Assessments of Diesel Exhaust

ORGANIZATION YEAR CONCLUSION

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

American Lung Association of Pennsylvania

cancer risk assessments of diesel exhaust27
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

American Lung Association of Pennsylvania

carcinogenic potential of diesel emissions
Carcinogenic Potential of Diesel Emissions
  • Known 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.

American Lung Association of Pennsylvania

carcinogenic potential of diesel emissions29
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

American Lung Association of Pennsylvania

carcinogenic potential of diesel emissions30
Carcinogenic Potential of Diesel Emissions
  • A similar 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 (bus and truck

drivers, railroad and shipyard

workers)

American Lung Association of Pennsylvania

carcinogenic potential of diesel emissions31
Carcinogenic Potential of Diesel Emissions
  • People are exposed to hundreds of times the

amount of carcinogens the Clean Air Act

recognizes as a reasonable precaution

(one-in-a-million):

    • 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: 89% of the risk:
      • 28% from on-road sources (e.g., trucks)
      • 60% from nonroad sources (industrial,

construction and farm equipment)

American Lung Association of Pennsylvania

populations at risk 1998 data
Populations at Risk (1998 data)

State Population Emphysema Chronic Bronchitis

Adult Asthma (>= 18 yr) Pediatric Asthma (< 18 yr)

NJ 8,095,542 91,513 277,593

210,480 105,914

PA 12,002,329 137,136 415,982

315,416 151,857

DE 744,066 8,461 25,666

19,460 9,557

MD 5,130,072 57,572 174,642

132,420 68,593

American Lung Association of Pennsylvania

populations at risk 1998 data continued
Populations at Risk (1998 data) (continued)

State Population Under 14 Years 65 Years and Over

NJ 8,095,542 1,680,818 1,106,028

PA 12,002,329 2,358,803 1,905,327

DE 744,066 150,327 96,809

MD 5,130,072 1,083,642 591,273

American Lung Association of Pennsylvania

the american lung association s recommended key steps
The American Lung Association’sRecommended Key Steps
  • Implement the clean air standards for trucks and buses and fuels – completely and on time.
  • Adopt strong equivalent standards for all nonroad diesel equipment.
  • Close the loophole for diesel electric generators.
  • Implement retrofit programs now.

American Lung Association of Pennsylvania

conclusion
Conclusion

Approximately one in ten Americans has a chronic

lung disease and is at risk from air pollution. Infants,

children, and the elderly are at increased risk, too.

These are not faceless statistics, but people close to you:

Your friends, your coworkers. Your parents, your children.

Your aunt with emphysema struggling to breathe.

Your coworker who can't make it in for that important task.

Your child taking that frightening trip to the emergency room.

Maybe even yourself.

American Lung Association of Pennsylvania

remember when you can t breathe nothing else matters
Remember:When You Can’t Breathe, Nothing Else Matters.

American Lung Association of Pennsylvania

additional materials
Additional Materials
  • (Not part of presentation, but for use in responding to questions, if necessary)

American Lung Association of Pennsylvania

factors affecting composition of diesel emissions
Factors Affecting Composition of Diesel Emissions
  • Engine types (light-duty to heavy-duty as

they appear in passenger vehicles to

off-road vehicles, in locomotives to

electric generators)

  • Engine operating conditions

(idle, accelerate, decelerate)

  • Fuel formulations

(e.g., sulfur or aromatic content)

American Lung Association of Pennsylvania

factors affecting fate of diesel emissions
Factors Affecting Fate of Diesel Emissions
  • Dilution
  • Chemical & physical changes

Example: Diesel exhaust “aging” results in secondary PM formed from gas phase components

  • Transport
  • Weather (sunlight, temperature, humidity, precipitation)
  • Other (interacting) pollutants
  • Interactions with ground-level environment

American Lung Association of Pennsylvania

example of study from current research
Example of Study from Current Research
  • Study in April 3, 2002 issue of Immunotherapy Weekly presented at annual meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI).
  • Prior evidence showed that Diesel Exhaust Particulate (DEP ) could increase immune system response and airway inflammation associated with various allergens.
  • This study examined hospital emergency room visits and inpatient admissions between 1995 to 2000. Asthma exacerbations for children under 18 years old increased 1.4 times in the fall compared with the spring, significantly correlated with higher levels of DEP.

American Lung Association of Pennsylvania

reproductive and developmental effects
Reproductive and Developmental Effects
  • Some possibilities in animal studies
  • Neurobehavioral and neurophysiological effects in

neonatal rodents

  • Organ systems not yet evaluated

American Lung Association of Pennsylvania

immunological effects
Immunological Effects
  • Several observed effects in

immune system biochemical

mediators, inflammation,

cytological changes

  • Diesel exhaust as potentiator for known allergens
  • Insufficient data to determine reference level

American Lung Association of Pennsylvania

genotoxic effects of diesel particulates or extracts
Genotoxic Effects of Diesel Particulates or Extracts
  • Mutagenic in several mammalian cell systems
  • Aberrations in chromosomes or cell division
  • Free radical inhibition of antioxidant enzymes
  • Separately, substances in diesel exhaust have

been identified as genotoxic

  • Questions remain about the level of

bioavailability

American Lung Association of Pennsylvania

carcinogenic potential of diesel emissions44
Carcinogenic Potential of Diesel Emissions
  • Lifetime lung cancer risks per microgram of diesel exhaust:
    • Cancer risk per microgram of diesel exhaust particulate per cubic meter of air:

Scenarios range on the order of 100 to

1000 per million population after 70 years

of exposure.

American Lung Association of Pennsylvania

major report on particulate air pollution march 6 2002 of jama
Major Report on Particulate Air Pollution:March 6, 2002 of JAMA
  • “Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution” by Pope, C. A., et al.
  • Prospective mortality study of 500,000 adults in 156 cities, followed over the years 1982-98.
  • Conclusion: “Each 10-µg/m3 elevation in fine particulate air pollution was associated with approximately a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer mortality, respectively.”

American Lung Association of Pennsylvania

important public health news from last year
Important Public Health News from Last Year
  • Dec. 21, 2000: EPA issues rule for diesel fuel and heavy duty diesel vehicles.
  • Feb. 28, 2001: EPA agrees to enforce rule.
  • May 3, 2002: Ruling by U. S. Circuit Court of Appeals for the District of Columbia Circuit upholds the rule.

American Lung Association of Pennsylvania

important public health news from last year47
Important Public Health News from Last Year
  • Rule to take effect in 2007.
  • EPA estimates that annually the rule will prevent 8,300 premature deaths, more than 9,500 hospitalizations, 5,500 cases of chronic bronchitis, 17,600 cases of acute bronchitis in children, 360,000 fewer asthma attacks, and more than 1.5 million lost workdays. The rule also will prevent cancers from diesel exhaust, which EPA has found to be a likely carcinogen in humans.

American Lung Association of Pennsylvania

references
References

… where you can find links to this same information – and more:

  • The 1998 California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment (OEHHA) Report www.arb.ca.gov/regact/diesltac/diesltac.htm
  • The 2000 US EPA Review Draft

www.epa.gov/ncea/dieslexh.htm

American Lung Association of Pennsylvania

references49
References
  • The 1998 & 2001 Natural Resources Defense Council Reports www.nrdc.org/air/transportation/
  • The 2001 OEHHA and American Lung Association of California’s Fact Sheet

www.californialung.org/downloads/diesel010501/ALA-OEHHA_diesel.pdf

American Lung Association of Pennsylvania