January 31, 2012

Lifetime deaths and life exceptancy impact from air pollution

I am fairly regularly asked about the peer reviewed sources for my deaths per terawatt hour articles and my lifetime deaths per twh from energy article. Reporters or university students will ask if my articles have been submitted for peer review and been published.

No, I have not submitted and gotten my articles on deaths per terawatt hour peer reviewed and published. However, there are a lot (hundreds) of published studies on which I build my case. All that I do is use simple math and the citation of respected peer reviewed published sources.

Various energy department reports for energy generation in TWH by type and peer reviewed sources for deaths caused.

I am very conservative on the air pollution deaths, because the numbers are so high that there is no need to go for any high estimate. I can also go primarily at the best epidemiology studies for Particulate matter. Air pollution has a bunch of other health impacters (ozone, smog - nitrous oxide, arsenic in water, etc..) But I do not need to tally up some things that may only be killing hundreds or thousands per year.
Increase in percent of cases over period of exposure. It is up to 16% after ten years and the trend is still increasing

Pollution levels are higher in China and India. Studies show that more air pollution makes health and mortality impacts worse. People in many cities in China will cough up black. This is why people in China protested to get the PM 2.5 reading tracked, because they knew they and their children were being poisoned every day. There is a lot of tracking of PM2.5 and PM10 levels. China until recently tried to avoid publishing PM2.5 numbers.

We have also reviewed the obviousness of air pollution harm from the history of the London Fog in 1952 that killed 14000 people over 2 weeks.

Cribb was then a mortician's assistant, working for Tom Cribb, his elderly uncle. On Friday Dec. 5, they were driving to a wake, with a line of cars full of mourners close behind. Neither man knew a catastrophe was brewing. They didn't know that a mass of stagnant air had just clamped a lid over London, trapping the smoke from millions of residential coal fires at ground level.

Cribb remembers being stunned by the blackness of the gathering fog. After a few minutes he couldn't see the curb from his spot behind the wheel. After a few more minutes, Tom Cribb got out and started walking in front of the hearse, to keep his nephew on the road. He carried a powerful hurricane lantern in one hand, but it was useless.

"It's like you were blind," says Cribb.

Everyone in London walked blind for the next four days

By Sunday, Dec. 7, visibility fell to one foot. Roads were littered with abandoned cars. Cattle in the city's Smithfield market were killed and thrown away before they could be slaughtered and sold — their lungs were black. On the second day of the smog, Saturday, Dec. 6, 500 people died in London. When the ambulances stopped running, thousands of gasping Londoners walked through the smog to the city's hospitals. The lips of the dying were blue. Heavy smoking and chronic exposure to pollution had already weakened the lungs of those who fell ill during the smog. Particulates and acids in the killer brew finished the job by triggering massive inflammations. In essence, the dead had suffocated.

Maureen Scholes, a nurse at the Royal London Hospital in 1952, says the smog penetrated through clothes, blackening undergarments

Counting the increase in the dead from the fog was not hard. There was a massive jump. The correlation between people falling down dead was also pretty easy to work out

There would be air inversions that would trap the air pollution and cause mass deaths
* 1948, October 30–31, Donora, PA: 20 died, 600 hospitalized, thousands more stricken. Lawsuits were not settled until 1951.
* 1953, November, New York: Smog kills between 170 and 260 people.
* 1954, October, Los Angeles: heavy smog shuts down schools and industry for most of the month.
* 1963, New York: blamed for 200 deaths
* 1966, New York: blamed for 169 deaths

I guess when you reduce the obviously visible air pollutants and slow down the deaths by about 80%, then people need to have peer reviewed studies. Even though the overall mortality increase can be 20% and the number of hospitalizations caused is 30%. There are all of the arguments about the affordability of medical coverage in the US. However, paying to mitigate car and fossil fuel air pollution could be widely enforced and paid for by the government and we would come out ahead. Instead we are choosing to pay for 30% more hospitalizations instead of paying to turn the tap and reducing the level of poisoning by 99%.

Converting micrograms per cubic meter of particulars in air into weight of particulates through lungs each year

Do not let the air pollution units confuse you. I will convert the micrograms per cubic meter in the air into pounds through your lungs each year.

In major cities there is between 20-370 micrograms of particulates (PM10 10 micron) per cubic meter of air.

Each day you take over 20,000 breaths and breathe about 35 pounds (15.9 kg) of air. At sea level and at 20 °C, dry air has a density of approximately 1.2 kg per m³ (cubic meter). So every day you are breathing 13.2 m³ of air. Therefore,jj

13.2 m³ • 20 micrograms = 265 μG (micrograms) = 0.265 mg (milligrams)
13.2 m³ • 370 micrograms = 4910 μG (micrograms) = 4.91 mg (milligrams)

So 0.2-4.9 mg of particulates enter into your lungs every day unless you live some of the particularly clean air areas.

In one year per the above statistics, 97-1800 mg (0.097 to 1.8 grams) of particulates enter your lungs. So in Beijing (with a very high average particulate load) over 1/8 ounce of particulates gets into each person's lungs each year. This may not sound like a lot, but the lungs don't have very effective mechanisms for expelling particulates that collect, so the effect is mostly accumulative.

The particulates from “smog” are not chemically and biologically inert either. They interact with the lungs, and from there the body, transferring their water and lymph soluble compounds directly to the blood stream. These in turn are well known to cause cardiovascular, pulmonary and hepatotoxic effects.

Were you ever exposed to significant levels of radiation from a nuclear power plant, to the degree that your life's accumulation of smog-born particulates affects your body?

Burnable Dirt

Let us burn a mountain of flammable dirt (coal) every year. What could go wrong ?

Coal is "burnable dirt". The world is burning 7 billion tons of this flammable mineral each year. It has hundreds of other things in it in parts per million, which sounds tiny. But when you burn a mountain of it, obviously those "parts per million" get multiplied by "billions" and bad things happen.

Coal is carbon plus polycyclic hydrocarbons. When it burns in air you get a lot of oxidized carbon (carbon dioxide, or CO2) and the weight of the added oxygen makes it about three times heavier. 7 billion tons of burnable dirt becomes about 21 billion tons of CO2 and hundreds of millions of tons of ash. It also releases hundreds of millions of tons of sulfur dioxide (a powerful pulmonary irritant), dozens of millions of tons of frighteningly toxic carcinogens, mutagens, and other “partially burned” constituents.

That's bad of course, but then we need to remember that to get the burnable dirt, "mining operations" blow up the tops of mountains, then schickenpooe all the overlying non-coal into mud into lakes of gunk that are retained indefinitely as damned up mires. These cesspools of left over mountains, trees, rock and stone are almost never "put back" to restore the mountain that once was there. They're left, abandoned, for all generations in the future to deal with.

Oil is burnable liquid gunk. We are burning 4 billion tons of it each year. It on burning also produces a huge variety of compounds, the least troublesome (in the large human-health picture) being carbon dioxide.

Back to the details

I focus on the parts of air pollution that are the big and best documented killers.

The mining deaths can be obtained from labor studies and industrial safety studies.
Those can be added together. the numbers are smaller than air pollution but the
deaths tend to be immediate and totally unambiguous. 5000 or 10000 people per year dieing in coal mines. Pretty clear cut allocation and the deaths also cannot be disputed.

Major past incidents like the Banqiao dam can just be tallied.

Transportation accidents. Freight rail traffic deaths are recorded and tracked.
40% of all rail freight in the US is to move coal. The ton per miles needs to be used for allocating the deaths. Also, we can back into the calculation from traffic and transportation safety reports. If someone gets hit by a train or truck full of coal, that is pretty unambiguous. When hundreds in Africa die when an oil truck has a spill and the people gather round and the oil catches fire and kills them, that seems to not require a peer reviewed study.

Life expectancy and Air pollution studies

There was Dutch work on estimating impact on life expectancy for people in clean air versus polluted air

China study on long term exposure of air pollution on life expectancy

This study exploits an arbitrary Chinese law to provide the first evidence on the impact of sustained exposure to total suspended particulates (TSP) air pollution on life expectancy. During the 1950-1980 central planning period, China established free winter heating of homes and offices via the provision of free coal for boilers in cities North of the Huai River as a basic right and largely denied heat to the South. Using a regression discontinuity design based on distance from the Huai River, we find that in cities to the North ambient concentrations of TSPs are about 200 μg/m3 (55%) higher and life expectancies are about 5 years lower. Moreover, the premature mortality is due to an increased prevalence of lung-related causes of death. We estimate that long-term exposure to an additional 100 μg/m3 of TSP is associated with a reduction in life expectancy at birth of about 2.5 years. This estimate is roughly 5 times larger than the estimated impact of TSPs on life expectancy from the fitting of an ordinary least squares equation.

US study of air pollution and life expectancy

A decrease of 10 μg per cubic meter in the concentration of fine particulate matter was associated with an estimated increase in mean (±SE) life expectancy of 0.61±0.20 year (P=0.004). The estimated effect of reduced exposure to pollution on life expectancy was not highly sensitive to adjustment for changes in socioeconomic, demographic, or proxy variables for the prevalence of smoking or to the restriction of observations to relatively large counties. Reductions in air pollution accounted for as much as 15% of the overall increase in life expectancy in the study areas.

A wrote a previous article that summarized peer reviewed air pollution studies which included studies in China.

A peer reviewed study that discusses a framework for allocating deaths from air pollution

A study from 2010 that summarizes the research on PM (particulate matter) 2.5 impact on health and mortality

Time-series studies estimate that a 10-μg/m3 increase in mean 24-hour PM2.5 concentration increases the relative risk (RR) for daily cardiovascular mortality by approximately 0.4% to 1.0%. Despite theoretical statistical risks ascribed to all individuals, this elevated risk from exposure is not equally distributed within a population. At present-day levels, PM2.5 likely poses an acute threat principally to susceptible people, even if seemingly healthy, such as the elderly and those with (unrecognized) existing coronary artery or structural heart disease. Therefore, the absolute risk rather than the RR of exposure may more effectively convey the tangible health burden within a population. A 10-μg/m3 increase during the preceding day contributes on average to the premature death of approximately 1 susceptible person per day in a region of 5 million people (based on annual US death rates in 2005). Although the dangers to 1 individual at any single time point may be small, the public health burden derived from this ubiquitous risk is enormous. Short-term increases in PM2.5 levels lead to the early mortality of tens of thousands of individuals per year in the United States alone

Cohort studies estimate that the RR associated with living in areas with higher PM levels over the long term is of greater magnitude than that observed from short-term exposure increases (RR between 1.06 and 1.76 per 10 μg/m3 PM2.5). In this context, the World Health Organization estimated that PM2.5 contributes to approximately 800 000 premature deaths per year, ranking it as the 13th leading cause of worldwide mortality.15 Hence, PM air pollution appears to be an important modifiable factor that affects the public health on a global scale.

Because of its comparatively large size and importance, the results of a recent analysis of Medicare files in 204 US urban counties with 11.5 million individuals older than 65 years merit discussion. Daily changes in PM2.5 levels were associated with a variety of cardiovascular hospital admission subtypes. A 10-μg/m3 increase in PM2.5 exposure was related to increases in hospitalizations for cerebrovascular disease by 0.81% (95% CI 0.3% to 1.32%), peripheral vascular disease by 0.86% (95% CI −0.06% to 1.79%), ischemic heart disease by 0.44% (95% CI 0.02% to 0.86%), arrhythmias by 0.57% (95% CI −0.01% to 1.15%), and heart failure by 1.28 (95% CI 0.78% to 1.78%). The most rapid effects, which occurred largely on the same day of PM2.5 elevation, were seen for cerebrovascular, arrhythmia, and heart failure admissions. Ischemic heart disease events tended to increase to a greater extent 2 days after exposures.

Notice in that last paragraph how the detailed peer reviewed studies track daily changes in air pollution levels and how on bad air pollution days more people go the hospital.

Air pollution gets worse on Tuesday and more people are in the hospital with heart and lung problems on the same day. As air pollution fluctuates the hospitalization moves together with it.

Table with summary of studies at this link

Increase in percent of cases over period of exposure

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