Date of Award

Summer 2024

Language

English

Embargo Period

7-9-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Environmental Health Sciences

Program

Environmental Health Sciences

First Advisor

David O. Carpenter

Committee Members

David Carpenter, David Spink, Haider Khwaja, Reliene Ramune, Lawrence Lessner

Keywords

National Emissions Inventory, Criteria Air Pollutants, Environmental Protection Agency, Emergency Room Visits, Statewide Planning and Research Cooperative System, Respiratory and Cardiovascular Diseases

Subject Categories

Environmental Public Health

Abstract

Abstract

Air pollution is a major environmental health hazard for the general population. Approximately 90% of the global population is at risk of both indoor and outdoor air pollution, and it accounts for an estimated 7 million premature deaths every year according to the World Health Organization (WHO). Multiple studies including epidemiological and molecular analyses have confirmed the negative effects of air pollutants on human health even at levels within the WHO guidelines. This study examines the health impacts of releases of criteria air pollution from point sources in New York State (NYS). There is evidence from population studies that have shown that increases in levels of the criteria air pollutants (CAPs) are associated with increases in cardiovascular and respiratory diseases. The criteria pollutants include particulates (PM10 and PM2.5), sulfur dioxide (SO2), nitrous oxides (NOx), carbon monoxide (CO), ozone (O3), and lead (Pb), as defined by the United States Environmental Protection Agency (USEPA). While emissions from point sources such as fixed industries and power plants are only one relatively minor component of total air pollution, because they are localized can allow one to examine the effects of these releases on the local population. In this ecologic study I have determined the association between emergency room (ER) visits that did not result in hospitalization for respiratory and cardiovascular diseases in NYS among individuals living in zip codes containing point sources of CAPs. Of particular interest is the examination of the release effects of particulates relative to the gaseous pollutants that have been studied less because they are more difficult to measure.

The specific aims of this dissertation project are to assess the associations, if any, between ER visits for asthma, chronic obstruction pulmonary disease (COPD), ischemic heart disease (IHD) and myocardial infarction (MI) and zip code level exposure to the CAPs, NOx, SO2, CO, and particulates (PM2.5 and PM10) among patients who live in zip codes that have point source emissions of the CAPs in NYS from 2010 to 2018 after control for other sources of air pollution and rates of smoking and level of poverty, and to determine the individual contribution of each criteria pollutant. Unfortunately, the exposure source I will use does not include information on O3 and there are minimal releases of Pb, so it will not be studied.

This was achieved by using publicly available data sets, the National Emissions Inventory (NEI) by the USEPA for exposure data, the United States Decennial Census (USDC) for population data, the Behavioral Risk Factor Surveillance System (BRFSS) for smoking data, the United States Census Bureau (USCB) for poverty, and the Statewide Planning and Research Cooperative System (SPARCS) for ER visits data. In the first aim, a generalized linear model with Quasi-Poisson regression is used, while the linear mixed effects regression model with a random county level effect is used in the second and third aims to analyze the rates of ER visits for all the diseases in the study and their associations with the CAPs. A p-value of

The results of this dissertation show positive associations between all of the CAPs and all of the diseases in the study except MI for which most patients are recorded as hospital admissions (HAs). A major unexpected observation is that the gaseous pollutants (CO, NOx, SO2) showed much stronger associations with asthma, COPD and IHD than the particulates (PM2.5 and PM10), although this may in part be because the gaseous air pollutants are greater from point sources. In addition, for COPD there was a greater risk from PM10 than PM2.5, indicating that while larger particulates do not penetrate deep into the alveoli, they still can increase risk of respiratory disease. These results demonstrate that CAPs point source pollution results in a small but significant contribution to the risk of respiratory and cardiovascular diseases in relation to ER visits that did not result in hospitalization. There are limitations to this study as it uses an ecologic study design that has the potential for misclassification of the exposure, and has analyzed only data from ER visits, not hospitalization. There is also a potential for residual confounding. Future research using more sophisticated study designs could better assess the research questions of interest.

License

This work is licensed under the University at Albany Standard Author Agreement.

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