The Impact of Climate Change on Air Quality & Respiratory Disease: Maryland/DC Metropolitan

AreaAlpana Kaushiva (Alpana.Kaushiva@jhuapl.edu), Shadrian Strong, Steven Babin, & Larry Paxton

The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States

• Ground level ozone forms smog and becomes harmful to humans by exacerbating respiratory conditions, primarily asthma (Knowlton et al. 2004).

• As climate change progresses, increased ozone concentrations emerge as a major public health concern (Gardiner et al. 2011).

• Increasing ground level ozone concentrations have been directly correlated with rising temperatures (Patz et al. 2005).

• Those with existing respiratory conditions, children and the elderly, and those who spend a significant amount of time outdoors are the most sensitive to ground level ozone pollution (Schlink et al. 2006).

GC33A-1055

The Cost ($) of Asthma due to Increased Ozone Emissions

Tables 1, 2, 3 2010 ozone concentration levels for MD, DC, and VA (ppb) were 49.9, 42, & 48.1, respectively. Information on acute prevalence was collected from the CDC’s Behavioral Risk Factor Surveillance System database. Cost was determined using the values of health care costs associated with climate penalty provided in the recent Union of Concerned Scientists Report.1

Figure 5. (Non-cumulative effects) Obtained from a recent Union of Concerned Scientist’s report, this table includes data on various health impacts from rising ozone levels for low and high emission scenarios in 2020.

Conclusions

Future Directions

Bottom line: We find that the cost of asthma in the near future has ~doubled relative to the costs predicted by the 2008 Union of Concerned Scientist’s report. While we can replicate their results using 2008 ozone statistics, we find that the inclusion of 2 additional years (2009, 2010) results in a significant increase in associated cost.

The impact of ozone on asthma appears to be a nonlinear trend, such that the addition of two additional years worth of data from the initial study showed a significant rise in resulting cost.

• We have been awarded a grant from SDI-Innovations in Healthcare Analytics, an organization that provides healthcare data. This grant will enable us to examine asthma data on hospital admissions and doctor office visits in EPA Region 3 in order to gain a better understanding of asthma prevalence and impacts of increasing air pollution.

• We aim to further analyze the problem of rising asthma prevalence and increasing ozone concentration as well as other climate change and public health issues. We are in contact with Asthmapolis, which has introduced tools to track asthma, and we are in the process of completing grants for other possible collaborations.

AcknowledgementsThis work has been sponsored under the Global Assimilation of Information for Action (GAIA, http://gaia.jhuapl.edu) initiative at The Johns Hopkins University, connecting decision-makers with the research community. See posters/talks:1. L. Paxton, PA31A-06. GAIA - a generalizable, extensible structure for integrating games, models and

social networking to support decision makers2. S. Strong, IN32B-12. Visualizing the Impact of Climate Change with GAIA3. L. Paxton, H52B-08. GAIA - A New Approach To Decision Making on Climate Disruption Issues

References1 Perera, Elizabeth, and Todd Sanford. Climate Change and Your Health: Rising Temperatures, Worsening

Ozone Pollution. Rep. Union of Concerned Scientists, 2011. Print.2 "CDC - Asthma - Behavioral Risk Factor Surveillance System (BRFSS)." Centers for Disease Control and

Prevention. Web. 25 Nov. 2011. <http://www.cdc.gov/asthma/brfss/default.htm>.3 Nolen, Janice E. State of the Air 2011. Rep. Washington, D.C.: American Lung Association, 2011. Print. 4 "Query Concentrations | AirExplorer | US EPA." US Environmental Protection Agency. Web. 25 Nov. 2011.

<http://www.epa.gov/cgi-bin/htmSQL/mxplorer/query_daily.hsql?poll=42101>.

Introduction: The Impact of Climate Change on Respiratory Health

Data & Assumptions

• In their 2011 “State of the Air” report, the American Lung Association rated the Washington/Baltimore/Northern Virginia region as one of the 25 most ozone polluted regions nationwide3. This is the motivating factor for this work.

• Acute and chronic asthma prevalence data for adults and children in MD, DC, and VA was obtained from the CDC’s Behavioral Risk Factor Surveillance System. • Acute: defined as an affirmative response to the question “Have

you ever been told by a doctor {nurse or other health professional} that you have asthma?”

• Chronic: defined as an affirmative response to that question followed by an affirmative response to the subsequent question “Do you still have asthma?”2

• Ozone concentrations in parts per billion (ppb) were collected from the EPA’s Air Explorer tool. Query concentrations from the Air Quality System (AQS), EPA's repository of ambient air quality data, were recorded for ozone for each county in MD and VA, and DC, and averaged yearly from 2000-2010 to come up with a regional average.4

• Costs of asthma due to increased ozone emissions was determined by calculating an increase in ppb of ozone using collected data and applying a cost per ppb increase for each region as reported by the Union of Concerned Scientists in 2008 dollars.

Figure 1a, b, c Comparison of trends in ozone concentration vs. acute asthma prevalence in MD, VA, and DC, from 2000-2010. Average daily maximum ozone concentration values for 2009 are omitted because they are significant outliers.

Figure 1d. Comparing chronic vs. acute asthma prevalence in adults in MD, DC, and VA from 2000-2010.

Ozone Concentration & Asthma Prevalence in the DC-metro Region

A

B

C

D

Figure 2a,b. Comparing chronic vs. acute asthma prevalence in children in MD and VA from 2003 to 2009.

Child Asthma Prevalence

A

B

Year MD: Cost (billion $ 2008) PPB

% Increase in Acute Asthma

2015 0.2 52.3 --

2020 0.3 54.7 0.9

2035 0.8 61.9 2.7

2050 1.3 69.1 2.7

2100 2.9 93.1 9

Year DC: Cost (billion $ 2008) PPB

% Increase in Acute Asthma

2015 0.04 48.3 --

2020 0.07 54.6 2

2035 0.2 73.5 6.2

2050 0.3 92.4 6.1

2100 0.7 155.4 20.5

Year VA: Cost (billion $ 2008) PPB

% Increase in Acute Asthma

2015 0.1 49.3 --

2020 0.2 50.5 1.2

2035 0.5 54.1 3.6

2050 0.9 57.7 3.6

2100 1.9 69.7 12

(1) (2)

(3)

Health Impacts 2020 (low)2020 (high) 2050 (low) 2050 (high)

+1 ppb +2 ppb +2 ppb +7 ppb

Occurrence of Acute Symptoms 1.4 M 2.8 M 3.4 M 11.8 M

ER Visits 600 1200 1480 5190

Senior Admission 1840 3680 6850 23940

Infant Admission 710 1420 1660 5680

Lost School Days 0.47 M 0.94 M 1.8 M 4.1 M

Premature Death 260 510 750 2610

Figure 4. Comparison of moderate, unhealthy for sensitive, and unhealthy ozone air quality days in Maryland, DC, and Virginia for 2000, 2005, and 2010.