Health Outcomes

• Multiple

Health Outcome List:

• Mortality (all-cause mortality, non-accidental mortality, and infant mortality)
• Respiratory outcomes (asthma hospitalizations, chronic obstructive pulmonary disease (COPD) hospitalizations, pneumonia hospitalizations, asthma emergency department (ED) visits, day with cough, day with wheeze, day with shortness of breath)
• Cardiovascular outcomes (cardiovascular disease, non-fatal myocardial infarction)
• Restricted days (minor restricted activity day, missed school day, work loss day)

Environmental Agents

List of Environmental Agents:

• Air pollutants (nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), particulate matter (PM2.5/fine))

Source of Environmental Agents:

• Regional, point (e.g., industrial), mobile (i.e., on-road traffic), and area sources

Economic Evaluation / Methods and Source

Type:

• Cost analysis (CA)

Cost Measures:

• Value of a statistical life for mortalities, cost of illness or willingness to pay estimates for morbidities

Potential Cost Measures:

• Not available

Benefits Measures:

• Not available

Potential Benefits Measures:

• Not available

Location:

• Detroit, Michigan, urban area including adjacent cities of Hamtramck, Highland Park, River Rouge, Ecorse, Lincoln Park, Melvindale, Dearborn, and Allen Park

Models Used:

• Framework for Rapid Emissions Scenarios and Health Impact Estimate (FRESH-EST)
• AERMOD dispersion model
• RLINE dispersion model
• Motor Vehicle Emissions Simulator (MOVES) emissions model

Models References:

• References cited in publication — FRESH-EST model (Milando et al., 2016); AERMOD dispersion model (Cimorelli et al., 2005); RLINE dispersion model (Snyder et al., 2013); MOVES emissions model (https://www.epa.gov/moves)

Methods Used:

• The authors calculated the health burden attributable to air pollution in the Detroit area, identified the role of different source types, and examined inequalities of exposures and health risks for different racial/ethnic groups. The authors —1) defined census blocks as the unit of analysis for exposure, health, and inequality metrics; 2) estimated spatially resolved and current exposures to PM2.5, O3, NO2, SO2 using air quality monitoring data and dispersion modeling; 3) apportioned concentrations to regional, local, point, mobile, and area sources using spatial resolution and dispersion modeling; 4) calculated the numbers of mortality and morbidity cases attributable to air pollution using health impact functions; 5) quantified health burden using the number of incident cases of mortality or morbidity attributable to pollutant exposure (attributable cases) and disability-adjusted life years (DALYs); 6) monetized health impacts using valuations in a previously published PM2.5 standard analysis using value of a statistical life for mortalities and cost of illness or willingness to pay for morbidities; and 7) applied two inequality metrics to evaluate inequalities of exposures and attributable health impacts.

Sources Used:

• Geocoded mortality data from the Michigan Department of Health and Human Services; Census block-level population data from 2010 census TIGER/Line shapefiles (US Census Bureau); Block-level age-specific subgroups (US Census Bureau 2010–2014 American Community Survey (ACS) 5-Year Estimates); United States ambient air quality monitoring data (US EPA, AQS Data Mart) Canada ambient air quality monitoring data (Ontario Ministry of Environment and Climate Change); Point source emissions (MDEQ-Michigan Air Emissions Reporting System (MAERS) Annual Pollutant Totals Query); Point source emissions (US EPA, National Emissions Inventory); Hospitalization rates from the 2013 ACS survey and data for Wayne County hospitals; Emergency department visits for asthma at the ZIP code level for Detroit and the county level outside of Detroit (DeGuire et al., 2016; Michigan Department of Health and Human Services, 2016); Rates for asthma-related respiratory symptom day rates from cohort study of children with asthma in Detroit (Betterman et al., 2017); Rates for other health outcomes from national rates used in Health Impact Assessment conducted by the US EPA (US EPA, 2015); Monetary values from the Regulatory Impact Analysis for the most recent particulate matter standard in the United States (US EPA, 2012); additional sources cited in the publication

Economic Citation / Fundings

Citation:

• Martenies SE, Milando CW, Williams GO, Batterman SA. Disease and health inequalities attributable to air pollutant exposure in Detroit, Michigan. International Journal of Environmental Research and Public Health. 2017. 14; 10.
• Pubmed
• DOI

NIEHS Funding:

• P30ES017885, R01ES022616

Other Funding:

• T42OH008455