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Impact of NOx Emission Reduction Policy on Hospitalizations for Respiratory Disease in New York State
Lin, S., R. Jones, C. Pantea, H. A. OZKAYNAK, S. T. RAO, S. Hwang, AND V. GARCIA. Impact of NOx Emission Reduction Policy on Hospitalizations for Respiratory Disease in New York State. Journal of Exposure Science and Environmental Epidemiology . Nature Publishing Group, London, Uk, 23(1):73-80, (2013).
The National Exposure Research Laboratory′s (NERL′s) Atmospheric Modeling and Analysis Division (AMAD) conducts research in support of EPA′s mission to protect human health and the environment. AMAD′s research program is engaged in developing and evaluating predictive atmospheric models on all spatial and temporal scales for forecasting the Nation′s air quality and for assessing changes in air quality and air pollutant exposures, as affected by changes in ecosystem management and regulatory decisions. AMAD is responsible for providing a sound scientific and technical basis for regulatory policies based on air quality models to improve ambient air quality. The models developed by AMAD are being used by EPA, NOAA, and the air pollution community in understanding and forecasting not only the magnitude of the air pollution problem, but also in developing emission control policies and regulations for air quality improvements.
To date, only a limited number of studies have examined the impact of ambient pollutant policy on respiratory morbidities. This accountability study examined the effect of a regional pollution control policy, namely, the US Environmental Protection Agency’s (EPA) nitrogen oxides (NOx ) Budget Trading Program (NBP), on respiratory health in New York State (NYS). Time-series analysis using generalized additive models was applied to assess changes in daily hospitalizations for respiratory diseases in NYS after the implementation of the NBP policy. Respiratory end points in the summers during the baseline period (1997--2000) were compared with those during the post-intervention period (2004--2006). Stratiﬁed analyses were also conducted to examine whether health impacts of the NBP differed by socio-demographic, regional, or clinical characteristics. Following the implementation of EPA’s NBP policy, there were signiﬁcant reductions in mean ozone levels (-2% to -9%) throughout NYS. After adjusting for time-varying variables, PM2.5 concentration, and meteorological factors, signiﬁcant post-intervention declines in respiratory admissions were observed in the Central -10.18, 95% conﬁdence interval (CI):-14.18, -6.01), Lower Hudson (-11.05, 95% CI: -16.54, -5.19), and New York City Metro regions (-5.71, 95% CI: -7.39, -4.00), consistent with wind trajectory patterns. Stratiﬁed analyses suggest that admissions for asthma, chronic airway obstruction, among those 5--17 years old, self-payers, Medicaid-covered, and rural residents declined the most post-NBP. This study suggests that the NOx control policy may have had a positive impact on both air pollution levels statewide and respiratory health in some NYS regions. However, the effect varied by disease subgroups, region, and socio-demographic characteristics.
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Organization:U.S. ENVIRONMENTAL PROTECTION AGENCY
OFFICE OF RESEARCH AND DEVELOPMENT
NATIONAL EXPOSURE RESEARCH LABORATORY
ATMOSPHERIC MODELING AND ANALYSIS DIVISION
ATMOSPHERIC EXPOSURE INTEGRATION BRANCH