Asthma FAQs in braille and on CD, Asthma UK

Partially sighted and blind people with asthma can now benefit from specially-targeted information from Asthma UK.

Frequently Asked Questions (FAQs) about asthma are now available in braille, on tape and on CD, and have been adapted to
include information specifically for people with sight problems, including, for example, suggestions on marking inhalers so
that different coloured devices can be distinguished.

Asthma advice for blind and partially sighted people is currently available via the Asthma UK Adviceline, through its
website, and through taped versions of Asthma Magazine. However, the new FAQs will be a welcome addition to these existing
resources for many people.

‘It’s important that everyone who has asthma knows as much about their condition as possible in order to control their
symptoms effectively,’ said Carol White, one of Asthma UK’s team of nurse specialists.

‘We want to ensure that the information we produce is accessible to everyone, and these new materials will allow us to
provide better support for people with visual impairments.’

The Asthma UK website uses scaleable fonts which users can make larger or smaller through the ‘View’ menu of their browsers,
so text can be read at the most comfortable size. It can also be read using screen readers.

To get hold of the FAQs in braille, on CD or on tape contact the Asthma UK Adviceline (08457 01 02 03; email an asthma nurse).

Asthma UK

AmeriCares Sending Medical Aid To Texas & Mexico

AmeriCares, a nonprofit humanitarian aid organization, is sending medical and infection control supplies to help several Texas health clinics treat and prevent the swine flu. The shipments include face masks, medicines and other vital supplies. Some clinics report patients with flu symptoms while others are taking precautions to prevent the spread of the disease.

“AmeriCares is watching this outbreak very carefully,” said Dr. Frank Bia, AmeriCares Medical Director and an expert in infectious disease. “As swine flu infects more people, it can adapt and become more dangerous, like a hurricane picking up strength over warm water.”

In addition to Texas, AmeriCares recently sent a shipment to Mexico which included medicines, face masks for infection control and nutritional support for people who have been infected. The medicines included antibiotics to help fight the flu, fever and pain reducers to control symptoms and an inhalant to help people with breathing problems.

About AmeriCares:

AmeriCares is a nonprofit international disaster relief and humanitarian aid organization which delivers medicines, medical supplies and aid to people in crisis around the world. Since it was established in 1982, AmeriCares has distributed more than $8 billion in humanitarian aid to 137 countries.

Source: AmeriCares
Further information on Swine Flu

See a Map Of H1N1 Outbreaks
See our Mexico Swine Flu Blog

Findings Suggest That A Biphasic Sleep Schedule Not Only Refreshes The Mind, But Can Make You Smarter

If you see a student dozing in the library or a co-worker catching 40 winks in her cubicle, don’t roll your eyes. New research from the University of California, Berkeley, shows that an hour’s nap can dramatically boost and restore your brain power. Indeed, the findings suggest that a biphasic sleep schedule not only refreshes the mind, but can make you smarter.

Conversely, the more hours we spend awake, the more sluggish our minds become, according to the findings. The results support previous data from the same research team that pulling an all-nighter – a common practice at college during midterms and finals – decreases the ability to cram in new facts by nearly 40 percent, due to a shutdown of brain regions during sleep deprivation.

“Sleep not only rights the wrong of prolonged wakefulness but, at a neurocognitive level, it moves you beyond where you were before you took a nap,” said Matthew Walker, an assistant professor of psychology at UC Berkeley and the lead investigator of these studies.

In the recent UC Berkeley sleep study, 39 healthy young adults were divided into two groups – nap and no-nap. At noon, all the participants were subjected to a rigorous learning task intended to tax the hippocampus, a region of the brain that helps store fact-based memories. Both groups performed at comparable levels.

At 2 p.m., the nap group took a 90-minute siesta while the no-nap group stayed awake. Later that day, at 6 p.m., participants performed a new round of learning exercises. Those who remained awake throughout the day became worse at learning. In contrast, those who napped did markedly better and actually improved in their capacity to learn.

These findings reinforce the researchers’ hypothesis that sleep is needed to clear the brain’s short-term memory storage and make room for new information, said Walker, who presented his preliminary findings on Sunday, Feb. 21, at the annual meeting of the American Association of the Advancement of Science (AAAS) in San Diego, Calif.

Since 2007, Walker and other sleep researchers have established that fact-based memories are temporarily stored in the hippocampus before being sent to the brain’s prefrontal cortex, which may have more storage space.

“It’s as though the e-mail inbox in your hippocampus is full and, until you sleep and clear out those fact e-mails, you’re not going to receive any more mail. It’s just going to bounce until you sleep and move it into another folder,” Walker said.

In the latest study, Walker and his team have broken new ground in discovering that this memory- refreshing process occurs when nappers are engaged in a specific stage of sleep. Electroencephalogram tests, which measure electrical activity in the brain, indicated that this refreshing of memory capacity is related to Stage 2 non-REM sleep, which takes place between deep sleep (non-REM) and the dream state known as Rapid Eye Movement (REM). Previously, the purpose of this stage was unclear, but the new results offer evidence as to why humans spend at least half their sleeping hours in Stage 2, non-REM, Walker said.

“I can’t imagine Mother Nature would have us spend 50 percent of the night going from one sleep stage to another for no reason,” Walker said. “Sleep is sophisticated. It acts locally to give us what we need.”

Walker and his team will go on to investigate whether the reduction of sleep experienced by people as they get older is related to the documented decrease in our ability to learn as we age. Finding that link may be helpful in understanding such neurodegenerative conditions as Alzheimer’s disease, Walker said.

In addition to Walker, co-investigators of these new findings are UC Berkeley post-doctoral fellow Bryce A. Mander and psychology undergraduate Sangeetha Santhanam.

Source:
Yasmin Anwar
University of California – Berkeley

Autism Research Finds Empirical Link Between Multisensory Integration And Autism

A new study by researchers at Albert Einstein College of Medicine of Yeshiva University has provided concrete evidence that children with autism spectrum disorders (ASD) process sensory information such as sound, touch and vision differently than typically developing children.

The study, which appears in the August 17 online issue of Autism Research, supports decades of clinical and anecdotal observations that individuals with ASD have difficulty coping with multiple sources of sensory information. The Einstein finding offers new insights into autism and could lead to objective measures for evaluating the effectiveness of autism therapies.

“One of the classic presentations of autism is the child in the corner with his hands over his ears rocking back and forth trying to block out the environment,” said senior author Sophie Molholm, Ph.D., associate professor in the Dominick P. Purpura Department of Neuroscience and of pediatrics. “People have long theorized that these children might not be integrating information across the senses very well. If you have all these sights and sounds coming at you but you can’t put them together in a meaningful way, the world can be an overwhelming place.”

The theory that autistic kids have trouble processing multisensory information has not been reliably supported by behavioral studies, and has rarely, if at all, been tested using measures of brain activity. Over the last few years, Dr. Molholm and her colleagues have been refining methods for measuring multisensory integration (MSI) using brainwave electroencephalogram (EEG) recordings.

In the current study, MSI was measured in 17 ASD children, ages 6 to 16, and 17 typically developing children matched for age and non-verbal IQ. The children watched a silent video of their choice while they were presented with unrelated sounds and vibrations. The auditory and vibrational stimuli were presented separately (creating so-called unisensory conditions) and then together (multisensory condition), which acted as the researchers’ index of MSI. The children’s EEG responses to the unisensory conditions were summed and compared to their EEG responses to multisensory conditions.

The responses of the typically developing children to the multisensory stimuli exceeded the sum of their responses to the unisensory stimuli an indication of healthy MSI, according to the researchers. In the ASD children, by contrast, the differences between the sum of children’s unisensory responses and their MSI responses were not nearly as pronounced, indicating that these kids were not integrating multisensory information as effectively.

“Our data makes a compelling case, at least for these conditions, that there are differences in multisensory integration between the two groups,” said Dr. Molholm.

After our nerves are stimulated, “sensory information arrives in the brain’s cortex within 20 milliseconds (ms), or 20/1000ths of a second,” said co-author John Foxe, Ph.D., professor in the Dominick P. Purpura Department of Neuroscience and of pediatrics and director of research of the Children’s Evaluation and Rehabilitation Center at Einstein. “Then it takes an additional 100 to 200 ms for the brain to integrate information arriving from different senses, since many brain regions are involved in analyzing it.”

In this study, the differences between the typically developing and ASD children were most striking for that time interval in which multisensory stimuli is normally processed. “We saw robust MSI in the typically developing kids from 100 and 200 ms after sensory stimulation reached the brain’s cortex,” said Dr. Foxe. “But in the ASD kids, MSI occurred significantly later at about 310 ms and at a much lower level.”

“This doesn’t mean that the children with ASD didn’t integrate the information at all,” he added. “It does mean that they didn’t integrate it as effectively as they should have, given their age and maturity. They may go on to integrate well later in life. We don’t know. This is a single slice of the developmental trajectory.”

“This was a much-needed study of multisensory integration in autism,” said Barry E. Stein, Ph.D., professor and chair of neurobiology & anatomy at Wake Forest University School of Medicine, who was not involved in the Einstein study. “Using simple logic and standard techniques for electrically mapping the brain, the authors have identified defects in the way ASD individuals synthesize cues from different senses. In doing so, they have not only helped confirm the insights of parents and clinicians, but they’ve improved our understanding of how the behavioral differences in children with ASD may result from sensory anomalies.”

“Today, there’s a cottage industry actually more like a military-industrial complex for multisensory integration therapies for children with autism,” said Dr. Foxe. “A lot of parents’ hard-earned cash goes into these interventions, all in the absence of actual empirical evidence that there is anything wrong with MSI in these children or that these therapies do any good.”

The researchers are currently evaluating MSI in children from 6 years of age through early adulthood to better understand the developmental trajectory of multisensory integration. They also plan to study MSI in lower-functioning ASD children. “This experimental paradigm is especially good for that, because it makes so little demand on the kids,” said Dr. Foxe. “As you can imagine, asking them to do tasks doesn’t work very well.”

Dr. Molholm and Dr. Foxe’s study, “Multisensory processing in children with autism: high-density electrical mapping of auditory-somatosensory integration,” appears in the August 17 online issue of Autism Research. The first author is Natalie Russo, Ph.D., a post-doctoral fellow with Dr. Molholm and Dr. Foxe. The other co-authors are doctoral students Alice Brandwein and Ted Altschuler, and Hilary Gomes, Ph.D., a professor in psychology at the City College of New York.

Support for this research was provided by Cure Autism Now, the National Institute of Mental Health, the Wallace Research Foundation and the Canadian Institute of Health Research.

Source: Albert Einstein College of Medicine of Yeshiva University

Moldy Homes A Serious Risk For Severe Asthma Attacks In Some

Exposure to high levels of fungus may increase the risk of severe asthma attacks among people with certain chitinase gene variants, according to a study from Harvard Medical School, Harvard Pilgrim Health Care Institute and Brigham and Women’s Hospital.

The research was published online on the American Thoracic Society’s journal Web site ahead of the print edition of the American Journal of Respiratory and Critical Care Medicine.

“We found that the interaction between environmental mold exposure and certain variants of chitinase genes were positively associated with severe asthma exacerbations requiring hospitalization,” said lead researcher, Ann Wu, assistant professor at the at Harvard Medical School and Harvard Pilgrim Health Care Institute.

Chitinases break down chitin, a component in many fungi, and are induced during allergic inflammation. It has been suggested by past research that these could be biomarkers of inflammation. Moreover, certain variants of chitinase genes are known to be expressed more heavily in people with asthma.

The researchers used data from the Childhood Asthma Management Program, a multicenter trial that enrolled children between the ages of 5 and 12 with mild to moderate persistent asthma. Mold measures were taken in the subjects’ homes at the beginning of the study, and homes were classified as having greater or less than 25,000 mold colonies per gram of household dust.

“This level of mold in dust is high for a residential environment. However, it is not likely to be easily recognized. Studies have shown that homes that have problems with dampness (e.g. visible mold on walls/ceilings, water collection in basement, etc.) have higher levels of mold, but there is no specific level that is currently accepted to ’cause’ problems,” said Dr. Wu.

Finally, using blood samples, the researchers genotyped all the single nucleotide polymorphisms-SNPs, or variants in which just a single “letter” of the DNA code in a given gene is different-of chitinase genes and a chitinase-like gene within the study population.

They then analyzed the appearance of different variations of chitinase genes with level of mold exposure and number of hospital visits from severe asthma exacerbations. They found that certain variants of the chitinase gene CHIT1, in conjunction with high mold exposure, were associated with increased risk of severe asthma attacks.

“Our results support increasing evidence that CHIT1, which is primarily expressed in the lung, plays an important role in the pathophysiology of asthma in the proper environmental context of exposure to chitin, which was approximated by mold levels,” said Dr. Wu. “To our knowledge this was the first study to examine the effect of mold levels on the association of SNPs in the genes of both chitinases and chitinase-like proteins with asthma and allergy-related phenotypes.”

Chitinases may play a role in future targets for asthma therapy. Inhibition of chitinase enzymatic activity has been demonstrated to prevent hyper-responsiveness and inflammation in mice. It is plausible, said Wu, that therapeutics designed to block chitinase enzyme activity may prevent hyper-responsiveness and inflammation related to asthma.

“Future research should focus on expanding and replicating these findings,” she said. “The focus should be on mechanisms of chitinases and chitinase-like proteins in allergic inflammation. Additionally, finding other genes that may interact with mold exposure will also be important. We plan to find a population to replicate these findings. Additionally, we are preparing to perform a Genome-Wide Association Study in this same population to identify other genes that may interact with mold exposure.”

Source: American Thoracic Society (ATS)

Southern California Wildfires Pose Health Risks To Children

In October of 2003, multiple wildfires raged throughout Southern California. Now, researchers at the University of Southern California (USC) report that residents without asthma in wildfire-endangered regions suffered as much as those with asthma.

The findings appear in the Dec. 1 print issue of the American Journal of Respiratory and Critical Care Medicine. The study is the subject of the journal’s cover story and is accompanied by an editorial Sverre Vedal, M.D. of the University of Washington School of Public Health and Community Medicine.

Using existing populations from the ongoing USC-led Children’s Health Study (CHS), researchers led by Nino K’nzli, M.D.,Ph.D., associate professor of preventive medicine at the Keck School of Medicine of USC, sent questionnaires to thousands of residents in 16 cities covered by the Children’s Health Study. These ranged from Alpine in San Diego County north to Atascadero.

“The Children’s Health Study is a valuable study for us,” says K’nzli. “The smoke from the fires that year came as a very strong additional problem to the smog and airborne particulates we normally see affecting the health of our children. It was vital for us to understand how and where the fires affected the participants of the CHS study.”

The October 2003 fires covered more than 3,000 square miles and destroyed 3,640 homes. Plumes of smoke dominated the region for several days raising particulate matter 10 to 20 times normal levels.

While many previous wildfire studies had focused on hospital admissions and emergency room visits, there had been less research into the consequences of wildfire smoke on children’s health. Since many communities affected by the fires were already associated with the Children’s Health Study, K’nzli and colleagues saw an opportunity to better assess the effects of the wildfires in an exceptionally large study.

While some of what they found was to be expected – increased nose, eye, throat irritations, for instance – what was surprising was that the relative increase in symptoms tended to be strongest among those without asthma.

“Children with asthma were more likely to take preventive action, such as wearing masks or staying indoors during the fire,” says K’nzli. “It appears that taking preventive action might indeed have reduced the health problems.’

While it is difficult to rigorously evaluate the effects of potentially protective measures such as wearing masks or staying indoors in such a study as this, the data do imply that simple protective measures as promoted by public agencies appears to reduce the health consequences, suggests K’nzli.

“One thing this study shows us is that during severe wildfires, children who do not have asthma may be experiencing what it is like to live with asthma,” he says. “That’s not to say that asthmatics weren’t affected. In fact, for several symptoms, we saw that asthmatics have as many health problems during times without fire smoke than what non-asthmatics reported for the days with the highest levels of smoke.”

The findings are a step towards further investigations into identifying those at highest risk to wildfires and other airborne pollutants such as smog. “It also appears that smoke, whether it be from fires or tobacco (as seen in previous CHS studies) is unlikely to pose the same health threat to all people. Identifying those at highest risk – due to genetic or other similar factors – is an important next step,” says K’nzli.

The study was funded by the South Coast Air Quality Management District (AQMD), National Institute of Environmental Health Sciences, and the Hastings Foundation.

Health Effects of the 2003 Southern California Wildfire on Children, Nino K’nzli, Ed Avol, Jun Wu, W. James Gauderman, Ed Rappaport, Joshua Millstein, Jonathan Bennion, Rob McConnell, Frank D. Gilliland, Kiros Berhane, Fred Lurmann, Arthur Winer and John M. Peters. Am J Respir Crit Care Med Vol 174. pp 1221-1228, 2006. Originally Published in Press as DOI: 10.1164/rccm.200604-519OC on August 31, 2006

Contact: Jennifer Chan

University of Southern California

Abbott’s HUMIRA® Receives FDA Approval for Inhibiting Structural Joint Damage and Improving Physical Function in Patients with Arthritis

Abbott announced today that the U.S. Food and Drug Administration (FDA) approved an expanded indication for HUMIRA® (adalimumab) that includes inhibiting structural joint damage and improving physical function in patients with psoriatic arthritis (PsA). The expanded indication is in addition to the psoriatic arthritis approval granted in October 2005.

HUMIRA is also approved in the U.S. for use in moderate to severe rheumatoid arthritis (RA) and active ankylosing spondylitis (AS).

PsA is a chronic disease that combines symptoms of arthritis, including joint pain and inflammation, and those of psoriatic skin disease, such as painful, raised red lesions covered by silvery white scales. Approximately one million men and women suffer from PsA in the United States and, when left untreated, the disease can be potentially disabling. Early recognition, diagnosis and treatment of PsA can relieve pain and inflammation and possibly help inhibit extensive joint involvement and damage in later stages of the disease.

“Psoriatic arthritis can be debilitating for many people, hindering everyday activities. For these people, and others, the new indication for HUMIRA is welcome news to our community,” said Gail Zimmerman, president and CEO of the National Psoriasis Foundation.

Study Results

The expanded indication is based on results from an extension of the Adalimumab Effectiveness in Psoriatic Arthritis Trial (ADEPT), the largest randomized, placebo-controlled biologic trial in PsA. ADEPT was a Phase III, controlled study in 313 patients with moderate to severe PsA, who had an inadequate response to NSAID (non-steroidal anti-inflammatory drug) therapy. Patients were randomized to receive either HUMIRA 40 mg every other week or placebo. At week 24, 285 patients elected to enroll in a 24-week open-label extension.

Progression of Structural Joint Damage

Patients taking HUMIRA experienced significantly less joint damage than patients taking placebo. Joint damage was assessed with X-rays taken at baseline and weeks 24 and 48, using the modified total Sharp score (mTSS), a measure of joint damage progression. A smaller change in mTSS reflects less progression of joint damage, with a positive score indicating worse radiographic damage. At week 24, the co-primary endpoint (the average change in joint damage, as measured by a mean change in mTSS) was 10 times greater in the placebo arm than in the HUMIRA arm (0.9 and -0.1, respectively; p

Physical Function

Patients taking HUMIRA showed significant improvement in physical function as assessed by the Health Assessment Questionnaire Disability Index (HAQ) score and the Short Form-36 Health Status Survey (SF-36). HAQ scores assess a patient’s ability to perform daily activities such as getting dressed, walking and climbing stairs. Statistically significant improvements in HAQ were achieved by patients in the HUMIRA group compared to placebo at week 24 (p

Urban Sediments After Hurricanes Katrina, Rita Contained High Levels Of Contaminants

In the first study to evaluate urban sediments after a natural disaster, scientists have found that floodwaters in New Orleans from Hurricanes Katrina and Rita in August and September 2005, contained high levels of fecal indicator bacteria and microbial pathogens.

The scientists collected water and sediment samples from the interior canal and shoreline of New Orleans and the offshore waters of Lake Pontchartrain, which showed higher-than-normal levels of bacteria and pathogens. Levels of the microbes fell within a few weeks after flooding had completely subsided.

“Our findings emphasize the importance of including environmental monitoring in disaster management plans,” said Helena Solo-Gabriele, an environmental engineer at the University of Miami and co-author of the study. “A rapid assessment of conditions can protect emergency workers and residents from potential illnesses that could result from exposure.”

The scientists–funded by the National Science Foundation (NSF) and affiliated with the University of Miami’s Rosenstiel School of Marine & Atmospheric Science (RSMAS) and other institutions–report their results in the Proceedings of the National Academy of Sciences. The paper, co-authored by 19 scientists and titled, “Impacts of Hurricanes Katrina and Rita on the Microbial Landscape of the New Orleans Area,” provides insights into public health and human exposure to both inhaled and ingested pathogens from sewage-contaminated floodwaters induced by hurricanes.

“We know that hurricanes bring infectious disease, chemical contamination and death in their wake,” said Don Rice, director of NSF’s chemical oceanography program, which funded the research. “Now we are making a concerted effort to study and understand the connections.”

During the hurricanes, a high volume of water flowed into cities in their paths. Residents were exposed to flood waters for a long period, say the researchers. The most contaminated area tested, near the New Orleans Superdome, contained high levels of sewage pathogens.

Scientists from RSMAS’ Center for Oceans and Human Health, funded by NSF and the National Institutes of Health, along with researchers at five other universities analyzed water and sediment samples collected as the floodwaters receded from New Orleans during the 2 months after the 2005 hurricanes.

The researchers point out that monitoring efforts should focus on evaluating the impacts of sediments within an area affected by hurricane floodwaters, as exposure to contaminated sediments, by inhaling or ingesting, could result in health risks. Efforts should include monitoring pathogens in addition to indicator microbes–those that aren’t themselves harmful but are known to exist alongside pathogens.

Improvements should focus, the scientists say, on reducing sewage contamination from groundwater seepage and storm water drainage in the region.

The National Science Foundation (NSF) is an independent federal agency that supports fundamental research and education across all fields of science and engineering, with an annual budget of $5.58 billion. NSF funds reach all 50 states through grants to nearly 1,700 universities and institutions. Each year, NSF receives about 40,000 competitive requests for funding, and makes nearly 10,000 new funding awards. The NSF also awards over $400 million in professional and service contracts yearly.

Useful NSF Web Sites:

NSF Home Page: nsf/

NSF News: nsf/news/

Science and Engineering Statistics: nsf/statistics/

Awards Searches: nsf/awardsearch/

Contact: Cheryl Dybas

National Science Foundation

40% Perth six-year-olds suffer asthma, Australia

A conference on air pollution has been told that 40 per cent of Perth children suffer from asthma by the time they reach
six years of age.

Professor Peter Sly, from the Institute For Child Health Research, was a keynote speaker at the conference organised by the
Conservation Council.

He revealed the figures.

Council spokeswoman Sue Graham-Taylor says there can be little doubt most of the blame lies with atmospheric pollution.

She says children are no safer inside the family home.

“The impacts of the products we use, the furniture we buy, the paints we use, the formaldehyde, the glues in our furniture,
the impacts on our health can hang around for years,” she said.

“I was quite alarmed at the fact that tobacco smoke is still a major factor and just our general lifestyles, in our homes.”

Nationwide Study Finds Long-Term Ozone Exposure Linked To Higher Risk Of Death

Long-term exposure to ground-level ozone, a major component of smog, is associated with an increased risk of death from respiratory ailments, according to a new nationwide study led by a researcher at the University of California, Berkeley.

The study, to be published in the March 12 issue of the New England Journal of Medicine, analyzed the risk of death for both ozone and fine particulate matter, two of the most prevalent components of air pollution. The study followed nearly 450,000 people for two decades and covered 96 metropolitan regions in the United States.

The researchers found that people living in areas with the highest concentrations of ozone, such as the Los Angeles metropolitan area and California’s Central Valley, had a 25 to 30 percent greater annual risk of dying from respiratory diseases compared with people from regions with the lowest levels of the pollutant. Those locations included the Great Plains area and regions near San Francisco and Seattle.

“This is the first time we’ve been able to connect chronic exposure to ozone, one of the most widespread pollutants in the world, with the risk of death, arguably the most important outcome in health impact studies used to justify air quality regulations,” said study lead author Michael Jerrett, UC Berkeley associate professor of environmental health sciences. “Previous research has connected short-term or acute ozone exposure to impaired lung function, aggravated asthma symptoms, increased emergency room visits and hospitalizations, but the impact of long-term exposure to ozone on mortality had not been pinned down until now.”

The study found that for every 10 parts-per-billion (ppb) increase in ozone level, there is a 4 percent increase in risk of death from respiratory causes, primarily pneumonia and chronic pulmonary obstructive pulmonary disease.

“World Health Organization data indicate that about 240,000 people die each year from respiratory causes in the United States,” said Jerrett. “Even a 4 percent increase can translate into thousands of excess deaths each year. Globally, some 7.7 million people die from respiratory causes, so worldwide the impact of ozone pollution could be very large.”

The findings come a year after the U.S. Environmental Protection Agency (EPA) strengthened its National Ambient Air Quality Standards for ground-level ozone from an annual average of 80 ppb to 75 ppb to reflect growing evidence of the harmful health effects of ozone. A group of leading scientists appointed to advise the EPA had actually recommended stricter health standards for ozone levels – from 60 to 70 ppb.

A month after the EPA released its new standards, a National Research Council report concluded that premature deaths related to ozone exposure of less than 24 hours are more likely among those with pre-existing diseases. The report called for more research on the link between mortality and ozone exposure over a period of weeks and years.

Ozone – gas made up of three oxygen atoms – forms a protective layer from the sun’s ultraviolet radiation when located in the Earth’s upper atmosphere. However, that same gas is toxic at ground level where it can be breathed by humans. Ground level ozone is formed through a complex chemical reaction in sunlight between nitrogen oxides (NOx), commonly spewed from vehicle exhaust, and industrial factory emissions.

The Intergovernmental Panel on Climate Change considers ground-level ozone, along with carbon dioxide and methane, to be one of the primary greenhouse gases in the Earth’s atmosphere.

“Ozone levels outdoors are not always highly correlated to ozone levels indoors, making it difficult to fully evaluate associations between ozone and health outcomes using ambient site monitors,” said study co-author C. Arden Pope III, professor of economics at Brigham Young University. “The reality is that most of us spend the majority of our time indoors. But this study suggests that repeated exposures to elevated ozone levels over time have cumulative effects on respiratory health.”

The new study analyzed data from 448,850 adults ages 30 and older enrolled in 1982 and 1983 in the American Cancer Society Cancer Prevention Study II.

The researchers correlated the information from that study with data from EPA air pollution monitors while controlling for potentially confounding factors such as a participant’s age, race, education, occupational exposures, smoking history and diet. The study also factored in other variables such as unemployment rates in the metropolitan and zip code area levels.

Ozone data were obtained from 1977 through 2000 between the months of April and September. Those months were chosen because ozone levels are typically higher when it’s warmer and because insufficient data was available during the cooler months.

Researchers included EPA measurements of fine particulate matter – particles equal to or smaller than 2.5 micrometers in diameter and typically found in smoke and haze – when they became available in 1999 and 2000. Because fine particle levels had already been linked to increased risk of premature death in previous studies, the researchers included them in the analysis to distinguish the effects of the two pollutants.

In an 18-year follow-up period, 48,884 of the people in the study died from cardiovascular causes such as heart disease and strokes, and 9,891 died from respiratory causes.

As has been observed in previous studies, the researchers found that fine particulate matter was linked to an increased risk of death from cardiovascular causes when analyzed alone and with ozone. The new finding was that the effects of ozone remained strongly linked to risk of death from respiratory problems, even after fine particle pollution was taken into account.

Not surprisingly, highly populated regions such as the Los Angeles, Riverside and Houston areas, where the climate is sunny for much of the year and the air mass is relatively stable, had the highest average concentrations of ozone, ranging from 62.5 to 104 ppb. The regions with the lowest ozone levels had average concentrations of 33.3 to 53.1 ppb.

“Places like the Pacific Northwest and the Minneapolis St. Paul region are cooler and see more rain in the summer, which keeps the ozone levels in check,” said Jerrett. “Similarly, the San Francisco Bay Area’s infamous summertime fog blocks the sun and helps protect the region from high ozone levels.”

Because ozone formation depends on a complex interaction of multiple factors, it is challenging to regulate, the study authors said. “Our study for the first time presents evidence suggesting that long-term exposure to ozone and fine particle pollution have separate, independent effects on mortality, and that they seem to impact different parts of the body,” said Jerrett. “With this research, we now know that controlling ozone is not only beneficial for mitigating global warming, but that it could also have near-term benefits in the reduction of deaths from respiratory causes.”

Notes:

Other co-authors of the paper are Richard Burnett from Health Canada, the federal health department headquartered in Ottawa; Kaz Ito and George Thurston from the New York University School of Medicine; Daniel Krewski and Dr. Yuanli Shi from the University of Ottawa; and Eugenia Calle and Dr. Michael Thun from the American Cancer Society.

The Health Effects Institute, a non-profit research organization based in Boston, Mass., helped support this research.

An EPA list of where U.S. counties stand in compliance with the current federal ozone standards is available at epa/air/ozonepollution/pdfs/2008_03_design_values_2004_2006.pdf.

Source: Sarah Yang

University of California – Berkeley