Endnotes

1. The size of the particle pollution under discussion here is PM2.5, also called fine particles or fine particulates. These particles are classified and monitored by size, being 2.5 microns and smaller in diameter. More explanation of these particles, their origins and health effects can be found in the chapter Health Effects of Ozone and Particle Pollution.

2. EPA. National Air Quality and Emissions Trends Report, 2003 Special Studies Edition. Washington, DC.: U.S. Government Printing Office, 2003. EPA Publication No. 454/R-03-005. http://www.epa.gov/oar/aqtrnd03/.

3. EPA. Section 126 Rule: Revised Deadlines. 2002. 40 CFR 97 63:21522-30.

4. See Appendix A for a complete discussion of the methodology for assessing these levels.

1. Because of changes to the boundaries of Metropolitan Statistical Areas in 2003, some counties which were included in one metropolitan area in the 2003 report are now included in another metropolitan area. For that reason, comparisons between rankings from the 2003 report and these lists may be difficult.

2. California has a more protective standard for year-round particle pollution, (annual PM2.5,) than does the rest of the nation. California's standard is set at 12 µg/m3, lower than the US standard of 15 µg/m3. The grading reported in the text for yearround exposure to particles is based on the more lenient US standard.

1. Bell ML, Davis DL, Fletcher T. A Retrospective Assessment of Mortality from the London Smog Episode of 1952: The Role of Influenza and Mortality. Environ Health Perspect 2004 ; 112:6-8.

2. Bell ML, Davis DL Reassessment of the Lethal London Fog of 1952: Novel Indicator of Acute and Chronic Consequences of Acute Exposure to Air Pollution. Environ Health Perspect 2001:389-394.

3. Bell and Davis 2001. Bell ML, Davis DL, Fletcher T. 2004.

4. Brunekreef, Burt. Air Pollution and Life Expectancy: Is There a Relation? Occup Environ Med 1997 Nov; 54(11):781-4. Pope, CA. Epidemiology of Fine Particulate Air Pollution and Human Health: Biological Mechanisms and Who’s at Risk? Environ Health Perspect 2000: 108 (suppl 4):713-723.

5. The data are collected over varying periods determined by EPA and the States. Some are collected each day, some are every other day, some every 3 days, still others every 6 days. For each day of data collected, a 24-hour average is then reported. Based on the data collected over a year and following the approved EPAprotocol, the annual average is then determined. This process is greatly simplified here. For more details, see EPA’s website.

6. U.S. EPA. Air Quality Criteria for Particulate Matter, Table 3-15. Comparison of Ambient Fine and Coarse Mode Particles. EPA/600/P-95/001aF April 1996.

7. U.S. EPA. Air Quality Criteria for Particulate Matter. April 1996.

8. Dockery DW, Pope CA, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG, Speizer FE. An Association Between Air Pollution and Mortality in Six U.S. Cities. NEJM 1993;329:1753-9.

9. Pope CA, Thun MJ, Namboodiri MM, Dockery DW, Evans JS, Speizer FE, Heath CW. Particulate Air Pollution as a Predictor of Mortality in a Prospective Study of U.S. Adults . Am J Respir Crit Care Med 1995;151:669-74.

10. Krewski D, Burnett RR, Goldberg MS, Hoover K, Siemiatycki J, Jerrett M, Abrahamowicz M, White WH, Others. Reanalysis of the Harvard Six Cities Study and the American Cancer Society Study of Particulate Air Pollution and Mortality. Health Effects Institute 2000 July.

11. Nenmar A, Hoet, PHM, Vanquickenborne B, Dinsdale D, Thomeer M, Hoylaerts MF, Vanbillioen H, Mortelmans L, Nemery B. Passage of Inhaled Particles in to the Blood Circulation in Humans. Circulation 2002; 105:411-414.

12. Churg A Brauer M, Avila-Casado MdC, Fortoul TI, Wright JL. Chronic Exposure to High Levels of Particulate Air Pollution and Small Airway Remodeling. Environ Health Perspect 2003 May;111:5: 714-718.

13. Zanobetti A, Schwartz J, Samoli E, Gryparis A, Tuoloumi G, Peacock J, Anderson RH, Le Tertre A, Bobros J, Celko M, Goren A, Forsberg B, Michelozzi P, Rabczenko D, Perez Hoyos S, Wichmann HE, Katsouyanni K. The Temporal Pattern of Respiratory and Heart Disease Mortality in Response to Air Pollution. Environl Health Perspect 2003;111:1188-1193. Dominici F, McDermott A, Zeger SL, Samet JM. Airborne Particulate Matter and Mortality: timescale effects in four US cities. Am. J. Epidemiol 2003;157, 2:1055-1065.

14. Dominici F, McDermott A, Zeger SL, Samet JM. On the Use of Generalized Additive Models in Time-Series Studies of Air Pollution and Health. Am. J. Epidemiol 2002;156, 3:193-203.

15. Hong, Y.-C., Lee J.-T., Kim, H., Ha, E.-H., Schwartz, J., and Christiani, D.C. Effects of Air Pollutants on Acute Stroke Mortality. Environ. Health Perspect. Vol. 110, pp. 187-191, 2002.

16. Tsai SS, Goggins WB, Chiu HF, Yang CY. Evidence for an Association Between Air Pollution and Daily Stroke Admissions in Kaohsiung, Taiwan. Stroke . 2003; 34(11):2612-6. Epub 2003 Oct 09.

17. D’Ippoliti D, Forastiere F, Ancona C, Agabity N, Fusco D, Michelozzi P, Perucci CA. Air Pollution and Myocardial Infarction in Rome: a case-crossover analysis. Epidemiology 2003;14:528-535.

18. Ghio AJ, Kim C, Devlin RB. Concentrated Ambient Air Particles Induce Mild Pulmonary Inflammation in Healthy Human Volunteers. Am J Respir Crit Care Med 2000; 162(3 Pt 1):981-8.

19. Metzger KB, Tolbert PE, Klein M, Peel JL, Flanders WD, Todd K, Mulholland JA, Ryan PB, Frumkin H. Ambient Air Pollution and Cardiovascular Emergency Department Visits in Atlanta, Georgia, 1993-2000. Epidemiology 2004;15:46-56.

20. Van Den Eeden SK, Quesenberry CP Jr, Shan J, Lurmann F. Particulate Air Pollution and Morbidity in the California Central Valley: a high particulate pollution region. Final Report to the California Air Resources Board, Contract 97-303, July 12, 2002.

21. Lin M, Chen Y, Burnett RT, Villeneuve PJ, Kerwski D. The Influence of Ambient Coarse Particulate Matter on Asthma Hospitalization in Children: case-crossover and time-series analyses. Environ. Health Perspet 2002;110:575-581.

22. Norris G, YoungPong SN, Koenig JQ, Larson TV, Sheppard L, Stout JW. An Association Between Fine Particles and Asthma Emergency Department Visits for Children in Seattle. Environ Health Perspect 1999;107:489-493

23. Tolbert PE, Mulholland JA, MacIntosh DD, Xu F, Daniels D, Devine OJ, Carlin BP, Klein M, Dorley J, Butler AJ, Nordenberg DF, Frumkin H, Ryan PB, White MC. Air Quality and Pediatric Emergency Room Visits for Asthma in Atlanta, Georgia. Am J Epidemiol 2000; 151:798-810.

24. Slaughter JC, Lumley T, Sheppard L, Koenig JQ, Shapiro, GG. Effects of Ambient Air Pollution on Symptom Severity and Medication Use in Children with Asthma. Ann Allergy Asthma Immunol 2003; 91:346-53.

25. Pope CA III. Epidemiology of Fine Particulate Air Pollution and Human Health: biological mechanisms and who’s at risk? Environ Health Perspect 2000;108: 713-723.

26. Lin S, Munsie JP, Hwang SA, Fitzerald E, Cayo MR. Childhood Asthma Hospitalization and Residential Exposure to State Route Traffic. Environ Res 2002; 88:73-81.

27. Avol EL, Gauderman WJ, Tan SM, London SJ, Peters JM. Respiratory Effects of Relocating to Areas of Differing Air Pollution Levels. Am J RespirCrit Care Med 2001;164:2067-2072.

28. Gauderman WJ, Gilliland GF, Vora H, Avol E, Stram D, McConnell R, Thomas D, Lurmann F, Margolis HG, Rappaport EB, Berhane K, Peters JM. Association between Air Pollution and Lung Function Growth in Southern California Children: results from a second cohort. Am J Respir Crit Care Med 2002;166:76-84.

29. Churg, ABrauer, M, Avila-Casado, MdC, Fortoul TI, Wright JL. Chronic Exposure to High Levels of Particulate Air Pollution and Small Airway Remodeling. Environ Health Perspect 2003; 111:714-718.

30. Pope CA, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K, Thurston GD. Lung Cancer, Cardiopulmonary Mortality, and Long-Term Exposure to Fine Particulate Air Pollution, JAMA 2002;287:9.

31. Pope CA III, Burnett RT, Thurston GD, Thun MJ, Calle EE, Krewski D, Godleski JJ. Cardiovascular Mortality and Year-round Exposure to Particulate Air Pollution: epidemiological evidence of general pathophysiological pathways of disease. Circulation . 2004; 109:71-77.

32. Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of Changes in Transportation and Commuting Behaviors During the 1996 Summer Olympic Games in Atlanta on Air Quality and Childhood Asthma. JAMA 2001;285:897-905.

33. Gent JF, Triche EW, Holford TR, Belanger K, Bracken MB, Beckett WS, Leaderer BP. Association of Low-Level Ozone and Fine Particles with Respiratory Symptoms in Children with Asthma. JAMA 2003;290:1859-1867. Desqueyroux H, Pujet JC, Prosper M, Squinazi F, Momas I. Short-Term Effects of Low-Level Air Pollution on Respiratory Health of Adults Suffering from Moderate to Severe Asthma. Environl Res 2002;89:29-37 and Burnett RT, Brook JR, Yung WT, Dales RE, Krewski D. Association between Ozone and Hospitalization for Respiratory Diseases in 16 Canadian Cities. Environl Res 1997;72:24-31.

34. Desqueyroux H, Pujet JC, Prosper M, Le Moullec Y, Momas I. Effects of Air Pollution on Adults with Chronic Obstructive Pulmonary Disease. Arch Environ Health. 2002;57:554-560. Höppe P. Peters A, Rabe G, Praml G, Lindner J, Jakobi G, Fruhmann G, Nowak D. Environmental Ozone Effects in Different Population Subgroups. Int J Hyg Environ Health. 2003; 206:505-516.

35. Friedman, JAMA 2001.

36. Gent JF, Triche EW, Holford TR, Belanger K, Bracken MB, Beckett WS, Leaderer BP. Association of Low-Level Ozone and Fine Particles with Respiratory Symptoms in Children with Asthma. JAMA 2003; 290:1859-1867.

37. Thurston GD, Bates DV. Air Pollution as an Underappreciated Cause of Asthma Symptoms. JAMA 2003; 290:1915-1917.

38. McConnell R, Berhane K Gilliland F, London SJ, Islam T, Gauderman WJ, Avol E, Margolis HG, Peters JM. Asthma in Exercising Children Exposed to Ozone. Lancet 2002; 359:386-91.

39. McDonnell WF, Abbey DE, Nishino N, Lebowitz MD. Yearround Ambient Ozone Concentration and the Incidence of Asthma in Nonsmoking Adults: the ashmog study. Environl Res 1999; 80:110-121.

40. Chen L, Jennison BL, Yang W, Omaye ST. Elementary School Absenteeism and Air Pollution. Inhal Toxicol 2000; 12:997-1016. Gilliland FD, Berhane K, Rappaport EB, Thomas DC, Avol E, Gauderman WJ, London SJ, Margolis HG, McConnell R, Islam KT, Peters JM. The Effects of Ambient Air Pollution on School Absenteeism Due to Respiratory Illness. Epidemiology 2001;12:43-54.

41. Delfino RJ, Murphy-Moulton AM, Becklake MR. Emergency Room Visits for Respiratory Illnesses among the Elderly in Montreal: association with low level ozone exposure. Environl Res 1998; 76:67-77.

42. Galizia A, Kinney PL. Year-round Residence in Areas of High Ozone: association with respiratory health in a nationwide sample of nonsmoking young adults. Environ Health Perspect 1999;107:675-679.

43. Peters JM, Avol E, Gauderman WJ, Linn WS, Navidi W, London SJ, Margolis H, Rappaport E, Vora H, Gong H, Thomas DC. A Study of Twelve Southern California Communities with Differing Levels and Types of Air Pollution. II. Effects on Pulmonary Function. Am J Respir Crit Care Med 1999; 159:768-775.

1. 42 U.S.C. §7401 (b) (1).

2. EPA data show declines nationally since the 1980s for all major pollutants. However, during the 1990s, EPA data showed no change in ozone nationwide. EPA. National Air Quality and Emissions Trends Report, 2003 Special Studies Edition. Washington, DC.: U.S. Government Printing Office; 2003. EPA Publication No. 454/R-03-005. http://www.epa.gov/oar/aqtrnd03/.

3. EPA. National Air Quality and Emissions Trends Report, 2003.

4. These six pollutants are ozone, particulates (particle pollution), nitrogen oxides, sulfur dioxide, carbon monoxide and lead. 42 U.S.C. § 7409(b) (1) and (d)(1).

5. EPA. NTC Fact Sheets On The New Ozone (Smog) And Particulate (Soot) Air Quality Standards To Be Signed Today By EPAAdministrator Carol M. Browner. July 16, 1997.

6. Abt Associates. The Particle Related Benefits of Reducing Power-Plant Emissions. Prepared for the Clean Air Task Force. October 2000. Available at www.cleartheair.org.

7. EPA. "Discussion of Multi-Pollutant Strategy," Meeting with the Edison Electric Institute, September 18, 2001, "Comparison of Requirements Under Business-as-usual and the Straw Proposal," page 10. http://www.cleartheair.org/currentstatus.pdf. EPA. December 4, 2001, Supplemental presentation to Edison Electric Institute on mercury. http://www.cleartheair/epamercury.pdf.

8. EPA. Rule to Reduce Interstate Transport of Fine Particulate Matter and Ozone (Interstate Air Quality Rule); Proposed Rule. Federal Register 69: 4566-4650. January 30, 2004.

9. Solomon, Gina et al. No Breathing in the Aisles: Diesel Exhaust Inside School Buses . Natural Resources Defense Council and the Coalition for Clean Air. January 2001.

10. EPA. Press Release: Bush Administration Proposes Major New Funding to Reduce School Bus Emissions. January 30, 2004.

11. American Lung Association and Environmental Defense. Closing the Diesel Divide: Protecting Public Health from Diesel Air Pollution. 2003.

12. EPA. Regulatory Announcement: Public Health and Environmental Benefits of EPA’s Proposed Program for Low-Emission Nonroad Diesel Engines and Fuel. April 2003.

2. EPA. National Air Quality and Emissions Trends Report, 2003 Special Studies Edition. Washington, DC.: U.S. Government Printing Office; 2003. EPA Publication No. 454/R-03-005. http://www.epa.gov/oar/aqtrnd03/.

3. EPA Trends Report 2003.

4. EPA Trends Report 2003. Table A-13: National Air Quality Trends Statistics by EPA Region 1991-2000.

5. EPA Trends Report 2003.

6. US EPA, Finding of Significant Contribution and Rulemaking for Certain States in the Ozone Transport Assessment Group Region for Purposes of Reducing Regional Transportation of Ozone, 40 CFR Parts 51, 72, 75 and 96.

7. EPA. Section 126 Rule: Revised Deadlines. 2002. 40 CFR 97 63:21522-30.

8. Notes from the New Brunswick Lung Association, 2003. One of the groups working to reduce cross border ozone transport, is the Lung Associations’ International Centre for Air Quality and Human Health created by the American Lung Association of Maine and the New Brunswick (Canada) Lung Association. The Centre promotes actions to reduce emissions and improve air quality for the people in the six New England states and in five eastern Canadian provinces. Actions high in the Centre’s priorities are assessing the region’s air quality and health impacts, facilitating research and educating the public.

9. Correspondence from Kevin Stewart, American Lung Association of Pennsylvania, February 5, 2003.

10. Communication from the American Lung Association of California, January 2003.

11. EPA, National Environmental Trends Database, 1999 data.

12. Office of Highway Policy Information, Federal Highway Administration, Highway Statistics 2001.

13. EPA, National Emissions Trends database, 1999 data. http://www.epa.gov/air/data/index.html.

14. All data on sources of VOCs, NO x , and PM 2.5 by region are from the EPA, National Emissions Trends database, 1999 data.

15. All data on 1983-2002 trend analysis are from EPA Trends Report 2003.

16. All discussion of trends in ozone is from the same source, EPA Trends Report 2003. Table A-13: National Air Quality Trends Statistics by EPA Region 1991-2000.

17. California Air Resources Board. Air Quality Almanac, 2002.