Achilles’ Heel

Abstract

S18: Landmarks of Air Pollution Epidemiology: Legacy of Douglas Dockery, Beatrix Theater, August 27, 2019, 1:30 PM - 3:00 PM In the early 1970’s, criticisms were raised regarding the limited exposure assessment in U.S. Environmental Protection Agency’s (EPA’s) Community Health and Environmental Surveillance System study in Chattanooga, TN. Subsequently, after the 1974 oil embargo, the Harvard Six Cities Study was proposed by Drs. Ferris and Speizer as an intervention study to assess the health impact of an anticipated increase in coal-related air pollution. As implemented by Drs. Dockery and Spengler, this was the first multi-city study with 1-in-2-day, central site measurements of ambient fine particulate matter (PM2.5) using the Harvard Impactor along with indoor measurements of PM2.5 and nitrogen dioxide in children’s homes. Although the anticipated increases in air pollution did not occur, time-series analysis of the impact of PM2.5 on daily mortality in these six cites made a major contribution to setting EPA’s 1997 daily National Ambient Air Quality Standard (NAAQS) for PM2.5 and a subsequent survival analysis was supportive of the annual PM2.5 NAAQS. In a joint Harvard-EPA component, the ambient PM2.5 filters were assessed with X-ray fluorescence to measure the elemental composition of particles and thereby assess the health impact of specific sources of fine particles. The subsequent Harvard-Health Canada 24-Cities Study was the first multi-city study with daily measurements of PM2.5 particle acidity using an annular denuder and, in State College, PA, daily counts of speciated fungal spores. Subsequently, in a series of intervention studies in multiple countries, Dr. Dockery has assessed the health benefits of specific control measures for particulate pollution. These studies were groundbreaking at the time and have informed design of future epidemiologic research with an emphasis on high quality exposure assessment. The views expressed in this presentation are those of the authors and do not necessarily represent the views or policies of the U.S. Environmental Protection Agency.