Abstract
Research Needs Relating to Health Effects of Exposure to Low Levels of Airborne Particulate Matter Robert F. Phalen andjefrey S . Lee University of California, Irvine, California 92697 University of Utah, Salt take City, Utah 841 12 oncern over the consistent and reproducible epidemio- logical associations between particulate air pollution and human mortality and morbidity stimulated a series of two international scientific colloquia. The first was held January 24-25, 1994, in Irvine, California, and the second was held May 1-3, 1996, in Park City, Utah. Each colloquium was attended by about 200 epidemiologists, toxicologists, chemists, clinicians, regulators, and other concerned specialists. At both colloquia, attendees were asked to submit written suggestions for future related research after they had listened to numerous formal papers and after participating in several open discus- sions. It is important to note that these research suggestions represent snapshots in time of the ideas of a large group of well-informed experts with vaned backgrounds; these recom- mendations do not carry the imprimatur of the colloquium sponsors, any regulatory body, or any other agency. This article summarizes the research suggestions from the second colloquium; a similar article was published relating to the earlier colloquium.(') The suggestions from attendees of the second colloquium, over 160 in total, were first sorted into broad categories based on the type of project suggested (epidemiology, toxicology, sampling, etc.), and then similar studies were combined under a single description. Some projects were suggested by five or more individuals, most by two or three individuals, and about 25 percent by only one person. In the summary lists that follow, the projects listed first within each category are those that were most frequently suggested. C Studies Related to Air Pollution Epidemiology and Epidemiologic Methods 1. Longitudinal panel studies of morbidity and mortality in healthy and compromised individuals (bronchitis, cardio- vascular-compromised, etc.), with personal exposure characterizations. 2. Effects of long-term exposures with extensive data collec- tion, including personal exposures and weather parame- ters. 3. Studies of the effects of exposure assessment errors on epidemiology study findmgs. 4. Meta-analyses in which studies are combined in order to identify roles of specific exposure agents. 5. Studies in cities (including those in Eastern and Western AyPL.OCCUP.ENVIRON.HYG. 13(6) JUNE 1998 Occupational Cohort Studies 1. Follow-up of particle-exposed occupational cohorts after retirement to look for chronic illnesses and possible induced sensitivity to environmental particulate air pollutants. 2. Studies of cohorts with current heavy particle exposures to look for excess cardiopulmonary-related morbidity and mortality. Research Needs by Category (Projects Are Not Necessarily Mutually Exclusive) Europe) which have high and low extreme levels of pollutants. Complete monitoring data are required. 6. Investigations of the effects (roles) of personal exposures on epidemiologic findings. 7. Collaborative (between economists and epidemiologists) research focusing on cost-benefit analyses and health val- uations. 8. Comparisons of mortality rates and incidence of diseases for the following: clean and highly polluted days; clean and highly polluted cities; and cities that have improving air quality. 9. Health effects of personal exposures, including studies of hospital deaths (with thorough monitoring of chemical species). 10. Incorporation of autopsy data into epidemiologic investi- gations. 11. Investigations directed at threshold phenomena. 12. Studies to explain the observed increases in asthma rates in light of improving outdoor air quality. 13. Investigation of population characteristics (as opposed to individual characteristics) in relation to morbidity and mortality. 14. Additional investigations of the roles of nonparticulate pollutants in epidemiologic investigations of particulate matter. Clinical Studies 1. Investigations of pollutant deposition and clearance in sub- jects with existing pulmonary diseases. 2. Investigations of pollutant effects in subpopulations that are expected to have enhanced sensitivity to particulate air pollutants. 3. Investigations of ventilatory and activity patterns for various types of people. 4. Investigations relating to the possibility of differentiating particulate-caused cardiovascular (and pulmonary) deaths from deaths produced by other causes. 1047-322X/98/1306-352$19.00/4 0 1998 AIH PI1 Sl047-322X(98)00004-1
Highlights
The protection of workers from adverse effects has followed strategies that differ substantially from those used in environmental exposure situations
Much of the recent epidemiological research is based not on average air pollutant particulate levels, but on changes in the level; the larger the incremental increase in particulate matter, the larger the associated health effects. Does this imply that any level of particulate pollutant, even one as low as a few tens of micrograms, is associated with adverse effects? Research suggestions that involve thresholds, dose-response considerations, and effects of cleaning the air address this issue
What Is the Proper Metric far Compliance?. This question is clearly related to the section on defining particulate matter; and several other suggested research projects directly apply to this question as well
Summary
University of California, Irvine, California 92697 University of Utah, Salt take City, Utah 841 12. The first was held January 24-25, 1994, in Irvine, California, and the second was held May 1-3, 1996, in Park City, Utah. Each colloquium was attended by about 200 epidemiologists, toxicologists, chemists, clinicians, regulators, and other concerned specialists. At both colloquia, attendees were asked to submit written suggestions for future related research after they had listened to numerous formal papers and after participating in several open discussions. This article summarizes the research suggestions from the second colloquium; a similar article was published relating to the earlier colloquium.('). The suggestions from attendees of the second colloquium, over 160 in total, were first sorted into broad categories based on the type of project suggested (epidemiology, toxicology, sampling, etc.), and similar studies were combined under a single description. In the summary lists that follow, the projects listed first within each category are those that were most frequently suggested
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