Abstract
Understanding and quantifying outdoor and indoor sources of human exposure are essential but often not adequately addressed in health effect studies for air pollution. Air pollution epidemiology, risk assessment, health tracking, and accountability assessments are examples of health effect studies that require but often lack adequate exposure information. Recent advances in exposure modeling along with better information on time–activity and exposure factor data provide us with unique opportunities to improve the assignment of exposures for both future and ongoing studies linking air pollution to health impacts. In September 2006, scientists from the US Environmental Protection Agency and the Centers for Disease Control and Prevention along with scientists from the academic community and state health departments convened a symposium on air pollution exposure and health to identify, evaluate, and improve current approaches for linking air pollution exposures to disease. This manuscript presents the key issues, challenges, and recommendations identified by the exposure working group, who used case studies of particulate matter, ozone, and toxic air-pollutant exposure to evaluate health effects for air pollution. One of the overarching lessons of this workshop is that obtaining better exposure information for these different health effect studies requires both goal setting for what is needed and mapping out the transition pathway from current capabilities for meeting these goals. Meeting our long-term goals requires definition of incremental steps that provide useful information for the interim and move us toward our long-term goals. Another overarching theme among the three different pollutants and the different health study approaches is the need for integration among alternate exposure-assessment approaches. For example, different groups may advocate exposure indicators, biomonitoring, mapping methods (GIS), modeling, environmental media monitoring, and/or personal exposure modeling. However, emerging research reveals that the greatest progress comes from integration among two or more of these efforts.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 6 print issues and online access
$259.00 per year
only $43.17 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Adgate J.L., Eberly L.E., Stroebel C., Pellizzari E.D., and Sexton K. Personal, indoor, and outdoor VOC exposures in a probability sample of children. J Expo Anal Environ Epidemiol 2004: 14: S4–S13.
Barry R., and Chorley R. Atmosphere, Weather, and Climate. Rutledge, London and New York, 1998.
Bates D.V. Adverse health impacts of air pollution—Continuing problems. Scandi J Work Environ Health 1995: 21 (6): 405–411.
Bennett D.H., and Koutrakis P. Determining the infiltration of outdoor particles in the indoor environment using a dynamic model. J Aerosol Sci 2006: 37 (6): 766–785.
Bernstein J.A., Alexis N., Barnes C., Bernstein I.L., Bernstein J.A., Nel A., Peden D., Diaz-Sanchez D., Tarlo S.M., and Williams P.B. Health effects of air pollution. J Allergy Clin Immunol 2004: 114 (5): 1116–1123.
Boothe V., Dimmick W.F., and Talbot T.O. Relating air quality to environmental public health tracking data. In: Aral M.M., Brebbia, C.A., Maslia, M.L., and Sinks, T. (Eds.). Environmental Exposure and Health. Wessex Institute Transactions on Ecology and the Environment, WIT Press: Southhampton, UK, 2005: 85, pp 43–52.
Burke J.M., Zufall M.J., and Özkaynak H. A population exposure model for particulate matter: case study results for PM2.5 in Philadelphia, PA. J Expo Anal Environ Epidemiol 2001: 11: 470–489.
Burnett R.T., Cakmak S., Brook J.R., and Krewski D. The role of particulate size and chemistry in the association between summertime ambient air pollution and hospitalization for cardiorespiratory diseases. Environ Health Perspect 1997: 105 (6): 614–620.
Catalano P.J., Ryan L.M., and Kaden D.A. Statistical design aspects of the NTP/HEI collaborative study on the health effects of chronic ozone inhalation. Inhal Toxicol 1996: 8 (3): 229–249.
Chapin F. Human Activity Patterns in the City. John Wiley & Sons, New York, 1974.
Chen W.C., and McKone T.E. Chronic health risks from aggregate exposures to ionizing radiation and chemicals: scientific basis for an assessment framework. Risk Anal 2001: 21 (1): 25–42.
Delfino R.J. Epidemiologic evidence for asthma and exposure to air toxics: linkages between occupational, indoor, and community air pollution research. Environ Health Perspect 2002: 110 (Suppl 4): 573–589.
English P., Neutra R., Scalf R., Sullivan M., Waller L., and Zhu L. Examining associations between childhood asthma and traffic flow using a geographic information system. Environ Health Perspect 1999: 107 (9): 761–767.
Eschenbacher W.L., Holian A., and Campion R.J. Air toxics and asthma: impacts and end points. Environ Health Perspect 1995: 103 (Suppl 6): 209–211.
Finlayson-Pitts B., and Pitts J.N. Chemistry of the Upper and Lower Atmopshere: Theory, Experiments, and Applications. Academic Press, San Diego, 2000.
Fuentes M., and Raftery A.E. Model evaluation and spatial interpolation by Bayesian combination of observations with outputs from numerical models. Biometrics 2005: 61: 36–45.
Fung K.Y., Khan S., Krewski D., and Chen Y. Association between air pollution and multiple respiratory hospitalizations among the elderly in Vancouver, Canada. Inhal Toxicol 2006: 18 (13): 1005–1011.
Geller M.D., Chang M.H., Sioutas C., Ostro B.D., and Lipsett M.J. Indoor/outdoor relationship and chemical composition of fine and coarse particles in the southern California deserts. Atmos Environ 2002: 36 (6): 1099–1110.
Geyh A.S., Xue J.P., Özkaynak H., and Spengler J.D. The Harvard Southern California chronic ozone exposure study: assessing ozone exposure of grade-school-age children in two Southern California communities. Environ Health Perspect 2000: 108 (3): 265–270.
Gilmour I.M., Jaakkola M.S., London S.J., Andre E., Nel A.E., and Rogers C.A. How exposure to environmental tobacco smoke, outdoor air pollutants, and increased pollen burdens influences the incidence of asthma. Environ Health Perspect 2006: 114: 627–633.
Gong Jr H., Linn W.S., Clark K.W., Anderson K.R., Geller M.D., and Sioutas C. Respiratory responses to exposures with fine particulates and nitrogen dioxide in the elderly with and without COPD. Inhal Toxicol 2005: 17 (3): 123–132.
Hackney J.D., Linn W.S., Buckley R.D., and Hislop H.J. Studies in adaption to ambient oxidant air pollution: effects of ozone exposure in Los Angeles residents vs. new arrivals. Environ Health Perspect 1976: 18: 141–146.
Hackney J.D., Linn W.S., Karuza S.K., Buckley R.D., Law D.C., Bates D.V., Hazucha M., Pengelly L.D., and Silverman F. Efects of ozone exposure in Canadians and Southern Californians. Evidence for adaptation? Arch Environ Health 1977: 32 (3): 110–116.
Haley V., Bateson T., Boothe V., Talbot T., Dimmick F., Paulu C., and Warner M., Technical Background Report: Case-Crossover Analysis of Acute Health Effects and Ambient Air Quality for Environmental Public Health Tracking. Submitted to U.S. Centers for Disease Control and Prevention, Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, Atlanta, GA January 9, 2007.
Hayes S.R. Estimating the effect of being indoors on total personal exposure to outdoor air pollution. JAPCA 1989: 39 (11): 1453–1461.
Isakov V., Graham S., Burke J., and Özkaynak H. Linking air quality and exposure models. EM Magazine 2006, 26–29.
Isakov V, and Özkaynak H A modeling methodology to support evaluation of public health impacts of air pollution reduction programs. Proceedings of the 29th International Technical Meeting on Air Pollution Modeling, Aveiro, Portugal, Sept 24-28, 2007.
Jerrett M., Arain A., Kanaroglou P., Beckerman B., Potoglou D., Sahsuvaroglu T., Morrison J., and Giovis C. A review and evaluation of intraurban air pollution exposure models. J Expo Anal Environ Epidemiol 2005: 15 (2): 185–204.
Kinney P.L., Chillrud S.N., Ramstrom S., Ross J., and Spengler J.D. Exposures to multiple air toxics in New York City. Environ Health Perspect 2002: 110 (Suppl. 4): 539–546.
Kinney P.L., and Lippmann M. Respiratory effects of seasonal exposures to ozone and particles. Arch Environ Health 2000: 55 (3): 210–216.
Klepeis N.E., Nelson W.C., Ott W.R., Robinson J.P., Tsang A.M., Switzer P., Behar J.V., Hern S.C., and Engelmann W.H. The National Human Activity Pattern Survey (NHAPS): A resource for assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol 2001: 11 (3): 231–252.
Künzli N., Jerrett M., Mack W.J., Beckerman B., LaBree L., Gilliland F., Thomas D., Peters J., and Hodis H.N. Ambient air pollution and atherosclerosis in Los Angeles. Environ Health Perspect 2005: 113 (2): 201–206.
Lanphear B.P., Hornung R., Khoury J., Yolton K, Baghurst P., Bellinger D.C., Canfield R.L., Dietrich K.N., Bornschein R., Greene T., Rothenberg S.J., Needleman H.L., Schnaas L., Wasserman G., Graziano J., and Roberts R. Low-level environmental lead exposure and children's intellectual function: an international pooled analysis. Environ Health Perspect 2005: 113 (7): 894–899.
Last J.M. A Dictionary of Epidemiology. International Epidemiological Association Inc., New York, 2001.
Lee K., Parkhurst W.J., Xue J.P., Özkaynak A.H., Neuberg D., and Spengler J.D. Outdoor/indoor/personal ozone exposures of children in Nashville, Tennessee. J Air Waste Manage Assoc 2004: 54 (3): 352–359.
Lee K., Vallarino J., Dumyahn T., Özkaynak H., and Spengler J.D. Ozone decay rates in residences. J Air Waste Manage Assoc 1999: 49 (10): 1238–1244.
Linn W.S., Avol E.L., Shamoo D.A., Peng R.C., Valencia L.M., Little D.E., and Hackney J.D. Repeated laboratory ozone exposures of volunteer Los Angeles residents: an apparent seasonal variation in response. Toxicol Ind Health 1988: 4 (4): 505–520.
Linn W.S., Buckley R.D., Spier C.E., Blessey R.L., Jones M.P., Fischer D.A., and Hackney J.D. Health effects of ozone exposure in asthmatics. Am Rev Respir Dis 1978: 117 (5): 835–843.
Linn W.S., Fischer D.A., Medway D.A., Anzar U.T., Spier C.E., Valencia L.M., Venet T.G., and Hackney J.D. Short-term respiratory effects of 0.12 ppm ozone exposure in volunteers with chronic obstructive pulmonary disease. Am Rev Respir Dis 1982: 125 (6): 658–663.
Linn W.S., Shamoo D.A., Venet T.G., Spier C.E., Valencia L.M., Anzar U.T., and Hackney J.D. Response to ozone in volunteers with chronic obstructive pulmonary disease. Arch Environ Health 1983: 38 (5): 278–283.
Lippmann M., and Schlesinger R.B. Toxicological bases for the setting of health-related air pollution standards. Annu Rev Public Health 2000: 21: 309–333.
Lobscheid A.B., Maddalena R.L., and McKone T.E. Contribution of locally grown foods in cumulative exposure assessments. J Expo Anal Environ Epidemiol 2004: 14 (1): 60–73.
Lobscheid A.B., and McKone T.E. Constraining uncertainties about the sources and magnitude of polycyclic aromatic hydrocarbon (PAH) levels in ambient air: the State of Minnesota as a case study. Atmos Environ 2004: 38 (33): 5501–5515.
Lobscheid A.B., McKone T.E., and Vallero D. Exploring relationships between outdoor air particulate-associated polycyclic aromatic hydrocarbon and PM2.5: a case study of benzo(a)pyrene in California metropolitan regions. Atmos Environ 2007: 41: 5659–5672.
Lucas J.N. Dose reconstruction for individuals exposed to ionizing radiation using chromosome painting. Radiat Res 1997: 148 (5 Suppl): S33–S38. Supplement: Space Radiation Damage and Biodosimetry.
Marchetti A.A., and Straume T. A search for neutron reactions that may be useful for Hiroshima dose reconstruction. Appl Radiat Isot 1996: 47 (1): 97–103.
Marshall J.D., McKone T.E., Deakin E.A., and Nazaroff W.W. Inhalation of motor vehicle emissions: effects of urban population and area. Atmos Environ 2005: 39 (2): 283–295.
Martins L.C., Pereira L.A., Lin C.A., Santos U.P., Prioli G., Luiz Odo C., Saldiva P.H., and Braga A.L. The effects of air pollution on cardiovascular diseases: lag structures. Revista de Saude Publica 2006: 40 (4): 677–683.
McConnell R., Berhane K., Gilliland F., London S.J., Islam T., Gauderman W.J., Avol E., Margolis H.G., and Peters J.M. Asthma in exercising children exposed to ozone: a cohort study.[see comment][erratum appears in Lancet 2002 Mar 9;359(9309):896]. Lancet 2002: 359 (9304): 386–391.
McKone T.E., Castorina R., Kuwabara Y., Harnly M.E., Eskenazi B., and Bradman A. Merging models and biomonitoring data to characterize sources and pathways of human exposure to organophosphorous pesticides in the Salinas Valley of California. Environ Sci Technol 2007: 41: 3233–3240.
Mortimer K., Matovinovic E., Lurmann F., Funk T., Balmes J.R., Mann J., Margolis H., Hammond S.K., and Tager I.B. Exposure to traffic and the risk of atopy in asthmatic children. Epidemiology 2004: 15 (4): S66–S67.
Muldoon S.B., Cauley J.A., Kuller L.H., Morrow L., Needleman H.L., Scott J., and Hooper F.J. Effects of blood lead levels on cognitive function of older women. Neuroepidemiology 1996: 15 (2): 62–72.
NARSTO NARSTO Measurement Methods Compendium: Ozone Methods. “Issued in 1999 and available from 1999: http://narsto.esd.ornl.gov/Compendium/methods/o3.shtml [Accessed 16 March 2007].
Needleman H.L. The current status of childhood low-level lead toxicity. Neurotoxicology 1993: 14 (2-3): 161–166.
Nuckols J.R., Ward M.H., and Jarup L. Using geographic information systems for exposure assessment in environmental epidemiology studies. Environ Health Perspect 2004: 112 (9): 1007–1015.
Ostro B.D. Examining acute health outcomes due to ozone exposure and their subsequent relationship to chronic disease outcomes. Environ Health Perspect 1993: 101: 213–216.
Özkaynak H., Palma T., Touma J.S., and Thurman J. Modeling population exposures to outdoor sources of hazardous air pollutants. J Exp Sci Environ Epidemiol 2008a: 18 (1): 45–58.
Özkaynak H., Glenn B., Qualters J.R., Strosnider H., McGeehin M.A., and Zenick H. Summary and findings of the EPA and CDC Symposium on Air Pollution Exposure and Health. J Exp Sci Environ Epidemiol 2008b (in press).
Pope III C.A., Hansen M.L., Long R.W., Nielsen K.R., Eatough N.L., Wilson W.E., and Eatough D.J. Ambient particulate pollution, heart rate variability, and blood markers of inflammation in a panel of elderly subjects. Environ Health Perspect 2004: 112: 339–345.
Pope III C.A., Muhlstein J.B., May H.T., Renlund D.G., Anderson J.L., and Horne B.D. Ischemic heart disease events triggered by short-term exposure to fine particulate air pollution. Circulation 2006: 114: 2443–2448.
Roberts E.M., English P.B., Wong M., Wolff C., Valdez S., Van den Eeden S.K., and Ray G.T. Progress in pediatric asthma surveillance II: geospatial patterns of asthma in Alameda County, California. Prev Chronic Dis 2006: 3 (3): A92.
Ross Z., English P.B., Scalf R., Gunier R., Smorodinsky S., Wall S., and Jerrett M. Nitrogen dioxide prediction in Southern California using land use regression modeling: potential for environmental health analyses. J Exp Sci Environ Epidemiol 2006: 16 (2): 106–114.
Rückerl R., Ibald-Mulli A., Koenig W., Woelke G., Cyrys J., Heinrich J., Cyrys J., Heinrich J., Marder V., Frampton M., Wichmann H.E., and Peters A. Air pollution and markers of inflammation and coagulation in patients with coronary heart disease. Am J Respir Crit Care Med 2006: 173: 432–441.
Peters J.M., Avol E., Gauderman W.J., Linn W.S., Navidi W., London S.J., Margolis H., Rappaport E., Vora H., Gong Jr H., and Thomas D.C. 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 (3): 768–775.
Phillips M.L., Esmen N.A., Hall T.A., and Lynch R. Determinants of exposure to volatile organic compounds in four Oklahoma cities. J Expo Anal Environ Epidemiol 2005: 15 (1): 35–46.
Rojas-Bracho L., Suh H.H., Oyola P., and Koutrakis P. Measurements of children's exposures to particles and nitrogen dioxide in Santiago, Chile. Sci Total Environ 2002: 287 (3): 249–264.
Romieu I., Lugo M.C., Colome S., Garcia A.M., Avila M.H., Geyh A., Velasco S.R., and Rendon E.P. Evaluation of indoor ozone concentration and predictors of indoor-outdoor ratio in Mexico City. J Air Waste Manage Assoc 1998: 48 (4): 327–335.
Ruidavets J.B., Cournot M., Cassadou S., Giroux M., Meybeck M., and Ferrieres J. Ozone air pollution is associated with acute myocardial infarction. Circulation 2005: 111 (5): 563–569.
Ryan P.B., Burke T.A., Cohen Hubal E.A., Cura J.J., and McKone T.E. Using biomarkers to inform cumulative risk assessment. Environ Health Perspect 2007: 115 (5): 833–840.
Ryan P.B., Soczek M.L., Treitman R.D., Spengler J.D., and Billick I.H. The Boston residential NO2 characterization study: II. Survey methodology and population concentration estimates. Atmos Environ 1988: 22: 2115–2125.
Sarnat S.E., Suh H.H., Coull B.A., Schwartz J., Stone P.H., and Gold D.R. Ambient particulate air pollution and cardiac arrhythmia in a panel of older adults in Steubenville, Ohio. Occup Environ Med 2006: 63 (10): 700–706.
Seinfeld J.H., and Pandos S.N. Atmospheric Chemistry and Physics: From Air Pollution to Climate Change. John Wiley & Sons Inc, New York, 1998.
Serrano-Trespalacios P.I., Ryan L., and Spengler J.D. Ambient, indoor and personal exposure relationships of volatile organic compounds in Mexico City Metropolitan Area. J Expo Anal Environ Epidemiol 2004: 14: S118–S132.
Singer B.C., Coleman B.K., Destaillats H., Hodgson A.T., Weschler C.J., and Nazaroff W.W. Indoor secondary pollutants from cleaning product and air freshener use in the presence of ozone. Atmos Environ 2006: 40: 6696–6710.
Son B., Breysse P., and Yang W. Volatile organic compounds concentrations in residential indoor and outdoor and its personal exposure in Korea. Environ Int 2003: 29 (1): 79–85.
Sohn M.D., McKone T.E., and Blancato J.N. Reconstructing population exposures from dose biomarkers: Inhalation of trichloroethylene (TCE) as a case study. J Expo Anal Environ Epidemiol 2004: 14 (3): 204–213.
Spengler J.D., Schwab M., Ryan P.B., Colome S.D., Wilson A.L., Billick I.H., and Becker E. Personal exposure to nitrogen dioxide in the Los Angeles Basin: study design and results. J Air Waste Manage Assoc 1994: 44: 39–47.
Spiro T.G., and Sligliani W.M. Chemistry of the Environment. Prenctice-Hall Inc., Upper Saddle River, New Jersey, 2003.
Thurston G.D., Bekkedal M.Y.V., Roberts E., Ito K., Pope A.C., Glenn B., Özkaynak H., and Utell M.J. Emerging Health and Air Quality Issues for Air Pollution Epidemiology, Surveillance and Accountability. J Exp Sci Environ Epidemiol 2008 (in press).
USEPA. Determination of Ozone by Ultraviolet Analysis, 1997. Issued in 1997 and available from http://nsdi.epa.gov/ttn/amtic/files/ambient/qaqc/ozone4.pdf [Accessed 16 March 2007].
USEPA. 2001 Introduction to Air Toxics Risk Assessment. Issued 2001 and available from rieved April 4, 2007, from http://www.epa.gov/ttn/atw/wks/appx1011.pdf [Accessed 4 April 2007].
USEPA. 2004 Criteria Document for Particulate Matter. Issued 2004 and available from http://www.epa.gov/ttn/naaqs/standards/pm/s_pm_cr_cd.html [Accessed 16 March 2007].
Vallejo M., Ruiz S., Hermosillo A.G., Borja-Aburto V.H., and Cardenas M. Ambient fine particles modify heart rate variability in young healthy adults. J Expo Sci Environ Epidemiol 2006: 16 (2): 125–130.
Wallace L.A., and Pellizzari E.D. Recent advances in measuring exhaled breath and estimating exposure and body burden for volatile organic compounds (VOCs). Environ Health Perspect 1995: 103 (Suppl 3): 95–98.
Weisel C.P. Assessing exposure to air toxics relative to asthma. Environ Health Perspect 2002: 110 (Suppl 4): 527–537.
Xue J., Liu S.V., Özkaynak H., and Spengler J.D. Parameter evaluation and model validation of ozone exposure assessment using Harvard Southern California Chronic Ozone Exposure Study data. J Air Waste Manage Assoc 2005: 55 (10): 1508–1515.
Zanobetti A., and Schwartz J. The effect of particulate air pollution on emergency admissions for myocardial infarction: a multicity case-crossover analysis. Environ Health Perspect 2005: 113: 978–982.
Zhang J., and Smith K.R. Indoor air pollution: a global health concern. Br Med Bull 2003: 68: 209–225.
Acknowledgements
We are grateful to the excellent contributions made by the symposium attendees who participated in the exposure break-out group discussions on the second day of the meeting.
Author information
Authors and Affiliations
Corresponding author
Additional information
Disclaimer
The United States Environmental Protection Agency through its Office of Research and Development partially funded and collaborated in the research described here under contract no. EP06D000722 to Dr. P. Barry Ryan and through Interagency Agreement DW-89-93058201-1 with Lawrence Berkeley National Laboratory through the US Department of Energy under Contract Grant no. DE-AC02-05CH11231. It has been subjected to Agency review and approved for publication. This work was also supported by Cooperative Agreement number U19/EH000097-03 from the US Centers for Disease Control and Prevention (CDC).
Rights and permissions
About this article
Cite this article
McKone, T., Ryan, P. & Özkaynak, H. Exposure information in environmental health research: Current opportunities and future directions for particulate matter, ozone, and toxic air pollutants. J Expo Sci Environ Epidemiol 19, 30–44 (2009). https://doi.org/10.1038/jes.2008.3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jes.2008.3
Keywords
This article is cited by
-
Environmental exposures and lymphoma risk: a nested case–control study using the Golden Retriever Lifetime Study cohort
Canine Medicine and Genetics (2022)
-
Emergency hospital admissions for cardiovascular diseases attributed to air pollution in Tehran during 2016-2019
Environmental Science and Pollution Research (2021)
-
Evaluating children’s location using a personal GPS logging instrument: limitations and lessons learned
Journal of Exposure Science & Environmental Epidemiology (2014)
-
Air pollution exposure prediction approaches used in air pollution epidemiology studies
Journal of Exposure Science & Environmental Epidemiology (2013)
-
Development and evaluation of alternative approaches for exposure assessment of multiple air pollutants in Atlanta, Georgia
Journal of Exposure Science & Environmental Epidemiology (2013)