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Objectives Approximately 2 billion workers globally are employed in informal settings, which are characterized by substantial risk from hazardous exposures and varying job tasks and schedules. Existing methods for identifying occupational hazards must be adapted for unregulated and challenging work environments. We designed and applied a method for objectively deriving time-activity patterns from wearable camera data and matched images with continuous measurements of personal inhalation exposure to size-specific particulate matter (PM) among workers at an informal electronic-waste (e-waste) recovery site. Methods One hundred and forty-two workers at the Agbogbloshie e-waste site in Accra, Ghana, wore sampling backpacks equipped with wearable cameras and real-time particle monitors during a total of 171 shifts. Self-reported recall of time-activity (30-min resolution) was collected during the end of shift interviews. Images (N = 35,588) and simultaneously measured PM2.5 were collected each minute and processed to identify activities established through worker interviews, observation, and existing literature. Descriptive statistics were generated for activity types, frequencies, and associated PM2.5 exposures. A kappa statistic measured agreement between self-reported and image-based time-activity data. Results Based on image-based time-activity patterns, workers primarily dismantled, sorted/loaded, burned, and transported e-waste materials for metal recovery with high variability in activity duration. Image-based and self-reported time-activity data had poor agreement (kappa = 0.17). Most measured exposures (90%) exceeded the World Health Organization (WHO) 24-h ambient PM2.5 target of 25 µg m−3. The average on-site PM2.5 was 81 µg m−3 (SD: 94). PM2.5 levels were highest during burning, sorting/loading and dismantling (203, 89, 83 µg m−3, respectively). PM2.5 exposure during long periods of non-work-related activities also exceeded the WHO standard in 88% of measured data. Conclusions In complex, informal work environments, wearable cameras can improve occupational exposure assessments and, in conjunction with monitoring equipment, identify activities associated with high exposures to workplace hazards by providing high-resolution time-activity data.

Sharing individualized results with health study participants, a practice we and others refer to as “report-back,” ensures participant access to exposure and health information and may promote health equity. However, the practice of report-back and the content shared is often limited by the time-intensive process of personalizing reports. Software tools that automate creation of individualized reports have been built for specific studies, but are largely not open-source or broadly modifiable. We created an open-source and generalizable tool, called the Macro for the Compilation of Report-backs (MCR), to automate compilation of health study reports. We piloted MCR in two environmental exposure studies in Massachusetts, USA, and interviewed research team members (n = 7) about the impact of MCR on the report-back process. Researchers using MCR created more detailed reports than during manual report-back, including more individualized numerical, text, and graphical results. Using MCR, researchers saved time producing draft and final reports. Researchers also reported feeling more creative in the design process and more confident in report-back quality control. While MCR does not expedite the entire report-back process, we hope that this open-source tool reduces the barriers to personalizing health study reports, promotes more equitable access to individualized data, and advances self-determination among participants.

BackgroundPediatric asthma is currently the most prevalent chronic disease in the United States, with children in lower income families disproportionately affected. This increased health burden is partly due to lower-quality and insufficient maintenance of affordable housing. A movement towards ‘green’ retrofits that improve energy efficiency and increase ventilation in existing affordable housing offers an opportunity to provide cost-effective interventions that can address these health disparities.MethodsWe combine indoor air quality modeling with a previously developed discrete event model for pediatric asthma exacerbation to simulate the effects of different types of energy retrofits implemented at an affordable housing site in Boston, MA.ResultsSimulation results show that retrofits lead to overall better health outcomes and healthcare cost savings if reduced air exchange due to energy-saving air tightening is compensated by mechanical ventilation. Especially when exposed to indoor tobacco smoke and intensive gas-stove cooking such retrofit would lead to an average annual cost saving of over USD 200, while without mechanical ventilation the same children would have experienced an increase of almost USD 200/year in health care utilization cost.ConclusionThe combination of indoor air quality modeling and discrete event modeling applied in this paper can allow for the inclusion of health impacts in cost-benefit analyses of proposed affordable housing energy retrofits.

The intake fraction (iF) expresses population exposure resulting from pollutant emissions. City-wide iFs estimated using simple one-compartment models, which have been used in a number of previous studies, have significant uncertainties and do not capture the intra-urban variation in exposure that is important for estimating health effects associated with traffic-related air pollutants. We present a novel and efficient approach for developing spatially-resolved iF estimates using dispersion modeling for near-road exposures that accounts for the spatial and temporal variation in meteorology, emissions and the population living and working near major roads. Using the new approach, iF estimates are developed for emissions of traffic-related fine particulate matter (PM2.5) in Lisbon, Portugal, and compared to estimates from a one-compartment model. Both methods use local meteorological and population data and represent exposures for a total of 2.8 million people. The new method produces an overall iF value of 16.4 ppm for the Lisbon metropolitan area, over twice that of the one-compartment model (8.1 ppm). Most of the exposure (12.0 ppm) occurs for the subset of the population (1.0 million people) living or working within 500 m of highways and major arterials. The iF for the remainder of the population (1.8 million people) is only 4.3 ppm. The spatially-resolved iF estimate accounts for high concentration areas, which can be densely populated, and accounts for much or most of the exposure from traffic-related emissions. The new method is computationally efficient and can improve estimates of exposure and health impacts occurring in urban areas, leading to more effective urban and transportation planning decisions to mitigate impacts.

In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the “Framework for Rapid Emissions Scenario and Health impact ESTimation” (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning. Keywords: Air quality management, Optimization, Health impact assessment, FRESH-EST

PM 2.5 concentrations throughout much of the U.S. have decreased over the last 15 years, but emissions and concentration trends can vary by location and source type. Such trends should be understood to inform air quality management and policies. This work examines trends in emissions, concentrations and source apportionments in two large Midwest U.S. cities, Detroit, Michigan, and Chicago, Illinois. Annual and seasonal trends were investigated using National Emission Inventory (NEI) data for 2002 to 2011, speciated ambient PM 2.5 data from 2001 to 2014, apportionments from positive matrix factorization (PMF) receptor modeling, and quantile regression. Over the study period, county-wide data suggest emissions from point sources decreased (Detroit) or held constant (Chicago), while emissions from on-road mobile sources were constant (Detroit) or increased (Chicago), however changes in methodology limit the interpretation of inventory trends. Ambient concentration data also suggest source and apportionment trends, e.g., annual median concentrations of PM 2.5 in the two cities declined by 3.2–3.6%/yr (faster than national trends), and sulfate concentrations (due to coal-fired facilities and other point source emissions) declined even faster; in contrast, organic and elemental carbon (tracers of gasoline and diesel vehicle exhaust) declined more slowly or held constant. The PMF models identified nine sources in Detroit and eight in Chicago, the most important being secondary sulfate, secondary nitrate and vehicle emissions. A minor crustal dust source, metals sources, and a biomass source also were present in both cities. These apportionments showed that the median relative contributions from secondary sulfate sources decreased by 4.2–5.5% per year in Detroit and Chicago, while contributions from metals sources, biomass sources, and vehicles increased from 1.3 to 9.2% per year. This first application of quantile regression to trend analyses of speciated PM 2.5 data reveals that source contributions to PM 2.5 varied as PM 2.5 concentrations decreased, and that the fraction of PM 2.5 due to emissions from vehicles and other local emissions has increased. Each data source has uncertainties, but emissions, monitoring and PMF data provide complementary information that can help to discern trends and identify contributing sources. Study results emphasize the need to target specific sources in policies and regulations aimed at decreasing PM 2.5 concentrations in urban areas.

Localized variations in traffic volume and speed can influence air pollutant emissions and corresponding concentrations in nearby communities, but most studies have utilized only aggregated traffic activity data. In this study, we compared the estimated influence of highway traffic activity on concentrations of primary oxides of nitrogen (NOx) and fine particulate matter (PM2.5) in communities near highways using a dispersion model informed by highly spatiotemporally-resolved variations of traffic volume and flow compared to the use of Annual Average Daily Traffic (AADT) data at a few locations. We used two sources of traffic activity data on 500 half-mile roadway segments on the five major highways in the Washington State Puget Sound during 2013. The first consisted of vehicle counts available every half-mile and 5 min; the second was traffic information (e.g., AADT) aggregated across the year and roadway network. Using the Motor Vehicle Emissions Simulator (MOVES) and the Research Line source dispersion model (RLINE), we modeled hourly concentrations of primary NOx and PM2.5 generated by highway traffic at nearly 4000 residences within 1 km of major highways. These concentrations were aggregated to daily and annual average concentrations, which were compared by input data source. At most locations, concentrations of primary NOx and PM2.5 modeled using the resolved traffic data had similar spatial and temporal distributions to concentrations predicted using the AADT data. However, several areas showed large differences. For example, 25% of residences within 150 m of a highway had concentrations that differed by more than 19% (8 ppb) for NOx and 32% (0.7 μg/m3) for PM2.5, and the AADT data consistently predicted lower concentrations than the resolved traffic data. Our findings indicate that temporal and spatial variation in traffic patterns can result in complex spatiotemporal variations of air pollutant concentrations that can be captured with the use of dispersion modeling with the appropriate inputs. The use of spatiotemporally resolved traffic activity data can improve exposure estimates and help reduce exposure measurement error in epidemiological studies, especially in communities near highly congested highways.

Efforts to reduce energy consumption and greenhouse gas emissions in the United States have led to widespread interest in energy-efficient retrofits in the residential sector. Weatherization retrofits, such as air sealing and insulation, lower residential energy consumption, resulting in reduced fuel and electricity-related emissions, improved ambient air quality, and avoided climate and health impacts. However, retrofits without adequate ventilation may worsen indoor air quality (IAQ) and lead to adverse health effects and costs that offset anticipated economic benefits. Building energy management and climate action plans often omit these potential consequences. This study presents a novel framework that quantifies health and energy costs and benefits related to residential energy-efficient retrofits. Energy savings from reduced consumption were estimated using historical energy prices. Reductions in ambient emissions of fine particulate matter (PM2.5) precursors were translated to avoided health impacts using health damage functions. Indoor PM2.5-related health impacts were estimated by applying PM2.5 concentration-response functions to changes in IAQ. Health impacts were monetized using health impact assessment techniques and compared to retrofit-related savings. For a modeled gas-heated midrise multifamily building in Boston, MA, weatherization retrofits without ventilation or filtration retrofits led to household health costs that far exceeded energy savings and population-level health savings, given increases in indoor PM2.5 concentrations (3.1 μg/m3 and 20.4 μg/m3 for standard and high-performance retrofits, respectively). In contrast, weatherization coupled with ventilation and filtration retrofits resulted in large savings. Overall, this study reinforces the need to quantify residential health impacts in assessments of energy-efficient retrofits.

The development of air quality management (AQM) strategies provides opportunities to improve public health and reduce health inequalities. This study evaluates health and inequality impacts of alternate SO(2) control strategies in Detroit, MI, a designated non-attainment area. Control alternatives include uniform reductions across sources, ranking approaches based on total emissions and health impacts per ton of pollutant emitted, and optimizations that meet concentration and health goals. Using dispersion modeling and quantitative health impact assessment (HIA), these strategies are evaluated in terms of ambient concentrations, health impacts, and the inequality in health risks. The health burden attributable to SO(2) emissions in Detroit falls primarily among children and includes 70 hospitalizations and 6,000 asthma-related respiratory symptom-days annually, equivalent to 7 disability-adjusted life years (DALYs). The health burden disproportionately falls on Hispanic/Latino residents, residents with less than a high school diploma, and foreign-born residents. Control strategies that target smaller facilities near exposed populations provide the greatest benefit in terms of the overall health burden reductions and the inequality of attributable health risk; conventional strategies that target the largest emission sources can increase inequality and provide only modest health benefits. The assessment is novel in using spatial analyses that account for urban scale gradients in exposure, demographics, vulnerability, and population health. We show that quantitative HIA methods can be used to develop AQM strategies that simultaneously meet environmental, public health, and environmental justice goals, advancing AQM beyond its current compliance-oriented focus.

The environmental burden of disease is the mortality and morbidity attributable to exposures of air pollution and other stressors. The inequality metrics used in cumulative impact and environmental justice studies can be incorporated into environmental burden studies to better understand the health disparities of ambient air pollutant exposures. This study examines the diseases and health disparities attributable to air pollutants for the Detroit urban area. We apportion this burden to various groups of emission sources and pollutants, and show how the burden is distributed among demographic and socioeconomic subgroups. The analysis uses spatially-resolved estimates of exposures, baseline health rates, age-stratified populations, and demographic characteristics that serve as proxies for increased vulnerability, e.g., race/ethnicity and income. Based on current levels, exposures to fine particulate matter (PM2.5), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2) are responsible for more than 10,000 disability-adjusted life years (DALYs) per year, causing an annual monetized health impact of $6.5 billion. This burden is mainly driven by PM2.5 and O3 exposures, which cause 660 premature deaths each year among the 945,000 individuals in the study area. NO2 exposures, largely from traffic, are important for respiratory outcomes among older adults and children with asthma, e.g., 46% of air-pollution related asthma hospitalizations are due to NO2 exposures. Based on quantitative inequality metrics, the greatest inequality of health burdens results from industrial and traffic emissions. These metrics also show disproportionate burdens among Hispanic/Latino populations due to industrial emissions, and among low income populations due to traffic emissions. Attributable health burdens are a function of exposures, susceptibility and vulnerability (e.g., baseline incidence rates), and population density. Because of these dependencies, inequality metrics should be calculated using the attributable health burden when feasible to avoid potentially underestimating inequality. Quantitative health impact and inequality analyses can inform health and environmental justice evaluations, providing important information to decision makers for prioritizing strategies to address exposures at the local level.

Comparative evaluations are needed to assess the suitability of near-road air pollution models for traffic-related ultrafine particle number concentration (PNC). Our goal was to evaluate the ability of dispersion (CALINE4, AERMOD, R-LINE, and QUIC) and regression models to predict PNC in a residential neighborhood (Somerville) and an urban center (Chinatown) near highways in and near Boston, Massachusetts. PNC was measured in each area, and models were compared to each other and measurements for hot (>18 °C) and cold (