EPA-450/5-85-004 The NAAQS Exposure Model (NEM) Applied to Carbon Monoxide: Addendum by Roy A. Paul and Ted Johnson PEI Associates, Inc. 505 South Duke Street, Suite 503 Durham, North Carolina 27701 Contract No. 68-02-4309 Work Assignment No 4 PN 3659-4 Task Manager Thomas R. McCurdy U.S. ENVIRONMENTAL PROTECTION AGENCY Office of Air and Radiation Office of Air Quality Planning and Standards Research Triangle Park, NC 27711 April 1985 ^ s Environmental pfotectjon Region 5, Library (PL-12J) 12th ------- DISCLAIMER This report was furnished to the U.S. Environmental Protection Agency by PEI Associates, Inc., in partial fulfillment of Contract No. 68-02-4309, Work Assignment No. 4. The contents of this report are reproduced herein as received from the contractor. The opinions, findings, and conclusions expressed are those of the authors and not necessarily those of the Environ- mental Protection Agency. ------- CONTENTS Tables iv Acknowledgment vi 1. Introduction 1 2. Exposure Estimates for Adults With Cardiovascular Disease in Four Urban Areas 4 "Best estimate" results 4 The significance of indoor sources 17 Uncertainty in NEM exposure estimates 17 3. Nationwide Extrapolations 19 Extrapolation results 19 Uncertainty of nationwide estimates 30 Comparing two forms of NAAQS 30 ------- TABLES Number Page 1-1 Air Quality Indicators for 8-hour Carbon Monoxide Standard With One Expected Exceedance.of 9 ppm per Year and With One Observed Exceedance of 9 ppm Per Year 3 2-1 Estimates of Occurrences for Adults With Cardiovascular Disease of 1-hour CO Exposures Above Selected Concentra- tion Values Assuming 9 ppm/1 ObEx Standard is Attained . 2-2 Estimates of Adults With Cardiovascular Disease who Have 1-hour CO Exposures Above Selected Concentration Values Assuming 9 ppm/1 ObEx Standard is Attained 2-3 Estimates of Adults With Cardiovascular Disease Whose Maximum 1-hour CO Exposure Occurs in Selected Concentration Ranges Assuming 9 ppm/1 ObEx Standard is Attained 2-4 Estimates of Occurrences for Adults With Cardiovascular Disease of 8-hour CO Exposures Above Selected Concentra- tion Values Assuming 9 ppm/1 ObEx Standard is Attained ... 8 2-5 Estimates of Adults With Cardiovascular Disease Who Have 8-hour CO Exposures Above Selected Concentration Values Assuming 9 ppm/1 ObEx Standard is Attained 9 2-6 Estimates of Adults With Cardiovascular Disease Whose Maximum 8-hour CO Exposure Occurs in Selected Concentration Ranges Assuming 9 ppm/1 ObEx Standard is Attained 10 2-7 Estimates of Occurrences for Adults With Cardiovascular Disease of COHb Levels Exceeding Selected Values Assuming 9 ppm/1 ObEx Standard is Attained 11 2-8 Estimates of Adults With Cardiovascular Disease Who Experience COHb Levels Exceeding Selected Values Assuming 9 ppm/1 ObEx Standard is Attained 12 2-9 Estimates of Adults With Cardiovascular Disease Whose Maximum COHb Level Occurs in Selected Ranges Assuming 9 ppm/1 ObEx Standard is Attained 13 ------- TABLES (continued) Number Page 2-10 Percentage of Adults With Cardiovascular Disease Experiencing COHb Levels Exceeding Selected Values Assuming 9 ppm/1 ObEx Standard is Attained 16 3-1 Estimates of Occurrences in the Cardiovascular Adult Urban U.S. Population of 1-hour Average CO Exposures Above Selected Concentration Values Under Alternative Air Quality Assumptions 20 3-2 Estimates of Cardiovascular Adults in Urban U.S. With 1-hour Average CO Exposures Above Selected Concentration Values Under Alternative Air Quality Assumptions 21 3-3 Estimates of Cardiovascular Adults in Urban U.S. Whose Maximum 1-hour Average CO Exposure Occurs in Selected Con- centration Ranges Under Alternative Air Quality Assumptions 22 3-4 Estimates of Occurrences in the Cardiovascular Adult Urban U.S. Population of 8-hour Average CO Exposures Above Selected Concentration Values Under Alternative Air Quality Assumptions 23 3-5 Estimates of Cardiovascular Adults in Urban U.S. With 8-hour Average CO Exposures Above Selected Concentration Values Under Alternative Air Quality Assumptions 24 3-6 Estimates of Cardiovascular Adults in Urban U.S. Whose Maximum 8-hour Average CO Exposure Occurs in Selected Con- centration Ranges Under Alternative Air Quality Assumptions 25 3-7 Estimates of Occurrences Among Cardiovascular Adults in Urban U.S. of COHb Levels Exceeding Selected Values Under Alternative Air Quality Assumptions 26 3-8 Estimates of Cardiovascular Adults in Urban U.S. Experiencing COHb Levels Exceeding Selected Values Under Alternative Air Quality Assumptions 27 3-9 Estimates of Cardiovascular Adults in Urban U.S. Whose Maximum COHb Level Occurs in Selected Concentration Ranges Under Alternative Air Quality Assumptions 28 3-10 Percentage of Cardiovascular Adult Urban U.S. Population Experiencing COHb Levels Exceeding Selected Values Under Alternative Air Quality Assumptions 29 ------- ACKNOWLEDGMENT This Addendum to the NAAQS Exposure Model Applied to Carbon Monoxide was largely due to the efforts of Mr. Thomas R. McCurdy, SASD. Appreciation is extended to him for this administrative and technical supervision. Other parties who developed and implemented the NEM are acknowledged in the original report. vi ------- SECTION 1 INTRODUCTION Under the Clean Air Act, the U.S. Environmental Protection Agency (EPA) is responsible for establishing National Ambient Air Quality Standards (NAAQS) and for reviewing them periodically to determine their adequacy on the basis of recent scientific research. In view of these responsibilities, the Strategies and Air Standards Division (SASD) of the Office of Air Quality Planning and Standards (OAQPS) is developing quantitative methods for assess- ing health risks associated with proposed air quality standards. An important aspect of health risk assessment is the estimation of popu- lation exposure. For the past few years, SASD has been engaged in the develop- ment of an exposure model suitable for evaluating alternative ambient air standards. The model is known as NEM, an acronym for NAAQS Dcposure Model. Several versions of NEM have been developed. The exposure district version of NEM simulates the pollutant concentrations expected to occur in selected exposure districts within a study area under user-specified regulatory scenarios. It then adjusts these estimates to account for an exhaustive set of microenvironments and simulates typical movements of population groups, called cohorts, through the districts and microenvironments. Outputs of the simulation program are population exposure estimates at specified pollutant 1 eve!s. Another version of NEM substitutes "neighborhood types" for exposure districts. A 1983 report described this neighborhood type (NT) model and its application to four U.S. urban areas (Chicago, IL, St. Louis, MO-IL, Philadelphia, PA, and Los Angeles, CA) to estimate population exposures associated with alternative NAAQS proposed for carbon monoxide (CO). Computer outputs from NEM provide estimates of population exposure for various measures of exposure and averaging times. In the case of CO, NEM also estimates carboxyhemoglobin (COHb) levels, an important indicator of the physiological effects of CO on the exposed population. In this addendum to ------- the 1983 report, results of NEM analyses of CO exposure in four study areas under two air quality assumptions are compared. The first assumption is that an air quality standard of 9 ppm with one expected exceedance (9 ppm 1 ExEx) is met in all four study areas. This assumption was used in previous reported analyses. The second assumption is that an air quality standard of 9 ppm with one observed exceedance is met in all study areas. The difference is that the first form of standard is based on the characteristic high, an air quality indicator statistically derived from daily maximum 8-hour values, while the second standard is based on the second highest 8-hour running average observed during the year. Note that a complete year of data contains 365 daily maximum 8-hour values versus nearly 8760 8-hour running average values. Note that some "observed" values are estimates based on the time series model used in NEM analyses. Table 1-1 lists the air quality indicators used for roll-back purposes under each form of the standard. ------- TABLE 1-1. AIR QUALITY INDICATORS FOR 8-HOUR CARBON MONOXIDE STANDARD WITH ONE EXPECTED EXCEEDANCE OF 9 ppm PER YEAR AND WITH ONE OBSERVED EXCEEDANCE OF 9 ppm PER YEAR Study area Chicago Los Angeles Philadelphia * St. Louis NT CR CC CI SR SC SI CR CC CI SR SC SI CR CC CI SR SC SI CR CC CI SR SC SI Air quality Expected exceedance standard3 7,2 15.6 10.8 9.5 10.0 8.3 8.8 20.1 20.3 15.5 16.6 20.3 14.3 14.3 7.2 7.9 7.9 10.4 6.1 10.7 14.7 12.5 11.5 14.7 indicator, ppm Observed exceedance standard0 7.5 15.9 10.6 12.2 12.2 9.5 9.0 18.1 21.7 13.6 15.6 21.7 18.3 18.3 11.4 8.3 8.3 11.7 6.7 11.1 14.4 14.0 10.2 14.4 Characteristic largest value estimated from distribution fit to daily maxi- mum 8-hour values. DSecond highest observed 8-hour running average value. ------- SECTION 2 EXPOSURE ESTIMATES FOR ADULTS WITH CARDIOVASCULAR DISEASE IN FOUR URBAN AREAS Exposure estimates presented in this report are for adults with cardio- vascular disease. Adults are defined to be persons at least 18 years old. Based on the currently available evidence, this subpopulation is judged to be the most sensitive group of persons with respect to CO-induced adverse health effects. As indicated on page 7-34 of the 1983 report, the values used for the percentage of adult females with cardiovascular disease was 4.2 percent and for adult males 5.8 percent. These values are based on the U.S. Depart- 2 ment of Health, Education, and Welfare data on coronary heart disease and, contrary to the statement on page 7-1 of the 1983 report, these estimates do not include individuals with peripheral vascular disease. 2.1 "BEST ESTIMATE" RESULTS Tables 2-1 through 2-9 contain selected printouts of a NEM analysis of exposure of adults with cardiovascular disease to CO in the four study areas under various air quality assumptions. Each table is identified as to CO/COHb indicator and air quality standard being simulated. CO exposure estimates are provided for both 1- and 8-hour average CO concentrations. In each case, the "best-estimate" microenvironment factors developed in Section 6 of the 1983 report were used to simulate the contribution of gas stoves and smoking to total CO exposure. Tables 2-1 through 2-9 are exactly analagous to Tables 7-1 through 7-9 of the 1983 report (pages 7-2 to 7-10) because the conditions specified are exactly the same except that a different form of NAAQS is used. 2.1.1 Attainment of 9 ppm/1 QbEx Standard NEM estimates in Tables 2-1 through 2-9 were developed by adjusting the air quality data for each study area using the roll-back formula described in Section 5.1 of the 1983 report so that the most polluted neighborhood type just meets a 9 ppm - 8 hour average - 1 observed exceedance (9 ppm/1 ObEx) ------- TABLE 2-1. ESTIMATES OF OCCURRENCES FOR ADULTS WITH CARDIOVASCULAR DISEASE OF 1-HOUR CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12.0 9.0 7.0 0.0 MAX. CONCENTRATION ENCOUNTERS AT MAX. CHICAGO 524 24,600 212,000 746,000 2,960,000 9,760,000 1,070.000,000 25.1 523 LOS ANGELES 5,790 97,400 849,000 4,330,000 14,800,000 2,670,000,000 20.5 5,790 PHILADELPHIA 1,280 1,230 33,100 141,000 441,0^0 1,320,000 1,020,000,000 28.0 1,270 ST LOUIS 709 6,910 16,600 41,800 241,000 381,000 3,070,000 416,000,000 32.5 707 ------- TABLE 2-2. ESTIMATES OF ADULTS WITH CARDIOVASCULAR DISEASE WHO HAVE 1-HOUR CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12.0 9.0 7.0 0.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM CHICAGO 523 11,400 22.300 53,200 109,000 121,000 122,000 25.1 523 LOS ANGELES 5,790 49,300 167,000 243,000 298,000 305,000 20.5 5,790 PHILADELPHIA 1,270 1,270 23,000 36,300 69,300 91,100 116,000 28.0 1,270 1 ST LOUIS 707 6,200 10,400' 21,000 28,800 36,600 44,800 47,500 32.5 707 ------- TABLE 2-3. ESTIMATES OF ADULTS WITH CARDIOVASCULAR DISEASE WHOSE MAXIMUM 1-HOUR CO EXPOSURE OCCURS IN SELECTED CONCENTRATION RANGES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED CONCENTRATION RANGE (PFM) 60.0 < C <= 100.0 55.0 < C <= 60.0 50.0 < C <= 55.0 45.0 < C <= 50.0 40.0 < C <= 45.0 35.0 < C <= 40.0 30.0 < C <= 35.0 25.0 < C <= 30.0 20.0 < C <= 25.0 15.0 < C <= 20.0 12.0 < C <= 15.0 9.0 < C <= 12.0 7.0 < C <= 9.0 0.0 < C <= 7.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM . CHICAGO 524 10,900 10,900 30,900 55,500 12,400 494 25.1 523 LOS ANGELES 5,790 43,500 118,000 80, add 50,500 6,390 20.5 5,790 PHILADELPHIA 1,280 21,700 13,800 32,500 21,800 25,200 28.0 1,270 1 1 1 ST LOUIS 1 1 1 1 709 5,490 4,190 10,700 7,730 7,850 3,160 2,730 32.5 707 ------- TABLE 2-4. ESTIMATES OF OCCURRENCES FOR ADULTS WITH CARDIOVASCULAR DISEASE OF 8-HOUR CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12. 0 9.0 7.0 0.0 MAX. CONCENTRATION ENCOUNTERS AT MAX. CHICAGO 78,700 1,840,000 1,070,000,000 11.6 120 LOS ANGELES 80,100 1,370,000 2,670,000,000 10.1 2,000 PHILADELPHIA 66,700 422,000 1,020,000,000 11.0 29 ST LOUIS 81,100 473,000 416,000,000 11.6 11 ------- TABLE 2-5. ESTIMATES OF ADULTS WITH CARDIOVASCULAR DISEASE WHO HAVE 8-HOUR CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12.0 9.0 7.0 1 0.0 1 1 1 MAX. CONCENTRATION i PEOPLE AT MAXIMUM I CHICAGO 5,260 67,100 122,000 11.6 120 LOS ANGELES 5,790 65,100 305,000 10.1 2,000 PHILADELPHIA 20,300 35,400 116,000 11.0 29 ST LOUIS 15,000 24,400 47,500 11.6 11 ------- TABLE 2-6. ESTIMATES OF ADULTS WITH CARDIOVASCULAR DISEASE WHOSE MAXIMUM 8-HOUR CO EXPOSURE OCCURS IN SELECTED CONCENTRATION RANGES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED ' 1 CONCENTRATION RANGE (PPM) ' 60.0 < C <= 100.0 55.0 < C < = 60.0 50.0 < C <= 55.0 45.0 < C <= 50.0 40.0 < C <= 45.0 35.0 < C <= 40.0 30.0 < C <= 35.0 25.0 < C <= 30.0 20.0 < C <= 25.0 15.0 < C <= 20.0 12.0 < C <= 15.0 9.0 < C <= 12.0 7.0 < C <= 9.0 0.0 < C <= 7.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM CHICAGO 5,270 61,900 54,400 11.6 120 LOS ANGELES 5,790 59,300 240,000 10.1 2,000 PHILADELPHIA 20,300 15,200 80,900 11.0 29 ST LOUIS 15,000 9,430 23,100 11.6 11 10 ------- TABLE 2-7. ESTIMATES OF OCCURRENCES FOR ADULTS WITH CARDIOVASCULAR DISEASE OF COHb LEVELS EXCEEDING SELECTED VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED COHB LEVEL EXCEEDED (PERCENT) 3.70 3.50 3.30 3.10 3.00 2.90 2.70 2.50 2.30 2.10 2.00 1.50 1.00 0.00 MAX. COHB CONC. ENCOUNTERS AT MAX. 1 CHICAGO 66,400 7,820,000 1,070,000,000 1.89 54 LOS ANGELES 49,400 13,900,000 2,670,000,000 1.78 1,560 PHILADELPHIA 43,400 1,070,000 1,020,000,000 1.86 15 1 1 ST LOUIS 1 21 58,700 2,140,000 416,000,000 2.05 5 11 ------- TABLE 2-8. ESTIMATES OF ADULTS WITH CARDIOVASCULAR DISEASE WHO EXPERIENCE COHb LEVELS EXCEEDING SELECTED VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED COHB LEVEL EXCEEDED (PERCENT) 3.70 3.50 3.30 3.10 3.00 2.90 2.70 2.50 2.30 2.10 2.00 1.50 1.00 0.00 MAX. COHB CONC. PEOPLE AT MAXIMUM CHICAGO 9,160 94,200 122,000 1.S9 54 LOS ANGELES 5,790 232,000 305,000 1.78 1,560 PHILADELPHIA 15,500 40,300 116,000 1.86 15 ST LOUIS 21 16,700 35,000 47,500 2.05 5 12 ------- TABLE 2-9. ESTIMATES OF ADULTS WITH CARDIOVASCULAR DISEASE WHOSE MAXIMUM COHb LEVEL OCCURS IN SELECTED RANGES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED COHB LEVEL RANGE (PERCENT) 3.70 < C <= 10.00 3.50 < C <= 3.70 3.30 < C <= 3.50 3.10 < C <= 3.30 3.00 < C <= 3.10 2.90 < C <= 3.00 1 2.70 < C <= 2.90 2.50 < C <= 2.70 1 2.30 < C <= 2.50 2.10 < C <= 2.30 2.00 < C <= 2.10 1.50 < C <= 2.00 1.00 < C <= 1.50 0.00 < C <= 1.00 MAX. COHB CONG. PEOPLE AT MAXIMUM CHICAGO 9,160 85,000 27,400 1.89 54 LOS ANGELES 5,790 227,000 72,800 1.78 1,560 PHILADELPHIA 15,500 24,800 76,000 1.86 15 1 ST LOUIS 1 1 1 21 16,700 1 18,300 1 12,500 1 2.05 1 5 1 13 ------- standard, i.e., one specifying that the number of 8-hour running average CO values exceeding 9 ppm shall not be greater than 1 per year. Table 2-1 pro- vides estimates of the number of occurrences for adults with cardiovascular disease of 1-hour exposures to CO concentrations exceeding selected values. (Exposures exactly equal to zero are counted as exceeding zero.) Thus, each column in Table 2-1 presents a cumulative frequency distribution in which the number of 1-hour exposures increases as CO concentration decreases; the dis- tribution reaches a maximum at a CO concentration of zero. This maximum is the number of adults with cardiovascular disease used in the simulation times the number of possible occurrences in a year (8760). Although NEM yields individual frequency distributions for cohorts who are at low, medium, and high activity levels when a given CO concentration is encountered, only the total frequency distribution for all activity levels is presented in Table 2-1. According to these estimates, none of the four study areas would have more than 6,910 occurrences of 1-hour CO exposures above 25 ppm if a 9 ppm/1 ObEx standard were just attained. This statement is also true for the 9 ppm/1 ExEx standard, as shown in Table 7-1 in the 1983 report. Table 2-2 uses an alternative exposure indicator, adults with cardio- vascular disease with 1-hour exposures. This is the number of adults with cardiovascular disease in the study area that experience one or more 1-hour exposures per year to CO concentrations that exceed a specified value. This exposure indicator is also expressed as a cumulative frequency distribution. The number of adults with cardiovascular disease exposed at zero concentra- tion (or above) is the total population of the study area. Table 2-3 provides estimates of the number of adults with cardiovascular disease who experience their peak exposure of the year within selected inter- vals of 1-hour CO concentrations. These estimates are not cumulative; each peak exposure falls within a single interval. Tables 2-4 through 2-6 are similar to Tables 2-1 through 2-3 except that exposures are estimated in terms of 8-hour running average CO concentrations. Because the average of any eight successive hourly concentrations is less than or equal to the highest value in the series, pollutant exposures usually occur at lower concentrations for 8-hour running averages than for 1-hour averages. For example, the maximum 8-hour running average concentration experienced in Chicago is 11.^ ppm (Table 2-4), while the maximum 1-hour concentration is 14 ------- 25.1 ppm (Table 2-1). Similarly, the number of 8-hour running average expo- sures above 9 ppm is 78,700 in Table 2-4, compared with 2,960,000 1-hour average exposures in Table 2-1. The 1983 report lists the general algorithm used by NEM to estimate COHb levels in the exposed populations. Full documentation of the rationale for the choice of these values is provided in an EPA memorandum referenced in that report. In essence, the carboxyhemoglobin algorithm estimates the COHb levels of an individual at the end of every hour of the year. Although COHb levels are, strictly speaking, the result of CO exposure, they can be described using concepts similar to those used for CO exposure. For example, Table 2-7 lists the number of occurrences of COHb levels that exceed selected values. Table 2-8 lists the number of adults with cardiovascular disease that experience COHb levels which exceed selected values. Table 2-9 lists the number of adults with cardiovascular disease who experience their highest COHb level within selected ranges of COHb values. As would be expected, Tables 2-7 and 2-8 present cumulative distributions, while Table 2-9 lists results in discrete intervals. The relative frequencies of high COHb levels among the four study areas can be compared by normalization, i.e., by converting the estimates of adults with cardiovascular disease experiencing different COHb levels to the correspond- ing percentage of total adults with cardiovascular disease in the study area population. Table 2-10 shows that none of the study areas have adults with cardiovascular disease with COHb levels exceeding 2.1 percent under the 9 ppm/1 ObEx standard. Approximately 13.4 percent of the Philadelphia adults with cardiovascular disease experience COHb levels exceeding 1.50 percent. Maximum COHb levels are 1.89 percent for Chicago, 1.78 percent for Los Angeles, 1.86 percent for Philadelphia, and 2.05 percent for St. Louis. As previously noted, the estimates presented in the tables are for adults with cardiovascular disease. The value used for the percentage of adult females with cardiovascular disease was 4.2 percent; for adult males the value was 5.8 percent. These values are identical to those used in the 1983 report. In this application of NEM, estimates for the whole population were ratioed down to the estimates for adults with cardiovascular disease by using these two values in conjunction with estimates of the percentages of adults who are male and female in each of the four cities (52% female and 48% 15 ------- TABLE 2-10. PERCENTAGE OF ADULTS WITH CARDIOVASCULAR DISEASE EXPERIENCING COHb LEVELS EXCEEDING SELECTED VALUES ASSUMING 9 PPM/1 OBEX STANDARD IS ATTAINED COHb level exceeded (percent) 3.00 2.90 2.80 2.70 2.60 2.50 2.40 2.30 2.10 2.00 1.50 1.00 0.00 Max. COHb cone. Percent at maximum Chicago 7.51 77.21 100.00 1.89 0.20 Los Angeles 1.90 76.07 100.00 1.78 2.14 Philadelphia 13.36 34.74 100.00 1.86 0.02 St. Louis 0.04 35.16 73.68 100.00 2.05 0.04 16 ------- male). The fact that all married women are females was accounted for in the calculation, but the fact that the male/female percentage breakdown varies from one occupation to another was not. The estimates use 1980 census data for the four cities but are projected to 1987 by using the multiplicative factor 1.195. The development of this factor is explained in the 1983 report. 2.2 THE SIGNIFICANCE OF INDOOR SOURCES Exposure estimates discussed in Section 2.1 assumed gas stoves and smok- ing contribute to total CO exposure. The significance of these CO sources was analyzed in Section 7.3 of the 1983 report. Maximum 1-hour CO exposures were found to be less than 1.0 percent higher when indoor sources were included in the analysis. Maximum 8-hour CO exposures were found to be 1.0 to 7.7 percent higher when indoor sources were included. In the NEM model, peak CO levels are generally experienced in transportation vehicles or along roadways— microenvironments with "best-estimate" multiplicative factors of 2.10 and 1.20, respectively. 2.3 UNCERTAINTY IN NEM EXPOSURE ESTIMATES Any method used to estimate exposure of large, diverse groups of people must deal with uncertainties in data and in assumptions used. The exposure model can only represent major features. Because the relevant data bases are often incomplete and/or inaccurate, professional judgment plays a significant role in selecting monitors to represent neighborhood types, in validating air quality data, in estimating cohort populations, and in determining cohort movements. Lower, best, and upper estimates of microenvironmental factors were presented in Section 6.0 of the 1983 report. The results of analyzing these factors indicate that the difference between the lower estimates and the upper estimates is appreciable. This large variation primarily results from the large differences between lower and upper estimates of multiplicative microenvironment factors, particularly those for transportation vehicles and roadsides. A limited sensitivity analysis was conducted on two of the physiological variables which determine COHb levels in the blood resulting from given 17 ------- patterns of CO exposure. Variations in the Haldane constant and ventilation rates have a significant effect, but not as large an effect as the variation in estimated microenvironment factors. Details of these analyses were given in the 1983 report.1 18 ------- SECTION 3 NATIONWIDE EXTRAPOLATIONS Section 2 summarizes the results of applying NEM to four study areas, namely, Chicago, Los Angeles, Philadelphia, and St. Louis. Rough estimates of national exposure for adults with cardiovascular disease were made by extrapolating these exposure and COHb estimates. The extrapolation procedure is described in Section 8 of the 1983 report. 3.1 EXTRAPOLATION RESULTS The results of the nationwide extrapolation are presented in Tables 3-1 through 3-10. The first nine tables can be divided into three sets of three tables. Tables 3-1, 3-2, and 3-3 present exposure estimates for a 1-hour averaging time. Estimates of occurrences during 1987 among adults with cardiovascular disease of 1-hour average CO exposures above selected concen- tration values under four alternative air quality assumptions are presented in Table 3-1. Estimates of the number of adults with cardiovascular disease in the urban U.S. who would incur 1-hour average CO exposures above the same set of selected concentrations under the same assumptions are presented in Table 3-2. Estimates of the number of urban U.S. adults whose maximum 1-hour average CO exposure would occur in various concentration ranges are presented in Table 3-3. Analogous estimates for 8-hour average CO exposures are presented in Tables 3-4, 3-5, and 3-6, respectively. Similar estimates for COHb levels resulting from CO exposure are presented in Tables 3-7, 3-8, and 3-9. The absolute numbers presented in Table 3-9 are presented in percentage form in Table 3-10. Estimates of the number of adults with cardiovascular disease who would have their blood COHb levels elevated above selected concentrations for various numbers of days if an 8-hour average 9 ppm/1 ExEx standard were just met in all urban areas are presented in Table 3-8. The table indicates the 19 ------- TABLE 3-1. ESTIMATES OF OCCURRENCES IN THE CARDIOVASCULAR ADULT URBAN U.S. POPULATION OF 1-HOUR AVERAGE CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12.0 9.0 7.0 0.0 MAX. CONCENTRATION ENCOUNTERS AT MAX. 9 PPM 8HR 1EXEX 10,200 21,900 168,000 915,000 6,620,000 27,700,000 102,000,000 370,000,000 45,900,000,000 36.0 10,200 9 PPM 8HR 108EX 11,700 134,000 778,000 5,410,000 22,700,000 93,700,000 306,000,000 45,900,000,000 32.5 11,700 12 PPM 8HR 1EXEX 10,200 21,900 124,000 359,000 1,700,000 6,570,000 31,300,000 88,500,000 296,000,000 873,000,000 45,900,000,000 49.0 10,200 1 15 PPM 8HR 1EXEX 1 10,200 21,900 21,900 33,600 359,000 849,000 2,140,000 6,310,000 21,300,000 78,700,000 185,000,000 602,000,000 1,640,000,000 45,900,000,000 61.5 10,200 20 ------- TABLE 3-2. ESTIMATES OF CARDIOVASCULAR ADULTS IN URBAN U.S. WITH 1-HOUR AVERAGE CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS 1 1 CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12.0 9.0 7.0 0.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM 9 PPM 8HR 1EXEX 10,200 21,900 157,000 535,000 1,290,000 2,820,000 4,390,000 5,140,000 5,240,000 36.0 10,200 9 PPM 8HR 10BEX 11,700 123,000 423,000 1,150,000 2,440,000 4,210,000 4,960,000 5,240,000 32.5 11,700 12 PPM 8HR 1EXEX 10,200 21,900 113,000 343,000 691,000 1,290,000 2,900,000 4,290,000 5,030,000 5,240,000 5,240,000 49.0 10,200 15 PPM 8HR 1EXEX 10,200 21,900 21,900 21,900 348,000 531,000 872,000 1,270,000 2,510,000 4,290,000 4,800,000 5,220,000 5,240,000 5,240,000 61.5 10,200 21 ------- TABLE 3-3. ESTIMATES OF CARDIOVASCULAR ADULTS IN URBAN U.S. WHOSE MAXIMUM 1-HOUR AVERAGE CO EXPOSURE OCCURS IN SELECTED CONCENTRATION RANGES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS CONCENTRATION RANGE (PPM) 60.0 < C <= 100.0 55.0 < C <= 60.0 50.0 < C <= 55.0 45.0 < C <= 50.0 40.0 < C <= 45.0 35.0 < C <= 40.0 30.0 < C <= 35.0 25.0 < C <= 30.0 20.0 < C <= 25.0 15.0 < C <= 20.0 12.0 < C <= 15.0 9.0 < C <= 12.0 7.0 < C <= 9.0 0.0 < C <= 7.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM 9 PPM 8HR 1EXEX 10,200 11,700 135,000 378,000 753,000 1,530,000 1,570,000 747,000 107,000 36.0 10,200 9 PPM 8HR 10BEX 11,700 111,000 300,000 729,000 1,290,000 1,770,000 745,000 284,000 32.5 11,700 12 PPM 8HR 1EXEX 10,200 11,700 90,600 235,000 344,000 603,000 1,610,000 1,390,000 738,000 211,000 4,730 49.0 10,200 15 PPM 8HR 1EXEX 10,200 11,700 326,000 184,000 341,000 401,000 1,240,000 1,770,000 510,000 426,000 18,600 61.5 10,200 22 ------- TABLE 3-4. ESTIMATES OF OCCURRENCES IN THE CARDIOVASCULAR ADULT URBAN U.S. POPULATION OF 8-HOUR AVERAGE CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 20.0 15.0 12.0 9.0 7.0 0.0 MAX. CONCENTRATION ENCOUNTERS AT MAX. 9 PPM 8HR 1EXEX 200,000 6,340,000 63,500,000 45,900,000,000 14.0 232 9 PPM 6HR 10BEX 3,690,000 51,900,000 45,900,000,000 11.5 2,480 12 PPM SHR 1EXEX 429,000 4,290,000 54,900,000 322,000,000 45,900,000,000 18.5 232 15 PPM 8HR 1EXEX 104,000 3,830,000 29,200,000 206,000,000 835,000,000 45,900,000,000 23.0 232 23 ------- TABLE 3-5. ESTIMATES OF CARDIOVASCULAR ADULTS IN URBAN U.S. WITH 8-HOUR AVERAGE CO EXPOSURES ABOVE SELECTED CONCENTRATION VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS CONCENTRATION EXCEEDED (PPM) 60.0 55.0 50.0 45.0 40.0 35.0 30.0 25.0 ao.o 15.0 12.0 9.0 7.0 0.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM 9 PPtl 8HR 1EXEX 98,000 618,000 2,650,000 5,240,000 14.0 232 9 PPM 8HR 10BEX 534,000 2,230,000 5,240,000 11.5 2,480 12 PPM 8HR 1EXEX 176,000 538,000 2,410,000 4,090,000 5,240,000 18.5 232 15 PPM 8HR 1EXEX 49,400 529,000 1,770,000 3,660,000 4,950,000 5,240,000 23.0 232 24 ------- TABLE 3-6. ESTIMATES OF CARDIOVASCULAR ADULTS IN URBAN U.S. WHOSE MAXIMUM 8-HOUR AVERAGE CO EXPOSURE OCCURS IN SELECTED CONCENTRATION RANGES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS CONCENTRATION RANGE (PPM) 60.0 < C <= 100.0 55.0 < C <= 60.0 50.0 < C <= 55.0 45.0 < C <= 50.0 40.0 < C <= 45.0 35.0 < C <= 40.0 30.0 < C <= 35.0 25.0 < C <= 30.0 20.0 < C <= 25.0 15.0 < C <= 20.0 12.0 < C <= 15.0 9.0 < C <= 12.0 7.0 < C < = 9.0 0.0 < C <= 7.0 MAX. CONCENTRATION PEOPLE AT MAXIMUM 9 PPM 8HR 1EXEX 98,100 520,000 2,030,000 2,590,000 14.0 232 9 PPM 8HR 10BEX 534,000 1,700,000 3,010,000 11.5 2,480 12 PPM 8HR 1EXEX 176,000 362,000 1,870,000 1,680,000 1,160,000 18.5 232 15 PPM 8HR 1EXEX 49,400 480,000 1,240,000 1,890,000 1,290,000 291,000 23.0 232 25 ------- TABLE 3-7. ESTIMATES OF OCCURRENCES AMONG CARDIOVASCULAR ADULTS IN URBAN U.S. OF COHb LEVELS EXCEEDING SELECTED VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS COHB LEVEL EXCEEDED (PERCENT) 3.70 3.50 3.30 3.10 3.00 2.90 2.70 2.50 2.30 2.10 2.00 1.50 1.00 0.00 MAX. COHB CONC. ENCOUNTERS AT MAX. 9 PPM 8HR 1EXEX 570 12,000 41,700 4,730,000 296,000,000 45,900,000,000 2.30 120 9 PPM 8HR 10BEX 350 2,780,000 248,000,000 45,900,000,000 2.04 82 12 PPM 8HR 1EXEX 570 2,650 14,800 76,700 473,000 1,580,000 2,730,000 36,300,000 1,070,000,000 45,900,000,000 3.02 120 15 PPM 8HR 1EXEX 637 6,690 15,300 51,800 106,000 250,000 810,000 1,880,000 4,100,000 8,580,000 13,900,000 151,000,000 2,270,000,000 45,900,000,000 3.75 120 26 ------- TABLE 3-8. ESTIMATES OF CARDIOVASCULAR ADULTS IN URBAN U.S. EXPERIENCING COHb LEVELS EXCEEDING SELECTED VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS COHB UEVEL EXCEEDED (PERCENT) 3.70 3.50 3.30 3.10 3.00 2.90 £.70 2.50 2.30 2.10 2.00 1.50 1.00 0.00 MAX. COHB CONC. PEOPLE AT MAXIMUM 1 9 PPM 8HR 1EXEX 281 5,500 22,200 7*2,000 4,140,000 5,240,000 2.30 120 9 PPM 8HR 10BEX 346 598,000 3,620,000 5,240,000 2.04 82 12 PPM 8HR 1EXEX 281 1,250 6,230 42,000 217,000 452,000 660,000 2,100,000 5,090,000 5,240,000 3.02 120 15 PPM 8HR 1EXEX 345 3,200 6,600 25,800 58,200 132,000 308,000 506,000 732,000 1,060,000 1,350,000 3,480,000 5,180,000 5,240,000 3.75 120 27 ------- TABLE 3-9. ESTIMATES OF CARDIOVASCULAR ADULTS IN URBAN U.S. WHOSE MAXIMUM COHb LEVEL OCCURS IN SELECTED CONCENTRATION RANGES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS 1 COHB LEVEL RANGE (PERCENT) 1 3.70 < C <= 10.00 3.50 < C <= 3.70 3.30 < C <= 3.50 3.10 < C <= 3.30 3.00 < C <= 3.10 2.90 < C <= 3.00 2.70 < C <= 2.90 2.50 < C < = 2.70 2.30 < C <= 2.50 2.10 < C <= 2.30 2.00 < C <= 2.10 1.50 < C <= 2.00 1.00 < C <= 1.50 0.00 < C <= 1.00 MAX. COHB CONC. PEOPLE AT MAXIMUM 9 PPM 8HR 1EXEX 285 5,230 16,700 720,000 3,400,000 1,100,000 2.30 120 9 PPM 8HR 10BEX 350 598,000 3,020,000 1,630,000 2.04 82 12 PPM 8HR 1EXEX 285 972 4,990 35,900 175,000 235,000 208,000 1,440,000 2,990,000 149,000 3.02 120 15 PPM 8HR 1EXEX 351 2,860 3,400 19,200 32,400 74,100 175,000 198,000 227,000 327,000 291,000 2,130,000 1,700,000 63,000 3.75 120 28 ------- TABLE 3-10. PERCENTAGE OF CARDIOVASCULAR ADULT URBAN U.S. POPULATION EXPERIENCING COHb LEVELS EXCEEDING SELECTED VALUES UNDER ALTERNATIVE AIR QUALITY ASSUMPTIONS COHb level exceeded (percent) 3.70 3.50 3.30 3.10 3.00 2.90 2.70 2.50 2.30 2.10 2.00 1.50 1.00 0.00 9 ppm 8 h 1 ExEx 0.01 0.10 0.42 14.16 79.01 100.00 9 ppm 8 h 1 ObEx 0.01 11.41 69.08 100.00 12 ppm 8 h 1 Ex Ex 0.01 0.02 0.12 0.80 4.14 8.63 12.60 40.08 97.14 100.00 15 ppm 8 h 1 ExEx 0.01 0.06 0.13 0.49 1.11 2.52 5.88 9.66 13.97 20.23 25.76 66.41 98.85 100.00 29 ------- frequency of repeated peak COHb levels. The table indicates, for example, that of the 5,500 adults with cardiovascular disease who are estimated to have their blood COHb level exceed 2.1 percent under the 9 ppm/1 ExEx standard, none would have it occur more than one day. 3.2 UNCERTAINTY OF NATIONWIDE ESTIMATES The uncertainty in the CO exposure and COHb estimates for the four base cities was discussed in Section 2. The nationwide estimates are even more uncertain because of the additional uncertainty introduced by the extrapola- tion of exposure estimates for these four cities to all urban areas in the U.S. The analyses discussed in the 1983 report indicated that uncertainty is already great at the city level. That even greater uncertainty exists in the nationwide estimates should be recognized when considering the estimates presented in Tables 3-1 through 3-10. 3.3 COMPARING TWO FORMS OF NAAQS Two forms of NAAQS are listed in Tables 3-1 through 3-10, both defined at the 9 ppm level. The first form is the expected exceedance (ExEx) form whereby one exceedance is expected to occur during the year, according to a distribution fitting procedure. The second form is the observed exceedance (ObEx) form whereby one observed exceedance means one 8-hour value at a CO monitor exceeded the standard during the year. Comparing exposure estimates under two forms of NAAQS in Tables 3-1 to 3-9 shows a rough similarity between the two distributions of exposure. For example, Table 3-1 shows 102,000,000 occurrences of 1-hour average exposure at 9 ppm or above under the 1 ExEx form of NAAQS and 93,700,000 occurrences under the 1 ObEx form. Table 3-6 shows 520,000 cardiovascular adults whose maximum exposure occurred in the range 9 ppm to 12 ppm under the 1 ExEx standard and 534,000 cardiovascular adults whose maximum exposure occurred in the same range under the 1 ObEx form. Comparing exposure estimates from the two forms of standard also shows a consistent downward shift in the distribution of exposures when the 1 ObEx form is employed. Each table shows a small number of people at the tail of the distribution who receive higher exposure under the 1 ExEx form of the 30 ------- NAAQS. Table 3-2 shows that an estimated 10,200 cardiovascular adults are exposed to CO above 35 ppm (1-hour average) under the 1 ExEx form, whereas none are exposed above this level under the 1 ObEx form. Table 3-5 shows that 98,000 cardiovascular adults are exposed above 12 ppm CO (8-h average) under the 1 ExEx form whereas none are exposed above this level in the 1 ObEx form. Comparing estimates of COHb levels of cardiovascular adults in Table 3-8 shows that 5,500 adults experience COHb above 2.10 ppm under the 1 ExEx form whereas none experience this level under the 1 ObEx form. While these distributions are different, both sets of estimates show no COHb levels above 2.50. REFERENCES 1. Johnson, T., and R. Paul. The NAAQS Exposure Model (NEM) Applied to Carbon Monoxide. Prepared by PEDCo Environmental, Inc. for Office of Air Quality Planning and Standards, U.S. Environmental Protection Agency. EPA-450/5-83-004, December 1983. 2. U.S. Department of Health, Education, and Welfare, Public Health Service. Coronary Heart Disease in Adults. United States: 1960-1962, Vital and Health Statistics Series 11, No. 10, December 1975. 31 ------- |