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HEALTH EFFECTS OF INCREASING SULFUR OXIDES  EMISSIONS
      J. F. Finklea, G.  G.  Akland,  M.  C.  Nelson
      R. I. Larsen, D.  B.  Turner,  W.  E.  Wilson
       National Environmental Research Center
         Office of Research and Development
           Environmental Protection Agency
       Research Triangle Park, North Carolina

                    March 6, 1975

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                             INTRODUCTION

     The Clean Air Act amendments  of 1970 recognized the  need to protect
the public health from any adverse health effects  attributable to pollu-
tants emitted from motor vehicles  or from stationary sources including
steam-electric power plants.   The  Act requires  that health-related air
quality standards be set to protect fully both  healthy and especially
susceptible segments of the population.   Health-related air quality
standards for sulfur oxides and particulates,  two  of the  most important
pollutants emitted by steam electric power plants, are scheduled to be
met before the end of this decade.  Meeting emission and  air quality
standards will prove a difficult challenge for an  electric utility in-
dustry already facing other major obstacles in its efforts to meet the
growing power demands of our nation.- The most difficult standards to
attain relate to sulfur oxides.
     Meeting standards will require substantial reductions in sulfur
oxide emissions.  The effect of not meeting standards and allowing sulfur
oxides emissions to grow can be better understood  after one reviews the
best available answers to the following eight questions:
     *  Why control sulfur oxides?
     *  How are sulfur oxides emissions changing?
     *  What are the relationships linking sulfur  dioxide to ambient
        levels of acid-sulfate aerosols?
     *  What adverse health effects are attributable to elevated ambient
        levels of sulfur oxides?

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     0  How will  growth in emissions  from steam electric power plants
        alter human exposures to acid-sulfate aerosols?
     0  What is the magnitude of the  public health problem likely to
        follow a  growth in emissions?
     0  How much  must sulfur oxides be controlled?
     0  What important caveats must be kept in mind?

     The answers  to these questions are better today than six months
ago.  However, the residual uncertainties again clearly demonstrate that
our scientific information base must  be rapidly augmented if we are to
assure the necessary base for sound policy decisions on the sulfur
oxides problem and other problems involving energy and our environment.
To do othervn'se is to invite a series of national  economic, environmental
and public health tragedies.
                     WHY CONTROL SULFUR OXIDES?

     For at least another decade industrial  nations will  combust increasing
quantities of fossil fuels that contain organic  and inorganic sulfur
compounds.  Unless specifically controlled,  the  sulfur compounds in
fossil fuels utilized by steam electric power plants will  be emitted
into the air as sulfur dioxide and, to a lesser  extent as  sulfur trioxide.
These sulfur oxides are transformed in power plant plumes  and later in

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the atmosphere into acid-sulfate aerosols (strong acids and sulfate
salts).  Acid-sulfate aerosols are fine participates which have a long
atmospheric residence and which are capable of penetrating deeply into
the human respiratory tract where they may become entrapped.  Acid-
sulfate aerosols can adversely affect human health, vegetation, fish,
materials, and visibility.

              HOW ARE SULFUR OXIDES EMISSIONS CHANGING?
     Two important concurrent changes in sulfur oxides emissions have
taken place in recent years:
     0  Urban emissions from area sources, industrial  sources and
        power plants have decreased. .
     0  Suburban and rural emissions from steam electric power plants
        have increased.

     Urban emissions of sulfur oxides from home heating and industrial
sources began to decrease just after World War II and air pollution
control efforts during the late 1960's only reinforced a trend that was
already well established.  Concern about urban air pollution did however
cause a number of utilities to seek low sulfur fuels which have since
become scarce and increasingly expensive.  Precise estimates are not
available but it is likely that sulfur oxide emissions in our major
cities were decreased by about 50% between 1960 and 1970.  Further
reductions are envisioned under the state implementation plans required
by the Clean Air Act amendments.

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                                                        M*.
     On the other hand,  suburban  and  rural  emissions  of  sulfur  oxides
rapidly increased between 1960  and  1970.   This  is  in  large  part attrib-
utable to a continued growth  in sulfur oxides emissions  from steam  electric
power plants which can be appreciated by  study  of  the regional  and  national
trends shown in Table 1.   Were  it not for steam-electric power  plants,
nationwide emissions of sulfur  oxides between 1950 and 1969 would have
decreased by 15% instead of increasing by 36%.   If emission standards
and existing air quality standards  are met, sulfur dioxide  emissions from
steam electric power plants must  be substantially  reduced.   The emission
picture will be further complicated by the need to import significant
quantities of high sulfur petroleum and utilize more  high sulfur domestic
coal.  Continuation of recent growth  rates in the  generation of electricity  '
by fossil-fuel steam electric power plants could greatly increase emissions
if permanent emissions controls are not installed  on  new plants or  plants
converting from low sulfur fuels  to high  sulfur fuel. On the other hand,
conservation measures and increasing  utility rates can slow growth  in
demand and thus lessen the adverse  effects of an unrestrained growth in
emissions of sulfur oxides.

                  WHAT ARE THE  RELATIONSHIPS LINKING
                  SULFUR DIOXIDE  TO AMBIENT LEVELS OF
                        ACID-SULFATE  AEROSOLS?
     Sulfur dioxide is transformed in the atmosphere  to  sulfur trioxide
and sulfuric acid by a number of different complex mechanisms whose
effective transformation rates  vary from  1 to 20%  per hour.  The predominant

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mechanism can be expected to vary from place to'place and over time
(Appendix A).  Sulfuric acid aerosols and the salts that form with ammonia
or metallic cations may be transported for long distances.   Urban acid-
sulfate aerosols contain at least three components:   first, a component
intruding from rural sources and distant urban plumes; second, a compo-
nent arising from sulfur oxide emissions in the urban area; and third,
a component of natural origin.  Acid-sulfate aerosols are removed by
rairiout and washout.  Sulfur trioxide in smaller amounts is also emitted
directly from combustion sources and is rapidly transformed into sulfuric
acid aerosol, thus associating worrisome levels of sulfuric acid with
power plant plumes.
     Power plants in the eastern half of the United States  are spatially
arranged (Figure 1} so that moving air parcels replenish their sulfur
loading more rapidly than acid sulfate aerosols can be removed by natural
processes.  The increased acid-sulfate aerosol loading is associated with
worrisome increases in atmospheric turbidity; rainfall acidity and ambient
air levels of suspended particulate sulfates in urban and rural areas.
Water soluble suspended particulate sulfates collected on a high volume
air sampler are a useful but imperfect proxy for acid-sulfate aerosols.
Increased acid-sulfate aerosol loadings mean that ambient air entering
downwind metropolitan regions may contain bothersome levels of pollutants
before emissions from the local air quality control region contribute a
further increment.

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     Where urban emissions  of sulfur  dioxide  predominate  and where
arriving air parcels-are not already  polluted,  there  is a relatively
good (.5 - .7) correlation  between  24 hour ambient  levels of sulfur
dioxide and ambient levels  of suspended sulfates.   It has also been
observed that suburban levels^of suspended sulfates are fairly well
correlated with central  city levels of sulfur dioxide but less well
correlated with suburban sulfur dioxide suggesting  that locally emitted
sulfur dioxide is transformed into  aerosols and transported to other
parts of large urban complexes.  Measurements around  industrial facili-
ties during full operation  and during shutdowns demonstrate a clear re-
lationship between local ambient levels of sulfur  dioxide and suspended
sulfates.  There is not always a good correlation  between ambient levels
of sulfur dioxide and suspended sulfates.   Poor correlations are expected
when photochemical smog is  present, and when  local  industrial emissions
introduce catalytic metals  or reactive hydrocarbons.   Poor correlations
are also observed when local emissions of  sulfur oxides are controlled
but more distant emissions  and intruding acid-sulfate aerosols are allowed
to increase.
     Thus, it is important  to consider regional emissions patterns when
projecting changes in acid-sulfate  aerosol levels.  Though our data base
is far from satisfactory, there is  evidence that acid-sulfate aerosols,
as measured by their suspended sulfate proxy, did  decrease substantially
in urban areas where sulfur dioxides were  stringently controlled during
the late 1960's.  However,  regional emissions increased because of locating

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steam electric power plants in rural  areas and because urban areas varied
in the timing and the stringency of emissions controls (Appendix A).   The
rate of regional  increase over the short period covered by the suspended
sulfate data base, which begins in the early 1960's and ends in 1970, was
probably initially more than balanced by local control measures, but this
decrease would not be expected to persist very long. Using the available
information from thirty-three urban National Air Sampling Network stations,
a proportional model linking regional sulfur dioxide emissions to suspended
sulfates was tested (Table 2 of Appendix A).  In this test a three year
moving mean of central city sulfur dioxide levels was used as a proxy for
sulfur dioxide emissions for the city and for any suburban station.  This
was necessary because historical emissions inventories are difficult to
obtain for individual cities and for sources other than power plants.
State and regional power plant emissions of sulfur oxides were calculated
from emissions inventories compiled for the Federal Power Commission.  The
percentage changes over time for these two components, one for the city
and the second for a contiguous region, were then summed and the resulting
predictive value compared with the observed changes in the three year
moving mean suspended sulfate level at the same air monitoring station.
Three year moving means were used instead of the values for a single year
because the sampling frequency of the National Air Sampling Network,
twenty-six days per year, allows meteorological conditions, especially
rainfall to unduly  influence values for a single year.  The proportional
emissions model will of course have to be validated and perhaps altered

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by research now underway and  projected  for  the  future.   Nevertheless,
important observations are possible:  First,  the  rough  proportional
emissions model fits quite well  in  the  largest  eastern  cities.   As
expected the model  does not fit  very  well  in  areas  where emissions  or
other model assumptions are rendered  questionable by  regional  topography,
high emissions of catalytically  active  metals or  photochemical  smog.
Furthermore, the model works  better for larger  cities than  for  smaller
cities.  Second, suspended sulfate  levels  decreased in  the  large eastern
cities in a more or less predictable  fashion  during the latter  part of the
last decade.  Decreases of 25-33% were  common.   Third,  suspended sulfates
are apparently increasing in  the few  southeastern stations  where data  is
available.  This also was expected  under the  proportional model.
     Thus, regional levels of suspended sulfates  may  well  increase  sub-
stantially during the present decade.  Based  on our present understanding,
one can assume an increase in acid-sulfate aerosols which is proportional
to regional increases in sulfur  dioxide emissions.

                    WHAT ADVERSE HEALTH EFFECTS ARE
                   ATTRIBUTABLE  TO  ELEVATED AMBIENT
                       LEVELS OF SULFUR OXIDES?
     Short term exposures to  elevated levels  of sulfur  oxides,  especially
acid-sulfate aerosols, are thought  to aggravate asthma  and  preexisting
heart and lung disorders.  Elevated short term  exposures to acid-sulfate
aerosols are also likely to have been largely responsible for perceptible
increases in daily mortality  observed during  air pollution  episodes.

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Repeated short term peak exposures  or more even elevations in annual
average exposures to acid-sulfate aerosols lasting several years are
likely to result in excess acute lower respiratory disease in children,
excess risk for chronic respiratory disease symptoms  in adults and
decreased ventilatory function in children.
     These effects were observed in community studies (Appendix C refer-
ence) where levels of sulfur dioxide, acid-sulfate aerosols and suspended
particulate matter were usually but not always simultaneously elevated.
Unfortunately, it is only now becoming possible to develop laboratory
animal models and clinical protocols that allow one to mount complemen-
tary studies on the effects of finely divided acid-sulfate aerosols on
susceptible population segments.  Early toxicology studies exposing
healthy young adult animals for short periods to sulfur dioxide alone
or tc sulfur dioxide and particulate have shown equivocal  results.  Con-
struction of dose response functions for acid sulfate aerosols utilized
in the present report is hampered by four problems:  first, suspended
sulfates must be employed as a proxy for acid-sulfate aerosols; second,
for some studies one had to recapitulate sulfate exposure from prediction
equations that utilized existing air monitoring data  for sulfur dioxide
and suspended particulates (Table 2); third, it was necessary to measure
excess risk of illness rather than  direct illness rates because studies
differed in their locale and their  methods of ascertainment of illness;
fourth, it should be emphasized that the derived dose-response functions
are best judgment threshold functions (Figures 2-6),  not precise mathematical

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fits.  Best judgment estimates were utilized because the data points

available for the assessment of a single adverse effect were not inde-

pendent.  In the assessment of a single adverse effect each constituent

study yielded very few data points and the control  of "no effects" level

assumed for each constituent study could differ from the "no effects"

level assumed for other studies used in the assessment of a single

adverse effect.  Moreover, a single adverse effect might be differently
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defined or ascertained in any set of studies.   Thus, the authors delib-

erately chose to emphasize the roughness of their assessment by the best

judgment approach.  In general, these best judgment functions (Table 3)

are more conservative in that they predict less excess illness than would

be the corresponding mathematical fits (Table 4).  For asthma, the best

judgment estimates may be high as only warm days were considered by the

dose-response function.  Despite these handicaps, the functions should

roughly quantify the expected adverse effects associated with various

exposures to sulfur oxides.  Major research efforts are necessary to

improve these functions.  Collecting such information will, however,

require several years and decision-makers require rough information before

the refined functions will be available.



                     HOW WILL GROWTH IN EMISSIONS
                   FROM STEAM ELECTRIC POWER PLANTS
                       ALTER HUMAN EXPOSURES TO
                        ACID SULFATE AEROSOLS?

     Emissions from steam-electric power plants contribute to two different

types of human exposure:  infrequent short-term elevations which are a

hazard for especially susceptible population groups and long-term elevations

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resulting  from changes in overall  urban and regional  levels of acid-sulfate


aerosols.
                                            **

     The impact of short-term peak exposures in the vicinity of power


plants depends upon fuel  consumed,  plant location, stack height, topography,


meteorology, population susceptibility and population density in the impact


area.  As yet, reliable national  estimates for the adverse effects of in-

         i
frequent short-term peak exposures are not available.   A primary stumbling


block is our incomplete understanding of acid-aerosol  formation in power


plant plumes.  Estimates of such exposure increments have been made for a


number of locales.  Sulfur dioxide exposure increments of greater than


900 pg/nr for 24 hours have been  predicted and observed in areas impacted


by emissions from steam-electric  power plants  combusting high sulfur coal.


Over an area of one square kilometer most impacted around urban power


plants, incremental sulfur dioxide  exposures of greater than 120 to 190 yg/iri3
                                        •

and incremental acid-sulfate aerosol  exposures of 3 to 6 yg/m^ could be


expected for about 20 days each year if these  plants utilized coal  or oil


containing typical quantities of  sulfur (2-3%).  Existing plume studies


suggest that sulfur dioxide in plumes from oil fired power plants may be


more rapidly converted to acid-aerosols than sulfur dioxide from coal


fired plants.  Preliminary estimates of the associated increments in daily


mortality, aggravation of asthma  and symptoms  of heart and lung disease in


the elderly suggest that the expected effects  in the immediate vicinity of


power plants are quite modest when  compared to the effects expected across


an entire metropolitan area.  It is, however,  safe to say that a measurable

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increment in adverse health effects  other  than  mortality  is  expected
and that the exposed population in these areas  may  number over 100,000.
     More progress has been made in  roughly  quantifying the  expected
increases in acid-sulfate aerosol exposures  and the associated adverse
health effects that are expected to  accompany  increasing  sulfur oxides
emissions over a power region or over several metropolitan areas.
Briefly the -steps employed are as follows:
     *  First, populations of each power region were placed  into one
        of four strata (based on the 1970  census):   rural (including
        places of less than 2500); urban places of  less than 100,000;
        urban areas larger than 100,000 but  less than 2,000,000; and
        urban areas larger than 2,000,000  (see  appendix B).
     *  Next, a cumulative frequency distribution for the expected
        24 hour suspended sulfate exposures  and summary statistics
        (arithmetic and geometric means and  their standard deviations)
        were estimated based upon the sulfate  distributions  monitored
        at all National Air Sampling Network sites  within each popula-
        tion class in each power region (Table  5).   The most current
        year, usually 1970 but sometimes 1969,  available  from each site
        was utilized.
     *  Next, it was assumed the regional  changes in sulfur  dioxide
        emissions would be accompanied by  proportionate changes in
        suspended sulfates in power  regions  east of the Mississippi

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                                  I 0
        River:   NPCCMAAC,  ECAR, MAIN, SERC.   It was also assumed
        that sulfur  dioxide  emissions from sources other than  steam
        electric power  plants would  not change between  1970 and 1980.
        No changes in sulfate levels for other regions  were postulated
        for the present analysis  even though  currently  nonpredictable
        increases are likely to occur on a limited scale and these
        estimates are included in Appendix E.  Stated another  way,
        regional transport of acidsulfate aerosols was  assumed only
        for power regions  generally  east of the Mississippi.   Thus any
        adverse health  effects occurring west of  the Mississippi  are
           x
        left out of  the present estimate.
     With these assumptions  in mind, changes  in acidsulfate aerosol
exposures were  estimated using the suspended  sulfate proxy.  The  probable
public health consequencies  of each  of the ten alternate emissions
scenarios summarized in Table 10  of  the report entitled Power  Generation:
Conservation, Health and Fuel Supply were evaluated.  Basically these
scenarios consider probable  emissions of sulfur oxides  emissions  under
varying conditions affecting demand  for electric  power, importation of
low sulfur petroleum fuels,  conservation practices and  installation of
permanent emissions  controls for  sulfur oxides.   Using  these techniques
it is possible  to approximate how such factors, as pricing, conservation,
restruction of  oil  imports and installation of  permanent emissions
controls are likely  to  affect public health.  Sulfur oxide emissions  for
each electric power  region under  each of the  scenarios  during  1975,  1977 and

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1980 are also shown in Appendix E.   Five points are worth noting:
First, the influence of utility rates and fuel  importation policy can
roughly have an affect on sulfur oxides emissions equal  to installation
of permanent emissions controls.  Second, conservation policies have a
maximal effect if permanent emissions controls  are not quickly and
universally installed on candidate  power plants.   In other words, con-
servation practices and flue gas desulfurization might somehow in the
short term be optimally combined in a least cost fashion.  Third,
importation of low sulfur fuels coupled with unrestrained demand and
historical growth would still leave an emissions problem equal to that
of the mid-19601s.  In other words, emissions restraints other than the
increasingly costly use of low sulfur imports is required.  Fourth,
important regional shifts in emissions which are likely to affect public
wealth can be hidden by national shifts.  For example, all other things
oeing equal, it is probably more important to control emissions east of
the Mississippi than in the Great Plans region.  Fifth, there is technical
consensus that actual demand will lie somewhere between the unrestrained
demand scenario of the National Electric Reliability Council and the
restrained demand scenarios forecast by our -Task Force.  Thus, one can
assume that the health effects consequences projected for those different
scenarios will bound our expected problems.  In fact, as we shall see,
the adverse effects on health are considerable under either scenario in
the absence of other conservation measures or installation of permanent
emissions controls.

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                         WHAT  IS  THE MAGNITUDE  OF
                     THE  PUBLIC HEALTH  PROBLEM  LIKELY
                     TO FOLLOW A  GROWTH IN  EMISSIONS?
     To answer this question one must use dose-response functions to
calculate the expected adverse effects,  assuming  that exposures  are reduced
as standards are met,  and compare these  effects with adverse effects
calculated from the previously ascertained dose-response functions and the
expected acid-sulfate  aerosol  exposures  under scenarios that assume that
standards are not met.  Differences of interest can then be calculated by
subtraction.  This step, however, must be preceded by defining the specific
segments of population at risk and the expected baseline frequencies of
the adverse< effects of interest.  The specific procedures for accomplishing
these steps are found  in Appendix C.
     .The adverse health effects attributable to not meeting clean air
standards will be considerable (Table 6) under either the unrestrained
demand scenario or the restrained demand scenarios that do not employ
permanent emissions controls.*  Using our best judgment estimates for the
unrestrained demand scenario, the number of excess or premature deaths
may reach over 3,000 per year by 1980 and the total excess between 1975
and 1980 could exceed  15,000.  Each year an average elderly person will
experience an unnecessary 3 to 4 days when their  chronic heart and lung
disorder will be perceptibly aggravated.  If standards are not met, and
electricity demand is  unrestrained, the excess number of aggravation days
for our senior citizens would be 10 million or more days each year and
total about 90 million days during the years 1975 to 1980.  Each year a
     *However, these effects constitute only a small fraction of total
mortality and morbidity.  For example, best judgment mortality estimates
show excess mortality to be less than one quarter percent of total
mortality.  This t°n approximates mortality from black lung disease.

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typical asthmatic might expect one unnecessary  asthma attack.   If
standards are not met, the excess  number of asthma attacks would be six
million each year and could total  about 25  million during the  years 1975
through 1980. Each year otherwise  health children would experience 250
to 450 thousand more common but severe acute respiratory disorders like
croup, acute bronchitis and pneumonia.  If  standards are not met, adults
would be burdened more frequently  with persistent chronic respiratory
disease symptoms.  In 1975 an excess of over 500,000 adults would be
involved and by 1980 an excess of  over 1,000,000 adults might  be expected
to report persistent chronic respiratory disease symptoms.  If a  least
squares fit estimate is utilized (Table 8), or  if demand is restrained
but emissions are not controlled (Tables 7  and  9), the picture is not
substantially changed.  One is still faced  with thousands of premature
deaths and millions of excess illnesses.
      In summary, present rough estimates conclude that substantial
excess adverse health effects can  be expected each year if clean air
requirements are not met:  thousands of premature deaths, millions of
days  of illness among susceptible  segments  of the population,  hundreds
of thousands of needless acute lower respiratory illnesses in otherwise
healthy children and hundreds of thousands  of chronic respiratory disorders
among adults.  If the health impacts of short-term fumigations prove
larger than expected, or if regional effects occur in the western power
regions, the calculations of excess adverse effects given here may prove
overly conservative.
      It is  important to remember that the present ambient sulfur dioxide

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standards would be about what is  necessary to protect public health if
dispersion conditions were good and if acid-aerosols did not intrude
from up wind sources. . One should also recall that the sulfur oxides
criteria document recognized the  problem of acid aerosols but that the
knowledge at that time led one to believe that long range transport of
aerosols was not a major constraint for air quality standards.  Newer
information has shown that long range transport is a major constraint.

                         HOW MUCH MUST SULFUR
                         OXIDES BE CONTROLLED?
     We have seen that meeting Clean Air Act requirements for reducing
sulfur oxide emissions from power plants should prove beneficial .in
protecting public health and that any residual adverse health effects
would be quite modest (zero to sixteen percent of 1970 estimates) under
our best judgment estimates.  Residual effects would be somewhat more
significant under the least squares fit estimates.  In either case one
would still be faced with the problem of adverse effects among asthmatics
and the elderly who are especially susceptible population segments.  In
other words, meeting Clean Air Act requirements should greatly benefit,
but not completely protect public health from adverse effects attributable
to acid sulfate aerosol exposures.
     The comparative importance of decelerating growth in demand, fuel
policy, conservation and permanent emissions controls such as flue gas
desulfurization should be appreciated.  First of all, it is not likely
that historical rates of growth in electricity demand will long persist.
Of all factors considered, completion of new nuclear plants now underway
coupled with a slowing of the growth in demand even in the face of

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restricting oil  imports could reduce excess  mortality,  excess acute
lower respiratory illness and excess chronic respiratory disease by one-
half.  This would also reduce aggravation of asthma and heart and lung
disease by about one-fifth.   These emissions changes coupled with reason-
able conservation measures could reduce excess  mortality, excess acute
lower respiratory disease and excess chronic respiratory disease by
                                /
three-quarters or more.  Similarly, aggravation of asthma and heart and
lung disease would be reduced by two-fifths.  It should be apparent that
national policies aimed at protecting public health through the control
of sulfur oxide emissions should also consider  the effects of conservation
and changes in growth on a regional basis.
     Given the uncertainties in our present  information base one would
not advocate more stringent, sulfur dioxide emission controls.  However,
it may well prove desirable in some locales  to  enhance the effectiveness
of sulfur dioxide controls by controlling interacting pollutants.  For
example, one might find it necessary to control metal particulates which
can efficiently convert low level  urban emissions into acid sulfate
aerosols, especially in cities with large metallurgical complexes.  In
other words, there is good reason to proceed with the control of sulfur
dioxide emissions from new power plants and  large industrial boilers.
Because of the widespread nature of the acid sulfate aerosol problem, it
would seem prudent, if at all possible to first retrofit the newer,
usually larger, power plants and industrial  boilers allowing them to use
high sulfur fuels and to divert clean fuels  including low sulfur coal to
older power plants, smaller industrial boilers and homes (Figures  7-9).
If one would permanently control 90 percent of the sulfur dioxide emissions

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                                                       \ •*.
from the 50 largest existing utility plants east of the Mississippi one
would reduce total  man-made sulfur oxide emissions by 15 percent.
Similar control of emissions from the 150 largest, generally newer
industrial boilers, again mostly in the eastern United States, would
further reduce man-made sulfur dioxide emissions by 10 percent.  If one
utilizes a simple roll back model and does not retrofit larger industrial
facilities one would have to require very stringent control of all  new
sources and not achieve reductions in sulfates below best judgment
estimates for health effects thresholds for many years.  On the other
hand, it also seems reasonable to emphasize again that the permanent
emissions controls called for in the state implementation plans will do
a very good job in reducing adverse health effects attributable to
sulfur oxides.
     'At this time one cannot describe a single best option for the
control of acid-sulfate aerosol exposures or a precise determination of
the degree of emissions control necessary.  There can be little doubt
that a key element in any control option will be permanent emissions
control for larger power plants and industrial boilers.  The degree of
control necessary should not require future major changes in the permanent
emissions control systems now becoming available for steam electric
power plants and industrial boilers to meet current emissions and air
quality standards.  This does not, however, preclude the possibility
that New  Source Performance Standards may not be made more stringent in
the future.
     One  should also realize that acid-sulfate aerosols could rapidly
become a  widespread regional problem in  the western half of the United
States if emissions are allowed to increase rapidly in these states and
cause a concomitant rapid deterioration  in air quality.  Indeed, there  is

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evidence that such aerosols already affect several large populated basins
in the western United States.  It would seem prudent then to plan for
•permanent emissions controls on all new power plants and industrial
sources in this part of our nation as well.  In the case of acid-sulfate
aerosols, one cannot rely upon dispersion or favorable siting as a
permanent solution for any area of,our country.

             WHAT IMPORTANT CAVEATS MUST BE KEPT IN MIND?
     *  The answers to the preceding questions are current best judgments
but they are clouded by significant scientific uncertainties involving
many key aspects of the sulfur oxides problem.  These have been dealt
with in some detail in previous technical reviews and briefing documents
that are public information.
     *  Interpretations of historical trends in emissions and air quality
are hampered by a very limited data base.  Indeed, our current monitoring
systems for sulfur dioxide, suspended sulfates, strong acids, precipita-
tion chemistry, trace metals, ammonia, and hydrocarbons are not adequate
enough to answer pertinent questions about the origin, transformation
and removal of sulfur oxide air pollutants.  Simultaneous monitoring in
urban, suburban and rural settings is required.
     *  Current measurements of suspended sulfates serve as a useful
proxy for acid-sulfate aerosols but measurements that delineate particle
size and chemical composition are  required for sulfur compounds and
other aerosol components.  Aerosols of natural and man-made origins must
be characterized and differentiated.
     *  The mechanisms and rates for the transformation of sulfur dioxide
to acid-sulfate aerosols in plumes and in the atmosphere are not well

-------
                                                               DRAFT
                               2]                        DO NOT QUOTE OR CITE
understood.   Plumes from controlled and uncontrolled industrial and
power plant combustion sources should be studied.
     *  Predictive models which will give needed precision to estimates
of long range transport and the influence of emission height must be
developed.
     *  More soundly based dose-response functions for the adverse
effects on public health and welfare must be developed.  Interlocking
clinical, epidemiological and laboratory animal studies are required to
reduce scientific uncertainties about adverse health effects.  Carefully
designed studies of plant damage, material degradation, visibility im-
pairment and climatic changes are required to develop reasonable damage
functions for adverse effects on the public welfare.
     *  Sound societal judgments can be based only on a sound scientific
information base.  Failure to acquire the needed information will lead
to needless discord and likely to one or more national economic or
public health tragedies.

                           MAJOR CONCLUSIONS
     *  Failure to control sulfur oxides emissions may well result in
        thousands of excess deaths and millions of excess illnesses.
     *  Acid-sulfate aerosols represent a complex public health and reg-
        ulatory problem.
     *  Control of sulfur oxide emissions from urban and rural power
        plants will be required.

-------
                          22
                                                            DRAFT
                                                    DO NOT QUOTE OR CITE
*  National  policies coordinating growth in energy demand, fuel


   policy, conservation practices and requirements for permanent
                                        »•

   emissions controls must be carefully coordinated.


*  It is our best judgment that massive conversion of urban power


   plants to high sulfur fuels and the use of tall stacks with


   supplementary control systems in rural  power plants will greatly


   increase sulfate concentrations and endanger public health.


*  Uncertainties in our scientific information base will  foster


   major societal disagreements about the steps necessary to


   control the problem.


*  Scientific uncertainties are being reduced by research programs


   but important information gaps will remain for five to ten years.

-------
                                       23
                                                                     DRAFT
                                                              00 NOT QUOTE OR CITE
                                     Table 1
                Thirty Year'Trend in Sulfur Oxides Emissions
                          from Steam Electric Power Plants
Electric Power Region
Northeast Power Coordinating
Council (NPCC) and Mid
Atlantic Area Coordinating
Group  (MACC)

East Central Area Reliability
Coorci nation Agreement (ECAR)
    America Interpool
Network (MAIN)

Southeastern Electric
Reliability Council (SERC)

Mid Continent Area Reliability
Coorci nation Agreement (i!ARCA)

Southwest Power Pool (SV.'PP)
and Electric Reliability
Council of Texas (ERCOT)

Western Systems Coordinating
Council (WSCC)
Yearly  Sulfur Dioxide Emissions (Millions of Tons!
 1950    1960     1969     1980 Estimates Under Un-
                           restrained Demand Scenat
                            Standards   Standards
                                           Met
                                           1.0
.9     1.3
 3.1
2.0
1.0
0.4
0.26 •
0.05
3.6
1.6
1.8
0.3
0.16
6.2
2.7
3.6
0.6
0.4
  0.04    0.09     0.2
Not Met
 3.4
10.0
3.7
6.5
1.2
2.2
2.3
1.0
2.2
0.4
0-4
                           1.1
                         0.5
United States**
  4.6
       P
       O •
16.7
28.1
778^
Nationwide Sulfur Oxides ***
Emissions
 23.8    23.3
               32.4
           43.0
             22.7
*    Assumes growth in power generation to 3.2 trillion KWH by 198C. "Standards
     not met" assumes continued use of oil imports but no further effort to meet
     "Clean Air Act" requirements restricting sulfur dioxide emissions.
**   1974 estimate 20.8 million tons.
***  1940 emissions 21.5; Mo change in emissions from sources other than power
     plants assumed between 1970 and 1980.

-------
                                        24
                                                                      DRAFT
                                                               DO NOT QUOTE OR CITE
                                 Table  2
               Recapitulating 24-hour  Levels o'f Suspended Sulfates from
                        Measured  Levels  of  Sulfur Dioxide*

Y            = 9 + ,03x                           1959 - 1960 Nashville**
 sulfate in             sulfur dioxide            Study (r=.8)
  yg/m                       in yg/m

Y            = 9 + .05x                           1966 - 1967 NASN data***
 sulfate in             sulfur dioxide            from 8 inland cities
   yg/m3                   in yg/nr                         (^ = .5)
               Recapitulating Annual  Average  Suspended  Sulfate Levels  from
                        Measured  Levels  of  Sulfur Dioxide
Y            = 9 + .04x                      •     Pooled  NASN  data  from
 sulfate in             sulfur dioxide             NY City, Chicago  and New
   yg/m3                    in yg/m3              Jersey  - 1962  - 1967
                                                           (r= .6)
*Similar recapitualtion equations  are  available which  link  particulates  and
suspended sulfates

**used for English and Japanese studies  where  like  Nashville  intruding sulfates
were not a problem

***used for U.S. studies

-------
                                             25
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Figure 7. Percentile distribution of S02 emissions from U.S.
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                 44
             APPENDIX A


      Pertinent Observations On

Atmospheric Reactions and Air Quality

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                   55
                                                DRAFT
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          APPENDIX  B

Categorization of Locales in

     Each Power Region

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                                  56
Table 1:  SMSA's of at Least 2 Million Population Cumulated by
          Electric Power Region


          Electric Power Region                       Population (000)

1.  NPCC - MACC
       Boston                                           3375
       Mew York                                        11529
       Philadelphia                                     4818
       Pittsburgh                                      • 2401
       Total                                           22123

2.  ECAR
       Cleveland                                        2064
       Detroit                                          4200
       Total                                            6264

3.  SERC
       Baltimore                                        2071
       Washington                                       2861
       Total                                            4932

4.  SWPP  - ERCOT
       Houston                                          2000
          •
5.  MAIN
       Chicago                                          6979
       St. Louis                                        2363
       Total                          .                  9342

6,.  MARC
       None

7.  WSCC
        Los Angeles  -  Long  Beach                         7032
        San  Francisco  -  Oakland                          3110
        Total                                   .         10142

        Grand Total                           '           54803

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Table 2:
                                    57
Cities of at Least 100,000 Population (but not in
SMSA of 2 Million) Cumulated by Electric Power Region
«ff
                                                                    Up ACT
                                                                OR CITE
         Electric Power Region
1.  NPCC - MAAC
       Albany
       All entown
       Bridgeport
       Buffalo
       Elizabeth
       Erie
       Hartford
       New Haven
       Patterson
       Providence
       Rochester
       Scranton
       Syracuse
       Vlaterbury
       Total

2.  ECAR
       Akron
       •Canton.
       Cincinnatti
       Columbus
       Dayton
       Evansville
       Flint
       Ft. Wayne
       Gary
       Grand Rapids
       Hammond
       Indianapolis
       Lansing
       Lexington
       Louisville
       Parma
       South Bend
       Toledo
       Warren
       Ycunastown
       Total
                                       Population (000)
                                              116
                                              no
                                              157
                                              463
                                              113
                                              129
                                              158
                                              138
                                              150
                                              180
                                              300
                                              105
                                              202
                                              110
                                             2431
                                              275
                                              110
                                              453
                                              540
                                              244
                                              139
                                              193
                                              178
                                              175
                                              200
                                              108
                                              745
                                              132
                                              108
                                              361
                                              100
                                              126
                                              384
                                              180
                                              140
                                             4891

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                                  5fi
                  DRAFT
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Table 2:   (continued)

           Electric Power Region

3.  SERC
       Atlanta
       Brimingham
       Chattanooga
       Charlotte, N.C.
       Columbia, S.C.
       Columbus, Ga.
       Ft. Lauderdale
       Greensboro
       Hampton
       Hialcah, Fla.
       Hollywood
       Huntsville
       Jackson
       Jacksonville
       Knoxville
       Macon
       Memphis
       Miami
       Mobile
       Montgomery
       Nashville
       Norfolk
       Portsmouth
       Raleigh
       Richmond
       St. Petersburg
       Savannah
       Tampa
       Va. Beach
       Winston-Sal em
       Newport News
       Total
Population (000)
        497
        301
        119
        241
        114
        114
        140
        144
        121
        102
        107
        138
        154
        529
        175
        122
        624
        335
        190
        133
        448
        308
        111
        122
        250
        216
        118
        278
        172
        133
        138
       6834

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                                   59
                  DRAFT
          00  NOT QUOTE OR CITE
Table 2 (continued)
          Electric Power Region
    SWPP - ERGOT
     Baton Rouge
     Little Rock
     New Orleans
     Okla. City
     Shreveport
     Tulsa
     Wichita
     Kansas City
     Topeka
     Austin
     Amarillo
     Beaumont
     Corpus Cristi
     Dallas
     El Paso
     Fort Worth
     Lubbock
     San Antorn'o
     Total

    MAIN
     Independence
     Kansas City
     Madison
     Milwaukee
     Peoria
     Rockford
     Springfield
     Total

    MARCA
     Cedar Rapids
     Des Moines
     Duluth
     Lincoln
     Minneapolis
     Omaha
     St. Paul
     Total
Population (000)
     166
     132
     593
     366
     182
     332
     277
     168
     125
     252
     127
     116
     205
     844
     322
     393
     149
     654
    5403
     112
     507
     173
     717
     127
     147
     120
    1903
     111
     201
     101
     150
     434
     347
     310
    1654

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                                 60
                 DRAFT
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Table 2:  (continued)

         Electric Power Region

7.  WSCC
     Albuquerque
     Colorado Springs
     Denver
     Freemont
     Fresno
     Huntington Beach
     Las Vegas
    ' Portland
     Riverside
     Sacramento
     Salt Lake City
     San Bernadino
     San Diego
     San Jose
     Santa Ana
     Seattle
     Spokane
     Stockton
     Tacoma
     Tucson
     Phoenix
     Total
Population (000)
    244
    135
    515
    101
    166
    116
    126
    383
    140
    254
    176
    104
    700
    446
    157
    531
    171
    108
    155
    263
    582
    5573
     Grand Total
  28589

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              61
       DRAFT
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        APPENDIX C


Demographaic Data and Procedure for

Calculating Adverse Health Effects

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                                          63
                                                                        DRAFT
                                                                DO NOT QUOTE OR CITE
Table 2:   Electric Power Region Population (000) Distribution by Age Source:
          Statistical  Abstract of the U.S. 1972, Table: 36., p. 31
Electric Power Region
1.
2.
3.
4.
5.
6.
7.

MPCC - MAAC
ECAR
MAIN
SERC
MARCA
S'.JPF - ERGOT
l-JSCC.
Grand Total
0-13*
12569
8119
5373
10076
2561
5879
8916
53493
14-20
6100
4000
2607
5112
1279
2953
4464
26492
21-64
25676
14790
10102
19143
4466
10634
17311
102122
65+
5244
2775
2128
3632
1089
2102
3045
20015
21 +
30920
17565
12230
22775
5555
12736
20356
122137
TOTAL
49589
29683
20209
37963
9395
21568
33736
202143
*A baseline prevalence of .6 acute lower respiratory disorders each year is assumed
based on reports from the National Center for Health Statistics.

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                                       fi*                      nn Nnr DRAfT
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                                                                      you it UK CITE





Table 3:   Average Deaths Per Day by Electric  Power  Region  and  City Size
Electric Power Region
1.
2.
3.
4.
5.
6.
7.

JPCC - MAAc
ECAR
MAIN
SERC
MARCA
S'.JPP - ERCOT
',-ISCC
Total
Total
1339
772
525
987
244
539
776
5182
Rural Small Urban
263
244
125
369
98
151
130
1380
413
238
109
314
103
203
284
1664
Larger Urban Large S'1S/
56
127
49
175
43
135
128
723
597
163
243
128
--
50
233
1414
Source:  Statistical  Abstract of U.S.  1972.  Table  79,  p.  58.

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                               65
                                                                DRAFT
                                                                Qi/orc OR
                 Studies  Upon  Which  Dose-Response
                         Estimates were  Based
A.  Mortality                           '   •   __.
    1.  Lindeberg, W.   Air Pollution in  Norway.  III.   Correlations  Between
        Air Pollutant  Concentrations and Death Rates  in  Oslo.   Published  by
        the Smoke Damage Council,  Oslo,  Norway.   1968.
    2.  Martin, A.E.  and W. Bradley.  Mortality,  Fog  and Atmospheric
        Pollution.  Hon. Bull.  Min.  Health (London).  19:  56-59,  1960.
    3.  Lawther, P. J.  Compliance with  the Clean Air Act:   Medical Aspects.
        J. Inst. Fuels (London).   36_:  341-344,  1963.
    4.  Glasser, M.,  and L. Greenburg.  Air Pollution Mortality and Weather.
        New York City 1960-1964.   (Presented  at the Epidemiology Section  of
        the Annual Meeting of the American Public Health Association,
        Philadelphia,  November 11, 1969.
    5.  Brasser, L. J., P. E. Ooosting,  and 0. von Zuilen.   Sulfur  Dioxide-
        To What Level  is it Acceptable?   Research Institute for Public
        Health Engineering.  Delft,  Netherlands.   Report G-300.   July  1967.
        (Originally published in Dutch,  September 1966).
    6.  Watanabe, H.  and F. Kaneko.   Excess Death Study of Air Pollution
        In:  Preceedings of the Second International  Clean Air Congress.
        (Englund, H.M. and W. T. Beery (eds.)  New York, Academic Press,
        1971.  p. 199-200.
    7.  Nose, Yoshikatsu and Yoshimitsu Nose.  Air Pollution and Respira-
        tory Diseases.  Part IV.  Relationship Between Properties of  Air
        Pollution and Obstructive Pulmonary Diseases in Several Cities in
        Yamaguchi Prefective.  J. Jap. Soc. Air Pollut.  5_(1):  130,  1970.
        Proceedings of the Japan Society of Air Pollution, llth. Annual

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                                 66
                                                                DRAFT
                                                         DO NOT QUOTE OR CITE
        Meeting,  1970).  .
    8.   Buechley,  R.  W.,  Riggan,  W.B., V.  Hasselblad,  and J.  B.  Van  Bruggen.
        SOo,  Levels  and  Perturbations  in Mortality.  Arch.  Environ.  Hlth.,
        27(3):  134,  1973.

3.   Aggravation of Heart and  Lung Disease  in  the  Elderly

    1.   Carnow, B. W. ,  R. M.  Senior,  R.  Karsh,  S.  Wesler, and L.  V.  Avioli.
        The Role of Air  Pollution in  Chronic  Obstructive  Pulmonary Disease.
        Amer. Med. Assoc. 21_4_(5): 894-899.   November  2, 1970.
    2.   Goldberg,  H.E.,  J.F.  Finklea,  J.H.  Farmer, A. A. Cohen,  F.B.  Benscn  and
        G.J.  Love.  Frequency and Severity of Cardiopulmonary Symptoms  in Adult
      .  Panels:  1970-1971 New York  Studies.   Health.
        Consequences of Air Pollution:   A  Report _from the  CHE_SS. .Program ^.A^lCLr.
        1971.   EPA #650/1-74-004.   pp.  5-85.   June 1974.

C.  Aggravation of Asthma

    1.  French, J.G.  Internal  Memorandum  on  1971-1972 CHESS Studies  of
        Aggravation of Asthma.
    2.  Sugita, 0., M. Shishido, E.  Mino,  S.  Kenji, M. Kobayashi ,  C.  Suzuki,
        N. Sukegawa, K. Saruta, and M.  Watanabe.  The Correlation  Between
        Respiratory Disease Symptoms in Children and Air Pollution.   Report No.
        1 - A questionnaire Health Survey.  Taiki  Osen Kenkyu 5_(1):134, 1970.
    3.  Finklea, J. F., J.  H.  Farmer, G. J.  Love,  D. C.  Calafiore  and G.  W.
        Sovocool .   Aggravation  of Asthma by  Air Pollutants:   1970-1971  New

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                                                              DRAFT
                                                       DO NOT QUOTE OR CITE
        York  Studies.    Health  Consequences of Air Pollutions
        A Report  from  the  CHESS Program,  1970  -  1971.   EPA  #650/1-74-004,
        page  5-71,  June  1974.
    4.   Finklea,  J.  F.,  D.  C. Calafiore,  C. J. Nelson,  W. B.  Riggan  and
        C.  B.  Hayes.   Aggravation  of  Asthma by Air  Pollutants:   1971
        Salt  Lake Basin  Studies.   Health Consequences
        of Air Pollution:   A  Report from  the CHESS  Program,  1970-1971.
        EPA # 650/1-74-004, page 2-75,  June 1974.

D.   Excess Acute  Lov;er Respiratory Disease  in  Children

    1.   Nelson, W.  C., J.  F.  Finklea, D.  E. House,  D. C.  Calafiore,  M. B.
        Hertz and D.  H.  Swanson.   Frequency of Acute Lower  Respiratory
        Disease in Children:  Retrospective Survey  of Salt  Lake  Basin
        Communities:  1967-1970. Health Consequences
        of Air Pollution:   A  Report from  the CHESS  Program,  1970-1971.
        EPA #650/1-74-004, page 2-55, June  1974.
    2.   Finklea,  J.  F.,  D.  I. Hammer, D.  E. House,  C. R.  Sharp,  W. C. Nelson
        and G. R. Lov.rimore.  Frequency of  Acute Lower  Respiratory Disease
        in Children:   Retrospective Survey  of  Five  Rocky  Mountain Communities,
         Health Consequences of  Air Pollution:  A Report
        from  the  CHESS Program, 1970-1971.  EPA  #650/1-74-004,  page  3-35,
        June  1974.
    3.   Douglas,  J.W.B.  and R.  E.  Waller.  Air Pollution  and Respiratory
        Infection in Children.   Brit. J.  Prev. Soc. Hed.  20:1-8, 1966.

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                                 60
        DRAFT
DO NOT QUOTE OR CITE
   4.  Lunn, J. E., J. Knowelden, and A. J. Handyside.  Patterns of
       Respiratory Illness in Sheffield Infant School Children.  Brit. J.
       Prev. Soc. Med. 21_:7-16, 1967.
   5.  Love, G. J., A. A. Cohen, J. F. Finklea, J. G. French, G. R. Lowrimore,
       W.  C. Nelson and P. B. Ramsey.  Prospective Surveys of Acute Respiratory
       Disease  in Volunteer Families: 1970-1971 New York Studies.
        Health  Consequences of Air Pollutio'n:  _A Report from the
       CHESS Program,  1970-1971.  EPA #650/1-74-004,  page 5-49, June 1974.
   6.  Hammer,  D.  I.   Frequency of Acute Lower Respiratory Disease in Two
       Southeastern Communities, 1968-1971.   EPA  intramural report, March 1974.

E.   Excess  Chronic  Respiratory Disease
        Burn, J.  L.  and J.  Pemberton.  Air  Pollution,  Bronchitis, and Lung •
        Cancer in Salford.   Int.  J.  Air  Water  Pollut.  7:15,  1963.
        Goldberg, H.,  J.  F.  Finklea, C.  J.  Nelson,  W.  B.  Stern,  R.  S. Chapman^
        D.  H. Swanson, and  A.  A.  Cohen.   Prevalence of Chronic Respiratory
        Symptoms  in  Adults:   1970 Survey of New York Communities.
        Health Consequences of Air Pollution:   A Report fro?"
        the CHESS Program,  1970-1971.   EPA  #650/1-74-004, June 1974.
        House, D. E..J. F.  Finklea,  C.  M. Shy, D.  C. Calafiroe,  W.  B. Riggan,
        J.  W. Southwick and L. J. 01 sen. Prevalence of Chronic  Respiratory
        Disease Symptoms in Adults:   1970 Survey of Salt Lake Basin
        Communities. Health Consequences of Air Pollution:
        A Report from the CHESS Program, 1970-1971.  EPA #650/1-74-004,  June 1974.

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                                                         DRAFT
                                                  00 WOT QUOTE OR CITE
4.  Hayes, C. G., D. I. Hammer, C.  M.  Shy,  V.  Hasselblad,  C.  R.  Sharp,
    J. P. Creason and K. E.  McClain.   Prevalence of Chronic Respiratory
    Disease Symptoms in Adults:  1970  Survey of Rocky Mountain Communities.
    Health Consequences of Air Pollution:   A Report
    from the CHESS Program,  1970-1971.  EPA #650/1-74-004, June 1974.
5.  Yashizo, T.  Air Pollution and  Chronic  Bronchitis.   Osaka Univ.  Med.  J.
    20:10-12, December 1968.
6.  House, D. E.  Preliminary Report on Prevalence of Chronic Respiratory
    Disease Symptoms in Adults:  1971  Survey of Four New Jersey
    Communities.  EPA intramural report, May 1973.
7.  Galke, W. and House, D.  E.  Prevalence  of Chronic Respiratory
    Disease Symptoms in Adults:  1971-1972  Survey of Two Southeastern
    United States Communities.  EPA intramural report,  February 1974.
8.  Galke, W. and House, D.  E.  Prevalence  of Chronic Respiratory Disease
    Symptoms in New York Adults - 1972.  EPA intramural  report,  February  1974.

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                                                                DRAFT
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                                 70


         Method of Obtaining  Excess Mortality and Morbidity


  I.   Mortality

  1.   Obtain annual death  rate for each  power region  (NPCC-MACC 10.0, SWPP-
      ERCOT 9.0, WSCC  8.5,  all  others  9.5) from Statistical Abstract of the
      U.  S. 1972, Table  79,  page  58.

  2.   Obtain daily death rate  by  dividing by 365.

  3.   Get expected deaths  per  day (Table 6) by multiplying by Total Population
      (Table 1).

  4.   Calculate percent  excess deaths  per day by accumulating percent excess
      deaths for each  of 365 days by application of Larsen log normal model
      on  the geometric mean, standard  geometric deviation and mortality dose-
      response function.

  5.   Obtain excess deaths  per year by multiplying percent excess deaths  by the
      expected number  of deaths per day.

 II.   Aggravation of Chronic Heart or  Lung Disease

  1.   Obtain population  at risk by multiplying the older population (Age  65+)
      by  the prevalence  of chronic heart or lung disease of 27.   (Statistical
      Abstract of the  U. S.  1972, Table  121, page 1,  page 15).

  2.   Calculate percent  excess aggravation per year by  accumulating percent
      excess aggravation per day  for each of 365 days by application of
      Larsen log normal  model, geometric mean, standard geometric deviation,
      and the heart or lung dose-response function.

  3.   Obtain excess days of aggravated chronic heart  or lung disease per
      year  by multiplying  percent excess days by the  average number of
      aggravated days  per  day  per person of  .20  (i.e.,  one would  experience
      aggravation of chronic symptoms  every fifth day,  without air pollution).

III.   Asthma

  1.   Obtain  population at risk by multiplying total  population by the asthma
      prevalence rate  of .03 for  all ages,  (DHEW, Vital and Health Statistics,
      Series 10, Number  84, September  1973, Prevalence  of Selected Chronic
      Respiratory Conditions U. S. 1970, Table 3, page  17.)

  2.   Calculate percent  excess asthma  attacks per year  by accumulating
      percent excess attacks for  each  of 365 days by  application  of Larsen
      log normal model on  geometric mean, standard geometric deviation, and
      the asthma dose-response function.

  3.   Obtain excess asthmatic  attacks  per year by multiplying percent
      excess attacks by  the average number of asthmatic attacks per day
      per asthmatic  (.02,  or about 7 per year).

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                                 71                               DRAFT
                                                          00 NOT QUOTE OR CITE

IV.   Lower Respiratory Disease (LRD),»io ChiTdren '
                                                 j?
 1.   Obtain population at risk, namely all  children  Age 0-13.

 2.   Calculate percent excess per year by using  annualvarithmetic mean and
     LRD dose-response function.

 3.   Obtain excess LRD cases per year by multiplying by annual  incidence
     rate for influenza and other respiratory conditions  of .06 (DHEW,
     Vital and Health Statistics, Series 10,  Number  88, January 1974,
     Acute Conditions-Incidence and  Associated Disability U.  S. 1971-72,
     Table 5, page 16).

 V.   Chronic Respiratory Disease for Smokers  and Nonsmokers

 1.   Obtain population at risk namely total  population  Age 21+  of whom 38
     percent are current Smokers and 62 percent  are  current Nonsmokers.

 2.   Calculate percent excess per year by using  annual  arithmetic mean
     and CRD dose-response functions.

 3.   Obtain excess ORD per year by multiplying appropriate figures by  CRD
     prevalence rate of .02 for nonsmokers and .10  for  smokers  (Prevalence
     of Selected Chronic Respiratory Conditions  1970, Archives  of
     Environmental Health, Vol. 27,  September 1973,  Table 5,  page 140).

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                72                           DRAFT
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              APPENDIX D
      Measurement of SOn  and  SCL

(hLSCL)  in Emissions from Power Plants

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                     UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
                                                                           DRAFT
                                                                   DO NOT QUOTE OR CITE
 SUBJECT. Measurement of S02 and $03
        from Power Plants
'TO:
                                         in Emissions     DATE: July 2, 1974
      J.  S. Nader

      Dr. A. P. Altshuller
           There is no good method at present to measure SO^  emissions from
       combustion sources.  The present method is an extractive  technique
       which  raises questions on how well SC^ and SO^ are separated in the
       process of sampling and to what extent S09 is converted to SO^.  SSMR
       is  approaching the problem of 503 measurement by an  in-situ spectroscopic
       technique uhich is under study with a contractor.  Hopefully,  this will
       provide a real time continuous measurement of SOj without the  problems
       associated with extractive sampling.

           Emission data reported in the literature is quite  general but
       offers some  idea of the range of values.  Oil-fired  sources have SO?
       emissions ranging from 85% to 100% of the sulfur content  of the oil  (1).
       Calculations on material balance suggest S02 emissions  as 98%  of the
       sulfur content of the fuel with 1% emitted as SO^ and  1%  in the fly ash.
       SO^ emission data show an extreme range from 0.25 to 11.5% of  the sulfur
       content of the fuel; a normal range of 0.25% to 2.75%;  and a high number
       of  values in the 1 to 1.25% range.  The emission concentrations do not
       appear to be a function of the percent of the sulfur in the oil only.
       For sulfur content in oil ranging from 1 to 5%, there  is  a wide scatter
       of  SO^j concentration data for emissions ranging from 6  to 40 ppm.

           Coal-fired sources have S02 emissions ranging from 80 to  100% of
       the coal sulfur content  (2).  563 emission data range  from 1 to 5% of
       the coal sulfur content.  Some detailed data are given  on S02  and SO^
       emissions as a function of boiler operating conditions  (3).  The SOj/
       S02 ratio for essentially the same coal sulfur content  can vary from
       0.5% to 5%  (a factor of 10) depending on the firing  operation.
       References

       1.   W.  S. Smith,  "Atmospheric  Emissions  from Fuel  Oil  Combustion."
           PHS.  Publ.  No.  999-AP-2, Nov.  1962.

       2.   W.  S. Smith and C.  W.  Gruber,  "Atmospheric  Emissions  from Coal
           Combustion." PHS Publ. No.  999-AP-24, April  1966.

       3.   S.  T. Cuffe and R.  W.  Gerstle, "Emissions from Coal-Fired Power
           Plants:   A  Comprehensive Summary."   PUS  Publ.  No.  999-AP-55,  1967.
EPA Form 1320—6 (11-71)

-------
                  7.                            DRAFT
                                         DO NOT QUOTE OR CITE
                APPENDIX E



 Sulfur Oxide Emissions  and Public Health

Impacts Under Alternate  Emission Scenarios

-------
                                       75
      Table E.I.   Sulfur Oxide Emissions for Power Plants, Other Emissions Sources,
                  and Total  by Electric Power Region for 1970 Base Year
Electric Power Region
NPCC-MAAC
ECAR
SERC
SWPP-ERCOT
MAIN
MARCA
WSCC
Total
        SOx Emissions (Million Tons)
Power Plant          Non-Power Plant
    3.8
    6.4
    4.0
    0.1
    3.0
    0.5
    0.3
                  Total
   18.1
•3.0
2.8
1.7
1.2
1.3
0.4
4.5
6.8
9.2
5.7
1.3
4.3
0.9
4.8
14.9
33.0
      Table E.2.  Estimated Future Power Plant Sulfur Oxide Emissions (Million
                  Tons/Year) By Electric Power Region for Scenario 1
National Electric Reliability Council Estimate:
Continuation of Historical Growth
Electric
Power
Region
NPCC-MAAC
ECAR
SERC
SWPP-ERCOT
MAIN
MARCA
WSCC
Total

Scenario #1, Standards Not Met
Year 75
3.2
7.9
4.9
1.0
3.1
0.7
0.6
21.4

Year 77
3.3
8.7
5.4
1.3
3.4
0.9
0.8
23.8

Year 80
3.4
10.0
6.5
2.2
3.7
1.2
1.1
28.1

Scenario #2. Standards Not Met
Year 75
1.3
3.0
3.2
0.8
2.3
0.7
0.4
11.7

Year 77
1.0
2.3
2.2
0.4
1.0
0.4
0.5
7.8

Year 80
1.0
2.3
2.2
0.4
1.0
0.4
0.5
7.8

                                                                           DRAFT

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