United States
Environmental Protection
Agency
Health Effects Research
Laboratory
Research Triangle Park NC 27711
vvEPA
Research and Development
EPA-600/S1-81-050 July 1981
Project Summary
The University of Akron
Urban Air Pollution and
Human Health Study
Richard A. Mostardi, Daniel L Ely, Nancy Woebkenberg, Mary Conlon, Marcia
Jarrett, and Glen Atwood
Approximately 350 volunteers from
East Cleveland, Ohio and 320
counterparts from Elyria, Ohio were
studied for the chronic effects of air
pollution. The East Cleveland area was
chosen for its proximity to heavy
industrial air pollution, and Elyria,
because it is an urban area with an
excellent past record for air quality.
Each volunteer submitted to
pulmonary function tests; electro-
cardiogram at rest, exercise, and post
exercise; trace element analysis in
hair, blood, and urine; carboxyhemo-
globin, methemoglobin and hormone
assay in blood; and were asked to
complete one epidemiological ques-
tionnaire.
During the duration of the work, air
quality was monitored by two aero-
metric stations in each city using total
suspended particulates (TSP), sus-
pended sulfate (SOo), suspended
nitrate (NOs), sulfur dioxide (SOz), and
nitrogen dioxide (IMOa) as criteria.
The results of this study indicate
that there are some significant differ-
ences in the young age groups for lung
function tests and questionnaire
responses which favor Elyria
residents. Differences are also found
in the older groups, and while not as
significant, favor the Cleveland resi-
dents. These results have many ramifi-
cations, the more obvious being that
there is some selective migration
associated with the Cleveland study
area. It would appear that there may
be an air pollution effect on the
younger volunteers but more detailed
study would be necessary for more
definitive conclusions.
This Project Summary was develop-
ed by EPA's Health Effects Research
Laboratory, Research Triangle Park,
NC, to announce key findings of the
research project that is fully docu-
mented in a separate report of the
same title (see Project Report ordering
information at back).
Introduction
Air pollution and its effects on human
health have been a major concern of the
scientific community-for many years.
The problem now seems to have been
intensified in many areas of. the United
States as high sulfur coal, in its abun-
dance, assumes a major role in energy
production. Unfortunately, the release
of sulfur containing compounds and
suspended particulates is associated
with the use of this natural resource,
both of which either singly or in
combinations have been shown to
affect human health. The pressing
question is, do sulfur oxides, suspended
particulates, and perhaps nitrogen diox-
ide produce respiratory exacerbation
and promote chronic obstructive respir-
atory disease (CORD) and if so what are
the associated critical levels or concen-
trations?
Many studies conducted throughout
the world have indicated that there is a
strong relationship between reduced
-------
pulmonary function, CORD, and the
sulfur oxide/particulate complex in
adult populations. Other studies, how-
ever, have not shown such a strong
relationship and suggest that the effects
do not exist or are casual. The reason for
such varied and divergent findings in
studies dealing with CORD are many
but could include the following: (1)
population mortality—deaths in the
study area associated with lung dis-
orders, especially carcinomas and
emphysema would preclude participa-
tion in the study; (2) population morbid-
ity—more than likely, people suffering
from CORD will leave the areas of high
pollution either of their own recogni-
zance or on the advice of a physician.
This also precludes participation in a
study of this type; (3) subject fear—
many people will not volunteer for
epidemiological studies of this type
because they are aware of the hazards
with air pollution, or may have a phys-
ical problem and are reluctant to have it
diagnosed; (4) association with air
pollution—people living adjacent to
industrial complexes often work there
or have relatives who work there.
Therefore, these people will not
volunteer for participation in air pollu-
tion studies because it is a controversial
subject and generally feel that industry
should not be subjected to more rigid
pollution control legislation and en-
forcement; (5) acute variations in air
pollutants—variations in the levels of
air pollution can affect pulmonary
function tests. Excessively high or low
levels of air pollutants during or several
days prior to pulmonaryfunctiontesting
can exert a considerable bias on single
test, cross sectional study. Such effects
must be monitored very closely; (6) vari-
ations in levels and types of pollution
and meteorology—photochemical pol-
lution problems are significantly differ-
ent from sulfur oxide/particualte pollu-
tion and studies conducted in one
environment are difficult to compare
with those done in another; (7) people
who live in a heavily polluted area
frequently leave for extended periods of
time during a given day. Many people
also are employed outside of the resi-
dential area. Therefore, they are only
exposed for a portion of the day which
could exert considerable effects on
epidemiological studies; (8) lack of
standardization in data collection—
different authors conduct differing lung
function tests, making study compari-
sons quite difficult. Furthermore, some
of the work is conducted with new or
unique tests which do not withstand
retesting and again are of limited value.
Two cities or parts of cities were
selected for this study, one with high
levels of industrial air pollution, the
other with comparably low levels. The
purpose of this work was to compare the
measured air and health parameters on
volunteer populations in these two
cities. Of particular interest were the
most chronic health effects. By measur-
ing the air quality and determining
pollution types and levels in the
immediate area of the exposed
populations and comparing these levels
with standard, well-tested epidemio-
logical methods it was felt that more
definitive assessments of any observed
health effects could be made.
Conclusions
Aerometric data between the two
cities (Cleveland and Elyria) for the year
1977-78 did show some significant
differences for SOa and NOz. However,
the values reported from each city were
not abnormally high. For the year 1979,
TSP and the respirable and non-
respirable fractions along with NOz
showed significant differences. In each
of the years, the Cleveland stations
recorded the highest values for each of
the variables.
The results of the data on the resident
populations indicate that the young
males and females (18-35) in Cleveland
reported more chronic respiratory
symptoms and showed a reduction in
lung function efficiency indicated by
pulmonary function testing. The older
populations of males and females (50-
75) were nearly identical with respect to
reporting chronic respiratory symptoms
but the older males and females in
Elyria showed a tendency for reduced
lung efficiency. On the basis of these
results we suggest that a migration of
the more susceptible individuals out of
Cleveland is influencing the data and
accounts for the observed differences.
Trace metal data between the two
cities were similar and none of the
mean values were abnormally high.
Carboxyhemoglobin (COHb) and me-
themoglobin (MetHb) data showed
some interesting differences. COHb
was significantly higher in both smokers
and nonsmokers in Cleveland and is
likely due to the heavy automobile traffic.
MetHb was significantly higher in Elyria
and was attributed to higher nitrate
levels in the city water supply. COHb
showed the usual smoking effects in
both males and females in both cities.
The results of the EGG tests were
subtle when the populations were
broken down into age and sex groups.
However, it appears that ECG variables
are significant in predicting normal or
abnormal vital capacity and forced
expiratory volume in males and females
in all age groups. These data illustrate
the importance of studying the relation-
ship between the respiratory and
cardiovascular system in air pollution
research.
Recommendations
Specific recommendations resulting
from these data would be difficult to
make. The study of the chronic effects of
air pollution through the testing of
volunteers permits limited statistical
interpretation. More effective, would be
evaluating the volunteers several times
each year over the course of many years
so that subtle trends could be more
effectively identified. Such studies
would require 10 to 20 years of study
and would prove to be quite expensive.
The data collected in this study does
effectively separate the populations
between Cleveland and Elyria as a
function of age; the questionnaire data
as well as the pulmonary function data
corroborate this. Whether or not these
effects can be attributed directly to air
quality cannot be determined at this
time. It does appear, however, thai
selective migration of the populations
could be in operation and contributing tc
the observed results.
-------
Richard A. Mostardi, Daniel L Ely, Nancy Woebkenberg, Mary Con/on, Marc/a
Jarrett, and Glenn Atwoodare with the University of Akron, Akron, OH 44325.
Wilson B. Riggan is the EPA Project Officer (see below).
The complete report, entitled "The University of Akron Urban Air Pollution and
Human Health Study," (Order No. PB 81-213 282; Cost: $14.00, subject to
change) will be available only from:
National Technical Information Service
5285 Port Royal Road
Springfield, VA 22161
Telephone: 703-487-4650
The EPA Project Officer can be contacted at:
Health Effects Research Laboratory
U.S. Environmental Protection Agency
Research Triangle Park, NC 27711
1 US GOVERNMENT PRINTING OFFICE 1981 -757-OU/7Z04
-------
United States
Environmental Protection
Agency
Center for Environmental Research
Information
Cincinnati OH 45268
Postage and
Fees Paid
Environmental
Protection
Agency
EPA 335
Official Business
Penalty for Private Use S300
t'S
t! 6 e*'VTH
23U b
CHICAGO II, 6060*
------- |