Environmental Benefits Mapping and Analysis Program
                 User's Manual


                   Appendices


                     September 2008

                      Prepared for
               Office of Air Quality Planning and
                       Standards
             U.S. Environmental Protection Agency
                Research Triangle Park, NC
                Neal  Fann, Project Manager

                      Prepared by
                   Abt Associates Inc.

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                             Table  of Contents
Appendix A: Training Courses
         A.1   United States	11
                A.1.1  Section 1. Data Files Needed for Training	11
                A.1.2  Section 2. Mapping Introduction	11
                       Raw Monitor Data	12
                          Example PM2.5 monitor data for 2000	12
                          Example O3 monitor data for 2000	19
                       Model Data	21
                          Example Air Quality Grid File: Baseline PM2.5	22
                       Health Incidence	24
                          Example Configuration Results File: Control PM2.5	24
                       Valuation Map	27
                          Example Valuation Results File: Control PM2.5	27
                       Audit Trail	35
                          Example Health Incidence: Control PM2.5	35
                       Report   	37
                          Example Pooled Incidence: Control PM2.5 RIA	37
                       Additional Mapping Activities	40
                A.1.3  Section 3. One-Step Analysis	40
                       Example PM2.5 Control 2020 15/35 National	40
                       Example PM2.5 Control 2020 14/35 State	53
                A.1.4  Section 4. Creating Grids	55
                       Air Quality Model Grids	55
                          Example: PM2.5 Control 2020 15/35 Adjusted	55
                          Example: Control PM2.5 RIA 2020 14/35 adjusted	56
                       Monitor Grids	56
                          Example: Baseline PM2.52004	57
                       Monitor Rollback	60
                          Example: Control PM2.5 2004 Percentage Rollback	60
                          Example: Control PM2.52004 Multiple Rollback Techniques	65
                A.1.5  Section 5. Health Incidence	69
                       Example: PM2.5 Control 2020 14/35	70
                       Example: PM2.5 Control 2020 14/35 Adjusted	87
                A.1.6  Section 6. Aggregation, Pooling, and Valuation	91
                       Example: PM2.5 Control 2020 14/35	92
                       Example: PM2.5 Control 2020 14/35 Adjusted	123
                       Example: Modifying One-Step Analysis Parameters	126
                A.1.7  Section 7. Adding New Datasets & Independent Study	128
                       Example: Adding Datasets for Detroit	129
                       Independent Study: Detroit Benefits Analysis	145
                A. 1.8  Answers to Training Exercises	152
         A.2   CityOne   	160
                A.2.1  Step 1. Data Files Needed for Training	161
                A.2.2  Step 2. Create Air Quality Grids for the Baseline and Control Scenarios	161
                A.2.3  Step 3. Specify Configuration Settings	167
                A.2.4  Step 4. Select Health Impact Functions	170

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               A.2.5 Step 5. Specify Aggregation, Pooling and Valuation	172
               A.2.6 Step 6. Generate Reports	180
               A.2.7 Step 7. View Your Reports	183
               A.2.8 Step 8. Map Your Results	184


Appendix B:  Monitor Rollback Algorithms                                        191

         B.1   Percentage  Rollback	191
         B.2   Incremental Rollback	192
         B.3   Rollback to  a Standard	192
               B.3.1 Interday Rollback - Generating Target Metric Values	193
                     Interday Rollback- Percentage	194
                     Interday Rollback- Incremental	195
                     Interday Rollback- Peak Shaving	196
               B.3.2 Intraday Rollback -Adjusting Hourly Observations	197
                     Intraday Rollback - Percentage	198
                        Example: All Hourly Observations Exceed the Intraday Background
                        (Single Iteration)	199
                        Example: Some Hourly Observations are Below the Intraday
                        Background (Multiple Iterations Required)	199
               B.3.3 Intraday Rollback - Incremental	202
               B.3.4 Interday and Intraday Rollback -Quadratic	204
                     Quadratic Rollback- Interday	205
                     Quadratic Rollback- Intraday	206


Appendix C:  Air Pollution Exposure Estimation Algorithms                 207

         C.1   Direct Modeling	208
         C.2   Closest Monitor.	208
               C.2.1 Closest Monitor-Temporal Scaling	209
               C.2.2 Closest Monitor - Spatial Scaling	210
               C.2.3 Closest Monitor - Temporal and Spatial Scaling	211
         C.3   Voronoi Neighbor Averaging (VNA)	212
               C.3.1 VNA | Temporal Scaling	216
               C.3.2 Voronoi Neighbor Averaging (VNA) - Spatial Scaling	220
               C.3.3 Voronoi Neighbor Averaging (VNA) - Temporal & Spatial Scaling	221
         C.4   Fixed Radius	222
         C.5   Temporal and Spatial Scaling Adjustment Factors	222
               C.5.1 Calculation of Scaling Factors	222
                     Example: PM2.5 Scaling Factors in U.S. Setup	223
                     Example: Ozone Scaling in U.S. Setup	224
         C.6   Binned Metrics	226


Appendix D:  Deriving Health Impact Functions                                  227

         D.1   Overview 	227
         D.2   Review Relative Risk and Odds Ratio	228

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        D.3   Linear Model	229
        D.4   Log-linear Model	230
        D.5   Logistic Model	232
        D.6   Cox proportional Hazards Model	239


Appendix  E: Health Incidence & Prevalence Data in  U.S. Setup            241

        E.1   Mortality  	241
               E.1.1 Mortality Rates 1996-1998	241
               E.1.2 Mortality Rate Projections 2000-2050	242

        E.2   Hospitalizations	243
        E.3   Emergency Room Visits for Asthma	245
        E.4   Nonfatal Heart Attacks	246
        E.5   School Loss Days	247
        E.6   Other Acute and Chronic Effects	248
               E.6.1 Acute Bronchitis	249
               E.6.2 Chronic Bronchitis Incidence Rate	249
               E.6.3 Chronic Bronchitis Prevalence Rate	250
               E.6.4 Lower Respiratory Symptoms	250
               E.6.5 Minor Restricted Activity Days (MRAD)	250
               E.6.6 Work Loss Days	250
        E.7   Asthma-Related Health Effects	250
               E.7.1 Shortness of Breath	251
               E.7.2 Wheeze	251
               E.7.3 Cough  	251
               E.7.4 Upper Respiratory Symptoms	252
               E.7.5 Asthma Population Estimates	252


Appendix  F: Participate  Matter Health Impact Functions in U.S.
Setup                                                                                     253

        F.1   Long-term Mortality	253
               F.1.1 Expert Functions	254
                     Parametric Distributions	255
                     Non-Parametric Distributions	259
                     Using Expert Functions in BenMAP	260
                     Distributional Details by Expert	261
                        Expert A    	261
                        Expert B    	262
                        Expert C    	264
                        Expert D    	265
                        Expert E    	266
                        Expert F    	267
                        Expert G    	269
                        Expert H    	270
                        Expert I     	271

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                         Expert J     	272
                         Expert K     	273
                         Expert L     	274
                F.1.2 Laden et al (2006)	276
                F.1.3 Pope et al (2002)	276
                F.1.4 Woodruff etal (1997)	277
                F.1.5 Woodruff etal (2006)	278
         F.2   Chronic / Severe Illness	278
                F.2.1 Abbey et al (1995b)	279
                F.2.2 Peters et al (2001)	279
         F.3   Hospitalizations	280
                F.3.1 lto(2003) 	282
                F.3.2 Moolgavkar (2000a), Chronic Lung	283
                F.3.3 Moolgavkar (2000b), Cardiovascular	284
                F.3.4 Moolgavkar (2003)	285
                F.3.5 Sheppard  (2003) 	285
         F.4   Emergency Room Visits	286
                F.4.1 Morris et al (1999)	286
         F.5   Minor Effects	287
                F.5.1 Dockeryetal (1996)	287
                F.5.2 Ostro(1987)	288
                F.5.3 Ostro and Rothschild (1989)	289
                F.5.4 Schwartz and Neas (2000)	291
         F.6   Asthma-Related Effects	291
                F.6.1 Ostro et al (2001)	292
                F.6.2 Pope et al (1991)	293
                F.6.3 Vedal et al (1998)	294
         F.7   Calculating Threshold-Adjusted Functions	295


Appendix  G:  Ozone Health  Impact Functions in  U.S. Setup                   300

         G.1   Short-term Mortality	300
                G.1.1 Bell et al (2004)	301
                G.1.2 Bell et al (2005)	302
                G.1.3 Huang et al (2005)	302
                G.1.4 Levy etal, 2005	303
                G.1.5 Ito and Thurston (1996)	304
                G.1.6 Ito et al  (2005)	304
                G.1.7 Moolgavkar et al (1995)	305
                G.1.8 Samet et al (1997)	305
                G.1.9 Schwartz (2005)	306
         G.2   Hospital Admissions	306
                G.2.1 Burnett et al (2001)	307
                G.2.2 Moolgavkar et al (1997)	308
                G.2.3 Schwartz (1994a)	308
                G.2.4 Schwartz (1994b)	309

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               G.2.5 Schwartz (1995)	309
         G.3  Emergency Room Visits	311
               G.3.1 Jaffe et al (2003)	311
               G.3.2 Peel et al (2005)	311
               G.3.3 Stieb(1996)	312
               G.3.4 Wilson et al (2005)	313
         G.4  Minor Effects	314
               G.4.1 Chen et al (2000)	314
               G.4.2 Crocker and Horst (1981)	316
               GAS Gilliland et al (2001)	316
               G.4.4 Ostro and Rothschild (1989)	318
         G.5  Converting Functions to 8-Hour Daily Maximum Metric	319


Appendix H: Health Valuation Functions in  U.S. Setup                        323

         H.1  Mortality  	323
               H.1.1 Value of a Statistical Life Based on 26 Studies	324
               H.1.2 Value of a Statistical Life Based on Selected Studies	324
         H.2  Chronic Illness	325
               H.2.1 Chronic Bronchitis	325
                      Unit Value Based on Two Studies of WTP	325
                      Alternative Cost of Illness Estimates	327
               H.2.2 Chronic Bronchitis Reversals	328
               H.2.3 Chronic Asthma	328
               H.2.4 Non-Fatal Myocardial Infarctions (Heart Attacks) 	329
         H.3  Hospital Admissions & Emergency Room Visits	331
               H.3.1 Hospital Admissions	331
               H.3.2 Emergency Room Visits for Asthma	334
         H.4  Acute Symptoms and Illness Not Requiring Hospitalization	334
               H.4.1 Acute Bronchitis in Children	336
               H.4.2 Upper Respiratory Symptoms (URS) in Children	337
               H.4.3 Lower Respiratory Symptoms (LRS) in Children	338
               H.4.4 Anyof 19 Respiratory Symptoms	339
               HAS Work Loss Days (WLDs)	340
               HA6 Minor Restricted Activity Days (MRADs)	340
               H.4.7 Asthma Exacerbation	341
               HAS School Loss Days	341


Appendix I:  Population  & Other Data in U.S. Setup                             343

          1.1  Population Data in U.S. Setup	343
                1.1.1 How BenMAP Forecasts Population	344
                1.1.2 Data Needed for Forecasting	346
                      Block-Level Census 2000	346
                      County-Level Forecasts	350
                1.1.3 PopGrid	351

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                     How to Use PopGrid	351
                     PopGrid Output	356
         I.2   Monitor Data in U.S. Setup	358
                1.2.1 Data Processing	360
                I.2.2 Output Files	361


Appendix J: Uncertainty & Pooling                                                 362

         J.1   Uncertainty	362
               J.1.1 Characterization of Uncertainty Surrounding Incidence Changes	362
               J.1.2 Characterization of Uncertainty Surrounding Dollar Benefits	363
               J.1.3 Characterization of Uncertainty Surrounding QALY Estimates	364

         J.2   Pooling   	364
               J.2.1 Weights Used for Pooling	365
                     Subjective Weights	365
                     Automatically Generated Weights	366
                     Fixed-Effect Weights	366
                     Random-/ Fixed-Effect Weights	367
               J.2.2 Mechanics of Pooling in BenMAP	370
               J.2.3 Summing Distributions	371
               J.2.4 Subtracting Distributions	372


Appendix K: Command Line BenMAP                                             374

         K.1   Overview 	374
         K.2   Variables 	374
         K.3   Commands	375
               K.3.1 Set Active Setup	375
               K.3.2 Create AQG	375
                     Model Direct	376
                     Monitor Direct	377
                     Monitor Model Relative	379
                     Monitor Rollback	379
               K.3.3 Run CFG	380
               K.3.4 RunAPV	381
               K.3.5 Generate Report	382
                     Audit Trail	382
                     CFGR Report	382
                     APVR Report	383
         K.4   Example 1	383
         K.5   Example 2	385


Appendix L: Function  Editor                                                         387

         L.1   User Defined Variables	387
         L.2   The Script Language	388


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        L.3  Operands	389
        L.4  Operations	389
        L.5  Arithmetic Functions	390
        L.6  Aggregate Functions	391

References                                                                       392
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                                                          Appendix A: Training Courses
Appendix A:  Training Courses
   BenMAP is intended primarily as a tool for estimating the health impacts, and associated
   economic values, associated with changes in ambient air pollution. It accomplishes this by
   running health impact functions, which relate a change in the concentration of a pollutant
   to a change in the incidence of a health endpoint. Inputs to health impact functions
   typically include:

   (a) the change in ambient air pollution level,

   (b) a health effect estimate,

   (c) the background incidence rate of the health endpoint, and

   (d) the exposed population.

   For example, in the case of a premature mortality health impact function, we might have
   the following:

   Mortality Change =  Air Pollution Change x Mortality Effect Estimate

                   x Mortality Incidence x Exposed Population

   where each term on the right is defined as follows:

   • Air Pollution Change.  The air quality change is calculated as the difference between the starting
    air pollution level, also called the baseline, and the air pollution level after some change, such as
    that caused by a regulation. In the case of particulate matter, this is typically estimated in
    micrograms per cubic meter (|ig/m3).

   • Mortality Effect Estimate. The mortality effect estimate is an estimate of the percentage change
    in mortality due to a one unit change in ambient air pollution. Epidemiological studies provide a
    good source for effect estimates.

   • Mortality Incidence. The mortality incidence rate is an estimate of the average number of people
    that die in a given population over a given period of time. For example, the mortality incidence
    rate might be the probability that a person will die in a given year. Mortality incidence rates and
    other health data are typically collected by each country's government. In addition, the World
    Health Organization is a good  source for data.

   • Exposed Population. The exposed population is the number of people affected by the air
    pollution reduction. The government census office is a good source for this information. In
    addition, private companies may  collect this information and offer it for sale.

   BenMAP also calculates the economic value of health impacts. For example,  after the
   calculation of the mortality change, you can value the premature deaths avoided by
   multiplying the change in mortality by an estimate of the value of a statistical life:

              Value Mortality = Mortality Change x Value of Statistical Life

   where the rightmost term is defined as follows:
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• Value of Statistical Life. The value of a statistical life is the economic value placed on
  eliminating the risk of one premature death.

Figure 1-1 provides the overall schematic of BenMAP, and the various major steps
involved in using it. This figure also highlights that BenMAP does not have air quality
modeling capabilities, and instead relies on modeling and monitoring inputs.
           Baseline conditions
     (air quality WITHOUT regulation/policy
             scenario in place)
     Control conditions
(air quality WITH regulation/policy
      scenario in place)
Air quality
changes
                    Change in air quality (difference between
                     baseline and control air quality conditions)
                                                           Health effects
                                                           incidence estimation
                        Monetary value (benefits) of
                          health effects incidence
                                reductions
                                in tabular formats
                                  , audit trails
                    Valuation
                    Reports
                     Figure 1-1. Overall schematic of BenMAP.


BenMAP also serves as a Geographic Information System (GIS), allowing users to create,
utilize, and visualize maps of air pollution, population, incidence rates, incidence rate
changes, economic valuations, and other types of data. BenMAP can thus be used for a
variety of purposes, including:

• Generating population/community level ambient pollution exposure maps;

• Comparing benefits associated with regulatory programs;

• Estimating health impacts and costs of existing air pollution concentrations;

• Estimating health benefits of alternative ambient air quality standards; and

• Performing sensitivity analyses of health or valuation functions, or of other inputs.
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           A wide range of people can use BenMAP, including scientists, policy analysts, and
           decision makers. Advanced users can explore a broad array of options, such as using the
           map querying features and exploring the impacts of different health impact and valuation
           functions.


A.1    United States

           This training is intended for a beginning user of BenMAP that wants to use the U.S. setup
           that comes with BenMAP. The training manual is organized into seven sections.

           • Section 1. Data Files Needed. This provides a list of the files that you will need for this training
             and where you can get them.

           • Section 2. Mapping. This module is designed to help you become comfortable using BenMAP
             by analyzing the various types of data that we will use throughout this course.

           • Section 3. One-step Analyses. You will create health incidence and valuation results. This
             one-step analysis uses pre-defined health incidence and economic valuation configurations,
             which you can combine with your own baseline and control air quality grids.

           • Section 4. Creating Grids. In this section, you will create air quality grids (aqg) from both air
             quality (AQ) model data and from monitor data. The overall goal will be to produce baseline
             and control  air quality grids for later estimations of health incidence and valuation.

           • Section 5. Health Incidence Estimation. In this section, you will modify an existing health
             incidence configuration and use it to create new health incidence results. You will create two
             separate sets of health incidence results based on the same configuration and two similar, but
             distinct, control strategies.

           • Section 6. Aggregation, Valuation, and Pooling. In this section, you will create an aggregation,
             pooling, and valuation (APV) configuration and use it to produce new valuation results. You
             will create two separate sets of valuation results based on the same configuration and two
             similar, but  distinct, control strategies.

           • Section 7. Adding New Datasets and an Independent Case Study. In this section, you will add
             new datasets to BenMAP and run a local-scale benefit analysis in Detroit, Michigan.

           We have broken down each of the above sections into various modules,  and each module
           provides a context section, a module goal, and one or more example BenMAP
           applications.  In addition, there is a section with answers to embedded exercise questions for
           Sections 2 through 7.

A.1.1   Section 1. Data Files Needed for Training

           A range of data files are needed for this training and can be accessed at the BenMAP
           website: http://www.epa.gov/air/benmap/.

A.1.2   Section 2. Mapping Introduction

           This module  is designed to help you become comfortable using BenMAP by analyzing  the
           various types of data that you will use throughout this course. In this lesson, you will focus
           on using BenMAP's GIS tool to view maps of air quality data (file names ending in .aqg),
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                                                                   Appendix A: Training Courses
           health incidence results (ending in .cfgr), and economic valuation results (ending in .apvr).

A.1.2.1 Raw Monitor Data

           Several years of recent monitor data for Ozone, PM10 and PM2.5 have been pre-loaded
           into the BenMAP database. These data are derived from the extensive network of
           monitoring sites throughout the U.S.  For the PM (parti culate matter) data, most of the
           monitor data is recorded on a daily basis.  The ozone measurements are recorded on an
           hourly basis.  When displaying the data for a pollutant, you can display different averaging
           techniques, typically referred to as air quality metrics.

A.1.2.1.1   Example PM2.5 monitor data for 2000

           Goal: To start learning about BenMAP and the GIS tool, and to explore PM2.5 monitor
           data for the year 2000. You will be working with monitor values preloaded into BenMAP's
           underlying database

           (a) Open BenMAP by clicking on the desktop icon or by choosing "Launch BenMAP 3 " from the
             Window's Start menu. This will bring up the main BenMAP window (Figure 2-1).
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Tools  Help
              Two Ways to Use BenMAP: Which Analysis Meets your Needs?
 One-Step Analysis
 After you import the air quality data
 for your area, use this tool to apply
 default settings and create a report.


    ,'i '•:"'''.- '      Air Quality Grid Creation
                Preloaded
              EPA parameters
          Report
Custom Analysis

Step 1 — Import air quality data


  "'-.i'i'1 v •• *     Air Quality QM Creation
      1  *



Step 2 — Set custom parameters

    *- X

              Incidence Estimation
                                           Step 3 — Use results from Step 2
                                           to set custom parameters
             Pooling, Aggregation
                and Valuation
                                           Step 4 — Run report
                                             Report
                           Active Setup:
                       Figure 2-1. Main BenMAP window.
 (b) From the Tools menu, choose "GIS/Mapping" (Figure 2-2).
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    Help
Air Quality Grid Aggregation
Model File Concatenates
Database Export
Database Import
Export Air Quality Grid

Modify Setup
Neighbor File Creator
One-Step Setup
                         Use BenMAP: Which Analysis Meets your Needs?
 juality data
[ol to apply
 Ite a report.
                        ml
   Creation
               Preloaded
             EPA parameters
         Report
Custom Analysis
Step 1 — Import air quality data

  '.  V:'^;."      Air Quality Grid Creiiion


Step 2 — Set custom parameters

               Incidence Estimation
                                            Step 3 — Use results from Step 2
                                            to set custom parameters
                                  Pooling. Aggregation
                                    and Valuation
                                            Step 4 — Run report
                                              Report
                                                           .1
                                      ill
                           Active Setup:
                        Figure 2-2. Opening the GIS tool.
This will open the BenMAP GIS window (an example is shown later in Figure 2-4). At the
top of the GIS window, you will see a series of buttons,  described below. Note that in this
terminology a layer is a map, and "active layer" means the topmost map  in the GIS
window. You can have multiple maps layered on top of each other in the GIS tool.
           Open a File
           Save active layer
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O
          Zoom to full extent


                  Zoom in, Zoom out
           Select a region to zoom into


           Drag map


           Display info - Displays information for all variables in active layer of that cell


           Build queries to limit data displayed (e.g. values > 80 ppb)

           Calculate layer statistics of the active layer
(c)Click on the Open a File button and choose "Monitors". In the Select Monitors window
  (Figure 2-3), set the  pollutant to "PM2.5", and under the library tab set the dataset to
  "EPA Standard Monitors" and year to "2000".

Although you will not use the Advanced button in this module, we could use it to further
limit the monitors that  we would display based on location, state, or other monitor criteria.
          '&• Select Monitors
             Pollutant:
             PM2.5
            |                                       icmi

            Library | Database, Columns | Database, Rows j Test! File

             Monilof_DalaSet:
             JERfstandardMonitois

             Monitor Library Year:
                                                          Advanced
                                                Cancel
                                                              OK
                      Figure 2-3. Select Monitors window.
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(d) Click the OK button. This will bring up the monitor locations on the BenMAP GIS
  window (Figure 2-4).
 'Layers'
                                     (Ates Equal Area Conic jj
                                                                         Close
                       Figure 2-4. PM25 monitors locations.
(e) Double-click on the "PM2.5, 2000" layer. This will open the Display Options window
  (Figure 2-5).
Set the variable to "QuarterlyMean", which represents the average of the four quarterly
means (i.e., the annual average).

Set start and end sizes to "100"; this is the size of the monitor points.

Do not change the other seven fields in the window. The min and max values define your
range.  You can edit this to narrow in on a specific range. The start and end color allow
you to pick the colors of the monitor points in your range.  The default size and default
color are for areas that are outside your range. The decimal digits are the number of
decimal digits displayed.
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               S (art Size: 100
  EndSiie:I1QQ
Default Size:
  SWCdec [~]    Win Value: fZ75~
  EndOofcc •"           '
                                                  MaxValue:  28,33
DefsutCofa:
                                                Decimal Digits:  2
                                                 Cancel
                             OK
                      Figure 2-5. Display Options window.
        Background: The main PM metrics are D24HourMean (the daily value) and
        QuarterlyMean (the mean of all days within an individual yearly quarter).  The
        GIS tool does not display the monitor values for particular day or quarter; rather,
        the GIS tool will show seasonal averages of these variables. For PM, the default
        "season" is typically the full year.  This will likely cause some confusion. When
        we display D24HourMean, we are actually displaying the average of the 365 days
        of data, and when we display QuarterlyMean we  are showing the average of the 4
        quarterly means. In short, both these variables should be thought of as more akin
        to an annual average. Note: the definition of metrics and seasons can be changed
        (discussed in Lab 7).
(f) After clicking OK, you will get a map of the annually averaged PM25 values at all the
  monitor locations. To gain a better sense of the monitor locations, use the
  "— Reference Layer —" drop down menu in the top right corner of the BenMAP GIS
  window to select the "County" overlay (Figure 2-6).  The reference layer overlays a
  specific grid type (e.g. county, state, CMAQ) on top of your data layer.  It provides
  geographic context to your data layer.
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£ BenMAPGIS
 Layers
                                0 j 21 I  Ates Equal Area Conic j*j
K* PM2.5.2000
  2.75-5.31
  5.31-7.87
  7.87-10,42
  10.42-12.98
 '.' 12.38-15.54
  15.54-18.10
  18,10-20.66
  20,66-23,21
  23,21-25,77
  25,77-28,33
                                                                              Close
         Figure 2-6. PM25 monitor locations overlaid with county boundaries.
  (g)Now overlay a State reference layer. Experiment with zooming in and out of the map
    (using the toolbar). Try out some of the other buttons, including Display info and
    Create layer statistics.  Note: the values are in micrograms per cubic meter (jig/m3).

  (h)Exercise (2.1): What are the D24HourMean, QuarterlyMean, and lat/lon  of the monitor
    at the northern tip of Maine? Hint: Use the Display info and Zoom buttons.	
             Answer:
  (i)Use the Build queries button to bring up the Build Query window (Figure 2-7). Use the
    fields list and mathematical operator buttons or simply type in that window to create a
    query that limits the monitors to those with QuarterlyMean less than 10 micrograms per
    cubic meter (|ig/m3). Click OK or Execute.
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"ields:
Longitude < « ;
Latitude
D24HourMean <* <> >
QuarterlyMean Nd .. ,
I )

QuarterMvlean < 10|


It
If









Cs

Sample Values:
16^42
15,62
17,17
16,80
19,52
15,42 vi

Execute
reel OK

                                    Figure 2-7. Build Query window.
               Tip: You construct a query in the query text field (indicated by red arrow above).
               You can type in the field name (or double-click it, e.g. "QuarterlyMean"), the values,
               and the operators (e.g. ">" or "=") in the query text field. To remove the query (i.e. see
               all your monitors), delete the query text field and click OK (or Execute). Execute is
               the same as OK except that it keeps the Build Query window open.
           (j)Exercise (2.2): What states have monitors with QuarterlyMean values >20 |ig/m3?
                      Answer:
           (k)Remove the query so that you can see all the monitors. Do not close the BenMAP GIS
             window, because it will be used again in the next example.
A.1.2.1.2   Example O3 monitor data for 2000

           The goal of this task is to learn about layers in the GIS tool and to explore the O3 monitor
           data for 2000.

           (a) Using the same GIS window, open a second dataset by clicking on Open a File and selecting
             "Monitors". This time, set the pollutant to "Ozone". As before, set the year to "2000". Click
             OK.
           (b) Uncheck "PM2.5" in the Layers panel by clicking in the checkbox. The PM2.5 monitors
             should disappear.
           (c) Double-click on the "Ozone, 2000" layer to open up the Display Options window for that layer
             (Figure 2-8). For the variable, select "DSHourMax", which is the average of the 8 hr maximum
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   window for each day in the ozone season.
 Change the "Start Size" and "End Size" to "100" and colors from dark blue (Start Color) to
 light blue (End Color). In other words, we are differentiating the ozone monitors from the
 PM2.5 monitors by having them range from dark to light blue.  Click OK. Note: these
 values are the concentrations of ozone in parts per billion (ppb).
Layers
      &
  Ozone, 2000
PM2.5,2000
2.75-5.31
5.31-7.87
7.87-10.42
10.42-12.98
12.98-15.54
15.54-18.10
18.10-20.66
20.66-23.21
23.21-25.77
25.77-28.33
                    M^wAMfe.,.
                     Variable: D8HoutM«x
                    Start Size; (100   jfj   Start Coto:
                    End Size; llDCJif    End Cote
                   Default Size: 120
_t|  D«i«utC«ta:
  Min Value;
  Max Value;
Decimal Dipts; 12

 Cancel       OK
                                                                             Close
       Figure 2-8. Display Options window values described in step (c) above.
 Background: There are a series of ozone metrics: DIHourMax (the maximum 1 hour
 value in a day), D24HourMean (daily mean), DSHourMean (daily mean of hours 10am -
 2pm), DSHourMax (the greatest mean for any 8 hour window in a day), and
 DSHourMean (daily mean of hours 9am - 4pm). Again, the GIS tool does not display
 the monitor values for any particular day.  It calculates and displays a seasonal average
 for each of the above metrics. The default ozone season is from May 1st through
 September 30th. For example, the DIHourMax is calculated by adding up the maximum
 value for that monitor for each day in the season and then dividing by the number of days
 in the ozone season. Note: the definition of metrics and seasons can be changed
 (discussed in Lab 7).
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           (d)Recheck "PM2.5, 2000" in the Layers panel. You should now see both the O3 and PM2.5 data.

           In the Layers panel, switch the order of the layers by right-clicking on the "PM2.5, 2000"
           layer and select "Move up" in the pop-up window. The active layer is always the topmost
           layer in the Layers panel. Note: Only the active layer is used in getting information or
           performing queries.

           (e)Exercise (2.3): What are the maximum and minimum QuarterlyMean values for the PM2.5
             monitors? Hint: use the Layer Statistics button and PM2.5 should be the active layer.
                     Answer:
           (f)Exercise (2.4): What are the maximum and minimum DSHourMax values for the ozone
             monitors? Which states have a DSHourMax greater than 60 parts per billion (ppb)?
             Hint: ozone should be the active layer. When performing the query, you might want to
             uncheck PM25 so that it is easier to see the ozone monitors.
                     Answer:
           (g)After you are done, click Close at the bottom right of the GIS window. This completes
             the "Raw Monitor Data" module for this lab.
A. 1.2.2 Model Data
           You will use CMAQ (an AQ model that simulates the chemistry and movement of various
           pollutants) outputs from the PM2.5 Regulatory Impact Analysis (RIA) for this training
           module. Unlike the monitor data visualized in the previous module, the model data has
           values that are on a regular grid and cover the whole area of the map. The RIA model data
           is a forecast of the air quality (AQ) for the year 2020. We will focus on a baseline scenario
           (think of this as "business-as-usual") and two control scenarios (in these cases additional
           regulations have been applied to emission source, resulting in generally lower pollution
           levels).

           We recommend that you are detailed and consistent in naming your BenMAP files.  In this
           lab, the file name includes references to the annual PM2.5 NAAQS (National Ambient Air
           Quality Standards) and a daily PM2.5 NAAQS. For example, the file
           "Baseline_PM25_RIA_2020_cmaq_grid_15_Annual_65_Daily.aqg" refers to the baseline
           model run on the CMAQ grid type in which most annual PM2.5 values are below 15
           |ig/m3 and most daily values are below 65 |ig/m3. For the rest of the modules, we will use
           the shorthand "Baseline PM2.5 RIA 2020 15/65" to refer to the baseline scenario with 15
           |ig/m3 annual NAAQS and 65 |ig/m3 daily NAAQS. An equivalent shorthand will be used
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           for the control scenarios.

A.1.2.2.1   Example Air Quality Grid File: Baseline PM2.5

           The goal of this example is to look at model data using the BenMAP GIS tool and to learn
           about the differences between political-type grids and CMAQ-type grids.

           (a)From the main BenMAP window, open a new GIS window by choosing "GIS/Mapping" in the
              Tools menu.
           (b)Click on the Open a File button, then choose "Air Quality Grid (* .aqg)". Under the "Air
              Quality Grids" folder in the Open an Air Quality Grid window, navigate to the folder
              "PM25_RIA", select the file named
              "Baseline_PM25_RIA_2020_cmaq_grid_15_Annual_65_Daily.aqg", and click Open.
           (c)In the GIS window that appears, double-click on the
              "Baseline_PM25_RIA_2020_cmaq_grid_15_Annual_65_Daily.aqg" layer to open the Display
              Options window.
           In that window, set the variable to "QuarterlyMean". This will cause the annual average data to be
           displayed.
           Also uncheck the grid outline; this is usually preferred, because the window often looks messy
           with both the data and the grid outlines displayed. Click OK in the Display Options window.
           Finally, use the drop-down menu near the upper right corner of the GIS window to overlay a
           "State" reference layer (Figure 2-9).
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 177-3.63
 3.63-5.50
 5.50-7.36
 7,36-9.23
 9.23-11.09
 11.09-12.95
 12,95-14,82
 14,82-16.68
 16.68-18.55
 18,55-20.41
                                                                              Close
           Figure 2-9. PM2S model output overlaid with state boundaries.
(d)Exercise (2.5): Use the Zoom in button to zoom into a state border region until you can
  see the model grid cells. Do the grid cells align with the state boundaries?  In other
  words, do the model grid cells perfectly fit within the political boundaries?
           Answer:
(e)Exercise (2.6): What states are out of attainment in this baseline model scenario? States
  that are out of attainment are those that have at least one QuarterlyMean grid cell value
  above 15 |ig/m3.
           Answer:
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           (f)Try overlaying the "CMAQ 36km Nation Overlap" overlay reference layer. Zoom into a
             small region. Note how the model values line-up with the reference layer.

           (g)When you are done exploring, close the GIS window by clicking Close. This completes
             the "Model Data" module.

A.1.2.3 Health Incidence
           To produce health incidence results, the first step is to calculate the change in pollution
           concentrations that would be produced by the application of a given set of emissions
           controls. The concentration change in a pollutant (say, PM2.5) is the difference (the
           "delta") between the modeling results from a control scenario and the modeling results
           from the baseline scenario. These deltas and a gridded population dataset are then used in
           concentration-response (C-R) functions to calculate the change in health incidence that
           would result from this change in pollution.  These C-R functions are based on
           epidemiological studies and can be selected by the user (see Lab 5).  Typically, these health
           incidence results show the number of avoided health incidence (e.g. the decrease in
           asthma, bronchitis, mortality, etc) due to a decrease in pollution.

           In the rest of this module, we refer to the health incidence results via the shorthand
           versions of their control scenario names (as explained in Section 2.2.1). Also recall that the
           abbreviation "cfgr" refers to health incidence results. Note: we don't actually go through
           the procedure of creating these health incidence results in this lab (see Labs 3 and 5);
           rather, we are just looking at the pre-computed results.

A.1.2.3.1   Example Configuration Results File: Control PM2.5

           The goal of this exercise is to use the GIS tool to explore the reductions in health incidence
           that would be due to the reductions in PM2.5 caused by the RIA control scenario. In
           particular, we will look at reductions in mortality, acute respiratory symptoms, chronic
           bronchitis, and emergency room (ER) visits.

           (a)From the main BenMAP window, open a new GIS window.

           (b)Click on the Open a File button, then select "Configuration Results (*.cfgr)". Under the
             "Configuration Results" folder, select the file named
             "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_35_daily.cfgr". Click Open.

           (c)This will bring up an additional window Edit GIS Field Names. In the last column of
             this window, change the names of the fields to more meaningful names, by highlighting
             the contents of each of the four cells and typing in "Mortality", "ChronBronc", "ER",
             and "AcutResp" (Figure 2-10). Note: the GIS field names cannot exceed 10 characters
             in length.

           Before clicking OK, do the next exercise.
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Edit CIS Field Names
DataSet
[EndpointGroup   'Endpoint
Pofcrtant
Mehfc
I Seasonal Metric
Gis Field Name
Alternative Mortality'Mortality        Mortality, AJ Cause PM2.5
Complete Version2 • Chronic Bronchitis  Chronic Btonchtes  PM2.5
Complete Version2 • Emergency RoomVi Emergency Room Vi PM2.5
Complete Version2 , Acute Respiratory S; Minor Restricted Act PM2.5
                                         D24Ho«Mean
                                         D24HourMean
                                         D24BowMean
                                         D24HoufMean
                           QuarterlyMean
                           QuarterlyMean
                         Result!
                         Result2
                         Result3
                       Figure 2-10. Edit GIS Field Names window.
  (d)Exercise (2.7): Look at the various columns in the Edit GIS Field Names window
     (information and variables used in the C-R functions, e.g. "Pollutant" and "Author").
     For what age range are we calculating the change in mortality? When finished with this
     exercise, click OK.
        Answer:
  (e)In the BenMAP GIS window, display mortality data, uncheck the CMAQ grid outline,
     and overlay a state reference layer. Note: these values are number of deaths prevented
     by the control scenario.

  (f) Exercise (2.8): Under this control strategy, which states had more than 25 avoided
     deaths?
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     Answer:
(g)Display acute respiratory symptoms, "AcutResp".

(h)Exercise (2.9): How do the number of acute respiratory incidences avoided compare to
  the number of premature deaths avoided? Hint: use the Display info or Calculate layer
  statistics buttons.
     Answer:
(i) Display and explore the GIS fields DELTAX and POPX.  Here, "X" refers to a number.
     Background: For each health incidence result, there is a corresponding population
     and delta variable. For example, DELTAO and POPO are the PM2.5 delta and the
     population that mortality was calculated from. The number comes from the initial
     result names.  For example, ResultO (mortality) matches DELTAO and POPO;
     Resultl (ChronBronc) matches DELTA1 and POP1; etc. Note, the population of
     interest is determined by the C-R function and is not necessarily equivalent
     between the various health incidence results (e.g. different age ranges, gender, or
     ethnic groups).
(j) Exercise (2.10): Compare the delta and mortality values.  Look at the spatial pattern of
  these two variables. Why do the delta and the mortality values not exactly correlate?
     Answer:
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           (k)Close the GIS window. This completes the "Health Incidence" module.

A.1.2.4  Valuation Map
           For the purposes of this course, "valuation results" are the economic benefits of avoiding
           the previously calculated changes in health incidence. These are the monetized benefits of
           the avoided premature mortalities and morbidities (i.e., non-fatal health effects), which are
           the two measures we discuss in this module.  These valuation results are calculated by
           taking the estimates of health incidence avoided and applying valuation functions to
           express those incidences in dollar terms. For example, the economic value of premature
           mortality avoided has a monetary value that is expressed as a distribution.  If you calculate
           a mean value of that distribution, you can then multiply that mean value by the number of
           mortalities avoided (due to your control strategy), resulting in an estimate of the economic
           benefit of avoiding those premature mortalities.

           The valuation results (and the underlying health incidence) are typically aggregated from
           the CMAQ or county grid to State or National totals.  The results (health incidence and
           valuation) are often pooled. Pooling are methods for combining similar health incidence
           or valuation results. For example, if you have two different studies (valuation functions)
           for calculating the  monetized benefit of avoided ER visits, you would  "pool" together these
           two results to create a single valuation for ER (see Lab 6).

           As in the "Health Incidence" module just completed, here we refer to the valuation results
           via the shorthand versions of their control scenario names. (Recall that the abbreviation
           "apvr" refers to economic valuation results.)

A.1.2.4.1   Example Valuation Results File: Control PM2.5

           The goal of this exercise is to use the GIS tool to explore the economic benefits of the
           above reductions in health incidence due to this  control scenario. In particular, we will
           look at the cost savings due to reductions in mortality and in morbidity. We will also
           compare the economic benefits to the pooled and aggregated health incidence results.

           (a)Open a new GIS window, click on the Open a File button, select "APV Configuration
              Results (*.apvr)", then select "Pooled Valuation Results" (Figure 2-11).
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    Configuration Results (*,cfgr)
    Modeling Data
    Monitors
    Population
Incidence Rest&s
Aggregated Incidence Resufts
Ported Incidence Resufts
Valuation Results
Aggregated Valuatwn Results

                             Aggregated QALY ViuMton Resuls
                             Pooled QALV Vatetton Results
                             All Results
                                                                               Close
               Figure 2-11. Selecting the "Pooled Valuation Results" file.
Tip: There are a lot of options for what type of data to map with apvr files.  Typically we use
"Pooled Incidence Results" (aggregated and pooled health incidence) or "Pooled Valuation
Results"  (aggregated and pooled valuations).	
   (b)In the Open an APV Configuration Results File window, under the folder
     "Configuration Results", select the file named
     "Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily_state.apvr". Click Open.

   (c)In the Edit GIS Field Names window that appears, edit the GIS field names. Use the
     same four field names as in the previous module ("Mortality", "ChronBronc", "ER",
     and "AcutResp").

   (d)After clicking OK, a Valuation Sums Layer window (Figure 2-12) will appear. This
     window is the starting point for adding together various valuation results to get total
     values for mortality and morbidity. We will view these summed results in the GIS
     window.
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                                                                            September 2008

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                 fl Valuation Sums Layer
                  Sum Identifier
Gis FieM Name
                                                     Add Sum
                                          Cancel
                OK
                   Figure 2-12. Valuation Sums Layer window.
     (l)To create a morbidity layer, click on the Add Sum button. An Add Valuation Sum
       window will appear (Figure 2-13).

    In the Include in Total column at the right, check all the health incidences that will be
summed together to make        morbidity (chronic bronchitis, ER visits, and acute
respiratory symptoms).

    At the bottom left corner of this window, type "Morbidity" into the Valuation Sum
Identifier field. Leave the        Summation Type field as "Dependent".
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£ Add Valuation Sum
'doling Window

Endpoint Group VaJuatianMethad Poolng Window Include in Total
Mortality Pocfag Window 1
Chronic Bronchitis Poe&ig Window 1 ^
Emergency Room Vi Pocing Window 1 **,
Acute Respiratory Sj Pcdmg Window! ^
Valuation Sum Identifier: Summation Type: ''. ' •: . - .
| Morbidity
(Dependent _^J |"--' jj Lan°el UK

   Figure 2-13. An v4
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w Add Valuation Sum
Pooling Window   Endpoint Group   VaSuatioriMethad   PodBrgWrektw
              Mortality
              Chronic Bronchitis
              Emergency RoomVi
              Acute Respiratory S>
                      Pooirtg Window 1
                      Pooing Window!
                      Poofcig Window 1
                                     Include in Total
  Valuation Sum Identifier:  Summation Type:
  j Morbidity
Dependent
                                                               Cancel
                                                       OK
                Figure 2-14. Valuation Sums Layer window after the
           morbidity sum identifier and GIS field name have been added.
      (3)Next, add mortality to the Valuation Sums Layer window by clicking on the Add
         Sum button again, then checking "Mortality" in the Add Valuation Sum window,
         typing "Mortality" into the Valuation Sum Identifier field, and clicking OK.

                  Return to the Valuation Sums Layer window and enter "Mortality" into
                  the GIS Field Name cell in the mortality row that has been added to that
                  window. Finally, click OK to close the window.

 (e)In the Layers area of the GIS window, you will see that two layers have been added:
    "Pooled Valuation Results Sums" and
    "Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily_state.apvr".

         Double click on the "Pooled Valuation Results Sums" layer and set the display
         variable to  "Mortality" (Figure 2-15).
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3 BenMAP CIS
 Layers
                                   |AIbeisEqudAieaCo™: j-J
  Pooled Valuation Results Sums
  1199616.50-3.7946198E08
  3.7846198E08-7.5772435E08
  7.5772435E08-1.1359B67E09
  1.1359867E 09-1.5142491E 09
  1.5142491E09-1.8925115E 09
  11.8925115E 09-2.2707738E 09
  2.27Q7738E 09-2.648Q362E 09
  2.6490362E09-3.0272986E09
  3.0272986E09-3.4055609E09
  3,4055609E09-3,783e234E09
  ControLRIA_2020_cmaq_gtidJ5_an
                                                                                         Close
              Figure 2-15. Economic benefit due to the reduction in deaths.
  (f) Display the morbidity valuation data.  Use the Display info button to explore some of
     the morbidity and mortality valuation values for specific states. Note: these benefits are
     in dollars.

  (g)In the same GIS window, we will now overlay a pooled and aggregated health incidence
     layer for the same control scenario. We can use this layer to see the total number of
     prevented health incidences in each State.

        (l)Use the Open a File button, select "APV Configuration Results (*.apvr)", then
           choose "Pooled Incidence Results" (Figure 2-16).
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                                                                                   September 2008

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Configuration Results (*.cfgr)
Modeling Data
Monitors
Population
Incidence Results
Aggregated Incidence Resuts

Valuation Resdto
Aggregated Valuation ReaJts
Pooled Valuation Resuts
QALV Valuation ftesufts
Aggregated QAlY vaJuatwft Re*u»«
Poded QAIY valuation Results
AflRejuts
                                                                              Close
             Figure 2-16. Selecting the "Pooled Incidence Results" file.
     (2)Under the "Configuration Results" folder, open the same file:
        "Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily_state.apvr".

     (3)In the Edit GIS Field Names window, edit the field names as before, then close
        that window.

    Double click the top layer,
"Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily_state.apvr (Pooled
    Incidence Results)" and set the variable to "Mortality".

     (4)We should now have the pooled and aggregated mortality incidence (number of
        deaths avoided per state) overlaying the pooled and aggregated mortality valuation
        (economic benefits per state) (Figure 2-17).
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                                                                           September 2008

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£ BenMAP GIS
                                                              00®
   0.1B-57.49
   57.49-114.80
   114.80-172.10
   172.10-229.41
   229,41-286.72
   286,72-344.03
   344,03-401.34
   401,34-456.64
   458,64-515.95
   515,95-573.26
  Pooled Valuation
  1199616.50-3.7
  3.7946198E 08-7
  7.5772435E08-'
  1.1359867E09-'
  1.5142491E 09-1
  1.8925115E 09-2
             v
^1 Q I
                                          |Afcas Equal Area Come j-J
                                                                                  Close
      Figure 2-17. State mortality totals overlaying state economic benefit totals.
  (h)Exercise (2.11): Compare the number of incidences for mortality and acute respiratory
     symptoms (one of the components of morbidity). What are the values for Washington
     State? Now compare the economic valuations for mortality and morbidity in the same
     state. What values did you get? What does contrasting the incidence numbers with the
     valuation numbers tell us about the valuation function for mortality versus the one for
     morbidity? Hint: you may need to switch the active layer by right clicking on the layer
     of interest in the Layers panel.
       Answer:
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           (i) Close the GIS window. This completes the "Valuation Map" module.

A. 1.2.5  Audit Trail

           The audit trail is a tool for looking at the headers of files created through BenMAP. In
           other words, it allows you to explore the metadata (the settings, inputs, and/or configura-
           tions) for a BenMAP file. An audit trail is a useful feature to check your work and see
           which options you selected in your analysis. You can use the audit trail to look at all of
           BenMAP's output files, including air quality grids, configuration files, and results files.

A.1.2.5.1   Example Health Incidence: Control PM2.5

           The goal of this exercise is to use the audit trail tool to explore the metadata of files created
           in BenMAP.

           (a)In the main BenMAP window, click on the Report graphic that is at the bottom of the
              right-hand panel (under "Custom Analysis"). In the Select Report Type window that
              appears, select "Audit Trail Reports" (Figure 2-18).  Click OK.
                   ('  I incidence and Valuation Resuls: Raw, Aggregated, and Poofed  (Created from". apvr files)

                   C  Raw Incidence Results, lOeated horn ".dgr lies-)

                   C*1  Piudii Trail Reports (C'eatedffcm'.dtjgMes>*clpites,* dgi ("lies, *.apy files, or *.apyr filesJ
                                                                  Cancel
OK
                                Figure 2-18. Select Report Type window.
           (b)In the Open window, under the "Configuration Results" folder, open the file
              "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_3 5_daily.cfgr".

           (c) An Audit Trail Report window will open that contains a tree structure giving the audit
              trail information (Figure 2-19). You can expand any section of the tree by clicking on
              the plus sign next to the heading, or collapse a section by clicking on the minus sign.
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                                                                                    September 2008

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H Audit Trail Report
   zAlKiiW®M$AP                                           ar«jaIJS:*iLefa
    ]•••• Latin Hypercube Points: 10
    !-- Population Dataset: United States Census - CMAQ 36km
    i-Year: 2020
      Threshold: 0
   l+l  Grid Definition
   [+l  Selected Studies
   l+l  Baseline Air Quality Grid: Z:\BenMAP\eenMAP_Fies\te_QuaSy_6iiids\PM25_RIA\Baserine_2020_PM25_cmaCLgrid_15_Annual_65_D
   i+l  Control Air Q uality G rid: Z: \BenMAP*e«MAP_Fies\A«_Qua%_G«b\PM25_RlA\Cort»oL2f^_PM25_cmaeLgrid_15_Annual_35_D ailj,
                                                                             Enport
                                                                                          OK
                          Figure 2-19. Audit Trail Report window.
  (d)Exercise (2.12): What population year was used in this study? What is the name of the
     grid type?
        Answer:
  (e)Exercise (2.13): What is the age range for the emergency room (ER) CR function, and
     who was the author of the study?
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                Answer:
           (f)Export the audit trail. Click the Export button. In the Save as window, save the file
             under the "Reports" folder as
             "Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily". This is a ".txt" file that
             can be easily opened in Microsoft Word or Notepad.
                Answer:
           (g)Close the Audit Trail Report window by clicking OK. This completes the "Audit Trail"
             module.

A. 1.2.6 Report
           Reports are a good way to summarize your BenMAP results in a table (columns and rows)
           and export them to be used in Excel or some other data analysis tool.

A.1.2.6.1   Example Pooled Incidence: Control PM2.5 RIA

           The goal of this exercise is to create reports from BenMAP results. In particular, to look at
           the pooled and aggregated health incidence results from the 2020 RIA control scenario.

           (a)In the main BenMAP window, click on the Report graphic under "Custom Analysis".

           In the Select Report Type window, select the "Incidence and Valuation Results" item.

           In the Open window, under the "Configuration Results" folder, open the file
           "Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily_state.apvr".

           (b) In the Choose a Result Type window that appears (Figure 2-20), select "Pooled
             Incidence Results". Click  OK.
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          Incidence and Valua

          Raw Incidence Rest

          Audit Trail Reports (C

                          Result Type
                             Incidence Restfc
                             Aggregated Incidence Resulte
V-sJusfan Results
Aggregated Valuation Resuta
Pooled Valuation Ftewls
fMY Valuation Re$ut$
                             Pooled QALYV<*Jc£on Results
                                       Caned
                        OK
Incidence Estimation


     1 "i;"1) "'"SI  Til
     irM L-'i h JP
     I ~-J *•!  -J !LiS4

id from ".apvr files)



es, or *.apvr files)
                                                                   OK
                                       I   |   reeport

                    Figure 2-20. Choose a Result Type window.
(c)In the Configuration Results Report window that appears (Figure 2-21), click on the
   checkbox for "Endpoint Group" in the "Pooled C-R Function Fields" area, and uncheck
   the checkboxes for "Variance" and "Latin Hypercube" in the "Result Fields" area. In
   other words, we are selecting which of the many available columns to display in the
   results table.

Under the "Display Options", the "Elements in Preview" field determines the number of
rows included in this preview window (in our example, 25).  When you save the report,
you will get all the rows.
  Background:  In the report window, there are two columns in the report that are grid
  fields ("Column" and "Row").  They are unique identifiers of each minimum spatial
  unit. For a CMAQ grid, these are merely the column and row number for each cell in
  the grid. For political grids, their meaning depends on your grid definition.  In our
  example, the column is the state code and the row is the FIPS code.
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£ APV Configuration Results Report
File
Col

jmn selection
Grid Fields: Pooled C-R Function Fields: Result Fields:
lyj Column >f Endpoint G
ryl Row Endpoint
Author
Qualifier
Location
Start Age
End Age
Year
Other Pollut
Reference
Grouping Options
oup 	 Fwscfon *t Point Estimate
PoiJtant ** Mean
Metiic ** Standard Deviation
Seasonal Metric Variance
Mettic Statistic
DataSet
Version
' Pwing Window
arts
Dteptaf Options

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           This completes the "Mapping Introduction" lab. In the next lab, "One-Step Analysis" we
           will run the one-step analysis, creating both health incidence results (cfgr) and valuation
           results (apvr).

A.1.2.7 Additional Mapping Activities

           1.  Overlay the PM2.5 monitor data over the baseline model data. Look at the similarity
              and differences in the pattern of monitor versus modeled data. Make sure that the
              monitors' layer is topmost.

           2.  Overlay the baseline model data over the control 2020 RIA 14/35 data. Compare the
              regions in the two layers that are out of attainment. Also, compare the regions that show
              PM2.5 concentrations greater than 10 |ig/m3.

A.1.3   Section 3. One-Step Analysis

           In  this section, you will create health incidence and valuation results. This one-step
           analysis uses pre-defined health incidence and economic valuation configurations, which
           you can combine with your own baseline and control air quality grids. We will run two
           separate one-step analyses for two similar, but distinct control strategies.

           The One-Step Analysis encapsulates all three stages of BenMAP:  (1) Calculate the change
           in  pollution concentrations that would be produced by the application of a given set of
           emissions controls. The concentration change in a pollutant (say, PM2.5) is the difference
           (the "delta") between the modeling results from an emissions control scenario and the
           modeling results from the baseline scenario. (2) These deltas, background incidence rates,
           and a gridded population dataset are then used in concentration-response (C-R) functions
           to  calculate the change in health incidence that would result from this change in pollution.
           Typically, these health incidence results show the decrease in health incidence (e.g. the
           decrease in asthma, bronchitis, mortality, etc) due to a decrease in pollution. (3)  These
           health incidence results are then used to calculate economic benefits due to changes in the
           population's mortality and morbidity.  For example, what is the economic valuation of the
           avoided premature mortality due to the emissions control? The valuation results (and the
           underlying health incidence) are typically then aggregated to county, state, or national
           totals. Note: in One-Step Analysis, the health incidence and valuation functions are
           standard EPA configurations.

A.1.3.1 Example PM2.5 Control 2020 15/35 National

        The goal of this exercise is to re-create the control RIA 2020 15 annual, 35 daily |ig/m3 health
        incidence and valuation study that we saw in the "Mapping Introduction" lab. We will
        produce similar health incidence results (.cfgr file) and valuation results (.apvr file).

        Procedures:

              (a)  In the main BenMAP window,  open one-step analysis. Simply click on the
                   left-hand panel graphic  under the label "One-Step Analysis". This will open the
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          One Step Analysis window.
H One Step Analysis
       Run Name:
   Output Directory:  J

    1. Air Quality Grids

     Baseline File:
     Select
                                                             Open
   Create
     Control File:
                                                                           Map Deltas
    2. Incidence
     At what level would you like to agpsgste your hckterwe result?
     [Nation
    3. Valuation
     At what level would you like to aggregate your valuation results?
     Valuation Aggregation must be at a level the sane as or higher than the Incidence aggregation.
      Nation
    Open Results
Cancel
Go
                        Figure 3-1. One-Step Analysis window.
     (b)  Set the "Run Name". This is the name that will be used for our cfgr and apvr files.
          A recommended practice is to be specific and base it on the control.  In the "Run
          Name" field, type:
          "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_3 5_daily_county".

      Note: we have added "county" to differentiate these results from our previous Control
  RIA 2020 15/35 results that       had been aggregated to State totals.

     (c)  Set the output directory. Use the Select button to select the "Configuration
          Results" directory
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    (d)  In the panel " 1. Air Quality Grids", set the baseline and control aqg. In many cases,
        the control AQG will have lower pollution values than our baseline. This
        reduction in modeled ambient PM2.5 is the result of our policy scenario that
        reduced emissions from industrial or other sources. Click the Open button next to
        the "Baseline File" field.

     An Open window will appear. Navigate to the "PM25_RIA" folder under the "Air
 Quality Grids" folder, select
 "Baseline_PM25_RIA_2020_cmaq_grid_15_Annual_65_Daily.aqg", and click Open.

     Repeat these steps for the "Control File", this time selecting

 "Control_PM25_RIA_2020_cmaq_grid_l 5_Annual_3 5_Daily.aqg".

    (e)  Map the change in pollution (the deltas) between the baseline and the control.
        Click on the Map Deltas button.  A BenMAP GIS window will appear with 3
        layers: "Delta" (the change in PM2.5), "Control Grid"  (the control modeled
        values), and "Baseline Grid" (the baseline modeled values) (Figure 3-2):

Layers
                                     1 Abets Equal AieaConic  jrj
  Delta
  Control Grid
  Baseline Grid
                                                                          Close
 Figure 3-2. GIS window for mapping deltas between the baseline and the control.
      (1) Double click the "Delta" layer in the BenMAP GIS window. In the Display
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       Option window, set the    variable to "QuarterlyMean" and turn off the grid
       outlines. Click OK.

       In the BenMAP GIS window, uncheck the "Control Grid" and "Baseline Grid" layers
       and overlay a  state reference layer.
  Background: The "Delta" is a map of the change in AQ between your baseline and control
  scenarios (i.e. baseline - control). Typically it is a good practice to check the delta. You
  can use this map to see if the changes in air quality are in the right direction (typically that
  you are getting positive values, i.e. reductions) and magnitude and that the changes are
  occurring in the appropriate places.  You can also use this window to look at the
  underlying control or baseline scenarios: "Control  Grid" and "Baseline Grid" in the Layers
  panel.
Layers
  Delta
  -0.01-0.51
  0.51-1.04
  1.04-1.56
  1.5G-2.08
  2.06-2.61
  2.61-3,13
  3.13-3.65
  3.65-4,17
  4,17-470
  4.70-5,22
  Control Grid
  Baseline Grid
^K|Qj©lo]<
                                       !«»* Equal Aiea Conic
                                                                              Close
        Figure 3-3. The resulting deltas between the baseline and the control.
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             (1)  Exercise (3.1): In which states are the difference between the
                 baseline and the control greater than 0.2 |ig/m3? Hint: use the Build
                 queries button.
  Answer:
             (2)  Exercise (3.2): Off the coast of California and on the Northeastern
                 edge of the CMAQ grid, there are significant reductions in
                 concentrations. Will these areas change our health incidence and
                 valuation values? Explain your answer.
  Answer:
(f)  Click Close in the BenMAP GIS window.  This will return you to the One Step
    Analysis window.

(g)  Aggregation. Aggregation refers to the summing of health incidence results and
    valuation results to get more meaningful totals.  In our case, the baseline and
    control modeled AQ data are at the fine scale of CMAQ grid cells. We want to
    aggregate them up to the county level.

             (1)  Exercise (3.3): Look at the aggregation levels for Incidence and
                 Valuation. What grids are available? If we set the Incidence grid to
                 state, what grids are now available for Valuation?
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        Answer:
                   (2)  Set the aggregation levels to "County" under "2. Incidence" and "3.
                       Valuation".

      (h)  Run one-step analysis. Click the Go button on the bottom of the One Step Analysis
          window. A Progress window will appear. The run will have completed when the
          One Step Results window appears (Figure 3-4).  Do not close the One Step Results
          window when it appears.

          Running a one-step analysis will take a few minutes.  If we were running a larger
          domain, the grid cells had finer resolution, or our configuration included more
          functions, the one-step analysis would take much longer.  The majority of the
          computation time is taken up in calculating the valuation results (apvr).

Analysis:  The rest of the exercises in Section 3.2 focus on analyzing the results of our
BenMAP One-step Analysis run. Specifically, we will look at the newly created health
incidence results (cfgr) and valuation results (apvr) files.

      (a)  One Step Results are a series of customized reports and plots that were designed
          for EPA's apvr setup. Because we are using a simplified configuration, these
          reports provide limited results.

          Click the Audit Trail Report button in the One Step Results window.
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             Incidence Results
              Table of Mortality
   Box Rot oJ
                 Incidence   [    Mortally Incidence
                           I
              Table of Morbidity I
                 Incidence   '
             Valuation Results

              Table of Mortality
                 Valuation
              Table of Morbidity
                 Valuation
             Audit Trail


              Audit Trail Report
   Box Bold
MortaUy Valuation
Cumulative
Distribution
Functions
  Bat Chart of
   Valuation
                 e |Z:\BenMAP\BefiMAP_Fles\Drfig
                                    Close
     Figure 34. One Step Results window providing custom reports and plots.
Tip:  By using the Load Apvr button (bottom of the One Step Analysis window), you
;an select any results file (apvr). Note, the full capabilities of the One Step Results
currently only work for a full EPA RIA configuration.
   (b)  Exercise (3.4): In the audit trail report and under "Configuration Results", open
       "CR Function 0"?  What is the function's endpoint? Who is the author of the
       underlying study? Under "Advanced", what is the aggregation name for incidence
       and valuation results?
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  Answer:
(c)  In the Audit Trail Report window, click OK to close the window. Click Close in
    the One Step Results window.  This will return you to the main BenMAP window.

(d)  Open a new BenMAP GIS window, click on the Open a File button, then select
    "Configuration Results (*.cfgr)". Under the "Configuration Results" folder, select
    the newly created file:
    "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_3 5_daily_county. cfgr".

(e)  In the Edit GIS Field Names window, change the field names to: "Mortality",
    "ChronBronc", "ER", and "AcutResp". Click OK.

    In the BenMAP GIS window, double click the layer
    "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_35_daily_county.cfgr" and
    display the "AcutResp" variable.

(f)  Exercise (3.5): Which grid is used in the health incidence results? Why is this
    different than the aggregation level in the One-step analysis window?  Note: you
    can use either the audit trail or the GIS tool for this exercise.
  Answer:
(g)  Exercise (3.6): Which states have a reduction of more than 4000 acute respiratory
    incidences? Hint: use the Build queries button.
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      Answer:
    (h)  Overlay the new .apvr (valuation results). Use the Open a File button, select
         "APV Configuration Results (*.apvr)", then choose "Pooled Incidence Results"
         (Figure 35).

         Open the file
         "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_35_daily_county.apvr". Edit
         the GIS field names to more meaningful names.
BenMAP GIS
Air Quality Grid (*.aqg)
ftPV-Conft§u»tion ReM»<*,«»ft
Configuration Results (*,cfgr)
Modeling Data
Monitors
Population
                                          J^»s Equal Area Conic  ^J  |- Reference Layer --
 27019.02-32520.1
 32520.11-38021.2
 38021.21-43522.3
 43522,31-49023.4
 49023,40-54524,5
Incidence Results
Aggregated Incidence Results

Valuation Results
Aggregated Valuation Results
Potted Valuation ResAs
QAIY Vacation Results
Aggregated Q**-Y Valuation Results
Pooled QAIY Valuation Resufts
Allfiesufts
                                                                                 !   Close
                     Figure 3-5. Opening pooled incidence results.
    (i)   Exercise (3.7): What grid is used in the pooled incidence results?
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  Answer:
(j)  Exercise (3.8): Select mortality for your pooled (and aggregated) incidence
    results. What is the state (col) and FIPS (row) codes for the county with the
    highest number of avoided mortalities?  What is the value?
  Answer:
(k)  Exercise (3.9): What are the maximum value and sum for avoided mortalities in
    the pooled incidence results?  Make the incidence results
    ("Control_PM25_RIA_2020_cmaq_grid_15_annual_35_daily_county.cfgr") the
    active layer. What are the maximum value and sum for avoided mortalities in the
    incidence results? Hint: Use the Calculate layer statistics button.
  Answer:
(1)  Overlay the pooled valuation results. As a reminder:

         Open a File, select "APV Configuration Results (*.apvr)", then select
         "Pooled Valuation Results". Open
         "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_3 5_daily_county. apvr".

         Edit the GIS field names. Use the same four field names ("Mortality",
         "ChronBronc", "ER", and "AcutResp").
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                In the Valuation Sums Layer window, click Add Sum to create a Mortality
                and a Morbidity Sum (Figure 3-6).  Click OK when you have added the two
                sums. We will view these summed results in the GIS window.
 Layers
iF Conirol_PM25_R
   Contro!_PM25_R
   -0.37-12.94
   12,94-26,26
   26.26-39.57
   39,57-52,88
  152.88-66,19
   66.19-79,51
   79,51-92,82
   92,82-106.13
   106,13-119,45
   119,45-132.76
   Control_PM25_F
   -0.59-6.14
   6.14-12.87
   12.87-19.59
   19.59-26.32
I*;! 26.32-33.05
                                                  GB Field Name
                                                  Mortality
          Figure 3-6. Creating valuation sums for the pooled valuation results.
                In the BenMAP GIS window, double click the "Pooled Valuation Result
                Sum" layer and display the "Morbidity" variable.

      (m) Exercise (3.10): What is the state (col) and FIPS (row) codes for the county with
           the greatest benefit (valuation of avoided morbidity and mortality)?  What are the
           morbidity and mortality benefits for this county?  What is the sum of the mortality
           and morbidity benefits across the whole country? Note: you could also do this
           through Reports.
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  Answer:
(n)  Save the pooled valuation results to a shapefile. Click on the Save Active Layer
    icon
. The Save the active layer to file window will appear.
    Under the "Reports" folder, save the shapefile as
    "PM25_RIA_2020_15_annual_3 5_daily_county_pooled_valuation".  Click Save.
    This shapefile can be used as an input for another GIS software program. Click
    Close in the GIS window returning you to the main BenMAP window.

(o)  From the main BenMAP window, run a standard pooled valuation report on our
    apvr. As a reminder:

    Close the One-Step Analysis window. From the main BenMAP window, click the
    Report graphic (bottom of the right-hand panel). Select a report type of "Incidence
    and Valuation Results".

    After we have opened the newly created county apvr, select the "Pooled Valuation
    Results" in the Choose a Results Type window.

    In the report window, check the "Endpoint Group" in the "Pooled Valuation
    Method Fields", uncheck the "Latin Hypercube" from the "Result Fields", and
    reduce the digits after decimal point to 0 (Figure 3-7).
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  APV Configuration Results Report
File
Column Selection
   Grid Fields:
                 Pooled Valuation Method Fields:
                                                                          Result Fields:
M Column
M Row
                   Pooling Window
** Point Estimate
* Mean
^ Standard Deviation
<* Variance
                  Add Sums


    Grouping Options
    (• Group by Gridcell, than by Pooled Valuation Method

    C Group by Pooled Valuation Method, (hen by Gridcet
                                                            DbpEsj? Options

                                                             Oip(s Afle< Decimal Point: jtT~

                                                                Etewents ir> Preview: 125
Preview
Column
               Row
                            ; Endpoint 6roi#i   ! Point Estimate
                                                          Mean
                                                                        Standard Deviation  Variance
                             Mortality        560,399         560,047         312,223
                             Chronic Bronchitis  16,790         ~1 6,664         20,446
                             EmetgencsiRoamVi 27             27            7
                             Acute Respiratory S; 22             22            5
                             Mortato        1.417508        1,416.618       789.756
                                                                                    97,483,415,552
                                                                                    418,026,400
                                                                                    53
                                                                                    28
                                                                                    623.714.238.464
                                                                                                    1
                                                                                                 Done
                         Figure 3-7. Report of pooled valuation results.
      (p)   Exercise (3.11): For col  1 and row 9, which endpoint (i.e. ER visits, Mortality,
            etc) has the greatest standard deviation? Which endpoint has the greatest
            coefficient of variation, a.k.a. relative standard deviation (standard
            deviation/mean)?
         Answer:
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              (q)  Close the APV Configuration Results Report window by clicking Done.

A.1.3.2 Example PM2.5 Control 2020 14/35 State
           The goal of this exercise is to create a control RIA 2020 14 annual, 35 daily |ig/m3 health
           incidence and valuation study. Unlike our previous example, we will aggregate to the state
           level. Our intuition is that this will have greater benefits than the control 2020 RIA 15/35
           |ig/m3 analysis because we have a lower annual NAAQS.


        Procedures: We have abbreviated the instructions because they are very similar to the steps
        you just completed in Section 3.2.
           (a)Open the One Step Analysis window.

           (a)Set the run name to:
             "Control_PM25_RIA_2020_cmaq_grid_l 4_annual_3 5_daily_state".

           (b)Set the output directory to "Configuration Results"

           (c)Set the baseline and control to:
             "Baseline_PM25_RIA_2020_cmaq_grid_l 5_Annual_65_Daily.aqg" and
             "Control_PM25_RIA_2020_cmaq_grid_14_Annual_35_Daily.aqg", respectively.

           (d)Go through the process of mapping the deltas. See section 3.2(e) for explicit
             instructions.

           (e)Exercise (3.12): How do the deltas for this analysis compare to our previous analysis.
             For example, you could use the same query (QuarterlyMean > 0.2) to compare the
             deltas.
                Answer:
           (f) Set the health incidence and valuation aggregation to the "State" grid and click Go.

                  Note: the One-step Results will not work for State aggregation. The current
                  One-step Reports are designed only for National or Report region aggregation
                  levels. They also assume that we are using the full EPA configuration. Instead, we
                  will use normal reports and mapping to analyze this run.


           Analysis: The rest of the exercises in Section 3.3 focus on analyzing the results of our
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BenMAP One-step Analysis run. Specifically, we will look at the newly created health
incidence c results (cfgr) and valuation results (apvr) files.


(a)Exercise (3.13): Map the pooled incidence results for
   "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_3 5_daily_state.apvr" and
   "Control_PM25_RIA_2020_cmaq_grid_14_annual_35_daily_state.apvr". Note: for
   detailed instructions see Section 3.2(d) in the analysis section.  How do the mortality
   values for IL compare between the 2 control scenarios? How does the mortality values
   for CA compare? What are the overall differences between the 2 control  strategies?
     Answer:
(b)Exercise (3.14): Overlay the pooled valuation results for
   "Control_PM25_RIA_2020_cmaq_grid_l4_annual_3 5_daily_state". Remember to
   create "Mortality" and "Morbidity" variables in the Valuation Sums Layer window.
   What are the mortality and morbidity values for CA? For IL? How does the sum of
   mortality and morbidity benefits across the 48 states compare to our results from
   "Control_PM25_RIA_2020_cmaq_grid_l 5_annual_35_daily_county" (see Exercise
   3.10)? Note: for detailed instructions see Section 3.2(1) in the analysis section.  You
   could also use reports to answer this question.
     Answer:
(c)After finishing the exercise, close the BenMAP GIS window.

(d)This completes the "One-Step Analysis" lab. In the next lab, "Creating Grids" we will
   create new air quality grids (aqg results) from both monitor and model data.
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A.1.4   Section 4. Creating Grids

           In this section, you will create air quality grids (aqg) from both air quality (AQ) model data
           and from monitor data. The overall goal will be to produce baseline and control air quality
           grids for later estimations of health incidence and valuation.

A.1.4.1 Air Quality Model Grids
           Think of AQ models as weather models for air pollution. They produce model results over
           the whole map on a regular grid. Examples of AQ models are CMAQ and CAMx. These
           models are post-processed to generate a csv file or a database table and their values are
           usually averaged to daily or yearly statistics. These post-processed datasets can now be
           imported into BenMAP.

A.1.4.1.1   Example: PM2.5 Control 2020 15/35 Adjusted

           The goal of this exercise is to create a control AQ grid for PM2.5. The CMAQ model data
           input is similar to the 15 annual, 35 daily |ig/m3 control scenario that we saw in the
           "Mapping Introduction" and "One-Step Analysis" sections, except that it has been
           post-processed (adjusted)  to remove the extreme high values.

           Procedures:

           (a)Open Air Quality Grid  Creation. Click on the graphic on the right-hand panel of
             BenMAP's main window

           (b)Choose "Model Direct" in the Air Quality Grid Creation Method window (Figure 41).
Choose Grid Creation Method
<• JModej Direct!
i" Monitor Diteci
C Monitor and Model ReMive
r Monitor Rollback

                Cancel
                                                               Go!
                         Figure 4-1. Air Quality Grid Creation Method window.
           (c)In the Model Direct Settings window, set the grid type to "CMAQ 36km Nation
             Overlap" and the pollutant to "PM2.5". Leaving the tab as "Generic Model Databases",
             click Browse. Navigate to the "PM25_RIA" folder under the "Air Quality Grids"
             folder.  In the Open window, change the "Files of type" field to "Text files" and select
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             the model data:
             "Control_PM25_RIA_2020_cmaq_grid_l 5_Annual_3 5_Daily_adjusted".

           (d)Click OK to create a new model derived aqg. Save the output under the "PM25_RIA"
             folder as: "Control_PM25_RIA_2020_cmaq_grid_15_Annual_35_Daily_adjusted".
             Note: this may take a few minutes to run.
A.1.4.1.2   Example: Control PM2.5 RIA 2020 14/35 adjusted

           The goal of this exercise is to create a control AQ grid for PM2.5, similar to the 14 annual,
           35 daily |ig/m3 control that we saw in the Mapping Introduction and One-step Analysis
           sections. Again, this model data has been post-processed to remove the extreme high
           values.

           Procedures:

           (a)Repeat the above steps, now using the 14 annual 35 daily adjusted model data

           Analysis:

           (a)Exercise (4.1): Open up either of the newly created adjusted model data using the GIS
             tool. Using the Query button, select regions that have a PM2.5 QuarterlyMean greater
             than 10 |ig/m3. Now change the query to QuarterlyMean greater than 15 |ig/m3(i.e. out
             of attainment). How do these results compare to the non-adjusted aqg's that we
             analyzed in the "Mapping Introduction" section (see Exercise 2.6)?
                Answer:
           (b)Close the GIS window. This completes the "AQ Model Grids" module.

A.1.4.2 Monitor Grids
           When we convert monitor data into an AQG, we need to interpolate from the monitor
           locations to all the grid locations. There are two overarching interpolation techniques:
           Closest Monitor (also known as nearest neighbor) and Voronoi Neighborhood Averaging
           (VNA). Closest Monitor means that the grid cell will have the same value as the nearest
           monitor. VNA uses distance to weight the average of monitors in calculating the grid cell's
           value. There are multiple advanced options to change the distance weighting functions and
           to apply maximum distance thresholds to these calculations.  Additional details are
           provided in the User's Manual.
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A.1.4.2.1   Example: Baseline PM2.5 2004
           The goal of this exercise is to generate an AQ grid from PM2.5 monitoring data from
           2004. In addition, we will compare closest monitor and VNA interpolation techniques.

           Procedures:

           (a)Click the Create Air Quality Grid button.

           (b)Select "Monitor Direct" and click the Go! button (Figure 4-2).
                                 Jfjyiir Quality Grid Creation ...
                                   Choose Grid Creafon Method
                                   
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                Monitor Direct Settings
Grid Type:
JCMAQ 36km Nation Overlap    VJ
Pollutant:
|p]iEF~____
                                            Irteipdalkio Method"
                                            ff  Closest Monitor

                                            f  Voranoi Neighborhood Averaging
               Library | Database, Columns J Database, Rows | Text File]
                Monitor DataSet:	
                |EPA Standard Monitors   ~                   T
                Monitor Librari» Yew:
                                                  Advanced
                                                    Cancel
                                                   Map
                                                   Go!
                    Figure 4-3. Monitor Direct Settings window.
(d)Click the Map button. This will bring up the BenMAP GIS window (Figure 4-4).
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£ BenMAP GIS
 Layers
  Monitors
  Air quality grid
®s | ^ [ Q  ©
                                      Abers Equal Area Conic j*

                                                             .
                                                                          Close
                 Figure 4-4. Map of monitors and closest monitor.


 (e)Double click the "Air quality grid" in the Layers list on the left side of the window.
   Select "QuarterlyMean" in the Variable list, and uncheck the "Grid Outline" box.

 (f) In the GIS window, overlay the  state reference layer

 (g)Zoom into the California-Nevada border area and look at the pattern of the AQG.

 (h)Click Close on the GIS window. This will return you to the Monitor Direct Settings
   window.

 (i) Exercise (4.2): Change the interpolation technique to VNA. Remap the data and look at
   the California-Nevada border. How does the VNA AQG compare to the Closest monitor
   AQG? Note: this will likely take significantly longer to calculate.
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                Answer:
           (j) Return to the Monitor Direct Settings window (by closing the GIS window), and click
              Go!
               Tip:  If you click Cancel at this point, you will not have created an aqg. Only by
               clicking Go! do you actually create a new aqg file. The Map button gives you a
               preview of the interpolated aqg, it does not actually produce the file.
           (k)In the Save as window, create a new folder, "PM25_Monitor" under the "Air Quality
              Grids" folder. Save the aqg as: "Baseline_PM25_2004_VNA_CMAQ_grid".

           (1) This completes the "Monitor Grid" module.

A.1.4.3 Monitor Rollback
           Monitor rollback is a method for creating control scenarios. The rollback technique has
           three main steps: (1) the pollutant and the monitoring data are chosen, (2) the chosen
           monitoring data is reduced through one or more of the three rollback approaches, and (3)
           the rolled back monitors are then interpolated to the chosen grid type. The three rollback
           approaches are: percentage, incremental, and rollback to a standard. Note: in constructing
           the rollback, we differentiate between the rolled back grid and the control grid. The
           rollback grid is  the grid type under which we want to perform the rollback. This typically is
           a political grid (e.g. State or county). In contrast, the monitor data will be interpolated to
           our control grid type.

A.1.4.3.1   Example: Control PM2.5 2004 Percentage Rollback

           The goal of this exercise is to create a control by performing a 10% rollback of monitors in
           the West coast and in Pennsylvania (remember, these regions had the largest deltas in the
           One-step analysis section). With this rollback approach, each daily value above the
           background level is rolled back by 10 percent. We will produce a county grid aqg.

           Procedures:

           (a)Click the Create Air Quality Grid button. This will bring up the Air Quality Grid
              Creation Method window.

           (b)Select "Monitor Rollback" and click the Go! button (Figure 4-5).
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Jyijr, flualtf firM epealippi .... ^
Choose Grid Creation
O Model Direct
O Monitor Direct


O Monitor and Model Relative
(*> Monitor Rollback

Cancel I Go!

                     Figure 4-5. Selecting Monitor Rollback.
(c)This will bring up the Monitor Rollback Settings: (1) Select Monitors window (Figure
   4-6). Select "PM2.5" from the pollutant list.

Make sure that the "Library" tab is selected, and select "EPA Standard Monitors" from the
monitor dataset list. Set the monitor library year to "2004". Select "State" from the
rollback grid type list.
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                Pollutant:
                |PM2.5                                   j

                Library | D atabase. Columns j Database, Rows |  Text File
                Monitor DataSet;
                [EPA Standard Monitors                       *
                Monitor Library Year;
                [2004	3
                                                           Advanced
                Rollback Grid Type:
                                                Cancel
Next
        Figure 4-6. Monitor Rollback Settings: (1) Select Monitors window.
(d)Click Next, which will bring up the Monitor Rollback Settings: (2) Select Rollback
  Regions & Settings window.
(e)In that window, click Add Region. A Select Region Rollback Type window will appear
   (Figure 4-7). Throughout this region, we will apply one rollback technique. In this case,
   we will be using a percentage rollback.

Select "Percentage Rollback" and click OK. You will be returned to the Monitor Rollback
Settings: (2) Select Rollback Regions & Settings window.
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                          £  Select Region Rollback
                           Rollback Type
                             Incremental Rollback
                             Rollback to 4 Standard
                                                        OK
                    Figure 4-7. Select Region Rollback Type window.
  (f)In region 1, set the rollback to 10% and the background to 3 |ig/m3. In other words, all
    monitor values that are greater than 3 will have a 10% reduction in value.

  (g)Apply the controls to the West coast states and PA (four states in total).  Use your
    mouse to click on the map to select a state. For example, we have selected California in
    Figure 4-8.
    £ Monitor Rollback Settings: (2) Select Rollback Regions and Settings
     Rollback Regions
        Region 1
     rRollback Parameters-
        Percent: |10.00

      Background: [3. OC|
•KKN
                                 Add Region   Delete Region   -Region to Delete--   ~^  l~ Export After Rollback
      Select All    Deselect All
                                                                      Back      Next
Figure 4-8. Monitor Rollback Settings (2) Select Rollback Regions and Settings window.
                     Selecting a region for a 10% monitor rollback.
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(h)Click Next

(i) In the Monitor Rollback Settings (3) Additional Grid Settings window (Figure 4-9), we
   want to use VNA interpolation and county grid type (i.e., the control grid). Uncheck
   "Make Baseline Grid (in addition to Control Grid)" because we did this in a previous
   step.
                Select Interpolation Method

                f" Closest Monitor
                f*
Select Scaling Method

<•  None

f"1  Spatial Only
                    Q rid Type: | County
                              Make 8*efce Gitd |in addition to Control Grid).
                                              Advanced
                                                Back
          Map
           Go!
         Figure 4-9. Monitor Rollback Settings (3) Additional Grid Settings
                         window. Setting county grid type.
(j) Click Go! and save the aqg under "PM25_Monitor":
   "Control_PM25_2004_VNA_county_10pct_rollback_3_background"


Analysis:

(a)Exercise (4.3): Create an audit trail report on our new monitor rollback aqg. Under
   "Advanced", what is the neighbor scaling type?  Under "Monitor Rollback", what are the four
   states (names and codes) that have been rolled back? What is the rollback method and value?
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                Answer:
           (b)Exercise (4.4): Map our new monitor rollback aqg.  What states have a QuarterlyMean greater
             than 15 (ig/m3?
                Answer:
A. 1.4.3.2   Example: Control PM2.5 2004 Multiple Rollback Techniques

           The goal of this exercise is to combine multiple rollback techniques into one control
           scenario. We will rollback the West coast incrementally. On the East coast, we will
           rollback to a standard using peak shaving. In other words, on the West coast, we will
           decrease all monitors by a fixed amount, while on the East coast we will define a standard
           and only reduce those monitors that exceed that standard, for only those hours over the
           standard. The aqg will have a CMAQ grid type.

           Procedures:

           (a)Go through the same steps as above to setup a monitor rollback for PM2.5 for 2004.
              Again select "State" as the rollback grid type.

           (b)Add the first region, then select "Incremental Rollback" in the Select Region Rollback
              Type window (Figure 4-10) and  click OK.
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                       Rollback Type
                          Percentage Rollback
                          Increment*! ft dbacfc.
                          Rollback to a Standard

                                     Caned
OK
                   Figure 4-10. Selecting incremental rollback.
(c)Set the rollback to 4 |ig/m3 and the background to 3. Select all the West coast states.

(d)Add a second region. In the Select Region Rollback Type window, set the type to
  "Rollback to a Standard". Here we have many more options in defining what our
  standard is and how we want to reduce the monitors so that they match that standard. In
  our case, we will set a standard that no monitor should have a daily mean value greater
  than 35 |ig/m3.

     (l)Set daily metric to "D24HourMean". Leave the seasonal metric blank and the
       annual statistic type blank.

     (2)Set the standard to 35 and leave the ordinality as 1.
     Background:  Ordinality refers to the number of monitor values in the season
     that can exceed your standard. For example, if we had set the ordinality to 4,
     than a monitor can have as many as three daily averages >35 |ig/m3 without
     violating the standard (i.e. it would not be rolled back). If it has more than 3
     daily averages in an exceedance of the standard, then the rollback technique
     will be applied to that monitor.
     (3)Set the rollback method to "Peak Shaving", and the background to 3 |ig/m3.

     (4)Select all the East coast states. Figure 4-11 shows the selection of the first state,
       Maine. Note: You may need to use the zoom button to get some of the smaller
       states.
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   £ Monitor Rollback Setting?: [2) Select Rollback Re&ions and Setting?
   RullbdckRegiurii
      Region 2
Attainment i CM
Daily Metric:
D24HourMean _^j
Seasonal Metric:
1 :d
Annual Statistic:
Ordinal!^:
1 ^j
Standard:
35.00 |
Highest value of D24HourMean <• 35


Interday Rollback Method, Background:
|Peak Shaving _»J
Intraday Rollback Me
[Percentage * |
3.00 |
hod. Backgiound
|
       Region 1
    •Rollback Parameters'
      Increment: 14.00
     Background: 3.00
Add Region |  Delete Region [ J- Region to Delete -   T]  J~ Export After Rollbac
     Select All    Deselect All
                                                                       Back      Next
Figure 4-11. Monitor Rollback Settings (2) Select Rollback Regions and Settings window.
                 Adding a second rollback region, rollback to standard.
  (e)Click Next to go to the Monitor Rollback Settings: (3) Additional Grid Settings
     window. This time, set the grid type to "CMAQ 36km Nation Overlap" and the
     interpolation to "VNA".

          Uncheck "Make Baseline Grid (in addition to Control Grid)" because we did this
          in a previous step (Figure 4-12).
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                 Monitor Rollback Settings:  (3) Additional...
               ~~S elect Interpolation Method	

                f*~  Closest Monitor

                f*  Voronoi Neighboihood Averaging
Select Scaling Methoch

'"*  None

r  Spatial Only
                    Grid Type; CMAO 36km N«»riOv«lap
                                              Advanced
                                                Back
          Map
           Go!
    Figure 4-12. Monitor Rollback Settings (3) Additional Grid Settings window.
                             Setting CMAQ grid type.
(f) Click Go!. Save the results under "PM25_Monitor" as:
   "Control_PM25_2004_VNA_CMAQ_4_incremental_35_daily_3_background"


Analysis:
(a)Exercise (4.5): Create an audit trail report on our new monitor rollback aqg.  Under
   "Monitor Rollback", describe the two rollback regions, focusing on their techniques?
      Answer:
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           (b)Exercise (4.6):  Map the deltas between the Baseline PM2 5 VNA 2004 and this multiple
              rollback control that we just created. How do the East Coast and West Coast deltas
              differ? How do you explain the pattern on the eastern boundary of CA, WA, and OR?
              Hint: Use the One-step analysis window to map the deltas. You don't need to perform a
              full One-step analysis. Instead, in the "1. Air Quality Grids" panel,  select your newly
              created "Baseline_PM25_2004_VNA_CMAQ_grid.aqg" as the "Baseline File" and your
              newly created control as the "Control File". Click Map Deltas.
                Answer:
           (c)Close any open BenMAP windows. This completes the "Monitor Rollback" module.

           (d)This completes the "Creating Grids" lab. In the next lab, "Health Incidence" we will
              take our aqg results and calculate the corresponding health incidence results due to the
              change in air quality.

A.1.5   Section 5. Health Incidence

           In this section, you will modify an existing health incidence configuration and use it to
           create new health incidence results. You will create two separate sets of health incidence
           results based on the same configuration and two similar, but distinct, control strategies.

           Creating health incidence results has three main stages:

                (l)Select baseline and control air quality grids (AQG) and other general settings.
                   These general settings include population dataset and analysis year, air quality
                   threshold, and statistical parameters.  The delta between the baseline and control
                   AQGs is combined with the population data as a major input to the health impact
                   functions.

                (2)Select specific health impact functions and modify default parameters. Some  of
                   these parameters include demographics (e.g., gender, race, or age ranges) and
                   incidence and prevalence rates.

                (3)Save all the settings from the first two stages as a configuration (cfg), which can
                   be re-used later with other baseline/control pairs if desired. Finally, run the health
                   incidence configuration, which will create a new health incidence results file
                   (cfgr).

           Health impact functions relate the change in number of observed, adverse health effects in
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           a given population to a given change in concentration for a given pollutant. These
           functions are usually based upon epidemiological studies with specific sub-populations,
           and have a baseline estimate of the health effect. Having estimated changes in air quality
           levels from monitored or modeled data in previous labs, in this section, we will learn how
           to use these changes in concentrations  and health impact functions to estimate changes in
           health incidence.

           In this lab, we start from an existing configuration to help you develop a new
           configuration. After working through this lab, however, you should also be able to create  a
           new configuration from scratch.

           Note: For many of the health endpoints (e.g., mortality), there are many different health
           impact functions that you could  choose to include in your configuration. This lab has you
           select specific functions  and teaches you how to differentiate these functions and modify
           the input parameters. This lab does not teach you how to determine which functions are the
           best ones for a particular study. To determine the best choices for a particular analysis, we
           recommend that you read the appendices accompanying BenMAP that describe the specific
           epidemiological studies that correspond to the specific health impact functions and/or that
           you discuss your choices with an epidemiologist. If you want to use EPA's standard set of
           functions, you can use the configurations that are pre-loaded for the one-step analysis when
           you download BenMAP.

A.1.5.1 Example: PM2.5 Control  2020 14/35

           The goal of this exercise is to create a new configuration by modifying the health incidence
           configuration that was used in the One-step analysis (Section 3) and create health
           incidence results for the  control  scenario RIA 2020 14 annual, 35 daily |ig/m3. We will
           add the following health impact functions to the previous configuration: mortality for
           infants, hospital admissions due to respiratory problems, and acute myocardial infarctions
           (AMIs), also known as heart attacks.

           Procedures:

           (a)In the main BenMAP  window, begin a health incidence estimation by clicking on the
             graphic titled "Incidence Estimation" located in the right-hand panel, under the "Step 2"
             heading. This will open the Configuration Creation Method window (Figure 5-1).
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                   £ Co nfigu ratio n C realio n Met ho d
                       Create New Configwation
                     (*" Ppen Existing Conlk}ufafai
       Figure 5-1. Health incidence Configuration Creation Method window.
(b)In this window, select "Open Existing Configuration". This means that we are starting
  from some already selected health impact functions (i.e., we are not "starting from
  scratch"). Click Go!. An Open window will appear. In the "Configurations" folder.
  Select the "PM25_RIA_2020_course.cfg" file and click Open.

(c)The Configuration Settings window (Figure 5-2) is used to set the baseline and control
  AQG files, and also to set some general parameters that will be used by all the health
  impact functions. In this window, we will change only the baseline and control AQG
  files. The rest of the settings (Latin Hypercube Points, Population DataSet and Year,
  Point Mode, and Threshold) will be left unchanged.

(d)In the  "Select Air Quality Grids" panel, next to the "Baseline File" field, click Open.
  The Open window will appear. Navigate to the "PM25_RIA" folder under the "Air
  Quality Grids" folder, select
  "Baseline_PM25_RIA_2020_cmaq_grid_15_Annual_65_Daily.aqg", and click Open.

(e)Repeat these steps  for the "Control File", this time selecting
  "Control_PM25_RIA_2020_cmaq_grid_l 4_Annual_3 5_Daily. aqg".
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Select Air Quality Grids
 Baseline File:

 2:\BenMAP\BenMAP_FilesSAir_Oualitji_G«d;SPM25_RIA\EaseSre_PM25_RIA_2020_ctnaq_gfid_15_AnnuaL6    Open

 Control File:
                                                                               Create
 Z: \B enMAP\B enMAP_Files\Ait_Qualily_Giids\™25_RIA\C
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  (f) Before continuing on to select health impact functions, we should do some quality
    assurance (QA) on the aqg files. Specifically, we want to look at the AQ deltas. In the
    Configuration Settings window (Figure 5-2),  click on Map Grids. This will open a
    new BenMAP GIS window.

  (g)In the BenMAP GIS window, uncheck the "Control Grid" and "Baseline Grid" in the
    "Layers" panel (on the left side). Double-click on the "Delta" layer, which will open the
    Display Options window.

         In the Display Options window, uncheck "Grid Outline" and set the Variable to
         "QuarterlyMean". Click OK.

         Back in the BenMAP GIS window, overlay a State reference layer. Your GIS
         window should now look similar to Figure 5-3.
£ BenMAP GIS
j^Jjaj^J
 Layers
                                                                             -  n x
  Delta
  -0.04-0.13
  0.13-0.30
  0.30-0.48
  0.48-0.65
  0.65-0.82
  0.82-0.99
  0.99-1.16
  1.16-1.34
  1.34-1.51
  1.51-1.68
  Control Grid
  Baseline Grid
                                       hters Equal Area Conic ^
                                                                            Close
                           Figure 5-3. Mapping delta AQ
  (h)Exercise (5.1): Using the Create Layer Statistics button, what are the maximum and
    mean for the QuarterlyMean of PM25? Using the Build query button, which states have
    a QuarterlyMean greater than 1.0 |ig/m3?
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     Answer:
(i) After you have completed the above exercise, click Close in the BenMAP GIS window
  to return to the Configuration Settings window. At this point we have set all the general
  parameters for our configuration. Note: we did not modify the latin hypercube points,
  population year, or threshold. Click Next.

(j) This will open a new Configuration Settings window (Figure 5-4). This window
  describes the specific health impact functions that were selected in the configuration
  file. We will also use this window to select new health impact functions for our new
  configuration. This window is divided into two panels:

  Available CR Functions: This describes all the available functions that are appropriate
  for this type of AQ data. In our case, these are all the PM25 functions. The left-hand
  panel is the  "Tree". It describes the hierarchy between endpoint groups (major groupings
  of adverse health effects) and endpoints (specific adverse health effects). You can
  expand any  section by clicking on the plus sign next to the heading, or collapse a section
  by clicking on the minus sign next to a heading. To see the specific health functions,
  you need to expand the endpoint heading of choice. The right-hand panel is the "Data"
  panel. The data are all the details of the specific health functions: the author of the
  study, location where the study was done, the specific function that BenMAP uses to
  calculate that adverse health effect, whether there is a  qualifier to the health function,
  etc. A complete description of each column can be found in the User's Manual. The
  scroll bar at the bottom of the "Available CR Functions" panel is for panning across the
  "Data" columns.

  Selected CR Functions:  This describes the functions that have been chosen for this
  specific configuration. The left-hand panel is "Function Identification", which contains
  all the columns necessary to uniquely identify the function. The  scroll bar at the bottom
  of the "Selected CR Functions" panel is for panning across the "Function Identification"
  columns. We recommend focusing on Endpoint, Author, Year and Qualifier. The
  right-hand panel is "Function Parameters". These parameters are used by the health
  functions and some of them can be edited by the user.  For example, you might change
  the age range ("Start Age" and "End Age") for a specific health impact function if you
  were interested in studying the impact on a certain  demographic.
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£ Configuration Settings
 Available CR Functions:
  Tree
(Data
  DataSet
                Endpoint Group   Endport
                                       I Metric
                                                   Seasonal Metric   Medic Statistic   Author
  li
 Selected CR Functions:
Function Identification
DataSet Endpoint Group fEnd
Alternative t< Mortality Mot
Complete Ve Chronic Bronchitis Chr<
Complete VE; Emergency Room V Erne
Complete Ve; Acute Respiratory S Mini
Function Pwameters
Race |G«dec ( Start Ags
30
27
0
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  available endpoints within that endpoint group. You can also expand a specific
  endpoint so that you can see the specific health functions for that particular
  endpoint. For example, expand the endpoint group "Emergency Room Visits,
  Respiratory" and the revealed endpoint "Emergency Room Visits, Asthma" to
  reveal the specific health impact functions.

(2)Exercise (5.2): How many health functions are there for the "Emergency Room
  Visits, Asthma" endpoint? Who are the author(s) for these functions/studies? What
  are the differences between these functions? (After you have completed this
  exercise, you might want to collapse the "Emergency Room Visits, Respiratory"
  endpoint group. This will reduce the clutter in the top panel.)
Answer:
(3)Exercise (5.3): What are the endpoints under the "Hospital Admissions, Respira-
  tory" endpoint group? How many functions are there under the "HA, Chronic Lung
  Disease" endpoint and who are their authors? Note: You might have to expand the
  width of the Endpoint column to make sure you have the right one.
Answer:
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     (4)Exercise (5.4): Who is the author of the mortality function used in our current
       configuration? Hint: Look at the "Function Identification" panel. If you look at the
       available mortality functions, how many of them are by this author? Looking at the
       Qualifier column, what differentiates this author's functions? Which of the
       functions are we using in our current configuration? Hint: We recommend
       reorganizing the columns in the "Data" panel so that you have Author, Start Age,
       End Age, Qualifier., and Function next to each other (see previous Tip).
     Answer:
(1) In the next series of steps, we will add new health functions to our configuration. We
  will add an additional mortality function, some hospital admission functions, and some
  acute myocardial infarction (AMI) functions. You will note that in many cases there will
  be multiple functions for the same endpoint by the same author. In most cases these will
  be differentiated by the content of the Qualifier column. In all of our cases, we will
  select the function that does not have a threshold or other qualifier.

     (l)We will start by adding a new "Mortality, All Cause" endpoint health function.
        Select the function that has Woodruff as the author and no qualifier (no threshold).
        To add  it to our configuration, simply click on the specific row and drag it to the
        "Selected CR Functions" panel (Figure 5-5).
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£ Configuration Settings
Available CR Functions:
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Selected CR Funetkim:
i
: Group tivipont, Author _t
MoKstey, AJ i Pop* *l al [
Jronchitis Chronic Bron Abbey e* * [
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sujwaiwy S M»wi Res-iru Osho sr»J [
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                 Figure 5-5. Adding a new health impact function.
Tip:  If you mistakenly add the wrong health impact function, you can delete it by
highlighting the particular function in the "Selected CR Functions" panel and clicking
Delete on your keyboard.
      (2)After moving a function into the configuration, you need to decide whether you
        want to change any of the "Function Parameters", i.e., the inputs to the health
        function. In the Woodruff case, we want to set the "Incidence DataSet" (i.e., the
        background incidence rate for mortality). Click on the "Incidence DataSet" cell for
        the Woodruff study. Use the drop-down menu to select "2020 Mortality Incidence"
        (Figure 5-6). In other words, we are using the incidence rate for mortality that has
        been projected to the year 2020.

             Note: In this case there is an available incidence rate dataset for 2020. For
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   other endpoints (e.g. Chronic Bronchitis), the background incidence rates are
   only available for 2000 because they have not been projected to 2020.
£ Configuration Settings










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(3)Exercise (5-5): Compare the Pope and Woodruff mortality studies in the
  "Available CR Functions" panel. What is the age range for each study? Write down
  the functions for each study.  Note: compare the respective Pope and Woodruff
  functions that you selected.
Answer:
(4)Next we will add a health function for hospital admission due to pneumonia. Under
  the "Hospital Admissions, Respiratory" endpoint group, expand the "HA,
  Pneumonia" endpoint. Select the function by Ito without a threshold shown in the
  qualifier column. Simply click on the appropriate function with your mouse and
  drag it to the "Selected CR Functions" panel.

       Note: In this case the incidence dataset has  already been selected. If you try to
       select another dataset you will see that 2000 is the only available dataset. In
       other words, the incidence and prevalence for hospital admissions due to
       pneumonia has not been projected to 2020.

(5)Next we will add health functions for hospital admissions due to chronic lung
  disease. Under the endpoint "HA, Chronic Lung Disease", add the functions by Ito
  and Moolgavkar (without threshold). Note: Make sure you are not using the
  endpoint "HA, Chronic Lung Disease (less Asthma)".

(6)Exercise (5-6): Compare the Ito and Moolgavkar studies. How do their specific
  functions compare? What is the beta (regression coefficient) for each study? Bonus
  question: Which function is more sensitive to changes in AQ?	
Answer:
(7)Finally, we will add health functions for AMI. Under the "Acute Myocardial
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Infarction" endpoint group and "Acute Myocardial Infarction, nonfatal" endpoint,
select the Peters study (no threshold). Here, we will do something slightly different.
Drag four copies of the Peters function to the "Selected CR Functions" panel. The
age range for this function is 18 to 99 years. We want to look at the effect on a
more specific demographic—that is, we want to break this into four age ranges.

     Starting with the first Peters function, select the "End Age"  cell in the
     "Function Parameters" panel. Edit the cell to 44. The new age range for the
     first Peters function is now 18 to 44, inclusive.

     For the next Peters function, modify the Start Age to 45 and the End Age to
     54. For the remaining Peters functions, change the age range to 55-64 and
     65-99, respectively. After modifying the age ranges, your Configuration
     Settings window should look similar to Figure 5-7.
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H Configuration Settings
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A
Run 1

       Figure 5-7. Four additional AMI functions with modified age ranges.
     (8)You have completed adding all the new health functions to your configuration. You
       should now have 12 functions in your "Selected CR Functions" panel (Figure 5-7).
       Double check to be sure all of the selected functions have an empty qualifier cell
       (check in the "Function Identification" panel by moving the bottom scroll bar until
       the Qualifier column is visible, note that the Pope function will say "no threshold").

(m)When you have set up all the health impact functions as instructed above, you are ready
  to save the new configuration and generate the health incidence results. Click Run. This
  will bring up a Save Configuration window (Figure 5-8).

       We want to save this new configuration (so that it can be re-used), so click Save.
       This will bring up a Save As window. Under the "Configurations" folder, in the
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       "File name" field, type in the new configuration file name,
       "PM25_RIA_2020_course_modified", and click Save. A Progress window will
       appear.
              i» Save Configuration
              ^••ilSt^SSlKPw'lissS'KS'iSilSi
                Ready to run configuration.  If you wish to save
                this configuration, dick the       button.  When
                ready, click OK, If you are not ready to run this
                configuration, dick Cancel,
                                   Save
1.
Cancel
OK
                     Figure 5-8. Save Configuration window.
(n)After the configuration is saved, you will be returned to the Save Configuration window
   (Figure 5-8). Now run the configuration by clicking OK. This will bring up another
   Save As window. Here we will save the configuration results (cfgr). Under the
   "Configuration Results" folder, save the results as
   "Control_PM25_RIA_2020_modified_cmaq_grid_l 4_annual_3 5_daily".

       The calculation of the results will begin and a Progress window will appear. The
       calculation of the results may take a few minutes. When the calculations are
       finished, you will be returned to the main BenMAP window.
Tip: If you are not ready to run this configuration, click Cancel.  If you generated
a   onf  gurat  on   you   an o  en t  e   onf   gurat  on and run   t to generate   a   u<
re  u   t  at a   atert    e.
Analysis:

The rest of the exercises in Section 5.2 focus on analyzing the results of our BenMAP run.
Specifically, we will look at the newly created health incidence configuration file (cfg) and
results file (cfgr). A good habit to get into is to quality-assure both your configuration and
your results. Some things to check include whether you have the right functions and
parameters selected and whether the results seem reasonable.


(a)First, we will look at the newly created configuration file (cfg) using the audit trail.
  From the main BenMAP window, click on the "Report" graphic in the right-hand panel.
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   Select the "Audit Trail Reports" in the Select Report Type window and click OK. Under
   the "Configurations" folder, select the new configuration,
   "PM25_RIA_2020_course_modified.cfg" and click Open.

(a)Exercise (5.7): What is the population year used in this configuration? How many
   health functions (CR functions) were used? What are the location and the incidence rate
   dataset used in the Woodruff mortality function? Hint: if you added the functions in the
   same order as the lab, the Woodruff study should be "CR Function 4". When you are
   done with this exercise, click OK to close the Audit Trail Report window.
     Answer:
(b)Using the Tools menu in the main BenMAP window, open a BenMAP GIS window.
  Click on Open a File, then select "Configuration Results (*.cfgr)". Under the
  "Configuration Results" folder, open our newly created file,
  "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily.cfgr".

(c)In the Edit GIS Field Names window, provide more meaningful names for your health
  incidence results, then click OK. Here are suggested names: MortPope, ChronBronc,
  ER, AcutResp, MortWood, HAPneum, HAChrlto, HAChrMool, AMI18, AMI45,
  AMI55, AMI65.  Note: BenMAP GIS field names cannot exceed 10 characters in length
  and cannot include commas.

(d)Exercise (5.8): Compare the Pope and Woodruff mortality results. How do the
  maximum values compare?  The Pope and Woodruff health impact functions are
  calculating avoided mortalities for different subgroups within the population. What is
  the Pope result measuring versus the Woodruff result? Do they have similar spatial
  patterns?
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     Answer:
(e)Exercise (5.9): Compare the Ito and Moolgavkar Hospital Admissions due to Chronic
  Lung Disease results. How do the maximum values compare? How do their respective
  populations compare (by "population", we mean the population variable POP1, POP2,
  etc. that correspond to the appropriate heath incidence result)? The spatial patterns of
  the two results are identical while their magnitudes differ. How do you explain this?
  Hint: Look back at Exercise 5.6.
     Answer:
(f) Exercise (5.10): Compare the AMIs (heart attacks) for various age groups. What are the
  maximum values for the AMI18 and AMI65 functions? What are the population
  maximum values for these two functions? Why do you think that the value of AMI18 is
  less than the value of AMI65? After you are done with the above exercises, close the
  BenMAP GIS window by clicking Close.
     Answer:
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(g)From the main BenMAP window, click on the "Report" graphic in the right-hand panel.
   Select "Raw Incidence Results" in the Select Report Type window and click OK. Under
   the folder "Configuration Results", open our results file,
   "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily.cfgr".

       In the "C-R Function Fields" panel within the "Column Selection" panel of the
       Configuration Results Report window (Figure 5-9),  select Endpoint, Author, Start
       Age, and End Age. In the "Result Fields" panel, deselect Delta and Variance.

       As you select or deselect items in the "Column  Selection" panel, your choices are
       reflected in the "Preview" panel in the bottom half of this window, which displays
       a preview of the columns that will be included in the results report when you save
       the file.
it Configuration Results Report
File



	 'Column Selection 	

G
jrid Fields:

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            Background:  Some of the key columns that can be included in results reports are the
            following: the "mean" is the mean of the Latin Hypercube points for this result; the
            "point estimate" is the single point estimate for this result; "percentiles" are the
            individual Latin Hypercube points for this result; the "baseline" is the number of
            individuals experiencing this adverse health effect due to all causes (typically incidence
            rate x population); the "percent of baseline" is the relative change in adverse health
            effects due to the control scenario we are considering (point estimate/baseline); the
            "population" is the population used in the particular health function at this grid cell.
           (h)Now that you have chosen all the columns to include in your results report, you can save
             the report. From the Configuration Results Report window, type Ctrl-S. Under the
             "Reports" folder, save the file as
             "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily". After the file
             has been saved, close the window by clicking Done.

                  Use Windows Explorer to navigate to the "Reports" folder. Double-click on the
                  newly created csv file and it should open in Excel. Note: if you are using an
                  earlier version of Excel, it may give you an error message saying that it could not
                  load the complete file.  Click OK in the warning window.

           (i) Exercise (5.11): All of the following questions refer to the grid cell 14, 63 (column,
             row) for the endpoint "Minor Restricted Activity Days" (within the endpoint group
             "Acute Respiratory Symptoms"). What is the background incidence (the total number of
             minor restricted activity days due to all causes) for this particular grid cell?  Hint: the
             column is called "Baseline". What is the change in adverse health effects (i.e., the
             number of minor restricted activity days avoided) under the control scenario? We know
             that the heath impact functions have an underlying statistical function that gives us a
             range of results. What is the estimate of the change in adverse health effects at the 5th
             percentile? What is the estimate at the 95th percentile? When you are finished with this
             exercise, close the Excel window.
                Answer:
A.1.5.2 Example: PM2.5 Control 2020 14/35 Adjusted
           The goal of this exercise is to re-use our newly modified health incidence configuration
           (from Section 5.2) and create health incidence results for the adjusted control scenario RIA
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2020 14 annual, 35 daily |ig/m3. Note: in the following instructions, we refer to "adjusted"
and "nonadjusted" results, AQ data, and/or configurations. The "nonadjusted" data and
configuration are from Section 5.2. The "adjusted" are from this Section (5.3).

Procedures: The following is a list of the necessary steps. We have abbreviated the
instructions because they are very similar to the steps you just completed in Section 5.2.


   (a)  Open "Incidence Estimation" from the main BenMAP window, Custom Analysis
       side.

   (a)  Select "Open Existing Configuration", and Click  Go!. Choose the newly created
       configuration "PM25_RIA_2020_course_modified.cfg" under the
       "Configurations" folder and open it.

   (a)  In the Configuration Settings window, change the baseline and control aqg files.
       Under the "PM25_RIA" folder, select the
       "Baseline_PM25_RIA_2020_cmaq_grid_15_Annual_65_Daily_adjusted.aqg" as
       the baseline and the
       "Control_PM25_RIA_2020_cmaq_grid_14_Annual_35_Daily_adjusted.aqg" as
       the control. Leave the rest of the settings the same.

   (a)  Quality-assure the aqg files. Click on the Map Grids button. In the new GIS
       window that opens, select only the "Delta" layer and in the Display Options
       window display the QuarterlyMean.

   (a)  Exercise (5.12): What are the maximum and mean for the delta QuarterlyMean of
       PM2.5? Which states have  a delta QuarterlyMean greater than 1.0 |ig/m3. Compare
       your answers to Exercise  5.1. Which scenario (adjusted or nonadjusted) do you
       predict will have greater number of avoided adverse health incidences? Explain
       your answer.
     Answer:
   (a) After returning to the Configuration Settings window, click Next.
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      (a)  Review your selected health functions. There should be 12 of them. Make sure
          they are the same functions you used in the last example then run the example by
          clicking Run.

      (a)  Do not save the configuration. There is no need to save it because the only
          changes were to the baseline and control files. Do create the health incidence
          results by clicking OK. Under the "Configuration Results" folder, save the results
          as
          "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_adjusted".
          The calculation of the results will begin and a Progress window will  appear. The
          calculation may take a few minutes.

Analysis: Now we will look at the newly created health incidence results file (cfgr). Because
we have already checked the cfg file in Section 5.2, we do not need to quality-assure this
configuration file again.

      (a)  Click on the right-hand "Report" graphic in the main BenMAP window. Use the
          Select Report Type window to open an audit trail for the new health incidence results
          file,
          "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_adjusted.cfg
      (b)  Exercise (5.13): What is the population year used in this cfgr? How many health
          functions (C-R functions) were used? How many Latin Hypercube points are used
          in calculating the C-R functions' statistical distribution?
        Answer:
      (c)  Open a BenMAP GIS window then open the same health incidence results file
          under the "Configuration Results" folder.

      (d)  Exercise (5.14): Compare the Pope and Woodruff mortality results. How do the
          maximum values compare? How do these results compare to the nonadjusted
          results (see Exercise 5.8)?
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  Answer:
(e)  Exercise (5.15): Compare the AMIs for various demographics. What are the
    maximum values for the AMI18 and AMI65 functions? What are the population
    maximum values for the two functions? How do these results compare to the
    nonadjusted results (see Exercise 5.10)?
  Answer:
(f)  From the main BenMAP window, follow the steps needed to create a raw
    incidence results report from the same health incidence results file. Select the same
    results columns as before (see Figure 5-8).

    Save the report under the "Reports" folder as
    "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_adjusted".
    Then open the new csv file in Excel.
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              (g)  Exercise (5.16): All of the following questions refer to the grid cell 14, 63
                   (column, row) for the endpoint "Minor Restricted Activity Days" (within the
                   endpoint group  "Acute Respiratory Symptoms"). What is the background
                   incidence (the total number of minor restricted activity days due to all causes) for
                   this particular grid cell? What is the change in adverse health effects (i.e. the
                   number of minor restricted activity days avoided) under the control scenario? We
                   know that the heath impact functions have an underlying statistical function that
                   gives us a range of results. What is the estimate of the change in adverse health
                   effects at the 5th percentile? What is the estimate at the 95th percentile? How do
                   these results compare to the nonadjusted results (see Exercise 5.11)?
                 Answer:
              (h)  Close the Excel file and any open BenMAP windows. This completes the "Health
                   Incidence" lab. In the next lab, "Aggregation, Pooling, and Valuation," we will
                   take our health incidence results and calculate the corresponding monetized
                   benefits due to these health effect changes.

A.1.6   Section 6. Aggregation, Pooling, and Valuation

           In this section, you will create an aggregation, pooling, and valuation (APV) configuration
           and use it to produce new valuation results. You will create two separate sets of valuation
           results based on the same configuration and two similar, but distinct, control strategies.

           Creating valuation results has four main stages:

                (l)Select a health incidence results file (cfgr) and set up pooling for similar results
                   (i.e. combining similar results together into one result).

                (2)Select specific valuation functions and pool similar valuations.

                (3)Select additional parameters for the valuation  functions, and decide on the
                   aggregation (e.g. summing results from county level to state level) for the health
                   incidence results and the valuation results.

                (4)Save all the settings from the first three stages as a configuration file (apv), which
                   can be re-used later with other health incidence results if desired. Finally, run the
                   aggregation, pooling, and valuation configuration, which will create a valuation
                   results file (apvr).
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           A reduction in air quality level is usually associated with lowering the risk for adverse
           health effects for a population. This reduction in risk is usually not the same for all
           individuals, and there is a need to translate the reduction in risk to a quantifiable economic
           value. BenMAP relies upon published studies where the unit value of such a reduction in
           risk has been calculated for various health effects.  Since multiple studies are sometimes
           available for a given health incidence, the user needs to choose between them, or adopt
           techniques to pool (statistically combine) the different functions in an appropriate manner.
           In this section, we will learn how to pool the results and monetize the reduction in risk for
           adverse health effects due to changes in air quality levels.

           Note: For many of the health endpoints (e.g., mortality), there are many different valuation
           functions that you could choose to include in your configuration. In addition, there are
           multiple ways to pool your health incidence and valuation results.  This lab has you select
           specific functions and teaches you how to differentiate these valuation functions and
           modify certain parameters. This lab does not teach you how to determine which valuation
           functions and pooling options are the best for a particular study. To determine the best
           choices for a particular analysis, we recommend that you read the appendices
           accompanying BenMAP that describe the specific studies that correspond to the specific
           valuation functions and/or that you discuss your choices with an economist.

A.1.6.1  Example: PM2.5 Control 2020 14/35

         The goal of this exercise is to create a new aggregation, pooling, and valuation configuration
         (apv) and produce valuation results for the control scenario RIA 2020 14 annual, 35 daily
         |ig/m3.

         Procedures:

               (a)  In the main BenMAP window, begin the process of creating an apv configuration
                   by clicking on the graphic titled "Pooling, Aggregation, and Valuation" in the
                   right-hand panel, under the "Step 3" heading.  This will open the APV
                   Configuration Creation Method window (Figure 6-1).

                       (*" [Create N ew Configuration f«Aggtegaiion.Po<*ri9 and Valuation'

                       C 0 pen E xisting Configuration fle fa Aggregation^ Roofing, and Valuation (", apv file).
                                                               Cancel
Go!
                        Figure 6-1. APV Configuration Creation Method window
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     (b)  In the APV Configuration Creation Method window (above), select "Create New
          Configuration for Aggregation, Pooling, and Valuation". Click Go!. An Open
          window will appear.

          We first have to select the health incidence results that this apv will be based on:
          the results that we created in Section 5.2. In the "Configuration Results" folder,
          select
          "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily.cfgr"file
          and click Open. This will open the Incidence Pooling and Aggregation window
          (Figure 6-2).
£ I nci de nee Poo ling an d Aggregation
'Available Incidence Results
Select Pooling Methods
                      Pooling Window Name:  [Pooing Window 1

                      Endpoirtt Group   | Enejpotnl       Au!h«
                                       Qualifier
L(J Pooling Method
                                               • Window lo Detete -
                                                                    Delete
                                                          Add
   Target Grid Type:
  Configuration Results File Name(s): Z:\BenMAP\BenMAP_Fies\Cori%aafai_ResuftsVControl_PM25_RIA_2020 V|    Browse
   Advanced
                                             Cancel
      Next
             Figure 6-2. APV Incidence Pooling and Aggregation window
     (c)  This window is where we will combine (pool) similar health incidence results
          together. Before we begin pooling, let us look at the main features of this window.
          First, the "Configuration Results File Name(s)" field near the bottom of the
          window shows the health incidence results (cfgr) that you just selected for this
          apv. If you want to use a different cfgr, you would use the Browse button to locate
          it. We will do this later, in the second example for this lab.
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    The "Target Grid Type" is the grid definition used to generate the selected health
    incidence results; it always matches the cfgr input's grid. The "Available Incidence
    Results" panel has  an expandable hierarchical tree that lists each of the health
    incidence results in the cfgr file. The "Select Pooling Methods" panel has one or
    more pooling windows. The pooling windows are where you will select individual
    health incidence results that you may want to pool. These selected results (whether
    or not they have been pooled) will then be available  for valuation (next window).
    The Add and Delete buttons add new pooling windows or remove pooling
    windows that have already been created.

(d)  First, change the name of the pooling window. (For  our configuration, there will
    be only one pooling window.) Click in the "Pooling  Window Name" field within
    the "Select Pooling Methods" panel.  Change the text "Pooling Window 1" to
    "Main Pooling Window".

(e)  In the "Available Incidence Results"  panel, expand "PM2.5" by clicking on the
    plus [+] sign. This  will reveal the available endpoint groups. You can expand any
    endpoint group to see the available endpoints within that endpoint group. In turn,
    you can expand a specific endpoint so that you can see the specific health
    incidence results available for that endpoint.

    We will begin by expanding the "Chronic Bronchitis" endpoint group and
    endpoint. Notice that the health incidence result is identified in the tree using the
    reference that describes the study used to derive the  underlying health incidence
    function. Click on the  chronic bronchitis result "Abbey D. E., B. E. Ostro, F.
    Pertersen and R. J. Burchette. 1995. ..." and drag it to the "Main Pooling
    Window" (Figure 6-3). That is all it takes—you have added the first health
    incidence result.
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!* Incider>ce Pooling and Aggregatton

 Available Incidence fiesute
Setecf Poolng Metfwds
 >• PM2.5
    »  Mortality
    -  CNonic Bronchitis
      - Chienie Bronchitis

   >  E tmtgenctf Boom Viits, fi esp
   >  Acute R tspMtoty Symptoms
   >  Hospital A()mts»ionj,
   >'  Acute Myocwdul Infarction
 T«get Grid Type;

Confouiation Rest** Rte Name(4 I


  Advanced
                |M*inPoolna Window
EndpdritGwup
Crvonic Granchbt JQvwiicBianchits  Abtej»eial
                                                                    Quaiw I Pooi^g Method
                                                 w.Be^sCor^PM^jRSriS^    irw*8
                                                                    Cawd
                                                  Next
            Figure 6-3. Adding a health incidence result to a pooling window
Tip: By hovering the cursor over the Available Incidence, you can see a more complete
description of these studies.
      (f)  For the "Emergency Room Visits, Respiratory" endpoint group, add the health
          incidence result "Norris G., et al. ..." to the "Main Pooling Window". Again,
          simply click on the specific result from the "Available Incidence Results" panel
          and drag it to the pooling window.

      (g)  For the "Acute Respiratory Symptoms" endpoint group, add the health incidence
          result "Ostro, B. D. and S. Rothschild ..." to the "Main Pooling Window". At this
          point you should have three endpoints with their corresponding three health
          incidence results in the pooling window (Figure 6-4).
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 v Incidence Pooling and Aggregation
"Available Incidence Results
                                 Select PooSng Methods
    PM2.5
    '+•  Mortality
    :-  Chronic Bronchitis
       - Chronic Bronchitis
            Abbey, D.E., B.E. Ostro.F. Pi
    ,-  Emergency Room Visits, Respiratory
       - E mergency R oom Visits, Asthma
            Morris. G , et al An associatb
    H  Acute Respiratory Symptoms
    l+l  Hospital Admissions, Respiialory
    1+1  Acute Myocardial Infarction
PooSng Window Name  Mart Peeing Window
Endpotrt Group
Chronic 8roncMi$
E mergence Room V
Acute Respiratoty S
Endport
                           AuChof
Qualifier
             Chiowc Btorichtfc  Abbey et al.
             Emergency Room Vr Morris et al.
             Nrw Res(rk;Secl Act Ostro and Rothschik
Pooling Method
                                                   ~ WmAm to Oetete •
                                                                           Delete
                                                     Add
    Target Grid Type:
   Configuration Results File Name(s)  'ZABenMAP\Ber«AP_Fies\Ccrfigyiaton_R£sultsSConlral_PM25_RIA_2020 -rj     Browse
    Advanced
                                        Cancel
                                        Next
          Figure 6-4. Initial three health incidence results in the pooling window
Tip:  If you mistakenly add the wrong health incidence result, you can delete it by
highlighting the particular function in the "Select Pooling Methods" panel and clicking
Delete on your keyboard. The Delete button in the Select Pooling Methods panel will remove
the whole pooling window.  Typically, you would not want to do this.
       (h)  For the rest of the endpoint groups, we will add multiple health incidence results
           per group. In the  "Available Incidence Results" panel, expand the "Mortality"
           endpoint group. Drag the "Pope et al.,..." result into the "Main Pooling Window"
           Repeat for the "Woodruff,  T.J., J. Grille..." result (Figure 6-5).
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£ Incidence Pooling and Aggregation
 Available Incidence Results"
Select PooSng MeJhods

 '-, PM2.5
   i-1  Mortality
      l-l Mortality, All Cause
           Pope etal.. 51 cities, 2002, N
           Woodruff, T.J..J. Grillo and K
   -)  Chronic Bronchitis
      i-l Chronic Bronchitis
           Abbey, D.E.,B.E. Oslro,F. P<
   -i  Emergency Room Visits, Respiratory
      i-i E mergency R oom Visits, Asthma
           Norris, G., et al. An associate
   '-i  Acute Respiratory Symptoms
      i-i Minor Restricted Activity Days
           Qstro, B.D. andS, Rothschild
   +i  Hospital Admissions, Respiratory
   '+l  Acute Myocardial Infarction
 Pooling Window Name: | Mail Roofing Window

Erriport Group   I Endport        Authof
D-iiontD Bfoochife i O»or»c Broochfe  Abbey et al.
                           Qualifier I Pooling Method
Emergency Room V
Acute Respratay S
Emeigency Room Vi Notris et al.
Mnof Restated Ad Ostto and Rothschrlt
Mortally, Al Cause
             Pope etal.       No thresh
             Woodruff et al.
                                               None
                                                •-Window to Delete-
                                                                       Delete
                                                    Add
   Target Grid Type:
  Configuration Results File Name(s): JZ \BenMAP'
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Tips:  (1) You can grab a whole group of endpoints and add all of their respective results
to the pooling window at once. (2) You do not need to add all of the available health
incidence results to your pooling window(s). If you are not interested in pooling or valuing
a particular result, do not add it to a pooling window.	
   (j)  For the "Hospital Admissions, Respiratory" endpoint group, add these three items
       to the pooling window:

       •  the "Ito" results for the "HA, Pneumonia" endpoint

       •  Both the "Ito" and the "Moolgavkar" results for the "HA, Chronic Lung
          Disease" endpoint.

   (k)  For the "Acute Myocardial Infarction" endpoint group, add the four age-specific
       "Peters" results to the pooling window (Figure 6-6). Note: although the four
       functions seem  to be missing in Figure 6-6, they are in the pooling window. You
       need to use the  scroll bar in the right hand panel to see the specific "Start Age"
       column.
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 Available Incidence
Sefed Pacing Methods
** r*n*L.3 *^
- MofUty.AJ Cause
Pepe el »!.. 51 cities, 2Ctt
Woodruff. IJ..J, Gritoar
- Chlorite BfoneWts
'-• Chrome BioncWte ,
Abbey. DE..B.E. 0*o. f
-' Emergency Room Visits, Respit«tt
.- Emergency ReornVirts, AstN
Norns, G., el at An ««€»
- Acute R«p««tory Symptom*

.™. Minor ri^ihdtd A€4m^ Ds^j^
0*uo.B.O andS.Bottet
- Hoipttal Adrftitswus, RetpirMory
- HA, Pneumonia
1(0. K AssooSiWis «< P«
- HA, Clwnic Ling Os««s«
Ho. K AiiOdMiorn d P«
Moolgavfcar, S H. Af PC*
•HAcu*eMy«;adiallo|*ct>«i^^™
.-. Acyle Mjs>e«idiat Wactw>>,
Peter*, A. OW. 0«*«y,
PooingWndowNwrw 1 Mam Poobig Wndow
En*>an(6!a» '
Chicrnc StoncWi!
Ert*ige«y Boons V
A/.iJ* R*-^»af«>i 5

Hotpdal Admraont




Acti>«Myoc«di4lln




Er*4x«rt ' ' AJJtw ' ' QuaMieT
Dtcoe B^eocJ*: Abbey *• &
Erto>my Rco^ v^ He»!Fj e? ^1
Mm« R*th«a*d A# 0 itio *K| R othv: h*

Pope el at Ho (N«h
Woo*uB « al
HA. Pn«*»»»i llo
-HA,, Ct^crac LtM 0
Ito
M«3%**«
AOM MfocwW Irt Peters el al




Poofcng Method



|


j


j
None « 1
1
1
i


* » |

Prtw* A f)W Dnrfcwu v pwWowloDeteie^ jr] 0«tel*
Add J
   Tifget Giid T^*:
    Advanced

                                                           Cancel
                                                                      Nssdt
Figure 6-6. All health incidence results added to the pooling window, with no pooling
    (1)   The "Main Pooling Window" has four places we could potentially pool the results
         (indicated by the red arrows in Figure 6-6).

    (m)  Starting with the "Mortality" endpoint group, click on the "None" in the
         corresponding Pooling Method column. A drop-down menu will appear that lists
         all the possible pooling methods. Select the "Sum (Dependent)" method (Figure
         6-7). This will cause the results from the Pope and Woodruff studies to be
         summed together to create a single mortality result.
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  Incidence Pooling and Aggregation
Available Incidence Results
                               Select Poofrtg Methods

'-i PM2.5
  '- Mortality
      - Mortality, All Cause
          Pope el al., 51 cities, 200;
          Woodruff, T.J.J. Grilloar
  '—> Chronic Bronchitis
      l-l Chronic Bronchitis
          Abbey, D.E..B.E. Qstro.F
  ;-i Emergency Room Visits, Respiralt
      H Emergency Room Visits, Asthr
          Morris, G., el al. An associ
  i-i Acute Respiratory Symptoms
      i-l Minor Restricted Activity Days
          Ostro, B,D. «nd S, Rothsc
   -i Hospital Admissions, Respiratory
      i-i HA, Pneumonia
          I to, K. Associations of Par
      I-! HA, Chronic Lung Disease
          I to, K, Associations of Par
          Moolgavkar, S.H, Air Polk
  :-i Acute Myocardial Infarction
      H Acute Myocardial I nfaretion, K
          Peters, A., D.W. Dockery.,
 PooSng Window Name: Mail Poofcg Window
EndpoJnt Gcoup
Chronic Broncbfe
Emergency Room V
Acute Respiratoiy S
Endpcw*        Aulhoi
Chronic Bionchtts  Abbey el at
Emsgenej" Room Vi Notrrs et al
Una Rednded Act Osho and Rothschils
Qualifier

              Mo.tatty.AJ Cause
Pooling Method

Hospital Adrwsaons
              Pope et al
              Woodruff et al

HA, Pneumonia    Ito
HA, Chrome Lung D
              Ito
              Modgavkat
Acrfe Myoc«i*il Irt Peleis et A
                                         No threshold
                                                   -WiretowiaDetete--
                                                                          Delete
  Target Grid Type:
   Advanced
                                                                         Cancel
          Mone

          Sum (Independent)
          Subtraction (Dependent)
          Subtraction (Independent)
          Subjective Weight*
          Random/Fixed Effects
          Fixed Effects
                                                   slone
                                                                                      Add
 Configuration Results File Name(s): ;ZABenMAP^enMAP_Ftes\jCor^ijaten_Resufts\Con>foLPM25_RIA_2020 -^ |       Browse
                                                                                      Next
              Figure 6-7. Adding a pooling method for the mortality results
  Background:  In the mortality case, we are using Sum because the results from the two
  studies are distinct from each other. The number of avoided adult mortalities (Pope) does
  not overlap with the number of avoided infant mortalities (Woodruff)—i.e., they are
  distinct age groups.  See  "Pooling Approaches" in the appendices.	
     (n)  Now we will add pooling to the "Hospital Admissions, Respiratory" results. There
          are two levels of pooling that can be done in this endpoint group, because it
          contains multiple endpoints ("HA, Pneumonia" and "HA, Chronic Lung Disease"),
          and one of those endpoints contains multiple results ("Ito" and "Moolgavkar").
          Starting with the bottom of the hierarchy, we will combine the "HA, Chronic Lung
          Disease" endpoint's results ("Ito" and "Moolgavkar"). After combining those
          results into a single result, we will take this new, pooled result and combine it with
          the "HA, Pneumonia" endpoint to create a single, combined result for the whole
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           endpoint group.

           First, click the "None" corresponding to the "HA, Chronic Lung Disease"
           endpoint. Select the "Random / Fixed Effects" pooling method from the
           drop-down menu. This combines the two results into one pooled result for the
           "HA, Chronic Lung Disease" endpoint.

           Next, click the "None" next to "Hospital Admissions, Respiratory" endpoint
           group.  Select the "Sum (Dependent)" pooling method (Figure 6-8). With this step,
           we have pooled the different endpoint results into one result for the endpoint
           group.
£ Incidence Pooling and Aggregation
 Available Incidence Results^
^Select Pooling Methods
 .-' PM2.5
   !-j Mortality
      '- Mortality, All Cause
          ;•  Pope et al., 51 cities, 200;
            Woodruff, T.J.J. Grille ar
   ,-' Chronic Bronchitis
      '•- Chronic Bronchitis
            Abbey, D.E..B.E. Qstro.F
   :-! Emergency Room Visits, Respirak
      — E mergency R oom Visits, Asthr
            Morris, G.,et al. Anassoti
   :-i Acute Respiratory Symptoms
      ,- M inor R estricted Activity Days
            Ostro, B.D. andS, Rothsc
   i-l Hospital Admissions, Respiratory
      l-i HA, Pneumonia
            I to, K, Associations of Par
      l-l HA, Chronic Lung Disease
            I to, K, Associations of Par
            Moolgavkar, S.H. Air Polk
   '-: Acute Myocardial Infarction
      H Acute Myocardial Infarction, N
            Peters, A., D.W. Dockery.,
 Poofir^ Window Name:  |Ma« Pooling Window
 Entfcwnl Group
 Chronic Bronchitis
 Emergency Room Viste, R
 Acute Respiratoiji Sympta
 Mortality

 Acute Mjxx-sicJtal Intacta
Erafcioint        Author
Chronic Bronchitis  Abbey et al.
Emergency Room Vi Morris et al.
Mirror Restricted Act Ostro and R
Mortality. All Cause
               Pope et al.
               Woodruff et
            •
HA, Pneumonia   I to
HA, Chronic Lung D
               Ito
               Moolgavkar
Acute Myocwdul Inl Peters et al,
Pooling Method
Sum (Dependent)
                                              Random /Fixed Effects
None
                                                 -Window to Delete--
                                                                           Delete
                                                      Add
   Target Grid Type:
  Configuration Results File Namels): ZAEer>MAP^ertA4P_Ftes\C(»^jfa
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Background: In calculating the combined HA chronic lung disease results, we are looking
at overlapping populations (same endpoint, same age range); therefore, we want to use
Random/FixedEffects to combine their distributions. In contrast, when we pool the HA
endpoint group, we are looking at nonoverlapping populations: pneumonia versus chronic
lung disease (i.e., different endpoints). Therefore, we want to pool the pneumonia and
chronic lung disease distributions by doing a Sum. See "Pooling Approaches" in the
appendices.
   (o)  The "Random / Fixed Effects" pooling method has advanced settings. To access
       these settings, double-click on the "Random / Fixed Effects" cell in the Pooling
       Method column. This will bring up an Advanced Pooling Options window (Figure
       6-9). There are multiple options for customizing this type of pooling (See the
       user's guide for specifics). We will not change the existing settings in this window.
       Click OK to close it.
               £ Advanced Pooling Options
Advanced Pooling Melted: PiigiTiffS^lfnitlgig^

    Monte Carlo Iterations,

                             Cancel
                                                             J
                                                         OK
                  Figure 6-9. Advanced Pooling Options window
   (p)  The "Acute Myocardial Infarction" endpoint group is the final group for which
       pooling could be done. In this configuration, however, we will not pool the four
       age-specific AMI results. Leaving the results unpooled will allow us to take
       advantage of age-specific valuation functions in the next stage of the APV
       configuration setup. In other words, we will have four separate AMI results to
       value instead of one single, combined result. To not pool the results, leave the
       "Pooling Method" for the AMI endpoint group as "None".

       We have now finished setting up the health incidence results pooling, which is the
       first of the four stages in creating valuation functions (see the  stages list at the
       beginning of Section 6). Your pooling window should look like Figure 6-8.

   (q)  Exercise (6.1): If you were going to pool the four AMI results, which pooling
       method would you use? Why?
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      Answer:
   (r)  Now we move on to the second stage of creating valuation functions: choosing the
        specific valuation functions and pooling similar valuations. Click Next in the
        Incidence Pooling and Aggregation window. This will open the Select Valuation
        Methods, Pooling, and Aggregation window (Figure 6-10).
v Se lect Va luatio n Met ho ds, Poo li ng, an d Aggregation;
 Valuation Methods
                          Variable DataSet
   EPA Standard Valuation Functions
                          Pooling Window Name: [Mam Roofing Window!

                          Endpoint Gtoup   Endport       Auth«
                          Chtonic Bioncbfc
                          E mergence Room V
                          Acute RespnalQiy S
                          Mortality
                          Hospital Admissions
                          Acute Myocatdul In Acute Mj«oc4idial Inl Petej el a!
Valuation Method
•-Select-
-Select-
-Select--
••Select-
-S elect- •

•-Select-
•-S elect-
-Select-
-Select-
Pooling Method
None
   Advanced   jy S kip QALY Valuation
                                                          Cancel     Previous      Next
     Figure 6-10. Select Valuation Methods, Pooling, and Aggregation window
   (s)  This window is where we will apply valuation functions to our health incidence
        results and combine (pool) similar valuation results together. Before beginning, let
        us look at the main features of this window. The "Valuation Methods" panel has
        an expandable hierarchical tree that lists the available valuation functions, based
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       on the incidence results in this configuration. The right-hand panel contains the
       pooling windows that were defined in the previous step. In our case, there is only
       one pooling window, "Main Pooling Window". If there had been three pooling
       windows created in the previous health incidence pooling step, then we would
       have three pooling windows in the Select Valuation Methods, Pooling, and
       Aggregation window.

        The "Variable DataSet" field at the top of the window defines specific variables
       used in the valuation functions. The "Skip QALY Valuation" checkbox at the
       bottom of the window determines whether or not we will configure and run QALY
       (Quality Adjusted Life Years) functions. In our case we will not be calculating
       QALY since we are interested in quantifying the benefits in dollars.
Background.  In the context of air pollution benefit analysis, the QALY represents the
combined mortality and morbidity benefits of some air quality change. This combined
metric is calculated by counting: (1) the number of life years gained; (2) the number of life
years lived without some chronic condition. In step 2, the life years are weighted
according to the severity of the condition (the "quality" of that year), such that a year in
near perfect health might be counted as 0.9, but a year lived with chronic bronchitis might
be counted as 0.5.
   (t)  In the "Valuation Methods" panel, expand "EPA Standard Valuation Functions".
       This will reveal the available endpoint groups. You can expand any endpoint
       group to see the available endpoints within that group. In turn, you can expand a
       specific endpoint so that you can see the specific valuation functions available for
       that endpoint.

       We will begin by expanding the "Chronic Bronchitis" endpoint group and
       endpoint. You will see six COI (Cost Of Illness) and one WTP (Willingness To
       Pay) functions. We will add the WTP function for average bronchitis severity ages
       30 to 99. Click on the "WTP: average severity 30-99" and drag it to the "Main
       Pooling Window" to the "Chronic Bronchitis" endpoint group's row (Figure 6-11).
       That is all it takes—you have added the first valuation function.
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• ii Se lect Valuation Met hods, Pooling, and Aggregation
 Valuation Methods
Vawfcfe DatsSet
  -  E PA Standard Valiwhon Fine how
    > Acute Myoeaidial Intatcton
    * Aewte Resfwatwy Symptom;
    - Chiowc BroncNi*
       -  Chionic Bionchto
           C01 me**s
      '*  Chlorite Bionchfe. Bevstalt
      HotpMAdfttiswrw, Retpnaiwy
      Emergency Ro«n Visti,, Respiai
    Advanced   jy SkpQALYVduation
f» j Mart Ptiolwg Window

Endpont       Atrfhe*
                                   Vakwhon Mettwd  Pooling Method
                                   WTP,
                                   •Sstect
                                                                            Now
                                   -Select-
                                   -Select-

                                   -Setect-
                                   •Select"
                                   -Select"
                               Caicel     ftevious      Neat
 Figure 6-11. Adding a valuation function for chronic bronchitis to the pooling window
     Tip:  By hovering your cursor over the valuation functions, you can read their full
     names. If you drag and drop a function and nothing happens, then you probably
     tried to drop it into the wrong endpoint. Retry with the correct endpoint.
      (u) Next we will add a valuation function for acute respiratory symptoms. Under the
          "Acute Respiratory Symptoms" endpoint group in the Valuation Methods column,
          expand the "Minor Restricted Activity Days" endpoint. Add the WTP valuation
          function for one day of lost work based on a contingent valuation (CV) study for
          ages  18 to 99 by clicking on the "WTP: 1  day, CV studies] 18-99" function and
          dragging it to the corresponding row in the "Main Pooling Window" (i.e. the
          "Acute Respiratory Symptoms" endpoint group).

      (v) Next we will add a valuation function for mortality. Under the "Mortality"
          endpoint group, expand the "Mortality, All Cause"  endpoint. Add the value of a
          statistical life (VSL) function that ranges from $1-10 million with a normal
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      distribution by clicking and dragging the function "VSL, based on range $1 to $10
      million, normal distribution, 0-99" to the pooling window (Figure 6-12).
1 Valuation Methods Variable DataSet
| H EPA Standard Valuation Functions i EPA Standard Variables _J
• -4.' ^cuts Mvocsrdisl InfBrction -i- 	
j •- Acute Respiratory Symptoms | Pooling Window N<


ane; i Man PooSng Window
i ;+: Any of 19 Respiratory Sym| 	 .. 	 	 !
i i- Minor Restricted Activity D.
| WTP: 1 day, CVstudie
I WTP: 3 symptoms 1 de
i i+: Chronic Bronchitis
| i+i Hospital Admissions, Respirator
i i+; Emergency Room Visits, Respii
I i-! Mortality
| I- Mortality, All Cause
I VSL, based on 26 valu
Endpoint Group
Chronic Bronchitis

Emergency Ftoont V
Acute K«$p»tety S

Mortality

Unofsitd A<4nli»^w.>-
Endport A»ihc«








i | VSL, based on range from $1 to $10 mlion, no«Ml drshibtidwi, i 0-SSLi.,, „, j
i VSL, based on range fr
i VSL, based on range fr
i VSL, based on range fr


1 < ! >
jw^mmf









Valuation Method Pooling Method |

WTP: average seve I
-Select- j

WTP:1 day.CVttu:

VSL, baied on rang
••Select-
None I
-Select-
-Select- j

-Select-
--Select-
<\ 	
Advanced jy S kip QALY Valuation


Cancel Previous Next

      Figure 6-12. Initial three valuation functions in the pooling window
Background:  Recall that in Section 6.2(m), we pooled the two underlying mortality
results to make this single, combined result to which we have just assigned a valuation
function. Because we pooled the health incidence results, we need only one valuation
function to calculate the value of mortality. If we had not pooled the results, we would
need at least one valuation function for each of the mortality results. The same holds
true for the HA endpoint group (see next step).
  (w) Under the "Hospital Admissions, Respiratory" endpoint group, expand the "HA,
      All Respiratory" endpoint. Add the valuation function for cost of illness (COI)
      medical costs and wage loss ages 65 to 99. Recall that in Section 6.2(n) we
      combined the individual HA chronic lung disease and pneumonia results to create
      a pooled result containing all respiratory results for ages 65 to 99.

  (x)
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Tip: You can click Previous to return to the Incidence Pooling and Aggregation window
if you want to inspect the underlying health incidence results or the incidence pooling.
You will not lose your present valuation configuration. When you are done exploring the
incidence results, click Next to return to the Select Valuation Methods, Pooling, and
Aggregation window.
   (y)  For the rest of the endpoint groups, we will be adding multiple valuation functions
       per group. Expand the "Emergency Room Visits, Respiratory" endpoint group and
       then the "Emergency Room Visits, Asthma" endpoint. Add the COI Smith
       valuation function. Repeat for the COI Standford study (Figure 6-13).

       Note: A "None" appeared in the Pooling Method column across from the endpoint
       group "Emergency Room Visits, Respiratory". Similar to the incidence pooling
       window, this indicates that we could potentially pool these two valuation
       functions. We will do this pooling in a later step.
Valuation Methods Variable DataSet:
-, EPA Standard Valuation Functions
f+i Acute Myocardial Infarction
l+! Acute Respiratory Symptoms
,ERA Standard Variables _~j
	 I

Pooling Window Name: 1 Mam Peofag Window
1+) Chronic Bronchitis
i+i Hospital Admissions, Respiratory
1-1 Emergency Room Visits, Respira
H E mergency R oom Visits, Astl
COI: Smith etaUl 997)

i+i Mortality












< 	 ' >
Endpoint Group
Chronic Bronchitis

Emergency Room V


Acute Respiratory S.

Mortality

Hospital AdMti$$»fis

Acute Myocwdiai In





Endpoirtt Aulht











Aci*e Mj««;ardwl in! Pete«:





Valuaibn Method Pooling Method

WTP- average severity 1 30-9,
None
COI: Smith etal. (1337)10-9!
COI: Standford et al, (1999)|'

W T P; 1 day, CV studies 11 8-:;

VSL, based on range from $1
' 1
COI: med costs + wage loss 1
None
-Setect--
--Setect-
--Setect-
> I
-Select- j
4 1 I M
Advanced ^ S kip QALY Valuation
Cancel Previous Next

Figure 6-13. Adding two emergency room visits valuation functions to the pooling
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                                 window
(z)  Next we will add valuation functions to the AMI health incidence results. We will
    add age-specific valuation functions to each of the age-specific health incidence
    results. To see the age-specific results, use the scroll bar for the pooling window to
    pan until you can see the Start Age column.

    In the "Valuation Methods" panel, expand "Acute Myocardial Infarction". We will
    add two valuation functions per age range: one function by Russell and the other
    by Wittels. We will use the COI function for 5 years of medical costs and 5 years
    of wages loss with a 3% discount rate (DR). Add the valuation function "COI: 5
    yrs med, 5 yrs wages, 3% DR, Russell (1998) | 25-44" to the AMI health incidence
    result for ages  18-44 (i.e., start age = 18).

    Repeat for "COI: 5 yrs med, 5 yrs wages, 3% DR, Wittels  (1990) | 25-44" (Figure
    614).

    Note:  As happened with the endpoint group "Emergency Room Visits,
    Respiratory", "None" appeared in the Pooling Method column next to the 18 to 44
    result. Again, this indicates that these  two valuation functions could be pooled.
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£ Select Valuation Methods, Pooling, and Aggregation
Valuation Methods
                              Variable DataSefc
 :- EPA Standard Valuation Functions    EPA Standard Variables    j-j
    + Acute Myocardial Infarction    •	
    + Acute Respiratory Symptoms     Pooling Window Name: (Mam Po*Tg~WMow
    + Chronic Bronchitis
   + H ospital Admissions, R espiratory
   - Emergency Room Visits, Respira
      -  Emergency Room Visits, Asll
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                                             Endport
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-Setect-
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                                                                                     None
                                                                                   ' None
    Advanced
                 S kip QALY Valuation
                                                                 Cancel
             Previous
     Next
 Figure 6-14. Adding two age specific AMI valuation functions to the pooling window
 Tip:  If you mistakenly add the wrong valuation function, you can delete it by highlighting
 the particular function in the right hand pooling window panel and clicking Delete on
 your keyboard.	
      (aa) Continue to add one Russell and one Wittels function for each of the remaining
           age ranges (i.e., 45-54, 55-64, and 65-99) (Figure 6-15).
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Valuation Methodt
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                                                      Appendix A: Training Courses
  (ad) For each of the AMI age ranges, we will pool together the Russell and Wittels
      age-specific valuation functions. Click on the "None" for the start age of 18 in the
      Pooling Method column (make sure that you are not selecting the "None" in the
      row above this one, which is for the entire the endpoint group), then select
      "Subjective Weights" (Figure 6-16).

      Repeat this step for each of the other three age ranges, choosing "Subjective
      Weights" in every case.
£ Select Valuation Methods, Pooling, and Aggregation

Valuation Methods Variable DataSet
; Ei Acute Myocari A
COhlOyr;
COhlOyr;
COhlOyr:
COhlOyr;
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Advanced p S kip QALY Valuation


Cancel Previous Next

Figure 6-16. Adding "Subjective Weights" pooling to the specific AMI valuation
                                  functions
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(ae)  At this point we have combined the two valuations for each age range. Now we
    want to "move up a level" in the hierarchy and combine the four age ranges. Click
    the "None" in the same row as the AMI endpoint group, then select "Sum
    (Dependent)" (Figure 6-17). This will create one valuation result for the entire
    endpoint group.
£ Select Valuation Methods , Pooling, and Aggregation
Valuation Methods Variable DataSet
'-i Acute Myocart A
COMOyrs
COMOyrs
COI: 10yr:
COMOyrs
COMOyr:
COMOyrs
CQMOyr:
COMOyrs
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COMOyr:
COI; Syrs
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COI: 5 urs
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	 1

Pooling Window Name: Main Poolng Window w
Endpoint Group
Chronic Bronchitis

Emergency Room Vis-its, Resptaiwy


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Natality

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CQI: 5 yrs med, 5 yr:
Subjective Weights ;
COI: Syrs med, Syr:
COI: Syrs med, Syr:

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Advanced j~s s kip QALY Valuation


Cancel Previous Next

Figure 6-17. Adding "Sum (Dependent)" pooling to the AMI endpoint group
(af) Finally, we need to set the specific weights to be used in the subjective weights
    pooling methods. Double-click on any of the "Subjective Weight" pooling method
    cells. The Select Subjective Weights window will open (Figure 6-18).
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      The default weight for each of the component functions is 0.5, i.e., the valuation
      functions are being weighted equally. We will leave the default weights for AMI's
      four poolings.

       For the emergency room (ER) pooling, we want to give more weight to the Smith
      valuation function. Edit the Weights column so that the Smith function is 0.60 and
      the Standford is 0.40. Click OK to set these weights and return to the Select
      Valuation Methods, Pooling, and Aggregation window.
£ 'Select Subjective Weights
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COI: 5 yrs mfid, 5 yis
COI: 5i«smed 5 ye:
Subjective Weights
COL 5jifs med, 5yr;
COI: 5 
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                                                    Appendix A: Training Courses
(ag) Exercise (6.2): Why did we use "Sum (Dependent)" pooling for the AMI endpoint
    group instead of "Random/fixed Effects" pooling?
  Answer:
(ah) At this point we have set up the pooling for health incidence results (Stage 1 in
    creating valuation functions), and have set up the specific functions and the
    pooling for similar valuations (Stage 2). Moving on to Stage 3, we need to set
    some additional parameters for the valuation functions, and decide on the
    aggregation levels for the health incidence results and the valuation results. We
    will then save all these settings from the three stages as a configuration (apv).

    In the Select Valuation Methods, Pooling, and Aggregation window, click the
    Advanced button. This will open the APV Configuration Advanced Settings
    window (Figure 6-19).

    Under the "Aggregation and Pooling" tab, use the drop-down menus to select
    "State" as the aggregation level for the incidence and valuation results. In other
    words, the results will be aggregated from CMAQ 36 km grid cells to states
    (minimum spatial unit).
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           * APV Configuration Advanced Settings
            Aggregation and Pooling Currency and Income 1
                      Incidence Aggregation:

                      Valuation Aggregation:

                         QALY Aggregation:
              Default Advanced Pooling Method: |Round weights to two digi^J
                  Default Monte Carlo Iterations:
                                        5000
                            Random Seed: JRandom Integer
                      jSort Incidence Results!
                                                     Cancel
OK
Figure 6-19. Advanced settings: Changing the aggregation level and the inflation dataset
      (ai) Under the "Currency and Income" tab set the "Inflation DataSet" to "EPA Standard
          Inflators" and make sure the "Currency Year" is set to 2000. Then, set the
          "Income Growth Adjustment DataSet" to "Income Elasticity (3/21/2007). Change
          the "Year" to 2020, the same year used in our aqg files created earlier in the
          training. Then select all of the "Endpoint Groups" by clicking on the first group,
          holding down the Shift key and clicking on the last group (Figure 6-20).
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         * APV Configuration Advanced Settings
         Aggregation and Pooling  Currency and Income


                Inflation Adjustment
                    Inflation Dataset: (EPA Standard Inflators
                      Currency Year: |2000
                 Income Growth Adjustment
                  Income Growth
                  Adjustment Dataset:
                                  Income Elasticity (3/21/07)
                            Year: J2020     T]


                     Endpoint Groups:
Asthma Exacerbation
Chronic Asthma
Chronic Bronchitis
Lower Respiratory Symptoms
Mortality	
Upper Respiratory Symptoms
                                                   Cancel
                               OK
Figure 6-20. Advanced settings: Setting the income growth adjustment parameters
   (aj)  Since, as noted earlier, we are not doing anything in this training with QALY
        weights (the third tab in the window), click OK.  This will return you to the Select
        Valuation Methods, Pooling, and Aggregation window.

        The last parameter you need to set is the "Variable DataSet" at the top of the
        window. Use the drop-down menu to select "EPA Standard Variables" (Figure
        6-21). Note: If you do not set the "Variable DataSet" you cannot save and run the
        configuration (next step).
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Valuation Methods
                      Variable DataSet
;- EPA Standard Valuation F
   '-'< Acute Myocardial Infai
     ;+) Acute Myocardial
 Acute Respiratory Syrr
: Chronic Bronchitis
 Hospital Admissions, F
 Emergency Room Visil
 Mortality
   Advanced
                      Pooling Window Name:  f Man Poofcg Window
Endpoint Group
Chronic Bronchitis

Emergency Room Visits, Respiratory


Acute Respiratory Symptoms

Mortality

Hospital Admissions, Respitatoiy

Acute Myocardial Infarction
                                              Endport
                                          icfow

                                       Author
                                              Acut* Myoc««fal W P«teis el al,
Valuation Method  Pooling Method

WTP: average seve
                                                                                    ; Subjective Weights
                                                                       COI: Smith etal. (13
                                                                       COI: Standford et a;

                                                                       WTP: 1 day, CV stu|

                                                                       VSL, based on tang;

                                                                       COI: med costs + w
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                                                         Appendix A: Training Courses
          This will bring up a Save As window. Under the "Configurations" folder, in the
          "File name" field, type in the new configuration file name,
          "PM25  RIA  2020 course modified state", and click Save.

           Ready to run Aggregation, Pooling, and Valuation
           Configuration, If you wish to      this configuration, click the
           Save button, When ready, dick OK,  If you are not ready to run
           this configuration, dick Cancel.
                                 Save
Caned
OK
      Figure 6-22. Save Aggregation, Pooling, and Valuation Configuration window
      (al) After the APV configuration is saved, you will be returned to the Save
          Aggregation, Pooling, and Valuation Configuration window (Figure 6-22). Now
          run the configuration by clicking OK. This will bring up another Save As window.
          Here we will save the valuation results (apvr). Under the "Configuration Results"
          folder, save the results as
          "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_state".

          The calculation of the results will begin and a Progress window will appear. The
          calculation of the results may take a few minutes. When the calculations are
          finished, you will be returned to the main BenMAP window.
   Tip:  If you are not ready to run this configuration, click Cancel.  If you generated a
   configuration, at a later time you can open the configuration and run it to generate
   valuation results at a later time.
   Background: The process of creating an aggregation, pooling, and valuation configuration
   (apv) is more restrictive than the process of creating a health incidence configuration (cfg)
   (discussed in Section 5).  If you change the number or type of health incidence results used
   in an APV process, you have to re-create the health incidence pooling. If you change the
   health incidence pooling, you have to re-create the valuation functions and pooling.
Analysis:
   The rest of the exercises in Section 6.2 focus on analyzing the results of our BenMAP run.
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Specifically, we will look at the newly created aggregation, pooling, and valuation config-
uration file (apv) and results file (apvr). Recall from Section 5 that quality-assuring both
your configuration and your results is a good idea.

   (a) First, we will use the audit trail to look at the newly created configuration file
       (apv). From the main BenMAP window, click on the "Report" graphic in the
       right-hand panel. Select the "Audit Trail Reports" in the Select Report Type
       window and click OK. Under the "Configurations" folder, select the new
       configuration,  "PM25RIA 2020 course modified state.apv" and click Open.

   (b) Exercise (6.3): What is the income growth adjustment year? For the incidence
       pooling, what are the pooling methods for the mortality and HA endpoint groups?
       What is the pooling method and advanced pooling method for the "HA, Chronic
       Lung Disease" endpoint? For the valuation pooling, what is the pooling method for
       the ER and AMI endpoint groups? What is the population year? When you are
       done with this  exercise, click OK to close the Audit Trail Report window.
     Answer:
   (c) Using the "Tools" menu in the main BenMAP window, open a BenMAP GIS
       window. Open the "APV Configuration Results (*.apvr)" and select the "Pooled
       Incidence Results". Under the "Configuration Results" folder, open our newly
       created file,
       "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_state.apvr
   (d) In the Edit GIS Field Names window, provide more meaningful names for your
       health incidence results then click OK. Here are some suggested names:
       ChronBronc, ER, AcutResp, Mortality, HA, AMI18, AMI45, AMI55, AMI65.

       Note: As you would expect, the individual results have been pooled together (for
       example, the Pope and Woodruff results have been pooled into one mortality
       result).
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(e)  Exercise (6.4): What are the numbers of avoided mortalities in California,
    Pennsylvania, and Illinois? How many acute respiratory symptoms were avoided
    in the same states?
  Answer:
(f)  Exercise (6.5): Compare the AMI (heart attacks) for various age groups. What are
    the maximum values for the AMI18 and AMI65 functions?
  Answer:
(g)  Next we will overlay a pooled valuation map for the same apvr. From the same
    GIS window, open "APV Configuration Results (*.apvr)" and select "Pooled
    Valuation Results". Under the "Configuration Results" folder, open our newly
    created file,
    "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_state.apvr
(h)  In the Edit GIS Field Names window, provide more meaningful names for your
    valuation results. Some suggested names are ChronBronc, ER, AcutResp,
    Mortality, HA, AMI.

(i)  In the Valuation Sums Layer window, add a sum for mortality and morbidity. For
    morbidity, check the following endpoint groups: chronic bronchitis, ER, acute
    respiratory symptoms, HA, AMI. Use "Dependent" as the summation type.

    Remember to edit the "GIS Field Name" to "morbidity" and "mortality",
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                                                   Appendix A: Training Courses
    respectively. Make the "Control_PM25_RIA.. .(Pooled Valuation Results 0)" layer
    the active layer; simply right-click on that layer and select "Move Up".

(j)  Exercise (6.6): What are the monetized benefits for the avoided acute respiratory
    symptoms in California, Pennsylvania, and Illinois? Now make the "Pooled
    Valuation Results Sums" layer active. What are the monetized benefits for the
    avoided morbidity events in the same states? What are the monetized benefits for
    the avoided mortalities in the same states? In comparing your answers to those for
    Exercise 6.5, what conclusion can you draw about the mortality valuation function
    versus the acute respiratory symptoms valuation function? When you are done
    with this exercise, close the GIS window.
  Answer:
(k)  Create a new report for our valuation results. From the main BenMAP window,
    click on "Report" in the right-hand panel and then select the "Incidence and
    Valuation Results: Raw; Aggregated and Pooled" type. Under the "Configuration
    Results" folder, open our newly created file,
    "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_state.apvr
    ". For the result type, select "Pooled Valuation Results".

    In the APV Configuration Results Report window (Figure 6-23),  select the
    "Endpoint Group" within the "Pooled Valuation Method Fields" panel. In the
    "Results Fields" panel, uncheck the "Variance". In the "Display Options" panel,
    reduce the "Digits After Decimal Point" to 0. The "Preview" panel in the bottom
    half of this window will reflect your choices.
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                                                   Appendix A: Training Courses
£ APV Configuration Results Report
File
•"Column Selection 	 - 	 - 	 - 	 - 	 - 	 !
Grid Fields: Pooled Valuation Method Fields: Result Fields:
& Colunr
Isf! Row
Groupin
ft Groi
C Grai
Preview
Column
1
1
1
1
1
 S tandatdDeviatiori^
. Location 
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                                                                 Appendix A: Training Courses
              (m) Exercise (6.7): All of the following questions refer to California, FIPS code 6 (i.e.,
                  column = 6, row = 1). What is the point estimate of the monetized benefit for the
                  number of avoided AMIs? What is the estimate of the monetized benefit for AMIs
                  at the 0.5 percentile? What is the estimate at the 99.5 percentile? When you are
                  finished with this exercise, close the Excel window.
                Answer:
A.1.6.2 Example: PM2.5 Control 2020 14/35 Adjusted
           The goal of this exercise is to re-use our newly created aggregation, pooling, and valuation
           configuration (apv) (Section 6.2) and produce valuation results for the adjusted control
           scenario RIA 2020 14 annual, 35 daily |ig/m3.

           Procedures:

           (a)In the main BenMAP window, click on the graphic titled "Pooling, Aggregation, and
             Valuation" in the right-hand panel. This will open the APV Configuration Creation
             Method window


           (a)In this window, select "Open Existing Configuration file for Aggregation, Pooling, and
             Valuation". Under the "Configurations" folder, select the newly created configuration
             "PM25_RIA_2020_course_modified_state.apv" and click Open.

           (a)In the Incidence Pooling and Aggregation window that opens, we  will change the input
             health incidence file (cfgr). Click the Browse button next to the "Configuration Results
             File Name(s)" field. Under the "Configuration Results" folder, select the health
             incidence  file
             "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_adjusted.cfgr".

           (a)Review your health incidence pooling window, "Main Pooling Window". The pooling
             configuration should be identical to our previous example (see Figure 6-8).

           (a)Click Next. The Select Valuation Methods, Pooling, and Aggregation window will
             appear. Review your valuation functions and pooling. The configuration should be
             identical to our previous example (see Figure 6-17). Click on Advanced to confirm that
             these settings are the same as before (see Figure 6-19 and Figure 6-20). When you are
             done reviewing the configuration, click Next.


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                                                          Appendix A: Training Courses
   (a)Do not save the configuration. There is no need to save since the only change was to
     the health incidence results file (cfgr). Do create the valuation results (apvr) by clicking
     OK. Under the "Configuration Results"  folder, save the results as
     "Control_PM25_RIA_2020_modified_cmaq_grid_14_annual_35_daily_state_adjusted"
     The calculation of the results will begin and a. Progress window will appear. The
     calculation may take a few minutes.

Analysis: Now we will look at the newly created aggregation, pooling, and valuation results
file (apvr).

   (a)Open an audit trail  for the new valuation results file,
     "Control_PM25_RIA_2020_modified_cmaq^rid_14_annual_35_daily_state_adjusted.apvr".

   (a)Exercise (6.8): What is the population year used in this apvr? What are the weights
     used for pooling the two ER valuation functions?
        Answer:
   (a)Open a BenMAP GIS window, then open the same valuation results file (apvr). Map the
     "Pooled Incidence Results".

   (a)Exercise (6.9): What are the numbers of avoided mortalities in California,
     Pennsylvania, and Illinois? How many acute respiratory symptoms were avoided in the
     same states? How do these results compare to the nonadjusted results (see Exercise
     6.4)?
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                                                       Appendix A: Training Courses
     Answer:
(a)Overlay the "Pooled Valuation Results" for the same apvr.  Edit the GIS field names. In
  the Valuation Sums Layer window, create sums for morbidity and mortality the same
  way you did above Exercise 6.6. Make the "Control_PM25_RIA.. .(Pooled Valuation
  Results 0)" layer the active layer.

(a)Exercise (6.10): What are the monetized benefits for the avoided acute respiratory
  symptoms in California, Pennsylvania, and Illinois? Now make the "Pooled Valuation
  Results Sums" layer active. What are the  monetized benefits for the avoided morbidity
  events in the same states? What are the monetized benefits for the avoided mortalities in
  the same states? How do these results compare to the nonadjusted results (see Exercise
  6.6)? When you are done with this exercise, close the GIS window.
     Answer:
(a)Create a new report for the valuation results file. After selecting the report type and
  opening the file, you should select the results type, "Pooled Valuation Results".

       In the APV Configuration Results Report window, select the "Endpoint Group"
       within the "Pooled Valuation Method Fields" panel. In the "Results Fields" panel,
       uncheck the "Variance". In the "Display Options" panel, reduce the "Digits After
       Decimal Point" to 0.

       Under the "Reports" folder, save the file as "Control_PM25_RIA_2020_modified_
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                  cmaq_grid_14_annual_35_daily_state_adjusted_value". Open the csv file in Excel.

           (a)Exercise (6.11): All of the following questions refer to California, FIPS code 6 (i.e.,.
             column = 6, row = 1). What is the point estimate of the monetized benefit for the
             number of avoided AMIs? What is the estimate of the monetized benefit for AMIs at the
             0.5 percentile? What is the estimate at the 99.5 percentile? How do these results
             compare to the nonadjusted results (see Exercise 6.7)? When you are finished with this
             exercise, close the Excel window.
                Answer:
A.1.6.3 Example: Modifying One-Step Analysis Parameters

           The goal of this exercise is to modify the One-Step Analysis to use our newly created
           health incidence and aggregation, pooling, and valuation configurations.

           Procedures:

           (a)From the main BenMAP window, select "One Step Analysis" from the "Parameters"
             menu (Figure 6-24).
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* BenMAP m
    Help
Air Quality Grid Aggregation
Model File Concatenator
Database Export
Database Import
Export Air Quality Grid
CIS/Mapping
Modify Setup
Neighbor File Creator
  ''Bn§*8tip8iiBip
                           I Use BenMAP: Which Analysis Meets your Needs?
                           juality data
                           jol to apply
                           fte a report.
!L
                             Creation
                 Prakmdad
               EPA parameters
           Report
                    Custom Analysis
                    Step 1 — Import air quality data
                                                            Air Quality Grid Creation
                                              Step 2 — Set custom parameters
                                                            Incidence Estimation
                                              Step 3 — Use results from Step 2
                                              to set custom parameters
                                  Fooling, Aggregation
                                     and Valuation
                                              Step 4 — Run report
                                                Report
                                      III
                             Active Setup:
             Figure 6-24. Parameters menu in the main BenMAP window.
  (a)This will open the One Step Setup Parameters window (Figure 6-25). Here you can
     select the health incidence (cfg) and valuation configuration (apv) files that will be used
     in the One-Step Analysis approach.
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              * One Step Setup  Parameters
                For each pollutant specify the standard cfg and apv files you wish used for the One-Step Analyses.
                    Pollutant: IPMZ5
               CFG File Name:  3.0\Configurations\User Manual Configurations\PM2.5 Wizard CFG.cfg   Browse
               APV File Name'  -0\Configurations\User Manual Configurations\PM2.5 Wizard APV.

                Currency Year: P°°°
Browse
                                                                  Cancel
OK
                      Figure 6-25. Modifying configurations for One-Step Analysis
           (a)Select "PM 2.5" from the Pollutant drop-down menu. Click the Browse button to the
             right of the CFG File Name box. In the Open window, under the "Configurations"
             folder, select "PM25_RIA_2020_course_modified.cfg" and click Open. This will return
             you to One Step Setup Parameters window.

                  Click the Browse button to the right of the APV File Name box, so that you can
                  select the new aggregation, pooling, and valuation configuration. In the Open
                  window, under the "Configurations" folder, select
                  "PM25_RIA_2020_course_modified_state.apv" and click Open. This will again
                  return us to One Step Setup Parameters window.

                  We have the option of changing the currency year, but in our case leave the
                  "Currency  Year" as 2000. Finally, click Save. The next time you run One-Step
                  Analysis, it will use these new configurations.

           (a)This completes the "Aggregation, Pooling, and Valuation" lab.  In the next lab, "Adding
             New Datasets & Independent Study", we will add the necessary data to do a
             metropolitan scale analysis of Detroit. After adding the new datasets, we will use our
             new configurations (from Sections 5 and 6) to create health incidence and valuation
             results for  our new domain.

A.1.7   Section 7. Adding New Datasets & Independent Study

           In this section, you will add new datasets to BenMAP and run a local-scale benefit analysis
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           in Detroit, Michigan.

           BenMAP contains pre-loaded data necessary to perform a health impact assessment that
           will meet most users' analytical needs. However, you can also import your own datasets
           into BenMAP when the pre-loaded datasets are not adequate for your analysis. For
           example, you can add new population datasets, new grid definitions, new health impact
           and valuation functions, and new background incidence rates for specific health endpoints.
           If you decide to conduct either a local-scale analysis or a non-U.S. analysis, you will likely
           need to add new datasets to model the benefits and adequately reflect those local factors. In
           other words, the U.S. national datasets may not be the best available data or functions for
           your study.

           In this section, you will add new datasets to conduct an entire benefit analysis for a change
           in air quality in the Detroit metropolitan area. Below are a few key aspects of the analysis:

           • Our model area is the greater Detroit metropolitan area, partially covering three counties:
             Wayne, Oakland, and Macomb.

           • The air quality grid cells are 1 km by 1 km.

           • The air quality model data are for 2020.

           • The control scenario models a 14.5 |ig/m3 annual PM2.5 standard for the core of the
             metropolitan region.

           Unlike our previous national studies, this lesson uses a finer-resolution grid,
           Detroit-specific population data, and Detroit-specific background incidence rates for
           hospital admissions due to asthma.

A.1.7.1 Example: Adding Datasets for Detroit

           The goal of this exercise is to add the necessary datasets so that we can conduct a
           local-scale analysis in Detroit. Specifically, we will add a new 1-km grid definition, a new
           population dataset for Detroit, and new background incidence for asthma hospital
           admissions for Detroit.

           Procedures:

           (a)From the  main BenMAP window, select "Modify Setup" from the Tools menu (Figure
             7-1).
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%Mmmimm
    Help
Air Quality Grid Aggregation
Model File Concatenator
Database Export
Database Import
Export Air Quality Grid
CIS/Mapping
Modify Setup
Neighbor File Creator
                           ! Use BenMAP: Which Analysis Meets your Needs?
                           juality data
                           jol to apply
                           fte a report.

                   r uuBtny ^nd
                 Preloaded
               EPA parameters
           Report
Custom Analysis
Step 1 — Import air quality data

  { '  ' " i.,'      Air Quality Grid Creallon


Step 2 — Set custom parameters
   i
  ' • ,          Incidence Estimation
                                              Step 3 — Use results from Step 2
                                              to set custom parameters
              Fooling, Aggregation
                 and Valuation
                                              Step 4 — Run report
                                                Report
                             Active Setup:
                        Figure 7-1. Choosing "Modify Setup'
  (b)This will open the Manage Setup window (Figure 7-2). Through this window, you can
     modify many of the datasets, parameters, and functions used in BenMAP. Specifically,
     you can add to or change any of the following 11 categories of data: grid definitions,
     pollutants, monitor datasets, incidence/prevalence datasets, population datasets, C-R
     function datasets, variable datasets, inflation datasets, valuation datasets, income growth
     adjustments, and QALY distribution datasets. To modify any one of these, you can click
     the Edit button below the appropriate list.
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H Manage Setup
  CMAQ 36km Nation Overlap
  CMAQ East 12krn
  CMAQ W 36km E 12km Partial Ov
  CMAQ West 12km
  I Cnuntu
                      Edit
                                PoPularits
                                Ozone
                                PM10
                                PM2.5
                                                                .Monitor DataSets
                                                                 EPA Standard Monitors
                                                                                  Edit
  i Incidence/Prevalence DataSels
   2000 Incidence and Prevalence
  12004 HA Incidence Detroit
   2005 Mortality Incidence
   2010 Mortality Incidence
   2015 Mortality Incidence
  I ?f1?n Mnrtfllitu Ihfiiriftmr*
                      Edit
                                Population DataSek
                                United Stales Census • County
                                United Slates Census - CMAQ 3tt
                                CMAQ East 12km
                                Woods ArwIPoote
                                CMAQ W 36km E 12km Paifel Ov
                               C-R Function DataSeSs
                               Complete Version2
                                                                                   Edit
                                                                 Valuation DaiiaSets              )
                                                                 E PA S tandard Valuation Functions   I
j Variable DataSets
iEPA Standard Variables
Inflation OataSets
EPA Standard lnfla»«s
                      Edit
                                                                                   Edit
  |i Income Growth Adjustments
  I Income Elasticity (3/21/2007)
                      Edit
                                QALY Dis&inrton DataSe*s
                                AMI DR OZ
                                AMIDR3X
                                AMI DR 7%
                                AMILE DR 02
                                AMIL£ DR 3%
                                                    E*
                                                                       Cancel
                                                                                    OK
                             Figure 7-2. Manage Setup window
 (c)We will start by adding a new grid definition. Click Edit below the Grid Definitions
    list. This will open the Manage Grid Definitions window (Figure 7-3). Here you can add
    new grid definitions or you can delete or edit existing grid definitions.
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               Manage Grid Definitions
                "Available Grid Definitions

                 CMAQ 36km Nation Oveilap
                 CMAQ East 12km
                 CMAQ W 36km E 12km Parti
Add
     ^_   GM Type;
                                          Sbapeiife
                   Delete
Edit
                                             Cancel
                          OK
                   Figure 7-3. Manage Grid Definitions window
 Tip: You can use the Edit button to view other grid definitions. Simply highlight the
 particular grid in the Available Grid Definitions list and click Edit. Make sure you do not
 accidentally save any changes while you are viewing the definition. You can use this
 same technique to view other datasets that have already been loaded (e.g., "Pollutants").
(d)We will add a new grid definition for Detroit. In the Manage Grid Definitions window,
   click the Add button. This will open a Grid Definition window (Figure 7-4). Here we
   can define our new grid.

        Note: When adding a series of new datasets, you should generally load the new
        grid definition first. Adding other datasets (e.g. adding population data) will
        typically depend on the new grid definition.
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ii Grid Definition
Grid ID:
JGridDefinitionO
Shapefile Grid Regular Grid | Regular Grid Visard f
Columns; Rows:
Minimum Longitude; M inimum Latitude
I o i o
Columns Per Longitude: Rows Per Latitude:
Preview ;




^^^^^^^^^^•jUItBl







Cancel 1 OK 1

                       Figure 7-4. Grid Definition window
(e)We will define the new grid based on an ESRI shapefile. First, we will set the name of
  the new grid. Edit the Grid ID field by changing the text to "Detroit CMAQ 1km".

       Next we load our shapefile. Click the "Shapefile Grid" tab. Next to the Load
       Shapefile field, click the browse button. Under the folder "Inputs" and the
       subfolder "Detroit", select the file "Detroit_grid.shp" and click Open. This will
       return you to the Grid Definition window.

       Click Preview to view your new grid (Figure 7-5).
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   Grid Definition
 Grid ID:
 jDetroitCMAQIkm

 Shapefile Grid j Regular Grid | Regular Grid Wizard',

 Load Shapefile;
 p:\lanMAMenMAP_Net\lnpuls\Oetot\
                          Preview  1
                                                            Cancel
OK
         Figure 7-5. Loading and previewing the Detroit CMAQ 1km grid
(f) Click OK. This will return you to the Manage Grid Definitions window. Scroll through
   the list of available grid definitions to confirm that your new grid is included then click
   OK. This will return you to the Manage Setup window. Note: It may take a minute or
   two to complete the loading of the new grid (indicated by the Manage Setup window
   becoming active again).

       Confirm that the new definition is in the Manage Setup window's grid definitions
       list. If it is, then you have successfully added a new grid definition.

(g)Next we will add a new background incidence rates dataset. This new dataset will have
   specific rates for Detroit instead of national averages. However, for the purposes of this
   lesson, the dataset will include only the "HA, Asthma" endpoint.  Click Edit below the
   Incidence/Prevalence DataSets list. This will open the Manage Incidence DataSets
   window (Figure 7-6). Here you can add new background incidence rates datasets or you
   can delete or edit existing background incidence rates datasets.
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            II. Manage. Incidence DataSets
             Available DataSets
             2000 1 ncidence and Prev
             2004 HA Incidence Detroit
             2005 Mortality Incidence
             2010 Mortality Incidence
             2015 Mortality Incidence
             2020 Mortality Incidence
             2025 Mortality Incidence
             2030 Mortality Incidence
             2035 Mortality Incidence
     •*•   DataSet Incidence Rates:
           Endpoint Group    Endpoint
                                                1
          iMotiaBy
                Mortality, All Cause  Inc
           Mortaiy
           Moteify
           Mortdiy
                Mortality, Cardiopulm ln(
                Mortality, Chronic Lu ln<
                Mortality, Lung Cane ln<
                Mortality, Non-Acoidi Inn
Aoule MjNjcaclal InJ Acule Myoeardial Inflni
HospialAdwiissbre, HA, All Cardiovascul In^'
                Delete
Add
                              Edit
                                                        Cancel
                                        OK
                    Figure 7-6. Manage Incidence DataSets window
(h)Click the Add button. This will open an Incidence DataSet Definition window (Figure
   7-7) that we will use to define our new background incidence rates dataset.
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S Incidence DataSet Definition
DataSet Name:
JlncidenceDataSet 0
DataSet Incidence Rates:
jEndpoint Group Endpoint Tjipe
J 4 1 1- j
Load From Database Delete



^^^^^^^^^KJuMl
GridDeMSore
J
rr— --y--^^
J

Cancel OK

                Figure 7-7. Incidence DataSet Definition window
(i) Edit the DataSet Name field by changing the text to "2004 HA Incidence Detroit". Click
  the Load From Database button. This will open a Load Incidence/Prevalence DataSets
  window. Using the Grid Definition drop-down menu, select the "Detroit CMAQ 1km"
  grid definition (Figure 7-8).
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 [&•;•'. ;-<.*•'-v*VrJ  •-;,•;••; ^:.^>.^>vr.y.,;•..;:•;'  /:>&y -jnj

   D ataS et N ame:                          Grid Definftionc
   [2004 HA Incidence Detroit
                                                            ^
   DataSet Incidenci
   Endpoint Group
Load Incidenee/Prevalence Database
                 Grid Definition.
                 [Detroit CMAO 1km
                 Database;
                                                      "B'iowi'e"
                                           Cancel
                                        OK
       Load From Database
            Delete
                                                         Cancel
                                                     OK
             Figure 7-8. Load Incidence/Prevalence Database window
(j) Next to the Database field, click Browse. In the new Open window, set the Files of type
  to "Excel Files". Under the folder "Inputs" and the subfolder "Detroit", select the file
  "background_incidence_Detroit" and click Open.

(k)This will open a Select a Table window. Here you will select the particular Excel sheet
  (within the Excel file) that contains the new background incidences rates data Using the
  drop-down menu, select "Sheetl$" (Figure 7-9)
'.; ;v -',;••••';-•
arid Definitid
Detroit CM/i
Database:
Z:\BenMAF




'/'•'-•• ! '''• :•- • •' ..!i • j'". ",'"•"'• ", ! <,;
Select a Table
Tables;
T 1
S ' :|-.-|-.-|-.-';|-.-|-.-:J
OK

i-arKei

L''i >'•,!„') <-. "" *'•'
•
"""""""Zl f

Browse


OK i

                        Figure 7-9. Select a Table window
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(1) Click OK. This will return you to the Load Incidence/Prevalence Database window.
   Click OK in that window to return to the Incidence Dataset Definitions window, where
   fields have now been filled in from the dataset you loaded. Explore some of the
   background incidence rates by highlighting various age ranges in the "DataSets
   Incidence Rates" panel and using the scrollbar in the right-hand panel (Figure 7-10).
  i»  Incidence DataSet Definition
   DataSetName:
Glid Definition:
J2004 HA Incidence Detroit
DataSet Incidence Rates:


E ndpoint G roup i E ndpoint
Type

H ospital Admissions, HA, Asthma Indder
H ospital Admissions, HA, Asthma Incider
Hospjtal Admissions, HA, Asthma loader
ll 	 	
Load From Database


Delete



J

*


CtAmn| Row (Value
J A

3
9 17 520547945205479E-6
9 16 5.2Q5479452Q5479E-6
9 20 4.931 50684931 507E-6
9 1 8, 4931 50694931 51 E-6
9 6 8.4931 50684931 51 E-6
3 5 8. 4931 50684931 51 E-6
9 4 8. 4931 50684931 51 E-6
9 3 8,4931 50684931 51 E-6
3 2 8. 4931 50684931 51 E-6 v
Cancel

OK


    Figure 7-10. Loading and viewing the Detroit background incidence rates
(m)Click OK. This will return you to the Manage Incidence DataSets window. Scroll
  through the list of available datasets to confirm that your new background incidence
  rates dataset is included, then click OK. This will return you to the Manage Setup
  window. Note: It may take a minute or two to complete the loading of the new dataset
  (indicated by the Manage Setup window becoming active again).

  Confirm that the new dataset is in the Manage Setup window's incidence/prevalence
  datasets list. If it is, then you have successfully added a new background incidence rates
  dataset.

(n)Next we will add a new population dataset. This new dataset will have more specific
  population information for the Detroit area than the national datasets. Click Edit below
  the Population DataSets list. This will open the Manage Population DataSets window
  (Figure 7-11). Here you can add new population  datasets or you can delete (but not edit)
  existing population datasets.
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       Note: The population datasets are relatively large, so it may take a few minutes to
       display each of the windows discussed here.
H Manage Population DataSets
'Available DataSets !
| U nited S tates Census - County |
United States Census - CMAQ 3E
CMAQ East 12km
Woods And Poole
CMAQ W 36km E 12km Partial 0
CMAQ West 12km
j Delete i| Add |

GridDeMtion:
^^•jUtfl

Population Configwation:
1 •
Values;
Race
IASIAN
ASIAN
ASIAN
ASIAN
ACIAkl 	

iendsr AgeRJ *
FEMALE OTOO1
FEMALE 1T04
FEMALE 5T09 '
FEMALE 10TO ^
... CCUAI c 1RTH ,
Cancel OK \
	 I
                Figure 7-11. Manage Population DataSets window
(o)Click the Add button. This will open a Load Population DataSet window (Figure 712).
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                 Population DataSet Name:
                 ]PopulationDataSet 0
                 Population Configuration:

                                 Defete
Add
View
                 Grid Definition:
                 Database:
                                                       Browse


                                            Cancel        OK
                  Figure 7-12. Load Population DataSet window
(p)Edit the Population DataSet Name field by changing the text to "Detroit CMAQ 1km".
  In the Population Configuration field, use the drop-down menu to select "United States
  Census". For the Grid Definition field, use the drop-down menu to select "Detroit
  CMAQ 1km".
   Background: The "Population Configuration" defines the age range, race, and
   gender variables in your population database. It is critical that the definitions in the
   population configuration match those used in the development of the database.
(q)Next to the Database field, click the Browse button. In the new Open window, set the
  Files of type to "Text Files". Under the folder "Inputs" and the subfolder "Detroit",
  select the file "Detroit_Pop" and click Open. This will return you to the Load
  Population DataSet window (Figure 7-13).
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                 Load Population DataSet
                 Population DataSet Name:
                  DetroicMAokni
                 Population Configurafan:
                                                              d
Oitel*
                                              Add
View
                 Grid Definition;
                  DetraitCMAQ1km
                 Database:
                 |Z: \B enM AP\B enMAPJles\lnpute\Detrott\De>roit_ C'|irgg||'I]|
                                             Caned
                         OK
     Figure 7-13. Setting the population configuration and the grid definition
(r) Click OK. A Progress window will appear. It will take a few minutes to load the
   population dataset. When it is loaded, you will be returned to the Manage Population
   DataSets window, where the fields have now been filled in from the dataset you loaded.
   Explore your new population dataset by highlighting "Detroit CMAQ 1km" in the
   Available DataSets list and using the horizontal and vertical  scrollbars on the right-hand
   panel (Figure 7-14).
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•!fe,Man3ge Population DataSets

Available DataSets
United States Census - County
United States Census - CMAQ 3E
CMAQ East 12km
Woods And Poole
CMAQ W 36km E 12km Partial 0
CMAQ West 12km
• i*fteiEiSi31;ta : '--y \1











Delete I Add I


Grid Definition:
\






Population Configuration:

Values:
Ifiaoe

BLACK
BLACK
BLACK
BLACK
BLACK
BLACK
NATAMER
NATAMER
NATAMER
NATAMER
NATAMER
| 4 i



Gender

FEMALE
FEMALE
FEMALE
FEMALE
FEMALE
FEMALE
MALE
MALE
MALE
MALE
MALE




Ageftanje

351033
401 044
451049
50T054
55T059
60T064
0100
1T04
5T09
10T014
251029




Column , Row *

34 48
34 48
34 48
34 48
34 48
34 48 >, ;
34 48
34 48
34 48
34 48
34 48
>

Cancel OK
	 	 J
         Figure 7-14. Loading and viewing the Detroit population dataset
(s)Click OK. This will return you to theManage Setup window. Note: It may take a
  minute or two to complete the loading of the new dataset (indicated by theManage
  Setup window becoming active again). Confirm that the new dataset is in theManage
  Setup window's population datasets list. If it is, then you have successfully added a new
  population dataset.

(t) You have now finished adding the necessary datasets for our Detroit study. From the
  Manage Setup window, click OK. This will return you to the main BenMAP window.


Analysis:

The rest of Section 7.2 focuses on analyzing one of the new datasets for Detroit.


(a)We will focus on the new population data for Detroit. Using the "Tools" menu in the
  main BenMAP window, open a BenMAP GIS window. Open the "Population" dataset
  (Figure 7-15).
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                                    Z   Abere Equal Area Canto  -H  - Reference Layer -
 Air Quality Grid (*.aqg)
 APV Configuration Results (*,apvr)
 Configuration Results (*.cfgr)
 Modeling Data
 Monitors
 Population
                                                                               Close
                       Figure 7-15. Mapping population data
(b)This will open a Select Population Data window. Using the drop-down menus, select
   "Detroit CMAQ 1km" as the population dataset and 2020 as the population year (Figure
   7-16). Click OK. A Progress window will appear. It may take a few minutes for your
   population data layer to appear in the "Layers" panel.
                            Select Population Data
                          Population DataSet
                          petroit CMAQ 1 km
                          Population Year;
                                       Caned
OK
                    Figure 7-16. Select Population Data window
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(c)Display the population data for African-American females, ages 30 to 34
  (B_F_30TO34).

       Select the "Detroit CMAQ 1km" as the reference layer. Now, change the reference
       layer to the county grid. This will automatically zoom out to the national domain.
       Zoom back in to the Detroit area (Figure 7-17).
                                                               Detroit
                                                              Study Area
                        Figure 7-17. Detroit study area
 Background: The following are example demographic codes in the Detroit dataset:
 N_M_40TO44 = Native American male 40 to 44 years; B_F_50TO54 =
 African-American female 50 to 54 years; A_M_60TO64 = Asian-American male 60
 to 64 years; W_F_50TO54 = white female 50 to 54 years; O_M_1TO4 = other male
 1 to 4 years.
(d)Exercise (7.1): Compare the different demographics from the Detroit population
  dataset. How does the spatial pattern of African-American females 30 to 34 differ from
  the spatial pattern of white females 30 to 34?
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                Answer:
A.1.7.2 Independent Study: Detroit Benefits Analysis
           The goal of this exercise is to model the health effects and the subsequent monetized
           benefits of a change in air pollution (PM2.5 concentrations) for the Detroit region.

           Procedures:

           The following steps should be thought of as general guidance on how to complete the
           Detroit benefit analysis. Unlike the earlier labs, this lab does not give detailed instructions
           on how to complete each stage of the model run and analysis for the Detroit study. If
           needed, you may refer to previous labs for more detailed instructions on specific steps.


              (a) Create a baseline and control aqg from the corresponding model data. You will
                  find two model datasets in the "Detroit" subfolder under the  "Inputs" folder. Both
                  datasets are for the 2020 model year and are on the "Detroit CMAQ 1km" grid.
                  The control scenario has some areas reduced to 14.5 |ig/m3 annual average PM25
                  concentrations. Be sure to clearly name your files so that you know which file is
                  the control and which is the baseline.

              (b) Open and modify the health incidence configuration created  in Section 5. Change
                  the population dataset to your new Detroit population dataset. Change the baseline
                  and control to your Detroit baseline and control.

                  Add a new function for the "HA, Asthma" endpoint (no threshold). Set the new
                  "HA, Asthma" function's incidence rate to the Detroit-specific background
                  incidence rates dataset. Save a new health incidence configuration and create  a
                  results file.

              (c) Re-create the apv configuration (from Section 6) using your new Detroit health
                  incidence results. Because we are adding a new incidence endpoint, you will have
                  to start from scratch (see Figures 6-8, 6-19, 6-20, and 6-21 for reference). Include
                  the new "HA, Asthma" incidence result in your "Hospital Admission, Respiratory"
                  pooling.

                  In selecting the valuation function for "Hospital Admissions, Respiratory", take
                  into account your new age range for your pooled results (i.e., look at the age
                  ranges of the health impact functions that  make up the pooled result). Aggregate
                  your health incidence  and valuation results to the county level. Save the apv

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       configuration and create a results file. This completes the modeling portion of the
       Detroit study.
Analysis:

We provide a series of exercises to guide your analysis of the results from the Detroit
study.


   (a) Exercise (7.2): What pooling type did you use to combine "HA, Pneumonia",
       "HA, Asthma", and "HA, Chronic Lung Disease" together? Why?
     Answer:
   (b) Exercise (7.3): Compare the total adult population (30-99) from the mortality
       incidence to the demographic population (Exercise 7.1). How does the "total"
       population's spatial pattern differ from the patterns for the two demographics
       (African-American females ages 30 to 34 and white females ages 30 to 34)?
     Answer:
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(c)  Exercise (7.4): Why are the aggregated incidence results a significant
    underestimate of the total change in incidence for the three counties? Hint: look at
    the extent of the nonaggregated domain.
  Answer:
(d)  Exercise (7.5): What is the total (over the three counties) monetized value for
    avoided premature mortalities? What is the total monetized value for avoided
    acute respiratory symptoms? What are the total health incidence results for these
    two endpoints?
  Answer:
(e)  Exercise (7.6): Answer the following questions using the totals for each county:
    What are number of "Hospital Admissions, Respiratory" avoided? What are the
    number of "HA, Asthma" avoided? What is the background incidence for "HA,
    Asthma"?
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     Answer:
   (f)  Exercise (7.7): What is the total (summed over endpoints) monetized benefit for
       each county? Give the mean and confidence intervals (0.5th and 99.5th percentiles).
     Answer:
Synthesis Questions:

The following questions are meant to help you synthesize what you have learned as you
have worked through the entire body of BenMAP course material. They draw from
multiple labs and course slides.


   (a) Exercise (7.8): Would you expect the benefits to increase or decrease if you used a
       later population year? Why?
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  Answer:
(b)  Exercise (7.9): Would you expect the monetized benefits to be higher or lower if
    you used a later currency year? Why?
  Answer:
(c)  Exercise (7.10): Why might your results differ if you used a national incidence
    baseline instead of a local incidence baseline for the "HA, Asthma" endpoint?
  Answer:
(d)  Exercise (7.11): If some of the health incidence results extended beyond the
    analysis year (in our case, 2020), should we discount these monetized benefits?
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  Answer:
(e)  Exercise (7.12): Unlike in our configuration, EPA generally uses more than one
    study to model adult mortality. They also do not tend to pool their mortality
    results. Why might you not want to pool adult mortality and instead report a range
    for your incidence results?
  Answer:
(f)  Exercise (7.13): Is BenMAP better suited to perform national (large-scale)
    analyses or local (urban-scale) analyses? Why?
  Answer:
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(g)  Exercise (7.14): What are some of the benefits of reducing air pollution that
    BenMAP does not currently quantify?
  Answer:
(h)  Exercise (7.15): Do you think that valuation estimates would be higher if we used
    willingness-to-pay (WTP) studies or cost-of-illness (COI) studies?
  Answer:
(i)  Exercise (7.16): What are some of the sources of uncertainty in a BenMAP
    analysis?
  Answer:
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A.1.8   Answers to Training Exercises


        Section 2 Answers

        (2.1)   D24HourMean = 10.56 |ig/m3; QuarterlyMean =10.44 |ig/m3; 1 at/1 on = (47.35, -68.32).

        (2.2)   States of Alabama, California, Georgia, Illinois, Michigan, Pennsylvania, Ohio,
               Tennessee

        (2.3)   QuarterlyMean maximum = 28.32 |ig/m3; minimum = 2.76 |ig/m3

        (2.4)   DSHourMax maximum = 67.68 ppb; minimum = 17.19 ppb
               States of Arizona, California, South Carolina, Tennessee, Utah.

        (2.5)   No, because the CMAQ grid is a regular grid, whereas the state and other political
               grids have irregular borders.

        (2.6)   States of California, Montana, Oregon.

        (2.7)   The age range is 30 to 99 years.

        (2.8)   States of California, Oregon, Pennsylvania, Washington.

        (2.9)   The number of acute respiratory symptoms avoided is much greater than the number
               of mortalities avoided.

        (2.10)  Because the health incidence values are a function of both delta and population.
               Therefore, a high delta in a low population area will still have a small health incidence
               change. In contrast, a relatively low delta in a high population area may have a large
               health incidence change—in other words, significantly fewer people having that health
               incidence.

        (2.11)  Incidence of mortality: 213; incidence of acute respiratory symptoms: 188,303.
               Valuation of mortality: $1.4 billion; valuation of morbidity $66 million.
               This means that even though there are far fewer mortalities, they are valued at a much
               higher rate than the morbidity incidences (as one would expect).

        (2.12)  Population year 2020.
               CMAQ 36 km

        (2.13)  0-17 years.
               Norris,  G., et al.

        Section 3 Answers

        (3.1)   States of Arizona, California, Idaho, Maryland, Montana, Nevada, Ohio, Oregon,
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       Pennsylvania, Utah, Washington, West Virginia, Wyoming.

(3.2)   No, because the C-R functions are based on deltas and population. The human
       population in the ocean is 0, so both the incidence and valuation over the ocean will be
       0.

(3.3)   Initially: County, State, Report_regions, and Nation grids.
       After setting Incidence to State, grids at the same scale or coarser are then available.

(3.4)   endpoint = Mortality, All Cause
       author = Pope et al.
       incidence aggregation = valuation aggregation = County

(3.5)   The CMAQ 36km Nation Overlap grid.
       Because aggregation occurs in the valuation step, the aggregated health incidence data
       is in the apvr file, not the cfgr file.

(3.6)   States of California, Washington, Oregon, Utah, Michigan, Ohio, Pennsylvania, New
       Jersey, New York,  Maryland,  and Virginia.

(3.7)   The County grid.

(3.8)   State code = 6, FIPS code = 37 (Los Angeles County); avoided mortalities = 132.76

(3.9)   health incidence maximum = 66.68; sum = 1707.67
       pooled incidence maximum =  132.76; sum = 1707.67

(3.10)  State code = 6, FIPS code = 37 (Los Angeles County); mortality = $876 million;
       morbidity = $38 million
       National mortality: $11.27 billion; National morbidity: $403 million.

(3.11)  For col 1, row 9, mortality has the greatest standard deviation = 247,031
       Chronic bronchitis has the greatest coefficient of variation = 16.587/13,520 = 1.23

(3.12)  The delta for the 14/35 analysis is significantly larger. For example, a larger portion
       of the states have more than 0.2 |ig/m3difference.

 (3.13) Illinois: 227 mortality for 14/35 scenario, 3.75 mortality for 15/35 scenario.
       California: 559 mortality for 14/35 scenario, 573 mortality for 15/35 scenario.
       Overall, the 14/35 scenario has more states showing significant numbers of avoided
       mortalities, especially in the East, whereas the 15/35 scenario has some western states
       with slightly greater reductions (e.g., California, Oregon, Washington). Total number
       of mortalities avoided for the lower 48 states is 4,787 for the 14/35 scenario and  1,707
       for the 15/35 scenario.

(3.14)  California: $3.69 billion saved in prevented mortality, $147 million saved in prevented
       morbidity.
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       Illinois: $1.5 billion saved in prevented mortality, $50 million saved in prevented
       morbidity.
       $31.6 billion mortality and $1.1 billion morbidity for the 14/35 scenario versus $11.2
       billion mortality and $403 million morbidity for the 15/35  scenario. In other words,
       our intuition was correct that the 14/35 scenario had higher benefits than the 15/35
       scenario.


Section 4 Answers

(4.1)   The adjusted aqg's have no values greater than 15 |ig/m3. In comparison, the
       non-adjusted aqg's do have regions with annual values greater than 15 |ig/m3.

(4.2)   The VNA AQG is much smoother, because it uses distance weighting to smooth the
       AQG between monitor locations.

(4.3)   Neighbor scaling type = inverse distance;
       Rollback region = California (6), Oregon (41), Pennsylvania (42), and Washington
       (53);
       Rollback method = percentage, the percentage of rollback = 0.1 (i.e.  10%)

(4.4)   California, Ohio, West Virginia, Maryland, Georgia, and Alabama.

(4.5)   Region 1: using peak shaving for inter and intraday rollback. Rolling back to a
       standard (attainment test) of 35 |ig/m3 on the D24HourMean metric and an ordinality
       ofl.
       Region2:  using incremental rollback, reducing all monitors by an increment of 4 |ig/m3
(4.6)   The Western states have a generally constant delta. This makes sense because we
       applied an incremental change (a constant reduction) to all the monitors in the region.
       In contrast, the East Coast has been reduced to a standard. Therefore, only areas that
       were over the standard (35 |ig/m3 daily mean) will be reduced. We see that the most
       significant changes are in Pennsylvania and to a lesser degree in Georgia.
       If we look at the eastern edge of the West coast states, we notice that the delta is not
       constant across each state. Initially, we might expect the deltas to be constant across
       the state, because we applied an incremental change to all the monitors. However, the
       AQG is the result of interpolating from the monitors to the grid cells. Therefore, on
       the eastern edge we are interpolating between monitors that did have a rollback and
       those areas that had no change.


Section 5 Answers

(5.1)   QuarterlyMean maximum = 1.67 |ig/m3.
       QuarterlyMean mean = 0.11 |ig/m3 (misleading because includes model domain over
       the ocean).
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       Washington, California, Oregon, Georgia, Pennsylvania, West Virginia.

(5.2)   Two functions.
       Both functions are by Norris.
       Differences include a qualifier (10 |ig/m3 threshold), Beta and PIBeta (standard
       deviation), and C (C=10 for the threshold function).

(5.3)   Endpoint: "HA, Chronic Lung Disease (less Asthma)". "HA, Chronic Lung Disease",
       HA, Pneumonia", "HA, Asthma".
       Four functions: two by Ito and two by Moolgavkar.

(5.4)   Pope.
       Three functions are by Pope.
       The three functions have different thresholds (0, 7.5, and 10 |ig/m3).
       The current configuration uses the 0 |ig/m3 threshold Pope function.

(5.5)   Pope age range 30-99 years, Woodruff age range 0-0 years.

                       1	—— IxIncxPop
       Pope function = ^   e   '

                            !-/,   r  x RAO . r   \xIncxPop
       Woodruff function =  ^   ^

(5.6)   Ito and Moolgavkar have the same functional form.
       Ito'sp = 0.001169.
       Moolgavkar's p = 0.00183.
       Bonus: Moolgavkar is more sensitive to changes in AQ. An equal change in AQ will
       result in a larger change in the health incidence from Moolgavkar's function compared
                                                                         1
       to Ito's function.  Mathematically, the larger p, the smaller the value of e    , and
       hence the larger the value of the whole function.

(5.7)   Population year = 2020.
       12 Concentration-Response (C-R) functions.
       Woodruff location is 86 cities and incidence dataset is 2020 Mortality Incidence Rates

(5.8)   Pope maximum = 66.78 premature deaths (ages 30-99) avoided.
       Woodruff maximum = 0.15 premature deaths (infant) avoided.
       Similar but not the exact same spatial patterns.

(5.9)   Ito maximum = 3.01.
       Moolgavkar maximum = 4.73.
       Moolgavkar population is the same as the Ito population.
       They have identical inputs.  The only difference between the two functions is the P;
       therefore, the Moolgavkar study is more sensitive to changes in AQ.
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(5.10)  AMI18 maximum = 3.63, population maximum = 2,434,707.
       AMI65 maximum = 65.36, population maximum = 988,819.
       Although the population for the 18-44 group is much greater than the population for
       the 65-99 group and the functions are the same, the incidence results are much smaller
       for the 18-44 age group. This implies that the incidence rate for younger group is
       much smaller than the incidence rate for the older group. This result reflects our
       intuition.

(5.11)  baseline = 5,452.946.
       point estimate = 4.7457.
       5thpercentile = 4.0085.
       95thpercentile = 5.4827.

(5.12)  QuarterlyMean maximum = 4.56 |ig/m3.
       QuarterlyMean mean = 0.32 |ig/m3.
       California, Washington, Oregon, Idaho, Wyoming, Montana, Utah, Pennsylvania,
       West Virginia.
       Compared to Exercise 5.1, the adjusted control has much larger AQ delta values and
       larger geographic areas of significant delta, especially in the West.
       The adjusted scenario should have a significantly larger change in adverse health
       effects because it has a significantly larger change in AQ.

(5.13)  Population year = 2020.
       12 CR functions.
       Number of Latin Hypercube Points =10.

(5.14)  Pope maximum = 196.13.
       Woodruff maximum = 0.52.
       The adjusted results are greater than the nonadjusted results.

(5.15)  AMI18 maximum = 11.13, population maximum = 2,434,707.
       AMI65 maximum = 189.75, population maximum = 988,819.
       The adjusted results are greater than the nonadjusted results. The adjusted population
       is equal to the nonadjusted population. There was also a change in spatial pattern. For
       the adjusted results, most of the significant results are in the West.

(5.16)  baseline = 5452.946.
       point estimate = 11.302.
       5thpercentile = 9.5474.
       95th percentile = 13.0561.
       The adjusted baseline equals the nonadjusted baseline. The adjusted mean is greater
       than the nonadjusted mean. The adjusted statistical spread and values are greater than
       the nonadjusted statistical spread and values.
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Section 6 Answers

(6.1)   Sum (Dependent) because the health incidence populations are nonoverlapping
       (distinct age groups).

(6.2)   We used Sum (Dependent) because the four AMI valuation results are for
       nonoverlapping populations (distinct age groups).

(6.3)   Income growth adjustment year = 2020.
       HA pooling and mortality pooling both use Sum (Dependent).
       HA Chronic Lung Disease pooling uses Random / Fixed Effects, with advanced
       pooling using round weight to two digits.
       ER endpoint group  valuation pooling = Subjective Weights
       AMI endpoint group valuation pooling = Sum (Dependent)
       Population year = 2020.

(6.4)   California mortalities = 560, acute respiratory symptoms = 503,139.
       Pennsylvania mortalities = 342, acute respiratory symptoms = 184,340.
       Illinois mortalities = 227, acute respiratory symptoms = 163,566.

(6.5)   AMI18 maximum = 30.
       AMI65 maximum = 555.

6.6)    California acute respiratory = $25.4 million, morbidity = $289.6 million,
       mortality =  $3.7 billion.
       Pennsylvania acute respiratory = $9.3 million, morbidity = $141.6 million,
       mortality =  $2.3 billion.
       Illinois acute respiratory =  $8.3 million, morbidity = $106.1 million,
       mortality =  $1.5 billion.
       The mortality incidence numbers are far smaller than the acute respiratory symptom
       numbers, but the mortality valuation is far greater than the acute respiratory valuation.
       Therefore, the mortality valuation function (VSL) must be much larger than the acute
       respiratory symptoms function.

(6.7)   AMI point estimate = $79.3 million.
       0.5th percentile = $14.6 million.
       99.5th percentile = $193.5 million.

(6.8)   Population year = 2020.
       Smith subjective weight = 0.60, Standford subjective weight = 0.40.

(6.9)   California mortalities = 2,295, acute respiratory symptoms = 2.1 million.
       Pennsylvania mortalities = 365, acute respiratory symptoms = 196,460.
       Illinois mortalities = 231, acute respiratory symptoms = 166,252.
       The adjusted health incidence results are greater than the nonadjusted results,
       especially in the West.
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6.10)  California acute respiratory = $107.2 million, morbidity = $1.19 billion,
       mortality = $15.15 billion.
       Pennsylvania acute respiratory. = $9.9 million, morbidity = $151 million,
       mortality = $2.41 billion.
       Illinois acute respiratory = $8.4 million, morbidity = $108 million,
       mortality = $1.53 billion.
       The adjusted valuation results are greater than the nonadjusted results, especially in
       the West.

(6.11)  AMI point estimate = $320 million.
       0.5th percentile = $59.7 million.
       99.5th percentile = $772 million.
       The adjusted mean is greater than the nonadjusted mean. The adjusted statistical
       spread and values are greater than the nonadjusted statistical spread and values.

Section 7 Answers

(7.1)   African-American females age 30-34 are concentrated in the central and eastern band
       of our domain (Northern Wayne Co.). White females age 30-34 are more concentrated
       in the northern (southern Oakland and Macomb Co.) and southwestern (central Wayne
       Co.) parts of our domain.

(7.2)   We used sum (dependent) to combine together the various "HA" endpoints. We used
       random/fixed effects to combine together the Ito and Moolgavkar "HA, Chronic Lung
       Disease" results into one result. The sum (dependent) pooling makes sense for the
       three endpoints because the populations are distinct, nonoverlapping. On the other
       hand, the two "HA, Chronic Lung Disease" results are for an overlapping population;
       therefore, the random/fixed effects pooling is appropriate.

(7.3)   The spatial pattern of total adult population is more spatially homogeneous than the
       pattern of the demographic data. It appears to be more similar to the combination of
       the African-American female and white female spatial patterns than to either of the
       individual demographic patterns.

(7.4)   The aggregated incidence results are a significant underestimate of the total change in
       incidence for the three counties because the "Detroit CMAQ 1km" grid does not cover
       the entire spatial extent of the three counties. In other words, we are characterizing the
       whole county's incidence change based on a subset of the county, i.e., based on a
       subset of the population.

(7.5)   Total monetized mortality benefit = $1.75 billion
       Total monetized acute respiratory symptoms benefit = $8.64 million
       Total mortality incidence results = 264
       Total acute respiratory symptoms results = 170,868

(7.6)   Macomb (FIPS 99):"HA, Respiratory " = 9.4, "HA, Asthma" = 0.85, "HA, Asthma"

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       baseline = 201.3
       Oakland (FIPS 125): "HA, Respiratory " = 35.6, "HA, Asthma" = 3.77, "HA, Asthma"
       baseline = 608.3
       Wayne (FIPS 163): "HA, Respiratory " = 115.0, "HA, Asthma" = 36.5, "HA, Asthma"
       baseline = 3,954.3

(7.7)   Macomb (FIPS 99) total monetized benefit: mean = $119 million, 0.5th = -$7.68
       million, 99.5th = $347 million
       Oakland (FIPS 125) total monetized benefit: mean = $464 million, 0.5th = -$29.2
       million, 99.5* = $1.37 billion
       Wayne (FIPS 163) total monetized benefit: mean = $1.28 billion, 0.5th = -$81.1
       million, 99.5th = $3.75 billion

(7.8)   For most areas, a later population year would mean a greater population. Because most
       of the health impact functions are proportional to population, a greater population
       would mean a greater benefit.

(7.9)   A later currency year would generally mean that the monetized benefits would be
       higher. The later the currency year, generally the greater the inflation, and hence the
       less the purchasing power of an individual dollar.  Therefore, the same benefit in a
       later currency year would equal a greater number of dollars.

(7.10)  A national background incidence rate would not reflect the local incidence rates for
       specific health endpoints. A local background incidence rate would likely more closely
       reflect the local population characteristics than the national average. The background
       incidence rates are an important variable in the underlying health impact function.

(7.11)  The AMI functions calculate a change in benefits beyond 2020. The AMI results are
       for five years of medical costs and five years of opportunity costs. Because these costs
       span five years (2020-2025), the benefits should be discounted back to 2020. We use a
       discount rate to reflect our tendency to value future costs less than present costs. In
       other words, if the combined costs were incurred only in 2020, we would value these
       costs more than if these same costs were spread over five later years.

(7.12)  By not pooling their adult mortality results, EPA is reporting a range of reasonable
       results. You can think of the different mortality results as spanning the minimum to
       maximum estimations of the health incidence results. In other words, a range provides
       a window between the worst- and best-case scenarios.

(7.13)  It depends. If you use only the national and regional-level health data pre-loaded in
       BenMAP,  it is better suited for national-scale analyses. Most of the input datasets have
       been developed with a national or at least regional perspective. For example, many of
       the health incidence functions were studied using large populations spread across
       multiple cities and states. As one goes to a more local scale, the default health
       incidence functions, valuation functions, and background incidence rates may become
       less and less representative of the local population. In addition, if the scale becomes
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               very small, then the populations become very small. If you have a small population,
               then the sample size may become problematic, which undermines the statistical
               functions used in BenMAP.
               In contrast, imagine that you are able to find high quality local health incidence
               functions, valuation functions, and background incidence rates for your particular
               study area. You would expect that BenMAP would give more representative results
               from these specific functions and datasets that have been "tuned" to your particular
               study area than it would for a national analysis.

        (7.14) BenMAP does not quantify the following benefits of reducing air pollution: improved
               ecosystem health, climatological benefits, improved visibility and consequentially
               improved aesthetics, and the reductions of pollution damages to infrastructure and
               buildings. However, with the addition of appropriate impact functions, it would be
               possible to use BenMAP to quantify these endpoints.

        (7.15) The valuation estimates would probably be higher if we used WTP functions instead
               of COI functions. COI functions do not include the cost of pain and suffering in the
               estimate of monetized value. WTP functions attempt to capture both COI and the cost
               of pain and suffering.

        (7.16) There are many sources of uncertainty in a human health benefit analysis. EPA has
               attempted to quantify some sources of uncertainty in BenMAP. For example, the
               uncertainty in the regression coefficients for the health impact functions and the
               underlying distribution are included in the valuation functions. Other uncertainties
               have not been quantified. For example, there is significant uncertainty in the baseline
               and control AQG, in the geographic variability of functions (i.e.,  which functions are
               really regional or local and do not translate to other areas), in the differences between
               personal exposure and outdoor pollution concentrations, and in the background
               incidence rates.

A.2    CityOne

           Below is a very simple tutorial using the CityOne setup available at the BenMAP website
           (http://www.epa.gov/air/benmap/). The tutorial is based on a hypothetical scenario where
           ambient PM2 5 concentrations are reduced by 25 percent in 2003. The steps in this analysis
           are as follows:

           Step 1. Data Files Needed for Training
           Step 2. Create Air Quality Grids for the Baseline & Control Scenario
           Step 3. Specify Configuration Settings
           Step 4. Select Health Impact Functions
           Step 5. Specify Aggregation, Pooling and Valuation
           Step 6. Generate Reports
           Step 7. View Your Reports
           Step 8. Map Your Results
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           Each step is explained in detail below.
A.2.1   Step 1. Data Files Needed for Training

           To do this training you need to download the CityOne files from the BenMAP website:
           http://www.epa.gov/air/benmap/. The data are most easily accessible if loaded in using the
           Data Import tool, which is discussed in the here in the chapter on loading data.

A.2.2   Step 2. Create Air Quality Grids for the Baseline and Control Scenarios

           Click on the Create Air Quality Grids button to begin inputting the air quality data
           needed by BenMAP. This will open up the window where you will input the air quality
           data. In general, you need two air quality grids to conduct a benefit analysis, one for a
           baseline scenario and one for the policy you are evaluating (the control scenario). We will
           be creating  our baseline and control scenarios together, through the Monitor Rollback air
           quality grid creation method.
                                    Choose Grid Creation Method
                                    f* |Model Direct!

                                    C Monitor Direct

                                    C Monitor and Model Relative

                                    C Monitor Rollback

                                                    Cancel
Go!
           Select Monitor Rollback from the list and click on Go!

           This will take you to the Monitor Rolback Settings: (1) Select Monitors screen where
           you will enter the information about the air quality monitoring data you want to use.

           Choose PM2.5 from the Pollutant drop-down menu. On the Library tab, choose CityOne
           Monitors from the Monitor DataSet drop-down menu, and choose 2003 from the
           Monitor Library Year drop-down list. Finally, in the Rollback Grid Type choose
           Metropolitan Area.
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               - Monitor Rollback Settings:  ...
                  Pollutant:
                  JPM2.5
                 Library  Database, Columns |  Database, Rows |  Text File |

                  Monitor DataSet:
                  J City One Monitors
                  Monitor Library Year:
                  12003
                  Rollback Grid Type:
                  I Metropolitan Area
                                                 Cancel
Next
When your window looks like the window above, click Next.

This will take you to the Monitor Rolback Settings: (2) Select Rollback Regions and
Settings window where you will choose the type of rollback for the CityOne metropolitan
area.
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 • Monitor Rollback Settings: (2) Select Rollback Regions and Setti.
 Rollback Regions
   Select All    Deselect All
Add Region   Delete Region  |- Region to Delete -
                                                                       Export After Rollback
                                                                    Back
                                                                             Next
Click Add Region. This will bring up the Select Region Rollback Type window.
                        • Select Region ...
                         Rollback Type
                         (* Percentage Ro||backl
                         f~~ Incremental Rollback
                         <~ Rollback to a Standard
                                       Cancel

                       OK
In the Select Region Rollback Type window you may select from three rollback options.
Select the Percentage Rollback option as shown above.  Click OK.
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 « Monitor Rollback Settings:  (2) Select Rollback Regions and Setti... I
 Rollback Regions
     Region 1
  rRollback Parameters-
     Percent: p|
   Background: 0.00
*
                                      Q
                              Add Region   Delete Region   - Region to Delete -
   Select All    Deselect All
                                          Export After Rollback
                                                                   Back      Next
In the box of Rollback Parameters for Region 1, type 25 in the Percent box.  (This will
reduce each of the monitors in the CityOne area by 25 percent.)  Then click on the Select
All box.  When your window looks like the window above, click Next.

This will take you to the Monitor Rolback Settings: (3) Additional Grid Settings
window, the final step in creating rollback grids.

Choose the Voronoi Neighborhood Averaging interpolation method. Leave the scaling
method as None.  From the Grid Type drop-down list choose County. Leave the box
checked next to Make Baseline Grid (in addition to Control Grid). This option will
cause BenMAP to create a baseline scenario air quality grid using the monitors selected in
the previous step, but without rolling their values back.  BenMap will create a second grid
with the rolled back monitors, which will serve as our control scenario air quality grid.
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                - Monitor Rollback Settings: ...
                 Select Interpolation Method
                 C Closest Monitor

                 (• Voronoi Neighborhood Averaging

                 C Fixed Radius (km.) I
Select Scaling Method

f*  None


'• "  Spatial Only
                     Grid Type:
                               Make Baseline Grid (in addition to Control Grid).
Advanced
Back
Map
Go!
When your window looks like the window above, click Go!.

BenMAP will now prompt you to save the baseline air quality grid.  Make sure you are in
the Air Quality Grids subfolder in the BenMAP directory and then save the file as: PM2.5
CityOne County Baseline 2003 VNA.aqg (you do not have to enter the ".aqg" extension).
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   Save the baseline Grid.
      My Recent
      Documents
      Desktop
    My Documents


        :J
     My Computer
     My Network
       Places
          Save in:  o Air Quality Grids
                                              &• n-
File name:      |PM2.5 CityOne County Baseline 2003 VNA

Save as type:    I Air Quality Grids (x.aqg)
BenMAP will now prompt you to save the control air quality grid.  Again, make sure you
are in the Air Quality Grids subfolder in the BenMAP directory and then save the file as:
PM2.5 CityOne County 25 Pet Rollback 2003 VNA.aqg (you do not have to enter the
".aqg" extension).
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              Save  the rolled back Grid.
                     Save in:  _j Air Quality Grids
                My Recent
                Documents
                 Desktop
               My Documents
                My Computer
                  €;
                    _f
                My Network
                  Places
File name:      12.5 City 0 ne County 25 Pet R ollback 2003 VNA ^

Save as type:    I Air Quality Grids (x.aqg)•*
           BenMAP will now create baseline and control air quality grids that you can use in your
           benefit analysis.  When the progress bar is complete, BenMAP will return to the main
           BenMAP screen.

A.2.3   Step 3. Specify Configuration Settings

           On the main BenMAP screen, click on the Create and Run Configuration button. In the
           following box, select Create New Configuration and click Go!.
                                  Configuration Great.
                                 |>" jCreate New Configuration!

                                 C~ Open Existing Configuration
                                                                  Go!
                                                                 Cancel
           This will bring up the Configuration Settings form, where you will enter the basic
           information about your analysis before selecting the health effects you wish to estimate.
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In the Baseline File field, you can either enter the path for your baseline air quality grid, or
click Open. For this example, click Open and browse to the Air Quality Grids folder.
Select PM2.5 CityOne County Baseline 2003 VNA and click Open.

Next, click on Open next to the Control File field and select PM2.5 CityOne County 25
Pet Rollback 2003 VNA and click Open.

This specifies that you want to conduct a benefit analysis of the difference between the
baseline and control scenarios for which we created air quality grids in Step 2.

In the Settings section of this window, there are several fields which set the overall scope
of the analysis.

In the Population DataSet field, select CityOne Tract Population from the drop down
menu. This tells BenMAP that you want your analysis to use tract-level population data
from this dataset when calculating health impacts.

In the Population Year field,  enter 2005 or select 2005 from the drop down menu. This
tells BenMAP that you want your analysis to use 2005 populations when calculating health
impacts.

In the Latin Hypercube Points field, enter 10 or select 10 from the drop down menu.
This tells BenMAP that you want to estimate the percentiles of the distribution of health
endpoint incidence using Latin Hypercube Sampling with 10 percentiles of the distribution,
representing the 5th,  15th, 25th, and so on up to the 95th percentile.

Leave the Run in Point Mode box unchecked.

Leave the Threshold field blank. This tells BenMAP that you want to estimate benefits
associated with all changes in  PM2.5, regardless of where those changes occur along the
range of PM2.5 concentrations. Selecting a non-zero threshold means that you would only
want to calculate benefits for changes occurring above the threshold.
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 - Configuration Settings
  Select Air Quality Grids
   Baseline File:
   jCAPrograrn Files^BenMAP 3.0V\ir Quality Grids\PM2.5 CityOne County Baseline 2003 VNA.aqg
   Control File:	
   (CAPrograrn Files\BenMAP 3.0Wir Quality Grids\PM2.5 CityOne County 25 Pet Rollback 2003 VNA.aqg
                                                  Open
                                                            Create
                                                  Open
                                                            Create
                                                                              Map Grids
  Settings
   Latin Hypercube Points:
   Population DataSet:
    Population Year:
   |CityOne Tract Population
   Run In Point Mode:
   r
   Threshold:
j-j  12005
                                                                     Cancel
                                                                                           Next
When your window looks like the above, click Next.
This will bring up the next page of the Configuration Settings form, where you can select
health impact functions from a set of available health impact functions.
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            8 Configuration Settings
             Available CR Functions:
              Tree
                                                 Data
              DataSet
                          E ndpoint G roup   Endpoint
                                                 Metric
                                                             S easonal M etric   M etric S tatistic
                                                                                     Author
              + CilyOne Health h
             Selected CR Functions:
              Function Identification
                           Function Parameters
              DataSet   [ Endpoint
Race
      Ethnicity
              Gender
Start Age   End Age Incidence DataSet Prevalence Data... Variable DataSet
                                                                       Cancel
                                                                                Previous
                                                                                           Run
            (Note: This screen can be resized if you are having trouble seeing all of the information.
            Individual columns can also be resized. Just click on the border of a column and drag to
            increase or decrease its width.)

A.2.4  Step 4. Select Health Impact Functions

            In this screen, you can select health impact functions to use in your analysis.  For this
            example, we are going to estimate the change in incidence of three health endpoints
            associated with PM2.5: acute bronchitis, acute myocardial infarctions (heart attacks), and
            emergency room visits for asthma. To select a health impact function, you must drag it
            from the upper box (Available C-R Functions) in the window to the lower box (Selected
            C-R Functions). You can drag groups of health impact functions over, or drill down and
            drag over individual functions.

            For acute bronchitis, drill down until you see the function by the Author Dockery et al.
            Drag the function into the lower panel  of the window. You should see a new row with the
            Endpoint Group Acute Bronchitis.
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3 Configuration Settings
Available CR Functions:













Tree
DataSet | E ndpoint G roup
- CityOne Health h


Endpoint



Hospital Admissions.
Lower Respiratory S
Mortality
Work Loss Days
Hospital Admissions.
Acute Bronchitis
Acute Bronchitis
Data ^
Metric
















•••• 1 D24HourMean
'+ Ar
4

utfi MunnarHial In





1



Seasonal Metric








QuarterlyMean


Metric Statistic








Mean










Author













— 1










I Dockerji et al. ^IH




TJ
> |
Selected CR Functions:



Function Identification
DataSet | Endpoint
<

Function Parameters
Race j Ethnicity
Gender
Start Age
End Age
Incidence DataSet
Prevalence Data...
Cancel







Variable DataSet
Previous


Run




For acute myocardial infarctions (AMI), drag the entire Endpoint Group titled Acute
MyocardialInfarction to the lower panel (do not drill down).  This will include the full set
of age-specific health impact functions for AMI.

For asthma emergency room visits, also drag over the entire the Endpoint Group titled
Emergency Room Visits, Respiratory.

You should now have seven health impact functions listed in the lower panel: one acute
bronchitis function, five AMI functions, and one ER visit function.
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3 Configuration Settings
Available CR Functions:





















Tree
DataSet
















| Endpoint Group
Lower Respiratory S
Mortality
Work Loss Days
Hospital Admissions
Acute Bronchitis
Acute Myocardial In
Acute Respiratory S
Chronic Bronchitis
Endpoint
























Data ^
Metric
















Seasonal Metric








Metric Statistic

















Author
















•pat tEmeraencuRoomVI I 1 1 ^9
<










	 VT^









Selected CR Functions:
Function Identification
DataSet
CityOne He;
Endpoint
Acute Bro
CityOne He; Acute My
CityOne He; Acute My
CityOne He; Acute My
CityOne He; Acute My
CityOne He;
Citi

One He;

Acute My
Emergenc
Function Parameters
Race [Ethnicity
















Gender








Start Age
8
18
25
45
55
65
0

End Age
12
24
44
54
64
99
17

Incidence DataSet
CityOne Incidence e
CityOne Incidence c
CityOne Incidence =
CityOne Incidence c
CityOne Incidence c
CityOne Incidence i
CityOne Incidence c
Prevalence Data...







Cancel









Variable DataSet







Previous










>
Run



           BenMAP will then prompt you to save your file.  Click Save. Browse to the
           Configurations subfolder within the BenMAP directory and save the file as: PM25
           Example Configuration.cfg (you do not need to include the ".cfg" extension).

           When you have saved the configuration file, click OK to run the configuration.

           BenMAP will prompt you to "Save Configuration Results to File".  Browse to the
           Configuration Results subfolder within the BenMAP directory and  save the file as: PM2.5
           CityOne County 25 Pet Rollback 2003 VNA Example, cfgr (you do not need to include the
           ".cfgr" extension)

           Once you have entered the filename, BenMAP will begin calculating the change in
           incidence for the set of health impact functions you have selected.  The run may take a few
           minutes to finish; a progress bar will let you know how it is proceeding.  When BenMAP
           is finished running your configuration, it will return to the main BenMAP screen.

A.2.5   Step 5. Specify Aggregation, Pooling and Valuation

           This step allows you to take the incidence results that BenMAP just produced and place an
           economic valuation on them.  Although not covered in this tutorial, this is also where you
           can select the geographic level of aggregation and combine individual incidence results
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into pooling groups.

From the main screen, click on the Aggregation, Pooling and Valuation button. This
will bring up a menu screen with two choices: Create New Configuration for Aggregation,
Pooling and Valuation., or Open Existing Configuration for Aggregation, Pooling and
Valuation (*.apvfile).
           * APV Configuration Creation Method
             C" Create New Configuration for Aggregation, Pooling, and Valuation.

             C Open Existing Configuration file for Aggregation, Pooling, and Valuation (x.apv file).
                                                    Cancel
Go!
Select Create New Configuration for Aggregation, Pooling and Valuation and click on
Go!

BenMAP will prompt you to open a Configuration Results File.  Browse to the
Configuration Results subfolder and select PM2.5 CityOne County 25 Pet Rollback 2003
VNA Example.cfgr.  Then click on Open.
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          Look in:  ,_j Configuration Results
                 •*> City One County 25 Pet Rollback 2003 VNA Example.cfgr
      My Recent
      Documents
       Desktop
    My Documents
     My Computer

       €J
     My Network   File name:
       Places
                 Files of type:
Configuration Results f.cfgr)
BenMAP will then open the Incidence Pooling and Aggregation window with the results
from running your configuration.  You should see a window that looks like the following:
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 9 Incidence Pooling and Aggregation
  Available Incidence Results
      Acute Bronchitis
      Acute Myocardial Infarc
      Emergency Room Visits.
  1                 >

    Target Grid Type:
                       Select Pooling Methods
                        Pooling Window N ame:  Pooling Window 1
Endpoint Group  I Endpoint
Author
             Qualifier
L(j Pooling Method
                                                 --Window to Delete-
                                                                       Delete
                                                                                   Add
   Configuration Results File Name(s): |C:\Program FilesSBenMAP 3.0\Configuration Results\C%One County 25 Pet  T]    Browse
    Advanced
                                               Cancel
                                 Next
Click on each of the results groups (acute bronchitis, acute myocardial infarction, and
emergency room visits) and drag them to the right panel.

For this example, we are not pooling any of the incidence results (although we will pool
valuations in the next window), so just click on Next at the bottom of the window.

This will take you to the Select Valuation Methods, Pooling, and Aggregation window.
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 § Select Valuation Methods, Pooling, and Aggregation
  Valuation Methods
                     Variable DataSet:
  + CityQne Valuation Functioi
    Advanced
Pooling Window N ame: [ Pooling Window 1

            Endpoint       Author
Endpoint Group
Acute Bronchitis
Acute Myocardial In
                     Emergency RoomV
                                 Acute Myocardial Inl Peters et al.
                S kip QALY Weights
                                                          Qu=
                                                          is-;
                                                          25-4
                                                          45-E
                                                          55-E
                                                          65+
Valuation Method
-Select-

-Select-
-Select-
-Select-
"Select-
-Select-
-S elect-
                                              Pooling M ethod
                                                                         None
                                                         Cancel
                                                                  Previous
                                                                             Next
A) Select a value for acute bronchitis
To select a valuation method for acute bronchitis, drill down the Acute Bronchitis
valuation group until you see individual valuation methods.  Click on the WTP: 6 day
illness, CV studies   0-17 method and drag it onto the Acute Bronchitis endpoint group in
the right hand panel. You should see the method appear under acute bronchitis in the
Valuation Method column in the right hand panel.

B) Select values for acute myocardial infarctions (heart attacks)
To select valuation methods for acute myocardial  infarctions, drill down the AMI valuation
group until you see a (long) list of individual valuation methods.  You might find it easier
to expand the column width of the Valuation Methods column (drag the right hand edge of
the column to the right to make it wider).  We will be working with the valuation estimates
from two studies, Wittels and Russell.  For each of the studies, there are a number of age
specific valuations.  There are also two different discount rates (the  discount rate is the rate
at which future medical costs are discounted to the present). Drag the age-specific
valuation estimates from Wittels for the 3 percent discount rate (COI, 5 yrs med, 5 yrs
wages, 3% DR, Wittels (1990)  age) to each matching age-specific line in the right hand
panel (Pooling Window 1)
Low Age column.
You may have to scroll over in the right hand panel to see the
Note that you will need to drag some age-specific valuation estimates to multiple lines in
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the pooling window, since there is not a perfect match between the available age-specific
valuation estimates and the age groups for which the incidence of heart attacks was
estimated. For example, you will have to drag the valuation estimate for the 25 to 44 age
group to both the 25 to 35 age group and the 35 to 45 age group in the pooling window.

Now repeat this process using the Russell 3  percent discount rate valuation estimates.
When you are finished, you should have two valuation estimates for each AMI age group,
and your pooling window should look like the one below.
   Select Valuation Methods,  Pooling, and Aggregation
  Valuation Methods
  - CityQne Valuation Functions
     - Acute Bronchitis
       - Acute Bronchitis
           WTP: 6 day illness, CV studies
     + E mergence R oom Visits, R espiratory
     - Acute Myocardial Infarction
       - Acute Myocardial Infarction, Nonfa
           COI: 5yrs med, 5 yrs wages, 3*
           GDI: 5yrs med, 5 yrs wages, 3*
           GDI: 5yrs med, 5 yrs wages, 3!
           GDI: 5yrs med, 5 yrs wages, 3!
           COI: 5yrs med, 5 yrs wages, 3*
           COI: 5yrs med, 5 yrs wages, 3'
           COI: 5yrs med, 5 yrs wages, 3!
           COI: 5yrs med, 5 yrs wages, 3!
           COI: 5yrs med, 5 yrs wages, 3*
            COI: 5 yrs men, Syts wages, 3
    Advanced
                S kip QALY Weights
                                Variable DataSet:
 Pooling Window N ame: | Pooling Window 1

Endpoint Group   Endpoint        Autl-
Acute Bronchitis

Acute Myocardial In Acute Myocardial Inl Pete
Valuation M ethod  Pooling M ethod

WTP: 6 day illness.
             None
             None
                             COI: 5yrs med, Syr;
                             COI: 5 yrs med, 5yr:
                                          I
                             COI: 5 yrs med, Syr;
                             COI: 5yrs med, Syr;
                                          I
                             COI: 5yrs med, Syr;
                             COI: 5yrs med, Syr;
                                          I
                             COI: 5yrs med, Syr;
                             COI: 5yrs med, Syr;
             None
             None
                                                                          None
                                                           Cancel
                                                                     Previous
                                                                                 Next
Now you can pool the valuation results for heart attacks in each age group using the unit
values from both Wittels and Rusell. In order to do so, you must select a pooling method.

BenMAP lets you select from several different pooling methods.  For this example, you
will be using subjective weights.  In other applications, you may wish to use fixed or
random effects weights.

To set the pooling method for each  age group result, click on the Pooling Method field in
the row ABOVE each pair of valuation methods (where it says None) and use the drop
down menu to select Subjective Weights. You  must repeat this for EACH age group in
order for pooling to take place over all age groups.

In addition  to pooling the results over the two valuation methods, we also need to
aggregate the results into a total estimate across age groups. In order to do so,  in the row
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with Endpoint Group (Endpoint Group = Acute Myocardial Infarction) click in the
Pooling Method field and select Sum (Dependent) from the drop down menu.
Your screen should look like the following:
   Select Valuation Methods, Pooling, and Aggregation
  Valuation Methods
- CityOne Valuation Functions
  - Acute Bronchitis
     - Acute Bronchitis
         WTP: 6 day illness, CV studies
  + E mergency R oom Visits, R espiratory
  - Acute Myocardial Infarction
     - Acute Myocardial Infarction, Nonfa
         COI: 5yrs med, 5 yrs wages, 3*
         COI: 5yrs med, 5 yrs wages, 3!
         COI: 5yrs med, 5 yrs wages, 3!
         COI: 5yrs med, 5 yrs wages, 3!
         COI: 5yrs med, 5 yrs wages, 31
         COI: 5yrs med, 5 yrs wages, 3'
         COI: 5yrs med, 5 yrs wages, 3!
         COI: 5yrs med, 5 yrs wages, 3!
         COI: 5yrs med, 5 yrs wages, 3*
         COI: 5yrs med, 5 yrs wages, 3*
    Advanced
              r? Skip QALY Weights
                                 Variable DataSet:
 Pooling Window N ame:  | Pooling Window 1

Endpoint Group   Endpoint        Autl-
Acute Bronchitis

Acute Myocardial In Acute Myocardial Inl Pete
Valuation Method

WTP: 6 day illness.
                                                                            Pooling Method    ^
                                                                           Sum (Dependent)
                                                                           Subjective Weights
                                                              COI: 5yrs med, Syr:
                                                              COI: 5yrs med, Syr:

                                                              COI: 5yrs med, Syr;
                                                              COI: 5yrs med, Syr

                                                              COI: 5yrs med, Syr
                                                              COI: 5yrs med, Syr

                                                              COI: 5yrs med, Syr:
                                                              COI: 5yrs med, Syr:
                                           Subjective Weights


                                           Subjective Weights


                                           Subjective Weights
                                                            Cancel
                                                                       Previous
                                                                                  Next
This pooling configuration for acute myocardial infarctions will assign a starting set of
equal weights to each valuation method for the set of five age groups, and then create an
overall estimate of acute myocardial infarctions by summing the age-specific pooled
estimates, treating the distributions for each age group as dependent (i.e. a draw from the 5
th percentile of the 45 to 54 age group will be added to the draw from the 5th percentile of
the 55 to 64 age group and so on).
C) Select values for asthma emergency room visits
To select values for asthma ER visits, drill down the Emergency Room Visits, Respiratory
heading to the Emergency Room Visits, Asthma, and then to the valuation approach
Standford et al,
hand panel.
              1999  0 - Max. Drag this to the Emergency Room Visits entry in the right
D) Choose variable dataset
In the Variable Dataset drop-down menu, choose CityOne Variables.  (BenMAP requires
that there be a variable dataset be chosen before going to the next step.)
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Your completed screen should look like the one below.
 - Select Valuation Methods, Pooling, and Aggregation
  Valuation Methods
    CityOne Valuation Functions
     -  Acute Bronchitis
       - Acute Bronchitis
            WTP: 6 day illness, CV studies
     -  E mergency R oom Visits, R espiratory
       - E mergency R oom Visits, Asthma
            COI: Standfordetal. (1999)10
     -  Acute Myocardial Infarction
       - Acute Myocardial Infarction, Nonfa
            COI: 5yrs med, 5 yrs wages, 3:
            COI: 5yrs med, 5 yrs wages, 3i
            COI: 5yrs med, 5 yrs wages, 3J
            COI: 5yrs med, 5 yrs wages, 3!
            COI: 5yrs med, 5 yrs wages, 3:
            COI: 5yrs med, 5 yrs wages, 3*
            COI: 5yrs med, 5 yrs wages, 3*
            COI: 5yrs med, 5 yrs wages, 3!
            COI: 5yrs med, 5 yrs wages, 3!
            COI: 5yrs med, 5 yrs wages, 3!
    Advanced
                 Skip PALY Weights
                                 Variable DataSet:
CityQne Variables
Pooling Window N ame: ) Pooling Window 1
Endpoint Group













Emergency Room V
<
Qualifier

25-44


45-54


55-64


65+




Valuation Method Pooling Method .*.
COI: 5 yrs med, Syr:
Subjective Weights
COI: 5 yrs med, Syr:
COI: 5 yrs nned, Syr:
Subjective Weights
COI: 5 yrs med, Syr:
COI: 5 yrs med, Syr:
Subjective Weights
COI: 5 yrs med, Syr;
COI: 5 yrs med, Syr:
Subjective Weights
COI: 5 yrs med, Syr:
COI: 5 yrs med, Syr:

COI: Standfordeta "T
                                                             Cancel
                                                                       Previous
                                                                                   Next
E) Entering subjective weights
Once you have completed this step, click on Run.  BenMAP will now bring up a window
to allow you to enter subjective weights.
BenMAP assigns a default equal weight to each selected valuation method.  You can
change these weights by clicking in the weight cells. However, for this exercise, you
should leave them at 0.5 for each study. Click on OK at the bottom of the screen. You
should see  a save dialog box.  Click on Save to save your APV configuration.  Save the file
as PM25 Direct example APV.
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            - Select Subjective Weights
             Pooling Window Name: [Pooling Window 1|
                          uling Window 1
             Endpoint Group
             Acute Bronchitis
            Acute Myocardialln
Endpoint
                                      Author
Acute Myoeardial Inl Peters et al.
Qualifier
                                                   18-24
                                                   25-44
                                                   45-54
                                                   55-64
Valuation Method  Pooling Method    Weights

WTP: 6 day illness.
             Sum (Dependent)
             Subjective Weights
CQI: Syrsrned, 5yr:              0.50
CO I: Syrsmed, Syr;              0.50
             Subjective Weights
CO I: Syrsmed, 5 yr:              0.50
CO I: Syrsmed, 5 yr:              0.50
             Subjective Weights
CO I: Byrsrned, 5yr:              0.50
CO I: Syrsmed, 5 yr:              0.50
             Subjective Weights
                                                         COI: 5 VK rned. 5 vr:
                                                         0.50
                                                                               Cancel
                                                                  OK
           Click on OK to start the pooling and aggregation.  First you will be prompted to enter a
           filename for the aggregation, pooling, and valuation configuration file that you just created.
           Enter PM25 Example Configuration.apv and click Save.
           Then you will be prompted to enter a filename for the aggregation, pooling, and valuation
           results. Enter PM2.5 CityOne County 25 Pet Rollback 2003 VNA Example.apvr and click
           Save. When the progress bar disappears, you will be returned to the main BenMAP
           screen.

A.2.6  Step 6. Generate Reports
           You may view your results within BenMAP, either in the preview window in the Create
           Reports button or through the mapping functions.  Alternatively, you may export the
           results to a comma separated values file (*.csv), or a shapefile (*.shp) which can be viewed
           in a GIS program such  as ESRI's Arc View product.
           A) Generate a Pooled Incidence Results report
           A Pooled Incidence Results report contains the incidence results you previously
           generated, using the aggregation level and pooling that you specified in the Incidence
           Pooling and Aggregation window.  Previously, in Step 5, we did not specify any pooling
           of incidence results (although valuations were pooled), so in this case the Pooled
           Incidence Results report will look just like the Aggregated Incidence Results report.  If
           some incidence results had been pooled, the two reports would be different.
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Click on the Create Reports button from the main BenMAP screen. This will bring up
the Select Result Type window
       3 Select Report Type
        f*  incidence. Valuation, QALY Resu|ts: Raw, Aggregated, and Pooled.  (Created from K.apvr fi|es|

        r*  Raw Incidence Results. (Created from *.cfgr files)

        C  Audit Trail Reports (Created from ".aqg files, *.cfg files, ".cfgr files, *.apv files, or ".apvr files)
                                                        Cancel
               OK
Select Incidence and Valuation Results: Raw, Aggregated and Pooled. Click OK. This
will bring up a window where you can select a results file.  Chose the PM2.5 CityOne
County 25 Pet Rollback 2003  VNA Example.apvr file, and click Open. This will bring up
the Choose a Result Type window
                          - Choose a Re.
                           Result Type
                           C Incidence Results
                           C Aggregated Incidence Results
                           C' Pooled Incidence Results
                           <~ Valuation Results
                           C Aggregated Valuation Results
                           <~ Pooled Valuation Results
                           r QALY Results
                           C Aggregated QALY Results
                           r Pooled QALY Results
                                       Cancel
OK
In the Choose a Result Type window, choose Pooled Incidence Results. Then click OK.
This will bring up the APV Configuration Results Report, where you can customize your
report display and select the fields you want to see in the report.  In the Pooled C-R
Function Fields box, check off Endpoint Group and Qualifier.
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- APV Configuration Results Report H
File
Column Selection
Grid Fields: Pooled Health Impact Function Fields: Result Fields:
• Colum
• Row
Groupinc
f* Grou
f~" Grou
Preview
Column
42
42
,n
4

n -.i -JE A A -in op:7n 1 n 7771 o ca-i n 	 I
I >\
Done

When your window looks like the window above, then go to the File menu and choose
Save. In the Save As window that appears, type in the file name and browse to the location
where you want to store the exported file. The Reports subfolder is a good location to
keep exported reports.  Type in the name, PM2.5 CityOne County 25 Pet Rollback 2003
VNA Example Health.csv in the box and click Save.  You can now open the report in
another application, such as a spreadsheet or database program.
B) Generate a Pooled Valuation Results report

This report is similar to the Pooled Incidence Results report, and uses the valuation
pooling you previously specified. Click on the Create Reports button from the main
BenMAP screen. This will bring up the Select Report Type window. Select Incidence
and Valuation Results: Raw, Aggregated and Pooled. Click OK. This will bring up a
window where you can select a results file.  Chose the PM2.5 CityOne County 25 Pet
Rollback 2003 VNA Example.apvr file, and click Open. This will bring up the Choose a
Result Type window.
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           In the Choose a Result Type window, choose Pooled Valuation Results. Then click OK.
           This will bring up the APV Configuration Results Report window, where you can
           customize your report display and select the fields you want to see in the report. In the
           Pooled Valuation Methods Fields box, check off Endpoint Group.
               APV Configuration Results Report
             File
             Column Selection

               Grid Fields:
                           Pooled Valuation Method Fields:
                                                                            Result Fields:
                 Column
                 Row
                             Endpoint
                             Author
                             Qualifier
                             ValuationMethod
                             Pooling Window
          V Point Estimate
          V Mean
          M" Standard Deviation
          >/ Variance
          
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                                                                  Appendix A: Training Courses
miiir^
:SJ File Edit View Insert Format lools Data Window Help ScanSoftPDF Adobe PDF

_ B X
t '}*-£-&
C2 •* £ Acute Bronchitis
A B C |D
1 Column Row Endpoint Group Qualifier
2 42 17|Acute Bronchitis 1
3 1 42 17 Acute Myocardial Infarction 18-24
4 42 17 Acute Myocardial Infarction 25-44
5 42 17 Acute Myocardial Infarction 45-54
6 42 17 Acute Myocardial Infarction 55-64
7 42 17 Acute Myocardial Infarction 65+
8 42 17 Emergency Room Visits, Respiratory
IT] 42 29 Acute Bronchitis
10 42 29 Acute Myocardial Infarction 18-24
JJJ 42 29 Acute Myocardial Infarction 25-44
12 42 29 Acute Myocardial Infarction 45-54
13 42 29 Acute Myocardial Infarction 55-64
14 42 29 Acute Myocardial Infarction 65+
15 42 29 Emergency Room Visits, Respiratory
16 42 45 Acute Bronchitis
TT] 42 45 Acute Myocardial Infarction 18-24
18 42 45 Acute Myocardial Infarction 25-44
19 42 45 Acute Mvocardial Infarction 45-54
H < > M \PM2.5 CityOne County 25 Pet Rol/
Ready
E F | G
Point Estimate Mean Standard Deviation
168.0954 165.6102 94.8504
0.076 0.0754 0.0258
10.857 10.7771 3.691
23.0998 22.93 7.8532
33.6191 33.372 11.4294
94.3078 93.6145 32.0617
60.9445 60.8104 13.728
133.9324 131.8112 75.3358
0.0658 0.0653 0.0224
8.4421 8.3814 2.8746
18.0136 17.8841 6.1337
25.7805 25.5952 8.7783
70.4115 69.9054 23.9754
49.4778 49.3717 11.1588
167.1015 164.3559 93.8264
0.0936 0.0929 0.0317
10.2333 10.1546 3.4687
21.4349 21.27 7.2657
MUM
H —
Variance
8996.5967
0.0007
13.6235
61.6721
130.6313
1027.9504
188.4572
5675.4771
0.0005
8.263
37.6219
77.0591
574.8197
124.5187
8803.3848
0.001
12.0321
52.7898 v
A.2.8   Step 8. Map Your Results

           You can also map any of the results that you have generated so far. This includes the air
           quality grids, population data, incidence results, and valuation results. In this example, we
           will look at the air quality grid for the base scenario, and view our incidence results.  For
           more information on these and other mapping functions, see Chapter 9.

           To use the BenMAP mapping functionality, go to the Tools menu and choose GIS /
           Mapping.  The BenMAP GIS window will appear, with buttons at the top for managing
           files and navigating the map.
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                                                      Appendix A: Training Courses
 9 BenMAP GIS
* Q
Layers
                                      Albers Equal Area Conic  •»• |
                                                                         Close
To see the name of each button, simply hold the cursor over it. Click on the Open a file
button, and select Air Quality Grid from the drop-down menu. Browse to the file PM2.5
CityOne County 25 Pet Rollback 2003 VNA.aqg file and click Open.

The name of the file will appear in the left-hand panel under Layers.  Double-click on the
name and a small box will appear with Display Options for viewing this layer.  Here you
can select the variable contained in the layer (file) that you want to view. In the air quality
grid, the variables that are available are the Quarterly Mean and the Daily Mean
(D24HourMean).  Select D24HourMean for the annual mean of the Daily Mean in the
Variable. In this box, you can also change the colors in the map display, and the
maximum and minimum values displayed.
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                                                            Appendix A: Training Courses
                       ~ Display Options
                            Variable: D24HourMean
                          Start Color:

                           End Color: •
                        Default Color: •"

                         Grid Outline: F
   M in Value:
;|10.GO
   Max Value:  12.50
Decimal Digits: [2

Cancel         OK
When done choosing your display options, click OK. You should see a map like the one
below.
 - BenMAP CIS
                                     _   n  x
  Layers
       \&\
| Albers Equal Area Conic

   PM2.5 CilyOne Cour
   10.60-10.79
   1079-10.98
   10.98-11.17
   11.17-11.36
   11.36-11.55
   11.55-11.74
   11.74-11.93
   l 1.93-12.12
   l2.12-12.31
   12.31-12.50
                                                                                Close
To see tract outlines, select County from the Reference Layer drop-down menu at the top
of the screen. You may also use the other reference layers: Metropolitan Area and Tract.
However, since the results have been calculated at the county level in this example, the
county reference is generally most appropriate.
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                                                                             September 2008

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 £ BenMAP CIS
                                                             -  n x
  Layers
I ^U <=(J Q,  O
   PM2.5 CityOne Cour
   10.60-10.79
   10.79-10.93
   10.98-11.17
   11.17-11.36
   11.36-11.55
   11.55-11.74
   11.74-11.93
   11.93-12.12
   12.12-12.31
   12.31-12.50
                                        I A|bets Equal Area conic jd
                                                                              Close
Now you can look at a geographical display of the incidence results you created for cases
of bronchitis, acute myocardial infarctions, and emergency room visits. Click on the Open
a file button at the top of the screen and select APV Configuration Results, then Incidence
Results.  In the next window, select PM2.5 CityOne County 25 Pet Rollback 2003 VNA
Example.apvr, then click Open. BenMAP will load your incidence results and display
them in a table.  Because GIS programs can typically only accommodate field names that
are 10  characters or less, there is a new column at the end of the table labeled Gis Field
Name. Here you can name your variables, as shown in the table below.
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                                                       Appendix A: Training Courses
Edit GIS Field Names
DataSet
Endpoint Group [Endpoint | Pollutant | Metric | Seasonal Metric
CityOne Health Impc Acute Bronchitis Acute Bronchitis PM2.5 D24HourMean QuarterlyMean
CityOne Health Impc Acute Myocardial Inl Acute Myocardial Inl PM2.5 D24HourMean
CityOne Health Impc Acute Myocardial Inl Acute Myocardial Inl PM2.5 D24HourMean
CityOne Health Impc Acute Myocardial Inl Acute Myocardial Inl PM2.5 D24HourMean
CityOne Health Impc Acute Myocardial Inl Acute Myocardial Inl PM2.5 D24HourMean
CityOne Health Impc Acute Myocardial Inl Acute Myocardial Inl PM2.5 D24HourMean
CityOne Health Imp; Emergency Room Vi Emergency Room Vi PM2.5 D24HourMean
4




Gis Field Name
Bronch
Myo1 824
Myo2544
Myo4554
Myo5564
Myo65up
OK


When you are satisfied with the variable names, click OK. The new layer will show in the
BenMAP GIS window on top of the first layer. If the previous layer is still checked, then it
will appear, but underneath the new layer.  Uncheck the box next to the bottom (previous)
layer to hide it.  Your screen should look like the one below.
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 £ BenMAP CIS
-~lfnlf5c
  Layers
                | @s | Qx | Q | © | O | Q | S |  I Albers Equal Area Conic j-J
   PM2.5CitiiOneCour
   PM2.5 CitiiOne Cour
   10.60-10.79
   10.79-10.98
   10.98-11.17
   11.17-11.36
   11.36-11.55
   11.55-11.74
   11.74-11.93
   11.93-12.12
   12.12-12.31
   12.31-12.50
                                                                               Close
Like the previous layer, double click on the name to bring up the Display Options box.
Under Variable you will see a list of the variable names you defined in the previous step.
Select Myo65up, uncheck the Grid Outline box, and click OK.  The viewer will now
display the annual increase in the number of acute myocardial infarctions for people ages
65 and up, as calculated between the base and control scenarios.  You can use the Display
Options to select other variables to view or change how the values are displayed.
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3 BenMAP CIS
_   n   x
   PM2.5 CityOne (
   69.90-94.97
   94.97-120.03
   120.03-145.09
   145.09-170.16
   170.16-195.22
   195.22-220.29
   220.29-245.35
  I 245.35-270.42
   270.42-295.43
   295.48-320.55
   PM2.5CilyOne<
   10.60-10.79
   10.79-10.98
   10.98-11.17
   11.17-11.36
   11.36-11.55
   11.55-11.74
                                © I O I 0 I  £ I   I Albers Equal Area Conic  ^]   |
                                                                                                   Close
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                                                                                              September 2008

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                                                     Appendix B: Monitor Rollback Algorithms
        Appendix B: Monitor Rollback Algorithms

          This Appendix details the rollback procedures that you can perform on monitor data.  The
          rollback procedure is a quick way to determine the monitor levels that would exist under
          various kinds of changes that you can specify. This includes three basic types of rollbacks:
          Percentage, Increment, and Rollback to Standard.

          Once a set of monitors has been selected, the user may define one or more non-overlapping
          rollback regions. A region is simply a set of states with an associated set of rollback
          parameter values. Three rollback types are available:

          • Percentage Rollback.  Monitor values are reduced the same percentage.

          • Incremental Rollback. Monitor values are reduced by the same fixed increment.

          • Rollback to a Standard. Monitor values are reduced so that attainment of a specified
            standard is reached.

          Each of these rollback types has different rollback parameters associated with it.

B.1     Percentage Rollback

          Percentage Rollback involves setting only two parameters - a percentage and a
          background level.  The rollback procedure is similarly straightforward - each observation
          at each monitor in the region has the portion of its value which is above background level
          reduced by percentage.
          Example:  Background Level: 35; Percentage: 25

          Initial Observations at a monitor in rollback region:

             20   20    25    59    35    51   83    35   30    67    87    79    63   35    35


          If we select the background level of 35, we first calculate the portion of each observation
          that is above background level, that is, we subtract the background level from the initial
          observation level.  Observations below background level are given a value of 0.

          Observation portions above background level:

             0     0     0    24    0     16   48    0     0     32    52    44    28   0     0


          When we apply the rollback percentage, each observation portion gets reduced by 25%.

          Reduced portions above background level:
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                                           191

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                                                      Appendix B: Monitor Rollback Algorithms
             0     0     0     18    0     12    36   0     0    24    39
                                            21    0
          Then, each reduced portion is added to the background level of 35.  Zero values are
          replaced by the initial observations.

          Reduced Observations:

             20   20    25    53    35   47    71    35    30   59    74   68    56   35    35
B.2    Incremental Rollback

          Incremental Rollback similarly involves setting only two parameters - an increment and a
          background level. The rollback procedure is quite similar to the percentage rollback
          procedure - each observation at each monitor in the region has the portion of its value
          which is above background level reduced by increment.  The reduced values are not
          allowed to become negative, however - that is, they are truncated at zero.
          Example:  Background Level: 35; Increment: 25

          Initial Observations:

             20    20    25   59    35   51    83   35    30   67    87    79    63    35    35


          Observation portions above background level:

             0     0     0    24    0    16    48   0     0    32    52    44    28    0     0
          Reduced portions above background level:

             000000     23    00


          Reduced Observations:
             20    20    25
35
58
                                 27    19    3     0     0
30   42    62   54    38   35    35
B.3    Rollback to a Standard

          Rollback to a Standard has two groups of parameters - those associated with the
          Attainment Test, which determines whether a monitor is in attainment (meets the
          standard), and those associated with the Rollback Methods, which are used to bring out of
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                                                                               September 2008

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                                                       Appendix B: Monitor Rollback Algorithms
           attainment monitors into attainment.

           The Attainment Test parameters are Metric, Ordinality, and Standard.  A monitor is
           considered in attainment if the nth highest value of the metric specified by Metric is at or
           below the value specified by Standard, where n is the value specified by Ordinality. For
           example, if Metric is TwentyFourHourDailyAverage, Ordinality is two, and Standard is
           eighty five, a monitor will be considered in attainment if the second highest value of
           TwentyFourHourDailyAverage is at or below eighty five.

           Supported metrics for pollutants with hourly observations (Ozone) include
           FiveHourDailyAverage, EightHourDailyAverage, TwelveHourDailyAverage,
           TwentyFourHourDailyAverage, OneHourDailyMax, and EightHourDailyMax. Supported
           metrics for pollutants with daily observations (PM10,  PM2.5) include
           TwentyFourHourDailyAverage and AnnualAverage. For Annual Average, Ordinality
           does not apply, since there is only a single metric value to work with.

           The Rollback Method parameters are Interday Rollback Method, Interday
           Background Level, Intraday Rollback Method, and Interday Background Level.
           These four parameters determine the rollback procedures used to bring out of attainment
           monitors into attainment  The Interday Rollback Method and Background Level are
           used to generate target values for the metric specified by the Attainment Test. The
           Intraday Rollback Method and Background Level are used to adjust hourly
           observations to meet the target metric values generated in the  previous step.  As such, the
           Intraday Rollback Method and Background Level are used only for pollutants with
           hourly observations (ozone).

B.3.1   Interday Rollback - Generating Target Metric Values

           Because standards are defined on metrics, not directly on observations, the first step in
           rolling back out of attainment monitors is generating target metric values.  There are four
           supported rollback methods for Interday Rollbacks - Percentage, Incremental, Peak
           Shaving, and Quadratic. Each of these rollback methods requires some preprocessing of
           the initial monitor metric values. We will  discuss this preprocessing first, and then go
           through Percentage, Incremental, and Peak Shaving rollbacks  in turn.  Quadratic rollback
           is more complicated than these  first three, and has its own section.

           The Interday Background Level specifies the portion of each metric value which cannot be
           affected by human intervention - we call this portion the non-anthropogenic portion.
           Whatever portion is left over after subtracting out the background level is referred to as the
           anthropogenic portion.  The anthropogenic portion of the initial monitor metric values is
           the only part which will be affected by the Interday Rollback Method.

           BenMAP calculates an  out of attainment value by determining the particular monitor
           metric value which caused the monitor to be out of attainment - this value is the nth
           highest value of the metric specified by the Attainment Test metric, where n is the
           Attainment Test Ordinality.  BenMAP then calculates an anthropogenic out of attainment
           value by subtracting the Interday Background Level from the out of attainment value.
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                                                       Appendix B: Monitor Rollback Algorithms
           BenMAP also calculates an anthropogenic standard by subtracting the Interday
           Background Level from the Attainment Test standard. Finally, BenMAP calculates a set of
           anthropogenic metric values and a set of non-anthropogenic metric values using the
           following procedure on each initial monitor metric value:

               IF the metric value is less than or equal to the Interday Background Level,

                     non-anthropogenic metric value = metric value

                     anthropogenic metric value = 0

               ELSE

                     non-anthropogenic metric value = Interday Background Level

                     anthropogenic metric value = metric value - Interday Background Level



B.3.1.1 Interday Rollback - Percentage

           To generate target metric values using Percentage rollback, BenMAP calculates the
           percentage required to reduce the anthropogenic out of attainment value to exactly the
           anthropogenic standard. This percentage reduction is then applied to all  of the
           anthropogenic metric values. Finally, these reduced anthropogenic metric values are added
           to the non-anthropogenic metric values to give the final target metric values.
           Example:

           Initial Metric Values:

             30   35    50   10    80   44    67    88   90    70   50    30    55    90    80   85
                              0

           Attainment Test: Highest value of metric <= 70

           Interday Background Level: 40

           Out of Attainment Value: 100

           Anthropogenic Out of Attainment Value: 60 (= 100 - 40)

           Anthropogenic Standard: 30 (= 70 - 40)

           Percentage Reduction Required: 50% (=(60-30)760)


           Non-Anthropogenic Metric Values:
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                                            194

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                                                      Appendix B: Monitor Rollback Algorithms
             30    35   40    40   40    40   40    40   40    40   40    30   40    40   40    40

          Anthropogenic Metric Values:

             0     0    10    60   40    4    27    48   50    30   10    0     15    50   40    45
          Reduced Anthropogenic Metric Values:

             0     0    5     30   20    2    14    24   25    15    5     0
                                                       25   20    23
          Target Metric Values:

             30    35   45   70   60    42   54    64   65    55    45    30   48    65    60    63


B.3.1.2 Interday Rollback - Incremental

          To generate target metric values using Incremental Rollback, BenMAP calculates the
          increment required to reduce the anthropogenic out of attainment value to exactly the
          anthropogenic standard. This incremental reduction is then applied to all of the
          anthropogenic metric values (but - they are not allowed to fall below zero). Finally, these
          reduced anthropogenic metric values are added to the non-anthropogenic metric values to
          give the final target metric values.


          Example:

          Initial Metric Values:
             30    35   50
10
0
80   44    67   88    90   70    50   30    55   90    80   85
          Attainment Test: Highest value of metric <= 70

          Interday Background Level: 40

          Interday Rollback Method: Incremental

          Out of Attainment Value: 100

          Anthropogenic Out of Attainment Value: 60

          Anthropogenic Standard: 30 (=70 - 30)

          Incremental Reduction Required: 30


          Non-Anthropogenic Metric Values:
                                           195
                                                                               September 2008

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                                                      Appendix B: Monitor Rollback Algorithms
             30    35    40   40    40   40    40   40    40   40   40    30   40    40   40    40

          Anthropogenic Metric Values:

             0     0     10   60    40   4     27   48    50   30   10    0    15    50   40    45

          Reduced Anthropogenic Metric Values:

             0     0     5    30    20   2     14   24    25   15   5     0    8     25   20    23

          Target Metric Values:

             30    35    45   70    60   42    54   64    65   55   45    30   48    65   60    63


B.3.1.3 Interday Rollback - Peak Shaving

          To generate target metric values using Peak Shaving rollback, BenMAP simply truncates
          all anthropogenic metric values at the anthropogenic standard. These reduced
          anthropogenic metric values are added to the non-anthropogenic metric values to give the
          final target metric values.


          Example:

          Initial Metric Values:

             30    35    50   10    80   44    67   88    90   70   50    30   55    90   80    85
                             0

          Attainment Test: Highest value of metric <= 70

          Interday Background Level: 40

          Interday Rollback Method: Peak Shaving

          Anthropogenic Standard: 30


          Non-Anthropogenic Metric Values:

             30    35    40   40    40   40    40   40    40   40   40    30   40    40   40    40

          Anthropogenic Metric Values:

             0     0     10   60    40   4     27   48    50   30   10    0    15    50   40    45
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                                           196

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                                                        Appendix B: Monitor Rollback Algorithms
           Reduced Anthropogenic Metric Values:

              0    0     10    30   30    4     27   30    30    30    10    0     15   30   30    30

           Target Metric Values:

              30   35    50    70   70    44    67   70    70    70    50    30    55   70   70    70


B.3.2   Intraday Rollback - Adjusting Hourly Observations

           Once a set of target metric values has been calculated for a pollutant with hourly
           observations (e.g., Ozone), BenMAP must adjust the hourly observations so that they
           produce the target metric values.  There are three supported rollback methods for Intraday
           Rollback - Percentage, Incremental, and Quadratic. Each of these rollback methods
           requires some preprocessing of the initial monitor observations, and each can require
           multiple iterations to hit the target metric values. We will discuss this preprocessing and
           iteration first, and then go through Percentage and Incremental rollbacks in turn.  Quadratic
           rollback is more complicated than these first two, and has its own section.

           For various reasons, each of the Intraday Rollback methods can fail to hit the target metric
           values during a single pass through the rollback procedure (these will be discussed in detail
           below).  As such, each of the rollback methods uses an iterative approach to get within a
           threshold of each of the target metric values - currently this threshold is 0.05.  The iterative
           approach works as follows:

           For each target metric value, BenMAP calculates the current value of the Attainment Test
           metric. For the first iteration, the metric value will be calculated using unadjusted hourly
           observations.  For subsequent iterations, the metric value will be calculated using the
           current values of the adjusted hourly observations.

           If the difference between the  metric value and the target metric value is less than or equal
           to 0.05, the rollback procedure is finished. Otherwise, another iteration is required.

           The Intraday Background Level specifies the portion of each observation which cannot be
           affected by human intervention - we call this portion the non-anthropogenic portion.
           Whatever portion is left over after subtracting out the background level is referred to as the
           anthropogenic portion.  The anthropogenic portion of the initial monitor observations is the
           only part which will be affected by the Intraday Rollback Method.

           In a way analogous to the Interday Rollback procedure, BenMAP calculates the
           twenty-four hourly anthropogenic observations and the twenty-four hourly
           non-anthropogenic observations using the following procedure for each hourly
           observation:
           IF the current value of the observation is less than or equal to the Intraday Background
           Level,
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                                             197

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                                                        Appendix B: Monitor Rollback Algorithms
                      non-anthropogenic observation = observation

                      anthropogenic observation = 0

               ELSE

                      non-anthropogenic observation = Intraday Background Level

                      anthropogenic observation = observation - Intraday Background Level
           Given (i) an Attainment Test Metric (e.g., EightHourDailyMax), (ii) an Intraday
           Background Level, and (iii) a target metric value for the day, BenMAP proceeds to adjust
           hourly observations in the following steps:
           1.   Calculate the Attainment Test metric (e.g., the 8-hour daily maximum);

           2.   Identify the "window" - i.e., the set of hours used to calculate the metric (e.g., if the
           8-hour daily maximum is achieved in the first 8 hours, then the window is comprised of
           the first 8 hours);

           3.   Calculate the non-anthropogenic hourly observations (=min(hourly observation,
           Intraday Background Level));

           4.   Calculate the anthropogenic hourly observations (=hourly observation - Intraday
           Background Level);

           5.   Calculate the non-anthropogenic metric value (= the metric using the
           non-anthropogenic hourly observations in the "window");

           6.   Calculate the anthropogenic metric value (= the metric using the anthropogenic hourly
           observations in the "window");

           7.   Calculate the anthropogenic target metric value (= the target metric value minus the
           non-anthropogenic metric value);

           8.   Calculate the reduction required to get the anthropogenic metric value down to the
           anthropogenic target metric value;

           9.   Adjust all anthropogenic hourly observations by the reduction calculated on the
           previous step;

           10.  Calculate the adjusted hourly observations (= the adjusted anthropogenic hourly
           observation + the non-anthropogenic hourly observation).

B.3.2.1 Intraday Rollback - Percentage

           Below, we present two examples of a percentage-based  Intraday Rollback. In one
           example, a single iteration is needed, and in the second example, two iterations are
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                                             198

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                                                        Appendix B: Monitor Rollback Algorithms
           required because a number of the monitor values fall below the assumed background level.

B.3.2.1.1   Example: All Hourly Observations Exceed the Intraday Background (Single Iteration)

           If all of the hourly observations in a day are greater than the Intraday Background Level,
           then the above procedure is straightforward and can be accomplished in a single iteration.
           We illustrate with the following example.  Suppose that:

           Metric = EightHourDailyMax,

           Target metric value for a given day = 85

           Intraday Background Level = 40.

           And that the hourly observations on that day are:

              530   45   50    60   45    45    45    60    70   100    100    100   100


              100    100    100   100    60   45    50    45   45    47    47
           Based on these observations, we see that the 8-hour daily maximum = 110.

           Assuming a background level of 40, then the Anthropogenic hourly observations are:

              490    5     10    20    5     5    5     20    30    60   60    60    60   60

              60   60   60    20    5     10   5     5     7    7

           Then, we know:

               Anthropogenic metric value = 70.

               Non-anthropogenic metric value = 40.

               Anthropogenic target metric value = 45.

               Percentage reduction required = ((70-45)770) = 35.7%

           All of the hourly anthropogenic observations are reduced by 35.7%. The average of the
           first 8 values (the window on which the Test metric is based) will be exactly 45, the
           anthropogenic target metric value. Finally, the adjusted hourly observations are calculated
           by adding the non-anthropogenic hourly observation to the adjusted hourly anthropogenic
           observations.

B.3.2.1.2   Example: Some Hourly Observations are Below the Intraday Background (Multiple Iterations Required)

           In the above example, the anthropogenic target metric value was met on a single iteration
                                                                                   September 2008
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                                            Appendix B: Monitor Rollback Algorithms
because all of the hourly observations were greater than the Intraday Background Level. In
this case, a simple percent reduction of all hourly values will produce an average in the
window that is equal to the anthropogenic target metric value. If some of the hourly
observations in a day are less than or equal to the Intraday Background Level, however,
then BenMAP uses an iterative procedure.  On each iteration, it adjusts hourly observations
using the 10-step method given above. It then compares the new metric value to the target
metric value.  If the difference is less than or equal to 0.05 ppb, the rollback procedure is
finished. Otherwise, another iteration is required.  The iterative procedure is illustrated in
the following example.

    Suppose that:

    Metric = EightHourDailyMax,

    Target metric value for a given day = 85

    Intraday Background Level = 40.
Suppose also that the hourly observations on that day are:

   530   20   25   60    35    35   40    60   70    100   100    100   100

   100    100    100    100    60    33   40    30   30    25   20

Then, we know that the 8-hour daily maximum = 100.6.

Non-Anthropogenic Hourly Observations, Iteration One:

   40   20   25    40   35    35    40    40   40   40    40

   40   40   40    40   40    40    40    33   40   30    30   25    20

    Anthropogenic Hourly Observations, Iteration One:

   490   0    0    20    0     0      0     20   30    60    60   60    60   60

   60   60   60    20   0     0    0    0    0     0

Non-Anthropogenic Metric Value: 34.4   (EightHourDailyMax - calculated over the same
eight hour window as the initial metric value was calculated over)

    Anthropogenic Metric Value: 66.3

    Anthropogenic Target Metric Value:  50.6

    Percentage Reduction Required:  23.6%
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Reduced Anthropogenic Hourly Observations, Iteration One:

   374   0     0    15    0     0    0     15   23   46   46   46


   46   46    46   46   46    15   0     0    0    0     0    0


Reduced Hourly Observations, Iteration One:

   414   20   25    55   35    35    40    55    63   86    86   86   86


   86   86    86   86   55    33   40    30   30   25    20


    Reduced Metric Value (EightHourDailyMax): 85.8

    Target Metric Value (EightHourDailyMax): 85




Non-Anthropogenic Hourly Observations, Iteration Two:

   40   20    25   40   35    35   40    40   40   40    40   40    40


   40   40    40   40   40    33   40    30   30   25    20


Anthropogenic Hourly Observations, Iteration Two:

   374   0     0    15    0     0    0     15   23   46   46   46    46


   46   46    46   46   15    0    0     0    0    0     0


Non-Anthropogenic Metric Value: 40    (EightHourDailyMax - calculated over the same
eight hour window the initial metric value was calculated over)

    Anthropogenic Metric Value: 45.8

    Anthropogenic Target Metric Value: 45

    Percentage Reduction Required: 1.9%




Reduced Anthropogenic Hourly Observations, Iteration Two:

   368   0     0    15    0     0    0     15   23   45   45   45    45   45
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             45    45   45    15    0     0     0    0     0    0

          Reduced Hourly Observations, Iteration Two:

             408    20   25    55   35    35    40   55    63    85    85   85    85   85

             85    85   85    55    33   40    30   30    25   20

          Reduced Metric Value (EightHourDailyMax): 85

          The above example, in addition to illustrating the Intraday Percentage Rollback, also
          illustrates one reason why the  iterative procedure can be necessary. When using the
          EightHourDailyMax metric in the Attainment Test, it is possible for the window over
          which the maximum eight hour average occurs to move after a single pass through the
          rollback procedure.  When this happens, it becomes necessary to go through additional
          iterations to hit the target metric value.

B.3.3   Intraday Rollback - Incremental

          To adjust hourly observations  using Incremental rollback, BenMAP calculates the
          increment required to reduce the anthropogenic metric value to exactly the anthropogenic
          target metric value.  This incremental reduction is then applied to all of the anthropogenic
          observations (but - they are not allowed to fall below zero). Finally, these reduced
          anthropogenic observations are added to the non-anthropogenic observations to give the
          final reduced observations.

          Example:

          Initial Hourly Observations:

             20    20   25    60    35   35    40   70    35   30    65    90    76

             65    35   35    54    60   33    40   30    30   25    20

               Initial Metric Value (EightHourDailyMax): 60

               Target Metric Value (EightHourDailyMax): 55

               Intraday Background Level: 40

               Intraday Rollback Method: Incremental


          Non-Anthropogenic Hourly Observations, Iteration One:

             20    20   25    40    35   35    40   40    35   30    40    40    40
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   40   35    35    40   40    33   40   30    30   25    20


Anthropogenic Hourly Observations, Iteration One:

   0    0     0     20   0     0    0    30    0    0     25   50   36


   25   0     0     14   20    0    0    0     0    0     0


    Non-Anthropogenic Metric Value (EightHourDailyMax): 38.8

    Anthropogenic Metric Value (EightHourDailyMax): 21.3

    Anthropogenic Target Metric Value (EightHourDailyMax): 16.3

    Incremental Reduction Required: 5.0




Reduced Anthropogenic Hourly Observations, Iteration One:

   0    0     0     15   0     0    0    25    0    0     20   45   31


   20   009    15    000000


Reduced Hourly Observations, Iteration One:

   20   20    25    55   35    35   40   65    35   30    60   85   71


   60   35    35    49   55    33   40   30    30   25    20


    Reduced Metric Value (EightHourDailyMax): 56.25

    Target Metric Value (EightHourDailyMax): 55




Non-Anthropogenic Hourly Observations, Iteration Two:

   20   20    25    40   35    35   40   40    35   30    40   40   40


   40   35    35    40   40    33   40   30    30   25    20


Anthropogenic Hourly Observations, Iteration Two:

   0    0     0     15   0     0    0    25    0    0     20   45   31
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             20    009     15   000000

              Non-Anthropogenic Metric Value (EightHourDailyMax): 38.8

              Anthropogenic Metric Value (EightHourDailyMax): 17.5

              Anthropogenic Target Metric Value (EightHourDailyMax): 16.3

              Incremental Reduction Required: 1.25


           Reduced Anthropogenic Hourly Observations, Iteration Two:

             0     0     0    14    0    0     0    24    0     0    19    44   30

             19    008     14   000000

           Reduced Hourly Observations, Iteration Two:

             20    20    25    54    35   35    40   64    35    30   59    84   70

             59    35    35    48    54   33    40   30    30    25   20

              Reduced Metric Value (EightHourDailyMax): 55.3

              Target Metric Value (EightHourDailyMax): 55
           This example should actually continue for one further iteration, with a new Incremental
           Reduction of 0.3.  This illustrates another reason why the iterative procedure can be
           necessary - for incremental reductions, the prohibition against values becoming negative
           can cause target metric values to not be met. Incremental reductions thus very often
           require multiple iterations.

B.3.4   Interday and Intraday Rollback - Quadratic

           Quadratic rollback is based on an algorithm developed by Horst and Duff. The idea
           behind quadratic rollback is to reduce large values proportionally more than small values
           while just achieving the standard - that is, the out-of-attainment value should be more or
           less at the standard after the rollback (some small amount of error is involved).

           The original quadratic rollback algorithm is designed to roll back hourly observations
           given a desired peak value.  That is, it assumes that the Attainment Test metric is the
           one-hour average and the Attainment Test ordinality is one. As such, the algorithm was
           modified slightly to allow for ordinalities other than one to be used.
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           The basic formula for quadratic rollback is:


           Reduced Observation =[1-(A + B* Initial Observation) ] * Initial Observation


           where:

           i ranges over the days being reduced.

           A= 1 -V

           V = Min(l, Vi)

           Vi = ( 2 * Maximum Observation Value * Standard ) / Xi

           Xi = ( 2 * Maximum Observation Value * Metrics! ) - Metricsi2

           B = Max( 0, [( V * Out of Attainment Value - Standard ) / Out of Attainment Value2] )

B.3.4.1 Quadratic Rollback - Interday

           Because Quadratic Rollback was originally designed to adjust hourly observations to meet
           a daily metric standard, it is slightly complicated to use it to generate target metric values.

           First, Quadratic Rollback calculates the anthropogenic out of attainment value by
           subtracting the Intraday Background Level from the out of attainment value. Note that this
           differs from the other interday rollback methods, which subtract the Interday Background
           Level from the out of attainment value. Similarly, the anthropogenic standard is calculated
           by subtracting the Intraday Background Level from the standard.

           The anthropogenic observations and non-anthropogenic observations are then calculated.
           For pollutants which have daily observations (PM10, PM2.5) the anthropogenic metric
           values are used (see above for their calculation). For pollutants which have hourly
           observations (Ozone), Quadratic Rollback loops through each metric value and calculates
           the twenty four corresponding anthropogenic observations and non-anthropogenic
           observations as follows:


               IF the metric value is at or below the Interday Background Level,

                     For each observation,

                            non-anthropogenic observation = observation

                            anthropogenic observation = 0

               ELSE
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                      For each observation,

                             IF the observation is at or below the Intraday Background Level

                                   non-anthropogenic observation = observation

                                   anthropogenic observation = 0

                             ELSE

                                   non-anthropogenic observation = Intraday Background Level

                                   anthropogenic observation = observation - Intraday Background
           Level
           A new set of anthropogenic metric values is then calculated by generating the Attainment
           Test metric from the anthropogenic observations.  The Quadratic Rollback algorithm is
           then called, passing in the anthropogenic metric values as Metrics, anthropogenic
           observations as Observations, anthropogenic standard as Standard, and anthropogenic out
           of attainment value as Out of Attainment Value.  The result is a set of reduced
           anthropogenic  observations.  These are then added together with the non-anthropogenic
           observations to give a final set of reduced observations.

           Then, if Quadratic Rollback was also selected as the Intraday Rollback method, these
           observations are used as the final reduced observations for the monitor.  Otherwise, metric
           targets are generated from these hourly observations, and the observations themselves are
           discarded

B.3.4.2 Quadratic Rollback - Intraday

           Quadratic Rollback can also be used to adjust hourly observations to meet metric targets
           generated via a different rollback method.  In this  case, the algorithm is used to adjust each
           set of twenty four hourly observations to meet the corresponding metric target. Intraday
           Quadratic Rollback uses the normal set of anthropogenic observations as Observations, a
           single normal anthropogenic metric value as Metrics, and the normal anthropogenic metric
           target as Standard.  Intraday Quadratic Rollback tends to always slightly miss its metric
           target, so it is not run in an iterative fashion as the other Intraday Rollback Methods are
           (doing so would sometimes result in an infinite loop).
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                                Appendix C: Air Pollution Exposure Estimation Algorithms
Appendix C: Air Pollution Exposure Estimation

Algorithms

   BenMAP has grouped individuals into what we refer to as "population grid-cells," where
   the grid-cells typically conform to some type of grid used in an air quality model, such as
   the REMSAD air quality model, or just the counties of the United States. For each type of
   grid, the population is built in each grid-cell by aggregating census block data.  In the next
   step, BenMAP estimates the air pollution exposure for each grid-cell, with the assumption
   that people living within a particular grid-cell experience the same air pollution levels.

   You have a variety of approaches to estimate the exposure to air pollution for the people
   living within a given population grid-cell. Perhaps the simplest approach is to use model
   data directly, and to assume that the people living within a particular model grid-cell
   experience the level estimated by the model. An alternative approach is to use air
   pollution monitoring data, where you may choose the closest monitor data to the center of
   a grid-cell or take an average of nearby monitors.  In a third general approach, you may
   combine both modeling and monitoring data to estimate exposure.

   When combining modeling and monitoring  data, BenMAP scales or adjusts the monitoring
   data with modeling data.  The advantage of modeling data is that they can provide
   predictions for years in which monitoring data are not available, as well  as to provide
   predictions in areas of the country for which monitoring data are not available.  And the
   advantage of monitor data is that they are based on actual observations.  Combining both
   sources of information, allows BenMAP to make more informed predictions.

   The goal of estimating exposure is to provide the necessary input for
   concentration-response functions, so that BenMAP can estimate the impact of air pollution
   on adverse health effects. Table C-l lists the types of metrics commonly used in
   concentration-response functions. In the case of air pollution metrics calculated on a daily
   basis, such as the one-hour maximum and the 24-hour average, it is often the case that
   there are missing days of data. Air quality modeling is often conducted on a subset of the
   days in the year,  and air quality monitors often miss a number of observations through out
   the year. To account for missing days, BenMAP represents the distribution of daily
   metrics with a certain number points or "bins," where each bin represents a certain range of
   the distribution, with the underlying assumption that missing days have the same
   distribution as the available data. For example, for analyses of the United States the
   Environmental Protection Agency has typically used 153 bins to represent the ozone
   season from May through September, and for particulate matter they have used 365 bins to
   represent the year. In addition to being able to account for incomplete or missing data, and
   using bins to represent the distribution provides a uniform approach that allows for easy
   comparison of different monitors.


   Table C-l. Metrics Typically Used in Concentration-Response Functions for Criteria
                                    Air Pollutants
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                                          Appendix C: Air Pollution Exposure Estimation Algorithms
Measurement
Frequency
Daily
(e.g., PM2.5,
PM10)
Metric Name
Daily Average
Annual Average
Metric Description
Daily average
Average of four quarterly averages. The four quarters are defined
as: Jan-Mar, April-June, Jul-Sep, Oct-Dec.
                          Annual Median     Median of values through out the year.
           Hourly
           (e.g., Ozone)
1-hour Daily Max

8-hour Daily
Average

12-hour Daily
Average

24-hour Daily
Average
Highest hourly value from 12:00 A.M. through 11:59 P.M.

Average of hourly values from 9:00 A.M. through 4:59 P.M.


Average of hourly values from 8:00 A.M. through 7:59 P.M.


Average of hours from 12:00 A.M. through 11:59 P.M.
C.1    Direct Modeling
           When using direct modeling data to estimate exposure, BenMAP assumes that the people
           living within a particular air pollution model grid-cell experience the same air pollution
           levels. BenMAP then estimates the air pollution metrics of interest, as defined for each
           pollutant. (See the section on defining pollutants in the Loading Data chapter.)

           Generally modeling data providing hourly observations are complete for any given day.
           However, it is common to have missing days of modeling data during the course of a year.
           Given the estimated metrics from the available data, BenMAP then represents the
           distribution of daily metrics with the number of days specified for each pollutant.  By
           calculating bins with the available days, BenMAP assumes that the distribution of missing
           days is similar to the distribution of available data.
C.2    Closest Monitor
           When using the closet monitor to represent air pollution levels at a population grid-cell,
           BenMAP identifies the center of the population grid-cell, and then chooses the monitor
           that is closest to the center. In the simplest case, BenMAP assigns the closest monitor to a
           population grid-cell, uses the monitoring data to calculate the annual and daily air pollution
           metrics, and then calculates the bins that represent the distribution of the daily metrics.
           The annual metrics and the binned daily metrics are then used in the calculation of health
           effects.

           The figure below presents nine population grid-cells and three monitors, with the focus on
           identifying the monitor closest to grid-cell "E." In this example, the closest monitor
           happens to be 10 miles away from the center of grid-cell E, and the data from this monitor
           would be used to estimate air pollution levels for the population in this grid-cell. An
           analogous procedure would be used to estimate air pollution levels in the other grid-cells
           (A, B, C, D, F,  G, H, and I).
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           To capture some of the information generated by air pollution models, BenMAP can also
           scale the data from the closest monitor with air pollution modeling data. BenMAP
           includes two types of scaling - "temporal" and "spatial" scaling. We discuss each below.
A


D
10 miles *
G
*
30 miles
B

15 miles
*
E
	 ^#
H
*
20 miles
25 miles C
*

F
* 15 miles
I
*
25 miles
                                   # = Center Grid-Cell "E"
                                   *
                                     = Air Pollution Monitor
C.2.1   Closest Monitor - Temporal Scaling

           With temporal scaling, BenMAP scales monitoring data with the ratio of the future-year to
           base-year modeling data, where the modeling data is from the modeling grid-cell
           containing the monitor. In the case of pollutants typically measured hourly, such as ozone,
           BenMAP scales the hourly monitor values, calculates the annual and daily metrics of
           interest, and then bins the daily metrics. In the case of pollutants typically measured daily,
           BenMAP scales the daily values, calculates the annual metrics of interest, and then bins the
           daily metric.

           Consider the case in the figure below.  To forecast air pollution levels for 2030, BenMAP
           would multiply the 1995 monitor value (80 ppb) by the ratio of the 2030 model value (70
           ppb) to the 1995 model value (95 ppb):

           Forecast2030 = Monitor Value 1995 * (Model Value D, 2030 / Model Value D, 1995)

           Forecast2030 = 80 ppb * (70 ppb / 95 ppb) = 58.9 ppb.
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                                                                                 September 2008

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                                         Appendix C: Air Pollution Exposure Estimation Algorithms
A


Model: D
1995 95ppb
2030 70ppb
*
Monitor:
1995 80 ppb
G


*
B

*
E


	 ^#


H
*


C
*

F


*


I

*

                                    # = Center Grid-Cell "E"
                                    *
                                     = Air Pollution Monitor
           In this example, we have examined the adjustment of a single monitor value with the ratio
           of single model values. The approach is essentially the same when there are multiple
           monitor values and multiple model values.

C.2.2   Closest Monitor - Spatial Scaling

           With spatial scaling, we are estimating a monitor value for the center of each population
           grid-cell. We start by choosing the closest monitor to the center of each population
           grid-cell, and then we scale this closest monitor with modeling data.  In particular,
           BenMAP multiplies the monitoring data with the ratio of the base-year modeling data for
           the destination grid-cell to the base-year modeling data for grid-cell containing the
           monitor. The spatial scaling occurs in the same fashion as with temporal scaling. In the
           case of pollutants typically measured hourly, such as ozone, BenMAP scales the hourly
           monitor values, calculates the annual and daily metrics of interest, and then bins the daily
           metrics. In the case of pollutants typically measured daily, BenMAP scales the daily
           values, calculates the annual metrics of interest, and then bins the daily metric.

           To estimate air pollution levels for 1995 in grid-cell "E" below, BenMAP would multiply
           the 1995 closest monitor value (80 ppb) by the ratio of the 1995 model value for grid-cell
           "E" (70 ppb) to the 1995 model value for grid-cell "D" (95 ppb):

           Forecastl995 = Monitor Valuel995 * (Model Value E, 1995 / Model Value D, 1995)

           Forecastl995 = 80 ppb * (85 ppb / 95 ppb) = 71.6 ppb.
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                                        Appendix C: Air Pollution Exposure Estimation Algorithms
A

Model: D
1995 95 ppb
*
Monitor:
1995 80 ppb
G

*
B
*
Model: E
1 995 85 ppb
	 ^#
H
*

C
*

F
*
I
*

                                   # = Center Grid-Cell "E"
                                   *
                                     = Air Pollution Monitor
C.2.3   Closest Monitor - Temporal and Spatial Scaling

           Combining both temporal and spatial scaling, BenMAP first multiplies monitoring data
           with both the ratio of the future-year to base-year modeling data, where the modeling data
           is from the modeling grid-cell containing the monitor. This gives a temporary forecast for
           2030.  BenMAP then multiplies this temporary forecast with the ratio of the future-year
           modeling data for the destination grid-cell to the future-year modeling data for grid-cell
           containing the monitor.  As seen below, this simplifies to multiplying monitoring data with
           both the ratio  of future-year modeling data from the destination grid-cell to the base-year
           modeling data from the grid-cell containing the monitor. Again, as described for temporal
           and spatial scaling, BenMAP first scales the hourly and daily values, generates the metrics
           of interest and then bins the daily metrics.

           To forecast air pollution levels for 2030 in the figure below, BenMAP would multiply the
           1995 monitor value (80 ppb) by the ratio of the 2030 model value (70 ppb) to the 1995
           model value (95 ppb):

           Temporary Forecast 2030 = Monitor Value 1995 * (Model Value D, 2030 / Model
           Value D, 1995)

           Temporary Forecast 2030 = 80 ppb *  (70 ppb / 95 ppb) = 58.9 ppb.

           Forecast 2030 = Temporary Forecast  2030 * (Model Value E, 2030 / Model Value D,
           2030)
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                                        Appendix C: Air Pollution Exposure Estimation Algorithms
           Forecast 2030 = 58.9 ppb * (60 ppb / 70 ppb) = 50.5 ppb.

           Note that through cancellation, this equation simplifies to:

           Forecast 2030 = Monitor Value 1995 * (Model Value E, 2030 / Model Value D, 1995)
A


Model: D
1995 95 ppb
2030 70 ppb
*
Monitor:
1995 80 ppb
G


*
B

*
Model: E
1 995 85 ppb
2030 60 ppb
	 *#

H
*


C
*

F


*

I

*

                                   # = Center Grid-Cell "E"
                                   *
                                    = Air Pollution Monitor
C.3    Voronoi Neighbor Averaging (VNA)

          Like the closest monitor approach, the Voronoi Neighbor Averaging (VNA) algorithm
          uses monitor data directly or in combination with modeling data. However, instead of
          using the single closest monitor to estimate exposure at a population grid-cell, the VNA
          algorithm interpolates air quality at every population grid cell by first identifying the set of
          monitors that best "surround" the center of the population grid-cell.
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                               Appendix C: Air Pollution Exposure Estimation Algorithms
                                      #
                         # = Center Grid-Cell "E"
                         *
                           = Air Pollution Monitor
In particular, BenMAP identifies the nearest monitors, or "neighbors," by drawing a
polygon, or "Voronoi" cell, around the center of each BenMAP grid cell. The polygons
have the special property that the boundaries are the same distance from the two closest
points.
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                               Appendix C: Air Pollution Exposure Estimation Algorithms
                           # = Center Grid-Cell "E"
                           *
                             = Air Pollution Monitor
BenMAP then chooses those monitors that share a boundary with the center of grid-cell
"E." These are the nearest neighbors, BenMAP uses these monitors to estimate the air
pollution level for this grid-cell.
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                          # = Center Grid-Cell "E"
                          *
                            = Air Pollution Monitor
To estimate the air pollution level in each grid-cell, BenMAP calculates the metrics for
each of the neighboring monitors, and then calculates an inverse-distance weighted average
of the metrics. The further the monitor is from the BenMAP grid-cell, the smaller the
weight.

In the figure below, the weight for the monitor 10 miles from the center of grid-cell E is
calculated as follows:
                                                    = 3.55
The weights for the other monitors would be calculated in a similar fashion. BenMAP
would then calculate an inverse-distance weighted average for 1995 air pollution levels in
grid-cell E as follows:

Forecast 1995 = 0.35*80 ppb + 0.24*90 ppb+ 0.24*60 ppb + 0.18*100 ppb = 81.2 ppb
                                  215
                                                                        September 2008

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                                         Appendix C: Air Pollution Exposure Estimation Algorithms
A



D
Monitor: *
1995 80 ppb
10 miles
G

*
B

Monitor:
1995 90 ppb^
15 miles
/E
.. # *

/ H
*
Monitor:
1995 100 ppb
20 miles
C
*


F
Monitor:
1995 60 ppb
15 miles
I
*

                                    # = Center Grid-Cell "E"
                                    *
                                      = Air Pollution Monitor
C.3.1   VNA | Temporal Scaling

           Like the closest monitor approach, the Voronoi Neighbor Averaging (VNA) algorithm uses
           monitor data directly or in combination with modeling data. However, instead of using
           the single closest monitor to estimate exposure at a population grid-cell, the VNA
           algorithm interpolates air quality at every population grid cell by first identifying the set of
           monitors that best "surround" the center of the population grid-cell.
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                                                                                   September 2008

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                               Appendix C: Air Pollution Exposure Estimation Algorithms
                                      #
                         # = Center Grid-Cell "E"
                         *
                           = Air Pollution Monitor
In particular, BenMAP identifies the nearest monitors, or "neighbors," by drawing a
polygon, or "Voronoi" cell, around the center of each BenMAP grid cell. The polygons
have the special property that the boundaries are the same distance from the two closest
points.
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                                                                         September 2008

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                               Appendix C: Air Pollution Exposure Estimation Algorithms
                           # = Center Grid-Cell "E"
                           *
                             = Air Pollution Monitor
We then choose those monitors that share a boundary with the center of grid-cell "E."
These are the nearest neighbors, we use these monitors to estimate the air pollution level
for this grid-cell.
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                                                                          September 2008

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                              Appendix C: Air Pollution Exposure Estimation Algorithms
                          # = Center Grid-Cell "E"
                          *
                            = Air Pollution Monitor
To estimate the air pollution level in each grid-cell, BenMAP calculates the annual and the
binned daily metrics for each of the neighboring monitors, and then calculates an
inverse-distance weighted average of the metrics.  The further the monitor is from the
BenMAP grid-cell, the smaller the weight.

In the figure below, the weight for the monitor 10 miles from the center of grid-cell E is
calculated as follows:
                                                    = 3.55
The weights for the other monitors would be calculated in a similar fashion. BenMAP
would then calculate an inverse-distance weighted average for 1995 air pollution levels in
grid-cell E as follows:

Forecast 1995 = 0.35*80 ppb + 0.24*90 ppb+ 0.24*60 ppb + 0.18*100 ppb = 81.2 ppb
                                  219
                                                                       September 2008

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                                         Appendix C: Air Pollution Exposure Estimation Algorithms
A



D
Monitor: *
1995 80 ppb
10 miles
G

*
B

Monitor:
1995 90 ppb^
15 miles
/E
.. # *

/ H
*
Monitor:
1995 100 ppb
20 miles
C
*


F
Monitor:
1995 60 ppb
15 miles
I
*

                                    # = Center Grid-Cell "E"
                                    *
                                      = Air Pollution Monitor
           Note that BenMAP is calculating an inverse-distance weighted average of the annual
           metrics and the binned daily metrics.  Alternatively, BenMAP could calculate an
           inverse-distance weighted average of the hourly and daily observations, calculated the
           annual and daily metrics, and then binned the daily metrics.

C.3.2   Voronoi Neighbor Averaging (VNA) - Spatial Scaling

           BenMAP can also combine VNA with spatial scaling. For each of the neighbor monitors,
           BenMAP multiplies the monitoring data with the ratio of the base-year modeling data for
           the destination grid-cell to the base-year modeling data for grid-cell containing the
           monitor.  The spatial scaling occurs in the same fashion as with temporal scaling. In the
           case of pollutants typically measured hourly, such as ozone, BenMAP scales the hourly
           monitor values, calculates the annual and daily metrics of interest, and then bins the daily
           metrics. In the case of pollutants typically measured daily, BenMAP scales the daily
           values, calculates the annual metrics of interest, and then bins the daily metric.

           Consider the example in the figure below. To forecast air pollution levels for 1995,
           BenMAP would multiply the 1995 monitor value by the ratio of the  1995 model value to
           the 1995 model value:
                                             220
                                                                                   September 2008

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                                          Appendix C: Air Pollution Exposure Estimation Algorithms
                                  Forscazt-cc* = / Wsizfa.* Monitor.*
                            (       ^\  (        S5 \  (       $5}  (        55}
                      astw = [03?*SO*-J +^.24*90*— J ^024*60*—J +^0.18*100*—J = IQ&ppb
A



Model: D
1995 95 ppb
Monitor: *
1995 80 ppb
10 miles
G



*

Model: B
1995 100 ppb
Monitor:
1995 90ppb^
15 miles
Model: /E
1995 85/ppb
. # -.

Mod/l: H
1995 120 ppb
*
Monitor:
1995 100 ppb
20 miles
C
*


Model: F
1995 80 ppb
Monitor:
1995 60 ppb
15 miles
I


*


                                    # = Center Grid-Cell "E"
                                    *
                                      = Air Pollution Monitor
C.3.3   Voronoi Neighbor Averaging (VNA) - Temporal & Spatial Scaling

           Combining both temporal and spatial scaling, BenMAP multiplies monitoring data with
           the ratio of the future-year to base-year modeling data, where the future-year modeling data
           are from the destination grid-cell and the base-year modeling data are from the grid-cell
           containing the monitor. One the hourly and daily monitoring data are scaled, BenMAP
           generates the metrics of interest, bins the daily metrics, and then uses the metrics to
           estimate adverse health effects in the population grid-cell.

           The figure below gives an example of combining temporal and spatial scaling.
                                             221
                                                                                   September 2008

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                                         Appendix C: Air Pollution Exposure Estimation Algorithms
                                 Forecast^-*.,-, - 2* Weight-* Monitor•*•
                                                              Model
                             {       6Q\  (       60 ^  (        601  (        60 ^
                    ^carr:ec = I 0.35*80*—I +1 024*90*—-I + I 0.24*60*—I + I 0.1S*!00*—I = 50.0
C.4    Fixed Radius

           When using the fixed radius option to represent air pollution levels at a population
           grid-cell, BenMAP identifies all monitors within a specified distance of the center of the
           population grid-cell, calculates the metrics at each monitor, and then calculates a weighted
           average of the metrics using the algorithms described for VNA. When no monitors are
           within the specified distance, BenMAP assigns the closest monitor to a population
           grid-cell, and calculates the metrics using the algorithms described for the closest monitor
           approach.

C.5    Temporal and Spatial Scaling Adjustment Factors

           As presented in the preceding examples of temporal and spatial scaling, the closest monitor
           , VNA, and fixed radius approaches can use model data to scale monitor observations.  In
           the examples above, we scaled single monitor values with the ratio of single model values.
           In fact, however, the scaling involves multiple monitor values and multiple model values.

           To proceed with the scaling, BenMAP takes the modeling values and splits them into
           groups, depending on how the pollutant is defined. (See the section on defining pollutants
           in the Loading Data chapter.) The United States setup has defined ozone to have  a default
           of 10 adjustment factors for the ozone season, where the first group represents the first 10
           percent of the model observations; the second group represents the observations between
           the 10th and 20th percentile; and so on through the tenth group, which represents  the
           observations between the 90th and 100th percentiles. BenMAP then averages the values in
           each group. The United States setup has defined particulate matter to have five adjustment
           factors for each of the four seasons in the year, where the first group in each season
           represents the first 20 percent of the model observations; the second group represents the
           observations between the 20th and 40th percentiles; and so on.  Then, as for ozone model
           values, BenMAP averages the particulate  matter model values in each group.

           BenMAP treats the monitor values in a similar way.  It sorts the monitor values from low
           to high, and divides them into the same number groups as there are scaling factors.

C.5.1   Calculation of Scaling Factors

           In developing scaling factors for the standard United States setup, BenMAP sorts  the
           modeling data into either 10 groups  or 20 groups, depending on the pollutant (e.g., 10  for
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                                         Appendix C: Air Pollution Exposure Estimation Algorithms
           ozone and 20 for particulate matter, 5 for each of the 4 seasons).  Given the number of
           groups, BenMAP then determines how to assign the model values. In determining to
           which group a value belongs, BenMAP assigns a two-digit "percentile" to each value.
           With values in a given grid-cell sorted from low to high, the percentile for each value will
           equal: (the observation rank number minus 0.5) divided by (the total number of values)
           multiplied by (100). If there are 250 hourly values, the first hourly value will have a
           percentile = (1-0.5)/(250)*(100) = 0.20%; the 27th value will have a percentile =
           (27-0.5)/(250)*(100) = 10.60%; and so on.

           Each data group is represented by "group-lo" and "group-hi" values. These are the
           minimum and the maximum percentiles in each group, where group-lo equals: (group rank
           minus 1) multiplied by (100) divided by (the number of groups); and group-hi equals:
           (group rank) multiplied by (100) divided by (the number of groups) minus 0.001.  If there
           are ten groups: the first group will have: group-lo = (1-1)7100*10 = 0.000%, and group-hi
           = (1/100* 10)-0.001 = 9.999% ; the second group will have: group-lo = (2-l)/100*10 =
           10.000%, and group-hi = (2/100*10)-0.001 = 19.999% ; and so on to the tenth group,
           which will have:  group-lo = (10-1)/100*10 = 90.000%, and group-hi = (10/100* 10)-0.001
           = 99.999%. BenMAP assigns each observation to a particular group with the following
           algorithm: if "group-lo" <"percentile" < "group-hi", then assign the observation to that data
           group.

           Below we give some examples  of the calculations that BenMAP performs when scaling.

C.5.1.1 Example: PM2.5 Scaling Factors in U.S. Setup
           After preparing the PM2.5 model and monitor data, BenMAP calculates the following:
           adjusted monitor.  ,. _ -momtor. .....
                                          REMSAD.
           where:

           adjusted monitor


           monitor
           k


           1
= predicted daily PM2.5 level, after
adjustment by model data (ug/m3)

= observed daily PM2.5 monitor level
(ug/m3)

= day identifier

= model season/quintile group (1 to
20)

= grid cell identifier for population
grid cell

= grid cell identifier for grid cell
containing monitor
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                                                                                  September 2008

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                                          Appendix C: Air Pollution Exposure Estimation Algorithms
           base                             = base-year (e.g., 2000)

           future                            = future-year (e.g., 2020)

           REMSAD                        = representative model
                                            season/quintile value (ug/m3)

           After adjusting the monitor values to reflect air quality modeling, BenMAP calculates for
           each monitor the PM2.5 metrics needed to estimate adverse health effects.  In the case of
           VNA, BenMAP then calculates a weighted average (e.g., inverse-distance weighted
           average) of the neighbors identified for each population grid cell:
           population grid cell,.^^ =2 adjusted monitorm ti,,£ • weightn •
                                 (—« _


           where:

           population grid cell                = inverse distance-weighted PM2.5
                                            metric at population grid cell (ug/m3)

           adjusted monitor                  = predicted PM2.5 metric, after
                                            adjustment by model data (ug/m3)

           m                               = monitor identifier

           base                             = base-year (e.g., 2000)

           future                            = future-year (e.g., 2020)

           weight                           = inverse-distance weight for monitor

           After generating the bins for both the baseline and control scenarios, BenMAP uses these
           to calculate the change in air quality needed in most  health impact functions to calculate
           the change in adverse health effects.  To calculate the change in air quality, BenMAP
           subtracts the baseline value in the first bin from the control value in the first bin, and so on
           for each of the bins created for the daily PM2 5 average.

C.5.1.2  Example: Ozone Scaling in U.S. Setup
           After preparing the ozone model and monitor data, BenMAP calculates the following:
           adjusted monitor.^.^^..^ -mon'Mor-.^.^^ • —
                                            CAMX.,.^
           where:
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                               Appendix C: Air Pollution Exposure Estimation Algorithms
adjusted monitor                 = predicted hourly ozone level,
                                 after adjustment by model data
                                 (ppb)

monitor                         = observed hourly ozone monitor
                                 level (ppb)

i                                = hour identifier

j                                = model decile group (1 to 10)

k                                = grid cell identifier for population
                                 grid cell

1                                = grid cell identifier for grid cell
                                 containing monitor

base                             = base-year (e.g., 1996)

future                           = future-year (e.g., 2030)

CAMX                          = representative model decile
                                 value (ppb)

After adjusting the monitor values to reflect air quality modeling, BenMAP calculates for
each monitor the ozone metrics needed to estimate adverse health effects.  In the case of
VNA, BenMAP then calculates a weighted average (e.g., inverse-distance weighted
average) of the neighbors identified for each population grid cell:
popuscslon grid ceil tjL1.. = £ adju^ied moniior  faa.
                          w  ]
where:

population grid cell                 = inverse distance-weighted ozone
                                  metric at population grid cell (ppb)

adjusted monitor                   = predicted ozone metric, after
                                  adjustment by model data (ppb)

m                                = monitor identifier

future                             = future-year (2020, 2030)

weight                            = inverse-distance weight for
                                  monitor

After generating the bins for both the baseline and control scenarios, BenMAP can use
these to calculate the change in air quality needed in most C-R functions to calculate the
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                                         Appendix C: Air Pollution Exposure Estimation Algorithms
           change in adverse health effects.  To calculate the change in air quality, BenMAP subtracts
           the baseline value in the first bin from the control value in the first bin, and so on for each
           of the bins created for the daily ozone metrics.
C.6    Binned Metrics

           When estimating air pollution exposure, it will often happen that metrics are often not
           available for each day in the year.  To remedy this, BenMAP calculates representative
           values or bins with the available daily metrics, under the assumption that the missing days
           have a similar distribution. Each bin represents a day. In the case where there are 365
           bins, the set of bins represents the entire year.

           When combining air pollution metrics from multiple monitors, BenMAP first calculates
           the bins for the daily metrics, and then combines the bins, such as with some form of VNA
           .  Once BenMAP has calculated binned exposure measures for both a baseline and a
           control scenario, BenMAP then takes the difference between the two scenarios for each
           bin - taking the difference between the baseline value in the first bin and the control value
           in the first bin, and so on for each of the bins.
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                                                  Appendix D: Deriving Health Impact Functions
        Appendix D: Deriving Health Impact  Functions

           This Appendix provides of an overview regarding the health impact functions that
           BenMAP uses to estimate the impact of a change in air pollution on adverse health effects.
           It provides a description of the particular types of health impact functions that BenMAP
           uses.

           The functional form of the relationship between the change in pollutant concentration, Ax,
           and the change in population health response (usually an incidence rate), Ay depends on
           the functional form of the C-R function from which it is derived, and this depends on the
           underlying relationship assumed in the epidemiological study chosen to estimate a given
           effect. For expository simplicity, the following subsections refer simply to a generic
           adverse health effect, "y" and uses paniculate matter (PM) as the pollutant - that is, Ax = A
           PM - to illustrate how the relationship between Ax and Ay is derived from each of several
           different C-R functions.

           Estimating the relationship between APM and Ay can be thought of as consisting of three
           steps:


           (1) choosing a functional form of the relationship between PM and y (the C-R function),
           (2) estimating the values of the parameters in the C-R function assumed, and
           (3) deriving the relationship between APM and Ay (the health impact function) from the
           relationship between PM and y (the C-R function).

           Epidemiological studies have used a variety of functional forms  for C-R functions.  Some
           studies have assumed that the relationship between adverse health and pollution is best
           described by a linear form, where the relationship between y and PM is estimated by a
           linear regression in which y is the dependent variable and PM is  one of several
           independent variables. Log-linear regression and logistic regression are other common
           forms.

           Note that the the log-linear form used in the epidemiological literature is often referred to
           as "Poisson regression" because the underlying dependent variable is a count (e.g., number
           of deaths), believed to be Poisson distributed. The model may be estimated by regression
           techniques but is often estimated by maximum likelihood techniques.  The form of the
           model, however, is still log-linear.

D.1     Overview

           The relationship between the concentration of a pollutant, x, and the population response,
           y, is called the concentration-response (C-R) function. For example, the concentration  of
           the pollutant may be fine particulate matter (PM2 5) in ug/m3 per day, and the population
           response may be the number  of premature deaths per 100,000 population per day. C-R
           functions are estimated in epidemiological studies. A functional form is chosen by the
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                                                    Appendix D: Deriving Health Impact Functions
           researcher, and the parameters of the function are estimated using data on the pollutant
           (e.g., daily levels of PM2 5) and the health response (e.g., daily mortality counts). There are
           several different functional forms, discussed below, that have been used for C-R functions.
           The one most commonly used is the log-linear form, in which the natural logarithm of the
           health response is a linear function of the pollutant concentration.

           For the purposes of estimating benefits, we are not interested in the C-R function itself,
           however, but the relationship between the change in concentration of the pollutant, Ax, and
           the corresponding change in the population health response, Ay. We want to know, for
           example, if the concentration of PM2 5 is reduced by 10 ug/m3, how many premature
           deaths will be avoided? The relationship between Ax and Ay can be derived from the C-R
           function, as described below, and we refer to this relationship as a health impact function.

           Many epidemiological studies, however, do not report the C-R  function, but instead report
           some measure of the change in the population health response associated with a specific
           change in the pollutant concentration. The most common measure reported is the relative
           risk associated with a given change in the pollutant concentration.  A general relationship
           between Ax and Ay can, however, be derived from the relative risk. The relative risk and
           similar measures reported in epidemiological studies are discussed in the sections below.
           The derivation of the relationship of interest for BenMAP - the relationship between Ax
           and Ay - is discussed in the subsequent sections.

D.2    Review Relative Risk and Odds Ratio

           The terms relative risk and odds ratio are related but distinct. Table D-l provides the basis
           for demonstrating their relationship.
                            Table D-l. Relative Risk and Odds Ratio Notation


           Exposure                      Fraction of Population            Adverse Effect Measure

                                      Affected        Not Affected    Relative Risk        Odds
Baseline Pollutant
Exposure
Control Pollutant Exposure
yO

yc
1-yO

1-yc
yO/(l-yc)
yO/yc
yc/(l-yc)
           The "risk" that people with baseline pollutant exposure will be adversely affected (e.g.,
           develop chronic bronchitis) is equal to y0, while people with control pollutant exposure
           face a risk, y  of being adversely affected. The relative risk (RR) is simply:
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                                                     Appendix D: Deriving Health Impact Functions
           The odds that an individual facing high exposure will be adversely affected is:
           The odds ratio is then:
           This can be rearranged as follows:
           As the risk associated with the specified change in pollutant exposure gets small (i.e., both
           y0 and  ycapproach zero), the ratio of (l-yc) to (l-y0) approaches one, and the odds ratio
           approaches the relative risk. This relationship can be used to calculate the pollutant
           coefficient in the C-R function from which the reported odds ratio or relative risk is
           derived, as described below.
D.3    Linear Model
           A linear relationship between the rate of adverse health effects (incidence rate) and various
           explanatory variables is of the form:
                                               v = a + B • PM
           where a incorporates all the other independent variables in the regression (evaluated at
           their mean values, for example) times their respective coefficients. The relationship
           between the change in the rate of the adverse health effect from the baseline rate (y0) to the
           rate after control (yc) associated with a change from PM0 to PMc is then:
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                                                    Appendix D: Deriving Health Impact Functions
                                      Av = JL. - y,, - j3{. PMe - PM,)=j3-AP.Vf.


           For example, Ostro et al. (1991, Table 5) reported a PM2 5 coefficient of 0.0006 (with a
           standard error of 0.0003) for a linear relationship between asthma and PM2 5 exposure.

           The lower and upper bound estimates  for the PM2 5 coefficient are calculated as follows


                               P-^^.4 -^-(t.96-0%) =0.0006-(1.960.0003) = L2iO";
                               A^«,^ =0+(l96-as) =0.0006 + (1.96-0.0003) =0.00119


           It is then straightforward to calculate lower and upper bound estimates of the change in
           asthma.

D.4    Log-linear Model

           The log-linear relationship defines the incidence rate (y) as:
           or, equivalently,
           where the parameter B is the incidence rate of y when the concentration of PM is zero, the
           parameter P is the coefficient of PM, ln(y) is the natural logarithm of y, and a = ln(B).
           Other covariates besides pollution clearly affect mortality.  The parameter B might be
           thought of as containing these other covariates, for example, evaluated at their means.
           That is, B = BoexpjBlxl + ...  + Bnxn}, where Bo is the incidence of y when all covariates
           in the model are zero, and xl,  ... , xn are the other covariates evaluated at their mean
           values. The parameter B drops out of the model, however, when changes in y are
           calculated, and is therefore not important.

           The relationship between  APM and Ay is:
           This may be rewritten as:
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                                          Appendix D: Deriving Health Impact Functions
where y0 is the baseline incidence rate of the health effect (i.e., the incidence rate before
the change in PM).

The change in the incidence of adverse health effects can then be calculated by multiplying
the change in the incidence rate, Ay, by the relevant population (e.g., if the rate is number
per 100,000 population, then the relevant population is the number of 100,000s in the
population).

When the PM coefficient (P) and its standard error (op) are published (e.g.,  Ostro et al.,
1989), then the coefficient estimates associated with the lower and upper bound may be
calculated easily as follows:
Epidemiological studies often report a relative risk for a given APM, rather than the
coefficient, P (e.g., Schwartz et al., 1995, Table 4). Recall that the relative risk (RR) is
simply the ratio of two risks:
Taking the natural log of both sides, the coefficient in the C-R function underlying the
relative risk can be derived as:
                                          •.?\r
The coefficients associated with the lower and upper bounds (e.g., the 2.5 and 97.5
percentiles) can be calculated by using a published confidence interval for relative risk, and
then calculating the associated coefficients.

Because of rounding of the published RR and its confidence interval, the standard error for
the coefficient implied by the lower bound of the RR will not exactly equal that implied by
the upper bound, so an average of the two estimates is used. The underlying standard error
for the coefficient (op) can be approximated by:
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                                                    Appendix D: Deriving Health Impact Functions
D.5    Logistic Model
           In some epidemiological studies, a logistic model is used to estimate the probability of an
           occurrence of an adverse health effect.  Given a vector of explanatory variables, X, the
           logistic model assumes the probability of an occurrence is:
           where (3 is a vector of coefficients. Greene (1997, p. 874) presents models with discrete
           dependent variables, such as the logit model.  See also Judge et al. (1985, p. 763).  This
           may be rewritten as:
           The odds of an occurrence is:
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                                       Appendix D: Deriving Health Impact Functions
                                         y-i
The odds ratio for the control scenario (odds ) versus the baseline (odds0) is then:
The change in the probability of an occurrence from the baseline to the control (Ay),
assuming that all the other covariates remain constant, may be derived from this odds ratio:
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                                          Appendix D: Deriving Health Impact Functions
Multiplying by:
gives:
                                  1-v.
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                                   234

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                                          Appendix D: Deriving Health Impact Functions
The change in the number of cases of the adverse health effect is then obtained by
multiplying by the relevant population:
                        *>-:-j = Av pop-
When the coefficient (P) and its standard error (op) are published (e.g., Pope et al., 1991,
Table 5), then the coefficient estimates associated with the lower and upper bound may be
calculated easily as follows:
Often the logistic regression coefficients are not published, and only the odds ratio
corresponding to a specified change in PM is presented (e.g., Schwartz et al., 1994). It is
easy to calculate the underlying coefficient as follows:

                                ln(aiKr ratal = APM • S
                                           A?.1./
The coefficients associated with the lower and upper bound estimates of the odds ratios are
calculated analogously.

The underlying standard error for the coefficient (op) can be approximated by:
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                                          Appendix D: Deriving Health Impact Functions
Sometimes, however, the relative risk is presented. The relative risk does not equal the
odds ratio, and a different procedure should be used to estimate the underlying coefficient.
Note that ESEERCO (1994, p. V-21) calculated (incorrectly) the underlying regression
coefficient for Abbey et al.  (1993, Table 5) by taking the logarithm of the relative risk and
dividing by the change in TSP.

The relative risk (RR) is simply:
where y0 is the risk (i.e., probability of an occurrence) at the baseline PM exposure and yc
is the risk at the control PM exposure.

When the baseline incidence rate (y0) is given, then it is easy to solve for the control
incidence rate (y):
The odds ratio, may then be calculated:
Given the odds ratio, the underlying coefficient (P) may be calculated as before:
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                                          Appendix D: Deriving Health Impact Functions
                                      In; odd: ratio]
                                   0 ~    AP.M    '


The odds ratio and the coefficient calculated from it are dependent on the baseline and
control incidence rates.  Unfortunately, it is not always clear what the baseline and control
incidence rates should be. Abbey et al. (1995b, Table 2) reported that there are 117 new
cases of chronic bronchitis out of a sample of 1,631, or a 7.17 percent rate.  In addition,
they reported the relative risk (RR = 1.81) for a new case of chronic bronchitis associated
with an annual mean concentration "increment" of 45 ug/m3  of PM25 exposure.

Assuming that the baseline rate for chronic bronchitis (y0) should be 7.17 percent, the
question becomes whether the "increment" of 45 ug/m3 should be added to or subtracted
from the existing PM2 5 concentration. If added the control incidence rate (yc) would be
greater than the baseline rate (y0), while subtraction would give a control rate less than the
incidence rate. In effect, one might reasonably derive two estimates of the odds ratio:

                                    _ X1.S"; _ , ,. .  .
An alternative is to simply assume that the relative risk (1.81) is reasonably close to the
odds ratio and calculate the underlying coefficient. It is easy to show that the relative risk
equals:
                                  237
                                                                        September 2008

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                                         Appendix D: Deriving Health Impact Functions
Assuming that:
It is then possible to calculate the underlying coefficient:
Since this coefficient estimate is based on the assumption that
it should be used in a C-R function that maintains this assumption.  In effect, it should be
applied to a log-linear C-R function:
Using the formula for the change in the incidence rate and assuming a 10 ug/m3 decline in
PM2 5, it is shown that this results in changes within the bounds suggested by the two
estimates based on using the estimated odds ratios:
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                                                    Appendix D: Deriving Health Impact Functions
           In this instance, it seems that simply using the relative risk to estimate the underlying
           coefficient results in a good approximation of the change in incidence.  Since it is unclear
           which of the two other coefficients (Pj or P2) should be used - as the published work was
           not explicit - the coefficient based on the relative risk and the log-linear functional form
           seems like a reasonable approach.

D.6    Cox proportional Hazards Model

           Use of a Cox proportional hazards model in an epidemiological study results in a C-R
           function that is log-linear in form.  It is often used to model survival times, and as a result,
           this discussion focuses on mortality impacts.

           The Cox proportional hazards model is based on a hazard function, defined as the
           probability that an individual dies at time t, conditional on having survived up to time t
           (Collet, 1994, p.  10).  More formally, the hazard function equals the probability density
           function for the risk of dying divided by one minus the cumulative probability density
           function:
           The proportional hazards model takes the form:
           where X is a vector of explanatory variables, (3 is a vector of coefficients, and h0(t) is the
           so-called "baseline hazard" rate. This terminology differs from that used in most of this
           discussion: this "baseline hazard" is the risk when all of the covariates (X) are set to zero;
           this is not the risk in the baseline scenario.

           The Cox proportional hazards model is sometimes termed a "semi-parametric" model,
           because the baseline hazard rate is calculated using a non-parametric method, while the
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                                          Appendix D: Deriving Health Impact Functions
impact of explanatory variables is parameterized.  Collet (1994) details the estimation of
Cox proportional hazards models; in particular, see Collet's discussion (pp. 95-97) of
nonparametric estimation of the baseline hazard.

Taking the ratio of the hazard functions for the baseline and control scenarios gives the
relative risk:
where it is assumed that the only difference between the baseline and control is the level of
 PM pollution.

The relative risk is often presented rather than the coefficient P, so it is necessary to
estimate  P in order to develop functional relationship between APM and Ay, as described
previously for log-linear C-R functions.
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                                   240

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                                     Appendix E: Health Incidence & Prevalence Data in U.S. Setup
        Appendix  E: Health Incidence & Prevalence  Data

        in U.S.  Setup

           Health impact functions developed from log-linear or logistic models estimate the percent
           change in an adverse health effect associated with a given pollutant change. In order to
           estimate the absolute change in incidence using these functions, we need the baseline
           incidence rate of the adverse health effect. And for certain health effects, such as asthma
           exacerbation, we need a prevalence rate, which estimates the percentage of the general
           population with a given ailment like asthma. This appendix describes the data used to
           estimate baseline incidence and prevalence rates for the health effects considered in this
           analysis.

E.1     Mortality

           This section describes the development of the year 2000 through 2050 county mortality
           rates for use in BenMAP. First, we describe the source of 1996-1998 county-level
           mortality rates,  and then we describe how we use national-level Census mortality rate
           projections to develop 2000-2050 county-level mortality rate projections.

E. 1.1   Mortality Rates 1996-1998

           Age, cause, and county-specific mortality rates were obtained from the U.S. Centers for
           Disease Control (CDC) for the years 1996 through 1998.  CDC maintains an  online data
           repository of health statistics, CDC Wonder, accessible at http://wonder.cdc.gov/. The
           mortality rates provided are derived from U.S. death records and U.S. Census Bureau
           postcensal population estimates. Mortality rates were averaged across three years (1996
           through 1998) to provide more stable estimates. Population-weighted national mortality
           rates are presented in Table E-l.
              Table E-l. Population-Weighted Mortality Rates (per 100 people per year) for
                                   Selected Conditions, by Age Group
           Mortality Category     0-17   18-24  25-29  30-34  35-44  45-54  55-64  65-74  75-84   85+
           (ICD codes)
           All-Cause
0.045  0.093  0.119  0.119  0.211  0.437   1.056  2.518  5.765  15.160
           Non-Accidental (ICD   0.025   0.022  0.057  0.057  0.150  0.383  1.006  2.453  5.637  14.859
           <800)

           Chronic Lung Disease   0.000   0.001  0.001  0.001  0.002  0.009  0.046  0.166  0.367  0.561
           (ICD 490-496)
           Cardio-Pulmonarv
0.004  0.005  0.013   0.013  0.044  0.143   0.420  1.163  3.179   9.846
                                            241
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                                       Appendix E: Health Incidence & Prevalence Data in U.S. Setup
E.1.2   Mortality Rate Projections 2000-2050

           To estimate age- and county-specific mortality rates in years 2000 through 2050, we
           calculated adjustment factors, based on a series of Census Bureau projected national
           mortality rates, to adjust the CDC Wonder age- and county-specific mortality rates in
           1996-1998 to corresponding rates for each future year.  The procedure we used was as
           follows:

           • For each age group, we derived an estimate of the national mortality rate in 1997 (the
             midpoint year in the period 1996 - 1998) consistent with the series of Census Bureau
             projected national mortality rates, which starts in 1999. We did this by regressing
             projected mortality rate on year, separately for each age group, using the ten years of
             Census Bureau projected rates from 1999 - 2008.  The resulting estimated national age-
             group-specific mortality rates for 1997 are shown in Table E-2. Note that the Census
             Bureau projected mortality rates were derived from crude death rates using the following
             formula, given by Chiang (1967, p.2 equation 7): M = Q/(1-(1-A)*Q), where M denotes
             projected mortality rate, Q denotes crude death rate, and A denotes the fraction of the
             interval (one year) lived by individuals who die in the interval.  A=0.1  if age < 1, and
             A=0.5 otherwise.

           • We then calculated, separately for each age-group, the ratio of Census Bureau national
             mortality rate in year Y (Y = 2000, 2001, ..., 2050) to the national mortality rate in 1997,
             estimated in the previous step to be consistent with the Census Bureau series of rates
             starting in 1999.  These ratios are shown for selected years in Table E-3.

           • Finally, to estimate mortality rates in year Y (Y = 2000, 2001, ..., 2050) that are both
             age-group-specific and county-specific, we multiplied the CDC Wonder county-specific
             age-group-specific mortality rates for  1996-1998 by the appropriate ratio calculated in
             the previous step. For example, to estimate the projected mortality rate in 2010 among
             ages 18-24 in Wayne County, MI, we multiplied the CDC Wonder mortality rate for ages
             18-24 in Wayne County in 1996-1998 by the ratio of Census Bureau projected national
             mortality rate in 2010 for ages 18-24 to (estimated) Census Bureau national  mortality
             rate in 1997 for ages 18-24.
           Table E-2.  All-Cause Mortality Rate (per 100 people per year), by Source, Year, and Age
                                                 Group
Source & Year
Census Bureau 2000
Est. Census Bureau 1997
CDC Wonder 1996-1 998
Estimated 2000 **
Infant *
0,
0,
0,
0,
.687
.706
.246
.239
1-17
0.030
0.031
0.034
0.033
18-24
0.093
0.095
0.093
0.091
25-34
0.106
0.108
0.119
0.116
35-44
0.192
0.199
0.211
0.204
45-54
0.408
0.421
0.437
0.424
55-64
0.998
1.032
1.056
1.022
65-74
2.454
2.555
2.518
2.419
75-84
5.636
5.787
5.765
5.615
85+
13.541
13.846
15.160
14.826
                          * Note that the Census Bureau estimate is for all deaths in the first year of
                          life. The CDC Wonder estimate if for post-neonatal mortality (deaths after
                          the first month), because the health impact function (see Appendix F)
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                                       Appendix E: Health Incidence & Prevalence Data in U.S. Setup
                           estimates post-neonatal mortality.
                           ** The estimate for 2000 is a population-weighted average of the
                           county-level forecasts for 2000 that are calculated from the CDC Wonder
                           county-level estimates and the ratio of the Census Bureau estimates for 2000
                           and 1997.
            Table E-3. Ratio of Future Year All-Cause Mortality Rate to 1997 Estimated All-Cause
                                       Mortality Rate, by Age Group
Year
2000
2005
2010
2015
2020
2025
2030
2035
2040
2045
2050
Infant
0.97
0.93
0.88
0.83
0.78
0.72
0.66
0.61
0.56
0.51
0.47
1-17
0.97
0.94
0.88
0.81
0.76
0.71
0.66
0.61
0.56
0.52
0.48
18-24
0.97
0.93
0.88
0.84
0.79
0.75
0.70
0.66
0.62
0.58
0.55
25-34
0.98
0.95
0.91
0.88
0.86
0.80
0.75
0.70
0.66
0.62
0.58
35-44
0.97
0.92
0.87
0.82
0.77
0.73
0.68
0.64
0.60
0.56
0.53
45-54
0.97
0.92
0.88
0.83
0.78
0.73
0.68
0.64
0.60
0.57
0.53
55-64
0.97
0.90
0.86
0.82
0.78
0.74
0.69
0.65
0.60
0.57
0.54
65-74
0.96
0.90
0.84
0.79
0.76
0.72
0.70
0.67
0.63
0.60
0.56
75-84
0.97
0.93
0.89
0.83
0.77
0.73
0.71
0.68
0.65
0.63
0.59
85+
0.98
0.95
0.91
0.89
0.86
0.82
0.77
0.72
0.70
0.69
0.68
E.2    Hospitalizations
           Regional hospitalization counts were obtained from the National Center for Health
           Statistics' (NCHS) National Hospital Discharge Survey (NHDS).  NHDS is a
           sample-based survey of non-Federal, short-stay hospitals (<30 days), and is the principal
           source of nationwide hospitalization data.  The survey collects data on patient
           characteristics, diagnoses, and medical procedures. However, note that the following
           hospital types are excluded from the survey: hospitals with an average patient length of
           stay of greater than 30 days, federal, military, Department of Veterans Affairs hospitals,
           institutional hospitals (e.g. prisons), and hospitals with fewer than six beds.

           Public use data files for the year 1999 survey were downloaded (from:
           ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHDS/) and processed to estimate
           hospitalization counts by region.  NCHS groups states into four regions using the
           following groupings defined by the U.S. Bureau of the Census:

           • Northeast - Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New
             York, New Jersey, Pennsylvania
           • Midwest - Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North
             Dakota, South Dakota, Nebraska, Kansas
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                           Appendix E: Health Incidence & Prevalence Data in U.S. Setup
• South - Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina,
  South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas,
  Louisiana, Oklahoma, Texas
• West - Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada,
  Washington, Oregon, California, Alaska, Hawaii
We calculated per capita hospitalization rates, by dividing these counts by the estimated
regional population estimates for 1999 that we derived from the U.S. Bureau of the Census
and the population projections used by NHDS to generate the counts.  Note that NHDS
started with hospital admission counts, based on a sample of admissions,  and then they
used population estimates to generate population-weighted hospital admission counts that
are representative of each region. This weighting used forecasts of 1999 population data.
Ideally, we would use these same forecasts to generate our admission rates. However,
while NHDS presented counts of hospital admissions with a high degree of age specificity,
it presented regional population data for only four  age groups: 0-14, 15-44, 45-64, and 65+.
Using only the NHDS data, we would be limited to calculating regional admission rates for
four groups. Because we are interested in a broader range of age groups, we turned to
2000 Census.

We used the 2000 Census to obtain more age specificity, and then corrected the 2000
Census figures so that the total population equaled the total for 1999 forecasted by NHDS.
That is, we sued the following procedure: (1) we calculated the count of hospital
admissions by region in 1999 for the age groups of interest, (2) we calculated the 2000
regional populations corresponding to these age groups, (3) calculated regional correction
factors, that equal the regional total population in 1999 divided by the regional total
population in 2000 by region, (4) multiplied the 2000 population estimates by these
correction factors, and (5) divided the 1999 regional count of hospital admissions by the
estimated  1999 population.

The endpoints in hospitalization studies are defined using different combinations of ICD
codes. Rather than generating a unique baseline incidence rate for each ICD code
combination, for the purposes of this analysis, we identified a core group  of hospitalization
rates from the studies and applied the appropriate combinations of these rates in the health
impact functions:

• all respiratory (ICD-9 460-519)
• chronic lung disease (ICD-9  490-496)
• asthma (ICD-9 493)
• pneumonia (ICD-9 480-487)
• acute bronchitis (ICD-9 466)
• acute laryngitis (ICD-9 464)
• all cardiovascular (ICD-9 390-459)
• ischemic heart disease (ICD-9 410-414)
• dysrhythmia (ICD-9 427)
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                                     Appendix E: Health Incidence & Prevalence Data in U.S. Setup
           • congestive heart failure (ICD-9 428)
           For each C-R function, we selected the baseline rate or combination of rates that most
           closely matches to the study endpoint definition. For studies that define chronic lung
           disease as ICD 490-492, 494-496, we subtracted the incidence rate for asthma (ICD 493)
           from the chronic lung disease rate (ICD 490-496). In some cases, the baseline rate will not
           match exactly to the endpoint definition in the study. For example, Burnett et al. (2001)
           studied the following respiratory conditions in infants <2 years of age: ICD 464.4, 466,
           480-486, 493. For this C-R function we apply an aggregate of the following rates:  ICD
           464, 466, 480-487, 493. Although they do not match exactly, we assume that relationship
           observed between the pollutant and study-defined endpoint is applicable for the additional
           codes. Table E-4 presents a summary of the national hospitalization rates for 1999 from
           NHDS.
              Table E-4. Hospitalization Rates (per 100 people per year), by Region and Age
                                                Group
Hospital Admission Category
Respiratory





Cardiovascular



all respiratory
acute laryngitis
acute bronchitis
pneumonia
asthma
chronic lung disease
all cardiovascular
ischemic heart disease
dysrhythmia
congestive heart
failure
ICD-9 Code 0-18
460-519
464
466
480-487
493
490-496
390-429
410-414
427
428
1
0,
0,
0,
0,
0,
0,
0,
0,
0,
.066
.055
.283
.308
.281
.291
.030
.004
.011
.003
18-24
0.271
0.002
0.017
0.069
0.081
0.089
0.052
0.008
0.017
0.005
25-34
0.
0.
0.
0.
0.
0,
0,
0,
0,
0,
,318
,001
,014
103
,110
.124
.146
.031
.027
.011
35-44
0.446
0.002
0.017
0.155
0.099
0.148
0.534
0.231
0.076
0.011
45-54
0.763
0.008
0.027
0.256
0.144
0.301
1.551
0.902
0.158
0.160
55-64
1.632
0.000
0.040
0.561
0.161
0.711
3.385
2.021
0.392
0.469
65+
5.200
0.005
0.156
2.355
0.205
1.573
8.541
3.708
1.387
2.167
E.3    Emergency Room Visits for Asthma

           Regional asthma emergency room visit counts were obtained from the National Hospital
           Ambulatory Medical Care Survey (NHAMCS).  NHAMCS is a sample-based survey,
           conducted by NCHS, designed to collect national data on ambulatory care utilization in
           hospital emergency and outpatient departments of non-Federal, short-stay hospitals (<30
           days). The target universe of the NHAMCS is in-person visits made in the United States to
           emergency and outpatient departments of non-Federal, short-stay hospitals (hospitals with
           an average stay of less than 30 days) or those whose specialty is general (medical or
           surgical) or children's general.
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                                      Appendix E: Health Incidence & Prevalence Data in U.S. Setup
           Public use data files for the year 2000 survey were downloaded (from:
           ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHAMCS/) and processed to
           estimate hospitalization counts by region. We obtained population estimates from the
           2000 U.S. Census.  The NCHS regional groupings described above were used to estimate
           regional emergency room visit rates.  Table E-5 presents the estimated asthma emergency
           room rates by region.
            Table E-5.  Emergency Room Visit Rates (per 100 people per year) for Asthma, by
                                         Region and Age Group
ER Category ICD-9 Code
asthma 493



Region
Northeast
Midwest
South
West
0-18
0.761
1.476
1.243
0.381
18-64
0.802
0.877
0.420
0.381
65+
0.300
0.334
0.192
0.137
E.4    Nonfatal Heart Attacks

           The relationship between short-term paniculate matter exposure and heart attacks was
           quantified in a case-crossover analysis by Peters et al. (2001).  The study population was
           selected from heart attack survivors in a medical clinic. Therefore, the applicable
           population to apply to the C-R function is all individuals surviving a heart attack in a given
           year. Several data sources are available to estimate the number of heart attacks per year.
           For example, several cohort studies have reported estimates of heart attack incidence rates
           in the specific populations under study. However, these rates depend on the specific
           characteristics of the populations under study and may not be the best data to extrapolate
           nationally. The American Heart Association reports approximately 540,000 new heart
           attacks per year using data from a multi-center study (Haase, 2002, to be published in the
           American Heart Association's 2003 Statistical Handbook). Exclusion of heart attack
           deaths reported by CDC Wonder yields approximately 330,000 nonfatal cases per year.

           An alternative approach to the estimation of heart attack rates is to use data from the
           National Hospital Discharge Survey, assuming that all heart attacks that are not instantly
           fatal will result in a hospitalization. According to the National Hospital Discharge Survey,
           in 1999 there were approximately 829,000 hospitalizations due to heart attacks (acute
           myocardial infarction: ICD-9 410) (Popovic, 2001, Table 8).  We used regional
           hospitalization rates over estimates extrapolated from cohort studies because the former is
           part of a nationally representative survey with a larger sample  size, which is intended to
           provide reliable national estimates. As additional information is provided regarding the
           American Heart Association methodology, we will evaluate the usefulness of this estimate
           of heart attack incidence.
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                                      Appendix E: Health Incidence & Prevalence Data in U.S. Setup
           Rosamond et al. (1999) reported that approximately six percent of male and eight percent
           of female hospitalized heart attack patients die within 28 days (either in or outside of the
           hospital). We, therefore, applied a factor of 0.93 to the count of hospitalizations to
           estimate the number of nonfatal heart attacks per year. To estimate the rate of nonfatal
           heart attack, we divided the count by the population estimate for 2000 from the U.S.
           Census.  Table E-6 presents the regional nonfatal heart attack incidence rates.
             Table E-6. Nonfatal Heart Attack Rates (per 100 people per year), by Region and
                                                Age Group
Effect
nonfatal heart attacks (ICD-9
410)



Region
Northeast
Midwest
South
West
0-18
0.0000
0.0003
0.0006
0.0000
18-64
0.2167
0.1772
0.1620
0.1391
65+
1.6359
1.4898
1.1797
1.1971
                           * Rates are based on data from the 1999 National Hospital
                           Discharge Survey (NHDS) and an estimate from Rosamond et al.
                           that approximately 7% of individuals hospitalized for a heart
                           attack die within 28 days.
E.5    School Loss Days
           Epidemiological studies have examined the relationship between air pollution and a variety
           of measures of school absence.  These measures include: school loss days for all causes,
           illness-related, and respiratory illness-related. We have two sources of information.  The
           first is the National Center for Education Statistics, which provided an estimate of
           all-cause school loss days, and the other is the National Health Interview Survey (Adams et
           al.,  1999, Table 47), which has data on different categories of acute school loss days.
           Table E-7 presents the estimated school loss day rates. Further detail is provided below on
           these rates.
                         Table E-7.  School Loss Day Rates (per student per year)
Type
Respiratory illness-related
absences
Illness-related absences
All-cause
Northeast
1.3
2.4
9.9
Midwest
1.7
2.6
9.9
South
1.1
2.6
9.9
West
2.2
3.7
9.9
                           * We based illness-related school loss day rates on data from the
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                                      Appendix E: Health Incidence & Prevalence Data in U.S. Setup
                           1996 NHIS  and an estimate of 180 school days per year. This
                           excludes school loss days due to injuries. We based the all-cause
                           school loss day rate on data from the National Center for
                           Education Statistics.
           All-Cause School Loss Day Rate

           Based on data from the U.S. Department of Education (1996, Table 42-1), the National
           Center for Education Statistics estimates that for the 1993-1994 school year, 5.5 percent of
           students are absent from school on a given day. This estimate is comparable to
           study-specific estimates from Chen et al. (2000) and Ransom and Pope (1992), which
           ranged from 4.5 to 5.1 percent.
           Illness-Related School Loss Day Rate

           The National Health Interview Survey (NHIS) has regional estimates of school loss days
           due to a variety of acute conditions (Adams et al., 1999).  NHIS is a nationwide
           sample-based survey of the health of the noninstitutionalized, civilian population,
           conducted by NCHS. The survey collects data on acute conditions, prevalence of chronic
           conditions, episodes of injury, activity limitations, and self-reported health status.
           However, it does not provide an estimate of all-cause school loss days.

           In estimating illness-related school loss days, we started with school loss days due to acute
           problems (Adams et al., 1999, Table 47) and  subtracted lost days due to injuries, in order
           to match the definition of the study used in the C-R function to estimate illness-related
           school absences (Gilliland et al., 2001). We then divided by 180 school days per to
           estimate illness-related school absence rates per school day.  Similarly, when estimating
           respiratory illness-related school loss  days, we use data from Adams et al. (1999, Table
           47). Note that we  estimated 180 school days in a year to calculate respiratory
           illness-related school absence rates per year.

E.6    Other Acute and Chronic Effects

           For many of the minor effect studies,  baseline rates from a single study are often the only
           source of information, and we assume that these rates hold for locations in the U.S.  The
           use of study-specific estimates are likely to increase the uncertainty around the estimate
           because they are often estimated from a single location using a relatively small sample.
           These endpoints include: acute bronchitis, chronic bronchitis, upper respiratory symptoms,
           lower respiratory symptoms. Table E-8 presents a summary of these baseline rates.
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                                      Appendix E: Health Incidence & Prevalence Data in U.S. Setup
                 Table E-8.  Selected Acute and Chronic Incidence (Cases / Person-Year)
                                  & Prevalence (Percentage Population)
Endpoint
Acute Bronchitis
Chronic Bronchitis
Chronic Bronchitis


Lower Respiratory
C^rmiitr>mc 
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                                     Appendix E: Health Incidence & Prevalence Data in U.S. Setup
           bronchitis.

E.6.3   Chronic Bronchitis Prevalence Rate

           We obtained the annual prevalence rate for chronic bronchitis from the American Lung
           Association (2002a, Table 4). Based on an analysis of 1999 National Health Interview
           Survey data, they estimated a rate of 0.0443 for persons 18 and older, they also reported
           the following prevalence rates for people in the age groups 18-44, 45-64, and 65+: 0.0367,
           0.0505, and 0.0587, respectively.

E.6.4   Lower Respiratory Symptoms

           Lower respiratory symptoms (LRS) are defined as two or more of the following: cough,
           chest pain, phlegm, wheeze. The proposed yearly incidence rate for 100 people, 43.8, is
           based on the percentiles in Schwartz et al. (Schwartz et al., 1994, Table 2).  The authors
           did not report the mean incidence rate, but rather reported various percentiles from the
           incidence rate distribution.  The percentiles  and associated per person per day values are 10
           th = 0 percent, 25th = 0 percent, 50th = 0 percent, 75th = 0.29 percent, and 90th = 0.34
           percent. The most conservative estimate consistent with the data are to assume the
           incidence per person per day is zero up to the 75th percentile, a constant 0.29 percent
           between the 75th and 90th percentiles, and a constant 0.34 percent between the 90th and 100
           th percentiles. Alternatively, assuming a linear slope between the 50th and 75th, 75th and 90
           th, and 90th to 100th percentiles, the  estimated mean incidence rate per person per day is
           0.12 percent. (For example, the 62.5th percentile would have an estimated incidence rate
           per person per day of 0.145 percent.) We used the latter approach in this analysis.

E.6.5   Minor Restricted Activity Days (MRAD)

           Ostro and Rothschild (1989, p. 243) provide an estimate of the annual incidence rate of
           MRADs per person of 7.8.

E.6.6   Work Loss Days

           The yearly work-loss-day incidence rate per 100 people is based on estimates from the
           1996 National Health Interview Survey (Adams et al., 1999, Table 41).  They reported a
           total annual work loss days of 352 million for individuals ages 18 to 65.  The total
           population of individuals of this age group in 1996 (162 million) was obtained from (U.S.
           Bureau of the Census, 1997, No. 22). The average annual rate of work loss days per
           individual is 2.17. Using a similar  approach, we calculated work-loss-day rates for ages
           18-24, 25-44, and 45-64, respectively.

E.7    Asthma-Related Health Effects

           Several studies have examined the impact of air pollution on asthma development or
           exacerbation. Many of the baseline incidence rates used in the C-R functions are based on
           study-specific estimates. The baseline rates for the various endpoints are described below
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                                     Appendix E: Health Incidence & Prevalence Data in U.S. Setup
           and summarized in  TableE-9.
                            Table E-9. Asthma-Related Health Effects Rates
Endpoint
Asthma Exacerbation, Shortness
of Breath, African American
Asthma Exacerbation, Wheeze,
African American
Asthma Exacerbation, Cough,
African American
Asthma Exacerbation, Cough
Upper Respiratory Symptoms
(URS)
Age
8-13
8-13
8-13
8-13
8-13
8-13
6-13
9-11
Parameter a
Incidence
Prevalence
Incidence
Prevalence
Incidence
Prevalence
Incidence
Incidence
Rate
13.51
7.40%
27.74
17.30%
24.46
14.50%
31.39
124.79
Source
Ostroetal(2001,p. 202)
Ostroetal(2001,p. 202)
Ostroetal(2001,p. 202)
Vedal etal (1998, Table 1)

                          NOTE: The incidence rate is the number of cases per person per
                          year. Prevalence refers to the fraction of people that have a
                          particular illness during a particular time period.
E.7.1   Shortness of Breath
           To estimate the annual rate of new shortness of breath episodes among African-American
           asthmatics, ages 8-13, we used the rate reported by Ostro et al. (2001, p.202).  We
           estimated the daily prevalence of shortness of breath episodes among African-American
           asthmatics, ages 8-13, by taking a weighted average of the reported rates in Ostro et al.
           (2001, p.202).
E.7.2   Wheeze
           The daily rate of new wheeze episodes among African-American asthmatics, ages 8-13, is
           reported by Ostro et al. (2001, p.202) as 0.076. We multiplied this value by 100 and by
           365 to get the annual incidence rate per 100 people.  The daily rate of prevalent wheeze
           episodes (0.173) among African-American asthmatics, ages 8-13, is estimated by taking a
           weighted average of the reported rates in Ostro et al. (2001, p.202)
E.7.3   Cough
           The daily rate of new cough episodes among African-American asthmatics, ages 8-13, is
           reported by Ostro et al. (2001, p.202) as 0.067. We multiplied this value by 100 and by
           365 to get the annual incidence rate per 100 people.  The daily rate of prevalent cough
           episodes (0.145) among African-American asthmatics, ages 8-13, is estimated by taking a
           weighted average of the reported rates in Ostro et al. (2001, p.202).
                                            251
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                                     Appendix E: Health Incidence & Prevalence Data in U.S. Setup
E.7.4   Upper Respiratory Symptoms

           Upper Respiratory Symptoms are defined as one or more of the following: runny or stuffy
           nose; wet cough; burning, aching, or red eyes.  Using the incidence rates for upper
           respiratory symptoms among asthmatics, published in Pope et al. (1991, Table 2), we
           calculated a sample size-weighted average incidence rate.

E.7.5   Asthma Population Estimates

           In studies examining the association between air pollution and the development or
           exacerbation of asthma, often times an estimate of the percent of the population with
           asthma is required.  Asthma percentages were obtained either directly from the National
           Health Interview Survey (NHIS) or an American Lung Association (2002c) report
           summarizing data from NHIS. Table E-10 presents asthma prevalence rates used to define
           asthmatic populations in the health impact functions.
              Table E-10. Asthma Prevalence Rates Used to Estimate Asthmatic Populations
Population Group
All Ages
<18
5-17
18-44
45-64
65+
African- American, 5 to 17
African- American, <18
Male, 27+
Prevalence
3.86%
5.27%
5.67%
3.71%
3.33%
2.21%
7.26%
7.35%
2.10%
Source

American Lung Association (2002c) *


American Lung Association (2002c) *
2000 NHIS public use data files **
                           * American Lung Association (2002c) is based on the 1999
                           National Health Interview Survey (Adams et al, 1999).
                           ** See
                           ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/NHIS/20
                           007
                                                                                  September 2008
                                            252

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                             Appendix F: Particulate Matter Health Impact Functions in U.S. Setup



        Appendix F:  Particulate Matter  Health Impact

        Functions in  U.S.  Setup

          In this Appendix, we present the PM-related health impact functions in BenMAP. Each
          sub-section has a table with a brief description of the health impact function and the
          underlying parameters.  Following each table, we present a brief summary of each of the
          studies and any items that are unique to the study.

          Note that Appendix D mathematically derives the standard types of health impact functions
          encountered in the epidemiological literature, such as, log-linear, logistic and linear, so we
          simply note here the type of functional  form. And Appendix E presents a description of
          the sources for the incidence and prevalence data used in the health impact functions.

F.1     Long-term Mortality

          There are two types of exposure to PM that may result in premature mortality. Short-term
          exposure may result in excess mortality on the same day or within a few days of exposure.
          Long-term exposure over, say, a year or more, may result in mortality in excess of what it
          would be if PM levels were generally lower, although the excess mortality that occurs will
          not necessarily be associated with any particular episode of elevated air pollution levels. In
          other words, long-term exposure may capture a facet of the association between PM and
          mortality that is not captured by short-term exposure. Table F-l lists the long-term
          mortality health impact functions.
               Table F-l. Health Impact Functions for Particulate Matter and Long-Term
                                            Mortality
Effect
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Author
Expert A
Expert B
Expert B
Expert C
Expert D
Expert E
Expert F
Expert F
Expert G
Year
2006
2006
2006
2006
2006
2006
2006
2006
2006
Location









Age
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
Metric
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Beta
0.0151
80
0.0126
20
0.0119
50
0.0119
30
0.0083
80
0.0196
70
0.0114
40
0.0093
70
0.0069
70
Std
Err









Form
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Notes

Range >10 to 30 ug. Unconditional dist. 2% no
causality included.
Range 4 to 10 ug. Unconditional dist. 2% no
causality included.

Unconditional dist. 5% no causality included.
Unconditional dist. 1 % no causality included.
Range >7 to 30 ug
Range 4 to 7 ug
Unconditional dist. 30% no causality included.
                                          253
                                                                             September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
Effect
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Mortality, All
Cause
Author
Expert H
Expert I
Expert J
Expert K
Expert K
Expert K
Expert K
Expert L
Expert L
Laden et al.
Laden et al.
Pope et al.
Pope et al.
Pope et al.
Pope et al.
Pope et al.
Woodruff et
al.
Woodruff et
al.
Woodruff et
al.
Woodruff et
al.
Year
2006
2006
2006
2006
2006
2006
2006
2006
2006
2006
2006
2002
2002
2002
2002
2002
1997
1997
2006
2006
Location









6 cities
6 cities
51 cities
51 cities
51 cities
51 cities
51 cities
86 cities
86 cities
204
counties
204
counties
Age
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
25-9
9
25-9
9
30-9
9
30-9
9
30-9
9
30-9
9
30-9
9
Infan
t
Infan
t
Infan
t
Infan
t
Metric
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Annual
Beta
0.0087
00
0.0118
10
0.0096
20
0.0068
90
0.0039
40
0.0039
40
0.0039
40
0.0093
40
0.0073
90
0.0148
42
0.0148
42
0.0065
55
0.0072
84
0.0087
40
0.0058
27
0.0058
27
0.0039
22
0.0039
22
0.0067
66
0.0067
66
Std
Err









0.0041
70
0.0041
70
0.0024
27
0.0026
96
0.0032
36
0.0021
57
0.0021
57
0.0012
21
0.0012
21
0.0073
39
0.0073
39
Form
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Log-lineal
Logistic
Logistic
Logistic
Logistic
Notes

Unconditional dist. 5% no causality included.

Range >16 to 30. No threshold. Conditional
dist.
Range 4 to 1 6 ug. No threshold. Conditional
dist.
Range 4 to 16 ug. Threshold 0 to 5 ug.
Conditional dist.
Range 4 to 16 ug. Threshold 5 to 10 ug.
Conditional dist.
Range >10 to 30 ug. Unconditional dist. 1% no
causality included.
Range 4 to 1 0 ug. Unconditional dist. 25% no
causality included.
Adjusted coefficient with 10 ug/m3 threshold.

Adjusted coefficient with 1 0 ug/m3 threshold.
Adjusted coefficient with 1 2 ug/m3 threshold.
Adjusted coefficient with 1 5 ug/m3 threshold.
Adjusted coefficient with 7.5 ug/m3 threshold.

Adjusted coefficient with 10 ug/m3 threshold.

Adjusted coefficient with 1 0 ug/m3 threshold.

F. 1.1   Expert Functions
           In this section, we describe the approach taken to incorporate into BenMAP concentration-
           response (C-R) functions that were obtained through expert elicitation for EPA (ffic,
           2006).

           We have specified expert distributions for the PM2.5 effect either as truncated parametric
           distributions or as non-parametric distributions. Therefore they can only be included in
                                             254
                                                                                  September 2008

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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           BenMAP in the form of custom distribution tables containing 15,000 random draws (with
           replacement) from an underlying distribution.  We first describe the way these custom
           distribution tables were created. Then we explain how these custom distribution tables
           should be handled in a configuration file to represent the expert-specified distribution as
           closely as possible.

           Note that the table on page 3-30 of the expert elicitation report (ffic,  2006) refers to the
           non-parametric distributions as "custom" distributions. However, BenMAP refers to
           distribution tables that are supplied in the form of a simulated draw as "custom distribution
           tables".  In order to avoid confusion in terminology, we will call the  expert-specified
           distributions, which did not have a parametric shape, "non-parametric" expert
           distributions.

           We divided the experts into two groups - those who specified a parametric distribution and
           those who specified a non-parametric distribution.  This division was necessary because
           the two groups required different methods for generating the custom distribution tables.
           We describe the respective algorithms below  and then provide an assessment of the results
           for each expert.

F. 1.1.1 Parametric Distributions
           Experts A, C, D, E, G, I, J, and K chose parametric distribution functions to  represent their
           subjective beliefs about the percent change in risk associated with an increase in PM2.5.
           In particular, they specified the following characteristics of the distribution:

           • The shape (e.g., Normal, Triangular, Weibull)

           • The truncation points (i.e., minimum and/or maximum)

           • Two or three percentile points

           • The likelihood that the association is causal and whether the function includes that (i.e.,
             whether the function is conditional on the association being causal or unconditional).

           There were two types of inconsistencies encountered in these specifications:

           (1) The experts who chose Normal or Weibull shapes for their distributions also specified
           minimum and/or maximum values at which there could be an effect. The Normal
           distribution has an unlimited support from -co to +00. The Weibull distribution has support
           (I,+GQ), where 1 is a location parameter that can be any value on the real line.  The
           specification of a minimum or a maximum value for the effect is therefore inconsistent
           with specifying these distributions.  Therefore, we interpreted these experts'  distributions
           as truncated Normal or truncated Weibull distributions. In other words, we assumed that
           the shape of the distribution is Normal or Weibull between the truncation points.

           (2) Experts A, C, and J indicated that they included the likelihood of causality in their
           subjective distributions.  However, the continuous parametric distributions specified were
           inconsistent with the causality likelihoods provided by these experts. Because there was
           no way to reconcile this, we chose to interpret the distributions of these experts as
                                                                                  September 2008
                                             255

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                     Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
unconditional and ignore the additional information on the likelihood of causality.  For
example, Expert A specified a truncated Normal distribution with a minimum 0 and a
maximum 4.  The expert also indicated that the likelihood of causality is 95 percent and it
is included in the distribution. This implies that the 5th percentile of the truncated Normal
distribution should be zero. The minimum and 5th percentile of the distribution both being
zero imply a density with a large (discrete) mass at zero.  This, however, is not consistent
with specifying a continuous Normal density.  (In the case of Expert A,  in addition, he
specified a 5th percentile value of 0.29, whereas a 5 percent chance of non-causality would
imply a 5th percentile value of 0.)

In order to create a random draw from  a parametric distribution it is not sufficient to know
its shape  and truncation points.  In addition, one needs to know the values of parameters
that distinguish this particular distribution from a class of similarly shaped distributions
with identical truncation points. Experts D and I reported parameter values of their
subjective distributions (see details in Table 1). Therefore, we simply drew 15,000 times
from each of their distributions.

However, the only information,  in addition to the shape and truncation points, which the
other experts provided was the percentile points.  To derive the parameter values of
interest, we used this information as follows:

Let F(x;6,min,max) be a truncated continuous parametric (cumulative)  distribution
function with (vector of) parameters 6  and truncation points min and max. The nth
percentile point is defined as the value xn such that JF(xn;6,min,max)=w/100. Thus, if we
know that the expert distribution's nth percentile point is xn and mth percentile point is xm
then the following has to hold:

           F(.m;6,min,max)=«/100
This is a system of non-linear equations that can be solved for the unknown distribution
parameters 6.  We used the Nelder and Mead (1965) numeric optimization algorithm,
available in R, to find the best-fitting estimates of parameters 6 for the truncated
distributions specified by the experts. Once estimates of 6 were obtained, the distributions
were specified fully and we had enough information to make 15,000 draws from each.

Table F-2 below summarizes the results for each expert who specified a parametric
distribution. In each case, we provide an "input" line that has all the information that was
provided by the expert. We also show the "output" line that contains the inferred
parameters and five percentile points of the distribution from which draws were made.

Highlighted in yellow are the percentiles specified by the expert and used to create the
equation system for the optimization. After finding the best-fitting parameters, we
calculated the associated percentiles and confirmed that they are close to the input values.
                                                                        September 2008
                                  256

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                     Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
             Table F-2. Description of the Parametric Expert Functions
Expert
A
C
D
E
G
I
J
Kl
4-16
ug/m3
K2
>16-30
ug/m3
Information
input
output
input
output
input
output
input
output
input
output
input
output
input
output
input
output
input
output
Distribution
Normal

Normal

Triangular

Normal

Normal

Normal

Weibull

Normal

Normal

Min
0

0

0.100

0

-co

0.200

0

-co

-co

P5
0.290
0.290

0.423

0.350

1.002

0.695

0.473
0.150
0.150
0.100
0.100
0.100
0.100
P25

0.929

0.875

0.662

1.590

0.875

0.912

0.525

0.277

0.455
P50

1.481
1.200
1.200

0.897
2.000
2.000
1.000
1.000

1.250
0.900
0.900
0.400
0.400
0.700
0.700
P75

2.059

1.528

1.107

2.410

1.124

1.588

1.331

0.521

0.942
P95
2.900
2.900
2.000
2.000

1.382
3.000
3.000
1.300
1.300

2.027
2.000
2.000

0.682

1.264
Max
4

+co

1.600

+co

1.500

2.300

3.000

0.800

1.500

Parameters
mean=?
sd=?
mean=1.42
sd=0.895
mean=?
sd=?
mean=1.196
sd=0.488
mode=0.95

mean=?
sd=?
mean=2
sd=0.608
mean=?
sd=?
mean= 1.001
sd=0.185
mean=1.25
3d=0.53

shape=?
scale=?
location=?
shape=2.21
scale=1.413
location=-0.326
mean=?
sd=?
mean=0.404
sd=0.184
mean=?
sd=?
mean=0.707
sd=0.367
For example, Expert A indicated that the distribution of the effect is Normal, with minimum
0 and maximum 4.  Under the assumption that this is actually a truncated Normal
distribution, we looked for the corresponding mean and standard deviation for it. The 5th
and the 95th percentile values (0.29 and 2.90, respectively) were used to specify the
following equations:

           jV(0.29;mean=?,sd=?,min=0,max=4)=0.05
                                  257
                                                                      September 2008

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                      Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
            7V(2.90; mean=?,sd=?,min=0,max=4)=0.95

The solution to this system was a mean of 1.42 and a standard deviation of 0.89. We also
verified that these parameters produced percentile values consistent with the ones supplied
by the expert.  We similarly solved for the parameters of the other experts who specified
parametric distributions, with the exception of experts D and I, who specified their
distributions fully.

The experts were asked to describe uncertainty distributions for the percent change in
mortality risk associated with a 1 ug/m3 change in PM2.5.  All of the experts assumed
log-linear (or piecewise log-linear) C-R functions.  If Z denotes the percent change elicited
from an expert, the relative risk associated with a 1 ug/m3 change in PM2.5 is (l+Z/100),
and the PM2.5 coefficient in the log-linear C-R function is ln(l+(Z/100)).  We applied this
transformation to the values drawn from each distribution.

Finally, some experts stated that their distribution does not incorporate the likelihood of
causality - i.e., they specified conditional distributions.  We made 15,000 draws from an
expert's conditional distribution. BenMAP contains a function that is zero. If an expert
specified, for example, a five percent chance that there is not a causal association, BenMAP
will draw from this zero function with five percent probability and draw from the
15,000-draw custom distribution (of positive values) with 95 percent probability. Table F-3
below shows summary statistics for the draws from the parametric distributions that became
BenMAP "custom" distribution tables. Additional details on the form of the distributions
are below and in Belova et al (2007).

  Table F-3. Descriptive Statistics of the Random Draws from the Parametric Expert
                                    Distributions
Expert
A
C
D (cond)
D
E (cond)
E
G (cond)
G
I (cond)
I
J
Kl (cond)
Kl
K2 (cond)
K2
Mean
0.01518
0.01193
0.00884
0.00838
0.01975
0.01967
0.00996
0.00697
0.01240
0.01181
0.00962
0.00394
0.00139
0.00689
0.00237
Standard
Deviation
0.00773
0.00466
0.00305
0.00354
0.00591
0.00619
0.00181
0.00480
0.00458
0.00523
0.00567
0.00175
0.00215
0.00350
0.00382
Min
0.00000
0.00001
0.00105
0.00000
0.00026
0.00000
0.00256
0.00000
0.00200
0.00000
0.00000
-0.00262
-0.00262
-0.00766
-0.00402
P25
0.00944
0.00870
0.00671
0.00623
0.01577
0.01575
0.00873
0.00000
0.00905
0.00845
0.00525
0.00278
0.00000
0.00452
0.00000
P50
0.01483
0.01189
0.00899
0.00875
0.01986
0.01989
0.00996
0.00892
0.01244
0.01214
0.00902
0.00398
0.00000
0.00698
0.00000
P75
0.02051
0.01509
0.01108
0.01092
0.02376
0.02381
0.01123
0.01062
0.01575
0.01559
0.01329
0.00520
0.00298
0.00937
0.00489
Max
0.03917
0.02848
0.01577
0.01577
0.04534
0.04534
0.01489
0.01489
0.02273
0.02273
0.02936
0.00797
0.00796
0.01489
0.01488
                                   258
                                                                         September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.2 Non-Parametric Distributions
          Experts B, F, H, and L chose a non-parametric distribution function to represent their
          subjective beliefs about the percent change in risk associated with 1 ug/m3 increase in PM
          2.5. They specified the following characteristics of the distribution:

          • The truncation points (i.e., minimum and/or maximum)
          • Five percentile points
          • The likelihood that the association is causal and whether the function includes that (i.e.,
           whether the function is conditional on the association being causal or unconditional)

          The only information that we had about these distributions was the minimum, the
          maximum, and the five percentiles. The  shape of the distribution was unknown.  Therefore,
          we made an assumption that the cumulative distribution function (cdf) is piece-wise linear.
          In other words, we assumed that all values between the percentiles are equally likely.
          Following this assumption, we used linear interpolation between the percentile points to
          derive the cdf for each expert.  We then made 15,000 draws from each cdf.

          Table F-4 shows the inputs and the outputs of this process for each expert. The inputs are
          the minimum, the maximum, and the percentiles.  The outputs are the percentiles that we
          calculated from the draws from the respective linearly interpolated cdfs.

                     Table F-4.  Description of the Non-Parametric Expert Functions
Expert
Bl
4-10
ug/m3
B2
>10-30
ug/m3
Fl
4-7
ug/m3
F2
>7-30
ug/m3
H
LI
4-10
ug/m3
L2
>10-30
ug/m3
Information
input
output
input
output
input
output
input
output
input
output
input
output
input

Min
0.010

0.100

0.370

0.290

0

0

0.020

P5
0.100
0.099
0.200
0.198
0.580
0.581
0.770
0.771
0
0
0.200
0.201
0.200
0.018
P10








0
0




P25
0.200
0.203
0.500
0.501
0.730
0.732
0.960
0.958
0.400
0.407
0.570
0.570
0.570
0.568
P50
1.200
1.213
1.200
1.191
0.930
0.928
1.100
1.100
0.700
0.710
1.000
0.996
1.000
1.003
P75
2.100
2.092
2.100
2.096
1.100
1.097
1.400
1.398
1.300
1.320
1.400
1.400
1.400
1.396
P95
2.600
2.599
2.600
2.597
1.400
1.407
1.600
1.606
2.000
2.010
1.600
1.619
1.600
1.634
Max
2.800

2.800

1.700

1.800

3.000

2.700

2.700

          Table F-5 below shows summary statistics for the draws from the non-parametric
          distributions that became BenMAP "custom" distribution tables.  The section below on
                                            259
                                                                                 September 2008

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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
          distributional details contains histograms for all the experts' distributions.

             Table F-5. Descriptive Statistics of the Random Draws from the Non-Parametric
                                          Expert Distributions
Expert
Bl (cond)
Bl
B2 (cond)
B2
Fl
F2
H
LI (cond)
LI
L2 (cond)c
L2
Mean
0.01217
0.01195
0.01290
0.01262
0.00937
0.01144
0.00870
0.00985
0.00739
0.00953
0.00934
Standard
Deviation
0.00897
0.00901
0.00813
0.00827
0.00268
0.00292
0.00662
0.00511
0.00613
0.00544
0.00549
Min
0.00010
0.00000
0.00100
0.00000
0.00370
0.00290
0.00000
0.00001
0.00000
0.00000
0.00000
P25
0.00200
0.00195
0.00489
0.00464
0.00727
0.00951
0.00406
0.00582
0.00001
0.00567
0.00531
P50
0.01195
0.01167
0.01187
0.01159
0.00924
0.01091
0.00702
0.00999
0.00727
0.00991
0.00964
P75
0.02090
0.02075
0.02068
0.02042
0.01092
0.01387
0.01302
0.01391
0.01250
0.01389
0.01371
Max
0.02761
0.02761
0.02761
0.02761
0.01686
0.01784
0.02954
0.02662
0.02659
0.02661
0.02661
F. 1.1.3 Using Expert Functions in BenMAP
          When an expert has specified certain functional specifics with certain probabilities, the
          resulting "C-R function" becomes a set of possible functions, each with an associated
          probability. For example, expert K specified a piecewise log-linear function (i.e., two
          different log-linear functions on two different parts of the range of PM2.5); this expert also
          specified a threshold within different ranges with different probabilities (and no threshold
          with a specified probability). BenMAP incorporates such a set of possible functions
          specified by an expert function by assigning appropriate weights to each specification.  We
          illustrate this using expert K's specification.

          Expert K specified one log-linear function if the baseline PM2.5 value falls within the range
          from 4 ug/m3 to 16 ug/m3 and another log-linear function if the baseline value falls within
          the range from >16 ug/m3  to 30 ug/m3. BenMAP thus incorporates two sets of functions -
          one set for each of these two PM2.5 ranges - and selects from the set appropriate for a given
          PM2.5 baseline value. Expert K also specified a 64% probability that there is no causal
          relationship; an 18% probability that there is a causal relationship with no threshold, a 4%
          probability that there is a causal relationship with a threshold somewhere between  5 ug/m3
          to 10 ug/m3, and a 14% probability that there is a causal relationship with a threshold
          somewhere between 0 ug/m3 to 5  ug/m3.  Thus, the set  of log-linear functions in BenMAP
          for expert K on the range from 4 ug/m3 to 16 ug/m3 contains:

          • a function with PM2.5 coefficient = 0 (no causality), which BenMAP selects with 65%
           probability;
          • a function with the PM2.5  coefficient expert K specified for the log-linear function on that
           range  and no threshold, which BenMAP selects with 18% probability;
          • a function with the PM2.5  coefficient expert K specified for the log-linear function on that
           range  and a threshold (with uniform probability) between 0 ug/m3 to 5 ug/m3, which
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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
            BenMAP selects with 14% probability; and
          • a function with the PM2.5 coefficient expert K specified for the log-linear function on that
            range and a threshold (with uniform probability) between 5 ug/m3 to 10 ug/m3, which
            BenMAP selects with 4% probability.

          If the PM2.5 baseline value is greater than 16 ug/m3, BenMAP goes through an analogous
          procedure to select a function from among the two functions in that set.

F.1.1.4 Distributional Details by Expert

           Distributional details on each expert distribution are presented below. The derivation of
           the distributions is  described above with additional details provided by Belova et al
           (2007).
F.1.1.4.1   Expert A
              Figure F-l. Histogram of the Random Draw from the Distribution of the PM2 5
                                       Effect Specified by Expert A
                               R H
                            £•
                            vi
                            I
                                  0.00
                                           0,01
                                                   0.02
                                                            0.03
                                                                     0.04
           Notes:

           -  Expert A specified a truncated Normal Distribution. We inferred the following values
             for the parameters of this distribution: mean=1.42 and standard deviation=0.89.

           -  The experts specified distributions for the percent changes in the relative risk.  The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                 Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.2   Experts
                  Figure F-2. Characteristics of the Random Draw from the Approximated
                            Distribution of the PM2 5 Effect Specified by Expert B

                                     (1)  Results for the range 4-10 ug/m3
           (a)Q-QPlotfbrC onditioral Distribution
 (b ) Cumulative Conditional Dis tributioii
          boat   CDK   3D 10   at is
                                                       OGBD   is oas   a. oia
                                                                             oajo   DOSS
           (c) Histogram of Conditional Distribution
          0.003.   D.COE   ooio   o.a is   o.c:o  0.025
(d) Histogr.nn of UnconditiiDiial Dis tiSmtiort
                                                       0.003   0035-  OOIC  0.315   O.CZO  O.D25
           Notes:

           - Expert B specified a non-parametric distribution using five percentile points. We
             linearly interpolated the cdf between them.  Panel (a) shows q-q plot of the expert
             percentiles and empirical percentiles for the draw. Panel (b) shows empirical cdf
             associated with the draw, the red "X" marks indicate corresponding expert percentiles.
             The distribution was conditional on causality. We created a corresponding unconditional
             distribution by adding extra 2 percent zeros to the draw. Panels (c) and (d) show the
             respective distributions.
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                      Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
  The experts specified distributions for the percent changes in the relative risk. The
  distribution of the corresponding PM2 5 effects was the following transformation of the
  percent change in relative risk Z - log(l+(Z/100)).
      Figure F-2. Characteristics of the Random Draw from the Approximated
          Distribution of the PM2 5 Effect Specified by Expert B (continued)

                        (2)  Results for the range >10-30 ug/m3

   (a.) Q-Q Hot for Conditional Distribution                 Ijb) Cumulative Conditional E>istributioii
 03CO   O.C05   0.01-3   0015   0020   03

             Epincai Percerties

  (c) Histogram of Conditional Distribution
                                                 njes   o.cno  o.aii   Q.OHJ   O.OK
(d) His tcgrarn of Unconditional Distribuikm
 U.3CO   C.MS  0.310   a.015

                 drav
                                             0 MO  D03S
                                                                  0 520   0 025
Notes:

- Expert B specified a non-parametric distribution using five percentile points. We
  linearly interpolated the cdf between them.  Panel (a) shows q-q plot of the expert
  percentiles and empirical percentiles for the draw.  Panel (b) shows empirical cdf
  associated with the draw, the red "X" marks indicate corresponding expert percentiles.
  The distribution was conditional on causality. We created a corresponding unconditional
  distribution by adding extra 2 percent zeros to the draw. Panels (c) and (d) show the
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                                                                           September 2008

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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
             respective distributions.

           - The experts specified distributions for the percent changes in the relative risk. The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
F. 1.1.4.3   Expert C
              Figure F-3. Histogram of the Random Draw from the Distribution of the PM2 5
                                       Effect Specified by Expert C
14
O.ODO
T
r

r

i 1-
Th
0.005 0.010 0.015 0.020 0.025
draw
                                                                     Q.030
           Notes:

           - Expert C specified a truncated Normal Distribution.  We inferred the following values
             for the parameters of this distribution: mean=1.20 and standard deviation=0.49.

           - The experts specified distributions for the percent changes in the relative risk. The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.4   Expert D
              Figure F-4. Histogram of the Random Draw from the Distribution of the PM2 5
                                       Effect Specified by Expert D

                 (a) Conditional Distribution                        (b) Unconditional Dis tnbution
           Notes:

           - Expert D specified a Triangular Distribution with minimum=0.1, maximum=l .6, and
             mode=0.95. The distribution was conditional on causality. We created a corresponding
             unconditional distribution by adding extra 5 percent zeros to the draw.

           - The experts specified distributions for the percent changes in the relative risk. The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.5   ExpertE
              Figure F-5.  Histogram of the Random Draw from the Distribution of the PM2 5
                                        Effect Specified by Expert E

                  (V) Conditional Distnbution                        (b) Unconditional Bis tnbution
                                                      o.w
           Notes:

           - Expert E specified a truncated Normal Distribution. We inferred the following
             parameters for this distribution: mean=2.00 and standard deviation=0.61. The
             distribution was conditional on causality. We created a corresponding unconditional
             distribution by adding extra 1 percent zeros to the draw.

           - The experts specified distributions for the percent changes in the relative risk. The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                 Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.6   Expert F
                 Figure F-6.  Characteristics of the Random Draw from the Approximated
                           Distribution of the PM2 5 Effect Specified by Expert F

                                    (1)  Results for the range 4-7 ug/m3
             (a) Q-Q Pbt for Urcorditional Distribution
(b) Cumulative Unconditional E'jsteifouti.on
               cts  ogre com  :sm:i  CUM? O:JM  Dam
                                                             oace owe.  t.oia  0,012 o.au  oaie
                                  (c) His togiam of Unconditional Distribution
                                   C.OM  0036  0.3C8 O.C10  .012  C014  00'6
           Notes:

           - Expert F specified a non-parametric distribution using five percentile points. We
             linearly interpolated the cdf between them.  Panel (a) shows q-q plot of the expert
             percentiles and empirical percentiles for the draw. Panel (b) shows empirical cdf
             associated with the draw, the red "X" marks indicate corresponding expert percentiles.
             Panel (c) shows the histogram of the distribution.

           - The experts specified distributions for the percent changes in the relative risk.  The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                     Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
      Figure F-6. Characteristics of the Random Draw from the Approximated
         Distribution of the PM2.5 Effect Specified by Expert F (continued)

                        (2)  Results for the range >7-30 ug/m3

  (a) Q-Q Plot for Unconditional Dis tnbution                (b) Cumulative Unconditional Distribution
                                                O.OC6
                       (c) His togram of Unconditional Distribution
                                                         ooio
                                                                   3,015
Notes:

- Expert F specified a non-parametric distribution using five percentile points. We
  linearly interpolated the cdf between them.  Panel (a) shows q-q plot of the expert
  percentiles and empirical percentiles for the draw. Panel (b) shows empirical cdf
  associated with the draw, the red "X" marks indicate corresponding expert percentiles.
  Panel (c) shows the histogram of the distribution.

- The experts specified distributions for the percent changes in the relative risk. The
  distribution of the corresponding PM2 5 effects was the following transformation of the
  percent change in relative risk Z - log(l+(Z/100)).
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                                 Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.7   Expert G
              Figure F-7. Histogram of the Random Draw from the Distribution of the PM2 5
                                        Effect Specified by Expert G
                  (X) Conditional Distribution
(b) Unconditional Dis tnbution
                  (a) Conditional Distribution
  (b) Unconditional Distnbutian
                                                                   0005
                                                                             0.010
                                                                                       OO'S
           Notes:

           - Expert G specified a truncated Normal Distribution. We inferred the following
             parameters for this distribution: mean=l .00 and standard deviation=0.19. The
             distribution was conditional on causality. We created a corresponding unconditional
             distribution by adding extra 30 percent zeros to the draw.

           - The experts specified distributions for the percent changes in the relative risk.  The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                 Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.8   Expert H
                  Figure F-8. Characteristics of the Random Draw from the Approximated
                            Distribution of the PM25 Effect Specified by Expert H
             0) Q-Q Pbt for Unconditional Distribution
                                                         (b) CmraiUtive Unconditional Distribution
             0.003  0035  0.310  0.015  C.0.20   0.025   0.030
                                                         O.COU  0.035  0.010  0.015  0.023  0025  0.030
                                   (c) His tograrn of Unconditional Distribution
                                   0033   OCQ5  0310  001S  5023  0025  0030

                                                 dr*.
           Notes:

           - Expert H specified a non-parametric distribution using six percentile points. We linearly
             interpolated the cdf between them.  Panel (a) shows q-q plot of the expert percentiles and
             empirical percentiles for the draw. Panel (b) shows empirical cdf associated with the
             draw, the red "X" marks indicate corresponding expert percentiles. Panel (c) shows the
             histogram of the distribution.

           - The experts specified distributions for the percent changes in the relative risk.  The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                  Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F. 1.1.4.9   Expert I
               Figure F-9.  Histogram of the Random Draw from the Distribution of the PM2 5
                                         Effect Specified by Expert I
                  (a) Conditional Distribution
                                                              (b) Unconditional Dis tnbution
                 3.005     0.0'0    '3.015    OOZO
                                                         O.CO'3    3.C05    3.013    3.015    ".023
                   (a) Conditional Distribution
                                                                (b) Unconditional Distribution
'Of     0.0-0    0.015     0020

           arao;
                                                          O.CC'D    3.COS    3.013    0.015    C.02D

                                                                          d'2'iVyc
            Notes:

            - Expert I specified a truncated Normal Distribution with mean=1.25 and standard
             deviation=0.53. The distribution was conditional on causality.  We created a
             corresponding unconditional distribution by adding extra 5 percent zeros to the draw.

            - The experts specified distributions for the percent changes in the relative risk. The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F.1.1.4.10   Expert J
              Figure F-10. Histogram of the Random Draw from the Distribution of the PM2 5
                                        Effect Specified by Expert J
                                                                   mo.-:.
                                    Q.QQQ   0.005   0.010   0.015   0.020   0.025   0.030

                                                      draw
           Notes:
             Expert J specified a truncated Weibull Distribution. We inferred the following values
             for the parameters of this distribution: shape=2.21, scale=1.41, and location=-0.33.

             The experts specified distributions for the percent changes in the relative risk. The
             distribution of the corresponding PM2 5 effects was the following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                 Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F.1.1.4.11   Expert K
              Figure F-ll. Histogram of the Random Draw from the Distribution of the PM2 5
                                        Effect Specified by Expert K
              (a) C onditional Distribution (4-16 ug/m)
 (b) Unconditional Distribution (4-16 ug/m )
                                                         -0 DC2  a. 033   1C02  O.COi   0.2C6   OOl'S
             (c) C conditional Distribution (> 16-30 ug/in)
(d) Unconditional Distribution (> 16-JO
               '<'<"   O.CW    3005
           Notes:

           - Expert K specified a truncated Normal Distribution two ranges (4-16 ug/m3 and >16-30
             ug/m3).  We inferred the following parameters for this distribution: mean=0.40 and
             standard deviation=0.18 in the lower range and mean=0.71 and standard deviation=0.37
             in the upper range. The distribution was conditional on causality. We created a
             corresponding unconditional distribution by adding extra 65 percent zeros to the draws in
             each range.

           - The experts specified distributions for the percent changes in the relative risk.  The
             distribution of the corresponding PM2 5 effects was the  following transformation of the
             percent change in relative risk Z - log(l+(Z/100)).
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                                  Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F.1.1.4.12   Expert L
                 Figure F-12. Characteristics of the Random Draw from the Approximated
                            Distribution of the PM2 5 Effect Specified by Expert L

                                     (1) Results for the range 4-10 ug/m3
              (a) Q-Q Plot for C conditional Distribution
           1 -• /!

              0003   0005  3013   0015  0023   0025

                        Eprk^ ~J*i'c*^!!ifi-

              fe) Histogram of Conditional Distribution
               j L JI LI I L!! L J!-. L .11U! iiilHiLlQljJllb

             0.003   0.3C5  0.013  0,3:5   0.023   0,325
 (b) Curtulatrre Conditional Distribution
OCXEl   0005   0015   0015  0 fH3   0 DZ5
(d) Histogram of Unconditional Dis trJbutiiDn
                                                         0.003   0.3C5   C.013   0.015   3,020   0.3Z5
            Notes:

            - Expert L specified a non-parametric distribution using five percentile points.  We
             linearly interpolated the cdf between them. Panel (a) shows q-q plot of the expert
             percentiles and empirical percentiles for the draw.  Panel (b) shows empirical cdf
             associated with the draw, the red "X" marks indicate corresponding expert percentiles.
             The distribution was conditional on causality.  We created a corresponding unconditional
             distribution by adding extra 25 percent zeros to the draw.  Panels (c) and (d) show the
             respective distributions.

            - The experts specified distributions for the percent changes in the relative risk.  The
             distribution of the corresponding PM2 5 effects was the following transformation of the
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                      Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
  percent change in relative risk Z - log(l+(Z/100)).
      Figure F-12. Characteristics of the Random Draw from the Approximated
          Distribution of the PM2 5 Effect Specified by Expert L (continued)

                        (2)  Results for the range >10-30 ug/m3

   i) Q-Q Plot for Condinonal Distribution                  (b) Cunnlitive Conditional Distribution
  n cm   o ran   :: o i y   « o 15
                                              *
                                              [
                                             aato
                                                        0010   0015   a 020   0075
  (c) Histogjam of Condbttional DistnbutiorL
  3.003   0.3C5   5,013   0.0 '.S  3,023   0.3Z5
(d) HistDgi'^atx of Uncondit
                                             a.wa  o.aK   c.oia   o.-ais  0.022   o.aa;
Notes:

- Expert L specified a non-parametric distribution using five percentile points. We
  linearly interpolated the cdf between them.  Panel (a) shows q-q plot of the expert
  percentiles and empirical percentiles for the draw.  Panel (b) shows empirical cdf
  associated with the draw, the red "X" marks indicate corresponding expert percentiles.
  The distribution was conditional on causality. We created a corresponding unconditional
  distribution by adding extra 1  percent zeros to the draw. Panels (c) and (d) show the
  respective distributions.

- The experts specified distributions for the percent changes in the relative risk.  The
                                    275
                                                                           September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup


            distribution of the corresponding PM2 5 effects was the following transformation of the
            percent change in relative risk Z - log(l+(Z/100)).

F.1.2   Laden et al (2006)

           A large body of epidemiologic literature  has found an association of increased fine
           particulate air pollution (PM2.5) with acute and chronic mortality.  The effect of
           improvements in particle exposure is less clear. Earlier analysis of the Harvard Six Cities
           adult cohort study showed an association between long-term ambient PM2.5 and mortality
           between enrollment in the mid-1970's and follow-up until 1990. The authors extended
           mortality follow-up for eight years in a period of reduced air pollution concentrations.
           Annual city-specific PM2.5 concentrations were measured between 1979-1988, and
           estimated for later years from publicly available data. E xposure was defined as (1)
           city-specific mean PM2.5 during the two follow-up periods, (2) mean PM2.5 in the first
           period and change between these periods, (3) overall mean PM2.5 across the entire
           follow-up, and (4) year-specific mean PM2.5. Mortality rate ratios were estimated with
           Cox proportional hazards regression controlling for individual risk factors.  The authors
           found an increase in overall mortality associated with each 10 ug/m3 increase in PM2.5
           modeled either as the  overall mean (RR=1.16, 95%CI=1.07-1.26) or as exposure in the
           year of death (RR=1.14, 95%CI=1.06-1.22). PM2.5 exposure was associated with lung
           cancer (RR=1.27, 95%CI=0.96-1.69) and cardiovascular deaths (RR=1.28,
           95%CI=1.13-1.44). Improved overall mortality was associated with decreased mean
           PM2.5 (10 microg/m(3)) between periods (RR=0.73, 95% CI=0.57-0.95). Total,
           cardiovascular, and lung cancer mortality were each positively associated with ambient
           PM2.5 concentrations. Reduced PM2.5 concentrations were associated with reduced
           mortality risk.
           All-Cause Mortality

           The coefficient and standard error for PM2 5 are estimated from the relative risk (1.16) and
           95% confidence interval (1.07-1.26) associated with a change in annual mean exposure of
           10.0 |ig/m3 (Laden et al, 2006, p. 667).

F.1.3   Pope et al (2002)

           The Pope et al. (2002) analysis is a longitudinal cohort tracking study that uses the same
           American Cancer Society (ACS) cohort as the original Pope et al. (1995) study, and the
           Krewski et al. (2000) reanalysis. Pope et al. (2002) analyzed survival data for the cohort
           from 1982 through  1998, 9 years longer than the original Pope study.  Pope et al. (2002)
           also obtained PM2 5 data in 116 metropolitan areas collected in 1999,  and the first three
           quarters of 2000. This is more metropolitan areas with PM2 5  data than was available in
           the Krewski reanalysis (61 areas), or the original Pope study (50 areas), providing a larger
           size cohort.

           They used a Cox proportional hazard model to estimate the impact of long-term PM
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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           exposure using three alternative measures of PM2 5 exposure; metropolitan area-wide
           annual mean PM levels from the beginning of tracking period ('79-'83 PM data, conducted
           for 61 metropolitan areas with 359,000 individuals), annual mean PM from the end of the
           tracking period ('99-'00, for 116 areas with 500,000 individuals), and the average annual
           mean PM levels of the two periods (for 51 metropolitan areas, with 319,000 individuals).
           PM levels were lower in '99-00 than in '79 - '83 in most cities, with the largest
           improvements occurring in cities with the highest original levels.

           Pope et al. (2002) followed Krewski et al. (2000) and Pope et al. (1995,  Table 2) and
           reported results for all-cause deaths, lung cancer (ICD-9 code: 162), cardiopulmonary
           deaths (ICD-9 codes:  401-440 and 460-519), and "all other" deaths. All-cause mortality
           includes accidents, suicides, homicides and legal interventions. The category "all other"
           deaths is all-cause mortality less lung cancer and cardiopulmonary deaths. Like the earlier
           studies, Pope et al. (2002) found that mean PM2 5 is significantly related to all-cause and
           cardiopulmonary mortality. In addition, Pope et al. (2002) found a significant relationship
           with lung cancer mortality, which was not found in the earlier studies. None of the three
           studies found a significant relationship with "all other" deaths.

           Pope et al. (2002) obtained ambient data on gaseous pollutants routinely monitored by
           EPA during the 1982-1998 observation period, including SO2, NO2, CO, and ozone. They
           did not find significant relationships between NO2, CO, and ozone and premature
           mortality, but there were significant relationships between SO4 (as well as SO2), and
           all-cause, cardiopulmonary, lung cancer and "all other" mortality.
           All-Cause Mortality, '79-'83 Exposure

           The coefficient and standard error for PM2 5 using the '79-'83 PM data are estimated from
           the relative risk (1.04) and 95% confidence interval (1.01-1.08) associated with a change
           in annual mean exposure of 10.0 |ig/m3 (Pope et al, 2002, Table 2).


           All-Cause Mortality, Average of '79-'83 and '99-'00 Exposure

           The coefficient and standard error for PM2 5 using the average of '79-'83 and '99-'00 PM
           data are estimated from the relative risk (1.06) and 95% confidence interval (1.02-1.11)
           associated with a change in annual mean exposure of 10.0 |ig/m3 (Pope et al, 2002, Table
           2).

F.1.4   Woodruff et al (1997)

           In a study of four million infants in 86 U.S. metropolitan areas conducted from 1989 to
           1991, Woodruff et al. (1997) found a significant link between PM10 exposure in the first
           two months of an infant's life with the probability of dying between the ages of 28 days
           and 364 days. PM10 exposure was significant for all-cause mortality.  PM10 was also
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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           significant for respiratory mortality in average birth-weight infants, but not low
           birth-weight infants.
           Post-Neonatal Mortality

           The coefficient and standard error are based on the odds ratio (1.04) and 95% confidence
           interval (1.02-1.07) associated with a 10 |ig/m3 change in PM10 (Woodruff et al., 1997,
           Table 3).

F.1.5   Woodruff et al (2006)

           Studies suggest that airborne particulate matter (PM) may be associated with postneonatal
           infant mortality, particularly with respiratory causes and sudden infant death syndrome
           (SIDS). To further explore this issue, the authors examined the relationship between
           long-term exposure to fine PM air pollution and postneonatal infant mortality in
           California. They linked monitoring data for PM2.5 to infants born in California in 1999
           and 2000 using maternal addresses for mothers who lived within 5 miles of a PM2.5
           monitor. They matched each postneonatal infant death to four infants surviving to 1 year of
           age, by birth weight category and date of birth (within 2 weeks). For each matched set, they
           calculated exposure as the average PM2.5 concentration over the period of life for the
           infant who died. They used conditional logistic regression to estimate the odds of
           postneonatal all-cause, respiratory-related, SIDS, and external-cause (a control category)
           mortality by exposure to PM2.5, controlling for the matched sets and maternal
           demographic factors.  They matched 788 postneonatal infant deaths to 3,089  infant
           survivors, with 51 and 120 postneonatal deaths due to respiratory causes and SIDS,
           respectively. They found an adjusted odds ratio for a 10-microg/m3 increase in PM2.5 of
           1.07 [95% confidence interval (CI), 0.93-1.24] for overall postneonatal mortality, 2.13
           (95% CI, 1.12-4.05) for respiratory-related  postneonatal mortality, 0.82 (95% CI,
           0.55-1.23) for SIDS, and 0.83 (95% CI, 0.50-1.39) for external causes.
           Post-Neonatal Mortality

           The coefficient and standard error for PM2 5 are estimated from the relative risk (1.07) and
           95% confidence interval (0.93-1.24) associated with a change in annual mean exposure of
           10.0 |ig/m3 (Woodruff et al., 2006, p. 786).

F.2    Chronic / Severe Illness

           Table F-6 summarizes the health impacts functions used to estimate the relationship
           between PM2 5 and chronic / severe health effects. Below, we present a brief summary of
           each of the studies and any items that are unique to the study.
                                                                                   September 2008
                                             278

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
              Table F-6.  Health Impact Functions for Particulate Matter and Chronic Illness
Effect
Chronic Bronchitis
Chronic Bronchitis
Acute Myocardial
Infarction, Nonfatal
Acute Myocardial
Infarction, Nonfatal
Author
Abbey et
al.
Abbey et
al.
Peters et
al.
Peters et
al.
Year
1995
1995
2001
2001
Lcoation
SF, SD, South
Coast Air Basin
SF, SD, South
Coast Air Basin
Boston, MA
Boston, MA
Age
27-99
27-99
18-99
18-99
Co-F
oil




Metric
Annual
Annual
D24HourMe
an
D24HourMe
an
Beta
0.013185
0.013185
0.033230
0.024121
Std Err
0.006796
0.006796
0.012791
0.009285
Form
Logistic
Logistic
Logistic
Logistic
Notes
Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

F.2.1   Abbey et al (1995b)
           Abbey et al. (1995b) examined the relationship between estimated PM2 5 (annual mean
           from 1966 to 1977), PM10 (annual mean from 1973 to 1977) and TSP (annual mean from
           1973 to 1977) and the same chronic respiratory symptoms in a sample population of 1,868
           Californian Seventh Day Adventists. The initial survey was conducted in 1977 and the
           final survey in  1987.  To ensure a better estimate of exposure, the study participants had to
           have been living in the same area for an extended period of time.  In single-pollutant
           models, there was a statistically significant PM2 5 relationship with development of chronic
           bronchitis, but  not for AOD or asthma; PM10 was significantly associated with chronic
           bronchitis and AOD;  and TSP was significantly associated with all cases of all three
           chronic symptoms. Other pollutants were not examined.
           Chronic Bronchitis

           The estimated coefficient (0.0137) is presented for a one |ig/m3 change in PM2 5 (Abbey et
           al., 1995b, Table 2). The standard error is calculated from the reported relative risk (1.81)
           and 95% confidence interval (0.98-3.25) for a 45 |ig/m3 change in PM2 5.

           Incidence Rate: annual bronchitis incidence rate per person (Abbey et al., 1993, Table 3) =
           0.00378
           Population: population of ages 27 and older without chronic bronchitis = 95.57% of population
           27+.  Using the same data set, Abbey et al. (1995a, p. 140)  reported that the respondents in 1977
           ranged in age from 27 to 95. The American Lung Association (2002b, Table 4) reports a chronic
           bronchitis prevalence rate for ages 18 and over of 4.43%.

F.2.2   Peters et al (2001)

           Peters et al. (2001) studied the relationship between increased particulate air pollution and
                                             279
                                                                                  September 2008

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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           onset of heart attacks in the Boston area from 1995 to 1996.  The authors used air quality
           data for PM10, PM10_2 5, PM2 5,"black carbon", O3, CO, NO2, and SO2 in a case-crossover
           analysis.  For each subject, the case period was matched to three control periods, each 24
           hours apart.  In univariate analyses, the authors observed a positive association between
           heart attack occurrence and PM2 5 levels hours before and days before onset.  The authors
           estimated multivariate conditional logistic models including two-hour and twenty-four
           hour pollutant concentrations for each  pollutant.  They found significant and independent
           associations between heart attack occurrence and both two-hour and twenty-four hour PM
           2 5 concentrations before onset.  Significant associations were observed  for PM10 as well.
           None of the  other particle measures or gaseous pollutants were significantly associated
           with acute myocardial infarction for the two hour or twenty-four hour period before onset.

           The patient population for this study was selected from health centers across the United
           States.  The  mean age of participants was  62 years old, with 21% of the study population
           under the age of 50. In order to  capture the full magnitude of heart attack occurrence
           potentially associated with air pollution and because  age was not listed  as an inclusion
           criteria for sample selection, we apply  an age range of  18 and over in the C-R function.
           According to the National Hospital Discharge Survey, there were no hospitalizations for
           heart attacks among children <15 years of age in 1999 and only 5.5% of all hospitalizations
           occurred in 15-44 year olds (Popovic, 2001, Table 10).
           Acute Myocardial Infarction, Nonfatal

           The coefficient and standard error are calculated from an odds ratio of 1.62 (95% CI
           1.13-2.34) for a 20 |ig/m3 increase in twenty-four hour average PM2 5 (Peters et al., 2001,
           Table 4, p. 2813).

           Incidence Rate: region-specific daily nonfatal heart attack rate per person 18+ = 93% of
           region-specific daily heart attack hospitalization rate (ICD code 410). This estimate assumes
           that all heart attacks that are not instantly fatal will result in a hospitalization.  In addition,
           Rosamond et al. (1999) report that approximately six percent of male and eight percent of
           female hospitalized heart attack patients die within 28 days (either in or outside of the
           hospital). We applied a factor of 0.93 to the number of hospitalizations to estimate the
           number of nonfatal heart attacks per year.
           Population: population of ages 18 and older

F.3    Hospitalizations

           Table F-7 summarizes the health impacts functions used to estimate the relationship
           between PM2 5 and hospital admissions.  Below, we present a brief summary of each of the
           studies and any items that are unique to the study.
                                                                                   September 2008
                                             280

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                    Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
Table F-7.  Health Impact Functions for Particulate Matter and Hospital Admissions
Effect
Congestive Heart Failure
Congestive Heart Failure
HA, Dysrhythmia
Dysrhythmia
Ischemic Heart (less
Myocardial Infarctions)
Ischemic Heart (less
Myocardial Infarctions)
Chronic Lung
Chronic Lung
Pneumonia
Pneumonia
All Cardiovascular (less
Myocardial Infarctions)
All Cardiovascular (less
Myocardial Infarctions)
Chronic Lung (less
Asthma)
Chronic Lung (less
Asthma)
All Cardiovascular (less
Myocardial Infarctions)
All Cardiovascular (less
Myocardial Infarctions)
Chronic Lung
Chronic Lung
Asthma
HA, Asthma
Author
Ito
Ito
Ito
Ito
Ito
Ito
Ito
Ito
Ito
Ito
Moolgavka
r
Moolgavka
r
Moolgavka
r
Moolgavka
r
Moolgavka
r
Moolgavka
r
Moolgavka
r
Moolgavka
r
Sheppard
Sheppard
Year
2003
2003
2003
2003
2003
2003
2003
2003
2003
2003
2000
2000
2000
2000
2003
2003
2003
2003
2003
2003
Lcoation
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Detroit, MI
Los
Angeles,
CA
Los
Angeles,
CA
Los
Angeles,
CA
Los
Angeles,
CA
Los
Angeles,
CA
Los
Angeles,
CA
Los
Angeles,
CA
Los
Angeles,
CA
Seattle,
WA
Seattle,
WA
Age
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
18-64
18-64
18-64
18-64
65-99
65-99
65-99
65-99
0-64
0-64
Co-Pol




















Metric
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
D24HourMe
an
Beta
0.00345
8
0.00307
4
0.00140
5
0.00124
9
0.00161
4
0.00143
5
0.00131
6
0.00116
9
0.00447
6
0.00397
9
0.00151
1
0.00140
0
0.00237
4
0.00220
0
0.00170
5
0.00158
0
0.00199
6
0.00185
0
0.00392
8
0.00332
4
Std Err
0.00145
3
0.00129
2
0.00228
7
0.00203
3
0.00130
0
0.00115
6
0.00232
2
0.00206
4
0.00186
7
0.00165
9
0.00036
8
0.00034
1
0.00079
1
0.00073
3
0.00037
1
0.00034
4
0.00056
5
0.00052
4
0.00123
5
0.00104
5
Form
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Log-linea
Notes
Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 10 ug/m3
threshold.

Adjusted coefficient
with 10 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 10 ug/m3
threshold.

Adjusted coefficient
with 1 0 ug/m3
threshold.

                                281
                                                                     September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F.3.1   Ito (2003)
           Lippmann et al. (2000) studied the association between particulate matter and daily
           mortality and hospitalizations among the elderly in Detroit, MI. Data were analyzed for
           two separate study periods, 1985-1990 and 1992-1994. The 1992-1994 study period had a
           greater variety of data on PM size and was the main focus of the report. The authors
           collected hospitalization data for a variety of cardiovascular and respiratory endpoints.
           They used daily air quality data for PM10, PM2 5, and PM10_2 5 in a Poisson regression
           model with generalized additive models (GAM) to adjust for nonlinear relationships and
           temporal trends. In single pollutant models, all PM metrics were statistically significant
           for pneumonia (ICD codes 480-486), PM10_2 5 and PM10 were significant for ischemic heart
           disease (ICD code 410-414), and PM2 5 and PM10 were significant for heart failure (ICD
           code 428).  There were positive, but not statistically significant associations, between  the
           PM metrics and COPD (ICD codes 490-496) and dysrhythmia (ICD code 427). In separate
           co-pollutant models with PM and either ozone, SO2, NO2, or CO, the results were
           generally comparable.

           In response to concerns with the Splus issue, Ito (2003) reanalyzed the study by Lippmann
           et al. (2000). The reanalysis by Ito reported that more generalized additive models with
           stringent convergence criteria and generalized linear models resulted in smaller relative
           risk estimates.
           Chronic Lung Disease (ICD-9 codes 490-496)

           The coefficient and standard error are based on the relative risk (1.043) and 95%
           confidence interval (0.902-1.207) for a 36 |ig/m3 increase in PM2 5 in the 3-day lag GAM
           stringent model (Ito, 2003, Table 8).
           Pneumonia (ICD-9 codes 480-487)
           The estimated PM2 5 coefficient and standard error are based on a relative risk of 1.154
           (95% CI -1.027, 1.298) due to a PM2 5 change of 36 |ig/m3 in the 1-day lag GAM stringent
           model (Ito, 2003, Table 7).
           Disrhythmia (ICD-9 code 429)
           The co-pollutant coefficient and standard error are calculated from a relative risk of 1.046
           (95% CI 0.906-1.207) for a 36 |ig/m3 increase in PM2 5 in the 1-day lag GAM stringent
           model (Ito, 2003, Table 10).
                                                                                  September 2008
                                             282

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           Congestive Heart Failure (ICD-9 code 428)
           The co-pollutant coefficient and standard error are calculated from a relative risk of 1.117
           (95% CI 1.020-1.224) for a 36 |ig/m3 increase in PM2 5 in the 1-day lag GAM stringent
           model (Ito, 2003, Table 11).


           Ischemic Heart Disease (ICD-9 codes 411-414)
           The co-pollutant coefficient and standard error are calculated from a relative risk of 1.053
           (95% CI 0.971-1.143) for a 36 |ig/m3 increase in PM2 5 in the 1-day lag GAM stringent
           model (Ito, 2003, Table 9)

           Note that Lippmann et al. (2000) report results for ICD codes 410-414. In the benefit
           analysis, avoided nonfatal heart attacks are estimated using the results reported by Peters et
           al. (2001). The baseline rate in the Peters et al. function is a modified heart attack
           hospitalization rate (ICD code 410), since most, if not all, nonfatal heart attacks will
           require hospitalization.  In order to avoid double counting heart attack hospitalizations, we
           have excluded ICD code 410 from the baseline incidence rate used in this function.

F.3.2   Moolgavkar (2000a), Chronic Lung

           Moolgavkar (2000a) examined the association between air pollution and COPD hospital
           admissions (ICD 490-496) in the Chicago, Los Angeles, and Phoenix metropolitan areas.
           He collected daily air pollution data for ozone, SO2, NO2, CO, and PM10 in all three areas.
           PM2 5 data was available only in Los Angeles. The data were analyzed using a Poisson
           regression model with generalized additive models to adjust for temporal trends. Separate
           models were run for 0 to 5 day lags in each location.  Among the 65+ age group in Chicago
           and Phoenix, weak associations were observed between the gaseous pollutants and
           admissions. No consistent associations were observed for PM10.  In Los Angeles,
           marginally significant associations were observed for PM2 5, which were generally lower
           than for the gases. In co-pollutant models with CO, the PM2 5 effect was reduced. Similar
           results were observed in the 0-19 and 20-64 year old age groups.

           The PM2 5 C-R functions are based on the single and co-pollutant models (PM2 5 and CO)
           reported for the 20-64 and 65+ age groups. Since the true PM effect is most likely best
           represented by a distributed lag model, then any single lag model should underestimate the
           total PM effect. As a result, we selected the lag models with the greatest effect estimates
           for use in the C-R functions.
           Hospital Admissions, Chronic Lung Disease Less Asthma (ICD-9 codes 490-492,
           494-496)

           In a model with CO, the coefficient and standard error are calculated from an estimated
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                                            283

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           percent change of 2.0 and t-statistic of 2.2 for a 10 |ig/m3 increase in PM2 5 in the two-day
           lag model (Moolgavkar, 2000a, Table 4, p. 81). In a log-linear model, the percent change is
           equal to (RR - 1)*  100.

           In this study, Moolgavkar defines and reports the "estimated" percent change as (log RR *
           100). Because the relative risk is close to 1, RR-1 and log RR are essentially the same.
           For example,  a true percent change of 2.0 would result in a relative risk of 1.020 and
           coefficient of 0.001980.  The "estimated" percent change, as reported by Moolgavkar, of
           2.0 results in a relative risk of 1.020201 and coefficient of 0.002.

           Note that although Moolgavkar (2000a) reports results for the 20-64 year old age range, for
           comparability to other studies, we apply the results to the population of ages 18 to 64.
           Note also that in order to avoid double counting non-elderly asthma hospitalizations (ICD
           code 493), which are typically estimated separately in EPA benefit analyses, we have
           excluded ICD code 493 from the baseline incidence rate used in this function.

F.3.3   Moolgavkar (2000b), Cardiovascular

           Moolgavkar (2000b) examined the association between air pollution and cardiovascular
           hospital admissions (ICD 390-448) in the Chicago, Los Angeles, and Phoenix metropolitan
           areas.  He collected daily air pollution data for ozone, SO2, NO2, CO, and PM10  in all three
           areas.  PM2 5 data was available only in Los Angeles.  The data were analyzed using a
           Poisson regression model with generalized additive models to adjust for temporal trends.
           Separate models were run for 0 to 5 day lags in each location.  Among the 65+ age group,
           the gaseous pollutants generally exhibited stronger effects than PM10 or PM2 5.  The
           strongest overall effects were observed for SO2 and CO.  In a single pollutant model, PM2 5
           was statistically significant for lag 0 and lag 1. In co-pollutant models with CO, the PM2 5
           effect dropped out and CO remained significant.  For  ages 20-64, SO2 and CO exhibited
           the strongest effect and any PM2 5 effect dropped out in co-pollutant models with CO.
           Hospital Admissions, All Cardiovascular (ICD codes 390-409, 411-459)

           The single pollutant coefficient and standard error are calculated from an estimated percent
           change of 1.4 and t-statistic of 4.1 for a 10 |ig/m3 increase in PM2 5 in the zero lag model
           (Moolgavkar, 2000b, Table 4, p. 1203).

           Note that (Moolgavkar (2000b) report results that include ICD code 410 (heart attack).  In a
           benefit analysis, avoided nonfatal heart attacks are typically estimated separately. The
           baseline rate in the Peters et al. function is a modified heart attack hospitalization rate (ICD
           code 410), since most,  if not all, nonfatal heart attacks will require hospitalization.  In
           order to avoid double counting heart attack hospitalizations, we have excluded ICD code
           410 from the baseline incidence rate used in this function.
                                                                                  September 2008
                                             284

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F.3.4   Moolgavkar (2003)

           Moolgavkar (2000a) examined the association between air pollution and COPD hospital
           admissions (ICD 490-496) in the Chicago, Los Angeles, and Phoenix metropolitan areas.
           In response to concerns with Splus issue, Moolgavkar (2003) reanalyzed his earlier studies.
           In the reanalysis, he reported that more generalized additive models with stringent
           convergence criteria and generalized linear models resulted in smaller relative risk
           estimates.
           Hospital Admissions, Chronic Lung (ICD-9 codes 490-496)

           The coefficient and standard error are calculated from an estimated percentage change of
           1.85 and t-statistic of 3.53 for a 10 |ig/m3 increase in PM2 5 in the 2-day lag GAM-30df
           stringent (10-8) model (Moolgavkar, 2003, Table 17). In a log-linear model, the percent
           change is equal to (RR - 1) * 100.

           The PM2 5 C-R functions for the 65+ age group are based on the reanalysis in Moolgavkar
           (2003) of the single and co-pollutant models (PM2 5 and CO).  The true PM effect is most
           likely best represented by a distributed lag model, then any single lag model should
           underestimate the total PM effect. As a result, we selected the lag models with the greatest
           effect estimates for use in the C-R functions.
           Hospital Admissions, All Cardiovascular (ICD-9 codes 390-429)

           The single pollutant coefficient and standard error are calculated from an estimated percent
           change of 1.58 and t-statistic of 4.59 for a 10 |ig/m3 increase in PM2 5 in the 0-day lag
           GAM-30df stringent (10-8) model (Moolgavkar, 2003, Table 12). In a log-linear model,
           the percent change is equal to (RR - 1) * 100.

F.3.5   Sheppard (2003)

           Sheppard et al. (1999) studied the relation between air pollution in Seattle and nonelderly
           (<65) hospital admissions for asthma from 1987 to 1994. They used air quality data for
           PM10, PM2 5, coarse PM10_2 5,  SO2, ozone, and CO in a Poisson regression model with
           control for time trends, seasonal variations, and temperature-related weather effects.
           PM2.5 levels were estimated from light scattering data. They found asthma hospital
           admissions associated with PM10, PM2 5, PM10_2 5, CO, and ozone. They did not observe
           an association for SO2. They  found PM and CO to be jointly associated with asthma
           admissions. The best fitting co-pollutant models were found using ozone. However,
           ozone data was only available April through October, so they did not consider ozone
           further.  For the remaining pollutants, the best fitting models included PM2 5 and CO.
           Results for other co-pollutant models were not reported.

           In response to concerns that the work by Sheppard et al.  (1999) may be biased because of
                                                                                 September 2008
                                            285

-------
                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
          the Splus issue, Sheppard (2003) reanalyzed some of this work, in particular Sheppard
          reanalyzed the original study's PM2 5 single pollutant model.
           Hospital Admissions, Asthma (ICD-9 code 493)

           The coefficient and standard error are based on the relative risk (1.04) and 95% confidence
           interval (1.01-1.06) for a 11.8 |ig/m3 increase in PM2 5 in the 1-day lag GAM stringent
           model (Sheppard, 2003, pp. 228-229).
F.4    Emergency Room Visits

           Table F-8 summarizes the health impacts functions used to estimate the relationship
           between PM2 5 and emergency room visits.  Below, we present a brief summary of each of
           the studies and any items that are unique to the study.
            Table F-8. Health Impact Functions for Particulate Matter and Emergency Room
                                                Visits
Effect
Asthma

Asthma
Author
Norris et al.

Norris et al.
Year
1999

1999
Lcoation
Seattle, WA

Seattle, WA
Age
0-17

0-17
Co-Poll
NO 2,
SO2
NO2,
SO2
Metric
D24HourMean

D24HourMean
Beta
0.01854
2
0.01652
7
Std Err
0.004644

0.004139
Form
Log-linear

Log-linear
Notes
Adjusted coefficient with
10 ug/m3 threshold.


F.4.1   Norris et al (1999)
          Norris et al. (1999) examined the relation between air pollution in Seattle and childhood
          (<18) hospital admissions for asthma from 1995 to 1996. The authors used air quality data
          for PM10, light scattering (used to estimate fine PM), CO, SO2, NO2, and O3 in a Poisson
          regression model with adjustments for day of the week, time trends, temperature, and dew
          point.  They found significant associations between asthma ER visits and light scattering
          (converted to PM2 5), PM10, and CO. No association was found between O3, NO2, or SO2
          and asthma ER visits, although O3 had a significant amount of missing data. In
          multipollutant models with either PM metric (light scattering or PM10) and NO2 and SO2,
          the PM coefficients remained significant while the gaseous pollutants were not associated
          with increased asthma ER visits. The PM C-R functions are based on results of the single
          and multipollutant models  reported.
                                            286
                                                                                September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup


           Emergency Room Visits, Asthma

           In a model with NO2 and SO2, the PM2 5 coefficient and standard error are calculated from
           a relative risk of 1.17 (95% CI 1.08-1.26) for a 9.5 |ig/m3 increase in PM2 5 (Norris et al.,
           1999, p. 491).



F.5     Minor Effects

           Table F-9 summarizes the health impacts functions used to estimate the relationship
           between PM2 5 and minor effects. Below, we present a brief summary of each of the
           studies and any items that are unique to the study.
              Table F-9. Health Impact Functions for Particulate Matter and Minor Effects
Effect
Acute Bronchitis


Acute Bronchitis


Work Loss Days


Work Loss Days

Minor Restricted
Activity Days

Minor Restricted
Activity Days
Lower
Respiratory
Symptoms
Lower
Respiratory
Symptoms
Author
Dockery et al.


Dockery et al.


Ostro


Ostro

Ostro and
Rothschild

Ostro and
Rothschild
Schwartz and
Neas

Schwartz and
Neas

Year
1996


1996


1987


1987

1989


1989

2000


2000


Lcoation
24
communitie
s
24
communitie
s
Nationwide


Nationwide

Nationwide


Nationwide

6 U.S.
cities

6 U.S.
cities

Age
8-12


8-12


18-64


18-64

18-64


18-64

7-14


7-14


Co-Poll











Ozone


Ozone







Metric
Annual


Annual


D24HourMea
n

D24HourMea
n
D24HourMea
n

D24HourMea
n
D24HourMea
n

D24HourMea
n

Beta
0.037894


0.027212


0.004600


0.004600

0.007410


0.007410

0.019712


0.019012


StdErr
0.023806


0.017096


0.000360


0.000360

0.000700


0.000700

0.006226


0.006005


Form
Logistic


Logistic


Log-linea
r

Log-linea
r
Log-linea
r

Log-linea
r
Logistic


Logistic


Notes
Adjusted coefficient
with 1 0 ug/m3
threshold.



Adjusted coefficient
with 1 0 ug/m3
threshold.


Adjusted coefficient
with 1 0 ug/m3
threshold.


Adjusted coefficient
with 1 0 ug/m3
threshold.



F.5.1   Dockery et al (1996)
           Dockery et al. (1996) examined the relationship between PM and other pollutants on the
           reported rates of asthma, persistent wheeze, chronic cough, and bronchitis, in a study of
           13,369 children ages 8-12 living in 24 communities in U.S. and Canada. Health data were
           collected in 1988-1991, and single-pollutant models were used in the analysis to test a
           number of measures of particulate air pollution. Dockery et al. found that annual level of
                                            287
                                                                                 September 2008

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                                Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           sulfates and particle acidity were significantly related to bronchitis, and PM21 and PM10
           were marginally significantly related to bronchitis. The original study measured PM2 13
           however when using the study's results we use PM2 5.  This makes only a negligible
           difference, assuming that the adverse effects of PM21 and PM2 5 are comparable. They
           also found nitrates were linked to asthma, and sulfates linked to chronic phlegm. It is
           important to note that the study examined annual pollution exposures, and the authors did
           not rule out that acute (daily) exposures could be related to asthma attacks and other acute
           episodes. Earlier work, by Dockery et al. (1989), based on six U.S. cities, found acute
           bronchitis and chronic cough significantly related to PM15. Because it is based on a larger
           sample, the Dockery et al. (1996) study is the better study to develop a C-R function
           linking PM2 5 with bronchitis.

           Bronchitis was counted in the  study only if there were "reports of symptoms in the past 12
           months" (Dockery et al., 1996, p. 501).  It is unclear, however, if the cases of bronchitis
           are acute and temporary, or if the bronchitis is a chronic condition. Dockery et al. found
           no relationship between PM and chronic cough and chronic phlegm, which are important
           indicators of chronic bronchitis.  For this analysis, we assumed that the C-R function based
           on Dockery et al. is measuring acute bronchitis.  The C-R function is based on results of
           the single pollutant model reported in Table  1.
           Acute Bronchitis

           The estimated logistic coefficient and standard error are based on the odds ratio (1.50) and
           95% confidence interval (0.91-2.47) associated with being in the most polluted city (PM2 l
           = 20.7 |ig/m3) versus the least polluted city (PM2 l = 5.8 |ig/m3) (Dockery et al., 1996,
           Tables 1 and 4).  The original study used PM213 however, we use the PM21 coefficient and
           apply it to PM2 5  data.

           Incidence Rate: annual bronchitis incidence rate per person = 0.043 (American Lung Association,
           2002a, Table 11)
           Population: population of ages 8-12.
F.5.2   Ostro (1987)

           Ostro (1987) estimated the impact of PM2 5 on the incidence of work-loss days (WLDs),
           restricted activity days (RADs), and respiratory-related RADs (RRADs) in a national
           sample of the adult working population, ages 18 to 65, living in metropolitan areas. The
           study population is based on the Health Interview Survey (HIS), conducted by the National
           Center for Health Statistics. The annual national survey results used in this analysis were
           conducted in 1976-1981. Ostro reported that two-week average PM2 5 levels were
           significantly linked to work-loss days, RADs, and RRADs, however there was some
           year-to-year variability in the results. Separate coefficients were developed for each year
                                                                                  September 2008
                                             288

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           in the analysis (1976-1981); these coefficients were pooled.  The coefficient used in the
           concentration-response function presented here is a weighted average of the coefficients in
           Ostro (1987, Table HI) using the inverse of the variance as the weight.
           Work Loss Days

           The coefficient used in the C-R function is a weighted average of the coefficients in Ostro
           (1987, Table ID) using the inverse of the variance as the weight:
                                              Is 31  i
                                              v _L
                                                       = 0.0046.
           The standard error of the coefficient is calculated as follows, assuming that the estimated
           year-specific coefficients are independent:
                                 =var
  J.SJ 4.
-z
                                                               van
           This eventually reduces down to:
                                         r;=-U>o-,=  -=0.00036.
           Incidence Rate: daily work-loss-day incidence rate per person ages 18 to 64 = 0.00595 (U.S.
           Bureau of the Census, 1997, No. 22; Adams et al.,  1999, Table 41)
           Population: adult population ages 18 to 64

F.5.3   Ostro and Rothschild (1989)

           Ostro and Rothschild (1989) estimated the impact of PM2 5 and ozone on the incidence of
           minor restricted activity days (MRADs) and respiratory-related restricted activity days
           (RRADs) in a national sample of the adult working population, ages 18 to 65, living in
           metropolitan areas. The study population is  based on the Health Interview Survey (HIS),
                                             289
                                                                                  September 2008

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                     Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
conducted by the National Center for Health Statistics. In publications from this ongoing
survey, non-elderly adult populations are generally reported as ages 18-64.  From the study,
it is not clear if the age range stops at 65 or includes 65 year olds. We apply the C-R
function to individuals ages 18-64 for consistency with other studies estimating impacts to
non-elderly adult populations.  The annual national survey results used in this analysis
were conducted in 1976-1981.  Controlling for PM2 5, two-week average ozone has highly
variable association with RRADs and MRADs.  Controlling for ozone, two-week average
PM2 5 was significantly linked to both health endpoints in most years.
Minor Restricted Activity Days

Using the results of the two-pollutant model, we developed separate coefficients for each
year in the analysis, which were then combined for use in this analysis. The coefficient is a
weighted average of the coefficients in Ostro and Rothschild (1989, Table 4) using the
inverse of the variance as the weight:
                                        o \
                                        Pi  ,
                               ^|lS-f . = 0.00741.
The standard error of the coefficient is calculated as follows, assuming that the estimated
year-specific coefficients are independent:
                      =var
                                                  1331
                                                     van ——
                                                          CT'7
This reduces down to:
                               ;=—^CF,=  —=0.00070.
                               ,*••  .if    ,*-•  111 .f f
Incidence Rate: daily incidence rate for minor restricted activity days (MRAD) = 0.02137 (Ostro
and Rothschild, 1989, p. 243)
Population: adult population ages 18 to 64
                                  290
                                                                        September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F.5.4   Schwartz and Neas (2000)

           Schwartz et al. (2000) replicated a previous analysis (Schwartz et al., 1994) linking PM
           levels to lower respiratory symptoms in children in six cities in the U.S.  The original study
           enrolled 1,844 children into a year-long study that was conducted in different years (1984
           to 1988) in six cities.  The students were in grades two through five at the time of
           enrollment in  1984. By the completion of the final study, the cohort would then be in the
           eighth grade (ages  13-14); this suggests an age range of 7 to 14.  The previous study
           focused on PM10, acid aerosols, and gaseous pollutants, although single-pollutant PM2 5
           results were reported.  Schwartz et al. (2000) focused more on the associations between
           PM2 5 and PM10_2 5 and lower respiratory symptoms. In single and co-pollutant models,
           PM2 5 was significantly associated with lower respiratory symptoms, while PM10_2 5 was
           not. PM10 2 5 exhibited a stronger association with cough than did PM2 5.  The PM2 5 C-R
           functions for lower respiratory symptoms are based on the results of the reported single
           pollutant and co-pollutant model (PM2 5 and PM10_2 5).
           Lower Respiratory Symptoms

           The coefficient and standard error are calculated from the reported odds ratio (1.33) and
           95% confidence interval (1.11-1.58) associated with a 15 |ig/m3 change inPM25 (Schwartz
           and Neas, 2000, Table 2).

           Incidence Rate: daily lower respiratory symptom incidence rate per person = 0.0012 (Schwartz et
           al., 1994, Table 2)
           Population: population of ages 7 to 14
F.6     Asthma-Related Effects

           Table F-10 summarizes the health impacts functions used to estimate the relationship
           between PM2 5 and asthma exacerbation. Below, we present a brief summary of each of
           the studies and any items that are unique to the study.
             Table F-10. Health Impact Functions for Particulate Matter and Asthma-Related
                                                Effects
Effect
Cough
Cough
Author
Ostro et al.
Ostro et al.
Year
2001
2001
Lcoation
Los Angeles,
CA
Los Angeles,
CA
Age
6-18
6-18
Co-Pol
1


Metric
D24HourMean
D24HourMean
Beta
0.001013
0.000985
Std Err
0.000768
0.000747
Form
Logistic
Logistic
Notes
Adjusted coefficient
with 1 0 ug/m3
threshold.

                                            291
                                                                                 September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
Effect
Shortness
of Breath
Shortness
of Breath
Wheeze
Wheeze
Upper
Respiratory
Symptoms
Upper
Respiratory
Symptoms
Cough
Cough
Author
Ostro et al.
Ostro et al.
Ostro et al.
Ostro et al.
Pope et al.
Pope et al.
Vedal et al.
Vedal et al.
Year
2001
2001
2001
2001
1991
1991
1998
1998
Lcoation
Los Angeles,
CA
Los Angeles,
CA
Los Angeles,
CA
Los Angeles,
CA
Utah Valley
Utah Valley
Vancouver,
CAN
Vancouver,
CAN
Age
6-18
6-18
6-18
6-18
9-11
9-11
6-18
6-18
Co-Pol
1








Metric
D24HourMean
D24HourMean
D24HourMean
D24HourMean
D24HourMean
D24HourMean
D24HourMean
D24HourMean
Beta
0.002636
0.002565
0.001996
0.001942
0.003600
0.003600
0.008376
0.008000
Std Err
0.001372
0.001335
0.000825
0.000803
0.001500
0.001500
0.004273
0.004082
Form
Logistic
Logistic
Logistic
Logistic
Logistic
Logistic
Logistic
Logistic
Notes
Adjusted coefficient
with 1 0 ug/m3
threshold.

Adjusted coefficient
with 10 ug/m3
threshold.

Adjusted coefficient
with 10 ug/m3
threshold.

Adjusted coefficient
with 10 ug/m3
threshold.

F.6.1   Ostro et al (2001)
           Ostro et al. (2001) studied the relation between air pollution in Los Angeles and asthma
           exacerbation in African-American children (8 to 13 years old) from August to November
           1993.  They used air quality data for PM10, PM2 5, NO2, and O3 in a logistic regression
           model with control for age, income, time trends, and temperature-related weather effects.
           The authors note that there were 26 days in which PM2 5 concentrations were reported
           higher than PM10 concentrations. The majority of results the authors reported were based
           on the full dataset. These results were used for the basis for the C-R functions.  Asthma
           symptom endpoints were defined in two ways: "probability of a day with symptoms" and
           "onset of symptom episodes". New onset of a symptom episode was defined as a day with
           symptoms followed by a symptom-free day.

           The authors found cough prevalence associated with PM10 and PM2 5 and cough incidence
           associated with PM2 5, PM10, and NO2. Ozone was not significantly associated  with cough
           among asthmatics. The authors found that both the prevalent and incident episodes of
           shortness of breath were associated with PM2 5 and PM10.  Neither ozone nor NO2 were
           significantly associated with shortness of breath among asthmatics. The authors found both
           the prevalence and incidence of wheeze associated with PM2 5, PM10, and NO2.  Ozone
           was not significantly associated with wheeze among asthmatics.

           The derived health impact functions are based on the results of single pollutant  models
           looking at the probability of symptoms.
                                            292
                                                                                September 2008

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           Asthma Exacerbation, Cough

           The coefficient and standard error are based on an odds ratio of 1.03 (95% CI 0.98-1.07)
           for a 30 |ig/m3 increase in 12-hour average PM2 5 concentration (Ostro et al., 2001, Table
           4, p.204).

           Incidence Rate: daily cough rate per person (Ostro et al., 2001, p.202) = 0.145
           Population: asthmatic African-American population ages 8 to 13 = 7.26% of African-American
           population ages 8 to 13. The American Lung Association (2002a, Table 9) estimates asthma
           prevalence for African-American children ages 5 to 17 at 7.26% (based on data from the
           1999 National Health Interview Survey).
           Asthma Exacerbation, Shortness of Breath

           The coefficient and standard error are based on an odds ratio of 1.08 (95% CI 1.00-1.17)
           for a 30 |ig/m3 increase in 12-hour average PM2 5 concentration (Ostro et al., 2001, Table
           4, p.204).

           Incidence Rate: daily shortness of breath rate per person (Ostro et al., 2001, p.202) = 0.074
           Population: asthmatic African-American population ages 8 to 13 = 7.26% of African-American
           population ages 8 to 13. (Described above.)


           Asthma Exacerbation, Wheeze
           The coefficient and standard error are based on an odds ratio of 1.06 (95% CI 1.01-1.11)
           for a 30 |ig/m3 increase in 12-hour average PM2 5 concentration (Ostro et al., 2001, Table
           4, p.204).

           Incidence Rate: daily wheeze rate per person (Ostro et al., 2001, p.202) = 0.173
           Population: asthmatic African-American population ages 8 to 13 = 7.26% of African-American
           population ages 8 to 13.  (Described above.)

F.6.2   Pope et al (1991)

           Using logistic regression, Pope et al. (1991) estimated the impact of PM10 on the incidence
           of a variety of minor symptoms in 55 subjects (34 "school-based" and 21 "patient-based")
           living in the Utah Valley from December 1989 through March 1990. The children in the
           Pope et al. study were asked to record respiratory symptoms in a daily diary. With this
           information, the daily occurrences of upper respiratory symptoms (URS) and lower
           respiratory symptoms (LRS) were related to daily PM10 concentrations.  Pope et al.
           describe URS as consisting of one or more of the following symptoms:  runny or stuffy
           nose; wet cough; and burning, aching, or red eyes. Levels of ozone, NO2, and SO2 were
           reported low during this period, and were not included in the analysis. The sample in this
           study is relatively small and is most representative of the asthmatic population, rather than
           the general population.  The school-based subjects (ranging in age from  9 to 11) were
                                                                                  September 2008
                                             293

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           chosen based on "a positive response to one or more of three questions: ever wheezed
           without a cold, wheezed for 3 days or more out of the week for a month or longer, and/or
           had a doctor say the 'child has asthma' (Pope et al., 1991, p. 669)." The patient-based
           subjects (ranging in age from 8 to 72) were receiving treatment for asthma and were
           referred by local physicians.  Regression results for the school-based sample (Pope et al.,
           1991, Table 5) show PM10 significantly associated with both upper and lower respiratory
           symptoms.  The patient-based sample did not find a significant PM10 effect.  The results
           from the school-based sample are used here.
           Upper Respiratory Symptoms

           The coefficient and standard error for a one |ig/m3 change in PM10 is reported in Table 5.

           Incidence Rate: daily upper respiratory symptom incidence rate per person = 0.3419 (Pope et al.,
           1991, Table 2)
           Population: asthmatic population ages 9 to 11 = 5.67% of population ages 9 to 11. (The
           American Lung Association (2002a, Table 7) estimates asthma prevalence for children
           ages 5 to 17 at 5.67%, based on data from the 1999 National Health Interview Survey.)

F.6.3   Vedal et al (1998)

           Vedal et al. (1998) studied the relationship between air pollution and respiratory symptoms
           among asthmatics and non-asthmatic children (ages 6 to 13) in Port Alberni, British
           Columbia, Canada. Four groups of elementary school children were sampled from a prior
           cross-sectional study: (1) all children with current asthma, (2) children without doctor
           diagnosed asthma who experienced a drop in FEV after exercise, (3) children not in groups
           1 or 2 who had evidence of airway obstruction, and (4) a control group of children with
           matched by classroom.  The authors used logistic regression and generalized estimating
           equations to examine the association between daily PM10 levels and daily increases in
           various respiratory symptoms among these groups. In the entire sample of children, PM10
           was significantly associated with cough, phlegm, nose symptoms, and throat soreness.
           Among children with diagnosed asthma, the authors report a significant association
           between PM10 and cough symptoms, while no consistent effects were observed in the other
           groups. Since the study population has an over-representation of asthmatics, due to the
           sampling strategy, the results from the full sample of children are not generalizeable to the
           entire population. The C-R function presented below is based on results among asthmatics
           only.
           Asthma Exacerbation, Cough

           The PM10 coefficient and standard error are based on an increase in odds of 8% (95% CI
           0-16%) reported in the abstract for a 10 jig/m3 increase in daily average PM10.
                                                                                 September 2008
                                            294

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                               Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
           Incidence Rate: daily cough rate per person (Vedal et al., 1998, Table 1, p. 1038) = 0.086
           Population: asthmatic population ages 6 to 13 = 5.67% of population ages 6 to 13. (The
           American Lung Association (2002a, Table 7) estimates asthma prevalence for children 5-
           17 at 5.67% (based on data from the 1999 National Health Interview Survey).)

F.7    Calculating Threshold-Adjusted Functions

           Following the approach taken in OAQPS' June 2005 particulate matter (PM) risk
           assessment, we used a 10 ug/m3 cutpoint for short-term (daily) C-R functions and a 7.5 ug/
           m3 cutpoint for long-term (annual metric) C-R functions from which PM2.5 health impact
           functions have been derived. The risk assessment noted that while there are likely
           biological thresholds in individuals for specific health responses, the available
           epidemiological studies do not support or refute the existence of thresholds at the
           population level for either long-term or short-term PM2.5 exposures within the range of air
           quality observed in the studies. It may therefore be appropriate to consider health risks
           estimated not only with the reported log-linear or logistic C-R functions, but also with
           modified functions that approximate non-linear, sigmoidal-shaped functions that would
           better reflect possible population thresholds.

           However, following the approach currently being taken in OAQPS' ongoing O3 risk
           assessment, we did not derive threshold models for O3 concentration-response functions.
           After debating the merits of considering possible thresholds for O3 for hospital admissions
           and mortality C-R functions, OAQPS staff concluded that, because the studies report a
           relationship down to very low ambient levels, at or below the estimated policy relevant
           background (PRB) concentrations (roughly around 0.03 ppm), consideration of threshold
           models for O3 is not warranted.  In addition, some of the O3 studies reported effects for
           mortality and hospital admissions in Canadian cities where the levels never exceeded the
           current 0.08 ppm standard.

           We approximated hypothetical sigmoidal PM2.5 C-R functions by "hockeystick" functions
           based on the reported log-linear or logistic functions.  This  approximation consisted of (1)
           imposing a cutpoint (i.e., an assumed threshold) on the original C-R function, that is
           intended to  reflect an inflection point in a typical sigmoidal shaped function, below which
           there is little or no population response, and (2) adjusting the slope of the original C-R
           function above the cutpoint.

           If the researchers in the original study fit a log-linear, linear, or logistic model through data
           that actually better support a sigmoidal or "hockeystick" form, the slope of the fitted curve
           would be smaller than the slope of the upward-sloping portion of the "true" hockeystick
           relationship, as shown in Exhibit 3.  The horizontal portion of the data below the cutpoint
           would essentially cause the estimated slope to be biased downward relative to the "true"
           slope of the upward-sloping portion of the hockeystick. The slope of the upward-sloping
           portion of the hockeystick model should therefore be adjusted  upward (from the slope of
           the reported C-R function), as shown in Figure F-13. If the data used in a study do not
           extend down below the cutpoint or extend only slightly below it, then the extent of the
           downward bias of the reported PM2.5 coefficient will be minimal, as illustrated in Figure
                                                                                  September 2008
                                             295

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                    Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
F-14.
 Figure F-13.  Relationship Between Estimated Log-Linear Concentration-Response
        Function and Hockeystick Model With Threshold C ~ General Case
        o
        §
        C
                                       -"True"
                                       hockey stick
                                       model
                                       Estimated C-R
                                       tinction
        LfvL
C
PM
HM_
 Figure F-14.  Relationship Between Estimated Log-Linear Concentration-Response
   Function and Hockeystick Model With Threshold C ~ Lowest Measured Level
                                296
                                                                    September 2008

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                      Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
                       (LML) Close to Hypothetical Threshold
         LML
                                                                    -"True?1
                                                                     hoc key stick
                                                                     model
                                                                    •Estimated OR
                                                                     function	
HML
We used a simple slope adjustment method based on the idea discussed above - that, if the data in
the study were best described by a hockeystick model with a cutpoint at c, then the slope estimated
in the study using a log-linear or logistic model would be approximately a weighted average of the
two slopes of the hockeystick - namely, zero and the slope of the upward-sloping portion of the
hockeystick. If we let:
                                    297
                                                                           September 2008

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                     Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
 •   LML denote the lowest measured PM level in the study,
 •   c denote the outpoint (for c > LML),2
                •v-vVvVVv-vVvVv \          j"
 •   HML denote the highest measured PM level in the study,

 •    fiest denote the slope (the PM coefficient) estimated in the study (using a log-linear or logistic

     model), and

 •    8  denote the "true" slope of the up ward-sloping portion of the hockevstick,
      '                   *         J.        A   ^'•.'vV•Vv*/


                   t = (p   (c-LML)    |   r f  (HML-c)

                         (HML - LML)        (HML - LML) '


 Solving for $T,
                                   (HML - c)

That is, the "true" slope of the upward-sloping portion of the hockeystick would be the
slope estimated in the study (using a log-linear or logistic model rather than a hockeystick
model) adjusted by the inverse of the proportion of the range of PM levels observed in the
study that was above the cutpoint. Note that if the LML was below the estimated PRB (or
if it was not available for the study), the estimated PRB was substituted for LML in the
above equation.

Table F-l 1 presents the threshold adjustments that were used to multiply with both the
mean coefficient estimate and its standard error.
 Table F-ll.  Threshold Adjustment Factors Based on Assumed Threshold of 10 ug/
                                         m3
Author

Abbey et al.
Dockery et al.
Ito
Laden et al.
Moolgavkar
Norris et al.
Year

1995
1996
2003
2006
2003
1999
Study Location
SF, SD, South Coast
Air Basin
24 communities
Detroit, MI
6 cities
Los Angeles, CA
Seattle, WA
Thresh
Min Max old

10
5.8 20.7 10
6 42 10
10.8 25.5 10
4 86 10
9 18.2 10
Threshold
Adj Notes

1.000
1.393
1 . 125 Min and max based on 5% and 95%.
1.000
1.079
1.122
                                  298
                                                                        September 2008

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Appendix F: Particulate Matter Health Impact Functions in U.S. Setup
Ostro
Ostro and
Rothschild
Ostro et al.
Peters et al.
Pope et al.


Pope et al.
Pope et al.
Pope et al.
Pope et al.
Schwartz and
Neas
Sheppard

Vedal et al.
Woodruff etal.
Woodruff etal.
1987
1989
2001
2001
1991


2002
2002
2002
2002

2000
2003

1998
1997
2006
Nationwide
Nationwide
Los Angeles, CA
Boston, MA
Utah Valley


51 cities
51 cities
51 cities
51 cities

6 U.S. cities
Seattle, WA

Vancouver, CAN
86 cities
204 counties
10
10
4.5 208.7 10
4.6 24.3 10
11 195 10


7.5 30 7.5
7.5 30 10
7.5 30 12
7.5 30 15

7.2 86 10
6 32 10

3 159 10
11.9 68.8 10
10
1.000
1.000
1.028
1.378
1.000


1.000
1.125
1.250
1.500

1.037
1.182

1.047
1.000
1.000
Study did not provide a mean, SD, or
pollutant range.
Study gave mean and std dev. We
estimate min is above threshold of 10.

Min and max based on 5% and 95%.

Mean: 17.7 & SD: 3.7. PM risk
assessment assumed min = 7.5 and max
= 30





Min and max based on 5% and 95%.
Min = policy-relevant background.
Actual min was 0.2 in North and 0.5 in
South.

Only presented interquartile PM2.5
range
              299
                                                    September 2008

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                                      Appendix G: Ozone Health Impact Functions in U.S. Setup
       Appendix G:  Ozone Health Impact Functions in

       U.S.  Setup

          In this Appendix, we present the health impact functions used to estimate ozone-related
          adverse health effects. Each sub-section has a table with a brief description of each health
          impact function and the underlying parameters. Following each table, we present a brief
          summary of each of the studies and any items that are unique to the study.

          Note that Appendix D mathematically derives the standard types of health impact functions
          encountered in the epidemiological literature, such as, log-linear, logistic and linear, so we
          simply note here the type of functional form. And Appendix E presents a description of
          the sources for the incidence and prevalence data used in the health impact functions.
G.1    Short-term Mortality

          Table G-l summarizes the health impacts functions used to estimate the relationship
          between ozone and short-term mortality. Below, we present a brief summary of each of
          the studies and any items that are unique to the study.
               Table G-l. Health Impact Functions for Ozone and Short-Term Mortality
Effect
Non-Accidental
Non-Accidental
Non-Accidental
All Cause
All Cause
Cardiopulmonar
y
Cardiopulmonar
y
Non-Accidental
Non-Accidental
Non-Accidental
Author
Bell et al.
Bell et al.
Bell et al.
Bell et al.
Bell et al.
Huang et al.
Huang et al.
Ito and
Thurston
Ito et al.
Ito et al.
Year
2004
2004
2004
2005
2005
2005
2005
1996
2005
2005
Lcoation
95 US cities
95 US cities
95 US cities
US & non-US
US & non-US
19 US cities
19 US cities
Chicago, IL


Age
0-99
0-99
0-99
0-99
0-99
0-99
0-99
18-99
0-99
0-99
Co-Poll







PM10


Metric
D24HourMea
n
D24HourMea
n
DSHourMax
D24HourMea
n
DSHourMax
D24HourMea
n
DSHourMax
DIHourMax
DIHourMax
D24HourMea
n
Beta
0.000390
0.000520
0.000261
0.001500
0.000795
0.001250
0.000813
0.000634
0.000400
0.001750
Std Err
0.000133
0.000128
0.000089
0.000401
0.000212
0.000398
0.000259
0.000251
0.000066
0.000357
Form
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r
Notes
Warm season.
All year.
Warm season.
8 -hour max from
24-hour mean.
Warm season.
Warm season.
8-hour max from
24-hour mean.
Warm season.
Warm season.
8 -hour max from
24-hour mean.

1 -hour max.
Warm season.
24-hour mean.
                                         300
                                                                           September 2008

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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
Non-Accidental

Non-Accidental
All Cause
All Cause

Non-Accidental
Non-Accidental
Non-Accidental
Non-Accidental


Non-Accidental
Non-Accidental

Ito et al.

Ito et al.
Levy et al.
Levy et al.

Moolgavkar et
al.
Moolgavkar et
al.
Moolgavkar et
al.
Samet et al.


Schwartz
Schwartz

2005

2005
2005
2005

1995
1995
1995
1997


2005
2005




US and
non-US
US and
non-US

Philadelphia,
PA
Philadelphia,
PA
Philadelphia,
PA
Philadelphia,
PA


14 US cities
14 US cities

0-99

0-99
0-99
0-99

0-99
0-99
18-99
18-99


0-99
0-99








TSP,
SO2
TSP,
SO2
CO,
NO2,
SO2,
TSP



DSHourMax

DSHourMax
DIHourMax
DSHourMax

D24HourMea
n
D24HourMea
n
D24HourMea
n
D24HourMea
n


DIHourMax
DSHourMax

0.001173

0.000532
0.000841
0.001119

0.001398
0.001389
0.000611
0.000936


0.000370
0.000426

0.000239

0.000088
0.000134
0.000179

0.000266
0.000373
0.000216
0.000312


0.000130
0.000150

Log-linea
r

Log-linea
r
Log-linea
r
Log-linea
r

Log-linea
r
Log-linea
r
Log-linea
r
Log-linea
r


Logistic
Logistic

Warm season.
8-hour max from
24-hour mean.
8 -hour max from
1 -hour max.
Warm season.
Warm season.
8-hour max from
1 -hour max.
Warm season.
Warm season.




Warm season.
Warm season.
8 -hour max from
1 -hour max.
G.1.1   Bell et al (2004)
           Ozone has been associated with various adverse health effects, including increased rates of
           hospital admissions and exacerbation of respiratory illnesses. Although numerous
           time-series studies have estimated associations between day-to-day variation in ozone
           levels and mortality counts, results have been inconclusive. The authors investigated
           whether short-term (daily and weekly) exposure to ambient ozone is associated with
           mortality in the United States.  Using analytical methods and databases developed for the
           National Morbidity, Mortality, and Air Pollution Study, they estimated a national average
           relative rate of mortality associated with short-term exposure to ambient ozone for 95 large
           US urban communities from 1987-2000. The authors used distributed-lag models for
           estimating community-specific relative rates of mortality adjusted for time-varying
           confounders (particulate matter, weather, seasonality, and long-term trends) and
           hierarchical models for combining relative rates across communities to estimate a national
           average relative rate, taking into account spatial heterogeneity. A 10-ppb increase in the
           previous week's ozone was associated with a 0.52% increase in daily mortality (95%
           posterior interval [PI], 0.27%-0.77%) and a 0.64% increase in cardiovascular and
           respiratory mortality (95% PI, 0.31%-0.98%). Effect estimates for aggregate ozone during
           the previous week were larger than for models considering only a single day's  exposure.
           Results were robust to adjustment for particulate matter, weather, seasonality,  and
           long-term trends. These results indicate a statistically significant association between
           short-term changes in ozone and mortality on average for 95 large US urban communities,
           which include about 40% of the total US population.
                                             301
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                                          Appendix G: Ozone Health Impact Functions in U.S. Setup
           Non-Accidental Mortality

           The coefficient and standard error are based on the relative risk (1.003908) and 95%
           confidence interval (1.0013-1.0065) associated with a 10 ppb increase in daily average
           ozone (Bell et al., 2004, p. 2376).

G.1.2   Bell et al (2005)

           Although many time-series studies of ozone and mortality have identified positive
           associations, others have yielded null or inconclusive results, making the results of these
           studies difficult to interpret.  The authors performed a meta-analysis of 144 effect estimates
           from 39 time-series studies, and estimated pooled effects by lags, age groups,
           cause-specific mortality, and concentration metrics. They compared results with pooled
           estimates from the National Morbidity, Mortality, and Air Pollution Study (NMMAPS), a
           time-series study of 95 large U.S. urban centers from 1987 to 2000.  Both meta-analysis
           and NMMAPS results provided strong evidence of a short-term association between ozone
           and mortality, with larger effects for cardiovascular and respiratory mortality, the elderly,
           and current-day ozone exposure. In both analyses, results were insensitive to adjustment
           for particulate matter and model specifications. In the meta-analysis, a 10-ppb increase in
           daily ozone at single-day or 2-day average of lags 0, 1, or 2 days was associated with an
           0.87% increase in total mortality (95% posterior interval = 0.55% to 1.18%), whereas the
           lag 0 NMMAPS estimate is 0.25% (0.12% to 0.39%).  Several findings indicate possible
           publication bias: meta-analysis results were consistently larger than those from NMMAPS;
           meta-analysis pooled estimates at lags 0 or 1 were larger when only a single lag was
           reported than when estimates for multiple lags were reported; and heterogeneity of
           city-specific estimates in the meta-analysis were larger than with NMMAPS.
           All-Cause Mortality

           The coefficient and standard error are based on the relative risk (1.008738) and 95%
           confidence interval (1.0055-1.0119) associated with a 10 ppb increase in daily average
           ozone (Bell et al., 2005, Table 6).

G.1.3   Huang et al (2005)

           The authors developed Bayesian hierarchical distributed lag models for estimating
           associations between daily variations in summer ozone levels and daily variations in
           cardiovascular and respiratory (CVDRESP) mortality counts for 19 large U.S. cities
           included in the National Morbidity, Mortality and Air Pollution Study (NMMAPS) for the
           summers of 1987-1994. In the first stage, they defined a semi-parametric distributed lag
           Poisson regression model to estimate city-specific relative rates of CVDRESP mortality
           associated with short-term exposure to summer ozone. In the second stage, they specified a
           class of distributions for the true city-specific relative rates to estimate an overall effect by
           taking into account the variability within and across cities. They performed the
           calculations with respect to several random effects distributions (normal, t-student,  and
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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
           mixture of normal), thus relaxing the common assumption of a two-stage normal-normal
           hierarchical model. They assessed the sensitivity of the results to: (i) lag structure for
           ozone exposure; (ii) degree of adjustment for long-term trends; (iii) inclusion of other
           pollutants in the model; (iv) heat waves; (v) random effects distributions; and (vi) prior
           hyperparameters. On average across cities, the authors found that a 10 ppb increase in
           summer ozone level over the previous week is associated with a  1.25 per cent increase in
           CVDRESP mortality (95 per cent posterior regions: 0.47, 2.03).  The relative rate estimates
           are also positive and statistically significant at lags 0,  1 and 2. They found that associations
           between summer ozone and CVDRESP mortality are  sensitive to the confounding
           adjustment for PM10, but are robust to: (i) the adjustment for long-term trends, other
           gaseous pollutants (NO2, SO2 and CO); (ii) the distributional assumptions at the second
           stage of the hierarchical model; and (iii) the prior distributions on all  unknown parameters.
           Cardiopulmonary Mortality

           Assuming a 10 ppb change in ozone, Huang et al (2005, Table 1) reported a 1.25% change
           in CVDRESP mortality with a 95% confidence interval of 0.47% to 2.03%.

           Note that Huang et al (2005, p. 549) define CVDRESP as including ICD-9 codes: 390-448,
           480-487, 490-496, and 507. This differs somewhat from the the definition of
           "cardiopulmonary" mortality in BenMAP - defined as ICD-9 codes 401-440 and 460-519.

G.1.4   Levy et al, 2005

           The authors conducted an empiric Bayes metaregression to estimate the ozone effect on
           mortality, and to assess whether this effect varies as a function of hypothesized
           confounders or effect modifiers.  They gathered 71 time-series studies relating ozone to
           all-cause mortality, and tjey selected 48 estimates from 28 studies for the metaregression.
           Metaregression covariates included the relationship between ozone concentrations and
           concentrations of other air pollutants, proxies for personal exposure-ambient concentration
           relationships, and the statistical methods used in the studies. For the metaregression, they
           applied a hierarchical linear model with known level-1 variances.  The authors estimated a
           grand mean of a 0.21% increase (95% confidence interval = 0.16-0.26%) in mortality per
           10-microg/m increase of 1-hour maximum ozone (0.41% increase per 10 ppb) without
           controlling for other air pollutants. In the metaregression, air-conditioning prevalence and
           lag time were the strongest predictors of between-study variability. Air pollution
           covariates yielded inconsistent findings in regression models, although correlation analyses
           indicated a potential influence of summertime PM2.5.
           All-Cause Mortality

           Levy et al (2005, Table 1) reported a 0.43% change in all-cause mortality with a 95%
           confidence interval of 0.29% to 0.56% associated with a 10 ug/m3 change in ozone.  We
           converted ug/m3 to ppb with an assumed relationship of 1.96 ug/m3 per 1.0 ppb.
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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
G.1.5   Ito and Thurston (1996)
           In this study, race, gender, and cause-specific counts of daily mortality in Cook County,
           Illinois (which encompasses the city of Chicago) during 1985-1990 were analyzed to
           determine if there was any heterogeneity in air pollution/weather/mortality associations
           across these various population subcategories.  Seasonal cross-correlations between
           mortality and environmental variables first were examined to identify appropriate lag
           structures.  Of the pollution variables considered — PM10, ozone, CO, SO2, and visual
           range-derived extinction coefficient — both PM10 and ozone showed significant
           associations with same-day and next-day mortality. The Poisson regression models
           employed included seasonal cycles (sine/cosine series), square and linear terms of lagged
           temperature, trend line, day-of-week dummy variables, and the average of the same day's
           and previous day's PM10 or ozone.

           The authors reported a significant relationship for ozone and PM10 with both pollutants in
           the model; no significant effects were found for SO2 and CO.  In single pollutant models
           the effects were slightly larger. The health impact  function for ozone is based on results
           from the co-pollutant models.
           Non-Accidental Mortality

           For a co-pollutant model with PM10, the ozone coefficient (0.000634) and standard error
           (0.000251) were obtained directly from the author because the published paper reported
           incorrect information.
G.1.6   Ito et al (2005)
           The authors conducted a review and meta-analysis of short-term ozone mortality studies,
           identified unresolved issues, and conducted an additional time-series analysis for 7 U.S.
           cities (Chicago, Detroit, Houston, Minneapolis-St. Paul, New York City, Philadelphia, and
           St. Louis). They found a combined estimate of 0.39% (95% confidence interval =
           0.26-0.51%) per 10-ppb increase in 1-hour daily maximum ozone for the all-age
           nonaccidental cause/single pollutant model (43 studies).  Adjusting for the funnel plot
           asymmetry resulted in a slightly reduced estimate (0.35%; 0.23-0.47%). In a subset for
           which particulate matter (PM) data were available (15 studies), the corresponding
           estimates were 0.40% (0.27-0.53%) for ozone alone and 0.37% (0.20-0.54%) with PM in
           model. The estimates for warm seasons were generally larger than those for cold seasons.
           The additional time-series analysis found that including PM in the model did not
           substantially reduce the ozone risk estimates. However, the difference in the weather
           adjustment model could result in a 2-fold difference in risk estimates (eg, 0.24% to 0.49%
           in multicity combined estimates across alternative weather models for the ozone-only
           all-year case). The authors concluded that the results suggest short-term associations
           between ozone and daily mortality in the majority of the cities, although the estimates
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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
           appear to be heterogeneous across cities.
           Non-Accidental Mortality

           Ito et al (2005) reported results for functions with both 1-hour daily maximum and 24-hour
           daily average metrics. We present both below.
           One-hour Max Function

           Assuming a 10 ppb change in the daily 1-hour maximum, Ito et al (2005, p. 446) reported a
           0.40% change in non-accidental mortality with a 95% confidence interval of 0.27% to
           0.53%.
           Daily Average Function

           Assuming a 20 ppb change in the daily 24-hour average, Ito et al (2005, p. 448) reported a
           3.5% change in non-accidental mortality with a 95% confidence interval of 2.1% to 4.9%.
G.1.7   Moolgavkar et al (1995)
           Moolgavkar et al. (1995) examined the relationship between daily non-accidental mortality
           and air pollution levels in Philadelphia, Pennsylvania from 1973 to 1988.  They examined
           ozone, TSP, and SO2 in a three-pollutant model, and found a significant relationship for
           ozone and SO2; TSP was not significant. In season-specific models, ozone was
           significantly associated with mortality only in the summer months.
           Mortality, Non-Accidental

           The health impact function for ozone is based on the full-year three-pollutant model
           reported in Table 5 (Moolgavkar et al.,  1995, p. 482).  The coefficient and standard error
           are based on the relative risk (1.063) and 95% confidence interval (1.018-1.108) associated
           with a 100 ppb increase in daily average ozone.
G.1.8   Samet et al (1997)
           Samet et al. (1997) examined the relationship between daily non-accidental mortality and
           air pollution levels in Philadelphia, Pennsylvania from 1974 to 1988.  They examined
           ozone, TSP, SO2, NO2, and CO in a Poisson regression model.  In single pollutant models,
           ozone, SO2, TSP, and CO were significantly associated with mortality. In a five-pollutant
           model, they found a positive statistically significant relationship for each pollutant except
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                                        Appendix G: Ozone Health Impact Functions in U.S. Setup
          NO2.
           Mortality, Non-Accidental

           The health impact function for ozone is based on the five-pollutant model (ozone, CO, NO
           2, SO2, and TSP) reported in Table 9 (Samet et al., 1997, p. 20). The ozone coefficient and
           standard error are based on the percent increase (1.91) and t-statistic (3) associated with a
           20.219 ppb increase in two-day average ozone.
G.1.9   Schwartz (2005)
           The author used the case-crossover approach, where the control for each person is the same
           person on a day near in time, when he or she did not die. This method controls for season
           and individual risk factors by matching. One can also choose the control day to have the
           same temperature as the event day. The author applied this approach to a study of more
           than 1 million deaths in 14 U.S. cities. He found that, with matching on temperature, a
           10-ppb increase in maximum hourly ozone concentrations was associated with a 0.23%
           (95% confidence interval  [CI] 0.01%, 0.44%) increase in the risk of dying. This finding
           was indistinguishable from the risk when only matching on season and controlling for
           temperature with regression splines (0.19%; 95% CI 03%, 0.35%). Control for suspended
           paniculate matter with an aerodynamic diameter of 10 mum or less (PM(10)) did not
           change this risk. However, the association was restricted to the warm months (0.37%
           increase; 95% CI 0.11%, 0.62%), with no effect in the cold months. The author concluded
           that the association between ozone and mortality risk is unlikely to be caused by
           confounding by temperature.
           Non-Accidental Mortality

           Assuming a 10 ppb change in the daily 1-hour maximum, Schwartz (2005, Table 2)
           reported a 0.37% change in non-accidental mortality with a 95% confidence interval of
           0.11% to 0.62%.

G.2    Hospital Admissions

           Table G-2 summarizes the health impacts functions used to estimate the relationship
           between ozone and hospital admissions. Below, we present a brief summary of each of the
           studies and any items that are unique to the study.
                 Table G-2.  Health Impact Functions for Ozone and Hospital Admissions
           Effect     Author     Year Lcoation   Age  Co-Poll  I Metric     Beta    Std Err form     Notes
E
                                                                                September 2008
                                            306

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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
All
Respiratory
All
Respiratory
Chronic Lung
Chronic Lung
Pneumonia
Pneumonia
Chronic Lung
(less Asthma)
Chronic Lung
(less Asthma)
Pneumonia
Pneumonia
Pneumonia
Pneumonia
All
Respiratory
All
Respiratory
All
Respiratory
An
Respiratory
Burnett et al.
Burnett et al.
Moolgavkar et
al.
Moolgavkar et
al.
Moolgavkar et
al.
Moolgavkar et
al.
Schwartz
Schwartz
Schwartz
Schwartz
Schwartz
Schwartz
Schwartz
Schwartz
Schwartz
Schwartz
2001
2001
1997
1997
1997
1997
1994
1994
1994
1994
1994
1994
1995
1995
1995
1995
Toronto,
CAN
Toronto,
CAN
Minneapolis
,MN
Minneapolis
,MN
Minneapolis
,MN
Minneapolis
,MN
Detroit, MI
Detroit, MI
Detroit, MI
Minneapolis
,MN
Detroit, MI
Minneapolis
,MN
New
Haven, CT
Tacoma,
WA
New
Haven, CT
Tacoma,
WA
0-1
0-1
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
65-99
PM2.5
PM2.5
PM10,
CO
PM10,
CO
PM10,
SO2,
NO 2
PM10,
SO2,
NO2
PM10
PM10
PM10
PM10
PM10
PM10
PM10
PM10
PM10
PM10
DIHourMax
DSHourMax
D24HourMea
n
DSHourMax
D24HourMea
n
DSHourMax
D24HourMea
n
DSHourMax
D24HourMea
n
D24HourMea
n
DSHourMax
DSHourMax
D24HourMea
n
D24HourMea
n
DSHourMax
DSHourMax
0.00730
1
0.00817
7
0.00280
0
0.00196
0
0.00380
0
0.00266
0
0.00552
3
0.00342
4
0.00521
0
0.00397
7
0.00323
0
0.00278
4
0.00265
-)
0.00714
7
0.00177
7
0.00493
1
0.002122 :
0.002377 1
0.001769 1
0.001238 1
0.001088 1
0.000762 1
0.002085 1
0.001293 1
0.001300 1
0.001865 1
0.000806 1
0.001305
0.001398
0.002565
0.000936
0.001770
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
og-linear
Warm season.
Warm season. 8-hour
max from 1 -hour
max.

All year. 8 -hour max
from 24-hour mean.

All year. 8-hour max
from 24-hour mean.
All year.
All year. 8-hour max
from 24-hour mean.
All year.
All year.
All year. 8 -hour max
from 24-hour mean.
All year. 8-hour max
from 24-hour mean.
Warm season.
Warm season.
Warm season. 8-hour
max from 24-hour
mean.
Warm season. 8-hour
max from 24-hour
mean.
G.2.1   Burnett et al (2001)
           Burnett et al. (2001) studied the association between air pollution and acute respiratory
           hospital admissions (ICD codes 493, 466, 464.4, 480-486) in Toronto from 1980-1994,
           among children less than 2 years of age. They collected hourly concentrations of the
           gaseous pollutants, CO, NO2, SO2, and ozone. Daily measures of particulate matter were
           estimated for the May to August period of 1992-1994 using TSP, sulfates, and coefficient
           of haze data. The authors report a positive association between ozone in the May through
           August months and respiratory hospital admissions, for several single days after elevated
           ozone levels.

           The strongest association was found using a five-day moving average of ozone.  No
           association was found in the September through April months.  In co-pollutant models
           with a particulate matter or another gaseous pollutant, the ozone effect was only slightly
           diminished.  The effects for PM and gaseous pollutants were generally significant in single
                                             307
                                                                                  September 2008

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                                        Appendix G: Ozone Health Impact Functions in U.S. Setup
           pollutant models but diminished in co-pollutant models with ozone, with the exception of
           CO. The C-R functions for ozone are based on a single pollutant and two co-pollutant
           models, using the five-day moving average of one-hour max ozone.
           Hospital Admissions, All Respiratory (ICD-9 codes 464, 466, 480-487, 493)

           In a model with PM2 5, the coefficient and standard error are based on the percent increase
           (33.0) and t-statistic (3.44) associated with a 45.2 ppb increase in the five-day moving
           average of one-hour max ozone (Burnett et al., 2001, Table 3).

G.2.2   Moolgavkar et al (1997)

           Moolgavkar et al. (1997) examined the relationship between air pollution and hospital
           admissions (ICD codes 490-496) for individuals 65 and older in Minneapolis-St. Paul,
           Minnesota, from January 1986 to December 1991. In a Poisson regression, they found no
           significant effect for any of the pollutants (PM10, ozone, or CO).  The effect for ozone was
           marginally significant.  The model with a 100 df smoother was reported to be optimal (p.
           368).  The health impact function for chronic lung disease is based on the results from a
           three-pollutant model (ozone, CO, PM10) using the 100 df smoother; the function for
           Pneumonia uses the 130 df smoother.
           Hospital Admissions, Chronic Lung Disease (ICD-9 codes 490-496)

           In a model with CO and PM10, the estimated coefficient and standard error are based on the
           percent increase (4.2) and 95% confidence interval of the percent increase (-1.0-9.4)
           associated with a change in daily average ozone levels of 15 ppb (Moolgavkar et al., 1997,
           Table 4).


           Hospital Admissions, Pneumonia (ICD-9 codes 480-487)

           In a model with NO2, PM10,and SO2, the estimated coefficient and standard error are based
           on the percent increase (5.7) and 95% confidence interval of the percent increase (2.5-8.9)
           associated with an increase in daily average ozone levels of 15 ppb (Moolgavkar et al.,
           1997, Table 4).

G.2.3   Schwartz (1994a)

           Schwartz  (1994a) examined the relationship between air pollution and hospital admissions
           for individuals 65 and older in Minneapolis-St. Paul, Minnesota, from  January 1986 to
           December 1989. In single-pollutant Poisson regression models, both ozone and PM10 were
           significantly associated with pneumonia admissions. In a two-pollutant model, Schwartz
           found PM10 significantly related to pneumonia; ozone was weakly linked to pneumonia.
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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
           The results were not sensitive to the methods used to control for seasonal patterns and
           weather.  The ozone C-R functions are based on the results of the single pollutant model
           and the two-pollutant model (PM10 and ozone) with spline smoothing for temporal patterns
           and weather.
           Hospital Admissions, Pneumonia (ICD-9 codes 480-487)

           In a model with PM10 and spline functions to adjust for time and weather, the coefficient
           and standard error are based on the relative risk (1.22) and 95% confidence interval (1.02,
           1.47) for a 50 ppb increase in daily average ozone levels (Schwartz, 1994a, Table 4).
G.2.4   Schwartz (1994b)

           Schwartz (1994b) examined the relationship between air pollution and hospital admissions
           (ICD codes 491-492, 494-496) for individuals 65 and older in Detroit, Michigan, from
           January 1986 to December 1989. In a two-pollutant Poisson regression model, Schwartz
           found both PM10  and ozone significantly linked to pneumonia and COPD. The authors
           state that effect estimates were relatively unchanged compared to the unreported single
           pollutant models. No significant associations were found between either pollutant and
           asthma admissions. The C-R function for chronic lung disease incidence is based on the
           results of the "basic" co-pollutant model (ozone and PM10) presented in Table 4 (p. 651).
           The study also reports results using generalized additive models to fit time and temperature
           variables, however no standard error or confidence intervals were reported.
           Hospital Admissions, Chronic Lung Disease less Asthma (ICD-9 codes 490-492, 494-
           496)

           The coefficient and standard error for the "basic" model are reported in Table 4 (Schwartz,
           1994b, p.651) for a one ppb change in daily average ozone.
           Hospital Admissions, Pneumonia (ICD-9 codes 480-487)
           The ozone C-R function for pneumonia incidence is based on the coefficient and standard
           error for the "basic" co-pollutant model presented in Table 4 (Schwartz, 1994b, p. 651).

G.2.5   Schwartz (1995)

           Studies have reported associations between short term changes in air pollution and
           respiratory hospital admissions. This relationship was examined in two cities with
           substantially different levels of sulphur dioxide (SO2) but similar levels of airborne
           particles in an attempt to separate the effects of the two pollutants.  Significant differences
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                              Appendix G: Ozone Health Impact Functions in U.S. Setup
in weather between the two cities allowed the evaluation of that potential confounder also.
Daily counts of admissions to all hospitals for respiratory disease (ICD 9 460-519) were
constructed for persons aged 65 years and older in two cities - New Haven, Connecticut
and Tacoma, Washington.

Each city was analysed separately. Average daily concentrations of SO2, inhalable
particles (PM10), and ozone were computed from all monitors in each city, and daily
average temperature and humidity were obtained from the US weather service. Daily
respiratory admission counts were regressed on temperature, humidity, day of the week
indicators, and air pollution.  A 19 day weighted moving regression filter was used to
remove all seasonal and subseasonal patterns from the data. Possible U- shaped
dependence of admissions  on temperature was dealt with using indicator variables for eight
categories each of temperature and humidity.

Each pollutant was first examined individually and then multiple pollutant models were
fitted.  All three pollutants were associated with respiratory hospital admissions of the
elderly. The PM10 associations were little changed by control for either  ozone or SO2.
The ozone association was likewise independent of the other pollutants.  The SO2
association was substantially attenuated by control for ozone in both cities, and by control
for PM10 in Tacoma.  The magnitude of the effect was small (relative risk 1.06 in New
Haven and 1.10 in Tacoma for a 50 micrograms/m3 increase in PM10, for example) but,
given the ubiquitous exposure, this has some public health significance.  The authors
concluded that air pollution concentrations within current guidelines were associated with
increased respiratory hospital admissions of the elderly. The strongest evidence for an
independent association was  for PM10, followed by ozone.
Hospital Admissions, All Respiratory (ICD-9 codes 460-519) ~ Tacoma

In a model with PM10, the coefficient and standard error are estimated from the relative
risk (1.20) and 95% confidence interval (1.06-1.37) for a 50 |ig/m3 increase in average
daily ozone levels (Schwartz, 1995, Table 6, p. 535). To calculate the coefficient, a
conversion of 1.96 ug/m3 per ppb was used, based on a density of ozone of 1.96 grams per
liter (at 25 degrees Celsius).
Hospital Admissions, All Respiratory (ICD-9 codes 460-519) ~ New Haven

In a model with PM10, the coefficient and standard error are estimated from the relative
risk (1.07) and 95% confidence interval (1.00-1.15) for a 50 ug/m3 increase in average
daily ozone levels (Schwartz, 1995, Table 3, p. 534).  To calculate the coefficient, a
conversion of 1.96 ug/m3 per ppb was used, based on a density of ozone of 1.96 grams per
liter (at 25 degrees Celsius).
                                                                       September 2008
                                  310

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                                        Appendix G: Ozone Health Impact Functions in U.S. Setup
G.3    Emergency Room Visits

           Table G-3 summarizes the health impacts functions used to estimate the relationship
           between ozone and emergency room (ER) visits.  Below, we present a brief summary of
           each of the studies and any items that are unique to the study.
               Table G-3. Health Impact Functions for Ozone and Emergency Room Visits
Effect
Asthma
Asthma
Asthma
Asthma
Asthma
Asthma
Author
Jaffe et al.
Peel et al.
Stieb et al.
Stieb et al.
Wilson et al.
Wilson et al.
Year
2003
2005
1996
1996
2005
2005
Lcoation
Ohio cities
Atlanta, GA
New Brunswick,
CAN
New Brunswick,
CAN
Portland, ME
Manchester, NH
Age
5-34
0-99
0-99
0-99
0-99
0-99
Co-Poll






Metric
DSHourMax
DSHourMax
DIHourMax
D24HourMean
DSHourMax
DSHourMax
Beta
0.003000
0.000870
0.000040
0.000100
0.003000
-0.001000
Std Err
0.001531
0.000529
0.000020
0.000040
0.001000
0.002000
Form
Log-linear
Log-linear
Quadratic
Quadratic
Log-linear
Log-linear
Notes


Warm season.
Warm season.


G.3.1   Jaffe et al (2003)
           Jaffe et al. (2003) examined the relationship between ER visits and air pollution for
           persons ages 5-34 in Cleveland, Columbus, and Cincinnati, Ohio, from 1991 through 1996.
           In single-pollutant Poisson regression models, ozone and SO2 were linked to asthma visits,
           and no significant effect was seen for NO2 and PM10.
           Emergency Room Visits, Asthma

           Assuming a 10 ppb increase in the daily 8-hour maximum ozone level, Jaffe et al (2003,
           Table 3) reported a 3.0% change in asthma ER visits with a 95% confidence interval of
           0.0% to 6.0%.
G.3.2   Peel et al (2005)
           A number of emergency department studies have corroborated findings from mortality and
           hospital admission studies regarding an association of ambient air pollution and respiratory
           outcomes. More refined assessment has been limited by study size and available air quality
           data. Measurements of 5 pollutants PM10, ozone, NO2, CO, and SO2 were available for
           the entire study period (1 January 1993 to 31 August 2000); detailed measurements of
           particulate matter were available for 25 months. The authors obtained data on 4 million
           emergency department visits from 31 hospitals in Atlanta. Visits for asthma, chronic
           obstructive pulmonary disease, upper respiratory infection, and pneumonia were assessed
           in relation to air pollutants using Poisson generalized estimating equations.  In
           single-pollutant models examining 3-day moving averages of pollutants (lags 0, 1, and 2):
           standard deviation increases of ozone, NO2, CO, and PM10 were associated with 1-3%
                                            311
                                                                                September 2008

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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
           increases in URI visits; a 2 microg/m increase of PM2.5 organic carbon was associated
           with a 3% increase in pneumonia visits; and standard deviation increases of NO2 and CO
           were associated with 2-3% increases in chronic obstructive pulmonary disease visits.
           Positive associations persisted beyond 3 days for several of the outcomes, and over a week
           for asthma. The results of this study contribute to the evidence of an association of several
           correlated gaseous and particulate pollutants, including ozone, NO2, CO, PM, and organic
           carbon, with specific respiratory conditions.
           Emergency Room Visits, Asthma

           The ozone coefficient and standard error are reported per 25 ppb increment of the
           maximum daily 8-hour average ozone level (Peel et al., 2003, Table 4). We used the
           results from the three cities combined.  The relative risk is 1.022, with a 95 percent
           confidence interval of 0.996 to 1.049.

G.3.3   Stieb (1996)

           Stieb et al. (1996) examined the relationship between ER visits and air pollution for
           persons of all ages in St. John, New Brunswick, Canada, from May through September in
           1984-1992. Ozone was significantly linked to ER visits, especially when ozone levels
           exceeded 75 ppb.  The authors reported results from a linear model, quadratic model, and
           linear-quadratic model using daily average and 1-hour maximum ozone. In the linear
           model, ozone was borderline significant. In the quadratic  and linear-quadratic models,
           ozone was highly significant. This is consistent with the author's conclusion that "only
           ozone appeared to have a nonlinear relationship with visit rates" (p. 1356) and that
           "quadratic, linear-quadratic, and indicator models consistently fit the data better than the
           linear model ..." (p. 1358). The linear term in the linear-quadratic model is negative,
           implying that at low ozone levels, increases in ozone are associated with decreases in risk.
           Since this does not seem biologically plausible, the ozone health impact functions
           described here are based on the results of the quadratic regression models presented in
           Table 2 (Stieb et al., 1996, p. 1356).
           Emergency Room Visits, Asthma

           One-hour Max Function

           The coefficient and standard error of the quadratic model are reported in Table 2 (Stieb et
           al., 1996, p. 1356) for a 1 ppb increase in 1-hour daily maximum ozone levels. The C-R
           function to estimate avoided emergency visits derived from a quadratic regression model is
           shown below:
                                                                                  September 2008
                                             312

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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
           Baseline Population: baseline population of St. John, New Brunswick (Stieb et al., 1996,
           p. 1354) =125,000
           Population: population of all ages


           Daily Average Function

           The coefficient and standard error of the quadratic model are reported in Table 2 (p. 1356)
           for a 1 ppb increase in daily average ozone levels. The C-R function to estimate avoided
           emergency visits derived from a quadratic regression model is shown below:


                         Aiiriwa ER Visits-   P   •[(
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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
G.4    Minor Effects
           Table G-4 summarizes the health impacts functions used to estimate the relationship
           between ozone and minor effects.  Below, we present a brief summary of each of the
           studies and any items that are unique to the study.
                    Table G-4. Health Impact Functions for Ozone and Minor Effects
Effect
School Loss
Days, All Cause
School Loss
Days, All Cause
Worker
Productivity
Worker
Productivity
School Loss
Days, All Cause
School Loss
Days, All Cause
Minor Restricted
Activity Days
Minor Restricted
Activity Days
Author
Chen et al.
Chen et al.
Crocker
and Horst
Crocker
and Horst
Gilliland et
al.
Gilliland et
al.
Ostro and
Rothschild
Ostro and
Rothschild
Year
2000
2000
1981
1981
2001
2001
1989
1989
Lcoation
Washoe Co,
NV
Washoe Co,
NV
Nationwide
Nationwide
Southern
California
Southern
California
Nationwide
Nationwide
Age
5-17
5-17
18-64
18-64
5-17
5-17
18-64
18-64
Co-Poll
PM10,
CO
PM10,
CO




PM2.5
PM2.5
Metric
DIHourMax
DSHourMax
D24HourMea
n
DSHourMax
DSHourMax
DSHourMean
DIHourMax
DSHourMax
Beta
0.01324
7
0.01576
3
0.14270
0
0.09275
5
0.00782
4
0.00815
0
0.00220
0
0.00259
6
Std Err
0.00498
5
0.00498
5


0.00444
5
0.00463
0
0.00065
8
0.00077
6
^orm
.inear
.inear
.inear
.inear
.og-linear
^og-linear
^og-linear
^og-linear
Notes

All year. 8-hour
max from 1 -hour
max.
All year.
All year. 8-hour
max from 24-hour
mean.
All year. 8-hour
max from 8 -hour
mean.


8-hour max from
1 -hour max.
G.4.1   Chen et al (2000)
           Chen et al. (2000) studied the association between air pollution and elementary school
           absenteeism (grades 1-6) in Washoe County, Nevada. Assuming that most children start
           kindergarten at age  5, the corresponding ages for grades 1 through 6 would be 6 through
           11. Daily absence data were available for all elementary schools in the Washoe Country
           School District. The authors regressed daily total absence rate on the three air pollutants,
           meteorological variables, and indicators for day of the week, month, and holidays. They
           reported statistically significant associations between both ozone and CO and daily total
           absence rate for grades one through six. PM10 was negatively associated with absence rate,
           after adjustment for ozone,  CO, and meteorological and temporal variables. The C-R
           function for ozone is based on the results from a multiple linear regression model with CO,
           ozone, and PM10.
           School Loss Days, All Cause

           The coefficient and standard error are presented in Table 3 (Chen et al., 2000, p. 1008) for
           a unit ppm increase in the two-week average of daily one-hour maximum ozone
                                            314
                                                                                 September 2008

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                               Appendix G: Ozone Health Impact Functions in U.S. Setup
concentration. This is converted to unit ppb increase by dividing by 1,000.

The reported coefficient represents an absolute increase in absenteeism rate for a unit
increase in ozone.  If we apply this study to other locations, we assume that the same
absolute increase will occur for a unit increase in ozone, regardless of the baseline rate.  If
the study location has a particularly high baseline rate, we may be overestimating decreases
in absenteeism nationally, and vice-versa. As an example, consider if the baseline
absenteeism rate were 10% in the study and 5% nationally.  An absolute increase in
absence rate of 2% associated with a given increase in ozone reflects a relative increase in
absence rate of 20% for the study population. However, in the national estimate, we would
assume the same absolute increase of 2%, but this would reflect a relative increase in the
absenteeism rate of 40%.

An alternative approach is to estimate apply the relative increase in absenteeism rate in the
C-R function by adjusting the results by the ratio of the national absenteeism rate to the
study-specific rate. As a result, the percent increase in absenteeism rate associated with an
increase in ozone is extrapolated nationally rather than the absolute increase in
absenteeism rate. The incidence derivation section above describes the data used to
estimate national and study-specific absence rates.

In addition to this scaling factor, there are two other scaling factors which are applied to
the function.  A scaling factor of 0.01 is used to convert the beta from a percentage (x 100)
per unit increase of ozone to a proportion per unit increase of ozone. As a result it can be
applied directly to the national population of school children ages 6 through 11 to estimate
the number of absences avoided.

The final scaling factor adjusts for the number of school days in the ozone season.  In the
modeling program, the function is applied to every day in the ozone season (May 1 -
September 30), however, in reality, school absences will be avoided only on school days.
We assume that children are in school during weekdays for all of May, two weeks in June,
one week in August, and all of September. This corresponds to approximately 2.75
months out of the 5 month season, resulting in an estimate of 39.3% of days (2.75/5*5/7).
The C-R function parameters are shown below.

Population: population of children ages 6-11
Scaling Factor 1: Ratio of national school absence rate to study-specific school absence rate =
1.081. (National school absence rate of 5.5% obtained from the U.S. Department of
Education (1996, Table 42-1). Study-specific school absence rate of 5.09% obtained from
Chen et al. (2000, Table 1).)
Scaling Factor 2: Convert beta in percentage terms to a proportion = 0.01
Scaling Factor 3: Proportion of days that are school days in the ozone season = 0.393. (Ozone is
modeled for the 5 months from May 1 through September 30. We assume that children are
in school during weekdays for all of May, 2 weeks in June,  1 week in August, and all of
September.  This corresponds to approximately 2.75 months out of the 5 month season,
resulting in an estimate of 39.3% of days (2.75/5*5/7).)
                                                                        September 2008
                                  315

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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
G.4.2   Crocker and Horst (1981)

           To monetize benefits associated with increased worker productivity resulting from
           improved ozone air quality, we used information reported in Crocker and Horst (1981) and
           summarized in EPA (1994). Crocker and Horst examined the impacts of ozone exposure
           on the productivity of outdoor citrus workers.  The study measured productivity impacts as
           the change in income associated with a change in ozone exposure, given as the elasticity of
           income with respect to ozone concentration (-0.1427). The relationship estimated by
           Crocker and Horst between wages and ozone is a log-log relationship.  Therefore the
           elasticity of wages with respect to ozone is a constant, equal to the coefficient of the log of
           ozone in the model.  The reported elasticity translates a ten percent reduction in ozone to a
           1.4 percent increase in income. Given the national median daily income for outdoor
           workers engaged in strenuous activity reported by the U.S. Census Bureau (2002), $68 per
           day (2000$), a ten percent reduction in ozone yields about $0.97 in increased daily wages. (
           The national median daily income for workers engaged in "farming,  forestry, and fishing"
           from the U.S. Census Bureau (2002, Table 621,  p. 403) is used as a surrogate for outdoor
           workers engaged in strenuous activity.) We adjust the national median daily income
           estimate to reflect regional variations in income using a factor based on the ratio of county
           median household income to national median household income. No information was
           available for quantifying the uncertainty  associated with the central valuation estimate.
           Therefore, no uncertainty analysis was conducted for this endpoint.
           Worker Productivity

           The C-R function for estimating changes in worker productivity is shown below:
                                               -,-  -  ,
                                 Ltprotiitcf, vr fy = p - 'da: ly: n c o w sp op • .


           Daily Income: median daily income for outdoor workers. (The national median daily income
           for workers engaged in "farming, forestry, and fishing" was obtained from the U.S. Census
           Bureau (2002, Table 621, p. 403) and is used as a surrogate for outdoor workers engaged
           in strenuous activity. This national median daily income ($68) is then scaled by the ratio
           of national median income to county  median income to estimate county median daily
           income for outdoor workers.)
           Population: population of adults 18 to 64 employed as farm workers.

6.4.3   Gilliland et al (2001)

           Gilliland et al. (2001) examined the association between air pollution and school
           absenteeism among 4th grade school  children (ages 9-10) in 12 southern  Californian
           communities. The study was conducted from January through June 1996. The authors
           used school records to collect daily absence data and parental  telephone interviews to
           identify causes.  They defined illness-related absences as respiratory or non-respiratory.  A
                                                                                 September 2008
                                            316

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                               Appendix G: Ozone Health Impact Functions in U.S. Setup
respiratory illness was defined as an illness that included at least one of the following:
runny nose/sneezing, sore throat, cough, earache, wheezing, or asthma attack. The authors
used 15 and 30 day distributed lag models to quantify the association between ozone, PM10
, and NO2 and incident school absences. Ozone levels were positively associated with all
school absence measures and significantly associated with all illness-related school
absences (non-respiratory illness, respiratory illness, URI and LRI).  Neither PM10 nor NO2
was significantly associated with illness-related school absences, but PM10 was associated
with non-illness related absences. The health impact function for ozone is based on the
results of the single pollutant model.
School Loss Days

Gilliland et al. (2001) defines an incident absence as an absence that followed attendance
on the previous day and the incidence rate as the number of incident absences on a given
day over the population at risk for an absence on a given day (i.e. those children who were
not absent on the previous day). Since school absences due to air pollution may last longer
than one day, an estimate of the average duration of school absences could be used to
calculated the total avoided school loss days from an estimate of avoided new absences. A
simple ratio of the total absence rate divided by the new absence rate would provide an
estimate of the average duration of school absences, which could be applied to the estimate
of avoided new absences as follows:
                        bj ei':ces=-[r'':cider:ce'(e~y ""' -1) 'dwatiorfpop
Since the function is log-linear, the baseline incidence rate (in this case, the rate of new
absences) is multiplied by duration, which reduces to the total school absence rate.
Therefore, the same result would be obtained by using a single estimate of the total school
absence rate in the C-R function. Using this approach, we assume that the same
relationship observed between pollutant and new school absences in the study would be
observed for total absences on a given day.  As a result, the total school absence rate is
used in the function below. The derivation of this rate is described in the section on
baseline incidence rate estimation.

For all absences, the coefficient and standard error are based on a percent increase of 16.3
percent (95% CI -2.6 percent, 38.9 percent)  associated with a 20 ppb  increase in 8-hour
average ozone concentration (2001, Table 6, p. 52).

A scaling factor is used to adjust for the number of school days in the ozone season. In the
modeling program, the function is applied to every day in the ozone season  (May 1 -
                                                                        September 2008
                                  317

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                                         Appendix G: Ozone Health Impact Functions in U.S. Setup
           September 30), however, in reality, school absences will be avoided only on school days.
           We assume that children are in school during weekdays for all of May, two weeks in June,
           one week in August, and all of September. This corresponds to approximately 2.75
           months out of the 5 month season, resulting in an estimate of 39.3% of days (2.75/5*5/7).

           In addition, not all children are at-risk for a new school absence, as defined by the study.
           On average, 5.5% of school children are absent from school on a given day (U.S.
           Department of Education, 1996, Table 42-1). Only those who are in school on the
           previous day are at risk for a new absence (1-0.055 = 94.5%).  As a result,  a factor of
           94.5% is used in the function to estimate the population of school children at-risk for a
           new absence.

           Incidence Rate: daily school absence rate = 0.055 (U.S. Department of Education, 1996, Table
           42-1)
           Population: population of children ages 9-10 not absent from school on a given day = 94.5% of
           children ages 9-10 (The proportion of children not absent from school on a given day (5.5%)
           is based on 1996 data from the U.S. Department of Education (1996, Table 42-1).)
           Scaling Factor: Proportion of days that are school days in the ozone season = 0.393
           (Ozone is modeled for the 5 months from May 1 through September 30.  We assume that
           children are in school during weekdays for all of May, 2 weeks in June, 1 week in August,
           and all of September. This corresponds to approximately 2.75 months out of the 5 month
           season, resulting in an estimate of 39.3% of days (2.75/5*5/7).)

G.4.4   Ostro and Rothschild (1989)

           Ostro and Rothschild (1989) estimated the impact of PM2 5 and ozone on the incidence of
           minor restricted activity days (MRADs) and  respiratory-related restricted activity days
           (RRADs) in a national sample of the adult working population, ages 18 to 65, living in
           metropolitan areas.  The study population is based on the Health Interview Survey (HIS),
           conducted by  the National Center for Health Statistics. In publications from this ongoing
           survey, non-elderly adult populations are generally reported as ages 18-64. From the study,
           it is not clear if the age range stops at 65 or includes 65 year olds. We apply the C-R
           function to individuals ages 18-64 for  consistency with other studies estimating impacts to
           non-elderly adult populations. The annual national survey results used in this analysis
           were conducted in 1976-1981. Controlling for PM2 5, two-week average ozone had a
           highly variable association with RRADs and MRADs.  Controlling for ozone, two-week
           average PM2 5 was significantly linked to both health endpoints in most years. The C-R
           function for ozone is based on the co-pollutant model with PM2 5.

           The study is based on a "convenience" sample of non-elderly individuals.  Applying the
           C-R function to this age group is likely a slight underestimate, as it seems likely that
           elderly are at least as susceptible to ozone as individuals under 65. A number of studies
           have found that  hospital admissions for the elderly are related to ozone exposures (e.g.,
           Schwartz, 1994b; Schwartz, 1995).
                                                                                  September 2008
                                             318

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                                        Appendix G: Ozone Health Impact Functions in U.S. Setup
           Minor Restricted Activity Days

           The coefficient and standard error used in the C-R function are based on a weighted
           average of the coefficients in Ostro and Rothschild (1989, Table 4).  The derivation of
           these estimates is described below.

           Incidence Rate: daily incidence rate for minor restricted activity days (MRAD) = 0.02137 (Ostro
           and Rothschild, 1989, p. 243)
           Population: adult population ages 18 to 64
           The coefficient used in the C-R function is a weighted average of the coefficients in Ostro
           and Rothschild (1989, Table 4) using the inverse of the variance as the weight. The
           calculation of the MRAD coefficient and its  standard error is exactly analogous to the
           calculation done for the work-loss days coefficient based on Ostro (1987).
                                                      =0.00220.
           The standard error of the coefficient is calculated as follows, assuming that the estimated
           year-specific coefficients are independent:
                                     m  ft  *    ' 1-^1 ft
                                        JL   '
                                                                van
           This reduces down to:
G.5    Converting Functions to 8-Hour Daily Maximum Metric

           A number of health impact functions were converted from 1-hour maximum, 24-hour
           average, and 8-hour average to the 8-hour maximum metric. To convert, say, a 1-hour
           maximum function, we multiplied the 1-hour maximum coefficient with the ratio of the
                                                                                September 2008
                                            319

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                              Appendix G: Ozone Health Impact Functions in U.S. Setup
typical 1-hour maximum value to the typical 8-hour maximum value. We calculated ozone
metric ratios for each quarter and year in the period 2000-2007. We calculated ratios by
monitor, and by county, core business statistical area (CBSA), state, and nation.

For each monitor, a day was considered valid if it had at least 18 hourly values out of 24.
A quarter was considered valid if it had at least 85 percent valid days.  Ratios are
calculated for the year, only if that year had four quarterly values. The CBSA codes, which
were defined by OMB on 6-6-03, were obtained from: http://www.census.gov/population/
estimates/metro-city/03msa.txt.

We chose the time period for the ratio calculation (e.g., spring and summer quarters) and
the locations based on the data used in each epidemiological study. Table G-5 presents the
8-hour adjustment used for each study. Tables G-6 through G-8 present supporting
documentation for some of the multi-city 8-hour adjustments.
                   Table G-5. Eight-Hour Adjustments by Study
Effect
Mortality,
Non-Accidental
Mortality, All
Cause
HA, All
Respiratory
School Loss
Days, All Cause
Worker
Productivity
School Loss
Days, All Cause
Mortality,
Cardiopulmonary
Mortality,
Non-Accidental
Mortality,
Non-Accidental
Mortality,
Non-Accidental
Mortality, All
Cause
HA, Chronic
Lung Disease
HA, Pneumonia
Minor Restricted
Activity Days
HA, Chronic
Lung Disease
(less Asthma)
Author
Bell et al.
Bell et al.
Burnett et
al.
Chen et al.
Crocker
and Horst
Gilliland et
al.
Huang et
al.
Ito et al.
Ito et al.
Ito et al.
Levy et al.
Moolgavka
r et al.
Moolgavka
r et al.
Ostro and
Rothschild
Schwartz
Year
2004
2005
2001
2000
1981
2001
2005
2005
2005
2006
2005
1997
1997
1989
1994
Lcoation
95 US cities
Meta-analysis
Toronto, CAN
Washoe Co,
NV
Florida
Southern
California
19 US cities
6 US cities
Meta-analysis
Meta-analysis
Meta-analysis
Minneapolis,
MN
Minneapolis,
MN
Nationwide
Detroit, MI
Adjustment Factor Location
Nation
From study. See comment.
Buffalo-Cheektowaga-Tonawan
da, NY MSA
Washoe County
FL
Los Angeles-Long Beach-Santa
Ana, CA MSA
See below
See below
From study. See comment.
From study. See comment.
From study. See comment.
Minneapolis-St.
Paul-Bloomington, MN-WI
MSA
Minneapolis-St.
Paul-Bloommgton, MN-WI
MSA
Nation
Detroit- Warren-Livonia, MI
MSA
Quarte
rs
2-3

2-3
1-4
1-4
1-4
See
below
See
below


-
1-4
1-4
1-4
1-4
Metric
24HourMean
24HourMean
1 Hour Max
IHourMax
24HourMean
SHourMean
24HourMean
24HourMean
24HourMean
1 HourMax
1 HourMax
24HourMean
24HourMean
1 HourMax
24HourMean
8-Hour
Adj
0.67
0.53
1.12
1.19
0.65
0.96
0.66
0.65
0.67
1.33
1.33
0.70
0.70
1.18
0.62
Notes





The statewide avg
is 0.96.





Data 2004-2007
only.
Data 2004-2007
only.

Data 2006 only.
                                  320
                                                                       September 2008

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                 Appendix G: Ozone Health Impact Functions in U.S. Setup
HA, Pneumonia

HA, Pneumonia


HA, All
Respiratory
HA, All
Respiratory
Mortality,
Non-Accidental
Schwartz

Schwartz


Schwartz

Schwartz

Schwartz

1994

1994


1995

1995

2004

Detroit, MI

Minneapolis,
MN

New Haven,
CT
Tacoma, WA

14 US cities

Detroit- Warren-Livonia, MI
MSA
Minneapolis-St.
Paul-Bloomington, MN-WI
MSA
New Haven-Milford, CT MSA

Seattle-Tacoma-Bellevue, WA
MSA
See below

1-4

1-4


2-3

2-3

See
below
24HourMean

24HourMean


24HourMean

24HourMean

IHourMax

0.62

0.70


0.67

0.69

0.67

Data 2006 only.

Data 2004-2007
only.







Table G-6. Eight-Hour Adjustment Details - 6-City Study
City/County
Detroit
Cook County
Houston
Minneapolis
Philadelphia
St. Louis


City/County
Birmingham
Boulder
Canton
Chicago
Cincinnati
Colorado Springs
Columbus
Detroit
Houston
New Haven
Pittsburgh
Provo
CBSAs or Counties Used in Ratio Average
Detroit-Warren-Livonia, MI MSA
Cook County
Houston-Baytown-Sugar Land, TX MSA
Minneapolis-St. Paul-Bloomington, MN-WI MSA
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD MSA
St. Louis, MO-IL MSA
Average
Table G-7. Eight-Hour Adjustment
CBSAs or Counties Used in Ratio Average Quarters Used
Birmingham-Hoover, AL MSA 2-3
Boulder, CO MSA 2-3
Canton-Massillon, OH MSA 2-3
Chicago-Naperville-Johet, IL-IN-WI MSA 2-3
Cmcinnati-Middletown, OH-KY-IN MSA 2-3
Colorado Springs, CO MSA 2-3
Columbus, OH MSA 2-3
Detroit- Warren-Livonia, MI MSA 2-3
Houston-Baytown-Sugar Land, TX MSA 2-3
New Haven-Milford, CT MSA 2-3
Pittsburgh, PA MSA 2-3
Provo-Orem, UT MSA 3
Quarters Used
2-'
2-'
2-'
2-'
2-3
2-3

Details —
Study Metric
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
IHourMax
Study Metric
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean

14-City Study
8-Hour Adj Notes
1.15
1.15
1.12
1.16
1.15
1.11
1.13
1.17
1.22
1.17
1.15
8-Hour Adj
0.63
0.65
0.59
0.70
0.65
0.64
0.64













1.13 Only quarter 3 available
                    321
                                                       September 2008

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Appendix G: Ozone Health Impact Functions in U.S. Setup
Seattle
Spokane


City/County
Atlanta
Chicago
Cleveland
Dallas/Ft Worth
Detroit
Houston


Los Angeles
Santa
Ana/Anaheim

Miami
New York

Philadelphia
Phoenix
Pittsburgh
San Bernardino
San Antonio
San Diego
Oakland
San Jose
Seattle


Seattle-Tacoma-Bellevue, WA MSA 2-3
Spokane, WA MSA 3
Average
Table G-8. Eight-Hour Adjustment
CBSAs or Counties Used in Ratio Average Quarters Used
Atlanta-Sandy Springs-Marietta, GA MSA 2-3
Chicago-Naperville-Joliet, IL-IN-WI MSA 2-3
Cleveland-Elyna-Mentor, OH MSA 2-3
Dallas-Fort Worth-Arlington, TX MSA 2-3
Detroit- Warren-Livonia, MI MSA 2-3
Houston-Baytown-Sugar Land, TX MSA 2-3


Los Angeles-Long Beach-Santa Ana, CA MSA 2-3

Los Angeles-Long Beach-Santa Ana, CA MSA 2-3
Miami-Fort Lauderdale-Miami Beach, FL
MSA 2-3
New York-Newark-Edison, NY-NJ-PA MSA 2-3
Phil adelphia-Camden- Wilmington,
PA-NJ-DE-MD MSA 2-3
Phoemx-Mesa-Scottsdale, AZ MSA 2-3
Pittsburgh, PA MSA 2-3
Riverside-San Bernardino-Ontario, CA MSA 2-3
San Antonio, TX MSA 2-3
San Diego-Carlsbad-San Marcos, CA MSA 2-3
San Francisco-Oakland-Fremont, CA MSA 2-3
San Jose-Sunnyvale-Santa Clara, CA MSA 2-3
Seattle-Tacoma-Bellevue, WA MSA 2-3

Average
IHourMax
IHourMax

Details —
Study Metric
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean


24HourMean

24HourMean

24HourMean
24HourMean

24HourMean
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean
24HourMean


1.15
1.08
1.15
19-City
8-Hour Adj
0.59
0.65
0.69
0.67
0.63
0.59


0.59

0.59

0.71
0.66

0.65
0.66
0.61
0.65
0.66
0.70
0.70
0.64
0.69

0.65

Only quarter 3 available

Study
Notes






Los Angeles and Santa
Ana/ Anaheim have same
CBS A.















Keeping 1 Los Angeles keeps
8-hour adj at 0.65.

   322
                                        September 2008

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                                              Appendix H: Health Valuation Functions in U.S. Setup
        Appendix H:  Health Valuation  Functions in U.S.

        Setup

           This appendix presents the unit values that are available in BenMAP for each of the health
           endpoints included in the current suite of health impact functions. Wherever possible, we
           present a distribution of the unit value, characterizing the uncertainty surrounding any
           point estimate. The mean of the distribution is taken as the point estimate of the unit
           value, and the distribution itself is used to characterize the uncertainty surrounding the unit
           value, which feeds into the uncertainty surrounding the monetary benefits associated with
           reducing the incidence of the health endpoint.  Below we give detailed descriptions of the
           derivations of unit values and their distributions, as well as tables listing the unit values
           and their distributions, available for each health endpoint. The definitions of the
           distributions and their parameters is given in Table H-l.
                  Table H-l.  Unit Value Uncertainty Distributions and Their Parameters


           Distribution *                 Parameter 1 (PI)                Parameter 2 (P2)

           Normal                      standard deviation                -

           Triangular                    minimum value                  maximum value

           Lognormal **                 mean of corresponding normal       standard deviation of corresponding
                                      distribution                    normal distribution

           Uniform                     minimum value                  maximum vaue

           Weibull ***                   a                            P


                            * In all cases, BenMAP calculates the mean of the distribution, which
                            is used as the "point estimate" of the unit value.

                            ** If Y is a normal random variable, and Y = logeX, then X is
                            lognormally distributed. Equivalently, X is lognormally distributed if
                            X = eY, where Y is normally distributed.
                            *** The Weibull distribution has the following probability density
                            function:

H.1    Mortality

           The economics literature concerning the appropriate method for valuing reductions in
           premature mortality risk is still developing.  The adoption of a value for the projected
           reduction in the risk of premature mortality is the subject of continuing discussion within
           the economics and public policy analysis communities.  Issues such as the appropriate
           discount rate and whether there are factors, such as age or the quality of life, that should be
           taken into consideration when estimating the value of avoided premature mortality are still
                                                                                    September 2008
                                              323

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                                               Appendix H: Health Valuation Functions in U.S. Setup
           under discussion.  BenMAP currently offers a variety of options reflecting the uncertainty
           surrounding the unit value for premature mortality.

H. 1.1   Value of a Statistical Life Based on 26 Studies

           One unit value available in BenMAP is $6.3 million. This estimate is the mean of a
           distribution fitted to 26 "value of statistical life" (VSL) estimates that appear in the
           economics literature and that have been identified in the Section 812 Reports to Congress
           as "applicable to policy analysis." This represents an intermediate value from a variety of
           estimates, and it is a value EPA has frequently used in Regulatory Impact Analyses (RIAs)
           as well as in the Section 812 Retrospective and Prospective Analyses of the Clean Air Act.


           The VSL approach and the set of selected studies mirrors that of Viscusi (1992) (with the
           addition of two studies), and uses the same criteria as Viscusi in his review of value-of-life
           studies. The $6.3  million estimate is consistent with Viscusi's conclusion (updated to
           2000$) that "most of the reasonable estimates of the value of life are clustered in the $3.8
           to $8.9 million range." Five of the 26 studies are contingent valuation (CV)  studies, which
           directly solicit WTP information from subjects; the rest are wage-risk studies, which base
           WTP estimates on estimates of the additional  compensation demanded in the labor market
           for riskier jobs. Because this VSL-based unit value does not distinguish among people
           based on the age at their death or the quality of their lives, it can be applied to all
           premature deaths.

H.1.2   Value of a Statistical Life Based on Selected Studies

           In addition to the value of a statistical life based on the results of 26 studies,  we have
           included three alternatives based loosely on the results of recent work by Mrozek and
           Taylor (2002) and Viscusi and Aldy (2003). Each of the four alternatives has a mean value
           of $5.5 million (2000$),  but with a different distributions: normal, uniform, triangular, and
           beta. Table H-2 presents the distribution parameters for the suite of mortality valuations
           currently available in BenMAP.
                              Table H-2. Unit Values Available for Mortality
           Basis for Estimate *
Age Range at  Unit Value  Distribution of Parameters of Distribution
   Death      (VSL)    Unit Value
             (2000$)
                                              mm.   max.
                                                                                  PI
                                              P2
           VSL, based on 26 value-of-life studies.

           VSL based on range from $1 million to $10
           million - 95% CI of assumed normal
           distribution.

           VSL based on range from $1 million to $10
           million - assumed uniform distribution.
  0     99     $6,324,101    Weibull        5.32E-6   1.509588

  0     99     $5,500,000    Normal    2,295,960.54
       99
$5,500,000   Uniform
1,000,000 10,000,000
                                               324
                                                                                     September 2008

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                                               Appendix H: Health Valuation Functions in U.S. Setup
           Basis for Estimate *                     Age Range at  Unit Value Distribution of Parameters of Distribution
                                                Death       (VSL)     Unit Value
                                                          (2000$)
                                              mm.  max.                           PI        P2
           VSL based on range from $1 million to $10     0    99    $5,500,000  Triangular      1,000,00010,000,000
           million - assumed triangular distribution.

                          *The original value of a statistical life was calculated in 1990 $. We have used
                          a factor of 1.3175, based on the All-Items CPI-U.

H.2    Chronic Illness

           This sub-section presents  the unit values developed for chronic bronchitis, chronic asthma,
           and non-fatal myocardial infarctions.

H.2.1   Chronic Bronchitis

           PM-related chronic bronchitis is expected to last from the initial onset of the illness
           throughout the rest of the  individual's life. WTP to avoid chronic bronchitis would
           therefore be expected to incorporate the present discounted value  of a potentially long
           stream of costs (e.g., medical expenditures and lost earnings) as well as WTP to avoid the
           pain and suffering associated with the illness.  Both WTP and COI estimates are currently
           available in BenMAP.

H.2.1.1 Unit Value Based on Two Studies of WTP

           Two contingent valuation studies, Viscusi et al. (1991) and Krupnick  and  Cropper  (1992),
           provide estimates of WTP to avoid  a case of chronic bronchitis. Viscusi et al. (1991) and
           Krupnick and Cropper (1992) were experimental studies intended to examine new
           methodologies for eliciting values for morbidity endpoints.  Although these studies were
           not specifically designed for policy analysis, they can be used to provide reasonable
           estimates of WTP to avoid a case of chronic bronchitis.  As with other contingent valuation
           studies, the reliability of the WTP estimates depends on the methods used to obtain the
           WTP values.  The Viscusi et  al. and the Krupnick and Cropper studies are broadly
           consistent with current contingent valuation practices, although specific attributes of the
           studies may not be.

           The study by Viscusi et al. (1991) uses a sample that is larger and more representative of
           the general population than the study by Krupnick  and Cropper (1992), which selects
           people who have a relative with the disease. However, the chronic bronchitis described to
           study subjects in the Viscusi study is severe, whereas a pollution-related case may be less
           severe.

           The relationship between  the severity of a case of chronic bronchitis and WTP to avoid it
           was estimated by Krupnick and Cropper (1992). We used that estimated relationship to
           derive a relationship between WTP to avoid a severe case of chronic bronchitis,  as
           described in the Viscusis study, and WTP to avoid a less severe case.  The estimated
           relationship (see Table 4 in Krupnick and Cropper) can be written as:
                                                                                     September 2008
                                              325

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                                   Appendix H: Health Valuation Functions in U.S. Setup
                                 \n.CH~TP*\= ex- ? ssv
where a denotes all the other variables in the regression model and their coefficients, B is
the coefficient of sev, estimated to be 0. 18, and sev denotes the severity level (a number
from  1 to 13). Let x (< 13) denote the severity level of a pollution-related case of chronic
bronchitis, and 13 denote the highest severity level (as described in Viscusi et al., 1991).
Then
and

                                  InffTT^.U or+ /?*.r.


Subtracting one equation from the other,
or
                                  ; FFJP  '
                                111
Exponentiating and rearranging terms,
There is uncertainty surrounding the exact values of WTP13; x, and B, and this uncertainty
can be incorporated in the equation, if you request that the analysis be carried out in
"uncertainty mode." The distribution of WTP to avoid a severe case of chronic bronchitis,
WTP13 ,is based on the distribution of WTP responses in the Viscusi et al. (1991) study.
The distribution of x, the severity level of an average case of pollution-related chronic
bronchitis, is modeled as a triangular distribution centered at 6.5, with endpoints at 1.0 and
12.0.  And the distribution of B is normal with mean = 0.18 and std. dev.= 0.0669 (the
estimate of b and standard error reported in Krupnick and Cropper, 1992).

In uncertainty mode, BenMAP uses a Monte Carlo approach.  On each Monte Carlo
iteration, random draws for these three variables are made, and the resulting WTPx is
                                                                         September 2008
                                   326

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                                             Appendix H: Health Valuation Functions in U.S. Setup
           calculated from the equation above. Because this function is non-linear, the expected
           value of WTP for a pollution-related case of CB cannot be obtained by using the expected
           values of the three uncertain inputs in the function (doing that will substantially understate
           mean WTP). A Monte Carlo analysis suggests, however, that the mean WTP to avoid a
           case of pollution-related chronic bronchitis is about $340,000. Therefore, if you request
           that the analysis be carried out in "point estimate" mode, that is the unit value that is used.

H.2.1.2 Alternative Cost of Illness Estimates

           Cost of illness  estimates for chronic bronchitis were derived from estimates of annual
           medical costs and annual lost earnings by Cropper and Krupnick (1990).  This study
           estimated annual lost earnings resulting from chronic bronchitis as a function of age at
           onset of the illness, for the following age categories: 25-43, 35-44, 45-54, and 55-65 (see
           Cropper and Krupnick, Table 8). Annual medical expenses were estimated for 10-years
           age groups (0-9, 10-19, 20-29, ..., 80-89).  We derived estimates of the present discounted
           value of the stream of medical and opportunity costs for people whose age of onset is 30,
           40, 50, 60, 70,  and 80. Medical costs (which are in 1977$ in the Cropper and Krupnick
           study) were inflated to 2000$ using the CPI-U for medical care; lost earnings (opportunity
           costs) were inflated to 2000$ using the Employment Cost Index for Wages and Salaries.
           Life expectancies were assumed to be unaffected by the illness. For example, an
           individual at age 70 has a life expectancy of 14.3 more years, and we assumed that
           someone whose age of onset of chronic bronchitis is 70 will also live for  14.3 more years.
           ( Source of life expectancies: National Center for Health Statistics, 1999, Table 5.) We
           also assumed that opportunity costs at ages 66 and over were zero. Present discounted
           values were calculated using three and seven percent discount rates.

           For each of the two discount rates, there are three cost of illness unit values for chronic
           bronchitis available in BenMAP, for the following age categories: 27-44, 45-64, and 65+.
           These are the age categories that were used in the epidemiological  study that estimated a
           concentration-response function for chronic bronchitis (Abbey et al., 1995b).   The
           estimate for the 27-44 age group is an average of the present discounted values calculated
           for ages 30 and 40; the estimate for the 45-64 age category is an average of the present
           discounted values calculated for ages 50 and 60; and the estimate for the 65+ age category
           is an average of the present discounted values calculated for ages 70 and 80. The suite of
           unit values available for use in BenMAP are shown in Table H-3 below.
                         Table H-3. Unit Values Available for Chronic Bronchitis
Basis for Estimate
WTP: average severity
COI: med costs + wage loss, 3% DR
Present Present
Age ot Onset Discounted Discounted
Value of Value of Unit Value Distribution
mm max Medical Opportunity
nun. max. _, _,
Costs Costs
30 99 N/A N/A $340,482 custom
27 44 $18,960 $135,463 $154,422 none
                                             327
                                                                                  September 2008

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                                             Appendix H: Health Valuation Functions in U.S. Setup
           Basis for Estimate
            Present     Present
Age ot Onset  Discounted   Discounted
            Value of     Value of   Unit Value  Distribution
            Medical    Opportunity
             Costs       Costs
                                          mm.  max.
45
65
COI: med costs + wage loss, 7% DR 27
45
65
64
99
44
64
99
$23,759
$11,088
$7,886
$14,390
$9,030
$76,029
$0
$80,444
$59,577
$0
$99,788
$11,088
$88,331
$73,967
$9,030
none
none
none
none
none
H.2.2   Chronic Bronchitis Reversals

           The unit value for chronic bronchitis reversals assumes that this is chronic bronchitis with
           a severity level of 1.  The method for generating a distribution of unit values in BenMAP is
           therefore the same as the WTP-based unit value method for chronic bronchitis (see above),
           with x=l.  The mean of this distribution is $150,221.

H.2.3   Chronic Asthma

           Two studies have estimated WTP to avoid chronic asthma in adults. Blumenschein and
           Johannesson (1998)  used two different contingent valuation (CV) methods, the
           dichotomous choice  method and a bidding game, to estimate mean willingness to pay for a
           cure for asthma. The mean WTP elicited from the bidding game was $189 per month, or
           $2,268 per year (in 1996$). The mean WTP elicited from the dichotomous choice
           approach was $343 per month, or $4,116 per year (in 1996$). Using $2,268 per year, a
           three percent discount rate, and 1997 life expectancies for males in the United States
           (National Center for Health Statistics,  1999, Table 5), the present discounted value of the
           stream of annual WTPs is $47,637 (in  2000$).

           O'Conor and Blomquist (1997) estimated WTP to avoid chronic asthma from  estimates of
           risk-risk tradeoffs. Combining the risk-risk tradeoffs with a statistical value of life,  the
           annual value of avoiding asthma can be derived.  Assuming a value of a statistical life of
           $6 million, they derived an annual WTP to avoid asthma of $1500 (O'Connor and
           Blomquist, 1997, p.  677).  For a value of a statistical life of $5,894,400 (in 1997 $), the
           corresponding implied annual value of avoiding chronic asthma, based on O'Conor and
           Blomquist would be $1,474. Assuming a three percent discount rate and 1997 life
           expectancies for males in the United States, the present discounted value of the stream of
           annual WTPs would be $30,257 (in 2000$). A unit value, based on a three percent
           discount rate, is the average of the two estimates, or $38,947. Following the method used
           for the §812 Prospective analysis, the uncertainty surrounding the WTP to avoid a case of
           chronic asthma among adult males was characterized by a triangular distribution on the
           range determined by the two study-specific WTP estimates.

           A second unit value, using a seven percent discount rate, is also available for use in
           BenMAP.  The method used to derive this unit value is the same as that described above
                                            328
                                                                                  September 2008

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                                             Appendix H: Health Valuation Functions in U.S. Setup
           for the three percent discount rate unit value.  The unit values available for use in BenMAP
           are summarized in Table H-4 below.
                          Table H-4. Unit Values Available for Chronic Asthma

                                    Age Range                Distribution of Unit Parameters of Distribution
           Basis for Estimate                        Unit Value         ,, .
                                   min.    max.                   Value         PI        P2
WTP: 3% DR (Discount Rate)
WTP:7%DR
27
27
99
99
$38,947
$25,357
triangular
triangular
$30,257
$19,699
$47,637
$31,015
H.2.4   Non-Fatal Myocardial Infarctions (Heart Attacks)

           In the absence of a suitable WTP value for reductions in the risk of non-fatal heart attacks,
           there are a variety of cost-of-illness unit values available for use in BenMAP. These
           cost-of-illness unit values incorporate two components: the direct medical costs and the
           opportunity cost (lost earnings) associated with the illness event.  Because the costs
           associated with a heart attack extend beyond the initial event itself, the unit values include
           costs incurred over five years. Using age-specific annual lost earnings estimated by
           Cropper and Krupnick (1990), and a three percent discount rate, we estimated the
           following present discounted values in lost earnings over 5 years due to a heart attack:
           $8,774 for someone between the ages of 25 and 44, $12,932 for someone between the ages
           of 45 and 54,  and $74,746 for someone between the ages of 55 and 65. The corresponding
           age-specific estimates of lost earnings using a seven percent discount rate are $7,855,
           $11,578, and  $66,920, respectively. Cropper and Krupnick do not provide lost earnings
           estimates for populations under 25 or over 65.  As such we do not include lost earnings in
           the cost estimates for these age groups.

           We have found three possible sources of estimates of the direct medical costs of a
           myocardial infarction (MI) in the literature:

           • Wittels et al. (1990) estimated expected total medical costs of MI over 5 years to be
             $51,211 (in 1986$) for people who were admitted to the hospital and survived
            hospitalization.  (There does not appear to be any discounting used.) Wittels et al. was
            used to value coronary heart disease in the 812 Retrospective Analysis of the Clean Air
            Act. Using the CPI-U for medical care, the Wittels estimate is $109,474 in year 2000$.
            This estimated cost is based on a medical cost model, which incorporated therapeutic
            options, projected outcomes and prices (using "knowledgeable cardiologists" as
            consultants). The model used medical data and medical decision algorithms to estimate
            the probabilities of certain events and/or medical procedures being used. The authors
            note that the average length of hospitalization for acute MI has decreased over time
            (from an average of 12.9 days in 1980 to an average of 11 days in 1983). Wittels et al.
            used 10 days as the average in their study.  It is unclear how much further the length of
             stay (LOS) for MI may have decreased from 1983 to the present. The average LOS for
            ICD code 410 (MI) in the year-2000 AHQR HCUP database is 5.5 days. However, this
                                                                                  September 2008
                                             329

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                                   Appendix H: Health Valuation Functions in U.S. Setup
  may include patients who died in the hospital (not included among our non-fatal MI
  cases), whose LOS was therefore substantially shorter than it would be if they hadn't
  died.

• Eisenstein et al. (2001) estimated 10-year costs of $44,663, in 1997$ (using a three
  percent discount rate), or $49,651 in 2000$ for MI patients, using statistical prediction
  (regression) models to estimate inpatient costs. Only inpatient costs (physician fees and
  hospital costs) were included.

• Russell et al. (1998) estimated first-year direct medical costs of treating nonfatal MI of
  $15,540 (in 1995$), and $1,051 annually thereafter.  Converting to year 2000$, that
  would be $18,880 for a 5-year period, using a three percent discount rate, or $17,850,
  using a seven percent discount rate.

The age group-specific estimates of opportunity cost over a five-year period are combined
with the medical cost estimates from each of the three studies listed above.  Because
opportunity costs are derived for each of five age groups, there are 3 x 5 = 15 unit values
for each of 2  discount rates, or 30 unit values available for use in BenMAP. These are
given in Table H-5 below.

Note that we were unable to achieve complete consistency, unfortunately, because of
limitations in the input studies.  For example, although we calculated opportunity costs
over a five-year period using a 3 percent and a 7 percent discount rate, we were not able to
do the same for medical  costs, except for the medical costs estimated by Russell et al. (in
which they estimate an annual cost). Wittels et al. appear to have used no discounting in
their estimate; Eisenstein et al. used a 3 percent discount rate.  Similarly, although almost
all cost estimates (opportunity costs and medical costs) are for a 5-year period, the medical
cost estimate reported by Eisenstein et al. is for a 10-year period. There was no reasonable
method for inferring from  that study what costs over a  5-year period would be.
            Table H-5. Unit Values Available for Myocardial Infarction
       Basis of Estimate
Age Range                  Opportunity Cost    „,.„  ,
              Medical Cost *       **         Total Cost
                             Min
       Max
COI: 5 yrs med, 5 yrs wages, 3%
DR, Wittels (1990)



COI: 10 yrs med, 5 yrs wages, 3%
DR, Eisenstein (2001)



0
25
45
55
66
0
25
45
55
66
24
44
54
65
99
24
44
54
65
99
$109,474
$109,474
$109,474
$109,474
$109,474
$49,651
$49,651
$49,651
$49,651
$49,651
$0
$9,033
$13,313
$76,951
$0
$0
$9,033
$13,313
$76,951
$0
$109,474
$118,507
$122,787
$186,425
$109,474
$49,651
$58,683
$62,964
$126,602
$49,651
                                  330
                                                                        September 2008

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                                                 Appendix H: Health Valuation Functions in U.S. Setup
COI: 5 yrs med, 5 yrs wages, 3% 0
DR, Russell (1998)
45
55
66
COI: 5 yrs med, 5 yrs wages, 7% 0
DR,Wittels(1990)
45
55
66
COI: 10 yrs med, 5 yrs wages, 7% 0
DR,Eisenstein(2001)
45
55
66
COI: 5 yrs med, 5 yrs wages, 7% 0
DR, Russell (1998)
45
55
66
24
44
54
65
99
24
44
54
65
99
24
44
54
65
99
24
44
54
65
99
$22,331
$22,331
$22,331
$22,331
$22,331
$109,474
$109,474
$109,474
$109,474
$109,474
$49,651
$49,651
$49,651
$49,651
$49,651
$21,113
$21,113
$21,113
$21,113
$21,113
$0
$9,033
$13,313
$76,951
$0
$0
$8,087
$11,919
$68,894
$0
$0
$8,087
$11,919
$68,894
$0
$0
$8,087
$11,919
$68,894
$0
$22,331
$31,363
$35,644
$99,281
$22,331
$109,474
$117,561
$121,393
$178,368
$109,474
$49,651
$57,738
$61,570
$118,545
$49,651
$21,113
$29,200
$33,032
$90,007
$21,113
                             * From Cropper and Krupnick (1990). Present discounted value of 5 yrs
                             of lost earnings, at 3% and 7% discount rate, adjusted from 1977$ to
                             2000$ using CPI-U "all items".
                             ** An average of the 5-year costs estimated by Wittels et al. (1990) and
                             Russell et al. (1998). Note that Wittels et al. appears not to have used
                             discounting in deriving a 5-year cost of $109,474; Russell et al.
                             estimated first-year direct medical costs and annual costs thereafter. The
                             resulting 5-year cost is $22,331, using a 3% discount rate, and $21,113,
                             using a 7% discount rate. Medical costs were inflated to 2000$ using
                             CPI-U for medical care.

H.3     Hospital Admissions & Emergency Room Visits

            This section presents the values for avoided hospital admissions, as well as avoided
            emergency room visits. We assume that hospital admissions due to acute exposure to air
            pollution pass through the emergency room.  However, the value of hospital admissions
            that we have calculated here does not account for the cost incurred in the emergency room
            visit.


H.3.1    Hospital Admissions

            As suggested above, the total value to society of an individual's avoidance of a hospital
            admission can be thought of as having  two components:  (1) the cost of illness (COI) to
            society, including the total medical costs plus the value of the lost productivity, as well as
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                                  Appendix H: Health Valuation Functions in U.S. Setup
(2) the WTP of the individual, as well as that of others, to avoid the pain and suffering
resulting from the illness.

In the absence of estimates of social WTP to avoid hospital admissions for specific
illnesses (components 1 plus 2 above), estimates of total COI (component 1) are available
for use in BenMAP as conservative (lower bound) estimates.  Because these estimates do
not include the value of avoiding the pain and suffering resulting from the illness
(component 2), they are biased downward.  Some analyses adjust COI estimates upward by
multiplying by an estimate of the ratio of WTP to COI, to better approximate total WTP.
Other analyses have avoided making this adjustment because of the possibility of
over-adjusting — that is, possibly replacing a known downward bias with an upward bias.
Based on Science Advisory Board (SAB) advice, the COI values currently available for use
in BenMAP are not adjusted.

Unit values are based on ICD-code-specific estimated hospital charges and opportunity
cost of time spent in the hospital (based on the average length of a hospital stay for the
illness).  The opportunity cost of a day spent in the hospital is estimated as the value of the
lost daily wage, regardless of whether or not the individual is in the workforce.

For all hospital admissions endpoints available in BenMAP, estimates of hospital charges
and lengths of hospital stays were based on discharge statistics provided by the Agency for
Healthcare Research and Quality's Healthcare Utilization Project (2000).  The total COI
for an ICD-code-specific hospital stay lasting n days is estimated as the mean hospital
charge plus n times the daily lost wage. Year 2000 county-specific median annual wages
divided by (52*5) were used to estimate county-specific median daily wages. (The source
for median is Geolytics, 2001.) Because wage data used in BenMAP are county-specific,
the unit value for a hospital admission varies from one county to another.

Most hospital admissions categories considered in epidemiological studies consisted of
sets of ICD codes.  The unit value for the set of ICD  codes was estimated as the weighted
average  of the ICD-code-specific COI estimates. The weights were the relative
frequencies of the ICD codes among hospital discharges in the United States, as  estimated
by the National Hospital Discharge Survey (Owings and Lawrence, 1999, Table  1).  The
hospital admissions for which unit values are available in BenMAP are given in  Table H-6.
Although unit values available for use in BenMAP are county-specific, the national median
daily wage was used to calculate opportunity costs and total costs for the table below, to
give  a general idea of the cost of illness estimates for the different hospital admissions
endpoints.

The mean hospital charges and mean lengths of stay provided by (AHRQ 2000) are based
on a very large nationally representative sample of about seven million hospital discharges,
and are therefore the best estimates of mean hospital charges and mean lengths of stay
available, with negligible standard errors.
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                       Appendix H: Health Valuation Functions in U.S. Setup
Table H-6. Unit Values Available for Hospital Admissions
EndPoint
HA, All Cardiovascular
HA, All Cardiovascular
HA, All Cardiovascular
HA, Congestive Heart Failure
HA, Dysrhythmia
HA, Ischemic Heart Disease
HA, All Respiratory
HA, All Respiratory
HA, All Respiratory
HA, Asthma
HA, Asthma
HA, Asthma
HA, Chronic Lung Disease
HA, Chronic Lung Disease
HA, Chronic Lung Disease
HA, Chronic Lung Disease (less
Asthma)
HA, Chronic Lung Disease (less
Asthma)
HA, Chronic Lung Disease (less
Asthma)
HA, Pneumonia
HA, Pneumonia
ICD Codes
390-429
390-429
390-429
428
427
410-414
460-519
460-519
460-519
493
493
493
490-496
490-496
490-496
490-492, 494-496
490-492, 494-496
490-492, 494-496
480-487
480-487
Age Range Mean Mean Total Cost of
Hospital Length of Illness (Unit
min. max. Charge * Stay (days) * Value) * *
65
0
20
65
0
65
65
0
0
0
65
0
65
0
20
65
0
20
65
0
99
99
64
99
99
99
99
99
2
64
99
99
99
99
64
99
99
64
99
99
$20,607
$20,873
$22,300
$14,573
$14,811
$25,322
$17,600
$14,999
$7,416
$7,448
$11,417
$8,098
$12,781
$10,882
$10,194
$12,993
$12,742
$11,820
$17,030
$14,693
5.07
4.71
4.15
5.60
3.70
4.81
6.88
5.63
2.97
2.95
4.99
3.30
5.59
4.59
4.04
5.69
5.45
4.48
7.07
5.92
$21,191
$21,415
$22,778
$15,218
$15,237
$25,876
$18,393
$15,647
$7,759
$7,788
$11,991
$8,478
$13,425
$11,412
$10,660
$13,648
$13,370
$11,820
$17,844
$15,375
* Source of hospital charges and lengths of stay: Agency for Healthcare
Research and Quality. 2000. HCUPnet, Healthcare Cost and Utilization
Project, http://www.agrq.gov/data/hcup/hcupnet.htm .
** The opportunity cost of a day spent in the hospital was estimated, for
this exhibit, at the median daily wage of all workers, $115.20, regardless
of age. The median daily wage was calculated by dividing the median
weekly wage ($576 in 2000$) by 5. The median weekly wage was
obtained from U.S. Census Bureau, Statistical Abstract of the United
States: 2001, Section 12, Table 621: "Full-Time Wage and Salary
Workers - Numbers and Earnings:  1985 to 2000." Actual unit values
used in BenMAP are based on county-specific wages, and are therefore
county-specific.
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H.3.2   Emergency Room Visits for Asthma

           Two unit values are currently available for use in BenMAP for asthma emergency room
           (ER) visits. One is $311.55, from Smith et al., 1997, who reported that there were
           approximately  1.2 million asthma-related ER visits made in 1987, at atotal cost of $186.5
           million, in 1987$.  The average cost per visit was therefore $155 in 1987$, or $311.55 in
           2000 $ (using the CPI-U for medical care to adjust to 2000$). The uncertainty surrounding
           this estimate, based on the uncertainty surrounding the number of ER visits and the total
           cost of all visits reported by Smith et al. is characterized by a triangular distribution
           centered at $311.55, on the interval [$230.67, $430.93].

           A second unit value is $260.67 from Stanford et al. (1999). This  study considered
           asthmatics in 1996-1997, in comparison to the Smith et al. (1997) study, which used 1987
           National Medical Expenditure Survey (NMES) data). In comparing their study, the
           authors note that the 1987 NMES, used by Smith et al., "may not reflect changes in
           treatment patterns  during the 1990s." In addition, its costs are the costs to the hospital (or
           ER) for treating asthma rather than charges or payments by the patient and/or third party
           payer.  Costs to the ER are probably a better measure of the value of the medical resources
           used up on an asthma ER visit (see above for a discussion of costs versus charges).

           The unit values and the corresponding distributions available in BenMAP for
           asthma-related  ER visits are summarized in Table H-7.
                     Table H-7. Unit Values Available for Asthma-Related ER Visits

           Basis for Estimate              Age Range   Unit Value Distribution of Unit   Parameters of Distribution
                                                             Value
                                    min.   max.                              PI         P2
COI: Smith etal. (1997)
COI: Standford et al. (1999)
0
0
99
99
$312
$261
triangular
normal
$231
5.22
$431
H.4    Acute Symptoms and Illness Not Requiring Hospitalization

           Several acute symptoms and illnesses have been associated with air pollution, including
           acute bronchitis in children, upper and lower respiratory symptoms, and exacerbation of
           asthma (as indicated by one of several  symptoms whose occurrence in an asthmatic
           generally suggests the onset of an asthma episode). In addition, several more general
           health endpoints which are associated with one or more of these acute symptoms and
           illnesses, such as minor restricted activity days, school loss days, and work loss days, have
           also been associated with air pollution. We briefly discuss the derivation of the unit values
           for each of these acute symptoms and illnesses.  Tables H-8 and H-9 summarize the values.
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 Appendix H: Health Valuation Functions in U.S. Setup
Table H-8. Unit Values Available for Acute Symptoms and Illnesses
Health
Endpoint

Acute Bronchitis


Any of 19
Respiratory
Symptoms
Minor Restricted
Activity Days

Lower
Respiratory
Symptoms

School Loss
Days
Upper
Respiratory
Symptoms

Work Loss Days
**
Age Range
Basis for Estimate * ,7 ,
Value
min. max.
WTP: 1 day illness, CV studies 0 17 $59
WTP: 6 day illness, CV studies 0 17 $356
WTP: 28 symptom-days, Dickie 0 17 $374
and Ulery
WTP: 1 day illness, CV studies 18 65 $24
WTP: 1 day, CV studies 18 99 $51
WTP: 3 symptoms 1 day, Dickie 18 99 $98
and Ulery (2002).
WTP: 1 day, CV studies 0 17 $16
WTP: 2 symptoms 1 day, Dickie 0 17 $187
and Ulery (2002).
WTP: 2 x 1 day, CV studies 0 17 $31
Described in text. 0 17 $75

WTP: 1 day, CV studies 0 17 $25
WTP: 2 symptoms 1 day, Dickie 0 17 $187
and Ulery (2002)
WTP: 2 x 1 day, CV studies 0 17 $49
Median daily wage, 18 65 $115
county-specific
Parameters of
Distribution Distribution
of Unit Value
PI
uniform 17.51
uniform 105.06
lognormal 5.947
uniform 0
triangular 20.71
lognormal 4.6088
uniform 6.94
lognormal 5.2556
uniform 13.89
none N/A

uniform 9.22
lognormal 5.2556
uniform 18.45
none N/A

P2
101.11
606.64
0.0907
48.25
80.37
0.0649
24.47
0.07048
48.93
N/A

43.11
0.07048
86.22
N/A

* All unit values pulled from a lognormal distribution from Model 1 ,
Table III in Dickie and Ulery are multiplied by 0.97381 1 to adjust for a
difference in mean household income between the study participants and
the general population. The unit values shown here have already been
adjusted.
** Unit values for work loss days are county-specific, based on
county-specific median wages. The unit value shown here is the national
median daily wage, given for illustrative purposes only.
335
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                                              Appendix H: Health Valuation Functions in U.S. Setup
            Table H-9. Unit Values Available for Asthma-related Acute Symptoms and Illnesses
Health
Endpoint

Asthma
Attacks;
Cough;
Moderate or
Worse; One
or more
symptoms;
Shortness of
Breath;
Wheeze
Basis for WTP Estimate*

Bad asthma day, Rowe and Chestnut
(1986)
1 symptom-day, Dickie and Ulery (2002)
Bbad asthma day, Rowe and Chestnut
(1986)
2 x bad asthma day, Rowe and Chestnut
Age Parameters of
Range Unit Unit Value Distribution
Value Distribution
min. max. PI P2
18 99 $43 uniform 15.56 70.88
18 99 $74 lognormal 4.321 0.0957
0 17 $43 uniform 15.56 70.88
0 17 $86 uniform 31.12 141.77
(1986)

1 symptom-day, Dickie and Ulery (2002)
                                                              17   $156   lognormal   5.074  0.0925
                            *A11 unit values pulled from a lognormal distribution from Model 1 ,
                            Table III in Dickie and Ulery, 2002, are multiplied by 0.97381 1 to
                            adjust for a difference in mean household income between the study
                            participants and the general population. The unit values shown here
                            have already been adjusted.

H.4.1   Acute Bronchitis in Children

           Estimating WTP to avoid a case of acute bronchitis is difficult for several reasons.  First,
           WTP to avoid acute bronchitis itself has not been estimated. Estimation of WTP to avoid
           this health endpoint therefore must be based on estimates of WTP to avoid symptoms that
           occur with this illness. Second, a case of acute bronchitis may last more than one day,
           whereas it is a day of avoided symptoms that is typically valued. Finally, the C-R function
           used in the benefit analysis for acute bronchitis was estimated for children, whereas WTP
           estimates  for those symptoms associated with acute bronchitis were obtained from adults.

           Three unit values are available in BenMAP for acute bronchitis in children.  In previous
           benefit analyses, EPA used a unit value of $59.3 1 . This is the midpoint between a low
           estimate and a high estimate. The  low estimate is the sum of the midrange values
           recommended by lEc (1994) for two symptoms believed to be associated with acute
           bronchitis: coughing and chest tightness.  The high estimate was taken to be twice the
           value of a minor respiratory restricted activity day. For a more complete description of the
           derivation of this estimate, see Abt Associates (2000, p. 4-30).

           The above unit value assumes that an  episode of acute bronchitis lasts only one day.
           However, this is generally not the case. More typically, it can last for 6 or 7  days. A
           simple adjustment, then, would be to multiply the original unit value of $59.3 1 by 6 or 7.
           A second  unit value of $356 (=$59.3 1x6) was therefore derived.

           Finally, as noted above, the epidemiological study relating air pollution to the incidence of
           acute bronchitis referred to children specifically. The value  of an avoided case should
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          therefore be WTP to avoid a case in a child, which may be different from WTP to avoid a
          case in an adult.  Recent work by Dickie and Ulery (2002) suggests, in fact, that parents are
          generally willing to pay about twice as much to avoid sickness in their children as in
          themselves. In one of several models they estimated, the natural logarithm of parents'
          WTP was related both to the number of symptom-days avoided and to whether it was their
          child or themselves at issue.  Dickie and Ulery noted that "experiencing all of the
          symptoms [considered in their study - cough and phlegm, shortness of breath/wheezing,
          chest pain, and fever] for 7 days, or 28 symptom-days altogether, is roughly equivalent to a
          case of acute bronchitis ..."  Using this model, and assuming that a case  of acute bronchitis
          can be reasonably modeled as consisting of 28 symptom-days, we estimated parents' WTP
          to avoid a case of acute bronchitis in a child to be $374. This is the third  unit value
          available in BenMAP.

          The mean household income  among participants in the Dickie and Ulery CV survey was
          slightly higher than the national average. We therefore adjusted all WTP estimates that
          resulted from their models downward slightly, using an income elasticity of WTP of 0.147,
          the average of the income elasticities estimated in the four models in the study. The
          adjustment factor thus derived was 0.9738.

H.4.2   Upper Respiratory Symptoms  (URS) in Children

          In past benefit analyses, EPA based willingness to pay to avoid a day of URS on
          symptom-specific WTPs to avoid those symptoms identified as part of the URS complex
          of symptoms. Pope et al. (1991) defined  a day of URS as consisting of one or more of the
          following symptoms: runny or stuffy nose; wet cough; and burning, aching, or red eyes.
          The three contingent valuation (CV) studies shown in Table H-10 have estimated WTP to
          avoid various morbidity symptoms that are either within the URS symptom complex
          defined by Pope et al., or are  similar to those symptoms.
            Table H-10. Median WTP Estimates and Derived Midrange Estimates (in 1999 $)
Symptom *
Throat congestion
Head/sinus congestion
Coughing
Eye irritation
Headache
Shortness of breath
Pain upon deep inhalation (PDI)
Wheeze
Coughing up phlegm
Dickie et al.
4.81
5.61
1.61
-
1.61
0.00
5.63
3.21
3.51 **
Tolley et al. (1986) Loehman et al.
(1979)
20.84
22.45 10.45
17.65 6.35
20.03
32.07
13.47
-
-
-
Mid-Range
Estimate
12.75
12.75
8.93
20.03
12.75
6.37
5.63
3.21
3.51
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                                             Appendix H: Health Valuation Functions in U.S. Setup
           Symptom *                  Dickie et al.    Tolley et al. (1986)   Loehman et al.     Mid-Range
                                                                    (1979)         Estimate

           Chest tightness                   8.03


                           * All estimates are WTP to avoid one day of symptom. Midrange
                           estimates were derived by lEc (1993).

                           ** 10% trimmed mean.
           The three individual symptoms that were identified as most closely matching those listed
           by Pope et al. for URS are cough, head/sinus congestion, and eye irritation, corresponding
           to "wet cough," "runny or stuffy nose," and "burning, aching or red eyes," respectively. A
           day of URS could consist of any one of the seven possible "symptom complexes"
           consisting of at least one of these three symptoms.  The original unit value for URS was
           based on the assumption that each of these seven URS complexes is equally likely. This
           unit value for URS, $24.64, is just an average of the seven estimates of mean WTP for the
           different URS complexes.

           The WTP estimates on which the first unit value is based were elicited from adults,
           whereas the health endpoint associated with air pollution in the epidemiological study is in
           children.  As noted above, recent research by Dickie and Ulery (2002) suggests that
           parental WTP to avoid symptoms and illnesses in their children is about twice what it is to
           avoid those symptoms and illnesses in themselves. We therefore derived a second unit
           value of $49.28 (=2 x $24.64) from the first unit value.

           A third unit value was derived by using Model  1, Table in in Dickie and Ulery (2002) (the
           same model used for acute bronchitis), assuming that a day  of URS consists of 2
           symptoms.  As noted above, this model relates parental WTP to the number of
           symptom-days avoided and to whether it is the parent or the child at issue.  The unit value
           derived from this model is $187.

           A WTP estimate elicited from parents concerning their WTP to avoid symptoms in their
           children may well include some calculation of lost earnings resulting from having to lose a
           day of work. Estimates from the Dickie and Ulery model therefore (appropriately)
           probably include not only their WTP to have their children avoid the pain and suffering
           associated with their illness, but also the opportunity cost of a parent having to stay home
           with a sick child.

H.4.3   Lower Respiratory Symptoms (LRS) in Children

           The three unit values for LRS in children currently available in BenMAP follow the same
           pattern as those for URS in children.  In past benefit analyses, EPA based willingness to
           pay to avoid a day of LRS on symptom-specific WTPs to avoid those symptoms identified
           as part of the LRS  complex of symptoms. Schwartz et al. (1994) defined a day of LRS as
           consisting of at least two of the  following symptoms: cough, chest tightness, coughing up
           phlegm, and wheeze.  Of the symptoms for which WTP estimates are available (listed in
           Table H-10), those that most closely match the  symptoms listed by Schwartz et al. are
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                                            Appendix H: Health Valuation Functions in U.S. Setup
          coughing, chest tightness, coughing up phlegm, and wheeze.  A day of LRS, as defined by
          Schwartz et al., could consist of any one of 11 possible combinations of at least two of
          these four symptoms. In the absence of any further information, each of the 11 possible
          "symptom clusters" was considered equally likely.  The original unit value for LRS,
          $15.57, is just an average of the eleven estimates of mean WTP for the different LRS
          symptom clusters.

          A second unit value is twice the original unit value, or $31.15, based on the evidence from
          Dickie and Ulery (2002) that parents are willing to pay about twice as much to avoid
          symptoms and illness in their children as in themselves.  The third unit value is based on
          Model 1, Table HI in Dickie and Ulery, assuming that, as for URS, a day of LRS consists
          of 2 symptoms. As noted above, this model relates parental WTP to the number of
          symptom-days avoided  and to whether it is the parent or the child at issue. The unit value
          derived from this model is $187.

H.4.4  Any of 19 Respiratory Symptoms

          The presence of "any of 19 acute respiratory symptoms" is a somewhat subjective health
          effect used by Krupnick et al. (1990). Moreover, not all  19 symptoms are listed in the
          Krupnick et al. study. It is therefore not clear exactly what symptoms were included in the
          study.  Even if all 19 symptoms were known, it is unlikely that WTP estimates could be
          obtained for all of the symptoms. Finally, even if all 19 symptoms were known and WTP
          estimates could be obtained for all  19 symptoms, the assumption of additivity of WTPs
          becomes tenuous with such a large number of symptoms. The likelihood that all 19
          symptoms would occur  simultaneously, moreover, is very small.

          Acute respiratory symptoms must be either upper respiratory symptoms or lower
          respiratory symptoms. In the absence of further knowledge about which of the two types
          of symptoms is more likely to occur among the "any of 19 acute respiratory symptoms,"
          we assumed that they occur with equal probability. Because this health endpoint may also
          consist of combinations of symptoms, it was also assumed that there is some (smaller)
          probability that upper and lower respiratory  symptoms occur together. To value avoidance
          of a day of "the presence of any of  19 acute respiratory symptoms" we therefore assumed
          that this health endpoint consists either of URS, or LRS, or both.  We also assumed that it
          is as likely to be URS as LRS and that it is half as likely to be both together.  That is, it was
          assumed that "the presence of any of 19 acute respiratory symptoms" is a day of URS with
          40 percent probability, a day of LRS with 40 percent probability, and a day of both URS
          and LRS with 20 percent probability. Using the point  estimates of WTP to avoid a day of
          URS and LRS derived above, the point estimate of WTP to avoid a day of "the presence of
          any of 19 acute respiratory symptoms" is:

          (0.40)($24.64) + (0.40)($15.57) + (0.20)($24.64 + $15.57) = $24.12.

          Because this health endpoint is only vaguely defined, and because of the lack of
          information on the relative frequencies of the different combinations of acute respiratory
          symptoms that might qualify as "any of 19 acute respiratory symptoms," the unit dollar
          value derived for this health endpoint must be considered only a rough approximation.
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                                            Appendix H: Health Valuation Functions in U.S. Setup
H.4.5   Work Loss Days (WLDs)

          Work loss days are valued at a day's wage. BenMAP calculates county-specific median
          daily wages from county-specific annual wages by dividing by (52*5), on the theory that a
          worker's vacation days are valued at the same daily rate as work days.
H.4.6   Minor Restricted Activity Days (MRADs)

           Two unit values are currently available in BenMAP for MRADs.  No studies are reported
           to have estimated WTP to avoid a minor restricted activity day (MRAD). However, ffic
           (1993) derived an estimate of WTP to avoid a minor respiratory restricted activity day
           (MRRAD), using WTP estimates from Tolley et al. (1986) for avoiding a three-symptom
           combination of coughing, throat congestion, and sinusitis.  This estimate of WTP to avoid
           a MRRAD, so defined, is $38.37 (1990 $). Although Ostro and Rothschild (1989)
           estimated the relationship between PM2 5 and MRADs, rather than MRRADs (a
           component of MRADs), it is likely that most of the MRADs associated with exposure to
           PM2 5 are in fact MRRADs. The original unit value, then, assumes that MRADs associated
           with PM exposure may be more specifically defined as MRRADs, and uses the estimate of
           mean WTP to avoid a MRRAD.

           Any estimate of mean WTP to avoid a MRRAD (or any other type of restricted activity day
           other than WLD) will be somewhat arbitrary because the endpoint itself is not precisely
           defined.  Many different combinations of symptoms could presumably result in some
           minor or less minor restriction in activity. Krupnick and Kopp (1988) argued that mild
           symptoms will not be sufficient to result in a MRRAD, so that WTP to avoid a MRRAD
           should exceed WTP to avoid any single mild symptom. A single severe symptom or a
           combination of symptoms could, however, be sufficient to restrict activity. Therefore
           WTP to avoid a MRRAD should, these authors argue, not necessarily  exceed WTP  to
           avoid a single severe symptom or a combination of symptoms. The "severity" of a
           symptom, however, is similarly not precisely defined; moreover, one level of severity of a
           symptom could induce restriction of activity for one individual while not doing so for
           another.  The same is true for any particular combination of symptoms.

           Given that there is inherently a substantial degree of arbitrariness in any point estimate of
           WTP to avoid a MRRAD (or other kinds of restricted activity days), the reasonable bounds
           on such an estimate must be considered. By definition, a MRRAD does not result in loss
           of work.  WTP to avoid a MRRAD should therefore be less than WTP to avoid a WLD.
           At the other extreme, WTP to avoid a MRRAD should exceed WTP to avoid a single mild
           symptom. The highest ffic midrange estimate of WTP to avoid a single symptom is $20.03
           (1999 $), for eye irritation. The point estimate of WTP to avoid a WLD in the benefit
           analysis is $83 (1990 $). If all the single symptoms evaluated by the studies are not severe,
           then the estimate of WTP to avoid a MRRAD should be somewhere between $16 and $83.
           Because the lEc estimate of $38 falls within this range (and acknowledging the degree  of
           arbitrariness associated with any estimate within this range), the lEc estimate is used as the
           mean of a triangular distribution centered at $38, ranging from $16 to  $61. Adjusting to
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                                            Appendix H: Health Valuation Functions in U.S. Setup
           2000 $, this is a triangular distribution centered at $50.55, ranging from $21 to $80.

           A second unit value is based on Model 1, Table HI in Dickie and Ulery (2002).  This
           model estimates the natural logarithm of parents' WTP to avoid symptoms as a linear
           function of the natural logarithm of the number of symptom-days avoided and whether or
           not the person avoiding the symptoms is the parent or the child.  The unit value derived
           from this model, assuming that an MRAD consists of one day of 3 symptoms in an adult, is
           $98.

H.4.7   Asthma Exacerbation

           Several respiratory symptoms in asthmatics or characterizations of an asthma episode have
           been associated with exposure to air pollutants.  All of these can generally be taken as
           indications of an asthma exacerbation ("asthma attack") when they occur in an asthmatic.
           BenMAP therefore uses the same set of unit values for all of the variations of "asthma
           exacerbation" that appear in the epidemiological literature.

           Two unit values are currently available in BenMAP for asthma exacerbation in adults, and
           three are currently available for asthma exacerbation in children. In  past benefit analyses,
           EPA based willingness to pay to avoid an asthma exacerbation on four WTP estimates
           from Rowe and Chestnut (1986) for avoiding a "bad asthma day." The mean of the four
           average WTPs is $32 (1990 $), or $43 in 2000$.  The uncertainty surrounding this estimate
           was characterized by a continuous uniform distribution on the range defined by the lowest
           and highest of the four average WTP estimates from Rowe and Chestnut, [$12,  $54] in
           1990$, or [$16, $71] in 2000 $.  This unit value is available for both adults and children.

           A second unit value for adults was derived by using Model 1, Table  in in Dickie and Ulery
           (2002) — the same model used for acute bronchitis, LRS, and URS — assuming that an
           asthma exacerbation consists of 1 symptom-day.   As noted above, this model relates
           parental WTP to the number of symptom-days avoided and to whether it is the parent or
           the child at issue. The unit value derived from this model for adults is $74.

           Two additional unit values are available for children. One of these is twice the original unit
           value, or $86, based on the evidence from  Dickie and Ulery (2002) that parents are willing
           to pay about twice as much to avoid symptoms and illness in their children as in
           themselves. The third unit value is based on Model 1, Table HI in Dickie and Ulery (the
           same model used for asthma exacerbation in adults, only now with the "adult or child"
           variable set to 1 rather than 0). The unit value derived from this model is $156.

H.4.8   School Loss Days

           There is currently one unit value available in BenMAP for school loss  days, based on (1)
           the probability that, if a school child stays  home from school, a parent  will have to stay
           home from work to care for the child, and  (2) the value of the parent's lost productivity.
           We first estimated the proportion of families with school-age children  in which both
           parents work, and then valued a school loss day as the probability of a  work loss day
           resulting from a school loss day (i.e., the proportion of households with school-age
                                                                                 September 2008
                                            341

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                                   Appendix H: Health Valuation Functions in U.S. Setup
children in which both parents work) times a measure of lost wages.

From the U.S. Bureau of the Census (2002) we obtained (1) the numbers of single,
married, and "other" (i.e., widowed, divorced, or separated) women with children in the
workforce, and (2) the rates of participation in the workforce of single, married, and
"other" women with children. From these two sets of statistics, we calculated a weighted
average participation rate of 72.85 percent, as shown in Table H-l 1.

Our estimated daily lost wage (if a mother must stay at home with a sick child) is based on
the median weekly wage among women age 25 and older in 2000 . This median weekly
wage is $551.  Dividing by 5 gives an estimated median daily wage of $103. The expected
loss in wages due to a day of school absence in which the mother would have to stay home
with her child is  estimated as the probability that the mother is in the workforce times the
daily wage she would lose if she missed a day = 72.85% of $103, or $75. We currently
have insufficient information to characterize the uncertainty surrounding this estimate.
 Table H-ll.  Women with Children: Number and Percent in the Labor Force, 2000,
                     and Weighted Average Participation Rate
Category
               Women in Labor   Participation
                   Force          Rate
                 (millions) *        (%) *
          Implied Total
           Number in   Implied Percent in
                    (1)
(2)
Population (in
  millions)

 (3) = (l)/(2)
                         Population
(4)
Population-Weigh
  ted Average
Participation Rate

[=sum (2) *(4) over
     rows]
Single
Married
Other **
Total
3.1
18.2
4.5
--
73.9%
70.6%
82.7%
--
4.19
25.78
5.44
35.42
11.84%
72.79%
15.36%
--
--
--
--
72.85%
                 * Source: U.S. Bureau of the Census (2002).
                 ** Widowed, divorced, or separated.
A unit value based on the approach described above is likely to understate the value of a
school loss day in two ways. First, it omits WTP to avoid the symptoms/illness which
resulted in the school absence. Second, it effectively gives zero value to school absences
which do not result in a work loss day.  The unit value of $75 is therefore considered an
"interim" value until such time as alternative means of estimating this unit value become
available.
                                  342
                                                                        September 2008

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                                               Appendix I: Population & Other Data in U.S. Setup
        Appendix I:  Population & Other Data in U.S.

        Setup

           This section describes the population and monitor data in the United States setup.

           • Population Data. This describes how BenMAP forecasts population; the block-level and
            county-level data underlying the forecasts; and the PopGrid software application, which
            aggregates block-level population data to whatever grid definition might be needed.

           • Monitor Data. The default United States  setup has ozone, PM2.5, PM10 and lead
            monitor data for the years 2000-2007.  Data for CO, NO2, and SO2 are available at the
            BenMAP website: http://www.epa.gov/air/benmap/.

1.1      Population Data in U.S. Setup

           The U.S. setup in BenMAP calculates health impacts for any desired grid definition, so
           long as you have a shapefile for that grid definition and population data for that grid
           definition. In this description, we use the term "population grid cell" to refer to a cell (e.g.,
           county) within a grid definition.  The foundation for calculating the population level in the
           population grid-cells is 2000 Census block data. A  separate application developed by Abt
           Associates, called "PopGrid," described below, combines the Census block data with any
           user-specified set of population grid-cells, so long as they are defined by a GIS shape file.
           Unfortunately, PopGrid relies on extremely large census files that are too large to include
           with BenMAP — hence the need for the separate application. If you are interested in
           PopGrid, please email: benmap@epa.gov.

           Within any given population grid-cell, BenMAP has 304 unique race-ethnicity-gender-age
           groups: 19 age groups by 2 ethnic groups by gender by 4 racial  groups (19*2*2*4=304).
           Exhibit B-l  presents the 304 population variables available in BenMAP.  As discussed
           below, these variables are available for use in developing age estimates in whatever
           grouping desired by you.
                    Exhibit 1-1  Demographic Groups and Variables Available in BenMAP

           Racial/Ethnic Group      Ethnicity   Age                                      Gender

           White, African American,    Hispanic,   <1, 1-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34,      Male,
           Asian, American Indian,     Non-Hispani 35-39,40-44,45-49,50-54,55-59,60-64,65-69,     Female
           Other, Hispanic           c         70-74, 75-79,80-84,85+
          In this section on population data in the U.S. setup, we describe:

          • Forecasting Population. This describes how BenMAP forecasts population.
                                                                                September 2008
                                            343

-------
                                                  Appendix I: Population & Other Data in U.S. Setup
           • Data Needed.  This section describes the block-level and county-level data underlying
             the forecasts.

           • PopGrid.  This section reviews the PopGrid software application, which aggregates
             block-level population data to whatever grid definition might be needed.

1.1.1    How BenMAP Forecasts Population

           In calculating the population in age groups that may include a portion of one of the pre-specified
           demographic groups in Exhibit 1-1, BenMAP assumes the population is uniformly distributed in
           the age group. For example, to calculate the number of children ages 3 through 12, BenMAP
           calculates:


                                         _!                  -
                                     -12   2      -^       ^5      °^4


           To estimate population levels for the years after the last Census in 2000, BenMAP scales the 2000
           Census-based estimate with  the ratio of the county-level forecast for the future year of interest
           over the 2000 county-level population level. Woods & Poole (2007) provides the
           county-level population forecasts used to calculate the scaling ratios; these data are
           discussed in detail below.

           In the simplest case, where one is forecasting a single population variable, say, children
           ages 4 to 9 in the year 2010, CAMPS calculates:
                                                                   , county2OlO
                                                                   , countyZOOO
           where the gth population grid-cell is wholly located within a given county.

           In the case, where the gth grid-cell includes "n" counties in its boundary, the situation is
           somewhat more complicated. BenMAP first estimates the fraction of individuals in a
           given age group (e.g., ages 4 to 9) that reside in the part of each county within the gth
           grid-cell.  BenMAP calculates this fraction by simply dividing the population all ages of a
           given county within the gth grid-cell by the total population in the gth grid-cell:
                                      .      _                   aH g in county c
                                 fraction ofage4
                                                4^gmcamtyc
                                                                   aH g
           Multiplying this fraction with the number of individuals ages 4 to 9 in the year 2000 gives
           an estimate of the number of individuals ages 4 to 9 that reside in the fraction of the county
           within the gth grid-cell in the year 2000:
                                                                                    September 2008
                                              344

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                                       Appendix I: Population & Other Data in U.S. Setup
                    , g in county., 2000 ~     4-9, g, 2000
To then forecast the population in 2010, we scale the 2000 estimate with the ratio of the
county projection for 2010 to the county projection for 2000:
                                                             9, cauntyc, 2010
                 9, gin countyc ,2010    L*St'4-9, g in countyc, 2000 '
                                                                  jc, 2000
Combining all these steps for "n" counties within the gth grid-cell, we forecast the
population of persons ages 4 to 9 in the year 2010 as follows:

                                         t0tCl1P°P>gln counfyc
                                            totalpopg
                           vc,2000
In the case where there are multiple age groups and multiple counties, BenMAP first
calculates the forecasted population level for individual age groups, and then combines the
forecasted age groups. In calculating the number of children ages 4 to 12, BenMAP
calculates:
                                         total pop gmcamfyc
                 , g, 2010 -  -4^), g, 2000 •
                          c=i                         g         4^ countyc 2000
total popg in countyc  agew_u countyc ;
                                                                         2oio
                                 -,,        .  .
                         c=i                  lOiai pupg     "S^lO-14, county c , 2000
                          , g,20W       4^,g,20W          iO^L4, g, 2010
Since the Woods and Poole (2007) projections only extend through 2030, we used the
existing projections and constant growth factors to provide additional projections. To
estimate population levels beyond 2030, CAPMS linearly extrapolates from the final two
years of data.  For example, to forecast population in 2035, CAPMS calculates:
                                                                          September 2008
                                   345

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                                                  Appendix I: Population & Other Data in U.S. Setup
                             ^5^4-9,2035
                                              , 2030
                                                             , 2030
1.1.2    Data Needed for Forecasting

           Underlying the population forecasts in BenMAP there are block-level databases used to
           provide year 2000 population estimates and a county-level database of forecast ratios.
           Both files have the same set of 304 race-ethnicity-gender-age population groups.

           The block-level data is typically not used directly in BenMAP, and instead is used with the
           PopGrid software (described below) to provide year 2000 estimates for a grid definition of
           interest (e.g., 12 kilometer CMAQ grid). The output from PopGrid with the year 2000
           population estimates can then be loaded into BenMAP.

           The county-level data comes pre-installed in the U.S.  setup, and is not something that the
           user needs to load herself.  These data are simply county-level ratios of a "future" year
           (2000-2030) and year 2000 population data for each county and  each of the 304 race-
           ethnicity-gender-age population groups.

           We describe the development of each databases below.

1.1.2.1   Block-Level Census 2000

           There are about five million "blocks" in the United States, and for each block we have 304
           race-ethnicity-gender-age groups.  The block-level population database is created
           separately for each state, in order to make the data more manageable. (A single national
           file of block data would be about six gigabytes.)

           The initial block file from the U.S.  Census Bureau is not in the form needed.  The block
           data has 7 racial categories and 23 age groups, as opposed to the 4 and 19 used in
           BenMAP. Table 1-4 summarizes the initial set  of variables and the final desired set of
           variables.
                     Table 1-4 Race, Ethnicity and Age Variables in 2000 Census Block Data
           Type
Race
Ethnicity  Gender Age
           Initial    White Alone, Black Alone, Native
           Variables American Alone, Asian Alone, Pacific
           (SF1 file) Islander / Hawaiian Alone, Other
                    Alone, Two or More Alone
                                         Male,
                                         Female
           Final     White, African-American,
           Desired   Asian-American, Native-American
           Variables
                               Hispanic,   Female,
                               Non-Hispan Male
                               ic
                   0-4, 5-9, 10-14, 15-17, 18-19, 20,
                   21, 22-24, 25-29, 30-34, 35-39,
                   40-44, 45-49, 50-54, 55-59,
                   60-61, 62-64, 65-66, 67-69,
                   70-74, 75-79, 80-84 85+

                   <1, 1-4, 5-9, 10-14, 15-19, 20-24,
                   25-29, 30-34, 35-39, 40-44,
                   45.49, 50-54, 55-59, 60-64,
                   65-69, 70-74, 75-79, 80-84, 85+
                                              346
                                                                                     September 2008

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                                      Appendix I: Population & Other Data in U.S. Setup
The initial set of input files are as follows.

 •  Census 2000 block-level file (Summary File 1)
    Data: ftp.census.gov/census 2000/datasets/Summary File  1
    Docs: http://www.census.gov/prod/cen2000/doc/sfl.pdf

 •  Census 2000 tract-level file (Summary File 4)
    Data: ftp.census.gov/census 2000/datasets/Summarv File  4
    Docs: http://www.census.gov/prod/cen2000/doc/sf4.pdf

 •  Census 2000 MARS national-level summary
    Docs: http://www.census.gov/popest/archives/files/MRSF-01 -US 1 .pdf

The SF4 and MARS data, as described below, are needed to reorganize the variables that
come initially in the SF1 file.  (For the sake of completeness, we note that there exists a
county-level Census 2000 MARS file, however, due to major population count
discrepancies between the county-level MARS file and block-level SF1 file, we used only
the nation-level summary table.  Tables in MARS documentation file did not have the
discrepancies that the county-level file had. We were unable to get an adequate
explanation of this from the US Census.)

The steps in preparing the data are as follows:
1. Adjust Age-classifications:

We combined some age groups in the SF1 data to match the age groups wanted for
BenMAP. For example, we combined age groups 15-17 and 18-19 to create the 15-19 age
group used in BenMAP.  Then, in the case of the 0-4 age group, we split it into <1 and 1-4
using the county-level SF4 data, which gave us the fraction of 0-4 year-olds who are <1.
2. Fill in Missing Racial-Ethnic Interactions:

We used the county-level SF4 data to calculate the fraction of Hispanics in each
ethnically-aggregated subpopulation from the block-level data, by age and sex. We used
these fractions to distribute each age-sex-race-block-level datum into Hispanics and
non-Hispanics.

This process tended to underestimate the number of Hispanics.  Therefore, we made a
correction.  We calculated the ratio of total Hispanics in a state to the estimated Hispanics
in a state. In each age-sex-race-block-level datum, if the resulting total  of Hispanics is not
greater than the total number of people in the datum, we increased the number of people
according to this ratio.
                                                                       September 2008
                                  347

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                                      Appendix I: Population & Other Data in U.S. Setup
3. Assign "Other" and "Multi-Racial" to the Remaining Four Racial Categories:

We assign the "Other" race category in two steps.  First, based on the national MARS data,
we estimated how many people in the "multi-racial" category checked off "some other
race" as one of their races, for Hispanics and non-Hispanics separately. In each
age-sex-race-block-level datum, we added those people to "other race" category to create
the re-distribution pool, analogously to the method implemented by Census while creating
MARS data (see U.S. Census Bureau, 2002a, Table 1, below). Second, based on the
national re-allocation fractions for Hispanics and non-Hispanics  (derived from the MARS
data), we assigned the "Other" race into the four races of interest and "multi-race".

After the assignment of the "Other" race category, we then assigned "multi-racial" category
to the four racial categories categories, using state fractions of these races in each
age-sex-race-block-level datum.
                                                                       September 2008
                                  348

-------
                                     Appendix I: Population & Other Data in U.S. Setup
Tabte 1 . Summer) of M Oilifietl Race anil Census 2000 Race OUcribuEfoii* fur tin* 1 tilted Slates
Subject

TOTAL POPULATION
One race
Specified race only
White
Black or African American
American Indian and Ala-ska Native
Asian
Native Hawaiian and G1hcr Pacific [slander

Non-specified race only

Two races
Specified race only
Specified and Ron-spedtied races

Three or more race*
Specified rase only
Specified and non-specified races

HLSPANK' OR LATINO AND RACK
On* race
Specified race only
White
Black or African American
American Indian and Alaska relative
Asian
Native Hawaiian and Otiser Pacific Islander

Non-specified race only

T'w« race*
Specified raze only
Spec i tied aiMl ean-spedfed imccs

Thrct or more race*
Specified race only
Specified and win-snedricd races

NOT HISPANIC OR LATINO AND RATE
One ract-
Specified race ^snly
White
Black OT African American
.American Indian and Alaska Native
Asian
Native Hawaiian and Olher Pacific M:ander

Nan-specified race orily

Two TJM:C-S
Specified race only
S.j>ecified and Bon-spedfieii races

Thrci* or mon1 race*
Specified race only
Specified and non-^ecified races
MiMlified Race
Numb«r
281,421,9*
277,524,226
277,524,226
228, 104,4 «5
35,704,124
2.663, R1S
10,589,265
462.534

(X)

3,578,053
3,578,053
IX)

319,627
319,627
(X)

35,305,818
34, 814,3 »
34,814,386
32,529,00)
1,391,117
566,378
132,461
95,430

IX)

433,726
433,72*


57,706
57,706
(X)

246,116,088
242,709,840
242,709,840
195,575,485
34,313,007
2,097,440
10,356.804
3*7,104

(X)

3,144,327
3,144,327
(X)

261,921
261,921
(X)
ft r teat
100.00
98.62
98.62
81.05
1 2.69
0.95
3.76
0.16

(Xl

1.27
1.27
(X)

0.11
0.11
(X)

100.00
9S.61
9S.61
92.13
3.94
1.60
0.66
0.27

(X)

1.23
1.23


0.16
0.16
(X)

100.00
9B.62
98.62
79.46
13.94
0.85
4.21
0.15

(Xi

1.28
1.28
(X)

0.1 1
0.11
(X)
I' nan 2MM!
Number
281,421,906
274,595,678
259 ,236,605
211,460,626
34,658,190
2,475,956
10,242,998
398,835

15359,073

6,368,075
3,366,517
3,001,558

458,153
297,298
160,855

35305,818
33,081,736
18,190,433
16,907,852
7IOJ53
407 ,§73
1 19,829
45326

14 ,891,303

2,110,965
315,611
1,795,354

113,117
48,933
64,184

246,116,088
241,513,942
241,046,172
194,552,774
33,947,837
2,068,883
10,1 23, 169
353:509

467,770

4,257,110
3,050,906
1,206,204

345,036
248,365
96,671
Pcrci'at
100X10
97.57
92.12
75.14
1232
0.88
3.64
0.14

5.46

2.26
1.20
1.07

0.16
0.1 1
0.06

100X10
93.70
51.52
47.89
2.01
1.15
034
0.13

42.1 »

5.98
0.89
5.09

0.32
0.14
0.18

100.00
98.13
97.94
79.05
13.79
0.84
4.11
0.14

0.19

1.73
1.24
0.49

0.14
0.10
0.04

-------
                                               Appendix I: Population & Other Data in U.S. Setup
1.1.2.2  County-Level Forecasts

          Woods & Poole (2006) developed county-level forecasts for each year from 2000 through
          2030, by age and gender for non-Hispanic White, African-American, Asian-American, and
          Native-American and for all Hispanics. As discussed below, the adjustments necessary to
          prepare the data for use in BenMAP are relatively straightforward. The starting data is the
          following:


           •  Woods & Poole county-level files
              Data: L:\project data\Benmap\Database Development^opulation\Woods and Poole
              from 2007-2008\Data\
              Docs: http://www.woodsandpoole.com/pdfs/CED07.pdf


          For each non-Hispanic subset of the population and each year from 2000-2030, we divided
          the Woods and Poole population for that year by the Woods and Poole population for that
          subset in 2000. These serve as the growth coefficients for the non-Hispanic subsets of each
          race.  We used a similar calculation to determine the growth rates for the Hispanic
          population. We assume that each Hispanic race grows at the same rate, and use these
          growth rates for the Hispanic subsets of each race.
           Matching Age Groups Used in BenMAP

           There are 86 age groups, so it is a simple matter of aggregating age groups to match the 19
           used in BenMAP.
           Matching Counties Used in U.S. Census

           The county geographic boundaries used by Woods & Poole are somewhat more aggregated
           than the county definitions used in the 2000 Census (and BenMAP), and the FIPS codes
           used by Woods and Poole are not always the standard codes used in the Census. To make
           the Woods and Poole data consistent with the county definitions in BenMAP, we
           disaggregated the Woods and Poole data and changed some of the FIPS codes to match the
           U.S. Census.
           Calculating Growth Ratios with Zero Population in 2000

           There are a small number of cases were the 2000 county population for a specific
           demographic group is zero, so the ratio of any future year to the year 2000 data is
           undefined.  In these relatively rare cases, we set the year 2000 ratio and all subsequent
           ratios to 1, assuming no growth.
                                                                                September 2008
                                            350

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                                                 Appendix I: Population & Other Data in U.S. Setup
1.1.3    PopGrid
           If the geographic center of a Census block falls within a population grid-cell, PopGrid
           assigns the block population to this particular population grid-cell.  Note that the grid-cells
           in an air quality model, such as CMAQ, may cross multiple county boundaries. PopGrid
           keeps track of the total number of people in each race-ethnic group by county within a
           particular population grid-cell.  Of course, when the population grid-cell is for U.S.
           counties, then there is only a single county associated with the population grid-cell.
           However, with air quality models, there can clearly be multiple counties in a population
           grid-cell.

           Keeping track of the total number of people in a county is necessary when forecasting
           population, as the population forecast for a given grid cell is equal to the year 2000
           population estimate from the Census Bureau multiplied by the ratio of future-year to year
           2000 county population estimates from Woods & Poole. BenMAP assumes that all
           age-gender groups within a given race-ethnic group have the same geographic distribution.
1.1.3.1  How to Use PopGrid
           After installing PopGrid, double-click on the PopGrid executable "PopGrid4.exe." The
           following screen will appear:
                                                                                   September 2008
                                             351

-------
                                        Appendix I: Population & Other Data in U.S. Setup
 S PopGrid 4.2
 Help
 Step i: Data j step 2: Shape File I Step 3; Run
   Census Data Files Directory: IC:\PopGrid\Data2
Browse
   Result Population File:

                                                                          Browse
                                                                             Close
The Census Data Files Directory box points PopGrid to where the block data are located
that PopGrid uses.  Make sure that the files in this directory are unzipped. This data folder
should look something like the following:
                                    352
                                                                            September 2008

-------
                                     Appendix I: Population & Other Data in U.S. Setup
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DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File
DAT File

" a GO
Date Modified A
2/25/20084:38 AM
2/24/20087:36 AM
2/24/20087:37 AM
2/24/2008 6:51 AM
2/24/20087:21 AM
2/24/2008 6:49 AM
2/24/20088:00 AM
2/24/2008 7: 11 AM
2/24/20087:19 AM
2/24/2008 7:01 AM
2/24/20087:18 AM
2/24/20087:13 AM
2/24/2008 7:02 AM
2/24/20088:04 AM
2/24/2008 7:47 AM
2/24/20087:22 AM
2/24/2008 6:52 AM
2/24/20087:05 AM
2/24/2008 7: 16 AM
2/24/20086:57 AM v
The Result Population File box provides the path and the name of the file that you want
to create. In the example above, PopGrid is being used to estimate population for the
intersection of air basins and counties in California (CA_AirBasin_by_County).

Click on the Step 2: Shape File tab.  Choose the shapefile that you want to use. The
example for air basins and counties in California looks as follows:
                                 353
                                                                      September 2008

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                                            Appendix I: Population & Other Data in U.S. Setup
 €PopGrid4.2
  Help

  Step liData | Step 2: Shape File | step 3; Run
    The shape file must be projected with the Geographic Coordinate System: North American Datum 1983.
    The attribute (dbf) file must have the columns COL and ROW and the value pairs must be unique.
      Shape File:
                «iaiiiLEiiiiim»i»^i^n»-w-iii.^cimn»»iiiin«Tjuiiii
Browse
  Xl-114.7161 Y:42.4770
                                                                                   Close
After choosing your shapefile, go to the Step 3: Run tab, which should look as follows:
                                       354
                                                                                  September 2008

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                                      Appendix I: Population & Other Data in U.S. Setup
 UPopGrid 4.2
 Help
  Step 1: Data  Step 2: Shape File  Step 3; Run ;
                                                           Run
                                                                        Close
Click Run. PopGrid will now begin processing. It can take a very long time to run. When
PopGrid has finished running, check the log file. The log file notes the start time, the files
that PopGrid used, and the end time. Also, at the very end of the log file, PopGrid notes
the number of people that PopGrid assigned to your grid definition ("Population covered
by grid") and the number of people that PopGrid determined are outside of your grid
definition ("Population outside grid").
                                  355
                                                                       September 2008

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                                              Appendix I: Population & Other Data in U.S. Setup
              6_18_2008_10_39_42_PM.txt - Notepad
            File  Edit  Format  View  Help

           Records processed   51ioooo
           Records processed   5120000
           Records processed   5130000
           Records processed   5140000
           Records processed   5150000
           Records processed   5160000
           Records processed   5170000
           Records processed   5180000
           Records processed   5190000
           Records processed   5200000
           Records processed   5210000
           Records processed   5220000
           Reading census file CENSUS48.dat
                               5230000
                               5240000
                               5250000
                               5260000

Records processed
Records processed
Records processed
Records processed
Reading census file CENSUS49.dat
Records processed   5270000
Records processed   5280000
MEMORYTABLE size :  13771108
Saving main table.
Finished © 6/18/2008 10:39:42 PM
2000 CENSUS :
Population covered  by grid :  13749883
Population outside  grid :  265833554
1.1.3.2  PopGrid Output
          PopGrid generates two files. One file has the number of people in each grid cell for each
          of the 304 race-ethnicity-gender-age demographic groups available in PopGrid.  Table 1-1
          presents an example of what the population file looks like from PopGrid. The Row and
          Column uniquely identify each grid cell. Note that the Race, Ethnicity, Gender and
          AgeRange variables are precisely defined (see section on loading population data
          LoadData_Setups_Population).
                          Table 1-1. Population File Fragment from PopGrid
Row
58
58
58
58
58
58
58
58
Column
81
81
81
81
81
81
81
81
Year
2000
2000
2000
2000
2000
2000
2000
2000
Population
1.54
0.03
0.01
0.01
4.86
0.12
0.03
0.03
Race
WHITE
BLACK
NATAMER
ASIAN
WHITE
BLACK
NATAMER
ASIAN
Ethnicity
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
Gender
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
AgeRange
OTOO
OTOO
OTOO
OTOO
1T04
1T04
1TO4
1TO4
                                           356
                                                                              September 2008

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                                     Appendix I: Population & Other Data in U.S. Setup
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
58
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
81
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
6.79
0.21
0.05
0.05
0.90
0.04
0.01
0.01
3.44
0.15
0.04
0.04
1.49
0.06
0.02
0.03
1.93
0.04
0.01
0.01
1.87
0.08
WHITE
BLACK
NATAMER
ASIAN
WHITE
BLACK
NATAMER
ASIAN
WHITE
BLACK
NATAMER
ASIAN
WHITE
BLACK
NATAMER
ASIAN
WHITE
BLACK
NATAMER
ASIAN
WHITE
BLACK
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
HISPANIC
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
MALE
5TO9
5T09
5T09
5TO9
10TO14
10T014
10TO14
10TO14
15T019
15T019
15TO19
15TO19
20T024
20T024
20TO24
20TO24
25T029
25T029
25TO29
25TO29
30T034
30T034
PopGrid generates a second file that keeps track of the fraction of the total population in
each of the eight race-ethnic groups that comes from each county in the United States.
Table 1-2 presents a sample. The SourceCol and SourceRow uniquely identify each
county, and the TargetCol and TargetRow uniquely identify each grid cell.  The Value
variable gives the fraction of the total population in the grid cell for a given race-ethnic
group that comes from the "source" county.

When a grid cell lies completely within a county, then the fraction will be 1. When a grid
cell is in more than county, then the sum of the fractions across the counties for a given
race-ethnic group must sum to one.  In Table 1-2, you can see that for grid cell
(TargetCol=123, TargetRow=18) that the fraction of Asian Non-Hispanic coming from
county (SourceCol=16, SourceRow=71) is 0.49 and for county (SourceCol=49,
SourceRow=3) the fraction is 0.51.  In this case, about half the population of Asian
Non-Hispanics comes from each of the two counties.  In the case of Black Hispanics, the
fraction from county (SourceCol=16, SourceRow=71) is only 0.12, with most Black
Hispanics in this grid cell coming from county (SourceCol=49, SourceRow=3).
                                  357
                                                                      September 2008

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                                              Appendix I: Population & Other Data in U.S. Setup
Table 1-2. Population-Weight File Fragment from PopGrid
SourceCol
16
16
16
16
16
16
16
16
49
49
49
49
49
49
49
49
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
SourceRow
71
71
71
71
71
71
71
71
3
3
3
3
3
3
3
3
23
23
23
23
23
23
23
23
23
23
23
23
23
23
23
23
TargetCol
123
123
123
123
123
123
123
123
123
123
123
123
123
123
123
123
45
45
45
45
45
45
45
45
45
45
45
45
45
45
45
45
TargetRow
18
18
18
18
18
18
18
18
18
18
18
18
18
18
18
18
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
Race
ASIAN
ASIAN
BLACK
BLACK
NATAMER
NATAMER
WHITE
WHITE
ASIAN
ASIAN
BLACK
BLACK
NATAMER
NATAMER
WHITE
WHITE
ASIAN
ASIAN
BLACK
BLACK
NATAMER
NATAMER
WHITE
WHITE
ASIAN
ASIAN
BLACK
BLACK
NATAMER
NATAMER
WHITE
WHITE
Ethnicity
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
NON-HISPANIC
HISPANIC
Value
0.49
0.21
0.49
0.12
0.98
0.43
0.23
0.06
0.51
0.79
0.51
0.88
0.02
0.57
0.77
0.94
0.00
0.00
0.00
0.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
Year
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
2000
1.2     Monitor Data in U.S. Setup

          BenMAP-ready data files were created from 2000 through 2007 data, as reported to the U.
          S. Environmental Protection Agency's (EPA) Air Quality System (AQS), for PM2.5,
          PM10 STP and LC, lead TSP, ozone, NO2, SO2, and CO. Table 1-5 summarizes the data
          sources and vintage of the processed data.
                                          358
                                                                              September 2008

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                                    Appendix I: Population & Other Data in U.S. Setup
        Table 1-5. Underlying data sources for BenMAP air quality data files.
Pollutant
PM15
Ozone
Lead TSP
PM10 STP
PM]0 LC:
AQS
Parameter
Code
88101
44201
12128
81102
85101
Year
iririri IAA^
2UUU— 2UUO
2007
2000-2006
2007
2000
2001-2006
2007
2000-2006
2007
2000-2007
Data Source
http :. . \vv,n,v. epa . gov rtn air i air saq s/
deraildata 'doivnloadaqsdata .farm
Requested from AQS representative
http ://i.v\v\v. epa . SOY rtn air v ainaqs/
deraildata 'downloadaqsdata .linn
Requested from AQS representative
http :. •'. WVAV. epa . sov 'ttn/aiiv'ainaqs/
deraildata dowuloadjqsdata . ban
http ://wv,n,v. epa . sov rtn airi ainaqs/
deraildata doivuloadaq sdsta .linn

Requested from AQS representative
http :/.av\v\v. epa . gov 'ttir air \: airsaqs/
deraildata 'doivuloadaqsdata iirm
Requested from AQS representative
Requested from AQS representative
Date
Acquired
5/22/2008
Documented
Vintage
4/10/2008
6/4/2008
5/22/2008
4/14/2008-
4/15/2008
6/4/2008
5/29/2008
5/29/2008
6/20/2007
4/9/2008
6/4/2008
5/22/2008
4/10/2008
6/4/2008
6/4/2008
The AQS data were uploaded to the STI Air Quality Archive (AQA) Oracle database. The
AQA database performs additional quality control (QC) checks against the AQS data, such
as uniqueness by AQS site, method, parameter occurrence code (POC), and duration
codes; checks of minimum and maximum values; and maximum rate of change between
consecutive data values (where appropriate). The specific QC checks imposed on the
BenMAP data are outlined in Table 1-6. No maximum value filters were applied to the
concentration data. High aerosol concentration values caused by dust storms or other
exceptional events are included in the BenMAP-ready data files.
                                 359
                                                                    September 2008

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                                                Appendix I: Population & Other Data in U.S. Setup
                       Table 1-6. Pollutant-specific QC checks performed in AQA
Pollutant
PM15
Ozone
Lead
PMW
CO
NO2
SO;
AQS Parameter
Code
88101
44201
12128
81 102 and
S5101
42101
42602
42401
Acceptable
Concentration Range
>= 0 ng/nf
>= 0 ppb
>= 0 ng.'nij
''•••= 0 \isfm'
>= 0 ppm
>= 0 ppb
>= 0 ppb
Maximum Rate
of Change
-
60 ppb
-
-
-
50 ppb
-
1.2.1    Data Processing
           STI developed data processing procedures consistent with those used in the past by Abt
           Associates to create air quality data for files for use in the BenMAP model. Critical data
           processing rules implemented in the deliverable data are listed below:

           • Data delivered by STI are reported with consistent units:  ug/m3 for aerosols; ppb for
            ozone, NO2, and SO2; and ppm for CO.

           • The "monitor name" field is populated by concatenating the AQS site, parameter, and
            POC codes.

           • The "monitor description" field is populated with the following metadata: method code,
            land use, location setting, POC, and AQS parameter code. The AQS probe location and
            monitoring objective code fields are left blank in STI-processed data.

           • The data were formatted with one record  per site, pollutant, POC, and year for use in the
            BenMAP program. Data for 365 days, or 8,760 hourly values, are expected per record.
            This format is satisfied regardless of leap years; an average of February 28 and 29 data
            are reported.
                                            360
                                                                                 September 2008

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                                               Appendix I: Population & Other Data in U.S. Setup
          • The monitoring method is allowed to change over the course of a year. To provide a
            more complete record, data with multiple method codes for a given site, parameter, POC,
            and year were combined and the first reported method code was reported in the
            BenMAP-ready data files.

          • Aerosol data collected with 24-hr sample durations were used before data collected with
            underlying 1-hr sample durations.One-hour sampling duration data are used for ozone,
            NO2, SO2,, and CO.

1.2.2    Output Files

          Table 1-7 lists the number of monitors by pollutant and year, represented in the resulting
          BenMAP-ready data files.
           Table 1-7. Number of monitors by pollutant, AQS parameter code, and year included
                                    in the BenMAP-ready data files
Pollutant
PM: 5
PM1D STP
PM;D LC
Lead TSP
Ozone
NG2
CG
SO2
AQS Parameter
Code
88101
81102
85101
12128
44201
42602
42101
42401
Number of Monitors by Year
2000
1.311
1,415
868
20?
1.138
444
523
613
2001
1.339
1.388
757
232
1.184
458
518
(505
2002
1.32S
1.320
714
253
1.191
445
498
580
2003
1,316
1,240
694
250
1,210
444
482
561
2004
1,226
1,211
6S8
231
1,206
446
452
557
2005
1,260
1,199
748
247
1,194
437
429
534
2006
U97
U64
558
204
1,199
428
413
518
2007
1,144
1,111
502
175
1,217
423
389
520
                                           361
                                                                               September 2008

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                                                              Appendix J: Uncertainty & Pooling
        Appendix J:  Uncertainty & Pooling
           This Appendix discusses the treatment of uncertainty in BenMAP, both for incidence changes and
           associated dollar benefits. Some background is then given on pooling methodology. Finally, the
           mechanics of the various Pooling Methods available in BenMAP are discussed in detail, including
           Subjective Weight based pooling, Fixed Effects pooling, Random / Fixed Effects pooling, and
           independent and dependent Sum and Subtraction.

J.1     Uncertainty

           Although there are several sources of uncertainty affecting estimates of incidence changes
           and associated benefits, the sources of uncertainty that are most readily quantifiable in
           benefit analyses are uncertainty surrounding the health impact functions and uncertainty
           surrounding unit dollar values. The total dollar benefit associated with a given endpoint
           group depends  on how much the endpoint group will change in the control scenario (e.g.,
           how many premature deaths will be avoided) and how much each unit of change is worth
           (e.g., how much a statistical death avoided is worth).

           Both the uncertainty about the incidence changes and uncertainty about unit dollar values
           can be characterized by distributions. Each "uncertainty distribution" characterizes our
           beliefs about what the true value of an unknown (e.g., the true change in incidence of a
           given health effect) is likely to be, based on the available information from relevant
           studies.  Although such an "uncertainty distribution" is not formally a Bayesian posterior
           distribution, it is very similar in concept and function (see, for example, the discussion of
           the Bayesian approach in Kennedy  1990, pp. 168-172). Unlike a sampling distribution
           (which describes the possible values that an estimator of an unknown value might take on),
           this uncertainty distribution describes our beliefs about what values the unknown value
           itself might be.

           Such uncertainty distributions can be constructed for each underlying unknown (such as a
           particular pollutant  coefficient for a particular location) or for a function of several
           underlying unknowns (such as the total dollar benefit of a regulation). In either case, an
           uncertainty distribution is a characterization of our beliefs about what the unknown (or the
           function of unknowns) is likely to be, based on all the available relevant information.
           Uncertainty statements based  on such distributions are typically expressed as 90 percent
           credible intervals.  This is the interval from the fifth percentile point of the uncertainty
           distribution to the ninety-fifth percentile point.  The 90 percent credible interval is a "
           credible range" within which, according to the available information (embodied in the
           uncertainty distribution of possible values), we believe the true value to lie with 90 percent
           probability. The uncertainty surrounding both incidence estimates and dollar benefits
           estimates can be characterized quantitatively in BenMAP.  Each is described separately
           below.

J. 1.1   Characterization of Uncertainty Surrounding Incidence Changes

           To calculate point estimates of the changes in incidence of a given adverse health effect
                                                                                 September 2008
                                            362

-------
                                                               Appendix J: Uncertainty & Pooling
           associated with a given set of air quality changes, BenMAP performs a series of
           calculations at each grid-cell. First, it accesses the health impact functions needed for the
           analysis, and then it accesses any data needed by the health impact functions. Typically,
           these include the grid-cell population, the change in population exposure at the grid-cell,
           and the appropriate baseline incidence rate.  BenMAP then calculates the change in
           incidence of adverse health effects for each selected health impact function.  The resulting
           incidence change is stored, and BenMAP  proceeds to the next grid-cell, where the above
           process is repeated.

           In Latin Hypercube mode, BenMAP reflects the uncertainty surrounding estimated
           incidence changes  (resulting from the sampling uncertainty surrounding the pollutant
           coefficients in the health impact functions used) by producing a distribution  of possible
           incidence changes  rather than a single point estimate.  To do this, it uses the  distribution (
           Dist Beta) associated with the pollutant coefficient (Beta, or P), and potentially the point
           estimate (Beta) and two parameters (PIBeta, P2Beta).  Typically, pollutant coefficients are
           normally distributed, with mean Beta and standard deviation PIBeta.

           BenMAP uses an N-point Latin Hypercube to represent the underlying distribution of P
           and to  create a corresponding distribution of incidence changes in each population grid
           cell, where N is specified by you. The Latin Hypercube method represents an underlying
           distribution by N percentile points of the distribution, where the «th percentile point is
           equal to:


                100   100
           "-11—37


           The Latin Hypercube method is used to enhance computer processing efficiency. It is a
           sampling method that divides a probability distribution into intervals of equal probability,
           with an assumption value for each interval assigned according to the interval's probability
           distribution. Compared with conventional Monte Carlo sampling, the Latin Hypercube
           approach is more precise  over a fewer number of trials because the distribution is sampled
           in a more even, consistent manner (Decisioneering, 1996,  pp. 104-105).

           Suppose, for example, that you elect to use a 20-point Latin Hypercube. BenMAP would
           then represent the distribution of P by 20 percentile points, specifically the 2.5th, 7.5th, ...,
           97.5th.  To do this,  the inverse cumulative distribution function specified by the distribution
           of P is  called with the input probability equal to each the 20 percentile points. BenMAP
           then generates an estimate of the incidence change in a grid-cell for each of these values of
           P, resulting in a distribution of N incidence changes. This distribution is stored, and
           BenMAP proceeds to the next population grid-cell, where the process is repeated.

J.1.2   Characterization of Uncertainty Surrounding Dollar Benefits

           The uncertainty distribution of the dollar benefits associated with a given health or welfare
           effect is derived from the two underlying uncertainty distributions - the distribution of the
           change in incidence of the effect (number of cases avoided) and the distribution of the
                                                                                   September 2008
                                             363

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                                                               Appendix J: Uncertainty & Pooling
           value of a case avoided (the "unit value").  The derivation of the uncertainty distribution
           for incidence change is described above. The distributions used to characterize the
           uncertainty surrounding unit values are described in detail in the appendix on the
           Economic Value of Health Effects. As noted in that Appendix, a variety of distributions
           have been used to characterize the uncertainty of unit values, including uniform, triangular,
           normal, and Weibull.

           To represent the underlying distribution of uncertainty surrounding unit values, a 100-point
           Latin Hypercube is generated in the same way described in the previous section for the
           distribution of p. That is, the unit value distribution is represented using the 0.5th, 1.5th, ...,
           and 99.5th percentile values of its distribution.

           A distribution of the uncertainty surrounding the dollar benefits associated with a given
           endpoint is then derived from Latin Hypercube  values generated to represent the change in
           incidence and the Latin Hypercube values generated to represent the unit value
           distribution.  To derive this new distribution, each of the  100 unit values is multiplied by
           each of the N incidence change values, yielding a set of 100  * N dollar benefits.  These
           values are sorted low to high and binned down to a final distribution of N dollar benefit
           values.

J.1.3   Characterization of Uncertainty Surrounding QALY Estimates

           The uncertainty distribution of the QALY estimates associated with a given health effect is
           similar to that for dollar benefits. That is, it is derived from  the two underlying uncertainty
           distributions - the distribution of the change in  incidence of the effect (number of cases
           avoided) and the distribution of the QALYs per case avoided.  The derivation of the
           uncertainty distribution for incidence change is  described above. The  distributions used to
           characterize the uncertainty surrounding QALYs are described in detail in the appendix on
           the Economic Value of Health Effects.  As noted in that Appendix, a variety of
           distributions have been used to characterize the uncertainty of unit values, including
           uniform, triangular, normal, and Weibull.

           To represent the underlying distribution of uncertainty surrounding unit values, a 100-point
           Latin Hypercube is generated in the same way described in the previous section for the
           distribution of p. That is, the unit value distribution is represented using the 0.5th, 1.5th, ...,
           and 99.5th percentile values of its distribution.

           A distribution of the uncertainty surrounding the QALYs associated with a given endpoint
           is then derived from Latin Hypercube values generated to represent the change in incidence
           and the Latin Hypercube values generated to represent the QALY distribution. To derive
           this new distribution, each of the 100 QALY weights is multiplied by each of the N
           incidence change values.  These values are sorted low to high and binned down to a final
           distribution of QALY values.

J.2    Pooling

           There is often more than one study that has estimated a health impact function for a given
                                                                                   September 2008
                                             364

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                                                               Appendix J: Uncertainty & Pooling
           pollutant-health endpoint combination. Each study provides an estimate of the pollutant
           coefficient, P, along with a measure of the uncertainty of the estimate. Because uncertainty
           decreases as sample size increases, combining data sets is expected to yield more reliable
           estimates of P, and therefore more reliable estimates of the incidence change predicted
           using p. Combining data from several comparable studies in order to analyze them
           together is often referred to as meta-analysis.

           For a number of reasons, including data confidentiality, it is often impractical or
           impossible to combine the original data sets.  Combining the results of studies in order to
           produce better estimates of P provides a second-best but still valuable way to synthesize
           information . This is referred to as pooling.  Pooling P's requires that all of the  studies
           contributing estimates of P use the same functional form for the health impact function.
           That is, the P's must be measuring the same thing.

           It is also possible to pool the study-specific estimates of incidence  change  derived from the
           health impact functions, instead  of pooling the underlying P's themselves.  For a variety of
           reasons, this is often possible when it is not feasible to pool the underlying P's.  For
           example, if one study is log-linear and another is linear, we could not pool the P's because
           they are not different estimates of a coefficient in the same health impact function, but are
           instead estimates of coefficients  in different health impact functions. We can, however,
           calculate the incidence change predicted by each health impact function (for a given
           change in pollutant concentration and, for the log-linear function, a given baseline
           incidence rate), and pool these incidence changes. BenMAP allows the pooling of
           incidence changes predicted by several studies for the same pollutant-health endpoint
           group combination. It also allows the pooling of the corresponding study-specific  estimates
           of monetary benefits.

           As with estimates based on only a single study, BenMAP allows you to  characterize the
           uncertainty surrounding pooled estimates of incidence change and/or monetary benefit. To
           do this, BenMAP pools the study-specific distributions of incidence changes (or monetary
           benefit or QALYs) to derive a pooled distribution.  This pooled distribution incorporates
           information from all the studies used in the pooling procedure.

J.2.1   Weights Used for Pooling

           The relative contribution of any  one  study in the pooling process depends  on the weight
           assigned to that study. A key component of the pooling process, then, is the determination
           of the weight given to each study. There are various methods that can be used to assign
           weights to studies. Below we discuss the possible weighting schemes that are available in
           BenMAP.

J.2.1.1 Subjective Weights

           BenMAP allows you the option of specifying the weights to be used. Suppose,  for
           example, you want to simply average all study-specific results. You would then assign a
           weight of 1/N to each of the N study-specific distributions that are to be pooled. Note that
           subjective weights are limited to two decimal places, and are normalized to sum to one, if
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           they do not already sum to one.

J. 2.1.2 Automatically Generated Weights

           A simple average has the advantage of simplicity but the disadvantage of not taking into
           account the uncertainty of each of the estimates. Estimates with great uncertainty
           surrounding them are given the same weight as estimates with very little uncertainty. A
           common method for weighting estimates involves using their variances. Variance takes
           into account both the consistency of data and the sample size used to obtain the estimate,
           two key factors that influence the reliability of results. BenMAP has two methods of
           automatically generating pooling weights using the variances of the input distributions -
           Fixed Effects Pooling and Random / Fixed Effects Pooling.

           The discussion of these two weighting schemes is first presented in terms of pooling the
           pollutant coefficients (the P's), because that most closely matches the discussion of the
           method for pooling study results  as it was originally presented by DerSimonian and Laird.
           We then give an overview of the  analogous weighting process used within BenMAP to
           generate weights for incidence changes rather than P's.

J.2.1.3 Fixed-Effect Weights

           The fixed  effects model assumes that there is a single true concentration-response
           relationship and therefore a single true value for the parameter p that applies everywhere.
           Differences among P's reported by different studies are therefore simply the result of
           sampling error. That is, each reported P is an estimate of the same underlying parameter.
           The certainty of an estimate is reflected in its variance (the larger the variance, the less
           certain the estimate). Fixed effects pooling therefore weights each estimate under
           consideration in proportion to the inverse of its variance.

           Suppose there are n studies, with the ith study providing an estimate pi with variance vi (1=1,
           ..., n).  Let
                                                       vi
           denote the sum of the inverse variances. Then the weight, wi, given to the ith estimate, pi, is:
                                                      1/v,
                                                     	
                                                       S
           This means that estimates with small variances (i.e., estimates with relatively little
           uncertainty surrounding them) receive large weights, and those with large variances receive
           small weights.
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           The estimate produced by pooling based on a fixed effects model, then, is just a weighted
           average of the estimates from the studies being considered, with the weights as defined
           above. That is:
                                                       ,  *  P, •
           The variance associated with this pooled estimate is the inverse of the sum of the inverse
           variances:
           Exhibit J-2 shows the relevant calculations for this pooling for three sample studies.


                        Exhibit J-2.  Example of Fixed Effects Model Calculations
Study
1
2
3
Sum
Pi
0.75
1.25
1.00

vi
0.1225
0.0025
0.0100

1/vi
8.16
400
100
£=508.16
wi
0.016
0.787
0.197
£= 1.000
wi*pi
0.012
0.984
0.197
1=1.193
           The sum of weighted contributions in the last column is the pooled estimate of P based on
           the fixed effects model. This estimate (1.193) is considerably closer to the estimate from
           study 2 (1.25) than is the estimate (1.0) that simply averages the study estimates. This
           reflects the fact that the estimate from study 2 has a much smaller variance than the
           estimates from the other two studies and is therefore more heavily weighted in the pooling.


           The variance of the pooled estimate, vfe, is the inverse of the sum of the variances, or
           0.00197. (The sums of the pi and vi  are not shown, since they  are of no importance.  The
           sum of the 1/vi is  S, used to calculate the weights.  The sum of the weights, wi, i=l, ..., n,
           is 1.0, as expected.)

J.2.1.4 Random- / Fixed-Effect Weights
           An alternative to the fixed effects model is the random effects model, which allows the possibility
           that the estimates pi from the different studies may in fact be estimates of different parameters,
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rather than just different estimates of a single underlying parameter.  In studies of the effects of
PM10 on mortality, for example, if the composition of PM10 varies among study locations the
underlying relationship between mortality and PM10 may be different from one study location to
another. For example, fine particles make up a greater fraction of PM10 in Philadelphia than in El
Paso. If fine particles are disproportionately responsible for mortality relative to coarse particles,
then one would expect the true value of |3 in Philadelphia to be greater than the true value of (3 in
El Paso. This would violate the assumption of the fixed effects model.

The following procedure can test whether it is appropriate to base the pooling on the random
effects model (vs. the fixed effects model):

A test statistic, Qw , the weighted sum of squared differences of the separate study estimates from
the pooled estimate based on the fixed effects model, is calculated as:


                                              1  /n   o \ 2
                                              Vi
Under the null hypothesis that there is a single underlying parameter, (3, of which all the |3i 's are
estimates, Qw has a chi-squared distribution with n-1 degrees of freedom. (Recall that n is the
number of studies in the meta-analysis.)  If Qw is greater than the critical value corresponding to
the desired confidence level, the null hypothesis is rejected. That is, in this case the evidence does
not support the fixed effects model, and the random effects model is assumed, allowing the
possibility that each study is estimating a different (3.  (BenMAP uses a five percent one-tailed
test).

The weights used in a pooling based on the random effects model must take into account not only
the within-study variances (used in a meta-analysis based on the fixed effects model) but the
between-study variance as well. These weights are calculated as follows:

Using Qw , the between-study variance, r|2, is:
It can be shown that the denominator is always positive. Therefore, if the numerator is negative
(i.e., if Qw < n-1), then r|2 is a negative number, and it is not possible to calculate a random effects
estimate. In this case, however, the small value of Qw would presumably have led to accepting
the null hypothesis described above, and the meta-analysis would be based on the fixed effects
model.  The remaining discussion therefore assumes that r|2 is positive.

Given a value for r|2 , the random effects estimate is calculated in almost the same way as the
fixed effects estimate. However, the weights now incorporate both the within-study variance (vi)
and the between-study variance (r\2). Whereas the weights implied by the fixed effects model
used only vi, the within-study variance, the weights  implied by the random effects model use vi +TJ
2.
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Let vi* = vi +r\2. Then:
                                            S*
The estimate produced by pooling based on the random effects model, then, is just a
weighted average of the estimates from the studies being considered, with the weights as
defined above. That is:
The variance associated with this random effects pooled estimate is, as it was for the fixed
effects pooled estimate, the inverse of the sum of the inverse variances:
                                              1
                                     rand
The weighting scheme used in a pooling based on the random effects model is basically the same
as that used if a fixed effects model is assumed, but the variances used in the calculations are
different. This is because a fixed effects model assumes that the variability among the estimates
from different studies is due only to sampling error (i.e., each study is thought of as representing
just another sample from the same underlying population), while the random effects model
assumes that there is not only sampling error associated with each study, but that there is also
between-study variability ~ each study is estimating a different underlying |3. Therefore, the sum
of the within-study variance and the between-study variance yields an overall variance estimate.
Fixed Effects and Random / Fixed Effects Weighting to Pool Incidence Change
Distributions and Dollar Benefit Distributions

Weights can be derived for pooling incidence changes predicted by different studies, using
either the fixed effects or the fixed / random effects model, in a way that is analogous to
the derivation of weights for pooling the a's in the C-R functions.  As described above,
BenMAP generates a Latin Hypercube representation of the distribution of incidence
change corresponding to each health impact function selected. The means of those
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                                                              Appendix J: Uncertainty & Pooling
           study-specific Latin Hypercube distributions of incidence change are used in exactly the
           same way as the reported a's are used in the calculation of fixed effects and random effects
           weights described above.  The variances of incidence change are used in the same way as
           the variances of the a's. The formulas above for calculating fixed effects weights, for
           testing the fixed effects hypothesis, and for calculating random effects weights can all be
           used by substituting the mean incidence change for the ith health impact function for ai and
           the variance of incidence change for the ith health impact function for vi.200

           Similarly, weights can be derived for dollar benefit distributions.  As described above,
           BenMAP generates a Latin Hypercube representation of the distribution of dollar benefits .
           The means of those Latin Hypercube distributions are used in exactly the same way as the
           reported a's are used in the calculation of fixed effects  and random effects weights
           described above.  The variances of dollar benefits are used in the same way as the
           variances of the a's. The formulas above for calculating fixed effects weights, for testing
           the fixed effects hypothesis, and for calculating random effects weights can all be used by
           substituting the mean dollar benefit change for the ith valuation for ai and the variance of
           dollar benefits for the ith valuation for vi.

           BenMAP always derives Fixed Effects and Random / Fixed Effects weights using
           nationally aggregated results, and uses those weights for pooling at each grid cell (or
           county, etc. if you choose to aggregate results prior to pooling).  This is done because
           BenMAP does not include any regionally based uncertainty - that is, all uncertainty is at
           the national level in BenMAP, and all regional differences (population, for example) are
           treated as certain.

J.2.2   Mechanics of Pooling in BenMAP

           Once weights are generated for each input  distribution, BenMAP has three options for
           using these weights to combine the input distributions into a single new distribution.
           These options are referred to as Advanced  Pooling Methods.

           Round Weights to Two Digits

           This is BenMAP's default Advanced Pooling Method,  and is always the method used
           when Subjective Weights are used. The first step is converting the weights to two digit
           integers by multiplying them by 100 and rounding to the nearest integer. If all the integral
           weights thus generated are divisible by the smallest weight, they are each divided by that
           smallest weight. For example, if the original weights were 0.1, 0.2, 0.3, and 0.4, the
           resulting integral weights would be 10/10,  20/10, 30/10, and 40/10 (or 1, 2, 3, and 4).

           BenMAP then creates a new distribution by sampling each entire input distribution
           according to its weight. That is, in the above example the first distribution would be
           sampled once, the second distribution twice,  and  so forth.  The advantage of sampling
           whole distributions is that it preserves the characteristics (i.e., the  moments - the mean, the
           variance, etc.) of the underlying distributions. Assuming n latin hypercube points, the
           resulting distribution will contain a maximum of 100 * n values, which are then sorted low
           to high and binned down to n values, which will represent the new, pooled distribution.
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           Round Weights to Three Digits

           This Advanced Pooling Method is essentially the same as rounding weights to two digits,
           except that the weights are converted to three digit integers, and so forth.  That is, the
           weights are multiplied by 1000 and rounded to the nearest integer. Again, if all the integral
           weights thus generated are divisible by the smallest weight, they are each divided by that
           smallest weight. Assuming n Latin Hypercube points, the resulting distribution with this
           Advanced Pooling Method can contain a maximum of 1000 * n values, which are sorted
           low to high and binned down to n values, which represent the new, pooled distribution.

           Exact Weights for Monte Carlo

           This Advanced Pooling Method uses a Monte Carlo method to  combine the input
           distributions.  Using this method, on each of many iterations, (1) an input distribution is
           selected (with the probability of selection equal to the weight assigned to the distribution),
           and (2) a value is randomly drawn from that distribution.  Values  chosen in this way are
           placed into a temporary pooled distribution, which will have one point per iteration of the
           Monte Carlo method.  The number of iterations is specified by the user, and defaults to
           5,000.  After the temporary distribution is fully generated, it is sorted low to high and
           binned  down to n values (where n is the number of Latin Hypercube Points chosen for the
           analysis).

J.2.3   Summing Distributions

           Sometimes rather than pooling distributions we want to add them. For example, some
           studies have estimated a health impact function for hospital admissions for COPD and
           another health impact function for hospital admissions for pneumonia. From each of these
           health impact functions, BenMAP can derive the corresponding distributions for incidence
           change. Hospital admissions for COPD and pneumonia are two of the most important
           components of respiratory hospital  admissions, and we may want to estimate the number of
           cases of "respiratory hospital admissions," as characterized by being either COPD or
           pneumonia. To do this we would add the two distributions.

           Summing across distributions can be done in one of two ways: We can assume the two
           distributions are independent of each other or dependent.  Which is the more reasonable
           assumption depends on the particulars of the distributions being summed.

           Assuming Independence

           This is  the Sum (Independent) Pooling Method. To sum two distributions that are
           independent, on each of many iterations of a Monte Carlo procedure, BenMAP (1)
           randomly selects a value from the first input distribution,  (2) randomly selects a value from
           the second input distribution, and (3) adds the two values together. To sum N distributions
           that are independent, BenMAP follows an analogous procedure in which, on each iteration
           it makes a random selection from each of the input distributions and then adds the results
           together.  When the Monte Carlo procedure is completed, all such generated results are
           sorted low to high  and binned down to the appropriate number of latin hypercube points.
           The number of iterations is determined by the Monte Carlo Iterations setting.
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           Assuming Dependence

           This is the Sum (Dependent) Pooling Method. Recall that the uncertainty distributions in
           BenMAP are latin hypercube representations, consisting of N percentile points.  To sum
           two distributions assumed to be dependent, BenMAP simply generates a new N point latin
           hypercube where each point is the sum of the corresponding points from the input latin
           hypercubes. That is, the first point in the new latin hypercube is the sum of the first points
           in the two input latin hypercubes, and so forth. To sum n distributions that are assumed to
           be dependent, BenMAP follows an analogous procedure in which each point in the new
           latin hypercube is the sum of the corresponding points from each of the input latin
           hypercubes.

J.2.4   Subtracting Distributions

           In some cases, you may want to subtract one or more distribution(s) from another. For
           example,  one  study may have estimated a health impact function for minor restricted
           activity days (MRADs), and another study may have estimated a health impact function for
           asthma "episodes." You may want to subtract the change in incidence of asthma episodes
           from the change in incidence from MRADs before estimating the monetary value of the
           MRADs,  so that the monetary value  of asthma episodes avoided will not be included.

           Subtracting across distributions can be done in one of two ways: we can assume the two
           distributions are independent of each other or dependent.  Which is the more reasonable
           assumption depends on the particulars of the distributions being subtracted.

           Assuming Independence

           This is the Subtraction (Independent) Pooling Method.  To subtract one distribution from
           another, assuming independence, on each of many iterations of a Monte Carlo procedure,
           BenMAP (1) randomly selects a value from the first input distribution, (2) randomly
           selects a value from the second input distribution, and (3) subtracts the second value from
           the first.  To subtract N distributions from another distribution, assuming independence,
           BenMAP follows an analogous procedure in which, on each iteration it makes a random
           selection  from each of the input distributions and then subtracts the second through the Nth
           from the first. When the Monte Carlo procedure is completed, all such generated results
           are sorted low to high and binned down to the appropriate number of Latin Hypercube
           points. The number of iterations is determined by the Monte Carlo Iterations setting.

           Assuming Dependence

           This is the Subtraction (Dependent) Pooling Method (see Chapter 6 for details). Recall
           that the uncertainty distributions in BenMAP are Latin Hypercube representations,
           consisting of N percentile points. To subtract one distribution from another,  assuming
           them to be dependent, BenMAP simply generates a new N point Latin Hypercube where
           each point is the result of subtracting the corresponding point of the second input Latin
           Hypercube from the corresponding point of the first input Latin Hypercube.  That is, the
           first point in the new Latin Hypercube is the result of subtracting the first point in the
           second Latin Hypercube from the first point of the first Latin Hypercube, and so forth.  To
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                                                   Appendix J: Uncertainty & Pooling
subtract n distributions from another distribution, assuming dependence, BenMAP follows
an analogous procedure in which each point in the new Latin Hypercube is the result of
subtracting the corresponding points of the second through the Nth input Latin Hypercubes
from the corresponding point of the first.
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                                                         Appendix K: Command Line Ben MAP
        Appendix K:  Command Line BenMAP

          The command line version of BenMAP is capable of performing all of the functions of the
          GUI-based version. It is most useful for large, complex analyses that require generation of
          a substantial number of files. This appendix describes the syntax and use of the command
          line version.

K.1     Overview

          The overall format of the file is a variable definitions section followed by a commands
          section.

          Comment statements are supported at any point in the file. Lines beginning with a pound
          character (#) are considered comment lines and will be ignored during file parsing.

          Additionally, LOAD  statements are supported at any point in the file. These
          work as string replacements - the contents of the file specified by  are simply
          inserted into the main file. Multi-level LOAD statements are supported, but no attempt is
          made to detect cycles (two files referencing each other with LOAD statements, for
          example).

          The control file is, in general, not case sensitive. In the case of user-defined strings,
          (variable values, etc.), it is preserved.

K.2    Variables

          The variable definitions section is optional, and if present will consist of a single line with
          the word "Variables"  on it, followed by one or more lines that define variables. A variable
          definition consists of a variable name and a variable value. When parsing lines in the
          commands section of the control file, all occurrences of the variable name will be replaced
          by the variable value.

          All variable names must begin and end with the percent character (%).

          Variable Name/Value replacement will be done in multiple passes (until no variable names
          remain), so variable values may contain other variable names.  No attempt will be made to
          detect cycles, however, so be careful not to introduce them. For example, avoid variable
          definitions like the following:
          %BENMAPDIR%        %AQGDIR%\

          %AQGDIR%            %BENMAPDIR%\Air Quality Grids



          Variable values must be contained in a single line, and will consist of the first
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                                                          Appendix K: Command Line Ben MAP
          non-whitespace character after the variable name through the newline character. Watch
          out for undesired trailing whitespaces!

K.3    Commands

          The commands section is required, and will consist of one or more command sections.
          There are five types of command sections:
              SETACTIVESETUP

              CREATE AQG

              RUN CFG

              RUN APV

              GENERATE REPORT


          This section will discuss each one in turn.

          In general, in command sections, there must be at least one white space between each
          token (where a token is either a command, a parameter name, or a parameter value).
          Additional white space is ignored, including newline characters.  To include white space in
          a parameter value, you must enclose the parameter in double quotes. The double quotes
          will not be included in the parameter value in this case (If you wish to include beginning
          and trailing double quotes in a parameter value, put two in a row at the beginning and end
          - e.g. ""Look at all those double quotes."").

K.3.1   Set Active Setup

          For the US version of the BenMAP command line executable the only valid value is
          United States.  The SETACTIVESETUP section is required.

          Example

              -ActiveSetup "United States"

K.3.2   Create AQG

          This section initiates the creation of one or more air quality grids (normally one, potentially
          two in the case of monitor rollback grid creation - see below).  It always starts with the
          words CREATE AQG. It must then include the following options, in any order:


              -Filename 
              -Gridtype 
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                                                          Appendix K: Command Line Ben MAP
              -Pollutant 
          The Filename value is the name of the air quality grid that will be created.
          The GridType value must be one found in the BenMAP database.  The actual values for
          this parameter are found on the Modify Setup screen in the Grid Definitions list box.
          Supported Pollutant values are:
              -Ozone
              -PM10
              -PM2.5

          These values are also found on the Modify Setup screen in the Pollutants list box.
          After these required options, the type of grid creation must be identified, and then the
          parameters for that grid creation type must be specified.  There are four air quality grid
          creation types:
              -ModelDirect
              -MonitorDirect
              -MonitorModelRelative
              -MonitorRollback

K.3.2.1 ModelDirect
          This section initiates the creation of a model direct air quality grid.
          This creation type has two required parameters:
              -ModelFilename 
              -DSNName  


          and one optional parameter:
              -TableName  


          Supported DSNName values are:
              "Excel Files"               Excel Spreadsheet (.xls)
              "Text Files"                Comma-delimited (.csv) files
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              "MS Access Database"      Access Database (.mdb)


          If the DSNName is "Excel Files" and there is more than one worksheet in the workbook or
          "MS Access Database" and there is more than one table in the database then the
          TableName parameter must indicate the worksheet or table name.

K.3.2.2 Monitor Direct
          This section initiates the creation of a monitor direct air quality grid.


           The required parameters are:
              -MonitorDataType 
              -InterpolationMethod 

          Valid values for MonitorDataType are:
                     -Library
              -DatabaseRows
              -DatabaseColumns
              -TextFile

          Valid values for Interpolation method are:
              -ClosestMonitor
              -VNA

          If MonitorDataType is Library then the following parameters are required:
              -MonitorDataSet 
               MonitorDataSet is the Dataset name of Monitor data stored in the BenMAP database.
          These values can be found on the Modify Setup screen in Monitor Datasets list box.
              -MonitorYear 
               Monitor Year specifies the year of interest in the monitor library.


          If MonitorDataType is DatabaseRows then the following parameters are required:
              -MonitorFile    
              -DSNName    
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                                                Appendix K: Command Line Ben MAP
and one optional parameter:

    -TableName  


Supported DSNName values are:

    -"Excel Files"                Excel Spreadsheet (.xls)
    -"Text Files"                Comma-delimited (.csv) files
    -"MS Access Database"Access Database (.mdb)
If the DSNName is "Excel Files" and there is more than one worksheet in the workbook or
"MS Access Database" and there is more than one table in the database then the
TableName parameter must indicate the worksheet or table name.

If MonitorDataType is DatabaseColumns then the same parameters for MonitorDataType
DatabaseRows are required along with the following:

    -MonitorDefFilename
    -DefDSNName
    -DefTableName
These parameters behave the same as the corresponding DatabaseRows parameters.

If MonitorDataType is TextFile the following parameter is required:

    -MonitorFile 
    MonitorFile specifies a comma separated values (*.csv, generally) file containing monitor
data.


Optional Parameters:
    -MaxDistance 
    Specifies the maximum distance (in kilometers) to be used in ClosestMonitor
interpolation or VNA interpolation.  Monitors outside this distance will not be considered
in the interpolation procedure.

    -MaxRelativeDi stance 

    Specifies the maximum relative distance to be used in VNA interpolation, where
relative distance is the multiple of the distance to the closest monitor used in the
interpolation procedure.

    -WeightingMethod 
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                                                          Appendix K: Command Line Ben MAP
              Specifies the weighting procedure used for monitors in VNA interpolation. Supported
          values are InverseDi stance and InverseDi stance Squared.  If this parameter is not specified,
          InverseDistance weighting is used.

K.3.2.3 Monitor Model Relative

          This section initiates the creation of a monitor model relative air quality grid. This
          creation type has all the same required and optional parameters as the MonitorDirect
          creation type. In addition, it has two/three new required parameters.
          Required Parameters:

              -ScalingMethod 

               Supported scaling methods are Spatial, Temporal, and Both.

              -BaseYearFilename 

              Specifies the base year adjustment file to use in monitor scaling.

              -BaseYearDSNName 

               Supported -BaseYearDSNName values are

               "Excel Files"               Excel Spreadsheet (.xls)

              "Text Files"                Comma-delimited (.csv) files

              "MS Access Database"      Access Database (.mdb)


          When the ScalingMethod is Temporal or Both, the FutureYearFileName and
          FutureYearDSNName parameters are required.  These specify the future year adjustment
          file to use in monitor scaling.

K.3.2.4 Monitor Rollback

          // MonitorRollback

          Spatial Scaling    = '-Spatial Scaling';

          BaselineFilename   = '-BaselineFilename';


          // RollbackOptions

          Percentage      = '-Percentage';

          Increment       = '-Increment';
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                                                            Appendix K: Command Line Ben MAP
           // RollbackToStandardOptions
           Standard       = '-Standard';
           Metric        =  '-Metric';
           Ordinality      = '-Ordinality';
           InterdayRollbackMethod = '-InterdayRollbackMethod';
           IntradayRollbackMethod = '-IntradayRollbackMethod';
K.3.3   Run CFG
           The command line version of BenMAP does not support creation of new .cfg files, both
           because this would be quite cumbersome to do in plain text, and because it probably is not
           needed. Slight modifications of existing .cfg files are supported, and it is thought that at
           this point this should be enough.
           As such, the only required parameter to run a configuration is the configuration filename.
           Optional parameters allow the slight modifications mentioned above.
           Required Parameters
               -CFGFilename 
                Specifies the .cfg file to run.
               -ResultsFilename 
                Specifies the .cfgr file to save the results in.

           Optional Parameters
               -BaselineAQG 
                Specifies the baseline air quality grid file to use when running the configuration - overrides
           whatever value is    present in the .cfg file.
               -ControlAQG 
                Specifies the control air quality grid file to use when running the configuration - overrides
           whatever value is    present in the .cfg file.
               -Year 
                Year in which to run the configuration (this will affect the population numbers used) -
           overrides whatever  value is present in the  .cfg file. Supported values are 1990 and up.
               -LatinHypercubePoints 
                Number of latin hypercube points to generate when running the configuration (zero means
           run in point mode),  overrides whatever value is present in the .cfg file.
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                                                              Appendix K: Command Line Ben MAP
               -Threshold 
               Threshold to use when running the configuration - overrides whatever value is present in the
           .cfg file.
K.3.4   Run APV
           The command line version of BenMAP does not support creation of new .apv files, both
           because this would be quite cumbersome to do in plain text, and because it probably  is not
           needed.  Slight modifications of existing .apv files are supported, and it is thought that at
           this point this should be enough.
           As such, the only required parameter to run an APV configuration is the APV
           configuration filename. Optional parameters allow the slight modifications mentioned
           above.
           Required Parameters
               -APVFilename 
                Specifies the .apv file to run.
               -ResultsFilename 
               Specifies the .apvr file to save the results in.

           Optional Parameters
               -CFGRFilename 
               Specifies the .cfgr file to use when running the APV configuration - note that this file must
           contain the same set of results which the .cfgr file originally used to generate the .apv file
           contained. Overrides whatever value is      present in the .apv file.
               -IncidenceAggregation 
               Level to aggregate incidence results to before pooling them. Supported values are None,
           County, State, and  Nation.  Overrides whatever value is present in the .apv file.
               -ValuationAggregation 
               Level to aggregate valuation results to before pooling them. Supported values are None,
           County, State, and  Nation (though the value must be greater than or equal to
           IncidenceAggregation). Overrides whatever value is present in the .apv file.
               -RandomSeed 
               Random seed to use for all procedures requiring pseudo-random numbers (e.g. monte carlo
           procedures).               Overrides the default behavior, which is to generate a new random
           seed each time the APV configuration is     run.
               -DollarYear 
               Year in which dollar figures should be reported. Supported values are 1980 - 2001.
           Overrides whatever value   is present in the .apv file.
                                                                                     September 2008
                                              381

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                                                           Appendix K: Command Line Ben MAP
K.3.5   Generate Report
           Reports come in three main varieties - Audit Trail Reports, which can be generated from
           any BenMAP file; Configuration Results Reports, which can be generated from .cfgr files;
           and APV Configuration Results Reports, which can be generated from .apvr files. All
           these report types need an input filename and an output filename.  CFGR reports and
           APVR reports additionally take many optional parameters.
           The format for each report type is:


           GENERATE REPORT 


               -InputFile 
               -ReportFile 
               


           Supported ReportType values are: AuditTrail, CFGR, and APVR.

K.3.5.1 AuditTrail
           Audit trail reports require only the parameters described in the "Generate Report" section.

K.3.5.2 CFGR Report
           A CFGR report may be generating using only the parameters described in the "Generate
           Report" section. However, there are also a number of additional options, described below.


           Optional Parameters
               -GridFields 
               Specifies the set of grid fields to include in the report. Grid fields include Column and Row.
           If this parameter is  not present, all fields will be included in the report.
               -CustomFields 
               Specifies the set of custom fields (C-R Function identifiers, in this case) to include in the
           report. If this             parameter is not present, all fields will be included in the report.
               -ResultFields 
               Specifies the set of result fields to include in the report. Result fields include Point Estimate,
           Population, Delta,  Mean, Standard Deviation, Variance, and Latin Hypercube Points. If this
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                                            382

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                                                          Appendix K: Command Line Ben MAP
          parameter is not present, all fields will      be included in the report.
              -Grouping 
              Specifies the grouping for the results - Gridcell, then C-R Function, or C-R Function, then
          Gridcell. Supported values are GridcellFirst, GridcellLast. The default value is GridcellFirst.
              -DecimalDigits 
              Specifies the number of digits after the decimal point to include in the report. Supported
          values are zero to eight.     The default value is four.

K.3.5.3 APVR Report

          Required Parameters

          APVR Reports require one additional parameter beyond those required for Audit Trail or
          CFGR Reports.

              -ResultType 

          Specifies the result type for which a report should be created. Supported result types are:
          IncidenceResults, Aggregatedlncidence, Pooledlncidence, Valuation, Aggregated Valuation,
          PooledValuation, QALYValuation, AggregatedQALYValuation and
          PooledQALYValuation.
          Optional Parameters

          All of the CFGR report parameters are supported for APVR reports as well, except that
          Population and Delta are not supported ResultField elements.

              -Totals 

          Specifies the type of totals which should be included in the report. Supported types are
          Dependent and Independent.  Totals can only be generated for valuation results (Valuation,
          Aggregated Valuation, and PooledValuation result types).

K.4    Example  1
           VARIABLES

           %CFG%                C:\BenMAP\Commandl_ine\Configurations\PM25 Wizard.cfg
           %APV%                C:\BenMAP\Commandl_ine\Configurations\PM25 Wizard.apv
           %RESULTSDIR%        C:\BenMAP\Temp
           %REPORTDIR%         C:\BenMAP\Temp
           %AQG%                C:\BenMAP\Commandl_ine\Air Quality Grids

           COMMANDS

           SETACTIVESETUP
                                                                               September 2008
                                           383

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                                              Appendix K: Command Line Ben MAP
   -ActiveSetup

CREATE AQG

   -Filename
   -GridType
   -Pollutant
"United States"
%AQG%\PM25_2002Baseline_50km.aqg
"CMAQ12km"
PM2.5
   MonitorDirect
   -InterpolationMethod    VNA_Alt
   -MonitorDataType      Library
   -MonitorDataSet
   -MonitorYear          2002
   -MaxDistance         50
CREATE AQG

   -Filename
   -GridType
   -Pollutant
      "EPA Standard Monitors"
%AQG%\PM25_2002Control_50km.aqg
"CMAQ12km"
PM2.5
   MonitorRollback
   -InterpolationMethod    VNA_Alt
   -MonitorDataType      Library
   -MonitorDataSet
   -MonitorYear          2002
   -RollbackGridType     State
   -MaxDistance         50
      "EPA Standard Monitors"
   RollbackToStandardOptions

   -Standard            65
   -Metric              D24HourMean
   -InterdayRollbackMethod      Quadratic
RUN CFG
   -CFGFilename
   -ResultsFilename
   -BaselineAQG
   -ControlAQG
%CFG%
%RESULTSDIR%\PM25_2002_50km.cfgr
%AQG%\PM25_2002Baseline_50km.aqg
%AQG%\PM25_2002Control_50km.aqg
RUN APV
   -APVFilename        %APV%
   -ResultsFilename      %RESULTSDIR%\PM25_2002_50km.apvr
   -CFGRFilename       %RESULTSDIR%\PM25_2002_50km.cfgr
   -IncidenceAggregation  Nation
   -ValuationAggregation  Nation

GENERATE REPORT APVR
   -InputFile
   -ReportFile
%RESULTSDIR%\PM25_2002_50km.apvr
%REPORTDIR%\PM25 2002 50km IncidenceNation.csv
                               384
                                                                   September 2008

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                                                          Appendix K: Command Line Ben MAP
              -ResultType
              -CustomFields
           Window"
              -ResultFields
              -DecimalDigits
Pooledlncidence
"Endpoint Group,Author,Start Age,Endpoint,Qualifier,Pooling

"Mean,Standard Deviation,Latin Hypercube Points"
 0
           GENERATE REPORT APVR
              -InputFile
              -ReportFile
              -ResultType
              -CustomFields
           Window"
              -ResultFields
              -DecimalDigits
K.5    Example 2
%RESULTSDIR%\PM25_2002_50km.apvr
%REPORTDIR%\PM25_2002_50km_ValuationNation.csv
 PooledValuation
"Endpoint Group,Author,Start Age,Endpoint,Qualifier,Pooling

"Mean,Standard Deviation,Latin Hypercube Points"
0
           VARIABLES

           %CFG%
           %APV%
           %RESULTSDIR%
           %REPORTDIR%
           %AQG%

           COMMANDS

           SETACTIVESETUP

              -ActiveSetup

           CREATE AQG

              -Filename
              -GridType
              -Pollutant

              MonitorDirect

              -InterpolationMethod
              -MonitorDataType
              -MonitorDataSet
              -MonitorYear

           CREATE AQG

              -Filename
              -GridType
              -Pollutant

              MonitorRollback

              -InterpolationMethod
              -MonitorDataType
C:\BenMAP\CommandLine\Configurations\PM25 Wizard.cfg
C:\BenMAP\CommandLine\Configurations\PM25 Wizard.apv
C:\BenMAP\Temp
C:\BenMAP\Temp
C:\BenMAP\CommandLine\Air Quality Grids
"United States"
%AQG%\PM25_2004Baseline.aqg
"County"
PM2.5
VNA_Alt
Library
       "EPA Standard Monitors"
2004
%AQG%\PM25_2004_Control.aqg
"County"
PM2.5
VNA_Alt
Library
                                            385
                                                                                September 2008

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                                               Appendix K: Command Line Ben MAP
   -MonitorDataSet             "EPA Standard Monitors"
   -MonitorYear         2004
   -RollbackGridType     State
   -MaxDistance         50
   RollbackToStandardOptions

   -Standard            35
   -Metric              D24HourMean
   -InterdayRollbackMethod       Quadratic
RUN CFG
   -CFGFilename        %CFG%
   -ResultsFilename      %RESULTSDIR%\PM25_2004.cfgr
   -BaselineAQG        %AQG%\PM25_2004Baseline.aqg
   -ControlAQG         %AQG%\PM25_2004Control.aqg

RUN APV

   -APVFilename        %APV%
   -ResultsFilename      %RESULTSDIR%\PM25_2004.apvr
   -CFGRFilename      %RESULTSDIR%\PM25_2004.cfgr
   -IncidenceAggregation  Nation
   -ValuationAggregation  Nation

GENERATE REPORT APVR

   -InputFile            %RESULTSDIR%\PM25_2004.apvr
   -ReportFile           %REPORTDIR%\PM25_2004_lncidenceNation.csv
   -ResultType          Pooledlncidence
   -CustomFields        "Endpoint Group,Author,Start Age,Endpoint,Qualifier,Pooling
Window"
   -ResultFields         "Mean,Standard Deviation,Latin Hypercube Points"
   -DecimalDigits         0

GENERATE REPORT APVR

   -InputFile            %RESULTSDIR%\PM25_2004.apvr
   -ReportFile           %REPORTDIR%\PM25_2004_ValuationNation.csv
   -ResultType           PooledValuation
   -CustomFields        "Endpoint Group,Author,Start Age,Endpoint,Qualifier,Pooling
Window"
   -ResultFields         "Mean,Standard Deviation,Latin Hypercube Points"
   -DecimalDigits        0
                                                                     September 2008
                                386

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                                                                  Appendix L: Function Editor
        Appendix L: Function Editor
           The function editor is used to develop both health impact functions and valuation
           functions. This appendix describes the syntax of this editor.
L.1     User Defined Variables

           In addition to pre-defined variables that you can select from the Available Variables list,
           you can create your own variables in the C-R Function Editor.

           A variable is an identifier whose value can change at runtime. Put differently, a variable is
           a name for a location in memory; you  can use the name to read or write to the memory
           location. Variables are like containers for data, and, because they are typed, they tell the
           compiler how to interpret the data they hold.

           The basic syntax for a variable declaration is

           var identifierList: type;

           where identifierList is a comma-delimited list of valid identifiers and type is any valid
           type. For example,

           var I: Integer;

           declares a variable I of type Integer, while

           var X,Y: Real;

           declares two variables—X and Y—of type Real.

           Consecutive variable declarations do not have to repeat the reserved word var:

           var

              X, Y, Z: Double;

              I,  J, K: Integer;

              Digit: 0..9;

              IndicatorName: String;

              Okay: Boolean;

           Variables can be initialized at the same time they are declared, using the syntax

           var identifier: type = constantExpression;

           where constantExpression is any constant expression representing a value of type type.
           Thus the declaration
                                                                                September 2008
                                            387

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                                                                       Appendix L: Function Editor
           var I: Integer = 7;
           is equivalent to the declaration and statement
           var I: Integer;


           I:=7;
           Multiple variable declarations (such as var X, Y, Z: Real;) cannot include initializations, nor
           can declarations of variant and file-type variables.

L.2    The Script Language
           In the C-R Function Editor, you can evaluate complex block of statements.
           You can use constructions like:
           If...then...else;
           for I:= ... to .. do ;
           while... do ;
           repeat.... until...;
           break;
           assignment (...:=....;)
           try...finally...end;
           try...except...end;
           Each function you create can be a single statement or a block of statements.
           When you specify it as a block of statements, your script must conform to the rules of the
           script language, as follows:
           1. Each single statement must end with a semicolon (;)
           2. You can use the following statements:
                variable := expression;
                If logical expression  then statement(s) [else statement(s)};
                for variable := from_expression to/downto to_expression do statement(s);
                while logical_expression do statement(s);
                repeat statement(s) until logical_expression;
                try statement(s) finally statement(s) end;
                try statement(s) except statement(s) end;
                inline comments:  // comment... until the end of the line
                                                                                      September 2008
                                               388

-------
                                                                   Appendix L: Function Editor
               nested comments:  { nested comment }

           Statement(s) in the above declarations states that you can specify either a single statement
           or a block of statements. The block of statements must be enclosed in begin ... end
           keywords. It is not necessary to enclose the body of the function in begin .. end. Cycle
           statements can use break keyword to break the cycle (break must also end with
           semicolon.)

L.3     Operands

           Expressions may contain the following constant and variable types:

           Integer numbers;
           Floating point numbers;
           Scientific numbers;


           Decimal separator for all floating point and scientific-format numbers in expressions, is
           independent of the Regional Settings of Windows and always is a decimal point ('.').

           Boolean values - TRUE or FALSE;

           Date type values - values of that type must be put in quotes (''), and also date separator
           character is independent of the Regional Settings of Windows and always is a slash - /, i.e.
           - '01/01/2005'

           String values - values of that type must be put in double quotes (" "); If a string contains
           double quotes, you should double them(i.e., "this is a ""string	);

L.4     Operations

           Arithmetical

               + - * /•
                ; ;  ; ' ;
               div - integer division;

               mod - modulo;

               A - power of;

               - - negate;

           Logical

               <, <=, >=, >, o, =;
               and, or, xor,  not;

           Bitwise
                                                                                 September 2008
                                            389

-------
                                                               Appendix L: Function Editor
              and, or, xor;

              ~ - negate;

L.5    Arithmetic Functions
          ABS(X)

          SQR(X)

          SQRT(X)

          SIGN(X)


          ZERO(X)

          TRUNC(X)=INT(X)

          FRAC(X)

          ROUND(X)


          CEIL(X)

          FLOOR(X)


          DEC(X)


          INC(X)


          ARG(X,Y)

          RADIUS(X,Y)

          POWER(X,Y)


          IPOWER(X,Y)


          XAY


          EXP(X)
absolute value

square = XA2 = X*X

square root

sign of X; =1 for X>0, =0 for X=0,
=-1 forX<0

=OforX=0, =lforX<>0

integer part

fractional part

rounds X to the nearest integer
value

always returns "ceil" integer value

always returns "floor" integer
value

decrements a value X by 1 and
returns a new value

increments a value X by 1 and
returns a new value

argument(phase) of X and Y

= sqrt(sqr(X)+sqr(Y))

raises X to a power of Y (Y is a
floating point value)

raises X to a power of Y (Y is a
integer value)

raises X to a power of Y (same as
above two functions)

exponent
                                         390
                                                                            September 2008

-------
                                                              Appendix L: Function Editor
          LN(X)
          LG(X)
          LOG(X)
          SIN(X)
          COS(X)
          TAN(X)
          COTAN(X)
          ASIN(X)
          ACOS(X)
          ATAN(X)
          SINH(X)
          COSH(X)
          TANH(X)
natural logarithm
decimal logarithm
base 2 logarithm
sine
cosine
tangent
cotangent
arcsine
arccosine
arctangent
hyperbolic sine
hyperbolic cosine
hyperbolic tangent
L.6    Aggregate Functions

          AVG(X1,X2,...)   returns average value of (unlimited number of) arguments.
          MAX(X1,X2,...)  maximum of (unlimited number of) arguments.
          MIN(X1,X2,...)   minimum of (unlimited number of) arguments.
          SUM(X1,X2,...)   sum of (unlimited number of) arguments.
          PROD(X1,X2,..)  product of (unlimited number of) arguments.
                                         391
                                                                           September 2008

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                                                                         References
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