&EPA

United States
Environmental Protection

Agency	EPA/600/R-24/252 I September 2024 I

Integrated Science Assessment (ISA) for Ozone and Related Photochemical Oxidants I US EPA

Proceedings for the Ozone National Ambient Air
Quality Standards Science and Policy Workshop


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Proceedings for the Ozone National Ambient
Air Quality Standards Science and Policy

Workshop

By

Office of Research and Development
Center for Public Health and Environmental Assessment

Office of Air and Radiation
Office of Air Quality Planning and Standards

Research Triangle Park, Durham, NC 27713

ICF

Reston, VA 20190

Contract Number: 68HERC19D0003


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Disclaimer

This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and
approved for publication. The views expressed by workshop participants are their own, and do not necessa
reflect those of the U.S. Environmental Protection Agency.


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Introduction

The last statutory periodic review of the air quality criteria and National Ambient Air Quality Standards
(NAAQS) for ozone (03) and related photochemical oxidants was completed in 2020. In December 2020,
the EPA issued its final decision to retain the existing 03 NAAQS without revision. In October 2021, the
U.S. Environmental Protection Agency (EPA) announced a reconsideration of the December 2020
decision. As part of the reconsideration, the EPA established a Clean Air Scientific Advisory Committee
(CASAC) Ozone Review Panel, which provided advice to the EPA Administrator on science and policy
documents through the CASAC. After carefully considering the CASAC's advice, the Administrator
announced a new review of the 03 NAAQS to ensure the standards reflect the most current, relevant
science. The EPA is incorporating the ongoing reconsideration into the new review of the 03 NAAQS and
the underlying air quality criteria.

The new review of the 03 NAAQS and air quality criteria was announced in August 2023. As part of the
planning phase of this review, the EPA held a virtual public workshop May 13-16, 2024, to inform
planning for the new review of the air quality criteria and the primary (health-based) and secondary
(welfare-based) 03 NAAQS. This workshop provided the EPA with an opportunity to receive input and
advice on key science and policy issues for the review.

Participants invited to the workshop included experts internal and external to the EPA. These experts
represented a variety of disciplines, including epidemiology; controlled human exposure studies; animal
toxicology; ecology; statistics; biological, environmental, and physical sciences; atmospheric and climate
science; human exposure science; and risk analysis. Workshop participants were invited to review
several documents developed in the last review of the 03 NAAQS and from the reconsideration. They
were asked to highlight significant new and emerging policy-relevant research on 03 and related
photochemical oxidants and to discuss how new evidence can build on the analyses and scientific
findings from the last review of the 03 NAAQS.

Workshop discussions will inform the development of planning and assessment documents intended to
serve as the foundation for the Agency's current review of the 03 NAAQS. These documents will include
the Integrated Review Plan, which will highlight the key policy-relevant issues and summarize
anticipated assessment approaches; the Integrated Science Assessment, which will summarize and
assess the most policy-relevant scientific evidence and make key science judgments; and quantitative air
quality, risk, and exposure analyses, as warranted.

This document is intended to serve as a high-level summary of important topics discussed during the
four-day workshop and to document new, potentially relevant research identified over the course of the
workshop.

Each session was organized by topics that included a series of discussion questions for the panel of
subject matter experts to discuss. Following each session was a question-and-answer period, in which
the participants and the public could offer additional thoughts and topic-related questions or scientific
literature.


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Table of Contents

Disclaimer	ii

Introduction	ii

Acronyms and Abbreviations	v

Summary of Sessions and Questions	1

Monday, May 13, 2024	1

Purpose of Meeting	1

Introduction to the NAAQS	1

Session 1: Characterizing 03 Chemistry and Transport, Air Quality Patterns, and 03 as a Greenhouse Gas... 2

Tuesday, May 14, 2024	10

Session 1: Planning for the Review of the Welfare Effects Evidence and Analyses: Review of Welfare Effects
Evidence	10

Session 2: Welfare Risk and Exposure Assessment	14

Wednesday, May 15, 2024	18

Session 1: Human Exposure to Ambient 03	18

Session 2: Planning for the Review of Health Effects Evidence: Emerging Evidence and Interpretation	20

Session 3: Planning for the Review of Health Effects Evidence: Evidence Integration	23

Thursday, May 16, 2024	26

Session 1: Planning for the Review of Health Effects Evidence: Public Health Implications	26

Session 2: Planning for the Review of Human Exposure and Health Risk Assessments	28

Appendix A: Attendance	32

Appendix B: Simple Public Agenda:	39

Workshop to Inform Review of the Ozone National Ambient Air Quality Standards	39

Appendix C: Detailed Agenda for Chairs/Panelists:	42

Day 1, May 13, 2024	42

Day 2, May 14, 2024	44

Day 3, May 15, 2024	48

Day 4, May 16, 2024	52

Bibliography	56

Characterizing Ozone Chemistry and Transport, Air Quality Patterns, and Ozone as a Greenhouse Gas-
May 13, 2024	56

Planning for the Review of the Welfare/Ecological Effects Evidence - May 14, 2024	72

Welfare Risk and Exposure Assessment - May 14, 2024	78

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Human Exposure to Ambient O3 - May 15, 2024	80

Planning for the Review of Health Effects Evidence: Emerging Evidence and Interpretation - May 15, 2024
	83

Planning for the Review of Health Effects Evidence: Evidence Integration - May 15, 2024	84

Planning for the Review of Health Effects Evidence: Public Health Implications - May 16, 2024	86

Planning for the Review of Human Exposure and Health Risk Assessments - May 16, 2024	95

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Acronyms and Abbreviations

Abbreviation	Term

AgMIP	Agricultural Model Intercomparison and Improvement Project

AI/ML	artificial intelligence and machine learning

CAA	Clean Air Act

CASAC	Clean Air Scientific Advisory Committee

CHAD	Consolidated Human Activity Database

CMAQ	Community Multiscale Air Quality Model

COVID	coronavirus disease

CPHEA	Center for Public Health and Environmental Assessment

CTM	chemical transport model

EJ	environmental justice

EPA	Environmental Protection Agency

FACE	free-air carbon dioxide enrichment

FIA	forest inventory analysis

HAP	hazardous air pollutants

hrs	hours

ISA	Integrated Science Assessment

MCC	multi-country multi-city

NPS	National Park Service

NO	nitric oxide

N02	nitrogen dioxide

NOx	nitric oxide and nitrogen dioxide

03	ozone

OAR	Office of Air and Radiation

ORD	Office of Research and Development

OTC	open top chamber

PM	particulate matter

Ppb	parts per billion

RBL	relative biomass loss

REA	Risk and Exposure Assessment

RF	radiative forcing

SME	subject matter expert

SOF	stomatal ozone flux

USDA	United States Department of Agriculture

U.S.	United States

VNA	Voronoi Neighbor Averaging

VOC	volatile organic compound

VCP	volatile chemical product

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Summary of Sessions and Questions
Monday, May 13, 2024

Purpose of Meeting

At the start of the workshop, the EPA noted for the audience the purpose of the workshop was to
discuss policy-relevant science that will inform the EPA's current review of the air quality criteria and the
NAAQS for 03 and related photochemical oxidants. Workshop participants were asked to discuss recent
science and key policy issues on 03 and related photochemical oxidants. Input from this workshop will
be considered during subsequent steps of the 03 NAAQS review process.

Introduction to the NAAQS

The NAAQS are intended to protect the public health and public welfare against harmful effects of
exposures to the "criteria" air pollutants. The criteria pollutants include 03 and related photochemical
oxidants, carbon monoxide, oxides of nitrogen, particulate matter, lead, and oxides of sulfur. The EPA
establishes and periodically reviews NAAQS under Sections 108 and 109 of the Clean Air Act (CAA).
Section 109(b)(1) of the CAA defines primary NAAQS as standards "the attainment and maintenance of
which in the judgment of the Administrator, based on such [air quality] criteria and allowing an
adequate margin of safety, are requisite to protect the public health." Under Section 109(b)(2), a
secondary NAAQS must "specify a level of air quality the attainment and maintenance of which in the
judgment of the Administrator, based on such criteria, is requisite to protect the public welfare from any
known or anticipated adverse effects associated with the presence of [the] pollutant in the ambient air."
The first Air Quality Criteria for Photochemical Oxidants document was issued in 1970 and the first
NAAQS for photochemical oxidants was published in 1971.

The three-phased NAAQS review process involves planning, assessment, and decision-making. The
planning phase includes this type of workshop and the development of an Integrated Review Plan. The
assessment phase includes development of an Integrated Science Assessment (ISA), a Policy Assessment
(PA) and, as warranted, quantitative air quality, risk, and exposure analyses. The decision-making phase
typically consists of a proposed decision, interagency review, public comments, and a final decision. The
Q3 NAAQS were last revised in 2015 and then retained in the 2020 decision.

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Session 1: Characterizing O3 Chemistry and Transport, Air Quality Patterns, and O3 as a
Greenhouse Gas

Session co-chair introduction to topics, discussion questions, and panel

Session co-chairs: Anne Barkley, U.S. EPA; Olivia Clifton, NASA-GISS and Columbia University

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. They
noted that this session would focus on atmospheric science and climate effects. They provided
background information on tropospheric 03 exposures (background and non-background exposures).
Tropospheric 03 is formed from photochemical reactions of nitrogen oxides (NOx) with volatile organic
compounds (VOCs); background 03 is sourced from stratospheric intrusions, international transport,
wildfires, lightning, global methane, and biogenic precursors. Research advances presented in the 2020
03 ISA emphasized the emergence of winter 03 events, the impact of the ENSO cycle, the reduction of
days of 03 concentration extremes, and climate impacts on global average surface temperatures.
Additionally, a 2022 Draft Policy Assessment included knowledge gaps (e.g., photochemical modeling at
high spatial and temporal resolutions, atmospheric chemistry and 03, seasonal and geographic
variations of 03 precursors, MDA8 and W126, and the magnitude of climate system responses besides
temperature).

Topic 1: O3 Chemistry and Transport and Resulting Concentration Patterns

Discussion Question:

Since the last review, what new information is available and what are the most significant advancements
in theoretical chemistry, kinetics and smog chamber work, field experiments, ambient monitoring,
satellite retrievals, and numerical modeling that improve our current understanding of 03 production
and transport? What are the implications of this new information? Is there newly available evidence
that indicates the importance of photochemical oxidants other than 03 regarding abundance in
ambient air?

Lead discussants: Sally Pusede, University of Virginia; Havala Pye, U.S. EPA

•	Precursor sources are changing: NOx emissions are decreasing as vehicle and power plant
emissions decrease and soil NOx could be becoming a more significant source. VOC emissions
are changing as volatile chemical products and fire emissions replace vehicle and industrial
emissions. As a result, VOC emissions are also becoming more oxygenated.

•	Because of these decreasing vehicle and power plant emissions, NOx-limited chemistry is
becoming more important and better understood. COVID lockdowns have offered glimpses of
this NOx-limited future. Also, new aerosol reactions, such as particulate nitrate photolysis, have
been identified that control chemistry in addition to VOCs. As wildfires have increased, NOx
reactivity has become increasingly influenced by VOCs emitted from wildfires, which contain
more oxygen than traffic-related VOCs; this NOxfire chemistry is also becoming better
understood.

•	Urban N02 concentrations have declined for decades, but this decline has slowed recently.

•	Hydrotrioxides are an important oxidant species.

•	Correctly forecasting the highest 03 days remains a challenge.

•	Wildland fire NOx emissions are increasing. It is challenging to track 03 in smoke as wildfire
smoke interacts with urban air; 03 formation chemistry from precursors within wildfire smoke
plumes is better understood than the chemistry of 03 formation resulting from the interaction

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of O3 precursors in wildfire plumes with 03 precursors and other pollutants in urban air.
Suggestion: More research is needed into how wildfire smoke interacts with urban airsheds and
the resulting implications for urban 03.

•	Work is increasing to inform environmental justice considerations with finer spatial resolution
data.

•	03 concentrations in ambient air are a function of chemical 03 production (from precursor
sources of VOCs and NOx), loss (through chemical reactions and deposition), and transport. The
experts suggested examining literature on precursor source emissions, formation and loss
chemistry, and atmospheric deposition, as they are most highly relevant for the current NAAQS
review and report remarkable changes in the processes influencing ambient 03 concentrations
and our understanding of them since the previous 03 NAAQS review (as discussed in next
bullets).

•	Concerning NOx precursor sources, the relative contribution of motor vehicles and power plants
to NOx emissions has decreased, resulting in 1) an increased sensitivity of 03 production to NOx
concentration, and 2) a larger contribution of NOxfrom soils and wildfires, which is relevant to
03 production and control because of different seasonal and diurnal patterns of emissions. Both
consequences could influence both ambient 03 concentrations and the relative effectiveness of
different control strategies (e.g., VOC vs. NOx emissions control).

•	Concerning VOC precursor sources, recent research indicates that VOCs in U.S. ambient air are
becoming more oxygenated because the relative contribution of oxygenated VOCs from volatile
chemical products (solvents, consumer products, industrial products) and wildland fire
emissions is increasing relative to motor vehicle VOC emissions, which are less oxygenated. How
these changes affect the chemistry and extent of 03 production is the subject of current
research. Research on biogenic VOCs is underway and research on industrial VOC emissions is
also needed.

•	Concerning 03 production and loss chemistry, hydrotrioxides were identified in 2022 as a
previously ignored species with high potential for strong atmospheric oxidizing ability.
Heterogeneous processes involving particulate matter, including particle uptake of hydroperoxy
radicals, particulate nitrate hydrolysis, and aerosol nitrate photolysis, can also impact 03
production in addition to VOCs and NOx, especially in areas with high particulate matter levels.
These processes are becoming better understood.

•	Concentrations and emissions are increasingly resolvable at greater spatial resolution using
satellites, mobile data, and models. This point is relevant to environmental justice-related
inequalities that frequently occur at the neighborhood scale or smaller, and for better
characterizing chemical processes that occur at a smaller scale than can be captured by typical
chemical transport models, like fire plumes, urban neighborhoods, and near water bodies.

•	03 deposition has become better understood and recent research shows that variability in 03
deposition can alter 03 concentrations on a scale similar to recently observed changes in NOx
emissions. Both emissions and deposition play a role in interannual variability in 03
concentrations as key details of dry deposition processes—including important pathways not
involving leaf stomata and the relationship of deposition to meteorology and biophysics—have
become better understood.

•	Chemical transport models used to predict 03 concentrations continue to improve. CMAQ, a
widely used model for 03 prediction, generally underpredicts 03 from January to May and

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overpredicts O3 from July to September, and it also generally underpredicts 03 in the western
United States and overestimates 03 in the eastern United States. Improvements are possible as
some of the research on physical and chemical processes described above is incorporated into
future development.

•	Major methodological advances have occurred in artificial intelligence and machine learning
approaches that can help us understand and predict 03 concentrations, including bias correction
(to nudge predictions closer to observations), process simulation (speeding up slow parts of
models without sacrificing accuracy), and improved spatial resolution (to the sub-km scale).

•	The decrease in precursor source emissions described above has led to a compression of the 03
concentration distribution in the United States, with fewer days of extremely high or low
concentrations, as well as to changes in spatial, seasonal, and diurnal patterns and in some cases
to divergent responses between different 03 metrics (e.g., those that are based on peak
concentrations used for public health protection vs. those based on weighted concentration
distributions used for plant exposure).

Topic 2: Relationships between O3 and Photochemical Oxidants Relevant for Health

Discussion Question:

What new information is available to inform how 03 versus total oxidant exposure differs across spatial
scales, particularly in urban areas where 03 concentrations are low because of reactions with NO, and
where environmental justice concerns are particularly important? What metrics are available to
accurately describe the relationship between 03 and total oxidant exposure; for example, could a
combination of indicators be used?

Lead discussants: William Vizuete, University of North Carolina; Gail Tonnesen, U.S. EPA Region 8

•	03 may not be a good indicator of total oxidant exposure because of complex chemical reactions
with fresh emissions in urban airsheds that can result in very low 03 concentrations despite
heavy smog and high NOx concentrations. Additionally, high 03 concentrations with low NOx
concentrations can occur at sites in the U.S. Intermountain West at higher elevations (mostly in
springtime) due to stratospheric 03 intrusions. Therefore, an 03 air quality metric may
misrepresent the state of total oxidant exposure.

•	One possible way to more accurately address total oxidant exposure would be to use other
indicators, or a combination of indicators, including N02, HCHO, H202, R02, or black carbon.
Currently, there is no set definition of which oxidants are included in total oxidant exposure. It
may be up to the atmospheric chemistry community to define total photochemical oxidants and
their relationship to 03, which would enable health scientists to evaluate 03 versus total oxidant
exposure in health studies.

•	Much more research is needed in this area, which may be limited by the availability of air quality
monitoring networks. Model products, hybrid models, and remote sensing products may be
helpful in bridging the monitoring gap and for estimating total oxidant exposure.

Question-and-Answer Session

What are your thoughts on Ox as an indicator?

•	A study from Canada explored 03 and N02. There are examples in the 03 chemistry literature of
using Ox in place of 03. Ox should be the subject of future investigation.

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Can the speakers talk about short-, medium-, and long(er)-lived compounds involved in complex 03
chemistry (that have health implications) that tend to be either positively correlated with 03
concentration (i.e., as 03 increases these species also increase) or negatively correlated with 03
concentrations (i.e., as 03 is chemically lost these species increase)? This question is asked in the
context of mixtures that people are exposed to and so perhaps should be considered in high(er) and
low(er) N0X regimes.

•	This question has two aspects: 1) understanding health effects from multipollutant mixtures and
2) measuring dynamic multipollutant mixtures as they photochemically age.

•	Exposure assessment relies on existing data from satellite and ground concentrations, with
retrospective modeling simulations playing a key role.

•	There is concern about conditions in which 03 concentrations can hit zero despite heavy
pollution (e.g., winter, early morning).

•	NOx and 03 will be correlated positively in some locations and negatively in others, which is
important to consider when conducting health studies and using statistical methods because it
could pose a challenge in data analyses.

•	Measurements are also affected photochemically when oxidants are formed during the day;
therefore, 03 and N02 may not be the best indicators for total oxidants.

•	Modeled spatial gradients may not be reliable for health impact assessment.

Do you have advice on how to recognize whether models are likely to be accurate or not?

•	The gold standard is observation-based evaluation wherein modeling data are compared with
data collected at observation stations.

•	Errors made by models in one location will also be repeated in others.

•	The use of machine learning models must be scrutinized in detail because of the errors they can
produce.

Topic 3: Monitoring and Modeling Advances Relevant to Welfare

Discussion Question:

What recent advances have been made in monitoring (including satellites) and modeling ambient
concentrations of 03? How accurate are recently developed modeling approaches (including hybrid
models that utilize data from satellites, land use information, ground-based monitors, etc.) at predicting
03 emissions and ambient 03 concentrations across locations (e.g., urban vs. rural, monitored vs.
unmonitored)? What have these new tools and information contributed to characterizing and
understanding how (e.g., wildfires, oil and gas operations, intercontinental transport) contribute to
ambient 03 concentrations, particularly in the west and intermountain west?

Lead discussants: Dan Goldberg, George Washington University; Heather Simon, U.S. EPA

•	03 satellite retrievals are a work in progress, including improvements in vertical column data,
spatial resolution, emissions estimates, precision, and uncertainty. Useful satellite-based
indicators have evolved, including using formaldehyde as a proxy for O3 and the formaldehyde-
to-NOx ratio to track increasingly NOx-limited conditions. Further improvements in precision and
spatial and temporal resolution are anticipated with the recent launch of the TEMPO satellite.

•	Air quality modeling has improved. Improved understanding of relevant sources, such as volatile
chemical products, wildfires, oil and gas operations, agricultural soil, and discoveries in

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chemistry, such as aerosol nitrate photolysis, are becoming more complete and better
represented in air quality models. Other notable modeling improvements include in-line
lightning and biogenic emissions and integrating multiscale meteorology and transport in
CMAQ, assimilation of satellite data into global models, characterization of dry deposition, and
development of machine learning approaches.

•	Advancements in ground-based monitoring systems include the NIST and EPA updates of the 03
cross-section value used in UV-based 03 analyzers and standard reference photometers
(increasing by 1.2%), development of a ground-based network for vertical column
measurements to complement satellite-based vertical column measurements, and application
of LIDAR and ozonesondes for measuring vertical 03 distributions.

•	Several noteworthy datasets have become available that are based on recent modeling and
measurement efforts, including a long-term datasetfrom EPA that ensures emissions
characterization methods and model versions are consistent across the entire time series from
2002 to 2019, global 03 data from the NASA GEOS Composition Forecast System and its
European counterpart, and numerous U.S. field campaigns in various locations.

Topic 4: Background O3 Concentrations

Discussion Questions:

There are various approaches to estimating background 03, with different definitions currently or
previously widely used within the U.S. air pollution research community. For instance, "U.S.
background" is defined as the 03 concentration that would occur if all U.S. anthropogenic 03 precursor
emissions were removed. "North American background" or "policy-relevant background" refers to the
03 concentration that would occur in the United States in the absence of anthropogenic emissions in
continental North America. In contrast, "baseline 03" is defined as the measured 03 concentration at
rural or remote sites that have not been influenced by recent, local emissions (U.S. EPA, 2020).

What new information is available on characterizing or estimating background 03 concentrations (e.g.,
including hybrid methods)?

Have new advances in monitoring and modeling contributed to characterizing sources and precursors
(e.g., wildfires, intercontinental transport, stratospheric exchange) that contribute to background 03
concentrations?

Is there new information on atmospheric transport, chemistry, and concentration trends that can be
used to reduce uncertainties in seasonal or daily background 03 estimates?

Lead discussants: Dan Jaffe, University of Washington; Barron Henderson, U.S. EPA

•	Background 03 from the stratosphere, soil, lightning, wildfires, biogenic sources, and
international pollution remains an important NAAQS concern; wildfires are becoming an
increasingly important contribution, with Canadian wildfires in the summer of 2023 largely
responsible for a more than threefold increase over previous years in the number of days the
current NAAQS level was exceeded.

•	Characterization of 03 using models could be enhanced through data assimilation, vertical
mixing, and measurements.

•	Greater understanding is needed of the impact of wildfire emissions and 03 on urban air quality,
particularly in the western United States where wildfire emissions can push an airshed over the
NAAQS 03 standard. Generalized additive models are helpful in estimating contributions of
smoke to 03 MDA8.

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Future research should also focus on source apportionment (e.g., the Western and Eastern United
States will have different primary 03 drivers) and investigating the role of precursors such as methane
and biogenic VOC emissions on 03.

Topic 5: O3 as a Greenhouse Gas

Discussion Questions:

•	How have modeling studies conducted since the previous 03 ISA changed its conclusions
regarding the response of the climate system to 03 impacts?

•	What new information is emerging on the role of regional and seasonal variations in the
atmospheric budgets of 03 and therefore on its climate impacts?

•	What new information is emerging on the impact of 03 on the terrestrial ecosphere and its
climate feedback?

•	What is the role of precursors in the climate impacts of 03 under possible future emission
scenarios?

Lead discussants: Jason West, University of North Carolina; Uma Shankar, U.S. EPA

•	Radiative forcing (RF) is a perturbation in the net radiative flux at the top of the atmosphere
because of a change in a radiatively active forcing agent. The impact of 03 RF on anthropogenic
C02 warming varies across different regions of the planet. Climate variables such as precipitation
and temperature, as well as atmospheric circulation patterns, can have regional impacts.

•	Uncertainties exist in model estimates of the spatial distribution of RF and temperature
changes. The AR5 reported a medium confidence in the RF estimates from 1850 to 2000 in the
Atmospheric Chemistry and Climate Model Intercomparison Project (ACCMIP) because of the
large standard deviation among regions. Uncertainty in the 03 climate impacts is due to
confounding climate variables and a lack of supporting literature.

•	In IPCC AR6, 03 RF is estimated at +0.47 [-0.24, +0.70] W m"2, which is 18% higher than reported
in IPCC AR5. The revised estimate is based on a better understanding of the distribution of
present-day tropospheric 03, and limited available constraints on pre-industrial 03 through
isotopic analysis of ice cores.

•	The CASAC review of the previous 03 ISA pointed out that there is a clear causal relationship
between 03 and global mean temperature, which leads to a small (0.1°C-0.3°C increase from
pre-industrial values) but significant contribution to climate warming. IPCC AR6 studies report a
slightly greater degree of warming (0.37°C) during the 1850-2013 period. However, the effects
of 03 on other climate change indicators (e.g., changes in atmospheric circulations evidenced by
changes in weather and precipitation patterns) are not clear because of a lack of agreement
among models and a lack of study data. A current challenge in modeling studies is connecting
regional-scale 03 concentrations to regional-scale RF and warming. Isolating the 03 climate
influence in the United States is complicated because of (a) emissions of 03 precursors from
outside the United States (e.g., Southeast Asia), and (b) the confounding impact of other short-
lived climate forcers (SLCFs).

•	It is important to study the effects of tropospheric 03 on ecosystems and their feedback to
climate via changes in the terrestrial carbon sink. Carbon sequestration by the land surface was
an endpoint evaluated in the 2020 ISA as likely to have a causal relationship to 03 via its adverse

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impact on vegetation. Changes in NOx concentrations also affect vegetation. The net impacts of
these changes are hard to quantify because of variability among species and their spatial
distributions. The IPCC AR6 demonstrates the link between C02 and 03, but the degree is still
unknown.

•	Controlling one air pollutant may exacerbate others, creating a challenge for regulation. In this
context, the role of methane in reducing tropospheric 03 is important for both climate and
health endpoints. While NOxemissions reductions are traditionally used to improve 03 air
quality, they result in increasing the lifetime and atmospheric concentration of methane and are
therefore a climate penalty. Reductions in VOCs and CO, on the other hand, avoid this penalty
and offer a better approach to simultaneously reducing 03 climate impacts and mitigating other
welfare and health impacts. Examining the impacts of 03 precursors—methane, NOx, VOCs and
CO—more hoiistically can provide more useful information on the impacts of 03 than
attempting to isolate an effect that would require expensive and time-consuming climate model
simulations to obtain a statistically robust signal.

Question-and-Answer Session

What is the current understanding about the large range of soil NOx emissions values in the scientific
literature?

•	Satellite data can be used to understand the range of values, especially in rural areas with little
previous monitoring.

•	Soil NOx emissions occur after fertilizer application, which has been an understudied area.

•	It is hoped that increases in observation density in these areas will improve understanding of
soil NOx emissions.

•	Models generally agree that reductions in NOx will cause a methane increase and an 03
decrease, although reducing VOCs will free up some hydroxyl radicals, which could address
methane.

•	Models have regional differences, but emissions of CO have the same effect across regions,
regardless of the emission location.

•	For VOCs, models often have varying simplistic representations of secondary organic aerosols,
contributing to the spread across models.

•	Answering the question on soil NOx solely with satellite data is challenging because of the
amount of unconstrained spatial and temporal variability.

•	Different models have very different estimates for soil NOx emissions, due in part to regional
differences in soil and microbes.

Can 03's causal impact on temperature be accounted for in contributions to wildfires and can it be
subtracted from background?

•	Wildfires are governed by many things in addition to temperature. Although it would be novel
to investigate the impact of temperature alone, it would likely be a small contribution compared
with those of precipitation and soil moisture. Many of the factors depend on wind and soil
moisture and changes in these factors may be due to climate changes. Teasing out the impact of
a single pollutant on the climate is difficult.

•	Even if some of these factors could be modeled correctly, translating them into a standard

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would be long and difficult. It may be better to look at a subset of our understanding to develop
standards instead.

How can tropospheric mixing be quantified?

• Some stratospheric-tropospheric exchange processes are two-way, but usually it is just the
mixing of lower concentrations with higher concentrations. It would be challenging, but
possible, to quantify this process with other tracers.

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Tuesday, May 14, 2024

Session 1: Planning for the Review of the Welfare Effects Evidence and Analyses: Review
of Welfare Effects Evidence

Session co-chair introduction to topics, discussion questions, and panel

Session co-chairs: Jeffrey Herrick, U.S. EPA; Kris Novak, U.S. EPA; Emmi Felker-Quinn, National Park

Service

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. The co-
chairs noted that the CAA definition of the effects on welfare includes, but is not limited to, effects on
soils, crops, vegetation, animals, wildlife, and climate. The presentation covered the scope of ecological
evidence considered in the ISAs and an overview of causality determinations from the 2020 ISA.

Topic 1: Ecosystem Processes

Discussion Question:

What new information is available about 03 effects on ecosystem processes, such as water cycling,
carbon sequestration, productivity, and belowground/biogeochemical cycling?

Lead discussants: Danica Lombardozzi, Colorado State University; Doug Kaylor U.S. EPA

Question panelists: Lisa Emberson, Emmi Felker-Quinn, Jason Lynch, Jeffrey Herrick

•	The effects of 03 on water cycling continue to be complex, occurring at multiple scales ranging
from altered stomatal response and water use in plants through measurements and models of
ecosystem water use. One approach to the topic may be to use plant water-use efficiency as an
integrated measure that can be related to transpiration; water cycling; carbon assimilation,
allocation, and sequestration; biomass; and yield. Another approach might be looking at
measurements of plant stress, of which water or drought stress is a part, which could
incorporate larger spatial scales and remotely sensed data.

•	Experts highlighted that many current studies do not examine 03 effects in isolation, but as a
suite of other factors, and that multifactorial designs should be assessed in the ISA.

•	A few of the studies mentioned linked C02 and 03 effects on terrestrial carbon and nitrogen
cycles. There is research examining 03-related impacts to nitrogen cycling via changes in
bacterial and fungal communities. Additionally, a recent meta-analysis assesses how
belowground functions respond to elevated 03 concentrations.

•	Experts agreed that models, particularly process-based models, might be important when
scaling from leaf to canopy level to estimate 03 effects on water cycling, carbon assimilation,
and carbon and nitrogen allocation. This approach is, however, a future avenue of research, and
the current state of modeling is not capable of estimating ecosystem level effects from 03
exposures.

•	The importance of considering both short- and long-term effects was highlighted.

•	Because there are different diurnal patterns of exposure and different bioregional factors
(climate, soil type, plant functional type, water dynamics), as well as species-specific stomatal
disfunction, it is important to think about individual ecosystem types and not apply models or
functions across ecosystems without regard to these differences.

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Topic 2: Community-level Effects
Discussion Questions:

Question 1: What new information is available about 03 effects at the community level such as
biodiversity, community composition, and species interactions?

Question 2: What new information is available on 03 effects on volatile plant signaling compounds and
plant-insect signaling?

Lead discussants: Emmi Felker-Quinn, National Park Service; Meredith Lassiter, U.S. EPA
Question panelists: Lisa Emberson, Doug Kaylor

•	03 alters aboveground ecological communities (conifer forests, broadleaf forests, grasslands,
agricultural systems—specifically interactions between crop species and weed species growing
in the same place, agroforestry) by decreasing the abundance of sensitive species and giving
tolerant species a competitive advantage. Information available since the release of the 2020
ISA supports these findings. Effects are also reported in lichens and in the endosphere and
phyllosphere (biome of micro-organisms living on and inside plants).

•	The belowground soil microbial community (including mycorrhizae, bacteria, and archaea) and
soil invertebrate community composition shifts are likely due to cascading effects of 03 on plant
chemistry and plant carbon allocation to leaves, wood, and roots. Many of these experimental
studies include one or more modifying factors (i.e., C02, nitrogen, warming, precipitation).
Emerging topics in microbial community effects since the 2020 ISA include ecosystem
multifunctionality and network stability.

•	Plant and microbial community responses in grasslands were highlighted as an example of the
complex interactions between aboveground and belowground communities under elevated 03.
Although much of this literature is from the previous decade, studies further examine
belowground interactions and additional factors that modulate 03 effects. For example,
grasslands with lower nitrogen deposition have a greater response to 03 stress than those with
higher nitrogen deposition, indicating stress history as a factor in 03 response.

•	Effects of 03 on biogenic volatile organic compounds (BVOCs), which plants emit to signal to
other community members and potential pollinators, were an emerging area of research during
the development of the 2020 ISA. Approximately 50 studies are now available on BVOCs,
primarily focused on pollination, with several studies on herbivore-plant and plant-plant
signaling.

•	03 impacts plant-pollinator interactions in three ways: 1) direct alteration of plant physiology
affecting the quantity and quality of BVOCs, 2) alteration of chemical signals in the air column
through reactions with 03, and 3) detection and perception of scents by pollinators. Recent
studies further characterize each of these areas or report new endpoints, such as monitoring of
pollinator antennal responses to floral blends. Other recent signaling studies have focused on
the potential link between pollinator behavior, 03 exposure, and plant yield, which includes
examining the number of visits to plants from pollinators and the abundance of pollinators in
fields.

Topic 3: Population/Individual Level Effects

Discussion Questions:

Question 1: What new information is available about 03 effects at the population or individual level,
such as survival, growth, reproduction, phenology, visible foliar injury, and crop yield?

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Question 2: In particular, is there new information on non-tree species, non-commodity crops, and
species that are threatened and endangered or culturally significant?

Question 3: What new information is available on 03 effects on insect herbivores and other wildlife?

Lead discussants: Ripley Tisdale, USDA; Jean-Jacques Dubois, U.S. EPA

Question panelists: Jason Lynch, Doug Kaylor, Meredith Lassiter, Susan Sachs, Amy Luo

•	The panelists reviewed and discussed National Park Service (NPS) community science data
collection efforts in Great Smoky Mountains National Park. Data collection on 03 injury to two
species of an herbaceous perennial has been ongoing since 2003. One of those species,
Rudbeckia laciniata, is culturally important to Native American groups. Panelists discussed the
variation in the severity of injury observed over the period of data collection, and the interacting
weather variables that might have modified it. Of particular interest to the panelists was the
possibility that since 2003, measured 03 concentrations have decreased overall in the study
area, whereas injury may have increased. Specifically, observations of injury occurred while 03
concentration was below 100 ppb. The Kohut et al. 2012 article was referenced and potential
upcoming publications were discussed, as were recent updates to the NPS list of 03 bioindicator
species.

•	The panel noted that the COVID pandemic may have provided opportunities for natural
experiments on the effects of 03 exposure on crop yield. During the initial pandemic lockdown,
annual European and global emissions dropped significantly by 30%-50%, and yield improved
by 2%-8%. In the United States, the soybean yields only recovered approximately 0.02% during
the COVID lockdowns in 2020. Potential interacting factors were discussed.

•	Other topics briefly mentioned were research on effects of nitrogen fertilization, crops on which
impacts of 03 have been reported, and effects on belowground plant parts. Modeling efforts
were also briefly discussed, with special attention given to the importance of exposure metrics.

•	Recent studies on the effects of 03 on vertebrates were reviewed briefly. One study of effects
on fruit fly hybridization was also referenced.

•	Further discussion of the impacts of 03 on crop yield was deferred to the next discussion
session.

Topic 4: Exposure/Dose Response

Discussion Questions:

Question 1: What new information is available on linking concentration weighted metrics (e.g., W126
and AOT40) to response of species found in the United States?

Question 2: Is there new information linking flux metrics to effects on species that occur in the U.S.?

Lead discussants: Lisa Emberson, University of York; Jeffrey Herrick, U.S. EPA

Question panelists: Emmi Felker-Quinn, Olivia Clifton, Jean-Jacques Dubois, Huiting Mao

•	The panelists discussed the cumulative concentration weighted metrics (e.g., W126 and AOT40)
for measuring exposure that are currently being used in the United States and in some cases in
Europe. The bases of these metrics were discussed in the context of available data on plant
species in the United States. The main paper discussed was Lee et al. (2022), which reported
W126 response functions in 16 U.S. tree seedlings. In another study, Li et al. (2023) linked the
AOT40 metric to effects on C3 and C4 crops that are grown in the United States.

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•	Cumulative concentration weighted metrics were discussed as NPS's W126 benchmarks to
protect vegetation. In the IMPS, 7 ppm-hrs W126 and 13 ppm-hrs W126 benchmarks are used for
tree seedling biomass loss. It was noted that 03 is estimated by interpolation in parks using
these benchmarks.

•	The panel discussed flux-based metrics and pros and cons of the European methods of flux. The
2023 update of the Manual on Methodologies and Criteria for Modelling and Mapping Critical
Loads and Levels and Air Pollution Effects, Risks, and Trends provides more information. This
update included four crops (wheat, potato, tomato, and rice), five forest trees (beech, birch
poplar, Norway spruce, Mediterranean deciduous oak, and Mediterranean evergreen), and one
grassland crop (perennial ryegrass). The phytotoxic 03 dose (POD) was discussed, which has
advantages as a more biologically meaningful descriptor of 03 exposure and incorporates the
influence of abiotic stress, such as heat or water stress, when compared with AOT40. However,
there are challenges with the amount of data required to calculate POD. Several studies were
discussed that explored the question of calculating flux metrics, including Braun et al. (2014),
Mills et al. (2011), Pleijel et al. (2022), Nelson et al. (2018), and Peng et al. (2019).

•	Researchers on the panel discussed studies calculating flux metrics and POD on vegetation in the
United States. However, it was noted that there are very few measurements linking effects on
plants to calculated flux metrics in the United States. Linking 03 flux to effects on U.S. vegetation
is an important area of future research. Some of the studies discussed on estimating 03 flux in
the United States included Anav et al. (2022), Clifton et al. (2020), and Mao et al. (2024).

Topic 5: Climate and Other Modifying Factors

Discussion Question:

Question 1: Is there new information on how 03 affects ecosystems and how its components are
modified by climate change and other factors (e.g., temperature, soil moisture, nutrients, and/or other
pollutants)?

Lead discussants: Jason Lynch, U.S. EPA; Kris Novak U.S. EPA

Question panelists: Emmi Felker-Quinn, Doug Kaylor, Danica Lombardozzi

•	Previous NAAQS reviews have shown that nitrogen deposition, C02, and climate variables may
exacerbate or negate the effects of 03 on plants. Recent studies were discussed that have
reported on the modifying factors of drought and excess nitrogen (Grulke and Heath 2019; Out-
Larbi et al., 2020), C02 (Tai et al., 2021; Watanabe et al., 2022), nitrogen (Feng et al., 2019;
Watanabe et al., 2022; Li et al., 2020), and temperature with 03 (Lee et al., 2020).

•	The issue of excess nitrogen across the United States was emphasized and continues to be a
stressor in ecosystems. While oxidized nitrogen has decreased in many areas, ammonia, on the
other hand, has increased. The form of nitrogen can have varying effects on the growth of plants
in combination with 03 exposure and should be considered.

•	Panelists highlighted two recent studies reviewing the impact of nitrogen deposition and 03 that
look at root biomass responses (Ping et al., 2020; Fenn et al., 2020). It was also noted that
nitrogen deposition can affect plants not only through increased soil nitrogen, but also via foliar
uptake of nitrogen, which should be considered as we aim to understand the role of 03 uptake,
because they use similar pathways. The load of nitrogen deposition is also important when
considering whether it will have a beneficial or deleterious effect.

•	Available datasets (derived from Forest Inventory and Analysis measurements) of mature tree

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growth and survival exposure-response relationships with W126 O3 exposure were discussed
and can possibly be tested and modified with temperature and precipitation projections.

•	The panel mentioned a recent meta-analysis by Shang et al. 2024 discussing the impacts of
drought and 03 on the different parameters related to quantifying photosynthesis, which could
be very useful for consideration in future modeling.

•	Both drought and temperature should be considered, especially because temperature and 03
increase together. Concurrent changes in humidity can also affect stomatal functioning and
should be included in studies exploring the effects of 03.

•	Previous research and theories suggest that elevated C02 may result in stomatal closure and
subsequent reduced water loss and increased water-use efficiency. From an ecosystem
perspective, C02 may also increase leaf area indices, which increases tree water loss rather than
reducing it, underscoring the need for more whole-plant/ecosystem approaches to assessing
these interactions.

•	A recent study by Ainsworth et al. (2020) suggests that "the terrestrial biosphere is currently at a
turning point shifting from a period where carbon dioxide and nitrogen fertilization dominate
the global carbon cycle to a period when warming and drought stress dominate."

•	The panelists agreed that 03 needs to be considered as a suite of complicated multivariate
stressors on plants, together with drought, climate, humidity, and other factors.

Question-and-Answer Session

Are there any studies on 03 impacts to wetland species in riparian zones, where soil moisture
conditions are variable?

•	The panelists recalled there may be studies from the 1990s and 2000s on this topic. A study was
noted by Kohut et al. (2012) in Rocky Mountain National Park where cutleaf coneflower
displayed more visible 03 foliar injury in riparian areas.

Do researchers find effects from mycorrhizal associations, we find that the effect of CO2 fertilization on
plant growth is contingent on complex interactions between N availability and mycorrhizal
association. Is there a similar interaction with 03?

•	The panelists were unaware of any studies that directly examine this association. However, this
topic was covered in the community belowground section of the 2020 ISA.

With all of these methods of calculating flux on the landscape level, how do we do that for the United
States and is it possible to link it to actual effects? What would be the best way to approach the issue?

•	The panelists suggested obtaining as much data as possible for calculations and future studies
will have a range of estimates for 03 flux/deposition to contribute to the understanding of this
topic.

Session 2: Welfare Risk and Exposure Assessment

Session co-chair introduction to topics, discussion questions, and panel
Session co-chairs: Leigh Meyer, U.S. EPA; Kris Novak, U.S. EPA

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. They
provided the history of the 03 NAAQS, the current secondary 03 standard, the currently available
welfare evidence and associated uncertainties, and the general approach for planning the upcoming risk
and exposure analyses.

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Topic 1: Modeling O3 Gradients
Discussion Questions:

Question 1: 03 concentration gradients exist across the United States and are influenced by the location
of emission sources and 03 chemistry and transport. Reflecting those concentration gradients can be
important in understanding the protection provided by the 03 standard. What modeling approaches are
available and might be employed to estimate ambient air 03 concentrations across large areas, including
forested areas and the sources that influence air quality in these areas? What is an appropriate
approach to model or estimate 03 impacts upwind of urban areas?

•	How might this be done to simulate different air quality scenarios, including one for when the
design value is just meeting the current standard?

•	What kind of case study areas or parts of the United States might be appropriate to include in
this assessment?

Lead discussants: Ben Wells, U.S. EPA; Barron Henderson, U.S. EPA; Olivia Clifton, NASA; William Vizuete,
University of North Carolina

•	The discussion highlighted the difficulties in modeling and computing capabilities for predicting
how observed 03 responds to hypothetical emissions by adjusting concentrations using modeled
sensitivities.

•	The EPA Air Quality Assessment Division stated its intent to investigate modeling and computing
capabilities to assess the possibility of modeling multiple years and emissions levels and
reflected on the challenges of the models, such as computational constraints and modeling bias,
which was large enough that data fusion would have been unstable. Alternative modeling
methods or tools that could be applied on an hourly basis and then aggregated will be
investigated.

•	The panel deliberated the strengths and weaknesses of different model types, possible
corrections, and the use of artificial intelligence (Al) tools to improve model performance and
computational efficiency.

Topic 2: Climate Change Risk and Exposure Assessments

Question 1: How might climate change (e.g., temperature, precipitation changes) be reflected in the air
quality scenarios included in the risk and exposure assessment? Are there climate change policies that
should be accounted for in the assessment? What analytical approaches could be used to assess the
influence of current climate change on risks to vegetation?

Lead Discussants: Rachel Sales, U.S. EPA; Drew Shindell, Duke University

•	The discussion highlighted the uncertainties and variability in predicting future climate change,
and how this might affect any inclusion of climate change in air quality scenarios. For example,
wildfire intensity and frequency are likely to change in the future but there are a lot of
uncertainties around predicting wildfires.

•	Another point of discussion was how climate change might affect seasonality, which in turn
might affect 03 measurements.

•	Panelists also discussed international climate change and 03 policy, particularly the importance
of methane policies, and how policies targeting methane might be salient in the future.

•	Finally, the panelists and discussants deliberated the strengths and weaknesses of longer versus
shorter time scales, and how shorter time scales and simpler models might be a path forward

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for including climate change impacts in future 03 reviews.

Topic 3: Exposure-Response Functions

Question 1: Recognizing the important role that species-specific exposure-response functions have
played in past reviews, are there new data or information that should be incorporated to improve our
understanding of these data and resulting exposure-response functions? Are there different analytical
approaches that should be utilized?

•	Are there other approaches that should be considered, including approaches that might
incorporate metrics for both peak concentrations and for cumulative/sustained exposures on
tree seedling biomass?

•	How can the dataset be analyzed differently to provide a clearer understanding of the patterns
of ambient air 03 concentrations common today (e.g., reduced prevalence of peak
concentrations)?

Lead Discussants: Travis Smith, U.S. EPA; Lisa Emberson, University of York

•	Panelists discussed the strengths and weaknesses of various 03 metrics, such as the AOT40,
W126, POD1, and various flux measurements. These measurements could be used in
exposure/response functions.

•	Panelists noted that previous research using flux metrics focused on European tree species. Lead
discussants noted that flux metrics could likely be applied to U.S. tree species, with some
adjustments for sensitivity.

•	Panelists discussed peak and chronic exposure to 03, uncertainties in how exposure-response
relationships might change over a tree's lifetime (i.e., mature versus seedling), and how critical
loads might be incorporated into exposure/responses functions.

•	The discussion concluded with discourse over future directions. Panelists thought that various
metrics should be considered in this review and that crop exposure/risk models should be
incorporated.

Topic 4: Community Forest Impacts

Question 1: What approaches and methods are available to estimate 03 tree community forest impacts
(e.g., species diversity and richness) considering interspecies competition and other interactions? For
example, what are current methods for modeling 03 concentration scenarios against tree species
competition over a period of time? What are their strengths and limitations?

•	Are studies, methods, or approaches available that might be used to relate extent and
magnitude of foliar injury in forested areas to public uses/values and ecosystem services that
might inform judgments of public welfare significance?

Lead Discussants: Kris Novak, U.S. EPA; Emmi Felker-Quinn, National Park Service

•	The discussion highlighted how species-specific responses to 03 could be applied to other
species and potentially scaled up to inform community changes. Panelists noted that the
environmental conditions also affect species-specific responses.

•	Panelists and lead discussants discussed the importance of visible foliar injury to public welfare.
Discussants noted that visible foliar injury can be used to inform the public about less visible air
quality measurements.

•	The discussion concluded with a deliberation of plants with high cultural value, and the

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sensitivity of such plants to O3. Panelists noted that Tribal input on culturally important plant
sensitivity to 03 would be valuable in upcoming reviews. It was noted that 03 exposure can also
degrade the nutritional value of certain plants, which can degrade cultural resources.
Discussants recommended that 03 effects on plants of cultural value be considered in future
reviews.

Question-and-Answer Session

•	The question-and-answer session considered different models and modeling techniques for
stand dynamics, tree growth and survival, forest structure, and competitive dynamics.

•	Discussion also included how a range of metrics may be used in the risk and exposure analysis
and linked to various air quality scenarios.

Does the discrepancy between the policy need for an ambient metric in contrast to the flux-based
approach used in recent science make the W126 more feasible compared with a flux metric?

•	The standard needs to be an ambient metric.

Can an ambient metric be used for the NAAQS, while a range of metrics could be used for risk
assessment to understand the implications of the NAAQS and interpret the meaning of exceedances?

•	This option is possible. Combinations could be used in tandem, and perhaps flux could be
assessed there.

•	For assessment purposes, focus is placed on what is scientifically appropriate and feasible in
terms of tools and data for analyses. Risk estimates can be linked to air quality scenarios, which
are characterized based on various metrics, and those inform how the standard is characterized
The assessments should rely on an appropriate metric (referencing the use of the W126 metric
in the 2015 Air Quality Assessment as an example).

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Wednesday, May 15, 2024

Session 1: Human Exposure to Ambient O3

Session co-chair introduction to topics, discussion questions, and panel
Session co-chairs: Peter Byrley, U.S. EPA; Michael Jerrett, UCLA

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. They
noted that 03 exposure was defined in the last ISA as the interface of the breathing zone with a
particular concentration of a specific pollutant over a certain period of time. 03 can be monitored in
various ways, including the use of fixed-site and/or personal monitors. For modeling, many models are
available including proximity-based models, spatiotemporal models, mechanistic models such as
chemical transport models, more complex hybrid models that incorporate multiple types of data, and
models that use newer machine learning methods. In the last review, one of the conclusions was that
there were more studies that utilized chemical transport modeling for 03. They highlighted the need to
include spatiotemporal considerations such as local traffic that emit 03 precursors. Errors are often
similar over urban scales because ambient 03 concentrations tend to have low spatial variability. The co-
chairs also discussed potential sources of exposure error that may impact epidemiologic outcomes and
presented information on potential confounding present in 03 measurement.

Topic 1: Exposure Surrogates, Errors, and Measurement/Modeling Approaches

Discussion Questions:

Question 1: What new information is available on the relationship between ambient 03 concentrations
and personal exposures in various microenvironments, including infiltration from outdoor to indoor
environments?

Question 2: What new information is available to improve our understanding of the discrepancies
between stationary monitor measurements and actual pollutant exposures?

Question 3: What recent advances have been made in monitoring and modeling (including hybrid
models that utilize data from satellites, land use information, ground-based monitors, etc.) ambient
concentrations of 03 across locations (e.g., urban vs. rural, monitored vs. unmonitored) to improve
understanding of human exposures?

Question 4: How have these approaches been evaluated and validated in various types of locations (e.g.,
urban vs. rural, monitored vs. unmonitored)?

Lead Discussants: Michael Jerrett, UCLA; Lisa Baxter, U.S. EPA

This discussion highlighted the complexities of the relationship between ambient 03 and personal
exposure and included discussion of emerging measurement and modeling techniques being used to
improve the understanding of this relationship. Several points were raised:

•	The use of satellite data and ensemble models has improved the ability to estimate ambient 03
concentrations, but personal exposure remains challenging to measure accurately. GPS tracking
has been developed to account for time-activity data, such as, but these have not penetrated
epidemiology as a discipline.

•	Indoor 03 levels are significantly lower than outdoor levels because of the indoor reactivity of
03, ventilation, and the scarcity of 03 sources indoors.

•	Fine-scale spatial data are lacking for 03 but are necessary for accurate exposure assessment.
High-density monitoring and personal monitoring data are needed to better understand these

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relationships.

•	Outdoor activities, such as exercise, can modify the health effects of 03. Climate change and
extreme weather events also affect 03 exposure.

•	Climate change and seasonality of 03 need to be better understood. Trends such as ventilation,
increasing air conditioning usage, and wildfires may change the understanding of seasonal 03
exposure.

•	Multipollutant analysis (including NOx and VOCs) at fine scales would aid in understanding 03
chemistry and exposure.

Topic 2: Exposure to O3 in a Multipollutant Environment

Discussion Questions:

What new information from measurement and modeling approaches is available to characterize the
relationships between 03 exposures and exposures to other ambient air pollutants? Does this new
information provide insight into the potential for co-pollutants confounding health studies?

Lead Discussants: Jeffrey Brook, University of Toronto; Peter Byrley, U.S. EPA

The discussion highlighted the complex interactions between different air pollutants, the need for a
more comprehensive approach that considers total oxidant exposure, and assessment of the health
impacts of photochemical oxidants in urban environments. Several points were raised:

•	03 can interact with complex urban air mixtures, forming an array of pollutants that may have
varying health effects across different locations.

•	There is a need to consider total oxidant exposure, rather than relying solely on 03
measurements, to better understand and assess the health impacts of these complex air
pollutant mixtures.

•	Expanding monitoring efforts to include a broader range of oxidants and pollutants could help
explain variations and discrepancies in current data and provide a more comprehensive
understanding of the health effects associated with these mixtures.

•	Epidemiologic studies have shown that the chronic health effects of PM2.5 are enhanced in the
presence of oxidant gases like 03.

•	Statistical methods that can analyze the independent and combined effects of multiple
pollutants could be useful in informing the ISA and addressing environmental justice concerns in
urban communities.

•	While the current approach focuses on 03 alone, more research is needed to understand the
health problems experienced due to the complex interactions between various air pollutants in
urban environments.

Question-and-Answer Session

How will the enhanced exposure estimates, which are not uniform across pollutants, impact our
understanding of 03 health effects in multipollutant epidemiologic studies, and what new challenge
associated with relative improvements in exposure estimates has been introduced in interpreting the
roles of respective pollutants and health outcomes?

•	There is concern about the ability to develop the best N02 model and the best 03 model and
combine them in an analysis. These models may need to be codeveloped to understand the
nature of the chemical mixtures in the atmosphere.

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•	Previous simulation studies have demonstrated that when looking at two pollutants, the one
measured with more precision might dominate the statistical modeling, and because of this,
multipollutant results must be interpreted carefully. Interpreting these complex and
multivariable analyses may be an area that machine learning could help.

03 and N02are positively correlated in some environments and negatively correlated in other
environments. How would you expect this varying relationship to affect results of epidemiologic
studies looking at 03 that include N02 as a potential confounder?

•	Not all N02 is the same and therefore may interact in both the environment and with human
health in varying ways. Some N02 may be more correlated with 03 but interact very differently
in environments with various mixtures.

•	Various monitoring mechanisms are available for indicators for total photochemical oxidants,
which may be an approach for collecting data.

•	Current work is investigating how control strategies may change as a function of space and time
across a place with heterogenous emission inventory.

•	Sources could give some insight on oxidant potential. Measuring 03 is becoming more complex
because long-haul transportation emissions from other countries impact U.S. measurements.

•	Other chemical mixtures that may interact with 03 and other oxidants would be feasible to
monitor. More information on the effects of exposure to multiple chemicals is something to
investigate.

Session 2: Planning for the Review of Health Effects Evidence: Emerging Evidence and
Interpretation

Session co-chair introduction to topics, discussion questions, and panel
Session co-chairs: David Lehmann, U.S. EPA; Howard Chang, Emory University

Session cochairs provided an overview of the ISA process for reviewing health evidence related to 03
exposure. They detailed its multi-step approach, which includes literature searches, screening, quality
evaluation, and the integration of evidence from epidemiologic, animal toxicological, and human
studies. The cochairs also briefly reviewed the causality determinations made in the 2020 ISA, which
issued 13 causality determinations for seven major health outcomes. A five-level hierarchy was
employed to classify the weight of evidence: short-term respiratory effects were deemed "causal," while
long-term respiratory effects and short-term metabolic effects were considered "likely to be causal."
Most other outcomes were categorized as "suggestive" of causality. Additionally, the session cochairs
introduced the aims of the session and key discussion questions. These questions focused on identifying
emerging evidence for new and previously reviewed health effects, assessing biological plausibility,
exploring methodologies to evaluate effect modifiers and exposure patterns, and examining studies
from diverse geographic regions. Finally, the session cochairs introduced lead discussants and the
panelists.

Topic 1: Emerging Evidence, Health Outcomes, and Methods

Discussion Questions:

Question 1: The last 03 ISA evaluated evidence for respiratory effects, cardiovascular effects, metabolic-
related health outcomes, reproductive and developmental outcomes, nervous system effects, cancer,
and mortality. Since the last review, what new or emerging 03-related health effect endpoints have
been evaluated in epidemiologic, controlled human exposure, or animal toxicological studies (e.g.,

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cognitive decline, autism, immune effects)?

Is there new evidence that further informs endpoints included in the 2020 ISA? Specifically, is there new
evidence that 1) is consistent with causality determinations in the 2020 ISA; 2) contradicts causality
determinations in the 2020 ISA; or 3) further improves the understanding of biological plausibility,
health outcomes for at-risk populations, and health outcomes at lower 03 concentrations?

Lead discussants: Parker Duffney, U.S. EPA; Alex Carll, University of Louisville

•	Emerging research areas/findings include neurodegenerative diseases, cognitive decline, autism
spectrum disorder, out-of-hospital cardiovascular effects and arrythmias, kidney and liver
disease, and the impact of COVID. Also, the role of the hypothalamic-pituitary-adrenal (HPA) axis
in 03-induced effects is becoming more well studied.

•	There has been a proliferation of epidemiology studies and chronic obstructive pulmonary
disease (COPD) and interstitial lung disease studies.

•	There is more attention in the literature to the interaction of 03 with temperature and climate
on health outcomes.

•	It was pointed out that what constitutes low 03 concentration should be reconsidered.

•	The EPA was advised to be sure to include nasal effects, which include nasal scrubbing of 03
impacting exposure in the lower airways as well as health effects relevant to the nose, such as
allergic rhinitis and the ability of 03 to act as an adjuvant to subsequent challenge.

•	The need to account for impact of outdoor activity on outcomes like metabolic disease was
stressed. When considering controlled human exposure studies, the EPA was reminded to keep
in mind that morbidity-related endpoints may be missed with the use of predominantly young
healthy individuals in controlled human exposure studies.

•	The importance of developing a better idea of true exposure from ambient air was raised. The
point was made that one's overall exposure is related to both indoor and outdoor 03 exposure
and that indoor penetrance of 03 is much less than other NAAQS pollutants, like particulate
matter.

•	There is growing interest in the role of BMI on health responses to 03, although this has not
been well studied in controlled human exposures. This is potentially relevant to endpoints
related to lipid profile changes.

•	Finally, the EPA was advised to think forward about how to interpret and apply data derived
from new experimental approaches like 'omics' and single cell investigations.

Question 2: Have recent controlled human exposure or animal toxicological studies examined the
potential mechanisms of action by which short-term and/or long-term 03 exposures may result in health
effects, particularly cardiovascular effects and other effects not determined to be "causal" in previous
ISAs? Do recent experimental studies provide insights into the biological plausibility of these 03-induced
effects?

Lead discussants: Aimen Farraj, U.S. EPA; David Peden, University of North Carolina

•	The point that there are responders and nonresponders to 03 was mentioned, as well as the lack
of understanding that drives one's response to 03. Subset analysis of controlled human
exposure data can help to identify subsets particularly at risk.

•	Expand exercise, low-level exposure, and lower dose studies to provide the most useful

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information to the community.

•	There is a need to expand the controlled human exposure endpoints to those outside of the
lung/respiratory system to help provide additional information about health effects seen in
epidemiologic and animal studies.

•	EPA was advised to think about how to apply other indicators of effects and new data types
(e.g., "omics") and revisit older datasets to apply current approaches to analyzing data when
possible.

•	Noting that the controlled human exposure evidence was inconsistent, downgrading the
causality determination from "likely" to "suggestive of causal relationship" was brought up. It
was pointed out that we do not really understand the origins of the variability. The point that
we are not all the same was stressed, even when focusing on healthy populations.

•	Very few mechanistic studies have been published since 2020, except for some work by Urmila
Kodavanti.

Question 3: What new or emerging methodologies or study designs are available in epidemiology to (1)
address potential effect modifiers (e.g., genetic traits and socioeconomic status) and confounders (both
chemical and nonchemical stressors); (2) disentangle the effects of long-term exposure and short-term
exposure to 03; (3) better understand potential heterogeneity in 03 effects assessed in U.S. multicity
studies; and (4) understand the role of 03 as a mediator?

Lead discussants: Howard Chang, Emory University; Kristen Rappazzo, U.S. EPA

•	There are no new techniques for effect modifiers, but there are some emerging methods in the
statistics literature that require additional development before application to effect modifiers.

•	It was noted that although there are no major new techniques, there is an increased
appreciation for accounting for a core set of modifiers in all studies, including temperature and
climate. Techniques using machine learning are still early in development.

•	While techniques for addressing confounders in other fields are available, they do not seem to
have been applied to 03 thus far. Causal methods have been applied to this type of research, but
the point was made that potential confounding factors were not always included in the models.

•	Not many studies look at both long- and short-term exposure to 03 because it is inherently very
difficult to study both simultaneously. Some advancements have been made, however, related
to identifying sensitive windows during development.

•	No new methods have been developed for addressing heterogeneity.

•	There are a few papers on how 03 can act as a mediator for temperature effects.

Topic 2: Interpretation of Evidence

Discussion Questions:

Question 1: What factors are important to consider when evaluating epidemiologic studies conducted in
geographic regions less representative of conditions in the U.S. (e.g., in terms of sources, air quality
mixtures, exposure patterns, population characteristics)?

Lead Discussants: Lisa Baxter, U.S. EPA; Antonella Zanobetti, Harvard University

•	Even within the United States there is significant variability in, for example, air quality.

•	Precursors vary across the United States. When interpreting results, it is important to think

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about potential differences in the application of findings in a regulatory context.

•	It might be useful to compare results from different regions across the country. In this way, the
EPA may better understand the potential health impact of variability in conditions in different
regions.

•	Some studies look at rural versus urban; the EPA could assess whether these comparisons have
been captured in previous ISAs.

•	Studies looking at mortality are conducted in cities, while many people reside in nonurban areas
where conditions are different.

•	Newer epidemiologic studies have been conducted in Asia and Europe, although not about 03
specifically. One panelist recommended that the EPA reviews/considers these studies because
they have the potential to be relevant to U.S. populations, provided they were properly
conducted and report enough information to make meaningful comparisons across geographies.

Question 2: To what extent is new scientific evidence becoming available from experimental or
epidemiologic studies to improve the understanding of effects associated with various patterns of 03
exposure (e.g., repeated short-term exposures to "peak" concentrations versus longer-term exposures
to "average" concentrations)?

Lead Discussants: James Brown U.S. EPA; Kristen Rappazzo, U.S. EPA

•	The panelists noted that their responses to earlier questions largely covered this question and,
for that reason, there was relatively little discussion among the panelists related to this
question.

•	The point was made that it is important to utilize different exposure designs when considering
patterns of 03 exposure.

Session 3: Planning for the Review of Health Effects Evidence: Evidence Integration

Session co-chair introduction to topics, discussion questions, and panel
Session co-chairs: Parker Duffney, U.S. EPA; Dave Peden, University of North Carolina

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. They
introduced the session as a holistic view of the entire evidence base and a consideration of issues in
integrating multiple kinds of evidence. They gave an overview of the integration of evidence and shared
the strengths and limitations of various kinds of evidence, the criteria for causality determinations (a
modification of the Bradford-Hill criteria), and the levels of causality based on the amount of uncertainty
in the evidence reviewed.

Discussion Questions:

Question 1: To what extent do recent advances in the 03 health effects evidence support integration of
findings across epidemiology, controlled human exposures, animal toxicology, and dosimetry? What
does the new evidence indicate regarding consistency of findings within disciplines (e.g., epidemiology
studies of cardiovascular mortality versus morbidity)? To what extent do recent 03 health effects
findings from a particular discipline compensate for data gaps in other disciplines?

Lead discussants: Parker Duffney, U.S. EPA; Michael Jerrett, UCLA

Emerging evidence:

•	Experts suggest further examining biological plausibility of 03-induced health effects, especially
for short-term cardiovascular effects.

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•	Coherence of data among disciplines is increasing as well.

Factors to be aware of during evidence integration:

•	Antioxidant status and differences between individuals/disease states or species.

•	Similarly, understanding of the differences between different experimental species for
measuring the outcome of interest.

•	Exposure alignment between experimental animal studies and human studies.

How one discipline can compensate for gaps in another:

•	There may be a better way to account for study limitations.

•	It is critical to acknowledge study limitations and be transparent.

•	Strong epidemiologic data can help identify health effects.

•	Controlled human exposure studies at low levels can reflect changes in biology that are
consistent with health effects seen in epidemiologic studies.

•	For animal studies, it is important to understand species differences when considering
comparability of reported endpoints to humans (e.g., rodents breathe through the nose and are
nocturnal).

•	Looking at all lines of evidence is key; there should be some level of coherence and clear
articulation of uncertainties to justify stronger causality determinations.

Question 2: What limitations are present in experimental studies that expose humans or animals to
"pure" 03 rather than to the ambient mix of 03 and related photochemical oxidants (plus other co-
occurring pollutants)? Is there new information available for us to better understand the health effects
of photochemical oxidants other than 03 in ambient air?

Lead discussants: Mehdi Hazari, U.S. EPA; Anne Barkley, U.S. EPA

•	There is little new evidence for 03 effects in a mixture. ISAs consider mixture studies when there
is also an 03-alone exposure group.

•	There are no data to suggest vast differences between 03 and other photochemical oxidants.

•	Effects of 03 can be chemical or biological.

•	A better understanding is needed of the climate impact on the makeup of relevant
photochemical mixtures.

•	Discussion in other sessions included how the relevant mixture of photochemical oxidants can
look very different in different places and with different sources of precursors and vary
temporally throughout the day.

•	The role of 03 in a mixture may be important; effects on transient receptor potential channels
was mentioned. Other photochemical oxidants have longer lifespans, which might make time of
exposure important to consider.

•	Some of this work has previously been done; therefore, review of older literature may be
necessary.

•	The EPA may need to consider mixtures that are dominated by one gas/oxidant.

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•	The importance of interpreting animal studies for what they do say and remembering factors
that would limit the relationship to results in humans was noted.

Question 3: In the 2020 03 ISA, experimental studies were considered for inclusion if subjects were
exposed to O3 concentrations less than or equal to 2 ppm (animals) or 0.4 ppm (humans). These limits
were based on findings that the deposition of 03 from a 2-hour exposure to 2 ppm 03 in a resting rat is
roughly equivalent to deposition of 03 resulting from a 2-hour exposure to 0.4 ppm in an exercising
human (Hatch et al., 1994). Are there new or other data that can inform the potential human health
implications of shorter-term animal studies at higher 03 concentrations? How can recent animal studies
examining 03 exposures well above ambient concentrations inform human responses near the level of
the current standard?

Lead discussants: James Brown, U.S. EPA; Annie Jarabek, U.S. EPA

•	It is important to consider the dose delivered to the head region, both when considering
obligate nose-breathing animals as well as breathing patterns seen in humans at rest versus
exercising.

•	03-related effects in the nose may be underappreciated.

•	Biological plausibility studies in animals may necessitate the use of higher concentrations of 03
exposure.

•	The dose cutoff depends on the endpoint. Panelists suggest looking into animal models for
thresholds that may be associated with different outcomes (i.e., Dr. Kodavanti's work showing
that insulin sensitivity responses occurred at doses that did not cause lung inflammation). The
dose relevant to effects was also dependent on animal strain.

•	Response depends on time, species, strain, and dose.

•	The discussion of relevant exposure concentration cutoff values focused more on animal
studies. There was general input that the human evidence cutoff at 400 ppb was sufficient or
could even be brought down to the 200-300 ppb range, again acknowledging that the relevant
cutoff might be endpoint specific. For animal studies, there may be justification for leaving the
cutoff where it is or expanding to higher concentrations, depending on the endpoint.

•	Animal studies can be used to help determine how much of a key event is needed to cause
downstream effects.

Question-and-Answer Session

Regarding the studies on the effect of 03 on glucose and insulin response, does the effect persist with
chronic exposure, or is the effect only short term?

•	It is a short-term effect; the intolerance goes away. However, animals can become desensitized
to 03 exposure. Given the animal responses, type 2 diabetes should be assessed as well.

•	A study in preprint assesses a singular gestational exposure to 03 that led to elevated blood
pressure that persisted through pregnancy. Pregnancy is another susceptible subgroup and prior
studies have shown lasting effects of 03 exposures during pregnancy. In addition, neurological
effects may develop at subchronic levels.

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Thursday, May 16, 2024

Session 1: Planning for the Review of Health Effects Evidence: Public Health Implications

Session co-chair introduction to topics, discussion questions, and panel
Session co-chairs: Alison Krajewski, U.S. EPA; Jason Sacks, U.S. EPA

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. They
discussed the importance of public health implications and the important questions to consider when
evaluating public health impacts, such as population and life stages, exposure conditions, and severity of
effect. The co-chairs noted important terms such as susceptibility and vulnerability and the difference
between each and explained EPA's intended approach to use the term "at-risk populations" in the ISA.
They described the four-category hierarchy the ISA uses for classification (adequate, suggestive,
inadequate, evidence of no effect) and further explained what each category entails. They also discussed
concentration response and how these thresholds differ from person to person based on the situation
and conditions, which makes it challenging to set standard thresholds.

Topic 1: At-Risk Populations

Discussion Questions:

Question 1: To what extent is new evidence available to inform the understanding of subpopulations
that are particularly susceptible to 03 exposures? How can recent evidence from epidemiologic,
controlled human exposure, and animal toxicological studies be used to inform conclusions related to
at-risk populations, such as genetic traits that may underlie susceptibility or additional life stages or
populations (e.g., those with preexisting diseases such as diabetes) potentially at increased risk of an 03-
related health effect? How can recent health effects evidence in particular populations be integrated
with other health information (e.g., mechanistic and biological plausibility information) to better
understand the public health impacts of 03 exposure?

Lead Discussants: Jason Sacks, U.S. EPA; Patrick Kinney, Boston University,

•	Those who had COVID and then recovered are likely a new at-risk population. In particular, they
may be at increased risk for other comorbidities (such as long COVID), but also may be at risk for
response to infection since infections may impact the airway and responsiveness.

•	In the toxicological literature, some studies examine housing enrichment.

•	In the epidemiologic literature, several studies examine cumulative impacts of at-risk factors
through indices like a neighborhood deprivation index and social vulnerability index.

•	While indices are helpful and provide meaningful insights on the impacts of at-risk factors, they
are indices, meaning they look at combined factors rather than tease apart the independent
effects of individual factors.

•	There was discussion about the separation of pregnancy and birth outcomes as an at-risk factor,
but the pregnancy and birth outcomes are part of the reproductive and developmental health
chapter or section, depending on the ISA.

•	There were several suggestions for potential research ideas that would be helpful for the ISAs,
including the 03 ISA.

•	The use of electronic health records (EHRs) and repeated-measure panel studies was discussed
to study 03-related health for populations with defined stress diseases, anxiety disorder, or
cardiovascular disease or dysautonomia.

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•	Environmental justice/redlining was also discussed in the context of identifying potentially at-
risk factors or populations.

•	There are differences in spatial/temporal resolution of exposures and stressors.

Question 2: Is there new information that identifies a combination of risk factors that can lead to one or
more life stages or populations being at greater risk compared to another? What new experimental and
observational studies are available to improve our understanding of critical exposure windows?

Lead Discussants: Kristen Rappazzo, U.S. EPA; Judit Marsillach, University of Washington

•	There was some additional discussion about the risk factors, including how COVID may impact
future research and considerations.

•	There was some discussion about identifying critical windows of exposure.

o The examples come mostly from the literature on reproduction (e.g.,

methods/approaches for identifying critical windows of exposure for gestational weeks).

o Time-series studies also might be helpful in identifying critical windows of exposure.

•	In addition to chemical co-exposures, it is important to consider the impact of nonchemical
stressors (e.g., temperature).

•	The combination of at-risk factors is important to know, like indices, but not all factors are equal
and there is no existing way to weight these factors.

•	Another at-risk factor that is emerging is weight-management drugs for obesity/BMI. The use of
these drugs may change how obesity/BMI are considered in analyses.

Topic 2: Concentration Response
Discussion Questions:

Question 1: How do the results of recent studies inform the shapes of the concentration-response
relationships for O3 and various health outcomes (e.g., mortality, hospital admissions), especially for
exposures relevant to 03 concentrations near the current 03 NAAQS?

Lead Discussants: Antonella Zanobetti, Harvard University; Lisa Baxter, U.S. EPA

•	New evidence is limited regarding concentration-response functions.

•	There was discussion on how exposure measurement can lead to error and then affect the
associations.

•	Some simulation models evaluate exposure models and can compare the measurements and
distributions for errors and precision.

•	To evaluate exposure models, there could be consideration of application of low-cost sensors to
help with area/geographies with limited monitoring or measuring.

•	There are also differences in exposure measurement/error in some spatial/temporal models.

Guestion-ancl-Answer Session

Can you talk about the 03 metric used as the basis for a threshold of 25 ppb?

•	It was an 8-hour maximum and a short-term analysis with a time series.

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Sessi ' g for the Review of Hur	sure and Health Risk Assessments

Session co-chair introduction to topics, discussion questions and panelists
Session Co-chairs: Mary Hutson, U.S. EPA; Tom Long, U.S. EPA

Session co-chairs introduced the topics, discussion questions, lead discussants, and panelists. They
noted that this session would review topics already covered in the workshop but would include a
broader range of new research and methods, which would inform EPA's quantitative risk assessments
for future NAAQS reviews. Four elements are considered when setting and reviewing standards: the
indicator, averaging times, form of standard, and level. In the 2020 review, the key evidence was
strongest for respiratory effects according to epidemiology and controlled human exposure studies.

Topic 1: Estimating Ambient Air Concentrations

Discussion Question:

Are there new approaches or improvements to estimating ambient concentrations for input into the
exposure modeling and epidemiologic-based risk assessment, including 03 concentrations representing
recent conditions and 03 concentrations just meeting objectives for each air quality scenario, that may
be appropriate to consider in this review? Specifically, is there new scientific evidence that can help
refine spatial and temporal estimates of 03 concentrations and/or inform estimates of changing 03
concentrations due to emissions reductions?

Lead Discussants: Heather Simon, U.S. EPA; William Vizuete, University of North Carolina; Ben
Wells, U.S. EPA

•	EPA discussed recent improvements in the modeling of ambient 03 concentrations to account
for changes in seasonal and diel distributions of 03 concentrations.

•	The ongoing challenges of addressing other photochemical oxidant sources (e.g., VOCs) in the
air quality models as NOx decreases were noted.

•	There is a need for better understanding of the spatial variations in 03 concentrations to
improve the characterization population exposures including potentially vulnerable
communities.

o Low-cost sensors were discussed, but the regulatory requirements for monitoring
network placement are aimed to capture data from locations where 03 levels are
expected to be highest, not specific populations.

o TEMPO could possibly measure boundary layer 03, but satellite products are better for
long-term averaging, not estimating day-to-day variability.

Topic 2: Estimating Exposure Concentrations

Discussion Question:

Are there new scientific developments related to the major components of exposure modeling,
including inputs to the model (e.g., microenvironmental concentrations, human activity patterns,
differential exposures to population groups, air exchange rate distributions, and indoor air chemistry)
that are appropriate for the EPA to consider in its assessment planning? Especially for the APEX model, is
there new scientific evidence available that may be appropriate to consider, such as new approaches or
tools for evaluating APEX performance (e.g., sensitivity analysis, field studies)?

Lead Discussants: John Langstaff, U.S. EPA; Alex Carll, University of Louisville; Michael Breen, U.S. EPA

•	Data inputs for APEX need improvement, particularly ambient 03 concentrations at fine spatial

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resolutions.

•	The recent incorporation of detailed school calendars from across the U.S. to the activity diaries
(CHAD) will improve APEX model inputs.

•	A new TracMyAir App—an individual exposure model that aims to predict real-time personal
exposures to PM, 03, and heat—may improve personal exposure estimates that could
potentially be used to support exposure assessment model inputs (e.g., CHAD diaries) and
evaluate model outputs.

•	The TracMyAir App could also evaluate the impacts of individuals who otherwise cannot
participate in controlled exposure studies (e.g., people with respiratory diseases).

•	The uncertainties related to modeling at-risk populations were highlighted, particularly the need
for more information on modeling activity patterns of at-risk populations, which may not be
fully captured (e.g., avoidance behaviors) in the current model inputs.

Topic 3: Lung Function Risk Analysis

Discussion Question:

Is there new information that would lessen uncertainties in the lung function models, particularly
uncertainties related to exposure circumstances less well studied in the controlled human exposure
experiments (e.g., response to low exposures and with low ventilation rates)? Are there approaches or
information regarding inter-individual variability in lung function that would support uncertainty and
variability characterization for 03-attributable lung function risk estimates?

Lead Discussants: Jim Brown, U.S. EPA; Jen Sellers, U.S. EPA; Sonja Sax, Epsilon

•	Discussion included the availability of new information to lessen uncertainties in the two lung
risk function models (Exposure-Response Model and the McDonnell Stewart Smith Model)
employed in the 2015 and 2020 reviews and, in particular, uncertainties related to exposure
circumstances less well studied in controlled human exposure experiments.

•	Issues related to health effects in response to 03 exposure were discussed, including
characterization of adverse health effects, the inter-individual variability of responses
documented in the controlled human exposure data, and the impact of prior exposures on the
responses.

Topic 4: Exposure to Benchmark Analyses

Discussion Question:

Is there new scientific evidence (e.g., human exposure studies, panel studies) that EPA should consider
that could inform benchmark 03 concentrations, exposure duration, and/or at-risk populations
evaluated in the population exposure to benchmark comparison analysis?

Lead Discussants: John Langstaff, U.S. EPA; Dave Peden, University of North Carolina; Sonja Sax, Epsilon

•	A recent 6.6-hour controlled human exposure study of 14 subjects at rest (Hernandez et al.,
2021) that showed a small but significant decrease in lung function was discussed, along with
potential for this study to inform the various exposure and risk models, which included data
from studies of similar duration but with exercise.

•	There is a need for more at-rest controlled human exposure studies at various durations with
more study subjects, including at-risk populations (e.g., people with asthma).

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Topic 5: Air Quality EpidemiologioBased Assessment

Discussion Questions:

Question 1: Do new studies exist that would permit EPA to estimate risks for specific at-risk
populations?

Lead Discussants: Neal Fann, U.S. EPA; Michael Jerrett, UCLA; Howard Chang, Emory University

•	The discussion highlighted new studies that could provide data inputs to the Environmental
Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) used for
epidemiologic-based exposure-risk assessments to characterize health impacts in at-risk
populations.

•	Several new multicity and nationwide studies reported associations with 03 exposure and
respiratory outcomes (Strosnider et al. 2019; Bi et al. 2023; and Stowell et al. 2024).

•	Several new studies assessed 03 exposure and associations with social determinants of health
effects at the neighborhood or zip code level (O'Lenick et al., 2017; Sheffield et al. 2019; Robles
et al. 2023; and Klompmaker et al. 2021).

•	Several recent national-level mortality studies of Medicare recipients assessed long-term effects
of 03 exposure at the individual and zip code levels with one study showing a protective effect.

Question 2: An important aspect in characterizing risk and making decisions regarding air quality
standard levels is the shape of the exposure-response relationships for 03 (based on the results from
controlled human exposure studies) and the shape of the concentration-response relationships for 03
(based on the epidemiologic studies). To what extent does new evidence made available since the last
review inform our understanding of: (1) the potential for a concentration threshold in the 03
concentration-response parameter; (2) the lowest concentrations from which one would specify the
concentration-response parameter; (3) nonlinear parametric or nonparametric concentration-response
functions at either low (i.e., y) concentrations; (4) the appropriate time lag to specify
when modeling 03 mortality and morbidity effects; (5) the specific sensitivity analyses that would be
appropriate to consider in support of uncertainty characterization for air quality epidemiologic-based
assessments?

Lead Discussants: Kristen Rappazzo, U.S. EPA; Antonella Zanobetti, Harvard University

•	In general, new epidemiologic studies focused on short-term effects have reported more linear
concentration-response functions with no threshold.

•	Recent studies of short-term effects of 03 exposure indicated that effects were seen in the first
one or two days for respiratory endpoints and had a lag of up to five days for cardiovascular
endpoints. Variability has been reported for outcomes associated with birth and pregnancy. It
was suggested that recent studies that reported on the synergistic effects of heat in the
changing climate could change the lag period.

•	The discussion highlighted the need for sensitivity analyses in support of uncertainty
characterization for air quality epidemiologic-based assessment, including for consideration of
different models and their impacts on thresholds; for studies to better control for factors like
respiratory infections in their analyses; and for studies to consider differences between personal
levels and ambient exposure levels when assessing dose-response concentrations.

Question 3: Is there new scientific evidence and/or new approaches, including joint effects and
interaction models, that would support the estimation 03-attributable risk for specific air quality

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scenarios independent of risk associated with exposure to other pollutants or stressors, such as
temperature? How might epidemiologic studies specifying stressors including temperature or pollen as
effect modifiers inform the EPA's understanding of the risks associated with 03 exposure under a
changing climate?

Lead Discussants: Neal Farm, U.S. EPA; Xiao Wu, Columbia University; Antonella Zanobetti, Harvard
University

•	A recent study (Coffman et al. 2024) employing BenMAP-CE to estimate the health impact
associated with changes in multiple air pollutants, which used both a single and multipollutant
approach, found that single-pollutant models are comparable with those quantified using a
multipollutant model.

•	Two recent studies assessed the interaction of 03 with climate and environmental stressors, as
well as synergistic effects of particulate matter and 03 that could inform the EPA's
understanding of the risks associated with O3 exposure under a changing climate (Dominici et al.
2022; Liu et al. 2023).

•	Accounting for temperature and other meteorological and regional parameters as effect
modifiers of a number of 03-attributable endpoints is important in epidemiologic-based risk
assessments.

Question-and-Answer Session

Was a study area at elevation considered for inclusion in the 2020 assessment and will the upcoming
review include one of these locations based on the higher 03 levels at elevation?

•	Both Denver and Salt Lake City were considered but not used. At the time, the modeling
platform was new with lower performance and did not model those areas well.

Re: the APEX model, how did one uncertainty stem from the underestimation of autocorrection in
individual behavior? Could the sensitivities be conducted with higher levels of autocorrelation to
better simulate groups with significant time outside?

•	This scenario is possible, and it would also be helpful to have more information on
autocorrelation using real diaries.

Could heat index be used as an indicator of temperature stress on health outcomes?

•	There do not appear to be any studies on this topic. Heat index is not the only measure of
temperature; humidity is a summary measure and in a non-fixed relationship.

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Appendix A: Attendance

U.S. EPA Planning Committee
Christine Alvarez

Project Manager

U.S. Environmental Protection Agency
Olivia Birkel

Project Manager Support

U.S. Environmental Protection Agency

Parker Duffney

Toxicologist

U.S. Environmental Protection Agency

Jeffrey Herrick

Ecologist

U.S. Environmental Protection Agency

Qingyu Meng

Physical Scientist

U.S. Environmental Protection Agency

Kristopher Novak

Ecologist

U.S. Environmental Protection Agency

Mary Hutson

Health Scientist

U.S. Environmental Protection Agency

Leigh Meyer, MS

Biologist

U.S. Environmental Protection Agency

Co-Chairs, Panelists, and Lead Discussants
Anne Barkley, PhD

Postdoctoral Research Scientist
U.S. Environmental Protection Agency

Mike Barna, PhD

Physical Scientist

National Park Service | Air Resources Division

Lisa Baxter, PhD

Director

U.S. Environmental Protection Agency

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Michael Breen, PhD

Research Physical Scientist

U.S. Environmental Protection Agency

James Brown, PhD

Senior Health Scientist

U.S. Environmental Protection Agency

Peter Byrley, PhD

Physical Scientist

U.S. Environmental Protection Agency

Alex Carll, PhD

Assistant Professor
University of Louisville

Wayne Cascio, MD

Director, Center for Public Health, and Environmental Assessment
U.S. Environmental Protection Agency

Howard Chang, PhD

Professor

Emory University | Rollins School of Public Health

Olivia Clifton, PhD

Associate Research Scientist

Columbia University | NASAGoddard Institute for Space Studies

Evan Coffman, MPH

Epidemiologist

U.S. Environmental Protection Agency

Rebecca Dalton, PhD

Ecologist

U.S. Environmental Protection Agency

Jean-Jacques Dubois, PhD

Ecologist

U.S. Environmental Protection Agency

Parker Duffney, PhD

Toxicologist

U.S. Environmental Protection Agency

Steven Dutton, PhD

Division Director

U.S. Environmental Protection Agency

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Lisa Emberson, PhD

Professor

University of York | Environment and Geography Department

Neal Fann, MPH

Senior Policy Analyst

U.S. Environmental Protection Agency

Aimen Farraj, PhD

Principal Investigator

U.S. Environmental Protection Agency

Daniel Goldberg, PhD

Assistant Research Professor

George Washington University | Department of Environmental and Occupational Health

Mehdi Hazari, PhD

Research Physiologist

U.S. Environmental Protection Agency

Barron Henderson, PhD

Physical Scientist

Air Quality Analysis Division | Air Quality Modeling Group of the Office of Air Quality Planning and
Standard

Jeff Herrick, PhD

Ecologist

U.S. Environmental Protection Agency

Kirstin Hester, PhD

Biologist

U.S. Environmental Protection Agency

Mary Hutson, PhD

Health Scientist

U.S. Environmental Protection Agency

Dan Jaffe, PhD

Professor

University of Washington-Bothell | School of STEM | Physical Sciences Division

Annie Jarabek, PhD

Senior Science Advisor

U.S. Environmental Protection Agency

Scott Jenkins, PhD

Chief, Integrated Health Assessment Branch

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U.S. Environmental Protection Agency
Michael Jerrett, PhD

Professor of Environmental Health Sciences
University of California - Los Angeles

Doug Kaylor, PhD

Ecologist

U.S. Environmental Protection Agency

Patrick Kinney, PhD/ScD

Beverly Brown Professor of Urban Health
Boston University, School of Public Health

Urmila Kodavanti, PhD

Research Biologist

U.S. Environmental Protection Agency

Alison Krajewski, PhD

Epidemiologist

U.S. Environmental Protection Agency

John Langstaff, MA

Environmental Scientist

U.S. Environmental Protection Agency

Meredith Lassiter, PhD

Ecologist

U.S. Environmental Protection Agency

David Lehmann, PhD

Toxicologist

U.S. Environmental Protection Agency

Danica Lombardozzi, PhD

Assistant Professor

Colorado State University | Ecosystem Science and Sustainability Department

Tom Long, PhD

Assistant Center Director

U.S. Environmental Protection Agency

Amy Luo

PhD Candidate, Ecology and Evolutionary Biology

University of Tennessee

Scientist in Park Intern

Great Smoky Mountain National Park

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Jason Lynch, PhD

Ecologist

U.S. Environmental Protection Agency

Huiting Mao, PhD

Professor

State University of New York College of Environmental Science and Forestry | Department of Chemistry

Judit Marsillach, PhD

Assistant Professor

University of Washington School of Public Health | Department of Environmental and Occupational
Health Sciences

Steve McDow, PhD

Physical Scientist

U.S. Environmental Protection Agency

Qingyu Meng, PhD

Physical Scientist

U.S. Environmental Protection Agency

Leigh Meyer, MS

Biologist

U.S. Environmental Protection Agency

Deirdre Murphy, PhD

U.S. Environmental Protection Agency

Kristopher Novak, PhD

Ecologist

U.S. Environmental Protection Agency
Dave Peden, MD

Professor, Dean for Translational Research, Medical Director
University of North Carolina at Chapel Hill

Robert Pinder, PhD

Supervisory Physical Scientist

U.S. Environmental Protection Agency

Sally Pusede, PhD

Associate Professor

University of Virginia | Department of Environmental Sciences

Havala Pye, PhD

Research Scientist

U.S. Environmental Protection Agency

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Emmi Felker-Quinn, PhD

Ecologist

National Park Service | Air Resources Division

Kristen Rappazzo, PhD

Research Epidemiologist

U.S. Environmental Protection Agency

Susan Sachs

Education Branch Coordinator
Great Smoky Mountains National Park

Jason Sacks, MPH

Research Epidemiologist

U.S. Environmental Protection Agency

Sonja Sax, ScD

Environmental Health Scientist, Senior Consultant
Epsilon Associates, Inc.

Uma Shankar, PhD

Physical Scientist

U.S. Environmental Protection Agency

Tim Sharac, MS

Physical Scientist

U.S. Environmental Protection Agency

Drew Shindell, PhD

Nicholas Professor of Earth Science
Duke University

Sam Silva, PhD

Assistant Professor
University of Southern California

Heather Simon, PhD

Physical Scientist

U.S. Environmental Protection Agency

Travis Smith, PhD

Ecologist

U.S. Environmental Protection Agency
Susan Stone, MS

Senior Environmental Health Scientist
U.S. Environmental Protection Agency

37


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Ripley Tisdale, PhD

USDA-ARS Research Plant Physiologist
Plant Science Research Unit

Gail Tonnesen, PhD

Environmental Engineer

U.S. Environmental Protection Agency | Region 8

William Vizuete, PhD

Professor

University of North Carolina at Chapel Hill | Gillings School of Global Public Health
Christopher Weaver, PhD

Division Director of the Integrated Climate Sciences Division
U.S. Environmental Protection Agency

Ben Wells

Statistician

U.S. Environmental Protection Agency

Jason West, PhD

Professor

University of North Carolina at Chapel Hill

Xiao Wu, PhD

Assistant Professor
Columbia University

Antonella Zanobetti, PhD

Principal Research Scientist

Harvard T.H. Chan School of Public Health

ICF Support

Janae Bonnell
Joshua Cleland
Tara Hamilton
Leah Hennelly
Aishwarya Javali
Kaedra Jones
Andrew Maresca
Lucas Melogno Rochas
Sheerin Shirajan
Harry Whately
Sam Whately

38


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Appendix B: Simple Public Agenda

Workshop to Inform Review of the Ozone National Ambient Air Quality
Standards

Agenda

Monday, May 13, 2024



Timing

Agenda Item

9:50 AM-10:00 AM

Host Opening

10:00 AM-10:15 AM

Opening Remarks

10:15 AM-10:30 AM

Welcome and Purpose of the Meeting

10:30 AM-11:00 AM

Introduction to NAAQS

Session 1: Characterizing Ozone Chemistry and Transport, Air Quality Patterns,
and Ozone as a Greenhouse Gas

11:00 AM-11:15 AM

Session Chair Introduction to Topics, Discussion Questions, and Panel

11:15 AM-12:00 PM

Topic 1: Ozone Chemistry and Transport and Resulting Concentration Patterns

12:00 PM- 12:45 PM

Topic 2: Current State of U.S. Emissions and Connection to Health and Environmental
Justice

12:45 PM — 1:00 PM

Questions and Answer Session

1:00 PM — 1:30 PM

Lunch

1:30 PM — 2:15 PM

Topic 3: Monitoring and Modeling Advances

2:15 PM — 3:00 PM

Topic 4: Background Ozone Concentrations

3:00 PM — 3:45 PM

Topic 5: Ozone as a Greenhouse Gas

3:45 PM — 4:00 PM

Questions and Answer Session

4:00 PM

Day 1 Adjournment

Tuesday, May 14, 2024

10:00 AM-10:10 AM

Host Opening

10:10 AM-10:15 AM

Opening Remarks

Session 1: Planning for the Review of the Welfare Effects Evidence and Analyses
Review of welfare effects evidence

10:15 AM-10:30 AM

Session Chair Introduction to Topics, Discussion Questions, and Panel

10:30 AM-11:00 AM

Topic 1: Ecosystem Processes

11:00 AM-11:30 AM

Topic 2: Community Level Effects

11:30 AM-12:00 PM

Topic 3: Population/Individual Level Effects

12:00 PM-12:30 PM

Topic 4: Exposure/Dose-Response

12:30 PM — 1:00 PM

Topic 5: Climate and Other Modifying Factors

1:00 PM — 1:15 PM

Questions and Answer Session

1:15 PM — 2:00 PM

Lunch

2:00 PM — 4:15 PM

Session 2: Welfare Risk and Exposure Assessment

4:15 PM — 4:30 PM

Questions and Answer Session

4:30 PM

Day 2 Adjournment

39


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Wednesday, May 15, 2024

Timing

Agenda Item

9:50 AM -10:00 AM
10:00 AM-10:15 AM

Host Opening
Opening Remarks

Session 1: Human Exposure to Ambient O3

10:15 AM -10:30 AM
10:30 AM-11:15 AM
11:15 AM-11:45 AM
11:45 AM -12:00 PM
12:00 PM-12:30 PM

Session Chair Introduction to Topics, Discussion Questions, and Panel

Topic 1: Exposure Surrogates, Errors, and Measurement/Modeling Approaches

Topic 2: Exposure to 03 in a Multipollutant Environment

Questions and Answer Session

Lunch

Session 2: Planning for the Review of Health Effects Evidence - Emerging Evidence and Interpretation

12:30 PM-12:45 PM
12:45 PM — 2:15 PM
2:15 PM — 3:15 PM

Session Chair Introduction to Topics, Discussion Questions, and Panel
Topic 1: Emerging Evidence, Health Outcomes, and Methods
Topic 2: Interpretation of Evidence

3:15 PM — 5:00 PM

Session 3: Planning for the Review of Health Effects Evidence - Evidence Integration

5:00 PM — 5:15 PM
5:15 PM

Questions and Answer Session
Day 3 Adjournment

Thursday, May 16, 2024

9:50 AM-10:00 AM
10:00 AM-10:15 AM

Host Opening
Opening Remarks

Session 1: Planning for the Review of Health Effects Evidence: Public Health Implications

10:15 AM -10:30 AM
10:30 AM-11:20 AM
11:20 AM-11:40 AM
11:40 AM-11:55 AM
11:55 AM -12:30 PM

Session Chair Introduction to Topics, Discussion Questions, and Panel

Topic 1: At-Risk Populations

Topic 2: Concentration Response

Questions and Answer Session

Lunch

Session 2: Planning for the Review of Human Exposure and Health Risk Assessments

12:30 PM-12:45 PM
12:45 PM — 1:15 PM
1:15 PM — 1:45 PM
1:45 PM — 2:15 PM
2:15 PM — 2:35 PM
2:35 PM — 3:35 PM
3:35 PM — 3:50 PM
3:50 PM — 4:00 PM

Session Chair Introduction to Topics, Discussion Questions, and Panel

Topic 1: Estimating Ambient Air Concentrations

Topic 2: Estimating Exposure Concentrations

Topic 3: Lung Function Risk Analysis

Topic 4: Exposure to Benchmark Analyses

Topic 5: Air Quality Epidemiologic-Based Assessment

Questions and Answer Session

Closing Remarks and Adjournment

40


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Monday, May 13, 2024

Timing (ET)

Agenda Item

9:50 AM-10:00 AM
10:00 AM-10:15 AM
10:15 AM-10:30 AM
10:30 AM-11:00 AM

Host Opening
Opening Remarks

Welcome and Purpose of the Meeting
Introduction to NAAQS

Session 1: Characterizing Ozone Chemistry and Transport, Air Quality Patterns,
and Ozone as a Greenhouse Gas

11:00 AM-11:15 AM
11:15 AM-12:00 PM

12:00 PM-12:45 PM

12:45 PM - 1:00 PM
1:00 PM -1:30 PM
1:30 PM -2:15 PM
2:15 PM -3:00 PM
3:00 PM -3:45 PM
3:45 PM -4:00 PM
4:00 PM

Session Chair Introduction to Topics, Discussion Questions, and Panel
Topic 1: Ozone Chemistry and Transport and Resulting Concentration
Patterns

Topic 2: Current State of U.S. Emissions and Connection to Health and
Environmental Justice
Questions and Answer Session
Lunch

Topic 3: Monitoring and Modeling Advances Relevant to Welfare

Topic 4: Background Ozone Concentrations

Topic 5: Ozone as a Greenhouse Gas

Questions and Answer Session

Day 1 Adjournment

Tuesday, May 14, 2024

10:00 AM-10:10 AM
10:10 AM-10:15 AM

Host Opening
Opening Remarks

Session 1: Planning for the Review of the Welfare/Ecological Effects Evidence

10:15 AM-10:30 AM
10:30 AM-11:00 AM
11:00 AM-11:30 AM
11:30 AM-12:00 PM
12:00 PM-12:30 PM
12:30 PM - 1:00 PM
1:00 PM -1:15 PM
1:15 PM -2:00 PM

Session Chair Introduction to Topics, Discussion Questions, and Panel

Topic 1: Ecosystem Processes

Topic 2: Community Level Effects

Topic 3: Population/Individual Level Effects

Topic 4: Exposure/Dose-Response

Topic 5: Climate and Other Modifying Factors

Questions and Answer Session

Lunch

2:00 PM -4:15 PM

Session 2: Welfare Risk and Exposure Assessment

4:15 PM -4:30 PM
4:30 PM

Questions and Answer Session
Day 2 Adjournment

41


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Appendix C: Detailed Agenda for Chairs/Panelists:
Day 1, May 13, 20241

Timing

Agenda Item

9:50-10:00 a.m. ET

Host Opening [ICF]

10:00-10:15 a.m. ET

Opening Remarks [Chris Frey, U.S. EPA]

10:15-10:30 a.m. ET

Welcome and Purpose of the Meeting [Steve Dutton, Chris Weaver and
Erika Sasser, U.S. EPA]

10:30-11:00 a.m. ET

Introduction to NAAQS [OAR and ORD, U.S. EPA]

Session 1: Characterizing Ozone Chemistry and Transport, Air Quality Patterns, and Ozone as a
Greenhouse Gas (11:00 am - 3:45 pm)

Session Co-chairs: Anne Barkley (EPA), Olivia Clifton (NASA-GISS/Columbia)

Panelists: Havala Pye (EPA), Barron Henderson (EPA), Heather Simon (EPA), Gail Tonnesen (EPA
Region 8), Olivia Clifton (NASA-GISS/Columbia), Dan Jaffe (Univ. Wash.), Daniel Goldberg (GWU), Sally
Pusede (UVA), Sam Silva (USC (Cali)), William Vizuete (UNC), Jason West (UNC), Uma Shankar (EPA),
Mike Barna (NPS), Drew Shindell (Duke), Peter Byrley (EPA), Chris Weaver (EPA), Rob Pinder (EPA), Jeff
Herrick (EPA)

11:00-11:15 a.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel



Topic 1: Ozone Chemistry and Transport and Resulting Concentration



Patterns



• What new information is available and what are the most



significant advances in theoretical chemistry, kinetics and

11:15 a.m.-12:00 p.m. ET

smog chamber work, field experiments, ambient monitoring,

Topic 1

satellite observations, and numerical modeling that improve

our current understanding of 03 production, loss, and



transport? What are the implications of this new



information?



Lead discussants assigned: Sally Pusede (UVa) and Havala Pye (EPA)



Topic 2: Current State of U.S. Emissions and Connection to Health and



Environmental Justice

12:00-12:45 p.m. ET



• What new information is available to inform how 03 versus

Topic 2

total oxidant exposure differ across spatial scales,



particularly in urban areas where 03 concentrations are low



because of reactions with NO and where environmental

1 Participation time is set to eastern standard time.

42


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Session 1: Characterizing Ozone Chemistry and Transport, Air Quality Patterns, and Ozone as a
Greenhouse Gas (11:00 am - 3:45 pm)

justice concerns are particularly important? What metrics
are available to accurately describe the relationship
between 03 and total oxidant exposure; for example, could a
combination of indicators be used?

Lead discussants assigned: William Vizuete (UNC) and Gail Tonnesen
(EPA Region 8)

12:45 - 1:00 p.m. ET	Questions and Answer Session

1:00 - 1:30 p.m. ET	Lunch

Topic 3: Monitoring and Modeling Advances Relevant to Welfare

•	What recent advances have been made in monitoring and modeling
concentrations of 03? How accurate are recently developed
modeling approaches (including hybrid models that utilize data from
satellites, land use information, ground-based monitors, etc.) at
predicting 03 emissions and 03 concentrations across locations (e.g.,
urban vs. rural, monitored vs. unmonitored)? What have the new
advances contributed to characterizing and understanding sources
and precursors (e.g., wildfires, oil and gas emissions,
intercontinental transport, etc.) that contribute to ambient 03,
particularly in the west and intermountain west where 03 has an
impact on sensitive ecosystems?

Lead discussants assigned: Dan Goldberg (GWU) and Heather Simon
(EPA)

Topic 4: Background Ozone Concentrations

•	What new information is available on characterizing or estimating
background 03 concentrations (e.g., including hybrid methods)?
What have new advances in monitoring and modeling contributed to
characterizing sources and precursors (e.g., wildfires,
intercontinental transport, stratosphere-troposphere exchange, etc.)
that contribute to background 03 concentrations? Is there new
information on atmospheric transport, chemistry, and concentration
trends that can be used to reduce uncertainties in seasonal or daily
background 03 estimates?

Lead discussants assigned: Dan Jaffe (Univ Wash) and Barron Henderson
(EPA)

Topic 5: Ozone as a Greenhouse Gas

•	How have modeling studies conducted since the previous Ozone ISA
3:00 - 3:45 p.m. ET changed the ISA conclusions regarding the response of the climate

system to 03 impacts? What new information is there on the role of
regional and seasonal variations in the atmospheric budgets of 03
and therefore on its climate impacts? What new information is there

1:30-2:15 p.m. ET
Topic 3

2:15-3:00 p.m. ET
Topic 4

43


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Session 1: Characterizing Ozone Chemistry and Transport, Air Quality Patterns, and Ozone as a
Greenhouse Gas (11:00 am - 3:45 pm)



on the impact of 03 on the terrestrial ecosphere and its climate
feedback? What is the role of precursors in the climate impacts of 03
under possible future emission scenarios?



Lead discussants assigned: Jason West (UNC) and Uma Shankar (EPA)

3:45-4:00 p.m. ET

Questions and Answer Session

4:00 p.m. ET

Adjourn [ICF]

Day 2, May 14, 20242

Timing

Agenda Item

10:00-10:10 a.m. ET

Host Opening [ICF]

10:10-10:15 a.m. ET

Opening Remarks [Liz Naess, U.S. EPA]

Session 1: Planning for the Review of the Welfare/Ecological Effects Evidence (10:15 am - 1:00 pm)

Session Co-chairs: Jeffrey Herrick/Kris Novak (EPA), Emmi Felker-Quinn (NPS)

Panelists: Doug Kaylor (EPA), Jason Lynch (EPA), Meredith Lassiter (EPA), Jean-Jacques Dubois (EPA),
Olivia Clifton (NASA), Danica Lombardozzi (CO State), Huiting Mao (SUNY-ESF), Lisa Emberson (Univ of
York, UK), Ripley Tisdale (USDA), Susan Sachs (NPS), Amy Luo (Univ of TN)

10:15-10:30 a.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel
Topic 1: Ecosystem Processes

10:30-11:00 a.m. ET

• What new information is available about ozone effects on ecosystem
processes such as water cycling, carbon sequestration, productivity,
and belowground/biogeochemical cycling?

Topic 1

Lead discussants assigned: Danica Lombardozzi (CO State) and Doug
Kaylor (EPA)

Question panel: Lisa Emberson (Univ of York, UK), Emmi Felker-Quinn
(NPS), Jason Lynch (EPA), Jeffrey Herrick (EPA)

Topic 2: Community-Level Effects

11:00-11:30 a.m. ET
Topic 2

•	What new information is available about ozone effects at the
community level such as biodiversity, community composition, and
species interactions?

•	What new information is available on ozone effects on volatile plant

2 Participation time is set to eastern standard time.

44


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11:30 a.m.-12:00 p.m. ET
Topic 3

Session 1: Planning for the Review of the Welfare/Ecological Effects Evidence (10:15 am - 1:00 pm)

signaling compounds and plant-insect signaling?

Lead discussants assigned: Emmi Felker-Quinn (NPS) and Meredith
Lassiter (EPA)

Question panel: Lisa Emberson (Univ of York, UK), Doug Kaylor (EPA)
Topic 3: Population/ Individual Level Effects

•	What new information is available about ozone effects at the
population or individual level such as survival, growth, reproduction,
phenology, visible foliar injury, and crop yield?

•	In particular, is there new information on non-tree species, non-
commodity crops, and species that are threatened and endangered
or culturally significant?

•	What new information is available on ozone effects on insect
herbivores and other wildlife?

Lead discussants assigned: Ripley Tisdale (USDA) and Jean-Jacques
Dubois (EPA)

Question panel: Jason Lynch (EPA), Doug Kaylor (EPA), Meredith Lassiter
(EPA), Susan Sachs (NPS), Amy Luo (Univ of TN)

Topic 4: Exposure/ Dose Response

•	What new information is available on linking concentration weighted
metrics (e.g., W126 & AOT40) to response of species found in the
United States?

•	Is there new information linking flux metrics to effects on species
that occur in the United States?

Lead discussants assigned: Lisa Emberson (Univ of York, UK) and Jeff
Herrick (EPA)

Question panel: Emmi Felker-Quinn (NPS), Olivia Clifton (NASA), Jean-
Jacques Dubois (EPA), Huiting Mao (SUNY-ESF)

Topic 5: Climate and Other Modifying Factors

•	Is there new information on how ozone's effects on ecosystems and
their components are modified by climate change and other factors
(e.g., temperature, soil moisture, nutrients, and/or other
pollutants)?

Lead discussants assigned: Jason Lynch (EPA) and Kris Novak (EPA)

Question panel: Emmi Felker-Quinn (NPS), Doug Kaylor (EPA), Danica
Lombardozzi (CO State)

Questions and Answer sessions
Lunch

12:00-12:30 p.m. ET
Topic 4

12:30-1:00 p.m. ET

1:00-1:15 p.m. ET
1:15-2:00 p.m. ET

45


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Session 2: Welfare Risk and Exposure Assessment (2:00 - 4:15 p.m. ET)

Session Co-chairs: Leigh Meyer (EPA), Kris Novak (EPA)

Panelists: Travis Smith (EPA), Deirdre Murphy (EPA), Jason Lynch (EPA), Kris Novak (EPA), Heather
Simon (EPA), Ben Wells (EPA), Susan Stone (EPA), Barron Henderson (EPA), Jean-Jacques Dubois (EPA),
Jeffrey Herrick (EPA), Tim Sharac (EPA), Rachel Sales (EPA), Emmi Felker-Quinn (NPS), Olivia Clifton
(NASA-GISS/Columbia), Huiting Mao (SUNY-ESF), Lisa Emberson (Univ of York, UK), Will Vizuete (UNC),
Dan Jaffe (Univ. of Wash), Sally Pusede (UVa), Drew Shindell (Duke), Susan Sachs (NPS), Amy Lou (Univ
ofTN), Ripley Tisdale (USDA)

2:00-2:15 p.m. ET

2:15-2:45 p.m. ET

2:45-3:15 p.m. ET

3:15-3:45 p.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel

•	Ozone concentration gradients exist across the US and are influenced by
the location of emission sources and ozone chemistry and transport.
Reflecting those concentration gradients can be important in understanding
the protection provided by the ozone standard. What modeling approaches
are available and might be employed to estimate ambient air 03
concentrations across large areas, including forested areas and the sources
that influence air quality in these areas? What is an appropriate approach
to model or estimate 03 impacts upwind of urban areas?

o How might this be done to simulate different air quality scenarios,
including one for when the design value is just meeting the current
standard?

o What kind of case study areas or parts of the United States might be
appropriate to include in this assessment?

Lead discussants assigned: Ben Wells (EPA), Barron Henderson (EPA), Olivia
Clifton (NASA-GISS/Columbia), Will Vizuete (UNC)

•	How might climate change (e.g., temperature, precipitation changes) be
reflected in the air quality scenarios included in the risk and exposure
assessment? Are there climate change policies that should be accounted for
in the assessment? What analytical approaches could be used to assess the
influence of current climate change on risks to vegetation?

Lead discussants assigned: Rachel Sales (EPA) and Drew Shindell (Duke)

•	Recognizing the important role that species-specific exposure-response
functions have played in past reviews, are there new data or information
that should be incorporated to improve our understanding of these data
and resulting exposure-response functions? Are there different analytical
approaches that should be utilized?

o Are there other approaches that should be considered, including
approaches that might incorporate metrics for both peak
concentrations and for cumulative/sustained exposures on tree
seedling biomass?
o How can the dataset be analyzed differently to provide a clearer
understanding of the patterns of ambient air 03 concentrations
common today (e.g., reduced prevalence of peak concentrations)?

Lead discussants assigned: Travis Smith (EPA) and Lisa Emberson (Univ of
York, UK)

46


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Session 2: Welfare Risk and Exposure Assessment (2:00 - 4:15 p.m. ET)

• What approaches and methods are available that estimate 03 tree

community forest impacts (e.g., species diversity and richness) considering
interspecies competition and other interactions? For example, what are
current methods for modeling O3 concentration scenarios against tree
species competition over a period of time? What are their strengths and
3:45-4:15 p.m. ET limitations?

o Are studies, methods, or approaches available that might be used to
relate extent and magnitude of foliar injury in forested areas to public
uses/values and ecosystem services that might inform judgments of
public welfare significance?

Lead discussants assigned: Kris Novak (EPA) and Emmi Felker-Quinn (NPS)

4:15 - 4:30 p.m. ET Questions and Answer Session
4:30 p.m. ET	Adjourn [ICF]

47


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Day 3, May 15, 20243

Timing

Agenda Item

9:50-10:00 a.m. ET

Host Opening [ICF]

10:10-10:15 a.m. ET

Opening Remarks [Steve Dutton, U.S. EPA]

Session 1: Human Exposure to Ambient 03 (10:15 a.m. - 11:45 a.m.)

Session Co-chairs: Peter Byrley (EPA), Michael Jerrett (UCLA)

Panelists: Lisa Baxter (EPA), Jeffrey Brook (U. Toronto), Peter Byrley (EPA), Michael Jerrett (UCLA),
Patrick Kinney (Boston U), Sonja Sax (Epsilon Associates Inc.), Gail Tonnesen (EPA Region 8), William
Vizuete (UNC)

10:15-10:30 a.m. ET

10:30-11:15 a.m. ET
Topic 1

11:15-11:45 a.m. ET
Topic 2

11:45 a.m.-12:00 p.m. ET
12:00-12:30 p.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel

Topic 1: Exposure Surrogates, Errors, and Measurement/Modeling

Approaches

•	What new information is available on the relationship between
ambient ozone concentrations and personal exposures in various
microenvironments, including infiltration from outdoor to indoor
environments? What new information is available to improve our
understanding of the discrepancies between stationary monitor
measurements and actual pollutant exposures? What recent advances
have been made in monitoring and modeling (including hybrid models
that utilize data from satellites, land use information, ground-based
monitors, etc.) ambient concentrations of ozone across locations (e.g.,
urban vs. rural, monitored vs. unmonitored) to improve understanding
of human exposures? How have these approaches been evaluated and
validated in various types of locations (e.g., urban vs. rural, monitored
vs. unmonitored)?

Lead discussants assigned: Michael Jerrett (UCLA), Lisa Baxter (EPA)

Topic 2: Exposure to 03 in a Multipollutant Environment

•	What new information from measurement and modeling approaches
is available to characterize the relationships between ozone exposures
and exposures to other ambient air pollutants? Does this new
information provide insight into the potential for co-pollutants
confounding health studies.

Lead discussants assigned: Jeffrey Brook (Univ. Toronto), Peter Byrley

(EPA)

Questions and Answer Session

Lunch

3 Participation time is set to eastern standard time.

48


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Session 2: Planning for the Review of Health Effects Evidence:

Emerging Evidence and Interpretation (12:30 - 3:15 p.m. ET)

Session Co-chairs: David Lehmann (EPA), Howard Chang (Emory University)

Panelists: Kristen Rappazzo (EPA), Aimen Farraj (EPA), Mehdi Hazari (EPA), Lisa Baxter (EPA), James
Brown (EPA), Evan Coffman (EPA), Kirstin Hester (EPA), Alison Krajewski (EPA), Annie Jarabek (EPA),
Parker Duffney (EPA), David Lehmann (EPA), Howard Chang (Emory University), Michael Jerrett
(UCLA), Antonella Zanobetti (Harvard University), Judit Marsillach (University of Washington), Patrick
Kinney (Boston University), Sonja Sax (Epsilon), Alex Carll (University of Louisville), David Peden
(University of North Carolina), Jason West (University of North Carolina)

12:30-12:45 p.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel

12:45-1:15 p.m. ET
Topic 1

Topic 1: Emerging Evidence, Health Outcomes, and Methods (12:45 - 2:15 p.m. ET)

•	The last 03 ISA evaluated evidence for respiratory effects,
cardiovascular effects, metabolic-related health outcomes,
reproductive and developmental outcomes, nervous system effects,
cancer, and mortality. Since the last review, what new or emerging 03-
related health effect endpoints have been evaluated in epidemiologic,
controlled human exposure, or animal toxicological studies (e.g.,
cognitive decline, autism, immune effects)? Is there new evidence that
further informs endpoints included in the 2020 ISA. Specifically, is
there new evidence 1) that is consistent with causality determinations
in the 2020 ISA, 2) that contradicts causality determinations in the
2020 ISA, or 3) that further improves the understanding of biological
plausibility, health outcomes for at-risk populations, and health
outcomes at lower 03 concentrations?

Lead discussants assigned: Parker Duffney (EPA), Alex Carll (University of
Louisville)

•	Have recent controlled human exposure or animal toxicological studies
examined the potential mechanisms of action by which short-term
and/or long-term 03 exposures may result in health effects,
particularly cardiovascular effects and other effects not determined to
be "causal" in previous ISAs? Do recent experimental studies provide
insights into the biological plausibility of these 03-induced effects?

Lead discussants assigned: Aimen Farraj (EPA), David Peden (University of
North Carolina)

•	What new or emerging methodologies or study designs are available in
epidemiology to (1) address potential effect modifiers (e.g., genetic
traits and socioeconomic status) and confounders (both chemical and
nonchemical stressors), (2) disentangle the effects of long-term
exposure and short-term exposure to 03, (3) better understand
potential heterogeneity in 03 effects assessed in U.S. multicity studies,

1:15-1:45 p.m. ET

1:45-2:15 p.m. ET

49


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Session 2: Planning for the Review of Health Effects Evidence:



and (4) understand the role of 03 as a mediator?

Lead discussants assigned: Howard Chang (Emory University), Kristen
Rappazzo (EPA)

Topic 2: Interpretation of

Evidence (2:15 - 3:15 p.m. ET)

2:15-2:45 p.m. ET

2:45-3:15 p.m. ET

•	What factors are important to consider when evaluating epidemiologic
studies conducted in geographic regions less representative of
conditions in the United States (e.g., In terms of sources, air quality
mixtures, exposure patterns, population characteristics)?

Lead discussants assigned: Lisa Baxter (EPA), Antonella Zanobetti (Harvard

University)

•	To what extent is new scientific evidence becoming available from
experimental or epidemiologic studies to improve the understanding
of effects associated with various patterns of 03 exposure (e.g.,
repeated short-term exposures to "peak" concentrations versus
longer-term exposures to "average" concentrations)?

Lead discussants assigned: James Brown (EPA), Kristen Rappazzo (EPA)

Session 3: Planning for the Review of Health Effects Evidence: Evidence Integration (3:15-5:00 p.m. ET)
Session Co-chairs: Parker Duffney (EPA), Dave Peden (UNC)

Panelists: Kristen Rappazzo (EPA), Aimen Farraj (EPA), Mehdi Hazari (EPA), Lisa Baxter (EPA), Jim
Brown (EPA), Parker Duffney (EPA), David Lehmann (EPA), Kirstin Hester (EPA), Evan Coffman (EPA),
Alison Krajewski (EPA), Anne Barkley (EPA), Michael Jerrett (UCLA), Howard Chang (Emory), Antonella
Zanobetti (Harvard), Judit Marsillach (University of Washington), Sonja Sax (Epsilon), Patrick Kinney
(Boston U), Alex Carll (U. Louisville), Dave Peden (UNC), Annie Jarabek (EPA), Jason West (UNC)

3:15-3:30 p.m. ET

3:30-4:00 p.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel

• To what extent do recent advances in the ozone health effects
evidence support integration of findings across epidemiology,
controlled human exposure, animal toxicology, and dosimetry? What
does the new evidence indicate regarding consistency of findings
within disciplines (e.g., epidemiology studies of cardiovascular
mortality versus morbidity)? To what extent do recent ozone health
effects findings from a particular discipline compensate for data gaps
in other disciplines?

Lead discussants assigned: Parker Duffney (EPA), Michael Jerrett (UCLA)

50


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Session 3: Planning for the Review of Health Effects Evidence: Evidence Integration (3:15-5:00 p.m. ET)

4:00-4:30 p.m. ET

4:30-5:00 p.m. ET

5:00-5:15 p.m. ET
5:15 p.m. ET

•	What limitations are present in experimental studies that expose
humans or animals to "pure" ozone rather than to the ambient mix of
ozone and related photochemical oxidants (plus other co-occurring
pollutants)? Is there new information available for us to better
understand the health effects of photochemical oxidants other than 03
in ambient air?

Lead discussants assigned: Mehdi Hazari (EPA), Anne Barkley (EPA)

•	In the 2020 Ozone ISA, experimental studies were considered for
inclusion if subjects were exposed to ozone concentrations less than or
equal to 2 ppm (in animals) or 0.4 ppm (in humans). These limits were
based on findings that the deposition of ozone from a 2-hour exposure
to 2 ppm ozone in a resting rat is roughly equivalent to deposition of
ozone resulting from a 2-hour exposure to 0.4 ppm in an exercising
human (Hatch et al., 1994). Is there new or other data that can inform
the potential human health implications of animal studies of shorter-
term, but higher ozone concentration? How can recent animal studies
examining ozone exposures well above ambient concentrations inform
human responses near the level of the current standard?

Lead discussants assigned: James Brown (EPA), Annie Jarabek (EPA)

Questions and Answer Session

Adjourn [ICF]

51


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Day 4, May 16, 20244

•	To what extent is new evidence available to inform the
understanding of subpopulations that are particularly at increased
risk to 03 exposures? How can recent evidence from epidemiologic,
controlled human exposure, and animal toxicological studies be
used to inform conclusions related to at-risk populations, such as
genetic traits that may underlie increased risk or additional life
stages or populations (e.g., preexisting diseases such as diabetes)
potentially at increased risk of an 03-related health effect? How can
recent health effects evidence in particular populations be
integrated with other health information (e.g., mechanistic and
biological plausibility information) to better understand the public
health impacts of 03 exposure?

Lead discussants assigned: Jason Sacks (EPA), Patrick Kinney (Boston U)

•	Is there new information that identifies a combination of risk
factors that can lead to one or more life stages or populations being
at greater risk compared to another? What new experimental and
observational studies are available to improve our understanding of
critical exposure windows?

Lead discussants assigned: Kristen Rappazzo (EPA) and Judit Marsillach

(U Washington)

4 Participation time is set to eastern standard time.

10:30-10:50 a.m. ET

10:50-11:20 a.m. ET

52


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Session 1: Planning for the Review of Health Effects Evidence: Public Health Implications
(10:15 a.m.-11:55 a.m.)

Topic 2: Concentration Response

11:20-11:40 a.m. ET

• How do the results of recent studies inform the shapes of the
concentration-response relationships for 03 and various health
outcomes (e.g., mortality, hospital admissions, etc.), especially for
exposures relevant to 03 concentrations near the current 03
NAAQS?

Lead discussants assigned: Antonella Zanobetti (Harvard) and Lisa
Baxter (EPA)

11:40-11:55 a.m. ET

Questions and Answer Session

11:55 a.m.-12:30 p.m. ET

Lunch

Session 2: Planning for the Review of Human Exposure and Health Risk Assessments (12:30 - 3:50
p.m. ET)

Session Co-chairs: Mary Hutson (EPA), Tom Long (EPA)

Panelists: Heather Simon (EPA), John Langstaff (EPA), Michael Breen (EPA), Neal Fann (EPA), Barron
Henderson (EPA), Jim Brown (EPA), Ben Wells (EPA), Jen Sellers (EPA), Kristen Rappazzo (EPA), Susan
Stone (EPA), Henry Raab (EPA), William Vizuete (UNC), Sonya Sax (Epsilon), Michael Jerrett (UCLA),
Antonella Zanobetti (HSPS), Dave Peden (UNC), Howard Chang (Emory), Xiao Wu (Columbia), Alex
Carll (University of Louisville), Sally Pusede (UVA)

12:30-12:45 p.m. ET

12:45-1:15 p.m. ET

1:15-1:45 p.m. ET

Session Chair Introduction to Topics, Discussion Questions, and Panel

Topic 1: Estimating Ambient Air Concentrations

•	Are there new approaches or improvements to estimating ambient
concentrations for input into the exposure modeling and
epidemiologic-based risk assessment, including 03 concentrations
representing recent conditions and 03 concentrations just meeting
objectives for each air quality scenario that may be appropriate to
consider in this review? Specifically, is there new scientific evidence
that can help refine spatial and temporal estimates of 03
concentrations and/or inform estimates of changing 03 concentrations
due to emissions reductions?

Lead Discussants Assigned: Heather Simon (EPA), William Vizuete (UNC)

Ben Wells (EPA)

Topic 2: Estimating Exposure Concentrations

•	Are there new scientific developments related to the major
components of exposure modeling, including inputs to the model (e.g.,
microenvironmental concentrations, human activity patterns,

53


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1:45-2:15 p.m. ET

Session 2: Planning for the Review of Human Exposure and Health Risk Assessments (12:30 - 3:50
p.m. ET)

differential exposures to population groups, air exchange rate
distributions, and indoor air chemistry) that are appropriate for EPA to
consider in its assessment planning? Especially for the APEX model, is
there new scientific evidence available that may be appropriate to
consider, such as new approaches or tools for evaluating APEX
performance (e.g., sensitivity analysis, field studies)?

Lead Discussants Assigned: John Langstaff (EPA), Alex Carll (University of
Louisville), Michael Breen (EPA)

Topic 3: Lung Function Risk Analysis:

•	Is there new information that would lessen uncertainties in the lung
function models, particularly uncertainties related to exposure
circumstances less well studied in the controlled human exposure
experiments (e.g., response to low exposures and with low ventilation
rates)? Are there approaches or information regarding inter-individual
variability in lung function that would support uncertainty and
variability characterization for 03-attributable lung function risk
estimates?

Lead Discussants Assigned: Jim Brown (EPA), Jen Sellers (EPA), Sonja Sax
(Epsilon)

Topic 4: Exposure to Benchmark Analyses

•	Is there new scientific evidence (e.g., human exposure studies, panel
studies) that EPA should consider to inform benchmark 03
concentrations, exposure duration and/or at-risk populations evaluated
in the population exposure to benchmark comparison analysis?

Lead Discussants Assigned: John Langstaff (EPA) Dave Peden (UNC), Sonja
Sax (Epsilon)

Topic 5: Air Quality Epidemiologic-Based Assessment

•	Do new studies exist that would permit EPA to estimate risks in specific
at-risk populations?

Lead Discussants Assigned: Neal Fann (EPA), Michael Jerrett (UCLA),
Howard Chang (Emory)

•	An important aspect in characterizing risk and making decisions
regarding air quality standard levels is the shape of the exposure-
response relationships for 03 based on the results from controlled
human exposure studies and the shape of the concentration-response
relationships for 03 based on the epidemiologic studies. To what extent
does new evidence made available since the last review inform our
understanding of: (1) the potential for a concentration threshold in the
ozone concentration-response parameter; (2) the lowest
concentrations from which one would specify the concentration-

2:15-2:35 p.m. ET

2:35-2:55 p.m. ET

2:55-3:25 p.m. ET

54


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Session 2: Planning for the Review of Human Exposure and Health Risk Assessments (12:30 - 3:50
p.m. ET)



response parameter; (3) nonlinear parametric or nonparametric
concentration-response functions at either low (i.e., y)
concentrations; (4) the appropriate time lag to specify when modeling
ozone-mortality and morbidity effects?; 5) what specific sensitivity
analyses would be appropriate to consider in support of uncertainty
characterization for air quality epidemiologic-based assessments?



Lead Discussants Assigned: Kristen Rappazzo (EPA), Antonella Zanobetti
(HSPH)

3:25-3:45 p.m. ET

• Is there new scientific evidence and/or new approaches including joint
effects and interaction models that would support the estimation 03-
attributable risk for specific air quality scenarios independent of risk
associated with exposure to other pollutants or stressors, such as
temperature? How might epidemiologic studies specifying stressors
including temperature or pollen as effect modifiers inform EPA's
understanding of the risks associated with ozone exposure under a
changing climate?

Lead Discussants Assigned: Neal Fann (EPA), Xiao Wu (Columbia), Antonella
Zanobetti (HSPH)

3:45-4:00 p.m. ET

Questions and Answer Session

4:00-4:05 p.m. ET

Closing Remarks/Adjourn [EPA]

55


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Bibliog ' f

Characterizing Ozone Chemistry and Transport, Air Quality Patterns, and Ozone as a
Greenhouse Gas - May 13, 2024

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the Lake Michigan region inferred from TROPOMI observations and ground-based measurements.
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Acdan, J.J.M.; Pierce, R.B.; Dickens, A.F.; Adelman, Z.; Nergui, T. (2023). Examining TROPOMI

formaldehyde to nitrogen dioxide ratios in the Lake Michigan region: Implications for ozone
exceedances. Atmos Chem Phys 23 (14): 7867-7885.

Acdan, J.J.M.; Pierce, R.B.; Dickens, A.F.; Adelman, Z.; Nergui, T. (2023). Examining TROPOMI

formaldehyde to nitrogen dioxide ratios in the Lake Michigan region: Implications for ozone
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Almaraz, M.; Bai, E.; Wang, C.; Trousdell, J.; Conley, S.; Faloona, I.; Houlton, B.Z. (2018). Agriculture is a
major source of NOx pollution in California. Science Advances 4 (1): eaao3477.

Alvarez, R.A.; Zavala-Araiza, D.; Lyon, D.R.; Allen, D.T.; Barkley, Z.R.; Brandt, A.R.; Davis, K.J.; Herndon,
S.C.; Jacob, D.J.; Karion, A.; Kort, E.A.; Lamb, B.K.; Lauvaux, T.; Maasakkers, J.D.; Marchese, A.J.;
Omara, M.; Pacala, S.W.; Peischl, J.; Robinson, A.L.; Shepson, P.B.; Sweeney, C.; Townsend-Small, A.;
Wofsy, S.C.; Hamburg, S.P. (2018). Assessment of methane emissions from the U.S. oil and gas
supply chain. Science 361 (6398): 186-188.

Appel, K.W.; Bash, J.O.; Fahey, K.M.; Foley, K.M.; Gilliam, R.C.; Hogrefe, C.; Hutzell, W.T.; Kang, D.;

Mathur, R.; Murphy, B.N.; Napelenok, S.L.; Nolte, C.G.; Pleim, J.E.; Pouliot, G.A.; Pye, H.O.T.; Ran, L.;
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Akritidis, D.; Pozzer, A.; Flemming, J.; Inness, A.; Nedelec, P.; Zanis, P. (2022). A process-oriented

evaluation of CAMS reanalysis ozone during tropopause folds over Europe for the period 2003-
2018. Atmos Chem Phys 22 (9): 6275-6289.

Becker, J.S.; DeLang, M.N.; Chang, K.-L.; Serre, M.L.; Cooper, O.R.; Wang, H.; Schultz, M.G.; Schroder, S.;
Lu, X.; Zhang, L.; Deushi, M.; Josse, B.; Keller, C.A.; Lamarque, J.-F.; Lin, M.; Liu, J.; Marecal, V.;
Strode, S.A.; Sudo, K.; Tilmes, S.; Zhang, L.; Brauer, M.; West, J.J. (2023). Using regionalized air
quality model performance and Bayesian maximum entropy data fusion to map global surface
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Berndt, T.; Chen, J.; Kjaergaard, E.R.; M0ller, K.H.; Tilgner, A.; Hoffmann, E.H.; Herrmann, H.; Crounse,
J.D.; Wennberg, P.O.; Kjaergaard, H.G. (2022). Hydrotrioxide (ROOOH) formation in the
atmosphere. Science 376 (6596): 979-982.

Bernier, C.; Wang, Y.; Gronoff, G.; Berkoff, T.; Knowland, K.E.; Sullivan, J.T.; Delgado, R.; Caicedo, V.;
Carroll, B. (2022). Cluster-based characterization of multi-dimensional tropospheric ozone
variability in coastal regions: An analysis of lidar measurements and model results. Atmos Chem
Phys 22 (23): 15313-15331.

Bourgeois, I.; Peischl, J.; Neuman, J.A.; Brown, S.S.; Thompson, C.R.; Aikin, K.C.; Allen, H.M.; Angot, H.;
Apel, E.C.; Baublitz, C.B.; Brewer, J.F.; Campuzano-Jost, P.; Commane, R.; Crounse, J.D.; Daube, B.C.;
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L.G.; Jimenez, J.L.; Kim, M.; Lacey, F.; McKain, K.; Murray, L.T.; Nault, B.A.; Parrish, D.D.; Ray, E.;
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Bullock Jr, O.R.; Foroutan, H.; Gilliam, R.C.; Herwehe, J.A. (2018). Adding four-dimensional data

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Buysse, C.E.; Kaulfus, A.; Nair, U.; Jaffe, D.A. (2019). Relationships between particulate matter, ozone,
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Hornbrook, R.S.; Peischl, J.; Pfannerstill, E.Y.; Piel, F.; Reij'rink, N.G.; Ringsdorf, A.; Warneke, C.;
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Chance, K.; Liu, X.; Miller, C.C.; Abad, G.G.; Huang, G.; Nowlan, C.; Souri, A.; Suleiman, R.; Sun, K.; Wang,
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R.; Edwards, D.; Fishman, J.; Flittner, D.; Geddes, J.; Grutter, M.; Herman, J.R.; Jacob, D.J.; Janz, S.;
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Clifton, O.E.; Fiore, A.M.; Massman, W.J.; Baublitz, C.B.; Coyle, M.; Emberson, L.; Fares, S.; Farmer, D.K.;
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Clifton, O.E.; Schwede, D.; Hogrefe, C.; Bash, J.O.; Bland, S.; Cheung, P.; Coyle, M.; Emberson, L.;

Flemming, J.; Fredj, E.; Galmarini, S.; Ganzeveld, L.; Gazetas, O.; Goded, I.; Holmes, C.D.; Horvath, L.;
Huijnen, V.; Li, Q.; Makar, P.A.; Mammarella, I.; Manca, G.; Munger, J.W.; Perez-Camanyo, J.L.;
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Coggon, M.M.; Gkatzelis, G.I.; McDonald, B.C.; Gilman, J.B.; Schwantes, R.H.; Abuhassan, N.; Aikin, K.C.;
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S.J.; Petropavlovskikh, I.; Ries, L.; Senik, I.; Sjoberg, K.; Solberg, S.; Spain, G.T.; Spangl, W.;
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Couillard, M.H.; Schwab, M.J.; Schwab, J.J.; Lu, C.-H.; Joseph, E.; Stutsrim, B.; Shrestha, B.; Zhang, J.;
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Crippa, M.; Guizzardi, D.; Butler, T.; Keating, T.; Wu, R.; Kaminski, J.; Kuenen, J.; Kurokawa, J.; Chatani, S.;
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Dang, R.; Jacob, D.J.; Shah, V.; Eastham, S.D.; Fritz, T.M.; Mickley, L.J.; Liu, T.; Wang, Y.; Wang, J. (2023).
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Foley, K.M.; Pouliot, G.A.; Eyth, A.; Aldridge, M.F.; Allen, C.; Appel, K.W.; Bash, J.O.; Beardsley, M.;

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