ESTIMATING MORTALITY RISK REDUCTION AND ECONOMIC BENEFITS FROM CONTROLLING OZONE AIR POLLUTION

Committee on Estimating Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure

Board on Environmental Studies and Toxicology

Division on Earth and Life Studies

NATIONAL RESEARCH COUNCIL OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

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Committee on Estimating Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure Board on Environmental Studies and Toxicology Division on Earth and Life Studies

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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This project was supported by Contract 68-C-03-081 between the National Academy of Sciences and the U.S. Environmental Protection Agency. Any opinions, findings, conclusions, or recommen- dations expressed in this publication are those of the authors and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number-13: 978-0-309-11994-8 International Standard Book Number-10: 0-309-11994-4 Additional copies of this report are available from The National Academies Press 500 Fifth Street, NW Box 285 Washington, DC 20055 800-624-6242 202-334-3313 (in the Washington metropolitan area) http://www.nap.edu Copyright 2008 by the National Academy of Sciences. All rights reserved. Printed in the United States of America.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distin- guished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of pol- icy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering com- munities. The Council is administered jointly by both Academies and the Institute of Medi- cine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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COMMITTEE ON ESTIMATING MORTALITY RISK REDUCTION BENEFITS FROM DECREASING TROPOSPHERIC OZONE EXPOSURE Members JOHN C. BAILAR III (Chair), University of Chicago, IL RICHARD T. BURNETT, Health Canada, Ottawa, ON, Canada LAURAINE G. CHESTNUT, Stratus Consulting Inc., Boulder, CO W. MICHAEL FOSTER, Duke University Medical Center, Durham, NC A. MYRICK FREEMAN, III, Bowdoin College, Brunswick, ME MONTSERRAT FUENTES, North Carolina State University, Raleigh, NC DANIEL S. GREENBAUM, Health Effects Institute, Boston, MA ALAN KRUPNICK, Resources for the Future, Washington, DC NINO KÜNZLI, Center for Research in Environmental Epidemiology at Municipal Institute of Medical Research, Barcelona, Spain KENT E. PINKERTON, University of California, Davis, CA ARMISTEAD G. RUSSELL, Georgia Institute of Technology, Atlanta, GA HELEN SUH, Harvard School of Public Health, Boston, MA EVELYN O. TALBOTT, University of Pittsburgh Graduate School of Public Health, PA Staff RAYMOND A. WASSEL, Project Director NORMAN GROSSBLATT, Senior Editor MIRSADA KARALIC-LONCAREVIC, Manager, Technical Information Center JOHN BROWN, Program Associate RADIAH ROSE, Senior Editorial Assistant Sponsor U.S. ENVIRONMENTAL PROTECTION AGENCY v

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BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY1 Members JONATHAN M. SAMET (Chair), Johns Hopkins University, Baltimore, MD RAMON ALVAREZ, Environmental Defense Fund, Austin, TX JOHN M. BALBUS, Environmental Defense Fund, Washington, DC DALLAS BURTRAW, Resources for the Future, Washington, DC JAMES S. BUS, Dow Chemical Company, Midland, MI RUTH DEFRIES, University of Maryland, College Park COSTEL D. DENSON, University of Delaware, Newark E. DONALD ELLIOTT, Willkie Farr & Gallagher LLP, Washington, DC MARY R. ENGLISH, University of Tennessee, Knoxville J. PAUL GILMAN, Covanta Energy Corporation, Fairfield, NJ SHERRI W. GOODMAN, Center for Naval Analyses, Alexandria, VA JUDITH A. GRAHAM (Retired), Pittsboro, NC WILLIAM P. HORN, Birch, Horton, Bittner and Cherot, Washington, DC WILLIAM M. LEWIS, JR., University of Colorado, Boulder JUDITH L. MEYER, University of Georgia, Athens DENNIS D. MURPHY, University of Nevada, Reno PATRICK Y. O’BRIEN, ChevronTexaco Energy Technology Company, Richmond, CA DOROTHY E. PATTON (Retired), U.S. Environmental Protection Agency, Chicago, IL DANNY D. REIBLE, University of Texas, Austin JOSEPH V. RODRICKS, ENVIRON International Corporation, Arlington, VA ARMISTEAD G. RUSSELL, Georgia Institute of Technology, Atlanta ROBERT F. SAWYER, University of California, Berkeley KIMBERLY M. THOMPSON, Massachusetts Institute of Technology, Cambridge MONICA G. TURNER, University of Wisconsin, Madison MARK J. UTELL, University of Rochester Medical Center, Rochester, NY CHRIS G. WHIPPLE, ENVIRON International Corporation, Emeryville, CA LAUREN ZEISE, California Environmental Protection Agency, Oakland Senior Staff JAMES J. REISA, Director DAVID J. POLICANSKY, Scholar RAYMOND A. WASSEL, Senior Program Officer for Environmental Studies EILEEN N. ABT, Senior Program Officer for Risk Analysis SUSAN N.J. MARTEL, Senior Program Officer for Toxicology KULBIR BAKSHI, Senior Program Officer ELLEN K. MANTUS, Senior Program Officer RUTH E. CROSSGROVE, Senior Editor 1 This study was planned, overseen, and supported by the Board on Environmental Studies and Toxicology. vi

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OTHER REPORTS OF THE BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY Respiratory Disease Research at NIOSH (2008) Evaluating Research Efficiency in the U.S. Environmental Protection Agency (2008) Hydrology, Ecology, and Fishes of the Klamath River Basin (2008) Applications of Toxicogenomic Technologies to Predictive Toxicology and Risk Assessment (2007) Models in Environmental Regulatory Decision Making (2007) Toxicity Testing in the Twenty-first Century: A Vision and a Strategy (2007) Sediment Dredging at Superfund Megasites: Assessing the Effectiveness (2007) Environmental Impacts of Wind-Energy Projects (2007) Scientific Review of the Proposed Risk Assessment Bulletin from the Office of Management and Budget (2007) Assessing the Human Health Risks of Trichloroethylene: Key Scientific Issues (2006) New Source Review for Stationary Sources of Air Pollution (2006) Human Biomonitoring for Environmental Chemicals (2006) Health Risks from Dioxin and Related Compounds: Evaluation of the EPA Re- assessment (2006) Fluoride in Drinking Water: A Scientific Review of EPA’s Standards (2006) State and Federal Standards for Mobile-Source Emissions (2006) Superfund and Mining Megasites—Lessons from the Coeur d’Alene River Ba- sin (2005) Health Implications of Perchlorate Ingestion (2005) Air Quality Management in the United States (2004) Endangered and Threatened Species of the Platte River (2004) Atlantic Salmon in Maine (2004) Endangered and Threatened Fishes in the Klamath River Basin (2004) Cumulative Environmental Effects of Alaska North Slope Oil and Gas Devel- opment (2003) Estimating the Public Health Benefits of Proposed Air Pollution Regulations (2002) Biosolids Applied to Land: Advancing Standards and Practices (2002) The Airliner Cabin Environment and Health of Passengers and Crew (2002) Arsenic in Drinking Water: 2001 Update (2001) Evaluating Vehicle Emissions Inspection and Maintenance Programs (2001) Compensating for Wetland Losses Under the Clean Water Act (2001) A Risk-Management Strategy for PCB-Contaminated Sediments (2001) Acute Exposure Guideline Levels for Selected Airborne Chemicals (five vol- umes, 2000-2007) Toxicological Effects of Methylmercury (2000) Strengthening Science at the U.S. Environmental Protection Agency (2000) Scientific Frontiers in Developmental Toxicology and Risk Assessment (2000) Ecological Indicators for the Nation (2000) vii

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Waste Incineration and Public Health (2000) Hormonally Active Agents in the Environment (1999) Research Priorities for Airborne Particulate Matter (four volumes, 1998-2004) The National Research Council’s Committee on Toxicology: The First 50 Years (1997) Carcinogens and Anticarcinogens in the Human Diet (1996) Upstream: Salmon and Society in the Pacific Northwest (1996) Science and the Endangered Species Act (1995) Wetlands: Characteristics and Boundaries (1995) Biologic Markers (five volumes, 1989-1995) Review of EPA’s Environmental Monitoring and Assessment Program (three volumes, 1994-1995) Science and Judgment in Risk Assessment (1994) Pesticides in the Diets of Infants and Children (1993) Dolphins and the Tuna Industry (1992) Science and the National Parks (1992) Human Exposure Assessment for Airborne Pollutants (1991) Rethinking the Ozone Problem in Urban and Regional Air Pollution (1991) Decline of the Sea Turtles (1990) Copies of these reports may be ordered from the National Academies Press (800) 624-6242 or (202) 334-3313 www.nap.edu viii

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Preface The U.S. Environmental Protection Agency (EPA) asked for an independent study by the National Research Council to evaluate the scientific and technical bases of approaches used by EPA for estimating ozone-mortality reduction and associated benefits of health-based standards over time. In response, the National Research Council established the Committee on Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure. Biographic information on the committee members is presented in Appendix A. In the course of preparing this report, the committee met four times. At three of the meetings—which were held in Irvine, CA; Washington, DC; and Woods Hole, MA—officials of EPA and academic researchers were invited to meet with the committee and present their views and results of their work. Interested members of the public at large were also given an opportunity to speak on those occasions. The fourth meeting was held in closed session so that the committee could complete drafting its report. Subsequently, the committee held three teleconferences to complete its deliberations. As this report was being written, EPA was in the process of reviewing the existing National Ambient Air Quality Standards (NAAQS) for ozone. The pri- mary (health-based) ozone NAAQS was set at 0.08 parts ppm for the annual fourth-highest daily maximum 8-h average concentration, averaged over 3 years. The committee’s statement of task (see Chapter 1) and its deliberations were not dependent on EPA’s decisions provided in its final rule on March 12, 2008 which lowered the level of the 8-h standard to 0.075 ppm. The committee received oral and written presentations from John Balmes, University of California, San Francisco; Michelle Bell, Yale University; Kiros Berhane, University of Southern California; J.R. DeShazo, University of California, Los Angeles; James Hammitt, Harvard University; Bryan Hubbell, EPA; Al McGartland, EPA; Joel Schwartz, Harvard University; Anne Smith, CRA International; Deborah Shprentz, consultant to the American Lung Association; and Ira Tager, University of California, Berkeley. Nathalie Simon, of EPA, provided the committee with information from EPA and the published scientific literature. This report has been reviewed in draft form by persons chosen for their diverse perspectives and technical expertise in accordance with procedures ix

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x Preface approved by the National Research Council’s Report Review Committee. The purpose of the independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards of objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We thank the following for their review of this report: Francesca Dominici, Johns Hopkins University; Mark Frampton, University of Rochester; John Graham, Frederick S. Pardee RAND Graduate School; Jane Hall, California State University; James Hammitt, Harvard University; Fintan Hurley, Institute of Occupational Medicine (in the United Kingdom); Jonathan Levy, Harvard University; Thomas Lumley, University of Washington; Frederick Lurmann, Sonoma Technology, Inc.; Jennifer Peel, Colorado State University; Richard Smith, University of North Carolina; Ira Tager, University of California, Berkeley; and Sverre Vedal, University of Washington. Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of the report was overseen by Gilbert Omenn, University of Michigan Medical School, and Edwin Clark, II, Earth Policy Institute. Appointed by the National Research Council, they were responsible for making certain that an independent examination of the report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of the report rests entirely with the author committee and the institution. We thank the report review monitor and coordinator. We also thank Bailus Walker, Jr. for his constructive service on the committee; he resigned from the committee for personal reasons. The committee’s work for this report was assisted by staff of the National Research Council’s Board on Environmental Studies and Toxicology (BEST). We thank Raymond Wassel, project director, and James Reisa, director of BEST. Technical information was provided by Mirsada Karalic-Loncarevic. Invaluable logistical support was provided by John Brown. Other staff members who contributed to this effort are Radiah Rose (senior editorial assistant) and Heidi Murray-Smith (research associate). The report was edited by Norman Grossblatt. John C. Bailar III, Chair Committee on Mortality Risk Reduction Benefits from Decreasing Tropospheric Ozone Exposure

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Contents SUMMARY ...................................................................................................................... 3 1 INTRODUCTION ............................................................................................... 17 Charge to the Committee, 18 2 OVERVIEW OF AMBIENT-OZONE STANDARDS DEVELOPMENT AND BENEFITS ASSESSMENT ....................................................................... 23 Introduction, 23 Setting National Ambient Air Quality Standards for Ozone, 23 Implementing the NAAQS, 29 The Scientific Basis of Primary NAAQS for Ozone, 30 Regulatory Benefits Assessment for Setting and Implementing National Ambient Air Quality Standards, 33 Environmental Protection Agency’s Approach to Estimating Ozone Mortality Impacts and Valuing Mortality Risk Reduction, 41 Overview of Other Approaches, 44 The Major Questions, 47 3 AMBIENT OZONE AND RELATED POLLUTANTS .................................... 48 Ozone Formation and Transport, 48 Ozone Measurement, 53 Sources of Ozone Precursors and Ozone Control, 55 Related Pollutants, 56 Ozone Control, 63 Ozone Dynamics and Monitoring: Implications for Health Studies, 66 Ozone-Exposure Modeling, 70 Summary, 72 4 CONTRIBUTIONS OF RELEVANT HEALTH STUDIES TO THE ESTIMATION OF REDUCTIONS IN PREMATURE MORTALITY .......... 75 Introduction, 75 Biologic Plausibility, 76 Ozone-Mortality Studies, 78 Susceptibility, 96 Other Factors That Affect Interpretation of Ozone Mortality Effects, 102 xi

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xii Contents Use of Epidemiologic Information in Ozone-Related Risk and Benefits Assessment, 117 Conclusions and Recommendations, 121 5 ECONOMIC VALUATION OF REDUCTION IN MORTALITY RISK ASSOCIATED WITH AMBIENT OZONE .................................................... 128 Introduction, 128 Conceptual Underpinnings of Valuation of Mortality Risk, 129 Empirical Methods of Valuing Mortality-Risk Reductions, 134 Environmental Protection Agency’s Current Approach to Valuing Mortality- Risk Reductions, 139 Empirical Evidence on Valuation of Mortality-Risk Reductions, 144 Findings and Recommendations, 155 Recommendations for Future Research, 158 6 OVERALL CONCLUSIONS AND RECOMMENDATIONS ....................... 160 Ozone Mortality Effect, 160 Interpretation of Results of Health Studies, 161 Health-Based Information for Benefits Assessments, 169 Valuation, 172 Research Recommendations, 176 Regulatory Impact Analyses Involving Ozone Mortality, 179 REFERENCES ............................................................................................................ 182 ABBREVIATIONS ...................................................................................................... 204 APPENDIX A: BIOGRAPHICAL INFORMATION ON THE COMMITTEE ON ESTIMATING MORTALITY RISK REDUCTION BENEFITS FROM DECREASING TROPOSPHERIC OZONE EXPOSURE....................................................................................... 206 APPENDIX B: ENVIRONMENTAL PROTECTION AGENCY’S REGULATORY IMPACT ANALYSIS FOR THE FINAL OZONE NATIONAL AMBIENT AIR QUALITY STANDARD....................................... 211 BOXES, FIGURES, AND TABLES BOXES 1-1 Statement of Task, 19 2-1 The Estimation of the “Policy Relevant Background,” 27 2-2 Definition of Value of a Statistical Life in Relation to Willingness to Pay, and a Numerical Example, 36 2-3 Definition of Value of a Statistical Life Year in Relation to Value of a Statistical Life, and Numerical Examples, 37 3-1 Policy Relevant Background, 54 4-1 Definitions of Time-Series Analysis and Meta-Analysis, 80

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xiii Contents FIGURES 1-1 Methods used by EPA to assess the effects of NAAQS and control strategies developed to implement the standards, 22 2-1 Counties violating 1997 primary 8-h NAAQS for ozone and other photochemical oxidants, 26 2-2 Counties with monitors readings that would violate alternate 8-h ozone standards of 0.070 and 0.075 ppm proposed by EPA in June 2007 (on basis of 2003-2005 monitoring data), 28 3-1 Source and chemical links between ozone and PM formation, 49 3-2 Ozone isopleth diagrams showing the nonlinear response of ozone to emissions of VOCs and NOx and how they can vary from a city center to a downwind location, 51 3-3 Ozone concentrations in Atlanta in 2006: (a) diurnal variation of ozone on July 22; (b) daily maximum, 51 3-4 Simulated ozone concentration and sensitivity of ozone to Atlanta-area NOx and VOC emissions for downtown Atlanta and a suburban location downwind, 52 3-5 Anthropogenic sources of 2002 ozone-precursor emissions of VOCs and NOx, 56 3-6 Left, ozone and PM2.5 nonattainment areas in the eastern United States in 2006. Right, implementation of CAIR and other controls is expected to bring future ozone concentrations in many areas in the eastern United States into attainment of the previous 0.08-ppm ozone NAAQS, 57 3-7 Composition of PM2.5 in representative urban and rural locations. Urban sites are Toronto, ON, Canada; Washington, DC; Atlanta, GA; Mexico City, Mexico; Los Angeles, CA; and Fresno, CA, 63 3-8 Calculated daily sensitivities of maximum 8-h averaged ozone in Atlanta, Chicago, Houston, Los Angeles, and New York regionwide changes in NOx emissions and corresponding simulated concentrations, 65 3-9 Activity patterns by time of day. Adapted from U.S. National Human Activity Pattern Survey, 69 4-1 Percentage increase in ozone-associated mortality in meta-analyses and time-series studies, 90 TABLES 2-1 History of Primary NAAQS for Ozone and Other Photochemical Oxidants, 25 3-1a Day-to-Day Correlation Between Air Pollutants in Boston, MA, by Season (Summer Nonshaded, Winter Shaded), 1999-2004, 58 3-1b Day-to-Day Correlation Between Air Pollutants in St. Louis, MO, by Season (Nonwinter Clear, Winter Shaded), April 2001-September 2002, 58 3-1c Day-to-Day Correlation Between Air Pollutants in Los Angeles, CA, by Season (Nonwinter Clear, Winter Shaded), June 2002-December 2003, 59 3-2 Pollutant Correlations at Jefferson Street SEARCH Site, Atlanta, GA, 1999-2006, 61 3-3 Simulated Sensitivity of Annual Average Ozone to NOx and Sensitivity of Fourth- Highest 8-h Average Ozone to NOx, 65 4-1 Summaries of Recent Studies of Acute Effects of Ozone on Mortality, 82

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xiv Contents 4-2 Summaries of Recent Time Series Studies of Acute Effects of Ozone on Mortality, 84 4-3 Summary of Meta-analyses, 86 B-1 (EPA 2008b, Table 7-14) Illustrative Strategy to Attain 0.075 ppm: Estimated Annual Reductions in the Incidence of Premature Mortality Associated with Ozone Exposure in 2020 (Incremental to Current Ozone Standard, Arithmetic Mean, 95% Confidence Intervals in Parentheses, 212