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WASTE INCINERATION & PUBLIC HEALTH
(PM10 at 150 µg/m3). As a result, EPA moved to institute a more-stringent U.S. short-term PM mass concentration limit of 65 µg/m3 for fine particles (PM2.5, the mass of particles below 2.5 µm in diameter), and an annual PM2.5 limit of 15 µg/m3. On May 14, 1999, a panel of the U.S. Court of Appeals for the District of Columbia Circuit remanded the new standards for PM2.5.
Numerous investigators have reported statistically significant positive associations between relative risk for death and various indexes of PM in many cities in the United States and other countries. The elderly (over 65), particularly those with pre-existing respiratory disease, were found to have higher risks than younger adults (Thurston 1996). Studies suggest that children are also at increased risk from the adverse health effects of air pollution. During the London fog episode, the second highest increase in mortality (after older adults) was in the neonatal age group (relative risk, (RR) = 1.93 for children less than 1 year) (United Kingdom Ministry of Health 1954). More recently, Saldiva et al. (1994) found acute exposure to air pollution in Sao Paulo, Brazil to be significantly associated with respiratory mortality in children less than 5 years of age, although the effect could not be definitively associated with a specific pollutant. Also, Bobak and Leon (1992) and Woodruff et al. (1997) both found long-term averages of air-pollution, including PM, to be associated with increased post neonatal (ages 1 to 12 months) mortality. Thus, air pollution exposure has been associated with increased mortality, with the very young and the elderly being indicated as being especially at risk.
Published summaries of PM reports have converted all results to a PM10-equivalence basis and provided quantitative comparisons (Ostro 1993; Dockery and Pope 1994; Thurston 1996). Other summaries have used total suspended particles (TSP) as the reference PM metric (Schwartz 1991, 1994a) and considered many of the same studies included in the PM10-equivalence summaries. (Other air pollutants were generally not addressed in deriving the coefficients reported by these summaries.) The results suggest about a 1% change in acute total mortality for a 10-µg/m3 change in daily PM10. Such a change represents a seemingly small increment in risk from exposure to this pollutant, but it must be remembered that peak PM 10 concentrations are commonly about 100 µg/m3 above concentrations for an average day, that large populations are affected by this ubiquitous pollutant, and that this reported RR is for total mortality (with even higher RRs being found in studies of more affected specific causes, such as respiratory disease, and for sensitive populations, such as the elderly). Also, the implied increments in lifetime risk from small increments in exposure to particles are very high compared with typical values of regulatory interest. In the reviews cited above, the highest PM10-associated relative risks for death were indicated for the elderly and for those with pre-existing respiratory conditions; both constitute populations that appear to be especially sensitive to acute exposures to air pollution.