exist<strong>in</strong>g NAAQS. Consequently, it is possible th<strong>at</strong> the standardwill be lowered, thereby putt<strong>in</strong>g <strong>Houston</strong> <strong>in</strong> noncompliance andmak<strong>in</strong>g it subject to further penalties. Regardless of the st<strong>at</strong>utoryissues surround<strong>in</strong>g ozone and PM 2.5, and despite longstand<strong>in</strong>gand ongo<strong>in</strong>g control programs, the Task Force determ<strong>in</strong>edth<strong>at</strong> current outdoor concentr<strong>at</strong>ions of both ozone andf<strong>in</strong>e particul<strong>at</strong>e m<strong>at</strong>ter represent a real and present thre<strong>at</strong> to thehealth of <strong>Houston</strong> residents.Diesel exhaust is a complic<strong>at</strong>ed chemical mixture th<strong>at</strong>contributes to ambient levels of both gaseous and particul<strong>at</strong>eair pollution <strong>in</strong> urban and rural environments. It conta<strong>in</strong>smany known or suspected cancer-caus<strong>in</strong>g substances aswell as other harmful pollutants th<strong>at</strong> may cause acute andchronic health effects. The widespread use of diesel eng<strong>in</strong>esmeans th<strong>at</strong> diesel exhaust and its by-products are ubiquitous<strong>in</strong> urban <strong>at</strong>mospheres, and exposure is virtually unavoidablefor city dwellers. Among those most likely to experience higher-than-averageexposures are commuters, <strong>in</strong>clud<strong>in</strong>g childrenrid<strong>in</strong>g school buses, bus and truck drivers, oper<strong>at</strong>ors of heavyequipment, and people liv<strong>in</strong>g near busy streets and roadways,port facilities, <strong>in</strong>dustrial plants, and truck load<strong>in</strong>g andunload<strong>in</strong>g oper<strong>at</strong>ions. Although direct measurements ofambient concentr<strong>at</strong>ions are unavailable, <strong>in</strong>direct estim<strong>at</strong>es ofdiesel particle levels <strong>in</strong> <strong>Houston</strong> suggest th<strong>at</strong> residents areexperienc<strong>in</strong>g <strong>in</strong>creased risk of illness and prem<strong>at</strong>ure de<strong>at</strong>hfrom current exposures.The identific<strong>at</strong>ion of ozone, PM 2.5, and diesel particul<strong>at</strong>em<strong>at</strong>ter as def<strong>in</strong>ite health risks is rel<strong>at</strong>ively straightforward ow<strong>in</strong>gto the compar<strong>at</strong>ively large d<strong>at</strong>a base on adverse health effectsth<strong>at</strong> exists for each substance, along with clear evidence th<strong>at</strong>people are exposed to outdoor levels considered unsafe. Thepicture is generally less certa<strong>in</strong> and more problem<strong>at</strong>ic for theHAPs, which <strong>in</strong>clude a diverse mix of carc<strong>in</strong>ogens and systemictoxicants. These air pollutants historically have receivedless regul<strong>at</strong>ory <strong>at</strong>tention, and ambient concentr<strong>at</strong>ions andexposure-effect rel<strong>at</strong>ionships tend to be less well characterized.Accord<strong>in</strong>gly, unambiguous assignment of these substancesto a particular risk c<strong>at</strong>egory is often h<strong>in</strong>dered by<strong>in</strong>complete and <strong>in</strong>adequ<strong>at</strong>e d<strong>at</strong>a, mak<strong>in</strong>g it necessary <strong>in</strong> many<strong>in</strong>stances to use scientific judgment as a basis for extrapol<strong>at</strong><strong>in</strong>gbeyond the limited or nonexistent d<strong>at</strong>a base.Despite these difficulties, the Task Force found conv<strong>in</strong>c<strong>in</strong>gevidence th<strong>at</strong> 12 HAPs are def<strong>in</strong>ite health risks for<strong>Houston</strong>ians - 4 carc<strong>in</strong>ogens, 4 systemic toxicants, 2 substancesth<strong>at</strong> are both, ozone, and f<strong>in</strong>e particul<strong>at</strong>e m<strong>at</strong>ter (SeeAppendix 8, Table A8.1). Another 9 (7 cancer-caus<strong>in</strong>gagents, 1 systemic toxicant, and 1 th<strong>at</strong> is both) were design<strong>at</strong>edprobable risks because the Task Force deemed there wassufficient, although less compell<strong>in</strong>g evidence th<strong>at</strong> they currentlypose significant health risks for people liv<strong>in</strong>g <strong>in</strong> <strong>Houston</strong> (seeAppendix 8, Table A8.2). Although available d<strong>at</strong>a werepartial and uneven, the Task Force also decided there was sufficientsuggestive evidence to justify label<strong>in</strong>g an additional 24substances - 20 carc<strong>in</strong>ogens, 2 systemic toxicants, and 2 th<strong>at</strong>are both - as possible health risks <strong>at</strong> ambient concentr<strong>at</strong>ions <strong>in</strong><strong>Houston</strong> air. A further 16 substances, all carc<strong>in</strong>ogens, werefound to represent unlikely health risks because there are noknown emissions <strong>in</strong> the <strong>Houston</strong> area and/or model<strong>in</strong>g suggestedth<strong>at</strong> ambient levels are likely to be negligible (seeTable 4).The <strong>in</strong>tr<strong>in</strong>sic challenges of compar<strong>in</strong>g HAPs-rel<strong>at</strong>edhealth risks are illustr<strong>at</strong>ed by the fact th<strong>at</strong> 118 (67%) of the 176HAPs exam<strong>in</strong>ed by the Task Force were assigned to the uncerta<strong>in</strong>risk c<strong>at</strong>egory. This decision was based on our collectivejudgment th<strong>at</strong> there is <strong>in</strong>sufficient evidence on hand to ascerta<strong>in</strong>whether these substances currently pose a significantthre<strong>at</strong> to the health and well-be<strong>in</strong>g of <strong>Houston</strong> residents. Inshort, it was not possible to say, with an acceptable degree ofcerta<strong>in</strong>ty, whether these pollutants are a health risk. Obviously,from a public health perspective this leaves us <strong>in</strong> an uns<strong>at</strong>isfy<strong>in</strong>gsitu<strong>at</strong>ion, where<strong>in</strong> we lack the necessary scientific <strong>in</strong>form<strong>at</strong>ionto dist<strong>in</strong>guish among def<strong>in</strong>ite, probable, possible, andunlikely health risks. Only targeted research aimed <strong>at</strong> fill<strong>in</strong>gcritical d<strong>at</strong>a gaps and resolv<strong>in</strong>g crucial uncerta<strong>in</strong>ties will allowus eventually to (a) determ<strong>in</strong>e the appropri<strong>at</strong>e risk c<strong>at</strong>egory forHAPs presently listed as uncerta<strong>in</strong> risks, and (b) verify the riskassignments for HAPs <strong>in</strong> other c<strong>at</strong>egories.Notwithstand<strong>in</strong>g the <strong>in</strong>herent scientific uncerta<strong>in</strong>ties, theresults of our assessment further re<strong>in</strong>force the prevail<strong>in</strong>g op<strong>in</strong>ionof many experts th<strong>at</strong> ambient air pollution <strong>in</strong> <strong>Houston</strong> isharmful to exposed <strong>in</strong>dividuals and popul<strong>at</strong>ions. Furthermore,we know th<strong>at</strong> air pollution-rel<strong>at</strong>ed health risks disproportion<strong>at</strong>e-24
In summary, we view the compar<strong>at</strong>ive risk process as a decisiontool for organiz<strong>in</strong>g and analyz<strong>in</strong>g <strong>in</strong>form<strong>at</strong>ion about airpollution <strong>in</strong> a manner th<strong>at</strong> will aid decision makers as theyPhoto by Heidi Bethelchoose among compet<strong>in</strong>g priorities.ly affect those most vulnerable - the young, the elderly, the sick,the pregnant, the unborn, and the poor. Cumul<strong>at</strong>ive health risksfrom comb<strong>in</strong>ed effects of concurrent exposure to multiple airpollutants are a particular concern <strong>in</strong> vulnerable popul<strong>at</strong>ions.Socio-economically disadvantaged groups, for example, aremore likely to live near <strong>in</strong>dustrial facilities and busy roadways,where air pollution levels are typically elev<strong>at</strong>ed. Moreover, theyare also more likely to work <strong>in</strong> hazardous occup<strong>at</strong>ions, to reside<strong>in</strong> dilapid<strong>at</strong>ed hous<strong>in</strong>g with <strong>in</strong>adequ<strong>at</strong>e air condition<strong>in</strong>g, to e<strong>at</strong>a substandard diet, to smoke cigarettes and dr<strong>in</strong>k alcohol, andto generally live more stressful and less healthful lifestyles. Ittherefore makes sense from a public health perspective todirect <strong>at</strong>tention and resources toward high-risk groups so as toanticip<strong>at</strong>e and prevent adverse effects, if possible. Fail<strong>in</strong>g th<strong>at</strong>,emphasis should be placed on stopp<strong>in</strong>g or limit<strong>in</strong>g exposuresth<strong>at</strong> damage the health and well-be<strong>in</strong>g of the most vulnerable<strong>in</strong> our society.As we look for cost-effective solutions, it is imper<strong>at</strong>ive tounderstand and acknowledge th<strong>at</strong> air pollution is a by-productof our culture and our way of life. It is produced as a directresult of choices we make, both <strong>in</strong>dividually and collectively,about energy sources, technologies, economic activities, andlifestyles. While the rel<strong>at</strong>ive contribution of a particular sourceor source c<strong>at</strong>egory may vary from place to place, it is theblend<strong>in</strong>g together of comb<strong>in</strong>ed emissions from numerouspo<strong>in</strong>t, mobile, and area sources th<strong>at</strong> makes <strong>Houston</strong>'s airquality unhealthful. Thus, focus<strong>in</strong>g on a s<strong>in</strong>gle type of source,no m<strong>at</strong>ter how obvious or obnoxious, is unlikely, by itself, tosolve the problem.In summary, we view the compar<strong>at</strong>ive risk process as adecision tool for organiz<strong>in</strong>g and analyz<strong>in</strong>g <strong>in</strong>form<strong>at</strong>ion about airpollution <strong>in</strong> a manner th<strong>at</strong> will aid decision makers as theychoose among compet<strong>in</strong>g priorities. It is not, <strong>in</strong> our op<strong>in</strong>ion, adecision rule th<strong>at</strong> autom<strong>at</strong>ically and <strong>in</strong>evitably leads to a specificconclusion about resource alloc<strong>at</strong>ion. We hope our risk rank<strong>in</strong>gswill be a useful adjunct to other relevant <strong>in</strong>form<strong>at</strong>ion, andth<strong>at</strong> results will contribute to <strong>in</strong>formed decisions not only abouthow to use available resources more effectively and efficiently,but also about how to justify the need for additional fund<strong>in</strong>g.We recommend th<strong>at</strong> decision makers avoid us<strong>in</strong>g our f<strong>in</strong>d<strong>in</strong>gsas a detailed road map th<strong>at</strong> provides precise directions abouthow to move forward; <strong>in</strong>stead, we recommend th<strong>at</strong> they useresults as a compass to help determ<strong>in</strong>e appropri<strong>at</strong>e directionsfor the development of an overarch<strong>in</strong>g str<strong>at</strong>egy to address<strong>Houston</strong>'s air pollution problem.25
- Page 1 and 2: A Closer Look at Air Pollution in H
- Page 3 and 4: A Closer Look at Air Pollution in H
- Page 5 and 6: Task Force MembersResearch StaffKen
- Page 7 and 8: AcknowledgementsThe Task Force woul
- Page 10: Just because a task is difficult, h
- Page 13 and 14: ing, and route of exposure, and oth
- Page 15 and 16: and vulnerable subgroups. Substance
- Page 17 and 18: accurately from death certificates.
- Page 19 and 20: assessments, and monitoring data fr
- Page 21 and 22: The reality is that, even at simila
- Page 23 and 24: ability, have inadequate means to c
- Page 25: Houston reaches $21,701. These are
- Page 29 and 30: AppendicesPhoto by Heidi Bethel27
- Page 31 and 32: Photo by Heidi Bethelgrouping to a
- Page 33 and 34: Appendix 2the time period is repres
- Page 35 and 36: Appendix 3an appreciable risk of ad
- Page 37 and 38: Table A3.1. Health Values and Refer
- Page 39 and 40: Table A3.1. Health Values and Refer
- Page 41 and 42: Table A3.1. Health Values and Refer
- Page 43 and 44: Appendix 4Metals, Diesel PM Convers
- Page 45 and 46: Under advice from staff at the U.S.
- Page 47 and 48: Appendix 5Table A5.1. Uncertain Ris
- Page 49 and 50: Appendix 6Brief Descriptions of Hea
- Page 51 and 52: Appendix 7Summary Map and Table for
- Page 53 and 54: Appendix 8: Table 1Supplemental Tab
- Page 55 and 56: Appendix 8: Table 3Table A8.3. Poss
- Page 57 and 58: ReferencesHackett, P., Sikov, M., &