Maximizing Health Benefits and Minimizing Inequality: Incorporating Local‐Scale Data in the Design and Evaluation of Air Quality Policies

The U.S. Environmental Protection Agency undertook a case study in the Detroit metropolitan area to test the viability of a new multipollutant risk‐based (MP/RB) approach to air quality management, informed by spatially resolved air quality, population, and baseline health data. The case study demonstrated that the MP/RB approach approximately doubled the human health benefits achieved by the traditional approach while increasing cost less than 20%—moving closer to the objective of Executive Order 12866 to maximize net benefits. Less well understood is how the distribution of health benefits from the MP/RB and traditional strategies affect the existing inequalities in air‐pollution‐related risks in Detroit. In this article, we identify Detroit populations that may be both most susceptible to air pollution health impacts (based on local‐scale baseline health data) and most vulnerable to air pollution (based on fine‐scale PM_2.5 air quality modeling and socioeconomic characteristics). Using these susceptible/vulnerable subpopulation profiles, we assess the relative impacts of each control strategy on risk inequality, applying the Atkinson Index (AI) to quantify health risk inequality at baseline and with either risk management approach. We find that the MP/RB approach delivers greater air quality improvements among these subpopulations while also generating substantial benefits among lower‐risk populations. Applying the AI, we confirm that the MP/RB strategy yields less PM_2.5 mortality and asthma hospitalization risk inequality than the traditional approach. We demonstrate the value of this approach to policymakers as they develop cost‐effective air quality management plans that maximize risk reduction while minimizing health inequality.     

Estimating the National Public Health Burden Associated with Exposure to Ambient PM2.5 and Ozone

Ground‐level ozone (O₃) and fine particulate matter (PM_2.5) are associated with increased risk of mortality. We quantify the burden of modeled 2005 concentrations of O₃ and PM_2.5 on health in the United States. We use the photochemical Community Multiscale Air Quality (CMAQ) model in conjunction with ambient monitored data to create fused surfaces of summer season average 8‐hour ozone and annual mean PM_2.5 levels at a 12 km grid resolution across the continental United States. Employing spatially resolved demographic and concentration data, we assess the spatial and age distribution of air‐pollution‐related mortality and morbidity. For both PM_2.5 and O₃ we also estimate: the percentage of total deaths due to each pollutant; the reduction in life years and life expectancy; and the deaths avoided according to hypothetical air quality improvements. Using PM_2.5 and O₃ mortality risk coefficients drawn from the long‐term American Cancer Society (ACS) cohort study and National Mortality and Morbidity Air Pollution Study (NMMAPS), respectively, we estimate 130,000 PM_2.5‐related deaths and 4,700 ozone‐related deaths to result from 2005 air quality levels. Among populations aged 65–99, we estimate nearly 1.1 million life years lost from PM_2.5 exposure and approximately 36,000 life years lost from ozone exposure. Among the 10 most populous counties, the percentage of deaths attributable to PM_2.5 and ozone ranges from 3.5% in San Jose to 10% in Los Angeles. These results show that despite significant improvements in air quality in recent decades, recent levels of PM_2.5 and ozone still pose a nontrivial risk to public health.     

Current and Future Particulate‐Matter‐Related Mortality Risks in the United States from Aviation Emissions During Landing and Takeoff

Demand for air travel is projected to increase in the upcoming years, with a corresponding influence on emissions, air quality, and public health. The trajectory of health impacts would be influenced by not just emissions growth, but also changes in nonaviation ambient concentrations that influence secondary fine particulate matter (PM_2.5) formation, population growth and aging, and potential shifts in PM_2.5 concentration‐response functions (CRFs). However, studies to date have not systematically evaluated the individual and joint contributions of these factors to health risk trajectories. In this study, we simulated emissions during landing and takeoff from aircraft at 99 airports across the United States for 2005 and for a 2025 flight activity projection scenario. We applied the Community Multiscale Air Quality (CMAQ) model with the Speciated Modeled Attainment Test (SMAT) to determine the contributions of these emissions to ambient concentrations, including scenarios with 2025 aircraft emissions and 2005 nonaviation air quality. We combined CMAQ outputs with PM_2.5 mortality CRFs and population projections, and evaluated the influence of changing emissions, nonaviation concentrations, and population factors. Given these scenarios, aviation‐related health impacts would increase by a factor of 6.1 from 2005 to 2025, with a factor of 2.1 attributable to emissions, a factor of 1.3 attributable to population factors, and a factor of 2.3 attributable to changing nonaviation concentrations which enhance secondary PM_2.5 formation. Our study emphasizes that the public health burden of aviation emissions would be significantly influenced by the joint effects of flight activity increases, nonaviation concentration changes, and population growth and aging.     

Finely Resolved On‐Road PM2.5 and Estimated Premature Mortality in Central North Carolina

To quantify the on‐road PM_2.5‐related premature mortality at a national scale, previous approaches to estimate concentrations at a 12‐km × 12‐km or larger grid cell resolution may not fully characterize concentration hotspots that occur near roadways and thus the areas of highest risk. Spatially resolved concentration estimates from on‐road emissions to capture these hotspots may improve characterization of the associated risk, but are rarely used for estimating premature mortality. In this study, we compared the on‐road PM_2.5‐related premature mortality in central North Carolina with two different concentration estimation approaches—(i) using the Community Multiscale Air Quality (CMAQ) model to model concentration at a coarser resolution of a 36‐km × 36‐km grid resolution, and (ii) using a hybrid of a Gaussian dispersion model, CMAQ, and a space–time interpolation technique to provide annual average PM_2.5 concentrations at a Census‐block level (～105,000 Census blocks). The hybrid modeling approach estimated 24% more on‐road PM_2.5‐related premature mortality than CMAQ. The major difference is from the primary on‐road PM_2.5 where the hybrid approach estimated 2.5 times more primary on‐road PM_2.5‐related premature mortality than CMAQ due to predicted exposure hotspots near roadways that coincide with high population areas. The results show that 72% of primary on‐road PM_2.5 premature mortality occurs within 1,000 m from roadways where 50% of the total population resides, highlighting the importance to characterize near‐road primary PM_2.5 and suggesting that previous studies may have underestimated premature mortality due to PM_2.5 from traffic‐related emissions.     

Approximations for Estimating Change in Life Expectancy Attributable to Air Pollution in Relation to Multiple Causes of Death Using a Cause Modified Life Table

There is considerable debate as to the most appropriate metric for characterizing the mortality impacts of air pollution. Life expectancy has been advocated as an informative measure. Although the life‐table calculus is relatively straightforward, it becomes increasingly cumbersome when repeated over large numbers of geographic areas and for multiple causes of death. Two simplifying assumptions were evaluated: linearity of the relation between excess rate ratio and change in life expectancy, and additivity of cause‐specific life‐table calculations. We employed excess rate ratios linking PM_2.5 and mortality from cerebrovascular disease, chronic obstructive pulmonary disease, ischemic heart disease, and lung cancer derived from a meta‐analysis of worldwide cohort studies. As a sensitivity analysis, we employed an integrated exposure response function based on the observed risk of PM_2.5 over a wide range of concentrations from ambient exposure, indoor exposure, second‐hand smoke, and personal smoking. Impacts were estimated in relation to a change in PM_2.5 from 19.5 μg/m³ estimated for Toronto to an estimated natural background concentration of 1.8 μg/m³. Estimated changes in life expectancy varied linearly with excess rate ratios, but at higher values the relationship was more accurately represented as a nonlinear function. Changes in life expectancy attributed to specific causes of death were additive with maximum error of 10%. Results were sensitive to assumptions about the air pollution concentration below which effects on mortality were not quantified. We have demonstrated valid approximations comprising expression of change in life expectancy as a function of excess mortality and summation across multiple causes of death.     

Uncertainty and Variability in Health-Related Damages from Coal-Fired Power Plants in the United States

The health‐related damages associated with emissions from coal‐fired power plants can vary greatly across facilities as a function of plant, site, and population characteristics, but the degree of variability and the contributing factors have not been formally evaluated. In this study, we modeled the monetized damages associated with 407 coal‐fired power plants in the United States, focusing on premature mortality from fine particulate matter (PM_2.5). We applied a reduced‐form chemistry‐transport model accounting for primary PM_2.5 emissions and the influence of sulfur dioxide (SO₂) and nitrogen oxide (NO_x) emissions on secondary particulate formation. Outputs were linked with a concentration‐response function for PM_2.5‐related mortality that incorporated nonlinearities and model uncertainty. We valued mortality with a value of statistical life approach, characterizing and propagating uncertainties in all model elements. At the median of the plant‐specific uncertainty distributions, damages across plants ranged from $30,000 to $500,000 per ton of PM_2.5, $6,000 to $50,000 per ton of SO₂, $500 to $15,000 per ton of NO_x, and $0.02 to $1.57 per kilowatt‐hour of electricity generated. Variability in damages per ton of emissions was almost entirely explained by population exposure per unit emissions (intake fraction), which itself was related to atmospheric conditions and the population size at various distances from the power plant. Variability in damages per kilowatt‐hour was highly correlated with SO₂ emissions, related to fuel and control technology characteristics, but was also correlated with atmospheric conditions and population size at various distances. Our findings emphasize that control strategies that consider variability in damages across facilities would yield more efficient outcomes.     

Enhancing the Characterization of Epistemic Uncertainties in PM2.5 Risk Analyses

The Environmental Benefits Mapping and Analysis Program (BenMAP) is a software tool developed by the U.S. Environmental Protection Agency (EPA) that is widely used inside and outside of EPA to produce quantitative estimates of public health risks from fine particulate matter (PM_2.5). This article discusses the purpose and appropriate role of a risk analysis tool to support risk management deliberations, and evaluates the functions of BenMAP in this context. It highlights the importance in quantitative risk analyses of characterization of epistemic uncertainty, or outright lack of knowledge, about the true risk relationships being quantified. This article describes and quantitatively illustrates sensitivities of PM_2.5 risk estimates to several key forms of epistemic uncertainty that pervade those calculations: the risk coefficient, shape of the risk function, and the relative toxicity of individual PM_2.5 constituents. It also summarizes findings from a review of U.S.‐based epidemiological evidence regarding the PM_2.5 risk coefficient for mortality from long‐term exposure. That review shows that the set of risk coefficients embedded in BenMAP substantially understates the range in the literature. We conclude that BenMAP would more usefully fulfill its role as a risk analysis support tool if its functions were extended to better enable and prompt its users to characterize the epistemic uncertainties in their risk calculations. This requires expanded automatic sensitivity analysis functions and more recognition of the full range of uncertainty in risk coefficients.     

Major Factors Influencing the Health Impacts from Controlling Air Pollutants with Nonlinear Chemistry: An Application to China

Predicting the human‐health effects of reducing atmospheric emissions of nitrogen oxide (NO_x) emissions from power plants, motor vehicles, and other sources is complex because of nonlinearity in the relevant atmospheric processes. We estimate the health impacts of changes in fine particulate matter (PM_2.5) and ozone concentrations that result from control of NO_x emissions alone and in conjunction with other pollutants in and outside the mega‐city of Shanghai, China. The Community Multiscale Air Quality (CMAQ) Modeling System is applied to model the effects on atmospheric concentrations of emissions from different economic sectors and geographic locations. Health impacts are quantified by combining concentration‐response functions from the epidemiological literature with pollutant concentration and population distributions. We find that the health benefits per ton of emission reduction are more sensitive to the location (i.e., inside vs. outside of Shanghai) than to the sectors that are controlled. For eastern China, we predict between 1 and 20 fewer premature deaths per year per 1,000 tons of NO_x emission reductions, valued at $300–$6,000 per ton. Health benefits are sensitive to seasonal variation in emission controls. Policies to control NO_x emissions need to consider emission location, season, and simultaneous control of other pollutants to avoid unintended consequences.     

Miscommunicating Risk,Uncertainty, and Causation: Fine Particulate Air Pollution and Mortality Risk as an Example

A recent paper in this journal (Fann et al., 2012) estimated that “about 80,000 premature mortalities would be avoided by lowering PM_2.5 levels to 5 μg/m³ nationwide” and that 2005 levels of PM_2.5 cause about 130,000 premature mortalities per year among people over age 29, with a 95% confidence interval of 51,000 to 200,000 premature mortalities per year.⁽¹⁾ These conclusions depend entirely on misinterpreting statistical coefficients describing the association between PM_2.5 and mortality rates in selected studies and models as if they were known to be valid causal coefficients. But they are not, and both the expert opinions of EPA researchers and analysis of data suggest that a true value of zero for the PM_2.5 mortality causal coefficient is not excluded by available data. Presenting continuous confidence intervals that exclude the discrete possibility of zero misrepresents what is currently known (and not known) about the hypothesized causal relation between changes in PM_2.5 levels and changes in mortality rates, suggesting greater certainty about projected health benefits than is justified.     

Validation of a Novel Air Toxic Risk Model with Air Monitoring

Three modeling systems were used to estimate human health risks from air pollution: two versions of MNRiskS (for Minnesota Risk Screening), and the USEPA National Air Toxics Assessment (NATA). MNRiskS is a unique cumulative risk modeling system used to assess risks from multiple air toxics, sources, and pathways on a local to a state‐wide scale. In addition, ambient outdoor air monitoring data were available for estimation of risks and comparison with the modeled estimates of air concentrations. Highest air concentrations and estimated risks were generally found in the Minneapolis‐St. Paul metropolitan area and lowest risks in undeveloped rural areas. Emissions from mobile and area (nonpoint) sources created greater estimated risks than emissions from point sources. Highest cancer risks were via ingestion pathway exposures to dioxins and related compounds. Diesel particles, acrolein, and formaldehyde created the highest estimated inhalation health impacts. Model‐estimated air concentrations were generally highest for NATA and lowest for the AERMOD version of MNRiskS. This validation study showed reasonable agreement between available measurements and model predictions, although results varied among pollutants, and predictions were often lower than measurements. The results increased confidence in identifying pollutants, pathways, geographic areas, sources, and receptors of potential concern, and thus provide a basis for informing pollution reduction strategies and focusing efforts on specific pollutants (diesel particles, acrolein, and formaldehyde), geographic areas (urban centers), and source categories (nonpoint sources). The results heighten concerns about risks from food chain exposures to dioxins and PAHs. Risk estimates were sensitive to variations in methodologies for treating emissions, dispersion, deposition, exposure, and toxicity.     

Assessment of Interindividual and Geographic Variability in Human Exposure to Fine Particulate Matter in Environmental Tobacco Smoke

Environmental tobacco smoke (ETS) is a major contributor to indoor human exposures to fine particulate matter of 2.5 μm or smaller (PM_2.5). The Stochastic Human Exposure and Dose Simulation for Particulate Matter (SHEDS‐PM) Model developed by the U.S. Environmental Protection Agency estimates distributions of outdoor and indoor PM_2.5 exposure for a specified population based on ambient concentrations and indoor emissions sources. A critical assessment was conducted of the methodology and data used in SHEDS‐PM for estimation of indoor exposure to ETS. For the residential microenvironment, SHEDS uses a mass‐balance approach, which is comparable to best practices. The default inputs in SHEDS‐PM were reviewed and more recent and extensive data sources were identified. Sensitivity analysis was used to determine which inputs should be prioritized for updating. Data regarding the proportion of smokers and “other smokers” and cigarette emission rate were found to be important. SHEDS‐PM does not currently account for in‐vehicle ETS exposure; however, in‐vehicle ETS‐related PM_2.5 levels can exceed those in residential microenvironments by a factor of 10 or more. Therefore, a mass‐balance‐based methodology for estimating in‐vehicle ETS PM_2.5 concentration is evaluated. Recommendations are made regarding updating of input data and algorithms related to ETS exposure in the SHEDS‐PM model. Interindividual variability for ETS exposure was quantified. Geographic variability in ETS exposure was quantified based on the varying prevalence of smokers in five selected locations in the United States.     

Assessment and Application of National Environmental Databases and Mapping Tools at the Local Level to Two Community Case Studies

Communities are concerned over pollution levels and seek methods to systematically identify and prioritize the environmental stressors in their communities. Geographic information system (GIS) maps of environmental information can be useful tools for communities in their assessment of environmental‐pollution‐related risks. Databases and mapping tools that supply community‐level estimates of ambient concentrations of hazardous pollutants, risk, and potential health impacts can provide relevant information for communities to understand, identify, and prioritize potential exposures and risk from multiple sources. An assessment of existing databases and mapping tools was conducted as part of this study to explore the utility of publicly available databases, and three of these databases were selected for use in a community‐level GIS mapping application. Queried data from the U.S. EPA's National‐Scale Air Toxics Assessment, Air Quality System, and National Emissions Inventory were mapped at the appropriate spatial and temporal resolutions for identifying risks of exposure to air pollutants in two communities. The maps combine monitored and model‐simulated pollutant and health risk estimates, along with local survey results, to assist communities with the identification of potential exposure sources and pollution hot spots. Findings from this case study analysis will provide information to advance the development of new tools to assist communities with environmental risk assessments and hazard prioritization.     

Using Uncertainty Analysis to Improve Consistency in Regulatory Assessments of Criteria Pollutant Standards

Regulatory impact analyses (RIAs), required for new major federal regulations, are often criticized for not incorporating epistemic uncertainties into their quantitative estimates of benefits and costs. “Integrated uncertainty analysis,” which relies on subjective judgments about epistemic uncertainty to quantitatively combine epistemic and statistical uncertainties, is often prescribed. This article identifies an additional source for subjective judgment regarding a key epistemic uncertainty in RIAs for National Ambient Air Quality Standards (NAAQS)—the regulator's degree of confidence in continuation of the relationship between pollutant concentration and health effects at varying concentration levels. An illustrative example is provided based on the 2013 decision on the NAAQS for fine particulate matter (PM_2.5). It shows how the regulator's justification for setting that NAAQS was structured around the regulator's subjective confidence in the continuation of health risks at different concentration levels, and it illustrates how such expressions of uncertainty might be directly incorporated into the risk reduction calculations used in the rule's RIA. The resulting confidence-weighted quantitative risk estimates are found to be substantially different from those in the RIA for that rule. This approach for accounting for an important source of subjective uncertainty also offers the advantage of establishing consistency between the scientific assumptions underlying RIA risk and benefit estimates and the science-based judgments developed when deciding on the relevant standards for important air pollutants such as PM_2.5.     

Caveats for Causal Interpretations of Linear Regression Coefficients for Fine Particulate (PM2.5) Air Pollution Health Effects

Recent linear regression analyses have concluded that decreasing levels of fine particulate matter (PM2.5) air pollution have increased life expectancy in the United States. These findings have left unresolved questions about the causal relation between reductions in PM2.5 levels and changes in cause‐specific (especially, cardiovascular disease, CVD) mortality risks. Their robustness (e.g., sensitivity to deletion of a single data point) has also been questioned. We investigate these issues in the National Mortality and Morbidity Air Pollution Study database. Comparing changes in PM2.5 levels and cause‐specific mortality rates for elderly people in 24 cities between two periods separated by a decade (1987–1989 and 1999–2000) shows that reductions in PM2.5 were significantly associated with increases in respiratory mortality rates and with decreases in CVD mortality rates. CVD and all‐cause mortality risks fell equally for all months of the year over this period, but average PM2.5 levels increased significantly for winter months. This casts doubts on the causal interpretation that declines in PM2.5 over the decade caused reduced short‐term mortality risks. Nonlinear regression suggests that reduced or negative marginal health benefits are associated with reductions of PM2.5 below 1999–2000 levels (about 15 μg/m³). Such nonlinear relations imply that risk communication statements that project a constant incremental reduction in mortality risks per unit reduction in PM2.5 do not adequately reflect the realistic possibility of nonlinear exposure‐response relations and diminishing returns to further exposure reductions.     

Prioritizing Environmental Health Risks in the UAE

This article presents the results of a comparative environmental risk‐ranking exercise that was conducted in the United Arab Emirates (UAE) to inform a strategic planning process led by the Environment Agency‐Abu Dhabi (EAD). It represents the first national‐level application of a deliberative method for comparative risk ranking first published in this journal. The deliberative method involves a five‐stage process that includes quantitative risk assessment by experts and deliberations by groups of stakeholders. The project reported in this article considered 14 categories of environmental risks to health identified through discussions with EAD staff: ambient and indoor air pollution; drinking water contamination; coastal water pollution; soil and groundwater contamination; contamination of fruits, vegetables, and seafood; ambient noise; stratospheric ozone depletion; electromagnetic fields from power lines; health impacts from climate change; and exposure to hazardous substances in industrial, construction, and agricultural work environments. Results from workshops involving 73 stakeholders who met in five separate groups to rank these risks individually and collaboratively indicated strong consensus that outdoor and indoor air pollution are the highest priorities in the UAE. Each of the five groups rated these as being among the highest risks. All groups rated soil and groundwater contamination as being among the lowest risks. In surveys administered after the ranking exercises, participants indicated that the results of the process represented their concerns and approved of using the ranking results to inform policy decisions. The results ultimately shaped a strategic plan that is now being implemented.     

Vehicle Emission Unit Risk Factors for Transportation Risk Assessments

When the transportation risk posed by shipments of hazardous chemical and radioactive materials is being assessed, it is necessary to evaluate the risks associated with both vehicle emissions and cargo-related risks. Diesel exhaust and fugitive dust emissions from vehicles transporting hazardous shipments lead to increased air pollution, which increases the risk of latent fatalities in the affected population along the transport route. The estimated risk from these vehicle-related sources can often be as large or larger than the estimated risk associated with the material being transported. In this paper, data from the U.S. Environmental Protection Agency's Motor Vehicle-Related Air Toxics Study are first used to develop latent cancer fatality estimates per kilometer of travel in rural and urban areas for all diesel truck classes. These unit risk factors are based on studies investigating the carcinogenic nature of diesel exhaust. With the same methodology, the current per-kilometer latent fatality risk factor used in transportation risk assessments for heavy diesel trucks in urban areas is revised and the analysis expanded to provide risk factors for rural areas and all diesel truck classes. These latter fatality estimates may include, but are not limited to, cancer fatalities and are based primarily on the most recent epidemiological data available on mortality rates associated with ambient air PM-10 concentrations.     

The Power of Perception: Health Risk Attributed to Air Pollution in an Urban Industrial Neighbourhood

This paper describes a multi-stakeholder process designed to assess the potential health risks associated with adverse air quality in an urban industrial neighborhood. The paper briefly describes the quantitative health risk assessment conducted by scientific experts, with input by a grassroots community group concerned about the impacts of adverse air quality on their health and quality of life. In this case, rather than accept the views of the scientific experts, the community used their powers of perception to advantage by successfully advocating for a professionally conducted community health survey. This survey was designed to document, systematically and rigorously, the health risk perceptions community members associated with exposure to adverse air quality in their neighborhood. This paper describes the institutional and community contexts within which the research is situated as well as the design, administration, analysis, and results of the community health survey administered to 402 households living in an urban industrial neighborhood in Hamilton, Ontario, Canada. These survey results served to legitimate the community's concerns about air quality and to help broaden operational definitions of health. In addition, the results of both health risk assessment exercises served to keep issues of air quality on the local political agenda. Implications of these findings for our understanding of the environmental justice process as well as the ability of communities to influence environmental health policy are discussed.     

Comparative Human Health Impact Assessment of Engineered Nanomaterials in the Framework of Life Cycle Assessment

For safe innovation, knowledge on potential human health impacts is essential. Ideally, these impacts are considered within a larger life‐cycle‐based context to support sustainable development of new applications and products. A methodological framework that accounts for human health impacts caused by inhalation of engineered nanomaterials (ENMs) in an indoor air environment has been previously developed. The objectives of this study are as follows: (i) evaluate the feasibility of applying the CF framework for NP exposure in the workplace based on currently available data; and (ii) supplement any resulting knowledge gaps with methods and data from the li fe c ycle a pproach and human r isk a ssessment (LICARA) project to develop a modified case‐specific version of the framework that will enable near‐term inclusion of NP human health impacts in life cycle assessment (LCA) using a case study involving nanoscale titanium dioxide (nanoTiO₂). The intent is to enhance typical LCA with elements of regulatory risk assessment, including its more detailed measure of uncertainty. The proof‐of‐principle demonstration of the framework highlighted the lack of available data for both the workplace emissions and human health effects of ENMs that is needed to calculate generalizable characterization factors using common human health impact assessment practices in LCA. The alternative approach of using intake fractions derived from workplace air concentration measurements and effect factors based on best‐available toxicity data supported the current case‐by‐case approach for assessing the human health life cycle impacts of ENMs. Ultimately, the proposed framework and calculations demonstrate the potential utility of integrating elements of risk assessment with LCA for ENMs once the data are available.     

Health Risks of Energy Systems

Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed.     

Data Available for Evaluating the Risks and Benefits of MTBE and Ethanol as Alternative Fuel Oxygenates

The wide-scale use of methyl tertiary butyl ether (MTBE) in gasoline has resulted in substantial public controversy and action to ban or control its use due to perceived impacts on water quality. Because oxygenates are still required under federal law, considerable research has focused on ethanol as a substitute for MTBE. In this article, we summarize the currently available literature on the air and water quality risks and benefits of MTBE versus ethanol as alternative fuel oxygenates. We find that MTBE-fuel blends are likely to have substantial air quality benefits; ethanol-fuel blends appear to offer similar benefits, but these may be at least partially negated because of ethanol's propensity to increase emissions and ambient concentrations of some air contaminants. Releases of gasoline containing either MTBE or ethanol could have an impact on some drinking water sources, although the impacts associated with MTBE tend to relate to aesthetics (i.e., taste and odor), whereas the impacts associated with ethanol generally relate to health risk (i.e., greater exposure to gasoline constituents such as benzene). It is likely that these water quality impacts will be outweighed by the air quality benefits associated with MTBE and perhaps ethanol use, which affect a much larger population. A lack of data on environmental exposures and associated health impacts hinders the completion of a comprehensive quantitative risk-benefit analysis, and the available air and water quality data should be evaluated in a broader risk-management context, which considers the potential life-cycle impacts, costs, and feasibility associated with alternative fuel oxygenates.