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      Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves

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          Abstract

          Gas and propane stoves emit nitrogen dioxide (NO 2) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO 2 exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO 2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization’s exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO 2 exposure alone. Short-term NO 2 exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft 2 in size incur four times more long-term NO 2 exposure than people in residences >3000 ft 2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO 2 exposure, respectively, than the national average.

          Abstract

          Gas combustion in U.S. stoves increases long-term NO 2 exposure 4.0 ppbv on average, causing racial and socioeconomic disparities.

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          The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants.

          Because human activities impact the timing, location, and degree of pollutant exposure, they play a key role in explaining exposure variation. This fact has motivated the collection of activity pattern data for their specific use in exposure assessments. The largest of these recent efforts is the National Human Activity Pattern Survey (NHAPS), a 2-year probability-based telephone survey (n=9386) of exposure-related human activities in the United States (U.S.) sponsored by the U.S. Environmental Protection Agency (EPA). The primary purpose of NHAPS was to provide comprehensive and current exposure information over broad geographical and temporal scales, particularly for use in probabilistic population exposure models. NHAPS was conducted on a virtually daily basis from late September 1992 through September 1994 by the University of Maryland's Survey Research Center using a computer-assisted telephone interview instrument (CATI) to collect 24-h retrospective diaries and answers to a number of personal and exposure-related questions from each respondent. The resulting diary records contain beginning and ending times for each distinct combination of location and activity occurring on the diary day (i.e., each microenvironment). Between 340 and 1713 respondents of all ages were interviewed in each of the 10 EPA regions across the 48 contiguous states. Interviews were completed in 63% of the households contacted. NHAPS respondents reported spending an average of 87% of their time in enclosed buildings and about 6% of their time in enclosed vehicles. These proportions are fairly constant across the various regions of the U.S. and Canada and for the California population between the late 1980s, when the California Air Resources Board (CARB) sponsored a state-wide activity pattern study, and the mid-1990s, when NHAPS was conducted. However, the number of people exposed to environmental tobacco smoke (ETS) in California seems to have decreased over the same time period, where exposure is determined by the reported time spent with a smoker. In both California and the entire nation, the most time spent exposed to ETS was reported to take place in residential locations.
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            Long-term air pollution exposure and cardio- respiratory mortality: a review

            Current day concentrations of ambient air pollution have been associated with a range of adverse health effects, particularly mortality and morbidity due to cardiovascular and respiratory diseases. In this review, we summarize the evidence from epidemiological studies on long-term exposure to fine and coarse particles, nitrogen dioxide (NO2) and elemental carbon on mortality from all-causes, cardiovascular disease and respiratory disease. We also summarize the findings on potentially susceptible subgroups across studies. We identified studies through a search in the databases Medline and Scopus and previous reviews until January 2013 and performed a meta-analysis if more than five studies were available for the same exposure metric. There is a significant number of new studies on long-term air pollution exposure, covering a wider geographic area, including Asia. These recent studies support associations found in previous cohort studies on PM2.5. The pooled effect estimate expressed as excess risk per 10 μg/m3 increase in PM2.5 exposure was 6% (95% CI 4, 8%) for all-cause and 11% (95% CI 5, 16%) for cardiovascular mortality. Long-term exposure to PM2.5 was more associated with mortality from cardiovascular disease (particularly ischemic heart disease) than from non-malignant respiratory diseases (pooled estimate 3% (95% CI −6, 13%)). Significant heterogeneity in PM2.5 effect estimates was found across studies, likely related to differences in particle composition, infiltration of particles indoors, population characteristics and methodological differences in exposure assessment and confounder control. All-cause mortality was significantly associated with elemental carbon (pooled estimate per 1 μg/m3 6% (95% CI 5, 7%)) and NO2 (pooled estimate per 10 μg/m3 5% (95% CI 3, 8%)), both markers of combustion sources. There was little evidence for an association between long term coarse particulate matter exposure and mortality, possibly due to the small number of studies and limitations in exposure assessment. Across studies, there was little evidence for a stronger association among women compared to men. In subjects with lower education and obese subjects a larger effect estimate for mortality related to fine PM was found, though the evidence for differences related to education has been weakened in more recent studies.
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              The Economic Burden of Asthma in the United States, 2008 - 2013

              Asthma is a chronic disease that affects quality of life, productivity at work and school, and healthcare use; and it can result in death. Measuring the current economic burden of asthma provides important information on the impact of asthma on society. This information can be used to make informed decisions about allocation of limited public health resources.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SoftwareRole: ValidationRole: VisualizationRole: Writing - original draftRole: Writing - review & editing
                Role: ConceptualizationRole: InvestigationRole: Methodology
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: Project administrationRole: ResourcesRole: Supervision
                Role: InvestigationRole: Project administrationRole: Validation
                Role: InvestigationRole: ResourcesRole: ValidationRole: Writing - review & editing
                Role: MethodologyRole: Writing - review & editing
                Role: MethodologyRole: Writing - review & editing
                Role: ConceptualizationRole: MethodologyRole: VisualizationRole: Writing - review & editing
                Role: Project administrationRole: Resources
                Role: MethodologyRole: Writing - review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing - review & editing
                Journal
                Sci Adv
                Sci Adv
                sciadv
                advances
                Science Advances
                American Association for the Advancement of Science
                2375-2548
                03 May 2024
                03 May 2024
                : 10
                : 18
                : eadm8680
                Affiliations
                [ 1 ]Earth System Science Department, Stanford University, 473 Via Ortega, Stanford, CA 94305, USA.
                [ 2 ]PSE Healthy Energy, 1140 Broadway, Suite 750, Oakland, CA 94612, USA.
                [ 3 ]Central California Asthma Collaborative, Suite J, 1400 Chester Ave., Bakersfield, CA 93301, USA.
                [ 4 ]T.H. Chan School of Public Health, Harvard University, 677 Huntington Ave., Boston, MA 02115, USA.
                [ 5 ]Woods Institute for the Environment and Precourt Institute for Energy, Stanford, CA 94305, USA.
                Author notes
                [* ]Corresponding author. Email: rob.jackson@ 123456stanford.edu
                Author information
                https://orcid.org/0000-0001-6323-1533
                https://orcid.org/0000-0002-3145-7922
                https://orcid.org/0000-0003-2619-2584
                https://orcid.org/0000-0002-6919-569X
                https://orcid.org/0000-0001-5255-6893
                https://orcid.org/0000-0001-6290-5372
                https://orcid.org/0000-0002-2538-4819
                https://orcid.org/0000-0002-2146-2955
                https://orcid.org/0000-0001-8846-7147
                Article
                adm8680
                10.1126/sciadv.adm8680
                11068006
                38701214
                893f8efe-b004-4a24-8aa0-fbf232b6218b
                Copyright © 2024 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial license, which permits use, distribution, and reproduction in any medium, so long as the resultant use is not for commercial advantage and provided the original work is properly cited.

                History
                : 09 November 2023
                : 02 April 2024
                Funding
                Funded by: HT LLC;
                Award ID: 1255423-1-UAGYN
                Categories
                Research Article
                Social and Interdisciplinary Sciences and Public Health
                SciAdv r-articles
                Public Health
                Custom metadata
                Judith Urtula

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