1. Air Pollution, Health, and Sustainable Energy Dan Greenbaum, President Health Effects Institute (HEI) PAHO Webinar on Health and Sustainable Development May 23, 2012 HEI is an independent, non-profit research institute funded jointly by the US Environmental Protection Agency and industry to provide credible, high quality science on air pollution and health for air quality decisions. HEI sponsors do not participate in the selection, oversight or review of HEI science, and HEI’s reports do not necessarily represent their views. 1

2. The Health Effects Institute: Trusted Science Cleaner Air Better Health 30 years of impartial, high-quality science on health effects of air pollution HEI structured to maintain credibility & transparency in often controversial regulatory debates Balanced government and industry funding Independent Board and Expert Science Committees Not affiliated with sponsors – no perceived “point of view” Research Committee selects all research competitively Separate Review Committee intensively peer reviews all results All results and data – both positive and negative – reported Science products responsive and widely credible to global leaders Targeted research : Over 250 studies on many pollutants Re-Analysis: e.g. Harvard Six Cities and American Cancer Society Studies Rapid Review: Traffic Health Effects, MTBE, Diesel Exhaust, Air Toxics A number of HEI studies/activities in Latin America over two decades

3. The HEI ESCALA Study (Estudio de Salud y Contaminaci ó n del Aire en Latinoam é rica) To understand effects of air pollution on health in key individual Latin American cities, develop regional profile, build capacity Nine cities in Mexico, Brazil, Chile Led by Latin American Scientists PIs: I Romieu, N Gouveia, L Cifuentes Supported by Hewlett Foundation, others Research completed-Final report under review by HEI Mexico -Mexico City -- Monterey -- Toluca Brazil -Sao Paolo -- Rio de Janiero -- Porto Alegre Chile -Santiago -- Concepcion -Temuco

4. Results of HEI’s ESCALA project PM 10 and Premature All-Cause, All-age Mortality Approximately 0.7% increase in mortality per10 µg/m 3 (3-day distributed lag)

5. HEI Evidence: Coordinated Multi-City Time-Series Studies (PM 10 and Gases) North America and Europe NMMAPS: National Morbidity, Mortality, and Air Pollution Study - 100 U.S. cities APHEA: Air Pollution and Health: a European Approach – 20 European countries APHENA: 119 cities in Europe and North America (Co-funded: HEI and EC) Asia PAPA (Public health and Air Pollution in Asia) 4 cities in Hong Kong, Mainland China, and Thailand 2 studies in Chennai and Delhi, India (all natural mortality only, limited adherence to common protocol due to nature of available data) Latin America ESCALA 9 cities in Mexico, Chile, and Brazil

6. Latin America in a Global Context (Worldwide results on Daily Changes in PM 10 and Daily Mortality) The effects of pollution are more similar than different … …international studies (e.g. American Cancer Society Study) can be broadly relevant

7. Estimating the Public Health Impact

8. Estimating Impacts in Latin America Based on the ESCALA Study: Validates that Latin American effects similar to international effects Enables use of international long-term cohort studies to estimate public health impact Three Cities: Mexico City, Santiago, Sao Paolo Analyzed health effects avoided if cities met WHO Air Quality Guidelines by 2025 Conducted by: Dr. Luis Cifuentes, ESCALA Investigator, Catholic University, Santiago, Chile

9. Significant Estimates of Public Health Impacts Mortality based on cohort (long term) studies (For example, air pollution above WHO guidelines leads to 5,000-7,000 premature deaths in Mexico City per year) Childhood (< 5 years) Acute Respiratory Infections The No. 1 cause of childhood death in developing world ( For example, air pollution leads to 80,000 new cases in Mexico City each year) Averted Number of Cases, 2010 - 2025, AQG Scenario Mexico CitySantiagoSao PauloTotal 95% CI Total Deaths 38,000 16,000 - 59,000 26,000 12,000 - 40,000 38,000 17,000 - 58,000 101,000 45,000 - 157,000 ARI (morbidity) 807,000 323,000 - 1,291,000 86,000 35,000 - 138,000 1,110,000 444,000 - 1,776,000 2,003,000 801,000 - 3,205,000

10. Applying Health Impacts to Sustainable Energy Choices

11. Hidden Costs of Energy: Unpriced Consequences of Energy Production and Use US National Academy of Sciences Report Published 2009 Congress Requested this study in the Energy Policy Act of 2005. Study Task: “Define and evaluate key external costs and benefits – related to health, environment, security, and infrastructure – that are associated with the production, distribution, and use of energy but not reflected in the market price of energy or fully addressed by current government policy.” 11

12. Electricity: Coal Aggregate non-climate damages (2005): $62 billion Air Pollution Damages from Coal Generation for 406 plants, 2005 Damages related to climate- change effects are not included Damage Estimates based on SO 2, NO x, and PM emissions 12

13. Transportation Aggregate 2005 non-climate damages: ≈ $ 56 billion Light-duty vehicles: $36 billion Heavy-duty vehicles: $20 billion Damages per vehicle-mile traveled (VMT) ranged from 1.2 cents to 1.7 cents. 23-38 cents/ gasoline gallon equivalent Damage estimates did not vary significantly across fuels and technologies; caution is needed for interpreting small differences. Some (electric, corn ethanol) had higher lifecycle damages Others (cellulosic ethanol, CNG) had lower lifecycle damages

14. Light-Duty Vehicles Non-Climate Damages in 2005

15. Conclusions Non-climate damages from electricity generation and transportation exceed $120 billion for the year 2005. These damages are principally related to emissions of NO x, SO 2, and PM. The above total is a substantial underestimate because it does not include damages related to climate change, health effects of hazardous pollutants, ecosystem effects, or infrastructure and security. How much a burden should be reduced depends on its magnitude and the cost of reducing it. Reducing emissions, improving energy efficiency, or shifting to cleaner methods of generating electricity could substantially reduce damages.

16. Muchas Gracias Dan Greenbaum dgreenbaum@healtheffects.org