1. H EALTH I MPACTS OF E NERGY C HOICES IN M ARYLAND November 21, 2013 Karin Gunther Russ, MS, RN Collaborative on Health and the Environment Rebecca Ruggles, Director Maryland Environmental Health Network

2. H EALTH I MPACTS OF E NERGY C HOICES IN M ARYLAND  Topics –Energy production and use in Maryland –Air pollution & disease –Impact in Maryland –Climate change

3. M ARYLAND E NERGY C ONSUMPTION 2007 * Direct use fuels are fuels other than electricity that are used directly in homes and businesses, such as natural gas, propane, and heating oil. Source: Maryland Energy Outlook 2010 http://energy.maryland.gov/documents/MEOFINALREPORTJAN2010.pdf

4. M ARYLAND E NERGY C ONSUMPTION BY E ND -U SE S ECTOR, 2011 Source: U.S. Energy Information Administration http://www.eia.gov/state/?sid=MD#tabs-2

5. E NERGY U SE

6. S ELECTED C OMPONENTS OF A IR P OLLUTION http://airqualityeffects.uckac.edu/old_kids_pages_Feb_3_2004/components_of_air_pollution.htm POLLUTANTDESCRIPTIONSOURCES Carbon Monoxide (COColorless, odorless gasVehicles burning gasoline Natural gas appliances Nitrogen Oxide (NOx)Several gaseous compounds made up of nitrogen and oxygen Vehicles Power plants burning fossil fuels Ozone (O3)Gaseous pollutantVehicle exhaust and certain other fumes Formed from other air pollutants in the presence of sunlight Particulate Matter (PM)Very small particles of soot, dust, or other matter, including tiny droplets of liquids Diesel engines Power plants Industries Wind-blown dust Wood stoves

7. A IR P OLLUTION IN M ARYLAND   Levels of Fine Particulate Matter (MDE, 2008) Red= Exceeds National Standards

8. A IR POLLUTION & D ISEASE IN M ARYLAND  Asthma & respiratory disease  Reproductive health  Cardiovascular disease  Cancer  Premature death

9. Asthma and Air Pollution “Air pollution is one of the most under- appreciated contributors to asthma exacerbation.” (American Academy of Pediatrics, 2004)   124,500 Maryland children, or 9.1%, had asthma in 2009 (Maryland Asthma Control Plan)   159,000 Maryland children, or 11.9%, had asthma in 2011 (DHMH report “Asthma in Maryland”)   Adult asthma rates in Maryland are the 5 th highest in the nation

10. Birth outcomes in Maryland

11. Air Quality and Poor Birth Outcomes  Air pollution has the largest evidence base of any environmental contributor to preterm birth and poor birth outcomes.  Epidemiological and animal studies link particulate matter (PM 2.5 and PM 10 ) and sulfur dioxide (SO 2 ), as well as carbon monoxide (CO), nitrogen dioxide (NO 2 ) and other nitrogen oxides (NO x ) in ambient air to shorter gestation. (Nieuwenhuijsen et al, 2013)

12. Heart Disease In Maryland (DHMH, 2011)

13. Air Pollution & Cardiovascular Disease  AHA Scientific Statement, 2004: – –Of special interest are several environmental air pollutants that include carbon monoxide, oxides of nitrogen, sulfur dioxide, ozone, lead, and particulate matter (“thoracic particles” [PM 10 ] <10 μm in aerodynamic diameter, “fine particles” [PM 2.5 ] <2.5 μm, and “coarse particles” [PM 10 to 2.5 ]). – –These pollutants are associated with increased hospitalization and mortality due to cardiovascular disease, especially in persons with congestive heart failure, frequent arrhythmias, or both.

14. Cancer in Maryland (DHMH, 2011)

15. Air Pollution is a Carcinogen  IARC report, October 2013: –Classified outdoor air pollution as carcinogenic to humans –After thoroughly reviewing the latest available scientific literature, leading experts convened by the IARC concluded:  sufficient evidence that exposure to outdoor air pollution causes lung cancer  a positive association with an increased risk of bladder cancer –Particulate matter, a major component of outdoor air pollution - evaluated separately - also classified as carcinogenic to humans

16. Premature Death in Maryland  DHMH, 2011: “For the first time, children are projected to have shorter lives than their parents.”

17. Premature Death  “Air pollution causes 200,000 early deaths each year in the U.S.” (MIT, 2013) –Emissions from road transportation are the most significant contributor, causing 53,000 premature deaths –Power generation followed closely behind, with 52,000 premature deaths

18.  IPCC Report 5, September 2013: – –“Warming of the climate system is unequivocal, and since the 1950s, many of the observed changes are unprecedented over decades to millennia. The atmosphere and ocean have warmed, the amounts of snow and ice have diminished, sea level has risen, and the concentrations of greenhouse gases have increased.” –“The atmospheric concentrations of carbon dioxide, methane, and nitrous oxide have increased to levels unprecedented in at least the last 800,000 years. Carbon dioxide concentrations have increased by 40% since pre-industrial times, primarily from fossil fuel emissions and secondarily from net land use change emissions. The ocean has absorbed about 30% of the emitted anthropogenic carbon dioxide, causing ocean acidification.”

19. Maryland's Plan to Reduce Greenhouse Gas Emissions- MDE 12/31/11  "With the fourth longest tidal coastline..., Maryland is the third state most vulnerable to sea level rise... increased storm intensity could have devastating... impacts on the Chesapeake Bay ecosystem and quality of life of Marylanders."

20. Maryland's Plan to Reduce Greenhouse Gas Emissions- MDE 12/31/11  "Health risks to Maryland's citizens, including heat-related stress and cardiovascular mortality and morbidity, respiratory illness, altered infectious disease patterns, impacts to water supply, and direct or mental harm from extreme storm events and flooding, are all possible."

21. S OLUTIONS  Halt Cove Point LNG export facility  Resist the Shale Gas Boom  Increase our use of Renewables  Define Renewables strictly  Close Coal-fired Power Plants  Invest in Mass Transit and TOD  Transition to Cleaner Vehicle Fuels