Overview
- According to firststreet.org (a group of researchers that quantify financial risk from climate change), based on the number of poor air quality days, Washtenaw County has worse air quality than 80% of counties in Michigan. [They predict] that the number of poor air quality days Air Quality Index AQI over 100 in Washtenaw County will be higher in 30 years.
- When the National Ambient Air Quality Standards were established in 1970, air pollution was regarded primarily as a threat to respiratory health. In 1993, National Institute of Environmental Health Science researchers published the landmark Six Cities Study, which established an association between fine particulate matter and mortality. Air pollution exposure is associated with oxidative stress and inflammation in human cells, which may lay a foundation for chronic diseases and cancer. In 2013, the International Agency for Research on Cancer of the World Health Organization (WHO) classified air pollution as a human carcinogen.
- A recent University of Michigan study concluded that long-term exposure to air pollution can lead to a loss of independence for older adults. In research published in JAMA Network Open, air pollution from traffic emerges as a key risk factor for older adults losing their ability to care for themselves without some or total assistance. Traffic-related air pollution releases fine particulate matter and gasses like nitrogen dioxide into the air that can harm the lungs, heart, brain, and other parts of the body.
- Researchers found that when people were exposed to high levels of pollution over long periods, like the 10 years studied in this research, they needed more help to manage their everyday activities. The study suggests that reducing exposure to air pollution, particularly from traffic sources, could help prolong independent living for older adults. That, according to senior author Sara Adar, Associate Professor of Epidemiology and Global Public Health at the University of Michigan School of Public Health, and Boya Zhang, first author of the study and research fellow at the Harvard T.H. Chan School of Public Health.
- In addition to documenting the act of losing independence, the study estimates the financial cost of lost independence due to air pollution. Applying a yearly cost of $16,028 per person who needed help with activities of daily living, the study estimated that losing independence due to residential exposures to traffic-related air pollution would add up to $11.7 billion in care expenses nationwide per year.
Transcription
David Fair: We all know air pollution is bad for our environment and our health. Now we're learning impacts go further and have a greater cost than we thought before. I'm David Fair, and welcome to this week's edition of Issues of the Environment. There is a study out of the University of Michigan that indicates air pollution is contributing to a loss of independence in older adults. How? Well, that's something we want to know. Our guest this morning was lead author of the study. Doctor Sara Adar is professor of epidemiology and global public health at the University of Michigan. Thank you so much for taking time with us today, Doctor Adar!
Dr. Sara Adar: Yeah! Thanks so much for having me!
David Fair: Well, as a layperson, this study feels like a bit of a shift--kind of moving from looking at air pollution as attached to specific chronic illness into a broader correlation to health and quality of life. Am I off base?
Dr. Sara Adar: No, not at all. I mean, I think that they're connected concepts, right? So, if you are more likely to develop chronic disease due to your air pollution exposures, then it's logical that that will likely impact how your aging trajectories look later on in life, your ability to take care of yourself and the costs associated with that.
David Fair: What was the hypothesis going into the research?
Dr. Sara Adar: Yeah. We hypothesized that all of these lifetime burdens of air pollution on our health--to our lungs, to our heart, to our brains--would really impact us in late life in a way that would be important for our ability to take care of ourselves as we hit older ages.
David Fair: So, what were the testing protocols then to gather the evidence for what ultimately became the conclusions?
Dr. Sara Adar: We worked within the context of the Health and Retirement Study, which is this longitudinal cohort. So, it's a group of 25,000 people. They started with--actually, they recruited more over time to fill in the ranks that started in 1992--and it's been ongoing since. And so, we used information about where people live and their exposures at their homes, as well as information that we gathered from those participants every two years about their health and their ability to take care of themselves.
David Fair: So, how long has this study been going on prior to publication?
Dr. Sara Adar: So, the study started in 1992. We started using data from around 2000 and later and followed people through 2016. I mean, the average time that we followed people in our study was just a little bit over ten years.
David Fair: This is Issues of the Environment on 89 one WEMU. And we're talking with Doctor Sara Adar from the University of Michigan. She is lead author of the study connecting air pollution to a loss of independence among older adults. For the purposes of this study and for the rest of our conversation, how do you define independence?
Dr. Sara Adar: Yeah. So, this was defined as people needing help to perform activities of daily living, so things like eating and bathing and taking care of themselves or them moving into a nursing home for care at older ages.
David Fair: The air pollution we're talking about, as outlined in the study published in JAMA Network Open, comes directly from traffic. Correct?
Dr. Sara Adar: Some of it does. So, we actually looked at air pollution from a variety of different sources, ranging from coal fire power plants to agricultural emissions and wildfires. But for this particular analysis, we did see that air pollution associated with traffic seemed to be the one that was most robustly associated with a loss of independence in late life.
David Fair: So, what about this exposure to these particular pollutants has a direct impact on older adults' ability to maintain their personal independence?
Dr. Sara Adar: The air pollutants that we studied are able to get really deep into our lungs. They can actually travel around our bodies. Some of these particles from traffic are so small. So, those exposures cause things like inflammation. They can actually alter our body's autonomic nervous system, which is sort of the balance of moving fast and moving slow. And over time, those things have a buildup of impact on our body. They can start to cause us to get lung disease. They can start to cause us to get atherosclerosis. They can impact how well our brain works and all of those things--your ability to breathe as well, your ability to process information while not having dementia--contribute to people's ability to take care of themselves in late life.
David Fair: Our pollution centers tend to be centered around low-income areas. Are there particular segments of the population that seem to be more affected, either geographically, racially, or by income level?
Dr. Sara Adar: Yeah, it's a great question. So, there's two parts to that story. One is that, as you said, in the United States, we have what we call environmental injustice, where there are certain communities, often minoritized communities or communities of low income, that do have higher exposures. So, just by definition of them having higher exposures, they will have a larger burden of the health impacts of air pollution. And then there's the second piece, which is whether or not individuals who, let's say, live in a lower quality home, the air pollution is more easily able to get through the windows and the walls and the doors and things like that. Whether or not they might have a more severe response to the pollutants themselves or, perhaps, people who have a history of chronic illness, they might have a more severe response to air pollution.
David Fair: Once again, we're talking with Doctor Sara Adar from the University of Michigan on 89 one WEMU's Issues of the Environment. And sometimes people say, "Well, I don't seem to be affected. I'm not going to care about this issue." But it does impact everybody. Because not only did you find the correlation between air pollution and health in older adults, but there was a true economic impact to that component, isn't there?
Dr. Sara Adar: There really is. So, as many people now who are taking care of their aging parents or aging relatives, it is expensive to help provide care to people who are no longer able to to accomplish activities of daily living. With a yearly cost of about $16,000 per person who needs help with these kinds of activities, we estimated that the air pollution in the United States could contribute up to like $11 or $12 billion in care expenses nationwide each year. So, those costs really do add up.
David Fair: On the positive side, if we know what the problem is, then we can work towards solution. And I would imagine there's ongoing efforts to transition away from fossil fuels and to more renewable energies is going to be a part of the solution.
Dr. Sara Adar: Yeah, I think that's exactly right. You know, one of the things that we see with air pollution is that all amounts contribute to worse health. But for me, the eternal optimist, that tells me that every amount that we can reduce the levels in our community will see improvements in health. So, all of these activities to switch to cleaner fuels to change the way in which we commute, all of those things will help improve the health of our communities.
David Fair: So, while we work to get to a place of healthier environment and healthier public, how do we go about limiting our exposure and avoiding some of the potential impacts right now?
Dr. Sara Adar: Yeah. Great question. So, of course, the number one way that we should do this is through population level efforts to regulate clean air and to sort of improve our systems around the society as a whole. But as an individual, you can also do things like install filters in your home or even making sure that you change out the filter in your furnace pretty frequently is a good way to reduce air pollution levels inside your home. If there are big events of pollution--for example, some of those wildfire events that we've seen, really avoiding being outside and exercising on those days can improve your exposures. Wearing masks if it's really extreme will also drop your exposures as well.
David Fair: Now, I don't mean to sound flippant because studies of this kind are extremely valuable. I do want to take it seriously. But outside the scientific and academic realm, we're sitting out here saying, "Great. They found another thing that can kill me." I'm curious. As researchers, do you ever have those kinds of intrusive thoughts?
Dr. Sara Adar: So, the reason that we pick to do studies like this one that the financial burden of the outcomes we're looking at is clear, we do that because we're hopeful that it will inform policy. It's compelling to see that something like lost independence and the health care costs that would be associated with that are linked to air pollution. When it comes time to regulate, that can go into the cost benefit analysis. So, for me, doing this type of research, which I do feel like is informing something like our pocketbooks can be useful to the society.
David Fair: Well, I'm grateful you and your colleagues are doing the research and letting us all know about it. Thank you so much for taking time to help educate us today!
Dr. Sara Adar: Yeah! Thank you so much again for having me!
David Fair: That is Doctor Sara Adar, lead author of a study on air pollution and loss of independence among older adults. Doctor Adar is professor of epidemiology and global public health at the University of Michigan and our guest on Issues of the Environment. For more information, take a look at our website at wemu.org. Issues of the Environment is produced with support from the Office of the Washtenaw County Water Resources Commissioner. We bring it to you every Wednesday. I'm David Fair, and this is your community NPR station 89 one WEMU FM, Ypsilanti.
Non-commercial, fact based reporting is made possible by your financial support. Make your donation to WEMU today to keep your community NPR station thriving.
Like 89.1 WEMU on Facebook and follow us on Twitter
Contact WEMU News at 734.487.3363 or email us at studio@wemu.org
