transportation and cumulative risk assessment...risk differences –pilot a worker cumulative risk...

Johns Hopkins Bloomberg School of Public Health

Transportation and

Cumulative Risk Assessment

Mary Fox

Joseph Amoah

Kirsten Koehler

Andrew Patton

Misti Zamora

CARTEEH Symposium 2019

© 2014, Johns Hopkins University. All rights reserved.

© 2014, Johns Hopkins University. All rights reserved.© 2014, Johns Hopkins University. All rights reserved.©2015, Johns Hopkins University. All rights reserved.©2016, Johns Hopkins University. All rights reserved.©2019, Johns Hopkins University. All rights reserved.

OutlineBackground

– Chemical risk assessment

– Cumulative risk assessment

Cumulative risk assessment applied to transportation and health

Advancing cumulative risk and health – transport-related research



Risk Assessment

Risk assessment is a process in which information is analyzed to determine if a hazard may cause harm.

– Step-wise process

– Decision-making framework

The goal is to provide the best possible characterization of risk based upon a rigorous evaluation of available information and knowledge.



How is risk assessment applied? (1)

4

“Conventional”

Framework for Cumulative Risk Assessment: EPA/630/P-02/0001F

Evaluates one thing at a time

Commonly practiced since 1950’s

Is this what real life is like?



How is risk assessment applied? (2)

5

“Cumulative”

Framework for Cumulative Risk Assessment: EPA/630/P-02/0001F

Evaluating complex exposures

Developments in “cumulative risk assessment” (CRA)



The CRA Vision: Science and policy

Evaluate “real-life” complex exposures

– Multiple chemicals

– Chemical and non-chemical stressors

Flexible case-specific approaches to regulation, rather than command and control

Will be directed toward holistic risk reduction (systems)

6

Cumulative Risk Assessment Guidance – Planning and Scoping, US EPA, 1997



Why transportation and health?

A cumulative risk issue



Case Example –Air toxics

A Baltimore example

Transport-related hazardous air pollutants (HAPs)



National Air Toxics Assessment Modeled US air toxics for 2011 (report released in 2015)Assessed 180 air toxics from the following types of emissions sources:

– Stationary sources, e.g., industrial facilities such as coke ovens for the steel industry, refineries and smaller sources like gas stations

– Mobile sources, e.g., cars, trucks and off-road vehicles like construction equipment and trains

– Events, e.g., wildfires, prescribed burning

– Biogenics, e.g., naturally-occurring emissionsThe emissions data were then modeled to make broad estimates of health risks over geographic areas of the country to provide a snapshot of air quality in 2011.

https://www.epa.gov/national-air-toxics-assessment/2011-nata-fact-sheet



Methods for Baltimore example

Data available at:

– https://www.epa.gov/national-air-toxics-assessment/2011-nata-assessment-results

Extracted Baltimore City data

Identified air toxics coming from road traffic (at least 50%)

Identified health effects associated with those chemicals

Est. cancer risk and non-cancer hazard quotient

https://www.epa.gov/national-air-toxics-assessment/2011-nata-assessment-results



HAPs from transport* in Baltimore (NATA 2011)

Chemical Critical Health Effects – Inhalation (EPA IRIS) Non-cancer HQ

Est. cancersper million

1,3 Butadiene Reproductive, Cancer (leukemia) 0.05 2

2,2,4 Trimethylpentane No toxicity reference values

Acrolein Respiratory 1.7

Benzene Immune, Cancer (leukemia) 0.03 7

Chromium VI# Respiratory, Cancer (lung) 0.0006 0.7

Diesel PM Respiratory 0.14

Ethylbenzene Developmental, Cancer (kidney) 0.0003 1

Polyaromatic Hydrocarbons Cancer (respiratory and gastrointestinal) 0.3

Propionaldehyde Respiratory 0.003

Toluene Neurological 0.0006

*50% or more of the estimated concentration from on-road sources# for Cr VI - 50% from commercial marine vessels



What about other exposures: noise,

stress?Though complicated, there appears to be a potential interaction between stress and pollution on health.

Stress tends to modify air pollution effects on health especially respiratory health.

Traffic noise can increase stress levels due to lack of sleep as well as increase air pollution.

The interaction of both is hypothesized to have a synergistic impact on health.



Conceptual

model for

combining

transport

related risks

Crashes

Noise

Stress

Individual factors

Disease

Air pollution

Population factors



CARTEEH Research

People: workers, kids, communities

Settings: border crossings, ports, schools, gas stations

Vehicles: connected vehicles, alternative fuel trucks



JHU: Exposure at gas stations

NJ and OR are the only states that require filling station workers to pump all gas.

– Most states spread exposures/risk over the entire driving population.

Little is known about their exposures at work or in total/cumulative

– Pumping (un-combusted chemicals), retail

– Working nearby heavily trafficked roadways (combustion products)

– Community or home exposures

© 2014, Johns Hopkins University. All rights reserved.©2015, Johns Hopkins University. All rights reserved.©2019, Johns Hopkins University. All rights reserved.

Project Objectives

Contributions

• Science

– Update knowledge of fueling exposures

– Consider interplay of chemical and psychosocial stress

• Policy

– Individual and population risk differences

– Pilot a worker cumulative risk assessment

Objectives

1. Describe gas station workers and consumer exposures

2. Describe worker psychosocial exposures including occupational and personal/home settings

3. Describe worker participant community environments

4. Synthesize data to develop worker cumulative exposure and risk profiles



Wrap up

Value of a cumulative risk approach

– Fits with systems – humans occupy many environments

Many aspects of transportation and health

– Pros and cons

• Risk assessment methods target cons

Getting to a system that promotes society and health

transportation and cumulative risk assessment...risk differences –pilot a worker cumulative risk...

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