MEETING BEFORE THE CALIFORNIA AIR RESOURCES BOARD HEARING ROOM CALIFORNIA AIR RESOURCES BOARD 2020 L STREET SACRAMENTO, CALIFORNIA THURSDAY, JANUARY 26, 1995 9:30 A.M. Nadine J. Parks Shorthand Reporter PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 ii MEMBERS PRESENT John Dunlap, Chairman Eugene Boston, M.D. Joseph Calhoun Lynne Edgerton M. Patricia Hilligoss John Lagarias Jack Parnell Barbara Riordan Doug Vagim Staff: Jim Boyd, Executive Officer Tom Cackette, Chief Deputy Executive Officer Mike Scheible, Deputy Executive Officer Mike Kenny, Chief Counsel John Holmes, Ph.D., Chief, Research Division Bob Barham, Assistant Chief, Research Division Dane Westerdahl, Manager, Biological Research Section, Research Division Helene Margolis, Staff, Research Division Dr. Morton Lippmann, Chair of Project External Advisory Committee John Batchelder, Manager, Health Assessment & Air Quality Standards Section, Research Division Norman Kado, Ph.D., Research Division Vicky Davis, Staff Counsel, Office of Legal Affairs Dr. Michael Lipsett, M.D., Public Health Medical Office, Office of Environmental Health Hazard Assessment Patricia Hutchens, Board Secretary Wendy Grandchamp, Secretary Bill Valdez PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 iii I N D E X PAGE Proceedings 1 Call to Order and Roll Call 1 Opening Remarks by Chairman Dunlap 1 AGENDA ITEMS: 95-1-1 Public Meeting to Consider Proposal for Phase III of the Epidemiologic Investigation to Identify Chronic Health Effects in Children Caused by Ambient Air Pollutants Introductory Remarks by Chairman Dunlap 6 Staff Presentation: Jim Boyd Executive Officer 6 Helene Margolis Staff Research Division 9 Dr. Morton Lippmann Chair External Advisory Committee 11 Questions/Comments 22 Overview Presented by Helene Margolis 43 Questions/Comments 60 PUBLIC COMMENTS: Veronica Kun National Resources Defense Council 64 Questions/Comments 69 PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 iv INDEX, continued. . . PAGE AGENDA ITEMS: 95-1-1 Written Comments Entered by Dr. John Holmes 72 Motion by Lagarias to Adopt Resolution 95-1 74 Roll Call Vote 74-75 95-1-2 Research Items Motion by Boston to Adopt Resolutions 95-2, 95-3, 95-4, 95-5 76 Board Action 76 95-1-3 Public Meeting to Consider Retention of Regulations Regarding State One-Hour Ambient Air Quality Standard for Sulfur Dioxide Introductory Remarks by Chairman Dunlap 77 Staff Presentation: Jim Boyd Executive Officer 77 Norman Kado, Ph.D. Research Division 79 Michael Lipsett, M.D. Public Health Medical Officer OEHHA 88 Questions/Comments 98 Written Comments Entered by Dr. John Holmes 111 Summation by Mr. Boyd 111 PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 v INDEX, continued. . . PAGE AGENDA ITEMS: 95-1-3 Motion by Lagarias to Adopt Resolution 95-6 112 Roll Call Vote 113 Adjournment 114 Certificate of Reporter 115 PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 1 1 P R O C E E D I N G S 2 --o0o-- 3 CHAIRMAN DUNLAP: I'd like to call the January, 4 1995, meeting of the California Air Resources Board to 5 order, and ask our Clerk to call the roll, please. 6 MS. HUTCHENS: Boston? 7 DR. BOSTON: Here. 8 MS. HUTCHENS: Calhoun? 9 MR. CALHOUN: Here. 10 MS. HUTCHENS: Edgerton? 11 MS. EDGERTON: Here. 12 MS. HUTCHENS: Hilligoss? 13 MAYOR HILLIGOSS: Here. 14 MS. HUTCHENS: Lagarias? 15 MR. LAGARIAS: Here. 16 MS. HUTCHENS: Parnell? 17 MR. PARNELL: Here. 18 MS. HUTCHENS: Riordan? 19 SUPERVISOR RIORDAN: Here. 20 MS. HUTCHENS: Vagim? 21 SUPERVISOR VAGIM: Here. 22 MS. HUTCHENS: Chairman Dunlap. 23 CHAIRMAN DUNLAP: Present. 24 Thank you. Since it appears that we may be able 25 to complete the Board's business today quickly, it's my hope PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 2 1 that we will continue without pausing for a lunch break. 2 Before taking up the first item this morning, I 3 would like to ask the Board's indulgence to make a few 4 personal remarks, and also following a rich tradition of my 5 predecessors. 6 Now, without necessarily drawing any conclusions 7 about me, I'd like to tell a short story. It's about a 8 rather absent-minded fellow who was late for work and, in 9 his haste, he forgot his umbrella -- which was unfortunate, 10 since it was raining that morning, much like it's been here 11 lately. 12 He got to his bus stop, boarded, and sat in the 13 only seat available, which was next to a woman who had her 14 umbrella nestled in her lap. 15 When they came to the man's stop, he rose up, got 16 his coat, and reached for the umbrella -- handle extending 17 out next to him. And the woman yelled loudly to him and 18 said, "Please, take your hands off of my umbrella. It's 19 mine. It's not yours." 20 And he profusely apologized and got off the bus 21 and out into the rain. 22 Well, at the end of the workday, he went to the 23 coat rack in his office to button up, and noticed that there 24 were five or six of his umbrellas in the coat rack. And he 25 grabbed three of them to take them home, figuring that he'd PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 3 1 have some at both places if he forgot again. 2 As he headed out and caught his bus -- and, again, 3 there was just one seat left, and it was adjacent to the 4 woman that he had rode with in the morning. And she took 5 one look at him and said, "Well, now, that's quite a haul 6 that you had today, isn't it?" 7 (Laughter.) 8 In our business of government and public policy, 9 perceptions can be far from the realities. So, I use that 10 story to illustrate the importance for us to be deliberative 11 in what we do, to rely on sound science as our base, and to 12 be forthright in our goals and beliefs as to what we must 13 continue to do to improve air quality in California. 14 I consider it a high honor to have been appointed 15 to this post by Governor Pete Wilson. I'm enthusiastic 16 about working with you as members of this Board. 17 I've worked in the environmental arena for the 18 past 15 years at both the local and State levels. During 19 that time, I was well aware of the rich tradition of the 20 Board. The Board is highly regarded for many achievements 21 for not only its technical expertise but its leadership role 22 in just about every area of air pollution control. 23 The need to move ahead on a steady, measured 24 course is essential to achieving clean air for all of 25 California's citizens. It is my goal to continually keep my PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 4 1 eye upon that prize, which is clean air for California. 2 1995 is an important year for us. As our Governor 3 pointed out in his "State of the State" address earlier this 4 month, we have an aggressive agenda to improve environmental 5 protection, including air quality that protects public 6 health, by reforming processes for environmental compliance 7 and making government more efficient. 8 Another important area is the future development 9 of the California environmental technology industry. We 10 must continue to encourage the development of new 11 environmental technologies that contribute to economic 12 growth for our State into the next century. 13 I strongly believe that the emphasis on clean 14 vehicles and clean fuels must be continued if we are to 15 achieve our State and Federal clean air goals. 16 In addition, we must strive to add value, whenever 17 possible, while we deliberate on our new regulatory program. 18 We must have solid returns for our efforts. We need to 19 comprehensively evaluate the impacts on those we regulate as 20 well as the citizenry of our State. 21 In the packet before each one of my colleagues, 22 Board members will find some of the key documents that 23 describe the policies of the Wilson Administration that will 24 guide our work for 1995, and no doubt for the years ahead. 25 They include the Governor's "State of the State" PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 5 1 address and attendant Press release, the Governor's policy 2 initiatives, Cal-EPA's 1995 initiatives, as well as the Cal- 3 EPA budget highlights for '95 and '96. 4 I know you may have read about them in the papers 5 in recent weeks, but now you have copies, and I hope you 6 find them useful. 7 In summary, I'm looking forward to working with 8 each of you, the Board staff, industry, and those affected 9 by our regulatory programs. I know that clean air can only 10 be achieved with all of us working closely together. 11 If I may, I'd also like to thank my predecessor, 12 Jacqueline Schafer, for her fine work and excellent service 13 as the CARB Chair during this past year. I know I speak for 14 all of us on the Board when I say how pleased I am that she 15 has stayed on with us as the Board's Communications Advisor. 16 We look forward to her many future contributions. 17 In addition, I've asked the staff to prepare for 18 the February Board meeting an appropriate token of our 19 appreciation and recognition of Jackie's contribution, as 20 well as outgoing Board member Supervisor Harriett Wieder and 21 our new Congressman Brian Bilbray. So, we'll take those 22 items up at our February meeting. 23 I would like to remind those in the audience who 24 would like to present testimony to the Board on any of 25 today's agenda items to please sign up with the Board PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 6 1 Secretary. If you have a written statement, please give 20 2 copies to her as well. 3 The first item on the agenda today is 95-1-1, 4 public meeting to consider a proposal for Phase III of the 5 epidemiologic investigation to identify chronic health 6 effects in children caused by ambient air pollutants. 7 This item is a presentation and discussion of one 8 of our most important research projects. Preceding staff's 9 presentation detailing this research project, we have an 10 invited speaker, Dr. Morton Lippmann. He will discuss why 11 this research is critical to the health effects evaluations 12 that are the basis of our standards protecting public 13 health. 14 Because Dr. Lippmann also serves as the Chair of 15 the External Review Committee for the project, I've asked 16 that, after staff's presentation, he provide his views 17 regarding the merits of the project. 18 At this point, I would like to ask Mr. Boyd to 19 introduce the item and begin the staff's presentation. 20 Jim? 21 MR. BOYD: Thank you, Mr. Chairman, and good 22 morning to you and to the Board members. 23 I'd like to take this opportunity to add the 24 staff's congratulations to our new Chairman, and to 25 particularly welcome him, from the staff, to his first Board PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 7 1 meeting. 2 With regard to this agenda item, we first 3 presented this project to your Board in June of 1991. The 4 project then and today represents to us a very important 5 step in our understanding of the health effects associated 6 with long-term exposure to air pollution. 7 In earlier hearings on the State's ambient air 8 quality standards, Board members have heard concerns 9 expressed about the long-term effects of ozone and other 10 pollutants that may be occurring and may -- and that's the 11 question -- and may be very serious. 12 So, this study was designed to measure these 13 effects in our children, a group for whom we are obligated, 14 I believe, to provide very special protection. They are 15 particularly vulnerable and, frankly, they are our future. 16 As Board members may recall, the project was 17 divided into three phases, and the first phase provided an 18 opportunity for the investigators to refine further the 19 protocol for the field portion of this complex research 20 effort. This step was designed into the project to help 21 ensure its overall success. 22 And, as you know, Phase I was completed in August 23 of 1992, and resulted in a full evaluation of the issues, 24 and finally a revised protocol for the second phase of the 25 project. The revised protocol represented a significantly PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 8 1 expanded scope of work that had received extensive scrutiny 2 and endorsement by the investigators' peers, including the 3 Board's Research Advisory Committees. 4 The proposal for the expanded scope of work, with 5 a proportionally increased budget, was brought before your 6 Board and approved in December of 1992. The project is 7 again being presented to the Board in order to provide both 8 a summary of Phase II accomplishments and interim results, 9 and to present to you a proposal to initiate and to fund a 10 portion of the third and final phase of the project. 11 The Board's Research Screening Committee reviewed 12 and approved a Phase II interim report in October of 1994. 13 And in December of 1994, they reviewed and approved the 14 technical and the cost proposals for Phase III that we're 15 bringing before you here today. 16 The cost proposal for Phase III is commensurate 17 with the proposed scope of work. In addition, the proposed 18 budget for Phase III is substantially reduced from what we 19 originally anticipated, because the ARB staff has assumed 20 responsibility for certain key elements of the research, and 21 because of the cooperative external funding -- or in-kind 22 support -- that we've received from others, including the 23 U.S. EPA and local air quality management districts. 24 Ms. Helene Margolis, an epidemiologist on your 25 Research staff, will make some introductory remarks, and PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 9 1 then she will introduce Dr. Lippmann, as Chairman Dunlap has 2 indicated. 3 Subsequent to Dr. Lippmann's presentation, Ms. 4 Margolis will present a brief history of the project, an 5 overview of the protocols for Phase II and then Phase III, a 6 report on Phase II accomplishments and the interim results 7 therefrom, and a summary of the proposed Phase III budget 8 and other related fiscal considerations. 9 Dr. Lippmann will conclude the presentation by 10 providing testimony regarding his personal views regarding 11 the merits of the proposed project and the investigators' 12 progress to date. 13 And with that, I would like to turn the 14 presentation over to Ms. Margolis, if you would. 15 MS. MARGOLIS: Thank you, Mr. Boyd. 16 In assessing the health effects of a pollutant, we 17 turn to health effects research. There are three main types 18 of research -- animal studies and studies of humans, either 19 exposed under controlled conditions in a clinical or 20 laboratory setting, or humans going about their daily 21 business and exposed under real life conditions, 22 epidemiology studies. Each type of study contributes to the 23 evaluation process and each has strengths and weaknesses. 24 Animal studies allow us to test substances at 25 concentrations or for durations we could not possibly expose PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 10 1 humans, and they allow us to explore mechanisms of effects. 2 But we must always consider whether the information we 3 gather is translatable to humans. 4 Controlled human exposure studies help us 5 determine if our observations are translatable and enhance 6 our knowledge of the effect in humans, but they are limited. 7 For example, for obvious reasons, one could not put a human 8 in a laboratory environment for an extended period to study 9 the effects of multiple years' exposure to air pollution. 10 This type of study is best addressed with a carefully 11 designed epidemiology study. 12 Because our discussion today is about a very large 13 epidemiology study -- the size is clearly a function of the 14 complexity of the health effects issue before us, which is 15 the long-term exposure effects -- we thought it might be 16 interesting for you to hear more about epidemiology and know 17 epidemiology is used to assess health effects. 18 To make this presentation, we're very fortunate to 19 have an invited speaker, Dr. Morton Lippmann. His 20 credentials are impressive. Dr. Lippmann holds a Bachelor 21 of Chemical Engineering degree from Cooper Union, a Master's 22 degree in Industrial Hygiene from Harvard, and a Ph.D. in 23 Environmental Health Sciences from New York University. 24 Dr. Lippmann is a Professor of Environmental 25 Medicine at New York University Medical Center, and he PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 11 1 directs a program on human exposure and health effects, as 2 well as a training program in industrial and environmental 3 hygiene. 4 His extramural activities include serving as 5 President of the International Society of Exposure Analysis, 6 membership on the Executive Committee of the EPA Science 7 Advisory Board, and the EPA Advisory Committee on Indoor Air 8 Quality and Total Human Exposure, and membership on the 9 Editorial Advisory Committee of Archives of Environmental 10 Health and Inhalation Toxicology. 11 He is a past Chair of the EPA Clean Air Scientific 12 Advisory Committee, and served on the National Academy of 13 Sciences National Research Council Committees on Measurement 14 and Control of Respirable Dust in Mines, Indoor Pollutants, 15 Toxicity Data Elements, and In Vivo Toxicity Testing of 16 Complex Mixtures. 17 His publications are very extensive. Dr. Lippmann 18 chairs the External Advisory Group for the children's health 19 study as well. And in that capacity, he has provided 20 invaluable input to the project, the process, and certainly 21 the success of the project overall. 22 I'm very pleased to introduce Dr. Lippmann. 23 DR. LIPPMANN: Thank you, Helene. 24 Perhaps just to add a little more background 25 relative to the issues here and the study in USC, I had PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 12 1 served on External Advisory Committee to the Harvard "Six 2 City" study since the early eighties through the end, and 3 the last few years, I chaired their committee. And I was a 4 member of the external advisory committee to the Harvard- 5 Canadian multicity study. 6 And so, when I talk about the progress of this 7 study in Southern California, I have a background of the 8 most comparable studies and their progress to weigh them 9 against. 10 My own research has involves studies of responses 11 to exposures in the natural world, in children's summer 12 camps, and adults engaged in outdoor exercise. And we were 13 the first to demonstrate that functional decrements could be 14 seen at concentrations well below the current ozone national 15 ambient air quality standard. 16 Our recent studies have shown that lung 17 inflammation can be detected in lung lavage of adults 18 engaged in recreational exercise in New York Harbor on 19 Governor's Island. And in terms of now, more recent studies 20 of summer camp children who are asthmatic at a Connecticut 21 River Valley camp, we have shown that not only do we get the 22 functional decrements that we reported in healthy children 23 in the past, but we see increased medication usage -- as 24 prescribed by the physicians at the camp -- and increased 25 symptoms in the children in proportion to both ozone and PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 13 1 acid aerosol content. 2 The functional decrements are the same as in 3 healthy children, but the symptoms and the use of medication 4 are new findings, which we had not previously seen, for 5 children exposed at concentrations that you would consider 6 quite low and well within the current standards, as well as 7 association with the acid in the atmosphere. 8 My assignment today, as I understood it, was to 9 talk about the lessons from the air pollution epidemiology 10 in more general terms, and then to move on into the current 11 Southern California study, and place that in the context of 12 the progress that's needed and is being made on defining the 13 conditions under which air pollution can cause serious 14 health effects. 15 The current major national interest is focused 16 perhaps more on particles than on ozone. Ozone is an easier 17 issue, in that its effects are clearly indicated. We have 18 substantial and important data from toxicology and from 19 human clinical studies which tells us a lot about how ozone 20 is affecting people. And some of our fieldwork has shown 21 comparable kinds of effects seen in clinical studies, but 22 with concentrations that are lower than those seen in 23 clinical studies, suggesting that the mixture is more potent 24 than the ozone alone. 25 The effects are characteristic of ozone, but other PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 14 1 elements in the mixture seem to potentiate those ozone 2 effects. But ozone is never present in the atmosphere, 3 certainly not in Southern California, alone. The 4 photochemical process generates fine particles as well as 5 ozone, so one can't have ozone alone. 6 Other processes generate fine particles. And so, 7 one of the important issues I'll come to later is the great 8 potential of the Southern California study to sort out how 9 the mixtures in Southern California are affecting health -- 10 something that is almost impossible to determine in 11 laboratory studies -- even when looking for acute transient 12 changes, because reproducing mixtures in the natural mix is 13 almost impossible in the laboratory. 14 There is a great deal of emerging literature on 15 the health effects of air pollution. And I gather this has 16 not yet reached California (displaying magazine). Two days 17 ago, my copy of Inhalation Toxicology for January, '95, 18 arrived on my desk, and it's devoted to many of the papers 19 presented last January in Irvine, California, at the 20 National Academy site, in a workshop sponsored by ARB. And 21 this is a landmark document. I commend ARB for having the 22 foresight to support this activity. 23 And, in fact, I've already copied some of the 24 summary tables in the first presentation here, which we may 25 look at later. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 15 1 Perhaps more serious effects of air pollution seem 2 to be focused more on the particles than on ozone, although, 3 as I will indicate, ozone can play an important modifying 4 role in the express toxicity of the particles as well as the 5 mixture affecting the functional response to ozone, as I 6 mentioned just earlier. 7 The data are quite consistent in showing a series 8 of responses among populations in the natural setting in 9 terms of excess daily mortality rates associated with fine 10 particles expressed as PM10, PM2.5, or fine particles, or 11 sulfate as a component of the -- major component of the 12 PM2.5. 13 In addition to excess daily mortality rates, there 14 are increased hospital admissions for respiratory disease, 15 emergency room visits for respiratory disease, bronchitic 16 symptoms in children, reduced lung capacity in children, 17 lost time from work in adults, lost time from school in 18 children, lost years of life -- especially from the six- 19 city study recently, and Pope's American Cancer Society 20 study -- development of asthma and increased severity of 21 asthma from the ARB-sponsored study of David Abbey. All of 22 these things have been associated primarily with the fine 23 particle content of the ambient air. 24 And people have been looking very hard for 25 confounding factors which might explain the apparent PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 16 1 statistical associations between these measures of air 2 pollution and all these health responses. 3 And despite very talented people looking very 4 hard, the likely confounders -- temperature, season, 5 allergies, climate, selection bias, diet, smoking, 6 occupation, et cetera -- have always washed out. They don't 7 explain the statistical association to air pollution. 8 David Bates has introduced the concept of 9 coherence -- that if there's excess daily mortality, it's 10 reasonable to expect that there be increased hospital 11 admissions, and emergency room visits, and symptoms. 12 And so, in a sense, each of these separate studies 13 in isolation can be criticized. But when they're coherent, 14 that is, they all seem to be pointing to the same kind of 15 complex and responses, they become more credible. 16 Now, some of them are clearly affected by the 17 gaseous pollutants that are present with the particles. And 18 ozone, in particular, seems to explain some of the effect in 19 many of these studies of populations and responses. 20 And the other important message from all of these 21 studies collectively is that for many of them -- the 22 mortality, the hospital admissions, and so forth, the 23 function changes in children -- for the population as a 24 whole, there's no definable threshold. We can't say that if 25 we get air pollution down to a certain level, we'll no PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 17 1 longer see any excess. We get almost an almost linear or 2 apparently a linear response -- that is, if we reduce 3 pollution, we'll get a proportionate decrease in these 4 responses, perhaps a decrease in the severity of many of 5 these responses. 6 But it's unrealistic to say that we can specify an 7 absolutely safe level of these pollutants. 8 Now, the epidemiology leaves many important issues 9 unresolved. For one thing, if it's the particles, there's 10 plenty of evidence that there's a variable toxicity of 11 particles. So, if we could identify the components of the 12 aerosol that are most clearly associated with the effects, 13 we could direct the control efforts in the most sensible and 14 economically reasonable way at the problem. 15 And so, this is one great strength of the Southern 16 California study. They are doing the most complete 17 characterization of what's in the air. So, even if they're 18 looking at one or several end points and not all of them, 19 the coherence of the results suggests that if we find out 20 the active elements for some of the end points, we'll 21 probably be on the track of finding out the active elements 22 for others as well. 23 Many people have doubted this emerging and 24 increasingly credible database on epidemiology for the lack 25 of known biological mechanisms for these responses. The PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 18 1 animal toxicology and the human clinical studies would not 2 predict responses at these low ambient levels. And so, we 3 don't understand the biological processes which are leading 4 to these effects. 5 And so, if we understood the mechanisms for 6 activation or stimulation by exposures that lead to disease 7 states and disease progression, we could have a better basis 8 for health advisories to the public as an interim measure 9 prior to more complete control. 10 We don't understand the susceptibility factors, 11 although the epidemiology and much of the clinical data are 12 quite clear that there's an enormous range of sensitivity to 13 pollution. 14 In the chamber studies, some people are very 15 responsive to ozone and others are not. And none of the 16 biological markers that have been examined seem to account 17 for that range of sensitivity. 18 Clearly, there's this range of sensitivity, which 19 is giving us the absence of threshold and the significant 20 responses within a large population in the epidemiology. 21 And it's driven by a small fraction of the population. 22 It's clear that most people are not adversely 23 affected by current air pollution levels. But you have 30 24 million plus people in California; and so, you end up with a 25 public health emergency when hundreds of thousands of people PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 19 1 are affected. 2 And understanding the susceptibility factors, 3 which means going back to the laboratory with the clues from 4 the epidemiology, is the way I think we're going to have to 5 go. 6 And that's the reason why the University of 7 Southern California study is so important. We have an 8 opportunity to get very complete characterization of the 9 exposure in terms of what's measurable, how much, what the 10 temporal pattern is. And we have a good selection of 11 communities, which vary substantially by design in terms of 12 ozone, NOx, and vapor acids, and particles. And this gives 13 us the best opportunity to see which of the pollutant 14 classes give us the indications of response. 15 We're going to have the most complete temporal 16 resolution ever of particles, and particles are becoming 17 more important, whether they're photochemical particles or 18 other particles. 19 For the first time there'll be continuous 20 monitoring in an epidemiology study on an hour by hour basis 21 of particle concentrations. This was not technically 22 feasible in the earlier Harvard and Canadian studies. And 23 this was one of the problems of separating ozone and 24 particles is that, technically, when you have continuous 25 measurements of one pollutant and every sixth day or even PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 20 1 everyday 24-hour measurements of the other, it's an unequal 2 contest, and the more important one may lose out. 3 They're going to extend on the Harvard approaches 4 to determine activity, and we all know from many of the 5 laboratory and epidemiologic studies that the amount of time 6 and the ventilation rates of people outdoors are major 7 determinants of the response. 8 So, this study, in my view, has been well designed 9 and, more importantly perhaps from your perspective today, 10 well executed. I think I've been very impressed with the 11 quality, and diversity, and talents of the team assembled. 12 They're not all from USC. Dr. Peters has brought in the 13 best people in California -- who happen to be, essentially, 14 the best people in the country in many cases -- to do the 15 exposure aspects, the questionnaire development, the 16 administration, the functional measurements. And my 17 observations are that the team has been working very well in 18 a cooperative way together. 19 They seem to hold their own individually and yet 20 see the larger picture and work well collaboratively. For a 21 study of this nature, I view their success in data 22 collection in the 12 communities in the earlier phases as 23 being remarkable and very impressive. They were able to get 24 in the field rapidly, get a large fraction of all the data 25 collection objectives accomplished successfully. At each of PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 21 1 the advisory committee meetings, they were able to report on 2 the status of the data and its preliminary interpretation in 3 a very timely way. 4 They have made excellent presentations at national 5 professional society meetings. In September of '94, I think 6 four of them made presentations at the annual meeting of 7 the International Society of Exposure Analysis and 8 International Society of Environmental Epidemiology. They 9 were well done and well received. And they have, as the 10 Harvard group has done previously, made excellent use of the 11 advisory committee. 12 I'm very pleased to have colleagues on the 13 committee who bring all kinds of backgrounds and strengths 14 to the advice. And it seems to me that each time we return, 15 we find that the team lead by Dr. Peters has told us about 16 progress and how they've used our advice and, in cases where 17 they didn't, why it was a good idea not to and justified it. 18 And so, I think ARB is certainly fortunate to have 19 a team of this quality and this degree of accomplishment 20 working here. It's important to note that while their 21 reports on responses to pollution from Phases I and II are 22 perhaps not yet definitive, they're not negative. 23 They have found interesting and important leads 24 and some indications that are consistent with the hypotheses 25 generated, but that it was always anticipated that the PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 22 1 really definitive analyses would require the kind of 2 prospective phase that was originally anticipated and 3 endorsed by the Air Resources Board. And even if the 4 results eventually turn out negative, that will be a very 5 important step to understand the extent of the problem. 6 And this is a team which can produce unbiased, 7 credible results, and it can't be cheap. These are complex 8 issues. And I just hope that the Board will see it, you 9 know, and have the wisdom to see that this has been a very 10 productive team and deserves continued support in order to 11 produce what you need as members of the Board. 12 I'll be happy to answer any questions that you 13 have. I had copies of some six summary papers -- charts 14 outlining papers, which I think are being distributed. And 15 if you have any questions about any of those, we can go into 16 it. 17 CHAIRMAN DUNLAP: Thank you. Any of my colleagues 18 on the Board have any questions of staff or Dr. Lippmann? 19 MR. LAGARIAS: Mr. Chairman, before I make my 20 comments, I'd like to welcome you to the Board, and look 21 forward to working with you. 22 CHAIRMAN DUNLAP: Thank you. 23 MR. LAGARIAS: Now, I can go back and make 24 comments. I have several regarding the project and several 25 regarding the tables, that you have in front of me. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 23 1 The first, Table 1, talks about mortality. How 2 does mortality relate to the chronic effects studies that 3 we're looking for in this epidemiological survey? 4 DR. LIPPMANN: They don't directly relate at all. 5 What I was trying to illustrate by this table is the 6 apparent consistency of one important response in terms of 7 health across many areas, communities, climates, and 8 including Santa Clara, California among the local ones. 9 But in cold climates, in hot and humid climates, 10 in all kinds of climates we seem to see this excess. This 11 was from Pope's paper at the National Academy. 12 MR. LAGARIAS: Well, it does make a point of 13 consistency. I notice four of those five studies are in 14 areas that have high sulfur oxide emissions. 15 How do you separate SO2, sulfuric acid, with PM10 16 studies? Because I understand they're -- 17 DR. LIPPMANN: Well, my -- I was perhaps more 18 personally involved in getting EPA to focus on acid aerosols 19 than anyone during the earlier PM10 review. And I don't 20 think some of the people who were writing acid off as a 21 major contributing part are not doing it prematurely (sic). 22 In fact, evidence in those studies where acid has been 23 measured, including the multicity study -- looking at 24 children in the 24 communities -- has shown that acid is 25 predictive both of function declines in children and PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 24 1 symptoms. And other studies are coming along. Just 2 published this month, the Uniontown study by the Harvard 3 group has found that acid predicts summertime peak flow 4 decrements. 5 Now, S02, in my view, is not important except as a 6 precursor chemical leading to acid aerosol formation. And 7 Santa Clara is one of those communities that people point to 8 in saying, "Well, it must be something other than acid, 9 because there's no acid. . ." -- 10 MR. LAGARIAS: Yeah. That's the interesting one. 11 DR. LIPPMANN: And it's clear that in communities 12 with relatively low acid, we still see these effects. So, 13 it may be true that acid has a greater punch per unit than 14 other particles; that particles, in general, appear to be 15 irritating to the lung. 16 I think it probably is no more complicated than 17 numerous sites of local irritation in the lung, and this may 18 be why the smaller particles seem to be more active than the 19 larger ones per unit mass. There's infinitely more smaller 20 particles in -- 21 MR. LAGARIAS: In a much higher surface area. 22 DR. LIPPMANN: At the same time, I take exception 23 to some people's view that acidic particles are absent or 24 very low in places like Utah Valley and Santa Clara, because 25 sulfate levels are not remarkably low. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 25 1 If you look at sulfate in California or sulfate in 2 the Utah Valley, it's a bit lower than in the eastern United 3 States, but not that much lower. There's about 300 parts 4 per million of sulfur in gasoline, which leads sulfate 5 formation. And when measured, it's usually neutralized. 6 But it didn't get there without going through an aerosol 7 phase. And so, I think that's important. 8 Another thing that we recently learned, to our 9 surprise, in our own laboratory -- Dr. Schlesinger's group 10 at NYU, who I collaborate with extensively, has been looking 11 at nitric acid responses of animals -- with ARB's support, 12 incidentally. And nitric acid, if you ask a chemist, is 13 always a vapor in the atmosphere. And we always looked at 14 it that way, and figured that it might be analogous to a 15 less powerful acid vapor like sulfur dioxide, and being an 16 upper airway irritant. 17 MR. LAGARIAS: Well, the epidemiological study 18 will be looking at acids. 19 DR. LIPPMANN: Exactly. But let me just note that 20 I think this is an interesting lead that we have come 21 across. When animals are exposed to nitric acid vapor, they 22 develop deep lung lesions and at relatively low 23 concentrations. And we went back to the physical chemistry 24 of the nitric acid. It appears to nucleate rapidly within 25 the atmosphere of the airways and then, once it gets onto PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 26 1 fine water droplets or self-nucleates -- I'm still not 2 quite sure -- it then does get into the deep lung. 3 So, the nitric acid appears functionally to behave 4 more like sulfuric acid than we had anticipated it would. 5 And while it hasn't been examined before -- and the USC 6 study will provide an opportunity to examine it -- it may 7 explain why those communities that have a lot of traffic 8 pollution are getting the characteristic acid -- small 9 airway acid -- acidic exposure responses. 10 So, I've perhaps walked a little far from your 11 question, but -- 12 MR. LAGARIAS: You did. 13 DR. LIPPMANN: -- I'm trying to be responsive to 14 it. 15 MR. LAGARIAS: Well, I'd like to ask -- the 16 increases in mortality that these tables refer to, are they 17 related to increases -- they're related to PM10 -- are they 18 related to episodes? Because other studies have shown that 19 increases in mortality with episodes are followed by 20 decreases shortly thereafter. 21 DR. LIPPMANN: These studies, which they 22 summarized -- Pope, Schwartz, and Dockery -- were with 23 various measures of particles, some of them PM10, some the 24 old-fashioned TSP; Santa Clara, coefficient of haze. And 25 these all refer to the daily mortality studies. And there PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 27 1 is an elevation, and there is some harvesting of the most 2 sensitive members of -- 3 MR. LAGARIAS: That's a "harsh" word, 4 "harvesting." 5 DR. LIPPMANN: That's the way that technology has 6 referred to it. 7 But it's also clear, and perhaps more important, 8 that the annual mortality rates do vary with PM 9 concentration, so that it's not just that, and it's not just 10 the dip. 11 The Table 3, which follows in your handout, is 12 from a paper Thurston at my lab will be presenting at the 13 air pollution meeting this year, in which he has taken those 14 studies which look at PM10 only -- not those converted 15 arbitrarily from TSP or COH to PM10 -- and it includes four 16 of those from the previous table, where the concentrations 17 are largely within the annual max, and shows that the four 18 more recent ones show somewhat smaller relative risk, all of 19 which still remains statistically significant. 20 The next page, also from Dr. Thurston's paper, 21 explains why there are somewhat reduced relative risks in 22 these other studies, in that these are four studies in which 23 the pollutants were modeled simultaneously. 24 And so, the fraction of the relative risk 25 attributable to PM has been reduced because some of it PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 28 1 appears to be attributable to other things in the mixture. 2 My message is that there's a pollution effect, and 3 that it's important for us to continue to refine what it is 4 in the pollution. That's perhaps bringing us back to your 5 initial question about particles. 6 If you look at any one pollutant very -- we have a 7 lot of misleading literature, I think, which shows NOx 8 associated with these things. I suspect that's because 9 whether you look at carbon monoxide, or nitrogen dioxide, or 10 particles, and look at one index of pollution, they serve as 11 surrogates for the other. Because if the meteorology leads 12 to high pollution, all of them go up and down together. And 13 this broad epidemiology will show that any pollutant you 14 look at seems to be associated with it. 15 I think the message that comes through out of all 16 of this, in my view, is that there's a pollution effect; 17 that PM currently looks more likely to be important than 18 other things, but that we need to get to studies where we 19 can separate the pollutant effects, where we have a range of 20 concentration differences in different communities from one 21 pollutant complex to the next -- 22 MR. LAGARIAS: Well, I couldn't agree with you 23 more in that respect, that all these pollutants may indeed 24 be contributors. But in your epidemiological study, you 25 have other confounding effects -- like life styles, diet, PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 29 1 economic strata, and so forth. And I just wondered if 2 these other effects in the epidemiological study might not 3 be greater than the effects that you're trying to monitor or 4 assess. 5 DR. LIPPMANN: There's no question that in 6 traditional epidemiology with small populations, these can 7 be greatly influential. 8 There are two answers to the question that I sort 9 of addressed earlier, saying that confounders don't explain 10 this. If you have prospective studies, such as those in the 11 six cities and the Pope study of American Cancer Society 12 data, you still see the same responses. 13 If you have very large cities, you are very 14 unlikely to be influenced in a negative manner by selection 15 bias, because you have national data indicating that people 16 don't vary that much in diet -- at least in the U.S. -- from 17 one large urban area to another. 18 So, cross-sectional studies that look solely at 19 the differences among communities have that limitation, but 20 we see the same kinds of coefficient in studies that don't 21 have that limitation. 22 So, epidemiology is a very crude art/science, and 23 it's easy to pick apart any one study. But I think it's the 24 coherence of the data which is impressive. 25 CHAIRMAN DUNLAP: Are there any other questions? PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 30 1 I had one, Dr. Lippmann, about the -- you mentioned -- and I 2 appreciate your comment about the cost of this study. It's 3 well taken. You mentioned that you thought the design of 4 the study was particularly well done. 5 Looking at it, you know, from a couple of years 6 into this process, are there any elements that you would 7 change in hindsight or would suggest be changed thus far? 8 DR. LIPPMANN: No. I think the compromises that 9 are reasonable have been made. And it's expensive in part 10 by increasing the number of communities. As you know, 11 powerful arguments were made for the investment in a larger 12 set of communities, so that the study would be more 13 definitive. 14 The six city study, in particular, was criticized 15 because six just inherently hasn't got as much power. And 16 the number of individuals studied in any one community is 17 not as important to the statistical analysis as the number 18 of communities. So, they reduced the number in a community 19 and increased the number of communities. Of course, that 20 increases the cost of the monitoring, which is a big part of 21 it. But this is much more likely to be definitive by having 22 that power and some redundancy in the nature of the 23 communities -- two communities of this character and two 24 communities of that character. 25 I had wished they didn't cut out some of the PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 31 1 measurements of exposure. But I think, in balance, they 2 have made the most reasonable -- 3 CHAIRMAN DUNLAP: And you're comfortable with the 4 reach, which is important for us to know as well? 5 DR. LIPPMANN: You can never be positive about 6 communities like this, but, yes, I think in terms of coming 7 to the best possible power of discriminating these pollution 8 effects across the -- which we hope is bearable, that this 9 is as well as any team could do. 10 CHAIRMAN DUNLAP: Okay. Thank you. 11 If there are no other questions -- Lynne, go 12 ahead, please. 13 MS. EDGERTON: Thank you for coming out to join 14 us. And I wanted to ask if you could put this study in some 15 context in terms of all the national study that's going on. 16 I've heard it represented to me in different ways about the 17 role that it may play, being on the cutting edge, of being 18 on the continuum following the six city study, and that 19 probably you've said that in all of your eloquent remarks 20 this morning. But maybe you could put exactly where -- how 21 do you see this fitting into the national understanding of 22 the effects of air pollution on our people? 23 DR. LIPPMANN: This is perhaps the most important 24 ongoing study in the country right now, which is one reason 25 why EPA is adding supplemental funding to it. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 32 1 It benefited, without question, from the prior six 2 city and multicity studies supported largely by the National 3 Institute of Environmental Health Studies. With the funding 4 limitations on the national scene -- which I'm sure you're 5 aware of, also -- I don't see any other study of this 6 magnitude being likely in the foreseeable future. I know in 7 my own group we have gone more toward the macroepidemiology 8 looking at available data resources, because this is about 9 the scale of funds that one can reasonably apply for and 10 get. 11 So, there is other work going on, which will be 12 complementary. But I think the nation is looking to 13 California for this study. And it's not just leaning on the 14 resources of California, but it makes sense that this is in 15 California because of the nature of the variations in 16 pollution. 17 When the multicity study tried to look at ozone, 18 it found that there was very little range. You have more 19 range in Southern California -- from the coastal communities 20 being low to the inland communities being high -- than you 21 do in the nation as a whole. 22 So, it would -- I can't imagine that the national 23 effort at understanding air pollution wouldn't be severely, 24 negatively impacted by the lack of completion of the study. 25 And, frankly, you've invested an awful lot so far. And you PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 33 1 wouldn't have gotten a good return on your investment 2 without completing it. 3 MS. EDGERTON: Thank you. I was interested in 4 your comments about the Connecticut study of children. One 5 of the comments that you made, which appeared to have been 6 surprising to you -- but may have not been; I may have 7 misunderstood -- was the large number of children who were 8 on medications. And I was wondering whether you were 9 suggesting that the increase in the number of children on 10 medication is somehow masking the real depth of the problem, 11 because they're not going to the emergency room or they're 12 not appearing in certain other areas because they are on 13 inhalers? 14 Is that what you were driving at, or did I -- 15 DR. LIPPMANN: No. In my haste, I didn't perhaps 16 make it clear. 17 MS. EDGERTON: But it was new. I hadn't heard -- 18 DR. LIPPMANN: No, it's not published yet. These 19 are results that we presented in September at the 20 International Society meetings. 21 We had an opportunity to study asthmatic children, 22 because the American Lung Association of Connecticut runs a 23 five-day summer program for asthmatic children, which are 24 drawn from around the State of Connecticut, through this 25 camp in the Connecticut River Valley. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 34 1 It's very expensive to put it on. And so, 2 volunteer physicians and nurses spend a week in residence at 3 the camp. It's an unusual circumstance. And so, we were 4 looking at children with moderate to severe asthma being 5 concentrated in one place at one time. 6 And so, I don't want to draw any implications 7 about the prevalence of asthma or the use of medications 8 from it. Because a physician was present, anytime a child 9 felt the need for medication during that one week of camp, 10 they would get the physician's permission to have it. So, 11 we had a very reliable standard about the use of medication. 12 They weren't self-administered. Therefore, it makes the 13 study more powerful. As ozone and acid went up from day to 14 day, we were seeing more medication usage prescribed. 15 Now, this is a very risky endeavor, from a study 16 point of view, to try to do something in five days, not 17 knowing the pollution levels or weather is going to be like. 18 We did it in 1991, in which case we started clean and went 19 to a dirty day on Friday. And we saw some effects. But the 20 number of children were small; the number of days were 21 small. We thought it'd be a good idea to get some more 22 data. 23 So, we went back to the same camp in 1992. And in 24 1992, we had one of those unusual years with virtually no 25 pollution in the Eastern United States. And so, we chalked PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 35 1 that up to control data, and we went back in the summer of 2 1993 and did it again. 3 And this time, we had a dirty day on Monday, and 4 it got cleaner during the week -- just the opposite of the 5 first year. 6 And plotting the data from all three years as 7 separate cohorts of children, they all fit on the same 8 relation -- '91 and '93 had enough range of pollution to 9 show the effects. They were consistent. 1992 had no 10 pollution, and the effects measures were in the low range of 11 the '91 and '93 data. And so, this study, I think, is 12 convincing. 13 We have current proposals in -- both to the Health 14 Effects Institute and to NIH -- to look at asthmatic 15 children in a future study. I've located cooperation from 16 School District 4 in East Harlem in Upper Manhattan. 70 17 percent of the children are Puerto Rican. And Puerto Rican 18 children have twice the asthma prevalence of black children, 19 who have twice the asthma prevalence of white children. And 20 so, we have a population where 20 percent of the children 21 are, according to the school district, asthmatic. 22 And we have their cooperation and endorsement for 23 doing studies at a school yard based summer recreational 24 program. Hopefully, we can gain support. That program 25 lasts six weeks. And we hope that we can come up with still PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 36 1 more definitive data on responses of asthmatic children to 2 pollution. But that's the state of the art at the current 3 time. 4 MS. EDGERTON: Thank you. I have another 5 question, and maybe that the staff wants to answer this. 6 I keep getting confused about how many asthmatic 7 children and how asthmatics we have in California. I 8 noticed in the sulfur dioxide report today, OEHHA estimates 9 that we have somewhere between 870,000 and one and a half 10 million asthmatics in California. 11 Does that take into account -- then I also read in 12 the last couple of weeks in the New York Times that there 13 was some 40 percent increase in asthma reported across the 14 nation. And I'm trying to put it together with this study 15 that we have here in California, in Southern California. 16 So we have any breakout as to the direction of 17 asthmatics in California? Do you think this -- first off, 18 do you think this number is correct? Does that take into 19 account the new CDC 40 percent increase? 20 DR. HOLMES: I've seen the number. I'm not sure 21 how to interpret it. We've been trying to get more 22 information on it to see if there's any indication whatever 23 that it may relate to pollution. But, as far as we know, 24 the study wasn't done to elucidate causes, but rather just 25 to, in effect, make a census of what the current state is PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 37 1 with asthma in the nation as a whole. 2 And the number that's usually heard around is 5 3 percent of the total population. I think Ms. Margolis, in 4 her remarks, may have some other data, which turn out to be 5 a very interesting -- albeit accidental -- finding that's 6 already come out of this study. 7 MS. EDGERTON: Well, thank you. I just will close 8 just making the remark -- I'm always trying to figure out, 9 from what I read and where I live, what is a fit. And where 10 I live in Southern California, a friend's child moved out to 11 teach the seventh grade at Marlborough School down the 12 street from me. 13 She came over for dinner. We asked her over for 14 dinner. A daughter of a friend of mine said, "How do you 15 like it?" 16 "Fine." 17 She said, "What do you do, Lynne?" You know, 18 friends, mother's, mother (sic). 19 I said, "Well, I work for the Air Board." 20 She said, "Well, is it normal for half of the 21 seventh grade just to be on inhalers?" 22 And I said, "What? Why do you ask me that?" 23 She said, "Half of my class brings inhalers to 24 school." 25 I said, "I don't think that's normal." PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 38 1 That's just one little bit of an -- just an 2 impression that I had, just a little bit of life that I 3 live. And then, I read another story and it says that, you 4 know, there are not that many people suffering, and 5 sometimes the rates aren't going up are what the stories 6 say, and sometimes they tell you something else. 7 It's very important to have this kind of study, in 8 my view, so that we can get a little bit more centered in 9 terms of what is actually happening. 10 Thank you. 11 MR. CALHOUN: Did she explain to you why half her 12 class brought these inhalants? 13 MS. EDGERTON: You think it was just a cool thing 14 to have? 15 (Laughter.) 16 MR. CALHOUN: I don't know. 17 MS. EDGERTON: I assume it's because their doctors 18 prescribed them. 19 DR. BOSTON: What was in the inhalers? 20 MS. EDGERTON: What was in the inhalers? 21 (Laughter.) 22 MS. EDGERTON: That's not a real drug school, 23 Marlborough. 24 CHAIRMAN DUNLAP: Okay. Thank you, Ms. Edgerton. 25 MR. LAGARIAS: That's Valium for the young. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 39 1 CHAIRMAN DUNLAP: I appreciate that. Are there 2 any other questions for staff or Dr. Lippmann? 3 DR. BOSTON: I just want to make a comment. 4 CHAIRMAN DUNLAP: Go ahead, Dr. Boston. 5 DR. BOSTON: I just wanted to make a comment, not 6 a question. I know that we've always struggled in trying to 7 assess health effects with trying to equate animal studies 8 with human health studies. And we've struggled with that 9 over the years on our Board. 10 And I was present at the inceptional meeting for 11 this particular study. And at that time, it was hailed as 12 something that finally we would have some human health 13 studies and human health effects to look at when we talked 14 about air pollution. And we were all quite excited about 15 it. 16 We had a feeling at that time that probably the 17 costs were going to be more than we had anticipated, and -- 18 as things usually are in that vein -- and it turns out that 19 probably that's correct. But I also am pleased to see that 20 the Air Board staff has done such a good job in trying to 21 reduce the overall cost by taking a more active role and 22 doing some of the assessments themselves. And this was 23 explained to me rather thoroughly a few days ago. 24 So, I think the overall benefit, even though it's 25 going to be very costly, is going to be well worth it. I PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 40 1 just wish longitudinal studies could progress more rapidly, 2 because that's the phase I'm interested in, really. And I 3 look forward to seeing what those results are. I think 4 they're going to be very meaningful to us. 5 I would like to ask maybe Helene to explain a 6 little bit more to the Board of what assistance in paying 7 for some of this we're getting from other entities, because 8 I think the Board would be interested in hearing some of 9 that. Could you help us with that? 10 MS. MARGOLIS: Yes. Well, first of all, very 11 clearly, the U.S. EPA is contributing directly to the 12 project through a cooperative agreement with ARB in specific 13 support of the project. So far, they've contributed, you 14 know, through this cooperative agreement, $450,000 to the 15 core effort. They'll also be contributing -- that's one 16 group. 17 Another group will be -- from U.S. EPA -- will be 18 contributing a minimum of 300,000 per year to the project, 19 also directly offsetting costs. 20 In addition, a major proportion of the costs are 21 being offset -- both in the past during Phase II, and we're 22 looking forward into Phase III -- by the cooperation of the 23 local ambient air quality districts. 24 We've had a great deal of interest in the project. 25 And within the limits of their resources, they have been PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 41 1 very supportive and forthcoming. And that directly reduces 2 the costs that one would have to pay to a contractor or even 3 in terms of recruiting additional ARB staff to do the work. 4 So, that kind of in-kind support goes a long way. 5 So, those are the resources that have directly 6 come to the project. 7 In addition, we've approached a number of other 8 entities, including NIH, National Institute of Environmental 9 Health Studies. And while they do not have resources to 10 contribute directly to the core project, they said, "Is 11 there work that would augment and supplement what you are 12 doing that we could fund at, you know, a smaller scale?" 13 And that was, in fact, the intent of the project -- was 14 designing it such that we had a defined set of questions to 15 address through the core effort, but designing it also so 16 that these adjunct projects could be attached to it that 17 also directly addressed questions that we're facing, and 18 enhance the outcome of this project. 19 So, there is a number of opportunities that we are 20 pursuing very actively in terms of that vein. 21 I believe Mr. Boyd and Mr. Cackette may have 22 additional information beyond that. 23 DR. BOSTON: Dr. Lippmann made the comment that 24 the whole nation was looking at the study. Do you think we 25 could enlist his support in getting us some funding from PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 42 1 across the country? 2 MS. MARGOLIS: We've tried. 3 DR. HOLMES: We aren't giving up, Dr. Boston. 4 We're still looking to EPA in Washington to help us out, and 5 there's also the possibility that the local region will be 6 able to see its way through to helping us out. 7 So, we're hoping that we'll be able to fill in a 8 lot of extra money, and the State will actually wind up 9 paying somewhat less. Let me emphasize one point that Ms. 10 Margolis made. The largest single cost element in Phase II 11 was the effort to do the air monitoring and related 12 activities. But districts around the State -- San Diego, 13 South Coast, Santa Barbara, San Luis Obispo -- have all 14 agreed to help us here. And that's one big reason why the 15 price tag has gone down from what we had originally 16 expected. 17 So, my hat's off to the districts for their help, 18 pitched in to help us here. 19 CHAIRMAN DUNLAP: Thank you, Dr. Holmes. 20 Any other questions of staff? If not, we'll call 21 our -- 22 MR. BOYD: Mr. Chairman, Ms. Margolis -- 23 unfortunately, we've only moved part way through this. Ms. 24 Margolis was going to quickly summarize for you the study, 25 its history, and a quick overview. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 43 1 CHAIRMAN DUNLAP: Okay. 2 MR. BOYD: And so, she's been asked to move it 3 along; but, nonetheless, we need to close that down in order 4 to give you the background that we'd like you to have. 5 CHAIRMAN DUNLAP: Very well. 6 MS. MARGOLIS: Thank you. 7 I'm going to use some slides here. We prepared a 8 talk that would basically provide a bit more information for 9 the new members of the Board who might not be as familiar 10 with the many steps we have taken in going forward with this 11 project. So, I will probably fast forward over those, 12 because it sounds like they've indirectly received a very 13 good briefing on that. 14 I guess the fundamental question that is -- or the 15 obvious question is why study of health effects of long-term 16 exposure to ambient pollution? Why are we studying this? 17 Current air quality standards are primarily based 18 on data on the health effects of air pollution associated 19 with exposures of a few hours or less. Therefore, they may 20 not adequately protect the public from effects associated 21 with the long-term exposures. That's exposures that occur 22 over periods of weeks or years. 23 There is evidence of adverse effects. Data from 24 animal studies, controlled human exposure studies, and 25 epidemiologic investigations support the possibility that PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 44 1 long-term exposure effects do occur. 2 However, this information is not sufficient for 3 the purposes of changing or establishing ambient air quality 4 standards. 5 Two questions regarding long-term exposure in 6 California must be answered: What are the health 7 consequences of repeated exposures to air pollutants at 8 concentrations greater than ambient air quality standards 9 and at concentrations equal to or less than current ambient 10 air quality standards? 11 The program goals that we set out with -- 12 essentially, the long-term exposure and health effects 13 research program was established to address this critical 14 public health issue. And the program goals are to determine 15 the effects of long-term exposure to ambient pollution on 16 both healthy and -- healthy individuals and individuals with 17 pre-existing disease conditions, to identify individual and 18 combined effects of specific pollutants. Dr. Lippmann 19 alluded to some of the complexity of that; that we're seeing 20 a pollution effect, but when it comes to the reality of 21 mitigating a public health hazard, one needs to know what it 22 is that we're supposed to be controlling. This will help. 23 Examine the influence of host characteristics. 24 For example, the individual's susceptibility on the 25 occurrence and outcome of specific responses. And finally, PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 45 1 determine the biologic mechanisms of the observed effects. 2 Most of these goals are best answered with 3 epidemiologic research; therefore, that's the major emphasis 4 of the program. And the project we are discussing today is 5 the core research effort for the program. 6 I challenge you to read this (speaking of slide on 7 screen). 8 (Laughter.) 9 MS. MARGOLIS: The point here is that we did not 10 just charge into this project. Throughout, the hallmark of 11 the effort has been planning and peer review. 12 The next flew slides have been intended to show 13 you some of the major steps that brought us to the point 14 where we are today. And so, these are where I'm going to 15 probably fast forward. 16 The milestones were that we had a planning 17 colloquium on air pollution epidemiology in December of 18 1989, that Dr. Boston had mentioned. And that was sort of 19 the jumping point where we convened a number of experts in 20 various fields to really gain the benefit of their knowledge 21 and their experience. 22 Both that information and other information 23 resulted in the development of a request for proposals for-- 24 I'm sorry -- request for proposals that defined a ten-year 25 project that was designed to be executed in three phases. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 46 1 The first phase was a study design refinement 2 period to ensure that a strategy was developed that had the 3 greatest likelihood of meeting the ARB's information needs. 4 Following the refine phase was the data collection 5 and analysis portion of the project, and this was divided 6 into two phases -- the idea being that, after 12 to 18 7 months, sufficient data would be collected to be able to 8 compare communities and to assess whether all elements of 9 the project were working. 10 It also would potentially afford us the 11 opportunity to begin addressing regulatory issues with short 12 turnaround time, such as whether there were detectable 13 effects of ambient acidity. 14 Thus, Phase II was planned as a cross-sectional 15 study in which communities with high- and low-pollution 16 exposures are compared at one point in time. The data 17 collected for the children in Phase II would serve as the 18 baseline information for Phase III, when they would be 19 followed individually over time. That's called 20 "longitudinally." And, therefore, the third phase was, in 21 fact, designed as a longitudinal study. 22 And this is a far more powerful approach for 23 answering questions related to long-term exposure. 24 The actual choice of the research group -- the 25 proposals were reviewed by staff, Dr. Whittenberger, a PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 47 1 renowned public health physician, and Dr. Bill McDonnell at 2 the U.S. EPA, and subsequently submitted to the ARB Advisory 3 Committees. 4 The University of Southern California was awarded 5 the contract. And the work, as you heard earlier, is being 6 led by -- or performed by a multidisciplinary team led by 7 Dr. John Peters. 8 And all the way through the process there's been 9 extensive peer review. That was -- I decided I'd fast 10 forward over this. This is another challenging slide. 11 But, essentially, once Phase I was initiated, the 12 study design and methods evaluation began immediately. 13 There were workshops to discuss the various issues, 14 specifically, how to assess health, how to measure 15 pollutants, which pollutants to study, and what was the best 16 study design and biostatistical approach. 17 A final report and extensive review of the revised 18 proposal for the Phases II and III were submitted, and they 19 were reviewed by the External Advisory Group, which Dr. 20 Lippmann is the Chair; the Research Screening Committee, and 21 Scientific Advisory Committee on Acid Deposition, and 22 finally was presented to the Board in December of 1992. And 23 they subsequently approved Phase II to continue. 24 The objectives of the study were narrowed down 25 significantly in terms of what questions to address first. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 48 1 And the objectives were to determine whether long-term 2 exposure to air pollution leads to effects in children; for 3 example, retarded lung growth; the rate of lung growth, is 4 it reduced? Is total lung growth reduced? 5 Is there greater frequency of respiratory 6 problems; for example, acute viral illnesses, bronchitis, or 7 asthma, and to determine the frequency and severity of the 8 effects, and ultimately to determine which pollutants or 9 combinations of pollutants at what concentrations cause the 10 effects. 11 As a result of Phase I, these were the pollutants 12 that were determined to pose potentially the greatest health 13 risk. And the first four -- ozone, PM10, NO2, and the 14 acids, nitric and hydrochloride -- were the ones that 15 clearly the study should be designed around. 16 In addition, PM2.5 mass and chemistry was 17 considered important and organic acids, formic and acetic, 18 were also considered important enough to focus measurement 19 efforts. 20 And this is a totally invisible slide of the study 21 region. And I apologize for that. I believe the package 22 you received should have a much better picture. But, 23 essentially, we have 12 communities. They were selected on 24 their air quality characteristics -- seeking out extremes of 25 high and low exposure -- to afford the best chance of PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 49 1 teasing apart the effects of the pollutants. 2 The communities were also selected based on the 3 demographics. 4 And this just shows the enrollment scheme for the 5 population. It had been decided that fourth, seventh, and 6 tenth graders would be enrolled during Phase II, a total of 7 basically 1800 fourth graders and 900 each of the seventh 8 graders and tenth graders. 9 And then, for Phase II, the plan is to enroll 10 another 1800 fourth graders. 11 Now, for Phase II results, I'm going to fast 12 forward through the milestones. The point is that we have 13 consistently reported back to the Research Screening 14 Committee and Scientific Advisory Committee for -- to update 15 them on the progress of the project and to obtain their 16 input. 17 The health effects assessments that have been 18 performed in the process of Phase 2 include a question -- 19 multiple questionnaires, pulmonary function testing, and 20 illness and school absence monitoring. 21 Now, the actual execution of this work is in many 22 respects an important result, as any kind of results that 23 come from the analyses, because they are essential to 24 obtaining reliable analytic results. 25 A questionnaire was -- the questionnaire covers PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 50 1 many, many areas. The first page is a parental consent 2 form. There are questionnaires available in Spanish. I 3 again apologize for the slide or the viewer as the case may 4 be. But, essentially, this introduces the parent to the -- 5 the success story here is that more than 3600 parents were 6 more than happy to participate in this study. 7 The questionnaires came back to us. In the first 8 wave that was sent out, there was about an 80 percent return 9 on them. Of those returned, there were, out of a hundred -- 10 and the questionnaire, by the way, has literally 101 11 questions. Most of the questionnaires were completely 12 filled out. Of about 3400 questionnaires that were first 13 received, 110 -- only 110 were missing significant 14 information. And this is an extraordinary level of interest 15 on the parent's part. 16 The questionnaire covers personal history, 17 location of birth, occurrence of diseases, and numerous 18 categories. Again, this is a slide of one of the health 19 team coming into the classroom and teaching the class. The 20 schools have welcomed us in and have indicated that this has 21 been an excellent learning experience for their students and 22 have definitely enriched their -- the education. 23 This shows a child being weighed. This is the 24 type of information that we -- we collect weight and height 25 at the time that we're doing pulmonary function testing. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 51 1 And it shows a child doing an actual test. And it's very 2 important that the -- that they're coached properly. Even 3 though the system is very automated, it radically improves 4 the reliability of pulmonary function tests with this modern 5 technology. It's still up to the technician to cheer them 6 on and get them to do their best effort. 7 And this young man was an asthmatic. And each 8 time he blew, it became harder. But, at the same time, he 9 was determined to do a good job. And so, I mean, this kind 10 of interest and excitement -- here's another young man 11 performing the test. 12 This is what I call the swarming effect. And it's 13 indicative of the interest that the children have. You see 14 one of the instructors showing the children what they're 15 seeing on the computer. It wasn't but a minute later that 16 we had this collection. And I have another slide where you 17 can't even see what the scene is. 18 Exposure assessment -- Dr. Lippmann really 19 provided a very good insight as to why this project is 20 unique. And I think this defines it We have many 21 measurements, and those measurements go into basically 22 developing the exposure model. And that exposure model will 23 allow us to develop much more refined exposure estimates and 24 ultimately dose estimates. 25 What occurs at an ambient site is not necessarily PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 52 1 what one receives in terms of effective dose. It's the 2 amount of time, the amount of concentration in the 3 environment, and it could be any number of environments -- 4 outdoor environments, indoor environments, in the car, et 5 cetera -- how long one is in that environment, and then how 6 rapidly one is breathing, and the amount of air, and 7 ultimately the amount of pollutant that might exist in that 8 air is then translated to the dose that one received. 9 The project looks at ambient air -- that's air in 10 the outside environment. It's taken indoor and outdoor 11 measurements at schools and homes. They've assessed time 12 and activity through a questionnaire -- where are the 13 children, at what activity levels are the children 14 performing in their respective locations? 15 And then there's been selected personal 16 monitoring, which provides not only direct measures of 17 exposure, but also serves to validate any exposure model 18 that one develops. 19 And this is -- one of the challenges we had was to 20 develop an ambient acidity monitor, which Dr. Susanne Hering 21 very successfully did so. But that's the instrument dead 22 center with the blue boxes. It measures hydrochloric and 23 nitric acid as well as PM2.5 for mass and ions. It's a 24 two-week integrated sampler. 25 In addition -- and essentially, of the 12 PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 53 1 communities, we utilized as many existing sites and deployed 2 new instruments to it. And then there were five new sites. 3 This is just the inside of the site (speaking of 4 photographic slide). 5 Now, this shows children -- we also did personal 6 measurements. And what they're wearing, the numbers, we 7 haven't just tagged children for the fun of it. They're 8 wearing little backpacks that contain active ozone samplers 9 This sampler was developed by Drs. Geyh and Koutrakis at 10 Harvard, and has provided invaluable amounts of information 11 on personal ozone exposure. 12 And this is a young man wearing it. Right above 13 the 6, you can see the little inlet for what the pump is 14 inside. And here you can see the children are not at all 15 impeded by wearing the packs. And they had great 16 opportunity to be playing outside. And we were not only 17 monitoring the pollution through the little packs, but we 18 were also recording the activity and, you know, tracking 19 them when they went inside, and basically provided every 20 reason for them to stay outside and play. 21 In terms of Phase II major accomplishments, as I 22 noted, we basically recruited to 3600 children from fourth, 23 seventh, and tenth grades. And that's a fairly amazing 24 feat, based on their level of interest and the fact that the 25 same children, for the most part, have come back. We PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 54 1 anticipated about a 10 percent loss to followup. 2 We initially saw 14 percent. And then, what we 3 found was that as much as four percent of that, those kids 4 could easily be tracked to another community that we were 5 studying. So, they're remaining in the project. 6 In 1993 and in 1994, each child completed lung 7 function tests, a health and general information 8 questionnaire, and activity questionnaire. 9 Illness and absence monitoring was implemented. 10 And, in fact, that particular task was considered so 11 important that U.S. EPA is split-funding an enhanced version 12 of it. And so, essentially, that funding is going to USC. 13 But it essentially effectively reducing the cost to us for 14 this task. 15 The demographics of the communities were 16 determined to be appropriate and of benefit to the study. 17 We've developed a reliable and accurate two-week sampler for 18 the acidity in acids, and a 12-community ambient air quality 19 network has been established. 20 Indoor and outdoor ozone measurements were -- 21 sorry -- an ozone timed exposure sampler was developed and 22 tested in the schools, and the data for ozone were collected 23 at all 48 schools in the study. Individual level ozone 24 exposure was measured as you saw in those earlier slides. 25 Individual level ozone, NO2, and PM historical PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 55 1 exposure estimates were generated using historical ambient 2 air quality data from essentially the California air quality 3 database that is probably not duplicated anyplace in the 4 country. 5 That gave a lifetime estimate of a child's 6 exposure for each of those pollutants. An exposure model -- 7 our exposure model development was initiated. Throughout 8 and for every element of the project, there has been a 9 rigorous quality assurance plan that has been implemented 10 and the procedures followed very closely. 11 The preliminary analyses have been performed using 12 health and historical exposure data. And I guess how one 13 could sum this up is that there's been enthusiastic 14 participation of children, parents, teachers, and schools. 15 The demographics are suitable. The ambient air quality 16 meets the study design requirements. Historical air 17 pollution exposure is more variable for individuals than 18 expected. However, that may turn out to enhance our ability 19 to tease apart effects when we get to the individual level, 20 because, essentially, it gives us that range of exposures 21 we're looking for in assessing effects. 22 The indoor concentrations of ozone at schools are 23 low relative to outdoor concentrations. The implication is 24 that it is appropriate on a hot afternoon in Southern 25 California, when there's an alert, to be pulling children PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 56 1 into the schoolroom or into the schools. 2 With respect to -- actually I need to go back. 3 (Speaking of slide sequence.) 4 MS. MARGOLIS: One of the other findings -- in 5 response to Ms. Edgerton -- was that one of the observations 6 -- and I was really excited about this -- now, what it means 7 we need to look into further. But where we heard that the 8 usual number cited for occurrence of asthma or prevalence of 9 asthma is about 5 to 8 percent in the population, the 10 average across the communities was running 15 and 16 11 percent. 12 The lowest we saw was 10 percent, and we saw as 13 much as 24 percent. It was not clear that this was 14 associated with any kind of air pollution exposure that we 15 were aware of. In fact, one of our thought-to-be clean 16 communities or nonpolluted communities had as much as 24 17 percent. You know, what this means, what kind of other 18 exposures -- maybe that community is near an agricultural 19 area. We need to look into this further. And the 20 longitudinal study will allow us to do so. 21 But clearly, the fact was that the prevalence 22 across the board was much higher than generally noted. 23 The other piece of information related to that, 24 though, is that that is consistent with other reports from 25 other studies. There have been reports from New Zealand, PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 57 1 from other parts of the U.S., where they're saying that 2 that's the type of prevalence that they're saying with 3 asthma. 4 In terms of the analyses, we're in the preliminary 5 stages. A final report is currently in preparation. These 6 were notes from the interim report that was submitted to the 7 Research Screening Committee in October. They accepted it 8 and were very pleased with the stage where we are at this 9 point in time. 10 Of the early analyses, when we looked at the FEV1, 11 which is a measure of lung function, and lifetime average 12 ambient peak ozone, that they were able to calculate the 13 children who were most exposed to peak ozone over their 14 lives exhibited a difference in lung function of a small 15 decrement. 16 There's a trend for an increasing effect with age, 17 and there's a suggestion of greater effect in boys. Again, 18 this is something that we'll learn more about in the 19 additional analyses. But also, more importantly, the key 20 here is at the individual level, and that's what the 21 longitudinal study allows us. 22 When we looked at communities -- again, in the 23 preliminary analyses -- the results were uncertain. More 24 will be gleaned in the additional analyses, but it brings us 25 back to the point that, by following an individual by PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 58 1 measuring their exposure individual level, you're increasing 2 your sensitivity to detect an effect. 3 The milestones -- essentially, as I noted, the 4 Phase II interim report was submitted and reviewed by the 5 Research Screening Committee and the Scientific Advisory 6 Committee. And in December of 1994, the Phase III 90-month 7 technical and cost proposal was submitted to the Research 8 Screening Committee. 9 They reviewed it, and they proposed and 10 recommended for funding 42 months. And that basically 11 brings us to this point today for the Phase III proposal. 12 Fundamentally, as you've heard from Dr. Lippmann, 13 the study design is not likely to change, communities are 14 appropriate. The children, we can enroll them. They're 15 actively participating. We'll be retaining the same 16 children and, as I noted earlier, adding another 1800 fourth 17 graders. 18 Health assessments are going to be the same. 19 Exposure assessment, with the exception of shifting 20 responsibility to ARB and the districts for the ambient air 21 quality data, is fundamentally the same. 22 One element that was put on hold and is not 23 contained in this portion of the proposal -- although it's 24 important -- is continued personal monitoring. But that was 25 done as a cost-saving measure, and we're hoping to obtain PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 59 1 outside resources for that. 2 The quality assurance plan will remain intact, and 3 there are some enhancements that will be built in. 4 Analyses and reporting of results -- especially 5 for Phase III -- I believe they're going to be coming a lot 6 more quickly and furiously, inasmuch -- as data is 7 collected, we now have the analytical tools to put them in, 8 more quickly compile the data, more quickly turn it around 9 and produce results. 10 And, essentially, what that brings us to then is 11 the budget summary. Just briefly, Phase I came in under 12 budget. Phase II is right on target. And, as you know, the 13 proposal for the first part of Phase III is about five and a 14 quarter million for a 42-month period. 15 I'll skip over this. The point of this slide was 16 very clearly that there will be a number of checkpoints, a 17 number of opportunities, and very much planned points where 18 we will be reporting back to the Research Screening 19 Committee. That's scheduled semiannually at least. 20 We will be reporting back to the Board with the 21 status of the project annually. And then, if any findings 22 come up sooner, obviously, that will also be brought to 23 their attention. 24 Just a brief note from a personal level -- this 25 project is an extraordinary level of effort, both by the PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 60 1 investigators and by the staff. But fundamentally, when I 2 look at this, and I see the children playing and I see them 3 outdoors on a hot afternoon, I realize that the implications 4 for public health are very great; that we know little or 5 nothing about long-term exposure health effects, and that 6 is, in fact -- in my estimation -- the best opportunity we 7 have to define them. 8 Thank you. 9 CHAIRMAN DUNLAP: Mr. Boyd, anything else? 10 MR. BOYD: I'm reluctant to take much more time. 11 But one comment, reflecting back on the funding issue and 12 the comments that were made earlier -- and Ms. Margolis did 13 say that either I or Mr. Cackette may have more to say. The 14 reason she said that is that in a very recent meeting 15 between ourselves and staff over this project and, of 16 course, looking at the funding issue and what have you, I 17 did mention to the staff, one, they've done an incredibly 18 good job of raising funding, but that we really hadn't 19 turned up the heat. I mean the Executive Officer hadn't put 20 on his sharpest clothes and hit the rubber chicken circuit 21 even yet to try to raise money, and that I would certainly 22 elevate it to our level to try to put the arm on a lot of 23 other folks. 24 Mr. Parnell has seen how we do that in other 25 areas, like PM10 and what have you. And we haven't even PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 61 1 come close to doing things we've done like for the San 2 Joaquin Valley study, this has so much interest on its own. 3 So, I'm quite confident that we'll backfill any problems, 4 and maybe we can oversubscribe the project, perhaps, if we 5 were to just make the next level of effort. 6 CHAIRMAN DUNLAP: Thank you. That's certainly 7 encouraging. 8 Mr. Lagarias. 9 MR. LAGARIAS: Well, I think you can count on the 10 support of the Board members in whatever capacity they can 11 help in raising the funds. 12 But the question I have -- when this study's over, 13 the year will be 2002, we'll have spent $15.7 million and, 14 hopefully, we'll have some very useful results that we can 15 apply to both our regulatory action and our overall 16 strategy. 17 Can we expect to get interim results that would 18 come out of this report that would be helpful in other 19 areas? And, if so, to what extent? 20 MS. MARGOLIS: Okay. I'm confident we will. I 21 think that we've already raised certain questions that 22 essentially, when we have two years of longitudinal data -- 23 which, essentially, we'll have collected in Phase II, that 24 offers a tremendous opportunity there. At the end of this 25 spring, pending your approval of our continuing the project, PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 62 1 we'll have three years of longitudinal data, plus all of the 2 other data that we've discussed. 3 I think, with that, there's -- we're developing or 4 we have the sensitivity to see effects. The fact that even 5 with a relatively crude estimate of ozone exposure, we're 6 able to detect an effect. I think, when you start enhancing 7 that with this higher resolution data, that that kind of 8 result will be forthcoming and in shorter time periods. 9 Clearly, this type of data begs analysis on a 10 continuous basis. And I know that the investigators and 11 myself are very interested in being able to go about the 12 business of doing that. 13 Well, I was thinking of some other fallout. For 14 example, you're reporting that the differences in indoor and 15 outdoor concentration levels of ozone in the classrooms are 16 significant, and that may give us some strategies that we 17 may look at. You find that between communities, it's 18 uncertain, which means there may be other confounding 19 factors that you may have to go back and look at. 20 And I, for one, am encouraged by what you're 21 doing. 22 MS. MARGOLIS: Thank you. 23 MR. LAGARIAS: Expensive though it is. 24 MS. MARGOLIS: Thank you. 25 CHAIRMAN DUNLAP: Go ahead, Ms. Edgerton. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 63 1 MS. EDGERTON: I think this is a very expensive 2 and worthwhile study. I also think that we have to be sure, 3 whenever we do studies, that they don't end up on some shelf 4 somewhere, and that, when we spend these kinds of public 5 monies, that we get commitments from the grantees to make 6 every effort to publish the results periodically and make 7 them available to the public in the most important journals, 8 whether it's Science, Human Journal, or whatever. 9 Could you tell me whether you have a commitment 10 for those Phase II results to be prepared and written for 11 the major publications so that the public can get the 12 results of this either way, and whether you also contemplate 13 that being in Phase III? 14 DR. HOLMES: I agree with you entirely, Ms. 15 Edgerton, that the payoff is getting this information not 16 only to our staff and to you, the Board members, but also to 17 the larger community, which Dr. Lippmann alluded to. 18 Whether or not the findings are published depends 19 a little bit on the nature of the findings themselves, 20 whether they are of sufficient interest or of sufficient 21 clarity to be submitted to one of the major journals. 22 And I think that we certainly can put a provision 23 in the agreement between ourselves and USC that these 24 results are to be submitted periodically to one or more of 25 the leading journals, I think with the proviso, as I PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 64 1 understand it, that it not be perhaps in some very highly 2 specialized, but rather a more general interest scientific 3 publication such as Science. 4 That we can make a provision of the contract for 5 Phase III. 6 MS. EDGERTON: Well, I would feel much more 7 comfortable with an arrangement such as that, because it is, 8 after all, public dollars paying for this. And irrespective 9 of whether we find -- whatever we find, I think it's value 10 added to have it communicated. 11 Thank you. 12 CHAIRMAN DUNLAP: Okay. Any other questions? 13 All right. At this point, I'd like to call our 14 first and only witness, who signed up to testify before the 15 Board, to please come forward to the podium. Ms. Veronica 16 Kun, Natural Resources Defense Council. 17 Good morning. 18 MS. KUN: Good morning. I don't know which one 19 this is (speaking of light and microphone extensions). But 20 my name is Veronica Kun, and I'm Senior Scientist with the 21 Los Angeles Office of the Natural Resources Defense Council. 22 I know many of you from having come before this 23 Board quite often on policy issues when you were 24 deliberating on the State air plan and other issues. But 25 this is really the first time that NRDC has come before you PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 65 1 to talk about an issue concerning a research decision. 2 And the reason is, is because we feel that getting 3 good science of air pollution is probably now one of the 4 most important things that this Board can do. We've seen -- 5 I've been doing air pollution advocacy for the last -- 6 intensively for the last seven years at NRDC. And I've seen 7 over the years an increasing skepticism and an increasing 8 questioning about the rationale for air pollution 9 regulation, for air pollution controls, and for the policies 10 that this Board and the air districts are undertaking. 11 And, in fact, just yesterday -- I don't know if 12 many of you saw the Wall Street Journal article in which the 13 reporter was talking about the difficulty that regulators in 14 Pennsylvania have been having convincing the public that 15 emissions controls on automobiles, that reformulated 16 gasoline, that I&M programs are worthwhile. 17 And one of the quotations in that article was from 18 a gentleman who said, "Well, but, you know, the air is a lot 19 cleaner than it used to be. I don't see the crud. I don't 20 see the dirt. In fact, I don't see anything. So, how do I 21 know that there's a real public harm here? How do I know 22 that there's a real public damage here?" 23 And, increasingly, even in Southern California, 24 we're facing those kinds of questions. And it's very 25 important to have good science, good scientific answers to PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 66 1 underscore and support the policies of this Board and the 2 kinds of important air pollution controls that I know that 3 we're all interested in seeing. 4 About three or four years ago, we began at NRDC to 5 feel a particularly acute need to try to demonstrate to the 6 public and to policy makers the need for controls. And we 7 published this report called "Out of Breath - Children's 8 Health and Air Pollution in Southern California." And I was 9 the principal author of that report. A team of us spent a 10 couple of years doing a couple of things. 11 First, we reviewed the scientific literature 12 available on the health effects of air pollution. And, 13 secondly, we tried to explain in laymen's terms why we 14 believed that it was so critical to examine children and 15 children's health with respect to air pollution, and why our 16 research and our regulatory efforts need to focus 17 particularly on them. 18 And I hope we were successful in doing that. But 19 I wanted to highlight for you some of the principal findings 20 of this report. 21 Let me start with the literature on air pollution, 22 general literature on air pollution. I think -- my 23 estimation is that the general literature on the acute 24 effects of air pollution, I think, is very -- is compelling, 25 is strong, is definitive. I think we know a great deal PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 67 1 about the immediate effects on lung function, on pollutant 2 exposure. We have lots of animal studies. We have lots of 3 chamber studies. And I think we're really beginning to 4 understand quite well the acute effects that exposures to 5 high levels of ozone or particulates have on both children 6 and adults. 7 Where we still need a great deal more effort and 8 investment is looking at those chronic effects, 9 understanding the long-term chronic health damage that 10 exposure to high levels of pollutants can cause. And this, 11 of course, is very critical for the people of Southern 12 California. Still, 90 percent of the population lives in 13 areas that chronically fail to meet one or more of the 14 ambient air pollution standards. 15 In Southern California, we have adults and 16 children who can be exposed on a more or less continuous 17 basis for days, for weeks, and during the smog season in 18 some areas for months. And the environmental community, as 19 you all I'm sure are, is very concerned that the evidence 20 that we have about acute damage doesn't even begin to 21 reflect what kind of damage chronic exposures can result in. 22 And for this reason, this study that you're 23 considering now is both extraordinarily, I think, well 24 structured and could have extraordinary implications for 25 understanding of these chronic effects, and especially the PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 68 1 chronic effects of children (sic). Of course, the two most 2 critical issues are how does this chronic exposure affect 3 the rate of growth of children's lungs, and how does it 4 affect the ultimate size of their lung capacity and their -- 5 and their response, and their susceptibility to respiratory 6 infections, to lung disease, to asthma, and -- both the 7 severity and the incidence of asthma. 8 I think these are all questions that are 9 exceedingly important to have answered in the public arena. 10 And although I know this is a big-ticket/money item -- it's 11 probably the biggest expenditure this Board will face in 12 terms of research dollars -- I just want to underscore how 13 important we who do advocacy feel that this effort is. 14 Without good science, we'll never convince the 15 public that what we're doing here is important and valuable. 16 And unless we know -- and, also, unless we know where to 17 target our efforts, what constituents of PM10 are the ones 18 that are really causing the effects that we think are going 19 to be -- unless we know what kind of differential there is 20 between the way children are exposed and the way adults are 21 exposed, we won't know how to structure emergency alert 22 programs, or how to create programs in schools that'll 23 protect children. 24 And I think these are all immensely valuable. So, 25 I won't -- I know that you've spent a great deal of time on PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 69 1 this issue already, and I won't go on much longer. But I 2 just want to make sure that you know that we in the 3 environmental community are very concerned about the policy 4 treatment of children and the dangers to children in air 5 pollution. We very much support your efforts in trying to 6 get good data on this issue. 7 And we want you to know that we very much 8 appreciate your pioneering efforts and your investments in 9 this area. Because, unless ARB continues to support this 10 kind of research, I'm afraid we won't get the information 11 that we need to get. 12 MR. LAGARIAS: Question. 13 CHAIRMAN DUNLAP: Thank you for your words. It's 14 appreciated. 15 Mr. Lagarias. 16 MR. LAGARIAS: We appreciate your support as an 17 advocacy group. Do you think your members would be willing 18 to help, financially support this study as well, since you 19 are the leaders in advocacy in this area? 20 MS. KUN: Well -- 21 MR. LAGARIAS: Can you make a commitment the way 22 we have? 23 MS. KUN: Well, actually, our members are -- have 24 taken an acute interest in trying to get this health 25 information out to the public. In fact, we had some very PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 70 1 generous donations to make sure that we could get this 2 information out and this report out, to disseminate it. And 3 we're trying to develop a brochure to let people -- to make 4 people more aware of air pollution problems and the kinds of 5 health effects that they have. 6 So, I think -- in our own way -- we are making an 7 investment; of course, not nearly as sizable as yours, in 8 making -- in not funding the basic research, but making sure 9 that that research gets out to the public and that it's 10 available. And, you know, we're doing the best we can on 11 that score. 12 MR. LAGARIAS: Well, go back to your members and 13 tell them we're privatizing our research. 14 (Laughter.) 15 CHAIRMAN DUNLAP: Thank you. Are there any others 16 that have signed up to speak before the Board? That was all 17 that I had on my list. 18 MR. PARNELL: Mr. Chairman? 19 CHAIRMAN DUNLAP: Mr. Parnell. 20 MR. PARNELL: With great hesitation -- I applaud 21 the work that's been done, but there's a question, probably 22 because I'm a novice in this area, that leads me to even ask 23 the question. But it goes back to something that Mr. 24 Lagarias asked earlier; that is, economic strata and all the 25 differences that that may bring to the issue. And it PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 71 1 strikes me that a lot of people have been a proponent of the 2 idea that nutrition generally has more to do -- or has much 3 to do with lung function, and could lead to a condition 4 where normal defense mechanisms could be compromised, such 5 that you might get a distortion when you look purely at 6 pollution or components of pollution. 7 And I wonder how you balance that or can you 8 balance that? 9 MS. MARGOLIS: I'll give a brief answer, then I'm 10 going to turn it over to Dr. Lippmann. 11 But, essentially, in our study, one of the series 12 of questions that is asked is related to, you know, vitamin 13 supplementation. In addition, indirectly, we have -- by 14 selecting for certain demographics, because we were looking 15 for stability in the community, you sort of indirectly 16 filter or narrow the scope of the range of health status. 17 We also have obtained information on health 18 insurance, so that indicates, you know, what kind of primary 19 health care the child might have access to. So, through 20 this type of information, while one cannot necessarily 21 define how those factors contribute to the end point, it 22 allows us to assess how those factors might be contributing 23 to our observations. 24 And on that note, I think I'll turn it over for 25 the more general discussion to Dr.Lippmann. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 72 1 DR. LIPPMANN: I think Helene hit the main points. 2 These are issues that have to be addressed in any 3 epidemiologic study, because they can have a real influence. 4 And to the extent that one can address them, the team has 5 addressed them through the questionnaire and through the 6 design of the study. 7 Hopefully, the study will produce quantitative 8 determinants of these influences of air pollution and of 9 nutrition. And so, there may be a benefit that's larger 10 than the air pollution results that comes from the study. 11 MR. PARNELL: Thank you. 12 CHAIRMAN DUNLAP: Okay. That concludes the public 13 testimony element of this Board item. 14 For the record, I'd like Mr. Boyd to summarize any 15 written comments that the Board has received by individuals 16 unable to join us today and testify before the full Board. 17 MR. BOYD: Dr. Holmes, I believe we have a letter? 18 DR. HOLMES: Yes, Mr. Chairman, we have two 19 letters regarding this research proposal -- a letter from 20 Dr. James Lents, Executive Officer of the South Coast AQMD, 21 in support of the study, and also reiterating the district's 22 support to provide both funding and in-kind services, too, 23 to -- 24 CHAIRMAN DUNLAP: What was the dollar amount he 25 specified? PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 73 1 DR. HOLMES: The amount he mentions is $200,000. 2 CHAIRMAN DUNLAP: Annually, or is that a one-time 3 thing? 4 DR. HOLMES: I think that's annually, yes. 5 CHAIRMAN DUNLAP: Okay. 6 DR. HOLMES: The in-kind may be even more than 7 that, depending on how we work out the monitoring 8 infrastructures. 9 The second letter is from Dr. Spencer Koerner, 10 M.D., Chairman of the Board of the American Lung Association 11 of California, supporting the project. The association 12 believes this project is a critical piece of investigation 13 necessary for us to better understand the long-term effects 14 air pollution on the human body, particularly children. 15 And that's the limit of what we received, Mr. 16 Chairman. 17 CHAIRMAN DUNLAP: Okay. Thank you, Dr. Holmes. 18 Mr. Boyd, does the staff have any other comments? 19 MR. BOYD: No, Mr. Chairman, I believe that 20 concludes our remarks. 21 CHAIRMAN DUNLAP: Okay. Since this is not a 22 regulatory item, it's not necessary to officially close the 23 record. However, we do have a resolution before the Board 24 for action. It's in each of the Board members' books. I 25 believe it's on page 10. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 74 1 At this point, why don't we pause for a few 2 moments to review the resolution, and we'll come back in a 3 moment. 4 (Thereupon, there was a pause in the 5 proceedings to allow members to peruse 6 the above-mentioned resolution.) 7 MR. LAGARIAS: Mr. Chairman? 8 CHAIRMAN DUNLAP: Yes, Mr. Lagarias. 9 MR. LAGARIAS: I move adoption of Resolution 95-1. 10 MR. CALHOUN: Second. 11 CHAIRMAN DUNLAP: Okay. Very good. We have a 12 motion and a second. Is there any other discussion, further 13 discussion by the Board? 14 Okay. I would like to call for a vote on 15 Resolution 95-1, and ask the Board Secretary to take roll. 16 MS. HUTCHENS: Boston? 17 DR. BOSTON: Yes. 18 MS. HUTCHENS: Calhoun? 19 MR. CALHOUN: Aye. 20 MS. HUTCHENS: Edgerton? 21 MS. EDGERTON: Yes. 22 MS. HUTCHENS: Hilligoss? 23 MAYOR HILLIGOSS: Aye. 24 MS. HUTCHENS: Lagarias? 25 MR. LAGARIAS: Aye. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 75 1 MS. HUTCHENS: Parnell? 2 MR. PARNELL: Aye. 3 MS. HUTCHENS: Riordan? 4 SUPERVISOR RIORDAN: Aye. 5 MS. HUTCHENS: Vagim? 6 SUPERVISOR VAGIM: Aye. 7 MS. HUTCHENS: Chairman Dunlap. 8 CHAIRMAN DUNLAP: Aye. 9 MS. HUTCHENS: Passes 9 to 0. 10 CHAIRMAN DUNLAP: Thank you. 11 Does our court reporter need a moment? 12 Okay. Why don't we take a five-minute break. 13 (Thereupon, a recess was taken.) 14 CHAIRMAN DUNLAP: If I could get you to take your 15 seats, we'll begin. 16 Thank you. The next items of business before the 17 Board today are four other research proposals. 18 Have all members of the Board had an opportunity 19 to review them? Okay. 20 Are there any additional concerns or comments by 21 members of the Board? All right. 22 If not, is the Board prepared to vote on these 23 resolutions? 24 Okay. The resolutions are also in each member's 25 Board book. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 76 1 DR. BOSTON: Mr. Chairman, I would like to move 2 the adoption of Resolutions 95-2, 95-3, 95-4, and 95-5. 3 SUPERVISOR RIORDAN: I'll second the motion. 4 CHAIRMAN DUNLAP: Very good. Thank you. Why 5 don't we take a moment to -- I guess we've already reviewed 6 them. We don't need to do that. 7 Why don't I ask -- do we need to take any 8 testimony? I guess we do not. No one signed up? 9 MR. BOYD: No one signed up. 10 CHAIRMAN DUNLAP: All right. Then I can ask the 11 Board Secretary to call the question. Do you call the 12 question at this point? 13 MS. HUTCHENS: If you want to, you can take an aye 14 or a nay vote, since there were no comments on it? 15 CHAIRMAN DUNLAP: A voice vote? We can? 16 MS. HUTCHENS: Voice vote. 17 CHAIRMAN DUNLAP: Okay. You want to call that, or 18 would you like me? 19 MS. HUTCHENS: You can just call for an aye or 20 nay. 21 CHAIRMAN DUNLAP: Okay. All those in favor of the 22 motion and the second that Dr. Boston and the seconder 23 covered, please say aye. 24 (Ayes.) 25 Any opposed? Very good. Then the motion carries. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 77 1 Thank you. 2 Now, I guess we'll take a moment to allow staff to 3 adjust your seating arrangement, or have you already done 4 that? 5 DR. HOLMES: We're ready. 6 CHAIRMAN DUNLAP: All right. Well, you're ahead 7 of me it seems. 8 MR. BOYD: We want to fulfill your commitment to 9 move this along. 10 CHAIRMAN DUNLAP: To move it along. There's 11 training wheels on this Chairman today. 12 (Laughter.) 13 CHAIRMAN DUNLAP: I would like to remind those of 14 you in the audience who would like to testify on the next 15 agenda item to please sign up with the Board Secretary. 16 The next item on the agenda today is 95-1-3. It's 17 a public meeting to consider retention of regulations 18 regarding the State's one-hour ambient air quality standard 19 for sulfur dioxide. 20 At this point, I would like to ask Mr. Boyd to 21 introduce the item and begin the staff's presentation. 22 MR. BOYD: Thank you, Mr. Chairman. As you all 23 know, the Board is required by law to periodically review 24 the State's ambient air quality standards to ensure that the 25 standards reflect current scientific knowledge. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 78 1 In this regard, the Board is required by the 2 statute to consider the effects on public health, safety, 3 and welfare when reviewing an ambient air quality standard. 4 The current State one-hour ambient air quality 5 standard for sulfur dioxide is 0.25 parts per million 6 averaged over one hour. Your Board staff and the staff of 7 the Office of Environmental Health Hazard Assessment have 8 reviewed this standard and have prepared the report that's 9 before you, a report to you and an additional technical 10 support document that provides the factual basis for our 11 joint recommendation to you on the standard. 12 Today, we will summarize key information 13 supporting our recommendations to retain the current one- 14 hour ambient air quality standard for sulfur dioxide. 15 First, Dr. Norman Kado will present general 16 information regarding the standard, including the ARB 17 staff's recommendations and the scientific basis for these 18 recommendations. 19 In the review process, the ARB also requests that 20 the Office of Environmental Health Hazard Assessment, or 21 OEHHA as we know it, develop a recommendation regarding the 22 standard based on a review of the health effects. 23 Dr. Michael Lipsett of the OEHHA staff will 24 present information on their recommendation following Dr. 25 Kado's presentation. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 79 1 So, if I might, I'd call on Dr. Norman Kado of our 2 Research staff to lead off the presentation. 3 DR. KADO: Thank you, Mr. Boyd. 4 Good morning, Chairman Dunlap and members of the 5 Board. I'm Dr. Norman Kado. I'm a toxicologist in the 6 Health Effects and Air Quality Standards Section of the Air 7 Resources Board's Research Division. 8 The presentation today is a summary of the 9 information published in greater detail in the staff report 10 and technical support document. 11 Four main areas of information will be presented 12 today. These include background information relevant to the 13 review of the standard; emissions, sources, and air quality 14 of sulfur dioxide; the scientific bases for the standard; 15 recommendations for the standard. 16 I will present information on the first two points 17 and Dr. Michael Lipsett of the Office of Environmental 18 Health Hazard Assessment will discuss the health basis for 19 the recommended ambient air quality standard. 20 Finally, I will discuss the recommendations. 21 In discussing the background information relevant 22 to the review of the standard, I will summarize the legal 23 requirement for review of the standard, regulatory history 24 of sulfur dioxide standards, including review of the current 25 standard, and the process for reviewing ambient air quality PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 80 1 standards. 2 Staff is presenting this item to the Board today 3 to fulfill the legal requirements for periodic review of 4 ambient air quality standards as stipulated in the 5 California Code of Regulations. This requirement was 6 initiated and enacted by the Board, and State law requires 7 that the ambient air quality standard review process will 8 consider health recommendations from the Office of 9 Environmental Health Hazard Assessment. 10 With regards to the regulatory history, the 11 California short-term/one-hour ambient air quality standard 12 for sulfur dioxide was initially adopted in 1969 by the 13 Department of Public Health. This occurred prior to the 14 establishment of the Air Resources Board. the standard was 15 set at 0.5 parts per million. And this early standard was 16 based on the approximate odor threshold for sulfur dioxide. 17 The standard was revised in 1983 by the Air 18 Resources Board to 0.25 parts per million averaged over one 19 hour, and was based on adverse health effects observed in 20 exercising asthmatic subjects under controlled laboratory 21 conditions. 22 These asthmatic subjects were exposed to 0.40 23 parts per million sulfur dioxide over a short period of 24 time, generally 5 to 10 minutes. The standard adopted in 25 1983 was based on an analysis that related one-hour average PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 81 1 concentrations to 10-minute average concentrations of sulfur 2 dioxide. 3 The ARB has established two ambient air quality 4 standards for sulfur dioxide as illustrated in the next 5 slide. 6 There is a one-hour averaged standard that is 7 based on health effects such as shortness of breath 8 resulting from short-term exposures, less than one hour; and 9 there is a 24-hour standard that is based on health effects, 10 such as increased incidence of respiratory disease, 11 resulting from longer term or chronic exposures to sulfur 12 dioxide. 13 As mentioned, the one-hour standard is 0.25 parts 14 per million, and the 24-hour standard is 0.04 parts per 15 million. Neither standard can be exceeded in attainment 16 areas. 17 The U.S. Environmental Protection Agency, the U.S. 18 EPA, has established primary health-based national ambient 19 air quality standards for sulfur dioxide. 20 There are two primary standards and one secondary 21 standard. One primary standard is 0.14 parts per million, 22 averaged over 24 hours; the other primary standard is 0.03 23 parts per million, based on an annual arithmetic mean. 24 The U.S. Environmental Protection Agency has also 25 recently reaffirmed a national secondary, welfare-based PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 82 1 standard of 0.5 parts per million averaged over three hours. 2 There is currently no health-based national short- 3 term ambient air quality standard for sulfur dioxide. 4 However, such a standard is now under U.S. EPA review with a 5 number of options being considered. The U.S. EPA has very 6 recently requested comment on proposed options regarding 7 short-term exposures to sulfur dioxide. These options are 8 summarized in the next slide. 9 The first option is to adopt a standard with an 10 averaging time of five minutes at a concentration of 0.60 11 parts per million. The second option is to establish a new 12 regulatory program under Section 303 of the Clean Air Act. 13 And the third option is to augment implementation of 14 existing standards by focusing on sources that are likely to 15 produce five-minute peak concentrations of sulfur dioxide. 16 The ARB staff intends to submit to the U.S. EPA 17 technical information regarding California's short-term 18 standard for sulfur dioxide. 19 I will now discuss the review process for ambient 20 air quality standards. The review process for State ambient 21 air quality standards is similar, but not identical, to the 22 review process for national ambient air quality standards. 23 The review process for the State ambient air 24 quality standards solicits input from the general public and 25 the scientific community. In this case, the process began PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 83 1 with a written request to the public for information on 2 sulfur dioxide effects. To also maximize the exchange of 3 information, the ARB's reviews of air quality standards are 4 timed to coordinate with U.S. EPA's reviews. 5 An important element in the review process is the 6 research review, which is detailed in the next slide. 7 Following t he call for public information, the 8 ARB, in collaboration with the Office of Environmental 9 Health Hazard Assessment, or OEHHA, prepares documents for 10 review. An important element, as required by law for 11 health-based standards, is the recommendation to the Board 12 from OEHHA. OEHHA is part of the California Environmental 13 Protection Agency. 14 Their written recommendations and supporting 15 documentation are reviewed by OEHHA's Air Quality Advisory 16 Committee, an independent panel composed of leading air 17 pollution health experts. 18 The ARB prepares a staff report which incorporates 19 OEHHA's recommendations, and the ARB also prepares a 20 technical support document. Both the ARB staff report and 21 technical support document are released to the public prior 22 to the Board meeting to allow time for public comment. 23 After the standard is proposed and there is public 24 comment, the Board considers adoption of the standard at a 25 public hearing. The adopted standard then is recorded with PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 84 1 the Office of Administrative Law. 2 As an introduction to the information on 3 emissions, sources, and air quality of sulfur dioxide, the 4 next slide illustrates the point that sulfur dioxide is 5 primarily produced from the combustion of sulfur-containing 6 fuels, and that atmospheric reactions of sulfur dioxide 7 yield other sulfur-containing air pollutants, primarily 8 sulfuric acid and sulfates. 9 Sulfuric acid and sulfates are primary 10 constituents of PM10 -- particulate matter 10 microns or 11 smaller -- and also reduce visibility. The ARB has 12 established ambient air quality standards for sulfates, 13 PM10, and visibility-reducing particles. 14 I would now like to discuss the sources and 15 emissions of sulfur dioxide in California summarized in the 16 next slide. 17 This slide summarizes the statewide sulfur dioxide 18 emissions by source. Approximately 57 percent of the total 19 average daily emissions, or approximately 230 tons per day, 20 are from mobile sources. Approximately 43 percent of the 21 total average daily emissions, or approximately 181 tons per 22 day, are from stationary sources. A more detailed analysis 23 of each source type is given in the next two slides. 24 This slide describes the mobile source categories. 25 The categories for mobile source emissions area divided into PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 85 1 other mobile sources, such as ships and aircraft, and on- 2 road vehicles. All of the mobile source emissions are 3 associated with the combustion of fuel. 4 The next slide describes the stationary source 5 categories. The categories for stationary source emissions 6 include fuel combustion, petroleum processing -- including 7 storage and transfer -- and other industrial processes. 8 The next slide illustrates the historic trends of 9 sulfur dioxide emissions for the State during the years 1975 10 through 1990. 11 Both stationary and mobile source emissions 12 declined considerably during these years. For stationary 13 sources, the decline was mainly due to industry switching 14 from oil to natural gas as the primary fuel for combustion 15 processes. 16 For mobile sources, the decline in sulfur dioxide 17 emissions is due to sulfur content limitations on gasoline. 18 Sulfur dioxide emissions continued to decline through 1985, 19 and this was due partly to the adoption of low sulfur diesel 20 fuel regulations in the South Coast Air Basin and in Ventura 21 County. 22 The next slide illustrates the projected trends of 23 sulfur dioxide for the State for the years 1990 through 24 2010. Overall, the downward trend in total sulfur dioxide 25 emissions observed between 1975 and 1990 is projected to PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 86 1 continue through the year 2000. 2 The downward trend in sulfur dioxide emissions is 3 reflected in the air quality data as illustrated in the next 4 slide. 5 The number of exceedances of the one-hour ambient 6 air quality standard for sulfur dioxide during the years 7 1984 through 1992, is summarized in this slide. The 8 exceedances illustrated do not include data that have been 9 identified as affected by an exceptional event. Exceedances 10 during these years occurred only at three sites in the 11 State. 12 These were the San Francisco Bay Area, the South 13 Coast, and the South Central Coast Air Basins. The South 14 Central Coast and its specific site, Nipomo, had eight 15 exceedances in this period, seven in 1985, and one in 1986. 16 The other two sites show only one exceedance each, both in 17 1984. 18 There have been no exceedances of the one-hour 19 sulfur dioxide standard at any site in the State since 1986. 20 Further, all areas of California are currently designated as 21 attainment for the State sulfur dioxide standards. 22 The ambient air concentration trends for sulfur 23 dioxide in the State are shown in the next slide. 24 For illustrative purposes, the South Coast Air 25 Basin trend for sulfur dioxide is presented, since it is one PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 87 1 of the areas that had an exceedance prior to 1987. The 2 white circles with yellow lines represent the average value 3 of the 30 highest one-hour concentrations reported for that 4 year. This is typically referred to as the mean of the top 5 30 daily maximum hourly sulfur dioxide concentrations. 6 The green circles with red lines represent a 7 three-year moving average of these values. The three-year 8 moving average is used to analyze and evaluate long-term air 9 quality trends. As illustrated from the chart, the airborne 10 concentrations of sulfur dioxide have been decreasing for a 11 number of years. The air quality data follows the 12 decreasing trends in emissions. 13 As mentioned previously, State law requires that 14 the ambient air quality standard review process will 15 consider health effects information. The health effects 16 information is summarized in the following slide and will be 17 further discussed in more detail by Dr. Michael Lipsett. 18 Sulfur dioxide is an irritating, water-soluble gas 19 that is efficiently absorbed into the upper respiratory 20 system. Based on studies of human volunteers exposed to 21 sulfur dioxide, investigators have found that asthmatics are 22 the most susceptible group. 23 Asthmatic volunteers, especially those volunteers 24 who are exercising while being exposed to sulfur dioxide, 25 typically respond by having bronchoconstriction, or PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 88 1 narrowing of the airways. As a result, they develop 2 clinical symptoms of wheezing, chest tightness, and 3 difficulty in breathing. 4 As mentioned earlier in this presentation, the 5 one-hour standard is based on short-term exposure of 6 asthmatics to sulfur dioxide. The chronic health effects of 7 sulfur dioxide were discussed previously under the 24-hour 8 ambient air quality standard for sulfur dioxide. 9 The ARB staff has reviewed the health effects 10 literature and the recommendation by OEHHA. I would now 11 like to introduce Dr. Michael Lipsett of OEHHA who will 12 discuss the health effects information, after which I will 13 discuss the staff recommendation. 14 Dr. Lipsett. 15 DR. LIPSETT: Thank you, Dr. Kado. I'm not on 16 yet? (Speaking of microphone) Okay. The last time I was 17 here, this microphone kept going on and off the entire 18 presentation. I hope that doesn't happen this time. 19 Chairman Dunlap and distinguished members of the 20 Board, I'm pleased to be able to present the recommendation 21 of the Office of Environmental Health Hazard Assessment 22 regarding our recommendation on California's short-term 23 sulfur dioxide ambient air quality standard. 24 Before presenting the actual recommendation, 25 however, I wanted to review briefly in a little bit more PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 89 1 detail than Dr. Kado did the process that we use to come up 2 with a recommendation. Since there are, I think, six 3 members of the Board who were not here the last time I 4 presented this information, I thought, as a courtesy, it 5 might be nice to present you with a little bit more 6 background information. 7 Is this something that you would like to hear 8 about? Okay. 9 Well, first, the way we initiate this review is to 10 conduct a computer literature search and, from that, 11 identify and review the key articles that we're going to use 12 in our recommendation. 13 We don't have a statutory mandate like the Federal 14 EPA does to produce a massive criteria document, so we try 15 and keep it focused. And, as you can see, our 16 recommendation is Appendix A of the staff report. It's 17 relatively short, and I hope was easily readable. 18 Occasionally we request additional data from 19 investigators whose reports we use, as was done in this 20 instance with a report from Rancho Los Amigos. And we do 21 initial -- additional analysis of their data if we think 22 it's appropriate to setting a standard. 23 Then, we draft our recommendation and submit it to 24 our Air Quality Advisory Committee. As Dr. Kado indicated, 25 this is a blue ribbon committee of experts. They're mainly PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 90 1 physicians, epidemiologists, and toxicologists who have 2 affiliations with major California universities, who have 3 conducted themselves extensive research on air pollution. 4 The current listing of our panel membership is on 5 pages 2 and 3 of Appendix A, so you can look and identify 6 those members yourselves. 7 Then, we publish, through the Office of 8 Administrative Law, the availability of this document and 9 the date of the Air Quality Advisory Committee meeting so 10 that interested members of the public and industries are 11 allowed to attend and to present their comments as well in 12 kind of a workshop format. 13 Could I have the next slide, please? 14 At the Air Quality Advisory Committee meeting, 15 they review their document at the public session. We have a 16 court reporter there taking notes. And they give us their 17 feedback on how we can improve the quality of our 18 presentation of the recommendation. 19 Then, there's an additional 30-day public comment 20 period, following which we initiate the revision of the 21 document, incorporating any comments received from the 22 public or addressing them, incorporating revisions suggested 23 by our committee. And occasionally we will also have 24 comments submitted by independent consultants who we have 25 engaged to review a document as well. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 91 1 In this case, we had Dr. Jane Koenig and Mr. 2 William Linn, both of whom have conducted many controlled 3 exposure studies of sulfur dioxide with asthmatics. And 4 their comments are reflected in our final recommendation as 5 well. 6 Then, we submit it to our management for review. 7 And after making any revisions they think are appropriate, 8 we submit to the Air Resources Board. 9 Next slide, please. 10 Now, on to our recommendation. As Dr. Kado 11 indicated, the short-term standard is intended to protect 12 exercising asthmatics. SO2 concentrations that are anywhere 13 near the current standard, even asthmatics at rest would not 14 be affected. So that exercise and the resultant increase in 15 respiration rate is necessary to elicit any kind of 16 response. 17 Asthma is -- as many of you I'm sure are familiar 18 with -- is a disease that has received a lot of additional 19 public scrutiny recently. Our understanding of the whole 20 disease process has completely changed in the past ten 21 years. We used to think of it as only a disease where the 22 airways would constrict, and we'd treat the symptoms related 23 to constriction. But we now recognize that it's a process 24 of chronic inflammation that has superimposed on it these 25 episodic periods of obstruction and accompanying symptoms, PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 92 1 which include -- again, as Dr. Kado had indicated -- 2 shortness of breath, cough, chest tightness, wheezing, and 3 the production of excess sputum. 4 Asthma prevalence has increased since the 1970s 5 throughout the U.S. In fact, it's a worldwide increase. 6 And we don't really have any good explanation of why this 7 has been the case. And in our document, using national 8 statistics -- because there are no good statewide statistics 9 on asthma prevalence -- we estimated that the number of 10 asthmatics in California is somewhere in the range of about 11 a million. 12 We can't put very narrow confidence intervals on 13 that because, as I said, we don't really have very good 14 prevalence data for the State of California. 15 The number of asthmatics who are likely to be at 16 risk from sulfur dioxide, however, is much smaller than 17 this, because of the nature of the point source emissions of 18 SO2. When you have any elevated concentrations, it's likely 19 to be due to emissions arising from a stationary source 20 rather than mobile sources. 21 Could I have the next slide, please? 22 Now, I wanted to spend about two or three minutes 23 just talking about the kinds of studies that form the basis 24 for our recommendation. We have based this recommendation 25 only on the results of controlled chamber studies. As I PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 93 1 think Dr. Lippmann had mentioned during your earlier 2 discussion, you can't get everything you would like to get 3 out of these studies, but they do have the advantage of 4 being able to control a lot of variability. And you are 5 able to know precisely the concentrations to which people 6 are exposed in the fixed situation. 7 In addition, that they have the advantage over 8 animal studies, in that you don't have to do any kind of 9 cross-species extrapolation. And the way these studies are 10 done is you have volunteers -- often these are medical or 11 nursing students -- exposed to either filtered air or 12 pollutant in kind of a random order. And they're double- 13 blinded experiments. Neither the investigators, who are 14 administering that particualr exposure, nor the subjects are 15 supposed to know what they're being exposed to. 16 Exposures can take place either in a chamber, 17 which is what most of the ones these studies are done with 18 now; or by a mouthpiece,which will bypass the kind of -- the 19 kind of scrubbing of pollutants that the nose does; or via 20 face mask, which allows sort of normal breathing as well, 21 but it's somewhat encumbered if you have a mask over both 22 your mouth and nose. 23 And these protocols often incorporate exercise or 24 hyperventilation to increase the dose that gets down into 25 the lung. Then, symptoms and lung function are measured PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 94 1 both before and sometimes during, and definitely after 2 exposures. And then these results are then analyzed for 3 differences between the pollutant exposures and the filtered 4 air exposures to try and assess how much affect on lung 5 function or symptoms might be attributable to the protocol 6 itself, which is the filtered air exposure, and how much the 7 pollutant. 8 So, you subtract the differences and do a 9 statistical analysis of that. 10 Could I have the next slide, please? 11 And what has been found with sulfur dioxide in 12 these controlled exposure studies is that asthmatics are 13 probably about an order of magnitude more sensitive than 14 nonasthmatics to the effects of bronchoconstriction. 15 Now, there is a lot of variability in the normal 16 population and a lot of variability among asthmatics, so 17 that the distributions actually overlap. But, in general, 18 the asthmatics tend to be much more sensitive to airway 19 constriction and the resulting respiratory symptoms and 20 changes in lung function. 21 As I mentioned at the beginning, we do need 22 exercise in these sorts of studies to be able to detect 23 effects in asthmatics at a concentration anywhere near what 24 the current standard is. 25 Something that is interesting about sulfur PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 95 1 dioxide, as opposed to some of the other pollutants that 2 have been tested in controlled studies, is the effects occur 3 within a minute or two of exposure. They tend to progress, 4 say up for the first maybe five to ten minutes, and then 5 they plateau after that, and often will begin to diminish 6 during the course of the exposure, say if it's a half an 7 hour or an hour. 8 And what we found in our analysis of the studies 9 that are listed in Table 1 to Appendix A -- I think there 10 are 17 studies listed there -- is that the adverse effects, 11 which we defined as both respiratory symptoms and changes in 12 lung function, were consistently observed at SO2 13 concentrations equal to or exceeding .4 parts per million. 14 There were a couple of studies that showed changes 15 in lung function at concentrations below that. But we and 16 our Advisory Committee felt that these changes in lung 17 function were not clinically significant. 18 And if you have questions about that, I can go 19 into that in a little more detail maybe after I finish the 20 presentation. 21 Could I have the next slide, please? 22 In making a recommendation for an ambient 23 standard, you never have complete information and, so, there 24 always remain a few uncertainties in terms of what you're 25 developing, and that's why you want to leave a margin of PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 96 1 safety in there. 2 With respect to SO2, some of the uncertainties 3 involve potential interactions with other pollutants. One 4 of the types of pollutants, especially, has not been studied 5 in terms of its interaction with SO2 in a controlled setting 6 is particulate matter. Ozone and SO2 have been studied 7 extensively in healthy individuals and without seeming to 8 find significant interaction. 9 There is one study that suggests that sequential 10 exposure to low-level ozone does seem to have an interaction 11 with sulfur dioxide in adolescent asthmatics. And our 12 committee felt that this kind of work needs to be developed 13 more before trying to incorporate it into the standard. 14 But this is not -- this is an area where there 15 does still remain some uncertainty. Another area is that 16 there are not what we consider to be adequate control 17 studies of other potentially susceptible subgroups, such as 18 people with chronic lung disease, chronic bronchitis, and 19 emphysema, or people who have what is called airway 20 hyperresponsiveness, but without asthma. 21 We think and our committee thought that asthmatics 22 would probably be the most susceptible of all these groups, 23 but the other ones have not really been adequately 24 investigated to confirm that. 25 And finally, there are data gaps in terms of PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 97 1 exposure. Dr. Kado indicated a little bit about this, but 2 we don't really have a good idea of the distributions, say, 3 of asthmatics in relation to major point sources of sulfur 4 dioxide throughout the State. 5 Could I have the next slide, please? 6 Okay. We have, in going through this entire 7 process and getting the feedback from our committee and our 8 other consultants and oral comments from several members of 9 the public, we felt it was appropriate to retain the 10 existing one-hour standard of .25 parts per million. We 11 feel that this is adequate to protect asthmatics and the 12 other potentially susceptible subgroups. 13 And finally, on pages 19 and 20 of our Appendix A 14 to the staff report, our committee felt, as do we, that 15 there are additional areas of research that ought to be 16 looked into before our next review. 17 I wanted to comment here, though, that there are 18 other pollutants that we think are of greater priority at 19 this point than sulfur dioxide. But if we had unlimited 20 resources to undertake research -- which I know we don't 21 have -- the projects that we think are most important are 22 listed there on pages 19 and 20. 23 And I thought I would just close at that and 24 answer any questions if there are any. 25 CHAIRMAN DUNLAP: Are there any questions by PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 98 1 members of the Board? 2 Mr. Vagim. 3 SUPERVISOR VAGIM: You mentioned that the last 4 time there was an exceedance in any of the areas -- one of 5 the areas in the Central South Coast, and that was Nipomo? 6 DR. KADO: Nipomo. 7 SUPERVISOR VAGIM: That's kind of in a remote 8 area. 9 DR. KADO: Yes, that's in San Luis -- as you know, 10 it's in San Luis Obispo. There is a petroleum processing 11 plant in the vicinity, and those monitors are placed -- at 12 least three of them were placed in a perimeter around that 13 facility. 14 SUPERVISOR VAGIM: So, it is more really directly 15 related to this petroleum plant than -- 16 DR. KADO: That's correct. 17 SUPERVISOR VAGIM: -- any air currents or 18 something like that. 19 DR. KADO: That's correct. 20 SUPERVISOR VAGIM: The other issue was in the pie 21 chart that you had here. You show a breakdown on the three 22 pie charts. First you start with mobile and then 23 stationary, and then you take the -- carve up just the 24 stationary part or the mobile part, and leave -- showing the 25 stationary as a part and then vice versa. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 99 1 But in the first cut, when you do that with the 2 mobile sources, on-road vehicles, 28 percent. But then, 3 "other mobile." Other mobile, I presume, would be off-road 4 and what else? 5 DR. KADO: They're mostly -- 6 SUPERVISOR VAGIM: That's a 50-50. 7 DR. KADO: Yes, such as aircraft, ships, and that 8 kind of -- 9 SUPERVISOR VAGIM: Because, when you start 10 thinking about the number of tailpipes on-road, and you talk 11 about the number of tailpipes off-road, they surely are 12 outnumbered by the on-road. 13 So, what's happening? Is there a big smokestack 14 out somewhere -- 15 MR. BATCHELDER: No, you have -- 16 SUPERVISOR VAGIM: -- moving around or something? 17 MR. BATCHELDER: You have to keep in mind that the 18 on-road population tends to have a high component of 19 gasoline. 20 The off-road and nonwheeled vehicle, if you will-- 21 SUPERVISOR VAGIM: Nonwheeled vehicle, like what? 22 MR. BATCHELDER: Ships -- 23 SUPERVISOR VAGIM: Ships. 24 MR. BATCHELDER: -- airplanes, as well as things 25 like construction equipment are not predominated by PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 100 1 gasoline. They have much higher sulfur content fuels. 2 There are things like diesel fuel and kerosene. So, even 3 though the number of vehicles may be different, the sulfur 4 content of their fuel differs tremendously. 5 SUPERVISOR VAGIM: So, diesel has a lot higher -- 6 MR. BATCHELDER: Diesel has a lot higher. I mean, 7 if you talk about unleaded gasoline under reformulated 8 gasoline conditions, you're talking about 50 parts per 9 million; whereas, low sulfur diesel fuel is still measured 10 in things like maybe half a percent or a quarter of a 11 percent. We're talking -- 12 SUPERVISOR VAGIM: In volume. 13 DR. KADO: 500 parts per million. 14 MR. BATCHELDER: We're talking very great 15 differences in magnitude. 16 SUPERVISOR VAGIM: And in ships, they still burn 17 bunker fuel and that type of stuff? 18 MR. BATCHELDER: I'm not the world's leading 19 expert on where the ships -- where they burn things. 20 However, in port, there are certain rules and regulations in 21 areas. Sometimes they don't allow the ships to burn the 22 bunker oil; sometimes they burn either -- other fuel oil, or 23 they're primarily burning it in port to make their own 24 electricity. Sometimes the straightforward approach is just 25 to have them plug into the dock. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 101 1 But, yeah, if you start talking about bunker oil, 2 you're starting to talk about multiple percent sulfur. 3 SUPERVISOR VAGIM: In the other chart we had, you 4 cut up the stationary sources. You have fuel combustion as 5 21 percent. Now, is that stationary source burning the same 6 diesel like for power generation and all that kind of -- 7 MR. BATCHELDER: Well, stationary sources, when 8 you talk about fuel combustion, it is essentially you're 9 burning fuel to either make process heat or steam. It's a 10 variety of things. Some of it is natural gas, which is very 11 low sulfur. Some of it is fuel oil based. In the 12 refineries, it gets a little tricky. Some of it is -- let's 13 take the case of Nipomo. 14 That particular refinery is the only refinery in 15 California that processes local California high-sulfur fuel 16 oil. It does relatively little sophisticated processing, 17 but the sulfur content -- even after that processing -- is 18 still too high. They do not use that material, the 19 processed material, in California. It's shipped out of 20 state. 21 So, part of that process is removing the sulfur 22 from the fuel oil. Some of that material escapes in the 23 process, you know, even though it does go through some 24 treatment facilities. Part of it is also burning the fuel 25 to heat up your product or your potential product. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 102 1 So, when we talk about fuel combustion, that 2 includes everything from natural gas up to and including 3 burning of, you know, maybe wastestream gases that you 4 recover for heat in a refinery or a similar kind of 5 operation. 6 SUPERVISOR VAGIM: At what point in time was this 7 chart locked in? 8 DR. KADO: This is a 1990 -- 9 SUPERVISOR VAGIM: 1990. 10 DR. KADO: Yeah. 11 SUPERVISOR VAGIM: Because a lot of folk could be 12 converted even further off of those fuels to natural gas, 13 right? And so, this chart would probably have a little bit 14 less of a slice for fuel combustion as today's -- I mean, 15 you go talk to utilities, they all say they're going to 16 natural gas, and don't -- leave us alone, we're all going to 17 natural gas. 18 MR. BATCHELDER: One of the items that's mentioned 19 in the staff report and is perhaps only briefly pressed on 20 here is that a lot of the progress is based on what would be 21 called fuel switching -- people who are switching from, in 22 the case of utilities, fuel oil of some sort to natural gas. 23 A lot of that is not done by regulation. It's 24 done by economics. So, to the extent that industry can burn 25 natural gas, because it's cheaper -- usually because they PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 103 1 have some sort of a relationship with the gas company -- 2 there's standby kinds of things and you get a cheaper rate, 3 if the natural gas is plentiful, yes, you burn the cheapest 4 thing you can get your hands on. 5 If there's some sort of a restriction because of-- 6 SUPERVISOR VAGIM: Whatever, price is better or -- 7 MR. BATCHELDER: You have to be able to go back to 8 burning fuel oil, which it's even worse than the situation I 9 alluded to between, say diesel fuel and gasoline. 10 SUPERVISOR VAGIM: Most of the power generation 11 folks have the ability to switch over to those fuels, don't 12 they? 13 MR. BATCHELDER: They have to in order to qualify 14 for what they call interruptable rates. 15 SUPERVISOR VAGIM: Right. 16 MR. BATCHELDER: And the utilities obviously look 17 for the cheapest thing that they can get their hands on. 18 SUPERVISOR VAGIM: But that still could happen 19 today. 20 MR. BATCHELDER: And that could still happen 21 today. I mean, you know, a pipeline bursts -- 22 SUPERVISOR VAGIM: Sure, sure. 23 MR. BATCHELDER: -- we go to war with Canada. 24 (Laughter.) 25 SUPERVISOR VAGIM: On the asthmatic issue, it PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 104 1 seems to be one of the criteria for the findings. How much 2 work has been done in asthmatics from a neurological 3 standpoint? 4 I mean, some say that it is a neurological problem 5 as much as a pollution problem. Has much work been done on 6 that? 7 DR. LIPSETT: When you say a neurological problem, 8 I guess I -- 9 SUPERVISOR VAGIM: Nervous disorder. Nervous 10 system disorder. 11 DR. LIPSETT: Well, it's -- some of what underlies 12 the bronchospasm that occurs after an exposure to SO2 or 13 other respiratory irritant is a nervous reflex, and the 14 nerves are -- the nerves that go into the lungs and go to 15 the smooth muscles surrounding the bronchi are stimulated to 16 produce the bronchi to constrict. 17 But our understanding of asthma really has changed 18 a lot. It's an inflammatory -- it's a chronic inflammatory 19 condition of the airways. It's true that stress or some 20 psychological disturbances may be able to trigger asthmatic 21 episodes of people who are susceptible. 22 But it is primarily a pathology of the lining of 23 the lungs, an inflammatory disorder. I don't know if that 24 answers your question. 25 SUPERVISOR VAGIM: Well, it's getting there. I PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 105 1 guess a more pointed question to be answered is how much 2 study has there been done on a cross-section of the 3 sociological aspects as asthmatics versus the environmental 4 aspect part of it? 5 DR. LIPSETT: Okay. Well -- 6 SUPERVISOR VAGIM: For example, not any scientific 7 study, but the folk that I know that have children with 8 asthmatics are typically awful bright, and they're awful -- 9 sometimes one could call them neurotic. And they get into 10 asthmatic conditions when they get nervous or tense. And 11 that is somewhat of a non -- not necessarily untypical of a 12 lot of asthmatics. 13 Has there been a study that stated that isn't the 14 case; the general populace at any time can have it because 15 there's an air pollution condition out there that will 16 create asthmatics? 17 DR. LIPSETT: Well, I think asthma is a chronic 18 kind of condition where someone who has this kind of 19 underlying inflammation, there are a variety of triggers, 20 none specifically. But in terms of the genesis of asthma -- 21 I mean what causes a person to have asthma -- part of it is 22 that the known risk factors are, if you say you have a 23 parent who's had asthma, there's a genetic component that 24 gives someone a predisposition to develop the asthma. And 25 particularly allergies -- people who have allergies are much PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 106 1 more susceptible to developing asthma. 2 And allergy is the primary -- one of the primary 3 risk factors for children who develop asthma. People can 4 develop asthma in an occupational setting from exposure to 5 certain kinds of chemicals. There have been instances of 6 high level exposure, say, to industrial irritants that have 7 resulted in -- basically it's a chronic airway obstruction, 8 which is otherwise known as asthma. 9 It's kind of a final common pathway for a variety 10 of insults to the lung that create this kind of 11 inflammation. 12 As for the psychological component, I mean I know 13 that there have been -- when I was in medical school, what I 14 was taught was that asthma was a psychological condition; 15 that that was the basic pathology. 16 And, as I was saying before, the science 17 underlying the understanding of asthma has completely 18 changed in the past ten years. We really understand it to 19 be more an inflammatory condition, allowing much better 20 management of it by people who know how to manage it. 21 Okay. 22 SUPERVISOR VAGIM: Before you get -- I just want 23 to make sure, though, the question is: How much study has 24 there been in interrelationships, though? How does this -- 25 is this a -- does the pollution exacerbate something that PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 107 1 would be there without pollution, or does pollution cause 2 it? 3 DR. LIPSETT: Okay. Well, there are two 4 dimensions of it. I think in the second instance, does 5 exposure to pollutants cause exacerbations of asthma, I 6 think, yes. There's been lots of research on that. 7 Does exposure to certain kinds of pollutants cause 8 asthma? And that's a big question mark at this point. 9 There have been a few studies, say, looking at high ozone 10 versus lower ozone levels. Because one of the basic things 11 that ozone causes in the airways is inflammation. 12 And there have been -- there's some suggestions 13 that chronic exposure to pollution may result in a higher 14 prevalence of asthma in that particular area. But this is 15 far from clear, and that's a big, open question. 16 DR. KADO: I'd like to also add that the basis of 17 the standard -- the health-base basis of the standard is 18 based on controlled human exposure studies. And these are 19 blind human exposure studies where the subjects or 20 volunteers do not know what they're getting, and they 21 succumb to the effects that we summarized in this 22 presentation. 23 CHAIRMAN DUNLAP: Hopefully, they don't succumb. 24 (Laughter.) 25 DR. KADO: Right. PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 108 1 SUPERVISOR VAGIM: Thank you. Thank you, Mr. 2 Chairman. 3 CHAIRMAN DUNLAP: Any other questions? 4 MR. CALHOUN: Yes, Mr. Chairman. 5 CHAIRMAN DUNLAP: Mr. Calhoun. 6 MR. CALHOUN: Dr. Lipsett, Dr. Lippmann said this 7 morning -- at least I thought I overheard him say that he 8 didn't think that we should be concerned about SO2. And I 9 sort of sense that you're saying the same thing. 10 DR. LIPSETT: In California, at the current levels 11 of exposure. That's why we're recommending the retention of 12 the existing standard. The compliance is virtually 13 universal. This is much different from, say, parts of 14 Europe and the East Coast, where there's a lot of combustion 15 of higher sulfur coal, where they do tend to have higher 16 levels of sulfur dioxide. 17 But, again, as I indicated towards the end of my 18 presentation, I think that there are some uncertainties in 19 terms of SO2's effects on asthmatics and other members of 20 the population. But because, in California, the control of 21 this particular pollutant has been so effective, that I 22 think in terms of research priorities, that those should be 23 lower down than looking at especially particles, and ozone, 24 and NO2. 25 I think those are all more important than sulfur PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 109 1 dioxide from a research standpoint. 2 MR. CALHOUN: Thank you. 3 CHAIRMAN DUNLAP: Ms. Edgerton. 4 MS. EDGERTON: I want to return just for a minute 5 to the effect of air pollution on health. With respect to 6 people who have allergies, it's my understanding that one of 7 the important aspects of the management -- and you can 8 comment on it as well -- is that they not be continually 9 exposed to the thing they're allergic to, because they may 10 convert to being asthmatic. 11 The conversion is a very feared issue with respect 12 to people who are allergic, because they may become 13 asthmatic. And what I was wondering was whether there are 14 any -- whether there was any work done about whether some of 15 these air pollutants hasten a conversion from a merely 16 allergic person to an asthmatic person. 17 DR. LIPSETT: Again, there are a couple of studies 18 that suggest that in areas that have more ozone especially 19 and particles, that there tends to be a higher -- there may 20 be a higher prevalence of asthmatics in those areas. 21 But for the specific question that you're asking, 22 I'm not aware of any studies that specifically indicate 23 that. There are a couple of studies looking at, say, people 24 who already have allergic asthma. And if they have a -- 25 there's one from Canada that shows that individuals with PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 110 1 allergic asthma, if they're preexposed to a low level of 2 ozone, even at rest, it tends to lower their threshold for a 3 response to the allergen. Once they inhale the allergen, 4 they'll have a greater response to it with a preexposure to 5 ozone. 6 There's actually a recent paper that I just saw in 7 the Lancet last week that suggests that this may also be 8 possible with a combination of nitrogen dioxide and sulfur 9 dioxide at higher levels than what we're talking about here. 10 And this is something that people are just really 11 beginning to look at in terms of effects of environmental 12 pollutants and the interactions with allergy and allergens. 13 For people who are not asthmatic but who have 14 allergies, they do tend to, say, be more sensitive to 15 cigarette smoke. And there's a thought that they may be 16 more sensitive to irritants generally. But in terms of this 17 cross-over or conversion from someone who's, quote/unquote, 18 "merely allergic" to someone who has asthma -- again, that's 19 kind of a long answer to your short question -- I don't 20 think that there's much. I'm not aware of any specifically 21 addressing that issue. 22 DR. BOSTON: And I agree. 23 MS. EDGERTON: You're not aware of any either. 24 (Laughter.) 25 CHAIRMAN DUNLAP: Any other questions from the PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 111 1 Board? 2 MS. EDGERTON: Thank you. 3 CHAIRMAN DUNLAP: Okay. Seeing that we don't have 4 anyone on the list to testify, I guess we will conclude the 5 public testimony portion of this item, and I'd ask Mr. Boyd 6 to summarize any written comments that the Board has 7 received. 8 MR. BOYD: Dr. Holmes? 9 DR. HOLMES: Mr. Chairman, there's only one 10 comment. That's a letter, again from Dr. James Lents of the 11 South Coast AQMD, urging that the Board retain both the 12 standard and the monitoring protocol that we've established 13 along with it. 14 CHAIRMAN DUNLAP: Very good. Thank you. 15 Since this is not a regulatory item, it is not 16 necessary to officially close the record; however, we do 17 have a resolution before the Board for action. 18 Before I do that, Mr. Boyd, do you have any final 19 words for us? 20 MR. BOYD: Thank you, Mr. Chairman. A quick 21 comment. 22 First, my thanks to Dr. Kado and Dr. Lipsett for 23 the fine work they've done for us. And just a comment: 24 While recommending that the present standard is, I guess I'd 25 say, proper according to the science and adequate to PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 112 1 therefore protect the health of the citizens of the State of 2 California, I think we should again take note and perhaps 3 celebrate the fact that we have no violations of the 4 standard and the public's health is not compromised in this 5 particular case, which is the exception, not the rule in 6 California. 7 So, I just wanted to make note of that again. And 8 maybe Mr. Martin can make note of that for the Press or 9 something. 10 CHAIRMAN DUNLAP: Okay. Thank you, Mr. Boyd. 11 We have before us a resolution, and why don't we 12 pause for a moment to review it, and then we will come back 13 for any action. 14 (Thereupon, there was a pause in the 15 proceedings to allow members to peruse 16 the resolution.) 17 CHAIRMAN DUNLAP: The Board has before it 18 Resolution No. 95-6, which contains the staff 19 recommendations. Do I have a motion? 20 MR. LAGARIAS: I move we adopt Resolution 95-6. 21 CHAIRMAN DUNLAP: Thank you. Is there a second? 22 MAYOR HILLIGOSS: Second. 23 CHAIRMAN DUNLAP: Very good. We have a motion and 24 a second. Is there any further discussion by members of the 25 Board? PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 113 1 All right. I'd like to ask the Board Secretary at 2 this time to please call the roll for a vote on Resolution 3 95-6. 4 MS. HUTCHENS: Boston? 5 DR. BOSTON: Yes. 6 MS. HUTCHENS: Calhoun? 7 MR. CALHOUN: Aye. 8 MS. HUTCHENS: Edgerton? 9 MS. EDGERTON: Yes. 10 MS. HUTCHENS: Hilligoss? 11 MAYOR HILLIGOSS: Aye. 12 MS. HUTCHENS: Lagarias? 13 MR. LAGARIAS: Aye. 14 MS. HUTCHENS: Parnell 15 MR. PARNELL: Aye. 16 MS. HUTCHENS: Riordan? 17 SUPERVISOR RIORDAN: Aye. 18 MS. HUTCHENS: Vagim? 19 SUPERVISOR VAGIM: Aye. 20 MS. HUTCHENS: Chairman Dunlap? 21 CHAIRMAN DUNLAP: Aye. 22 MS. HUTCHENS: Passes 9-0. 23 CHAIRMAN DUNLAP: Very good. Thank you. 24 Mr. Boyd, under the category of other business, is 25 there anything further that you'd like the Board to consider PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 114 1 today? 2 MR. BOYD: No, Mr. Chairman. I have no further 3 business for today, and I'll just note that our next Board 4 meeting is scheduled for the 23rd and 24th of February in 5 this facility. And I would observe that, as we develop the 6 agenda a little further, I would predict it's probably just 7 a one-day meeting. 8 We'll have further information for you on that. 9 CHAIRMAN DUNLAP: Very good. Thank you. 10 We will adjourn this January meeting of the Air 11 Resources Board. 12 Thank you. 13 (Thereupon, the meeting was adjourned 14 at 12:35 p.m.) 15 --o0o-- 16 17 18 19 20 21 22 23 24 25 PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345 115 CERTIFICATE OF SHORTHAND REPORTER I, Nadine J. Parks, a shorthand reporter of the State of California, hereby certifies that I am a disinterested person herein; that the foregoing meeting before the California Air Resources Board was reported by me in shorthand writing, and thereafter transcribed into typewriting. I further certify that I am not of counsel or attorney to any of the parties to said meeting, nor am I interested in the outcome of said meeting. IN WITNESS WHEREOF, I have hereunto set my hand this 3rd day of February, 1995. Nadine J. Parks Shorthand Reporter PETERS SHORTHAND REPORTING CORPORATION (916) 362-2345