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AbstractThere has been increasing interest in accounting for inequality in health risks and benefits within regulatory impact analyses, both given more general interest in the distributions of benefits and growing concerns about inequity (defined as those inequalities deemed unjust or unfair) and environmental injustice (in this context, those health risk inequalities that are correlated with race/ethnicity and certain other sociodemographic factors). Although there has been growing literature on this topic, there has been limited progress in practice, and the lack of quantification limits consideration of inequality in the policy process. Controversy remains regarding the best approaches to formally incorporate inequality, when these approaches should be used, and even whether it makes sense to quantify inequality in this context. The objective of this article is to review the literature on approaches for incorporating estimates of, and concerns for, inequality into regulatory impact analyses, especially those where environmental justice considerations are relevant, and consider the interpretation of these approaches and the implications for decision making. Using the case example of the Transportation and Climate Initiative, a collaboration among Northeast and Mid‐Atlantic states to reduce carbon emissions from the transportation sector, multiple strategies are described that could be used to shed light on health risk inequality and inequity, consider them in pending policy decisions, and evaluate their implications for the policy or instrument choice. Given appropriate contextualization and acknowledgment of the multidimensionality of equity, quantitative inequality indicators can provide meaningful insight about both inequality and inequity in health risks.

Although cumulative risk assessment by definition evaluates the joint effects of chemical and nonchemical stressors, studies to date have not considered both dimensions, in part because toxicological studies cannot capture many stressors of interest. Epidemiology can potentially include all relevant stressors, but developing and extracting the necessary information is challenging given some of the inherent limitations of epidemiology. In this article, I propose a conceptual framework within which epidemiological studies could be evaluated for their inclusion into cumulative risk assessment, including a problem formulation/planning and scoping step that focuses on stressors meaningful for risk management decisions, extension of the chemical mixtures framework to include nonchemical stressors, and formal consideration of vulnerability characteristics of the population. In the long term, broadening the applicability and informativeness of cumulative risk assessment will require enhanced communication and collaboration between epidemiologists and risk assessors, in which the structure of social and environmental epidemiological analyses may be informed in part by the needs of cumulative risk assessment.

In Science and Decisions: Advancing Risk Assessment, the National Research Council recommends improvements in the U.S. Environmental Protection Agency's approach to risk assessment. The recommendations aim to increase the utility of these assessments, embedding them within a new risk‐based decision‐making framework. The framework involves first identifying the problem and possible options for addressing it, conducting related analyses, then reviewing the results and making the risk management decision. Experience with longstanding requirements for regulatory impact analysis provides insights into the implementation of this framework. First, neither the Science and Decisions framework nor the framework for regulatory impact analysis should be viewed as a static or linear process, where each step is completed before moving on to the next. Risk management options are best evaluated through an iterative and integrative procedure. The extent to which a hazard has been previously studied will strongly influence analysts' ability to identify options prior to conducting formal analyses, and these options will be altered and refined as the analysis progresses. Second, experience with regulatory impact analysis suggests that legal and political constraints may limit the range of options assessed, contrary to both existing guidance for regulatory impact analysis and the Science and Decisions recommendations. Analysts will need to work creatively to broaden the range of options considered. Finally, the usefulness of regulatory impact analysis has been significantly hampered by the inability to quantify many health impacts of concern, suggesting that the scientific improvements offered within Science and Decisions will fill an crucial research gap.

Abstract Background There has been growing interest among exposure assessors, epidemiologists, and policymakers in the concept of "hot spots", or more broadly, the "spatial extent" of impacts from traffic-related air pollutants. This review attempts to quantitatively synthesize findings about the spatial extent under various circumstances. Methods We include both the peer-reviewed literature and government reports, and focus on four significant air pollutants: carbon monoxide, benzene, nitrogen oxides, and particulate matter (including both ultrafine particle counts and fine particle mass). From the identified studies, we extracted information about significant factors that would be hypothesized to influence the spatial extent within the study, such as the study type (e.g., monitoring, air dispersion modeling, GIS-based epidemiological studies), focus on concentrations or health risks, pollutant under study, background concentration, emission rate, and meteorological factors, as well as the study's implicit or explicit definition of spatial extent. We supplement this meta-analysis with results from some illustrative atmospheric dispersion modeling. Results We found that pollutant characteristics and background concentrations best explained variability in previously published spatial extent estimates, with a modifying influence of local meteorology, once some extreme values based on health risk estimates were removed from the analysis. As hypothesized, inert pollutants with high background concentrations had the largest spatial extent (often demonstrating no significant gradient), and pollutants formed in near-source chemical reactions (e.g., nitrogen dioxide) had a larger spatial extent than pollutants depleted in near-source chemical reactions or removed through coagulation processes (e.g., nitrogen oxide and ultrafine particles). Our illustrative dispersion model illustrated the complex interplay of spatial extent definitions, emission rates, background concentrations, and meteorological conditions on spatial extent estimates even for non-reactive pollutants. Our findings indicate that, provided that a health risk threshold is not imposed, the spatial extent of impact for mobile sources reviewed in this study is on the order of 100–400 m for elemental carbon or particulate matter mass concentration (excluding background concentration), 200–500 m for nitrogen dioxide and 100–300 m for ultrafine particle counts. Conclusion First, to allow for meaningful comparisons across studies, it is important to state the definition of spatial extent explicitly, including the comparison method, threshold values, and whether background concentration is included. Second, the observation that the spatial extent is generally within a few hundred meters for highway or city roads demonstrates the need for high .

Colleges and universities that are interested in reducing their environmental impacts are faced with the difficulties of providing incentives for sustainable behavior and attempting to quantify the gains that policies would provide. In this paper, we use a case study to demonstrate the benefits as well as the difficulties encountered with one type of incentive program, a revolving loan fund. During the five‐year tenure of the case study fund, the program yielded a 34 percent return on conservation investments, with associated decreases in resource usage, ambient air emissions, and water consumption. Using a past damage function study, we estimate that the reduced emissions result in over US$100,000 of avoided environmental externalities per year. Although the economic returns and environmental benefits were significant, participation declined rapidly after the initial rollout of the program and relatively non‐technical conservation measures were generally the focus of projects. Through surveys of both participating and non‐participating facility directors, we determined that lack of knowledge of effective conservation measures and limitations in staff availability were the key barriers preventing more extensive participation. Increased flow of information, through such actions as frequent facility director correspondence and independent energy audits of facilities, would be likely to encourage sustainable resource consumption in future applications of revolving loan funds and other campus greening efforts.

The health‐related damages associated with emissions from coal‐fired power plants can vary greatly across facilities as a function of plant, site, and population characteristics, but the degree of variability and the contributing factors have not been formally evaluated. In this study, we modeled the monetized damages associated with 407 coal‐fired power plants in the United States, focusing on premature mortality from fine particulate matter (PM2.5). We applied a reduced‐form chemistry‐transport model accounting for primary PM2.5 emissions and the influence of sulfur dioxide (SO2) and nitrogen oxide (NOx) emissions on secondary particulate formation. Outputs were linked with a concentration‐response function for PM2.5‐related mortality that incorporated nonlinearities and model uncertainty. We valued mortality with a value of statistical life approach, characterizing and propagating uncertainties in all model elements. At the median of the plant‐specific uncertainty distributions, damages across plants ranged from $30,000 to $500,000 per ton of PM2.5, $6,000 to $50,000 per ton of SO2, $500 to $15,000 per ton of NOx, and $0.02 to $1.57 per kilowatt‐hour of electricity generated. Variability in damages per ton of emissions was almost entirely explained by population exposure per unit emissions (intake fraction), which itself was related to atmospheric conditions and the population size at various distances from the power plant. Variability in damages per kilowatt‐hour was highly correlated with SO2 emissions, related to fuel and control technology characteristics, but was also correlated with atmospheric conditions and population size at various distances. Our findings emphasize that control strategies that consider variability in damages across facilities would yield more efficient outcomes.

For many policy analyses, including but not limited to cumulative risk assessments, it is important to characterize the individual and joint health effects of multiple stressors. With an increasing focus on psychosocial and other nonchemical stressors, this often includes epidemiological meta‐analysis. Meta‐analysis has limitations if epidemiological studies do not include all of the stressors of interest or do not provide multivariable outputs in a format necessary for risk assessment. Given these limitations, novel analytical methods are often needed to synthesize the published literature or to build upon available evidence. In this article, we discuss three recent case studies that highlight the strengths and limitations of meta‐analytic approaches and other research synthesis techniques for human health risk assessment applications. First, a literature‐based meta‐analysis within a risk assessment context informed the design of a new epidemiological investigation of the differential toxicity of fine particulate matter constituents. Second, a literature synthesis for an effects‐based cumulative risk assessment of hypertension risk factors led to a decision to develop new epidemiological associations using structural equation modeling. Third, discrete event simulation modeling was used to simulate the impact of changes in the built environment on environmental exposures and associated asthma outcomes, linking literature meta‐analyses for key associations with a simulation model to synthesize all of the model components. These case studies emphasize the importance of conducting epidemiology with a risk assessment application in mind, the need for interdisciplinary collaboration, and the value of advanced analytical methods to synthesize epidemiological and other evidence for risk assessment applications.

One of the common challenges for life cycle impact assessment and risk assessment is the need to estimate the population exposures associated with emissions. The concept of intake fraction (a unitless term representing the fraction of material or its precursor released from a source that is eventually inhaled or ingested) can be used when limited site data are available or the number of sources to model is large. Although studies have estimated intake fractions for some pollutant‐source combinations, there is a need to quickly and accurately estimate intake fractions for sources and settings not previously evaluated. It would be expected that limited source or site information could be used to yield intake fraction estimates with reasonable accuracy. To test this theory, we developed regression models to predict intake fractions previously estimated for primary fine particles (PM2.5) and secondary sulfate and nitrate particles from power plants and mobile sources in the United States. Our regression models were able to predict pollutant‐specific intake fractions with R2 between 0.53 and 0.86 and equations that reflected expected relationships (e.g., intake fraction increased with population density, stack height influenced the intake fraction of primary but not secondary particles). Further analysis would be needed to generalize beyond this case study and construct models applicable across source categories and settings, but our analysis demonstrates that inclusion of a limited number of parameters can significantly reduce the uncertainty in population‐average exposure estimates.a

In environmental risk management, there are often interests in maximizing public health benefits (efficiency) and addressing inequality in the distribution of health outcomes. However, both dimensions are not generally considered within a single analytical framework. In this study, we estimate both total population health benefits and changes in quantitative indicators of health inequality for a number of alternative spatial distributions of diesel particulate filter retrofits across half of an urban bus fleet in Boston, Massachusetts. We focus on the impact of emissions controls on primary fine particulate matter (PM2.5) emissions, modeling the effect on PM2.5 concentrations and premature mortality. Given spatial heterogeneity in baseline mortality rates, we apply the Atkinson index and other inequality indicators to quantify changes in the distribution of mortality risk. Across the different spatial distributions of control strategies, the public health benefits varied by more than a factor of two, related to factors such as mileage driven per day, population density near roadways, and baseline mortality rates in exposed populations. Changes in health inequality indicators varied across control strategies, with the subset of optimal strategies considering both efficiency and equality generally robust across different parametric assumptions and inequality indicators. Our analysis demonstrates the viability of formal analytical approaches to jointly address both efficiency and equality in risk assessment, providing a tool for decisionmakers who wish to consider both issues.

Demand for air travel is projected to increase in the upcoming years, with a corresponding influence on emissions, air quality, and public health. The trajectory of health impacts would be influenced by not just emissions growth, but also changes in nonaviation ambient concentrations that influence secondary fine particulate matter (PM2.5) formation, population growth and aging, and potential shifts in PM2.5 concentration‐response functions (CRFs). However, studies to date have not systematically evaluated the individual and joint contributions of these factors to health risk trajectories. In this study, we simulated emissions during landing and takeoff from aircraft at 99 airports across the United States for 2005 and for a 2025 flight activity projection scenario. We applied the Community Multiscale Air Quality (CMAQ) model with the Speciated Modeled Attainment Test (SMAT) to determine the contributions of these emissions to ambient concentrations, including scenarios with 2025 aircraft emissions and 2005 nonaviation air quality. We combined CMAQ outputs with PM2.5 mortality CRFs and population projections, and evaluated the influence of changing emissions, nonaviation concentrations, and population factors. Given these scenarios, aviation‐related health impacts would increase by a factor of 6.1 from 2005 to 2025, with a factor of 2.1 attributable to emissions, a factor of 1.3 attributable to population factors, and a factor of 2.3 attributable to changing nonaviation concentrations which enhance secondary PM2.5 formation. Our study emphasizes that the public health burden of aviation emissions would be significantly influenced by the joint effects of flight activity increases, nonaviation concentration changes, and population growth and aging.

Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through "income" and "stock" effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new‐home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home‐health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single‐family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality‐adjusted life years (both discounted at 3%)each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk‐tradeoff approach to real‐world casestudies of proposed code changes.