Presentation, May 28, 2014

Massachusetts Department of Public Health · from Mass.gov · 34 pages · 6.8 MB
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LOGAN AIRPORT HEALTH STUDY 
Massachusetts Department of Public Health
Bureau of Environmental Health

Elaine Krueger Brian Dumser

Outline 
3 
I. Background of the Logan Airport Health Stud
II. Study Design/Methods/Peer Review
III. Health Outcomes Assessment
IV. Data Analysis Methods
V. Exposure Assessment
VI. Results
VII. Conclusions and Recommendations
VIII. Questions
y

I. Legislative Directive 
4 
Chapter 159 of The Acts of 2000 of the Massachusetts
General Court included a line item directive that stated 
“the Director of the Bureau of Environmental Health
Assessment [presently named the Bureau of Environmental
Health] of the department shall conduct an environmental
risk assessment of the health impacts of the General
Lawrence Logan Airport in the East Boston section of the
city of Boston on any community that is located within a 5
mile radius of the airport and is potentially impacted by
the airport … that the assessment may include, but not be
limited to, examining incidences of respiratory diseases
and cancers and performing medical and laboratory tests
and examinations of residents of these communities …”

II. Study Design/Methods 
5 
The Logan Airport
Health Study (LAHS)
was a cross-sectional
disease prevalence
study aimed at
determining if the
prevalence of targeted
health outcomes were
higher among residents
living closer to the
airport

Peer Review 
6 
Peer Reviewers: 
 Dr. Thomas Burke, Associate Dean for Public Health
Practice and Training, Johns Hopkins Bloomberg School
of Public Health; 
 Dr. Thomas Mason, Professor, College of Public Health,
Department of Environmental and Occupational
Health, University of South Florida; and 
 Dr. Philip Hopke, Bayard D. Clarkson Distinguished
Professor, and Director of the Center for Air Resources
Engineering and Science, at Clarkson University

III. Health Outcome Assessment 
7 
 Piloted survey instrument 
 Random Digit Dial (RDD) telephone health survey 
 6,072 eligible adults; 2,215 children 
 Oversampling of areas closest to Logan Airport 
 Respiratory disease, cardiovascular disease, and
auditory outcomes 
 Information on risk factors 
 Age, sex, race/ethnicity, income, education, health
behaviors, CVD risk factors, occupational exposures 
 Residential history

Health Outcomes Evaluated In Adults 
8 
Respiratory
Outcomes 
Lifetime, current
and probable
asthma
Chronic
Obstructive
Pulmonary
Disease (COPD) 
Cardiovascular
Outcomes 
Myocardial
Infarction
Coronary Heart
Disease (CHD) 
Auditory
Outcomes 
Hearing
Impairment
Severe hearing
loss
Tinnitus

Health Outcomes Evaluated in Children 
9 
Respiratory
Outcomes 
Lifetime, current
and probable
asthma 
Auditory
Outcomes 
Hearing
impairment

10 
Risk Factors Considered In Adults
ADULTS 
• Age, Sex, Race, Ethnicity 
• Household Income (PIR) 
• Education 
• Smoking Status, Household Indoor Smoking 
• Body Mass Index (BMI) 
• Alcohol Intake, Binge Drinking 
• Gastroesophageal reflux disease (GERD) 
• Diabetes 
• Hypertension 
• High Cholesterol 
• Family History Of Heart Disease 
• Background Air Pollution Exposure 
• Use Of Chemicals In The Home

11 
Risk Factors Considered In Adults
CHILDREN 
• Age, Sex 
• Household Income (PIR) 
• Maternal Education 
• Household Indoor Smoking 
• Household NO2 Sources 
• Household Allergens 
• Household Mold 
• Background Air Pollution Exposure

IV. Data Analysis Methods 
12 
 Descriptive statistics of the population 
 Produced crude prevalence estimates by exposure
category 
 Explored associations between other risk factors and
outcomes 
 Trend tests were also conducted for any observed
associations 
 All statistics performed using SUDAAN – a statistical
software package

V. Exposure Assessment 
13 
 Air dispersion modeling was performed using US FAA’s Emissions and 
Dispersion Modeling System (EDMS including AERMOD) to quantify the
ambient air pollution concentrations in the study area and improve
exposure classification of the participants in the health survey 
 Massport provided 2005 emissions inventory data and daily flight
operations for Logan Airport (kg/year) 
Source Category CO NOx PM2.5 SOx VOC
Aircraft 1149808 1193034 21368 111641 434959 
Ground Service Equipment 2262228 254757 7425 20161 79166 
Auxiliary Power Units 48849 22971 4443 3933 3267 
Parking Facilities 545896 74347 1137 N/A 111635 
Roadways 378889 85137 2596 N/A 37526 
Stationary Sources 11382 74169 11626 115507 663 
Training Fires 1371 22 375 2 216 
Grand Total 4398423 1704437 48970 251244 667432

Exposure Classification 
14 
 Modeling results predicted air concentrations of 5 pollutants (CO, NO
PM2.5, SOx, and VOCs) from airport operations across the study are 
 Exposure maps were developed using ESRI ArcGIS Spatial Analyst 
 Analysis showed a similar location of highest annual, daily, and
hour peak concentrations for all pollutants in the high exposure
area. 
 Annual average concentrations for each pollutant were similar a
used to map exposure categories. 
 Three exposure categories were assigned: 
 Low category: ≤  0th percentile 
 Medium category: > 50th – 80th percentile 
 High category: > 80th percentile
x,
a.
1-
nd

Exposure Categories

ME Low

Medium

BE High

 stimating “Background” For Air 
Pollution Not Related to Logan Airport 
16 
 To account for background air pollution exposure not related to
Logan Airport, two measures of background air pollution
exposure were developed: 
1. Each household was assigned a derived background 
annual average PM2.5 concentration 
 Each household was assigned an annual average PM2.5
concentration based on measurements from the ambient air
monitoring station nearest their home. The household values
were adjusted by subtracting the predicted airport-related
contributions of PM2.5 from AERMOD predictions. 
2. Near-roadway exposures 
 Households were categorized based on their proximity (200
meters) to major roadways (average daily traffic of 20,000
vehicles)

Exposure to Airport-Related Noise 
17 
 Modeled noise contours 
 Contour maps from  assport based on US FAA’s 
Integrated Noise Model (INM) 
 Exposure categories chosen using US EPA and the World
Health Organization (WHO) health-based guideline to
protect against noise-induced hearing loss 
 Cumulative noise exposure over a 24-hour period of
less than or equal to 70 dB 
 Exposure Categories for Airport-Related Noise 
 Low category ≤  dB 
 Medium category 60-64 dB 
 High category ≥ 6  dB

Logan Noise Contours 2005

2005

Logan Airport Noise Contours,

VI. Results 
19 
 Airport-related pollutant concentrations were
estimated to be highest near the perimeter of
Logan Airport and to fall off rapidly with increased
distance
Air pollution concentrations were low relative to
background 


Results 
20 
 The odds ratio (OR) represents the odds of an outcome given a
particular exposure compared to the odds of the outcome in
the absence of exposure 
 OR =1 Exposure does not affect odds of outcome 
 OR >1 Exposure associated with higher odds of outcome 
 OR <1 Exposure associated with lower odds of outcome 
 The p- value is a statistical measure to determine if the findings
may be attributed to chance 
 A p -value ≤ 0.05 indicates that the results are statistically
significant

Respiratory Outcomes in Adults 
21 
The study did not find statistically significant differences in current
asthma or probable asthma in the high vs. the low exposure areas
after controlling for risk factors 
Health Outcome Odds Ratio 95% CI p value
Current Asthma
Low 1.0 1.0 – 1.0 
Medium 1.0 0.8 – 1.3 0.93 
High 1.2 0.8 – 1.8 0.43 
Probable Asthma
Low 1.0 1.0 – 1.0 
Medium 0.8 0.5 – 1.2 0.31 
High 1.1 0.6 – 1.9 0.77

Respiratory Outcomes in Adults 
22 
COPD among adults who have resided in their respective exposure
area for 3 or more years was statistically significantly elevated in
the high exposure area compared to the low exposure area 
Health Outcome Odds Ratio 95% CI p value
COPD
Low 1.0 1.0 – 1.0 
Medium 1.6 1.1 – 2.3 0.01 
High 1.8 1.1 – 3.0 0.02

Respiratory Outcomes in Children 
23 
The study found statistically significant differences in probable
asthma in children between the high vs. the low exposure areas after
controlling for risk factors 
Health Outcome Odds Ratio 95% CI p value
Current Asthma
Low 1.0 1.0 – 1.0 
Medium 1.0 0.7 – 1.6 0.90 
High 1.2 0.7 – 2.3 0.52 
Probable Asthma
Low 1.0 1.0 – 1.0 
Medium 1.3 0.5 – 3.0 0.58 
High 3.6 1.1 – 11.0 0.03

Cardiovascular Outcomes in Adults 
24 
The study did not find statistically significant differences in
cardiovascular outcomes between the high vs. the low exposure
areas 
Health Outcome Odds Ratio 95% CI p value
Coronary Heart Disease
Lower 1.0 1.0 – 1.0 
Medium 0.7 0.4 – 1.2 0.22 
Higher 1.1 0.4 – 3.1 0.86 
Myocardial Infarction
Low 1.0 1.0 – 1.0 
Medium 1.0 0.7 – 1.6 0.89 
High 0.8 0.4 – 1.7 0.62

Auditory Outcomes in Adults 
25 
The study did not find differences in auditory outcomes between
the high vs. the low exposure areas 
Health Outcome Odds Ratio 95% CI p value
Hearing Impairment
Low 1.0 1.0 – 1.0 
Medium 0.6 0.4 – 1.0 0.07 
High 0.9 0.3 – 2.5 0.80 
Hearing Impairment and
Uses Hearing Aid
Low 1.0 1.0 – 1.0 
Medium 0.6 0.2 – 1.7 0.32 
High 1.9 0.2 – 15 0.54 
Tinnitus
Low 1.0 1.0 – 1.0 
Medium 0.8 0.5 – 1.5 0.53 
High 0.5 0.1 – 2.1 0.35

Auditory Outcomes in Children 
26 
There were no significant differences in hearing impairment
between the high vs. the low exposure areas 
Health Outcome Odds Ratio 95% CI p value
Hearing
Impairment
Low 1.0 1.0 – 1.0 
Medium 0.7 0.3 – 2.0 0.53 
High 1.7 0.4 – 7.5 0.50

Conclusions 
27 
 After controlling for other risk factors, some
respiratory outcomes were found to be statistically
significantly higher in the high vs. the low exposure
areas 
 Adults 
 COPD was statistically significantly elevated when length
of residence was restricted to 3 or more years 
 Children 
 Probable asthma in children was statistically significantly
elevated in the high vs. the low exposure areas

Conclusions 
28 
 No associations were observed between air pollution
exposure areas and cardiovascular outcomes 
 No associations were observed between auditory
effects (i.e., hearing loss and tinnitus) and exposure
areas in adults or children

Recommendations 
29 
 The results of this study should be reviewed by Massport and
others to determine mitigating steps that can be taken across the
study area. 
 Massport has undertaken initiatives to reduce air pollution
impacts within their control (e.g., providing infrastructure for
compressed natural gas (CNG) fuels and electricity charging
stations, Alternative Fuel Vehicle Program). Similar initiatives
could be considered in consultation with local communities that
would serve to further reduce the burden of indoor and outdoor
sources of air pollution on residents in closest proximity to the
airport.

Recommendations 
30 
 Massport has also been working with the East Boston
Neighborhood Health Center (EBNHC) to address workforce issues
among Massport employees. Massport could expand these
efforts with the EBNHC as well as other community health centers
to better address respiratory health notably among children in
closest proximity to the airport. 
 While air dispersion modeling indicates that the contribution from
Logan Airport operations across the study area is relatively small,
air pollution levels are higher in urban areas. Predicted pollutant
concentrations were higher near the perimeter of the airport; thus,
any methods that can be implemented to continue to reduce
airport-related air pollution should be explored.

Recommendations 
31 
 Department of Public Health/Bureau of Environmental Health
(DPH/BEH) should work with communities within the high exposure
area (in whole or in part) on initiatives that would serve to further
reduce exacerbation of pre-existing respiratory diseases (e.g.,
asthma and COPD) among residents. 
 DPH/BEH will continue to support  assDEP’s efforts to reduce 
motor vehicle emissions including expansion of the Low Emissions
Vehicle program and diesel engine retrofit initiatives; 
 Upon request DPH  BEH’s Indoor Air Quality (IAQ) Program staff 
will work with local municipalities to conduct IAQ assessments in
schools and public buildings;

Recommendations 
32 
 Upon request DPH will work with local officials to address
concerns that may be associated with local development
initiatives; 
 DPH/BEH will collaborate with the DPH Bureau of Community 
Health and Prevention’s Tobacco Cessation and Prevention 
Program on their efforts to work with local boards of health and
tobacco-free community partnerships. These efforts enforce youth
access and secondhand smoking laws and provide
educational/outreach resources to support smoke-free workplace
and housing programs.

Recommendations 
33 
 DPH/BEH will continue to work with state regulatory agencies to
review annual filings by Massport (i.e., Logan Airport
Environmental Data Report and Environmental Status and Planning
Report). 
 DPH/BEH will continue to monitor pediatric asthma through its
existing pediatric asthma surveillance system.

34 
Questions