Are changes in ambient air pollution composition and mixtures leading to increased rates of adverse cardiovascular, respiratory, and infectious events and pregnancy outcomes? A New York State susceptibility study
Since the early- to mid-2000s, policy initiatives to improve air quality have been implemented nationally and across New York State (NYS). These initiatives include use of ultra-low sulfur on-road diesel fuel starting in October 2006, the requirement for particle regenerative traps on new heavy-duty diesel on-road trucks and buses on July 1, 2007, the requirement for NOx control as of January 1, 2010, decreases in the sulfur content of non-road diesel fuel between 2007 and 2014, and the requirement that all No. 2 based fuels sold in NYS be ultra-low sulfur by July 1, 2012. Additionally, several actions (e.g. emission control technology retrofits in the Ohio River Valley, Cross-State Air Pollution Rule, and electricity policy changes in Ontario) have occurred during this same time to reduce SO2 and NOx emissions from power plants in upwind source areas. During this period, there were also major economic drivers of changes in air quality in NYS and the United States, including the 2008 recession and the change in the price of natural gas compared to coal and oil. In epidemiology studies of NYS adult residents living in 6 NY cities, we assessed whether these policies were associated with changes in the rate of cause-specific cardiovascular, respiratory, and respiratory infectious disease hospitalizations and emergency department visits per unit mass of PM2.5, and explored associations between these same hospitalization and ED visit rates and source specific PM concentrations.