Air Pollution and Community Health A Critical Review and Data Sourcebook Frederick W. Lipfert Air pollution has affected community health since the advent of the industrial age and arguably since the discovery of fire. While organized societies have taken important steps to reduce and control emissions, the quality of the air we breathe today remains a critical concern. Air Pollution and Community Health transforms the major epidemiological works of the past 40 years into a coherent picture of the effects of air pollution on respiration, hospitalization, and mortality. The book re-evaluates these studies to clarify their findings within a consistent analytical framework and to define statistical relationships between various measures of community health and air quality. Lipfert emphasizes observational studies and the quality of the data used. The book is organized by health endpoint rather than by pollutant, beginning with the major air pollution disasters that helped galvanize the environmental revolution. His analysis shows that community air pollution acts primarily to exacerbate existing conditions in susceptible individuals, rather than to create new cases of respiratory disease. He concludes that "the alarms that sounded over 40 years ago are still ringing"—substantial health risks are still presented by the current urban mixtures of air pollution. Many of the studies reviewed suggest that the current ambient air quality standards required by the Clean Air Act fail to protect the health of the most susceptible individuals. Further, because of the role of natural sources of air pollution, questions are raised as to whether complete protection can ever be achieved. The book presents data from many of the epidemiological studies reviewed, including those of the major disasters of 1930–1960. Graphical presentations are featured for easy reference; many new analyses are presented here for the first time. The book also includes introductory chapters on air pollution, statistical analysis, and respiratory physiology, for the convenience of readers who may not be well versed in all of these topics. The major technical chapters on mortality and hospitalization include reviews of the effects of air pollution episodes, time-series analyses, cross-sectional studies, and long-term studies of pollution abatement. The chapters on respiratory function include both the effects of air pollution on function and the role of lung function as an independent predictor of longevity. Air Pollution and Community Health presents one of the first comprehensive analyses of the subject. It should be used to re-examine the effectiveness of air pollution research and control policies in the United States and is essential reading for all professionals involved in air pollution control or public health.
