The Forest and the Trees: How Population-Level Health Protections Sometimes Fail the Individual

Seltenrich, Nate

doi:10.1289/ehp.125-a65

Cited by 5 publications

(2 citation statements)

References 8 publications

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“…Particulate respirators designed to filter 95% of particulates may reduce the health effects of urban pollution (38). However, ineffective and flimsy surgical-style masks are perhaps the most widely used as a result of availability, knowledge gaps, and cost (39). This highlights a key challenge of shifting responsibility to the individual; personal harm reduction measures that require knowledge and resources may have reduced efficacy when implemented in the most vulnerable populations.…”

Section: Individual Measuresmentioning

confidence: 99%

Ambient Air Pollution and Clinical Implications for Susceptible Populations

Hooper

Kaufman

2018

Annals ATS

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Air pollution is associated with a diversity of health effects, and evidence for a causal relationship with specific diseases exists. Exposure to air pollution is ubiquitous and typically beyond the control of the individual; the resulting health burden for the population can be high. Disproportionate effects are seen in individuals who have increased susceptibility to air pollution owing to individual- or community-level characteristics. As studies grow increasingly sophisticated, the understanding of who comprises the susceptible population continuously expands. Characteristics of susceptibility include genetic predisposition; socioeconomic factors; life stage; the presence of preexisting diseases, such as asthma, chronic obstructive pulmonary disease, cystic fibrosis; and the unique population of lung transplant recipients. This review explores how select populations, namely individuals with preexisting pulmonary disease and those living in communities of low socioeconomic status, have an increased susceptibility to the health effects of ambient air pollution. Genetic susceptibility, though a fundamental determinant of risk, is beyond the scope of this review and is not discussed. Strategies designed to mitigate air pollution-related health effects are discussed using a framework that addresses pollution exposure at multiple levels-government, state, community, and the individual. Emission reduction strategies remain the basis for public health protection; however, ancillary harm reduction measures are explored that can be adopted by susceptible communities and individuals.

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Section: Individual Measuresmentioning

confidence: 99%

Ambient Air Pollution and Clinical Implications for Susceptible Populations

Hooper

Kaufman

2018

Annals ATS

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“… 19 It is worth noting that policies that make individuals responsible for protecting themselves from environmental risks raise issues of justice, since some people may not be able to afford such protections (Seltenrich 2017). …”

mentioning

confidence: 99%

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty, Utility, Fairness, and Accountability for Reasonableness

Resnik

MacDougall

Smith

2018

The American Journal of Bioethics

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Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations.

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Individual- and Household-Level Interventions to Reduce Air Pollution Exposures and Health Risks: a Review of the Recent Literature

Allen

Barn

2020

Curr Envir Health Rpt

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Purpose of Review We reviewed recent peer-reviewed literature on three categories of individual- and household-level interventions against air pollution: air purifiers, facemasks, and behavior change. Recent Findings High-efficiency particulate air/arresting (HEPA) filter air purifier use over days to weeks can substantially reduce fine particulate matter (PM2.5) concentrations indoors and improve subclinical cardiopulmonary health. Modeling studies suggest that the population-level benefits of HEPA filter air purification would often exceed costs. Well-fitting N95 and equivalent respirators can reduce PM2.5 exposure, with several randomized crossover studies also reporting improvements in subclinical cardiovascular health. The health benefits of other types of face coverings have not been tested and their effectiveness in reducing exposure is highly variable, depends largely on fit, and is unrelated to cost. Behavior modifications may reduce exposure, but there has been little research on health impacts. Summary There is now substantial evidence that HEPA filter air purifiers reduce indoor PM2.5 concentrations and improve subclinical health indicators. As a result, their use is being recommended by a growing number of government and public health organizations. Several studies have also reported subclinical cardiovascular health benefits from well-fitting respirators, while evidence of health benefits from other types of facemasks and behavior changes remains very limited. In situations when emissions cannot be controlled at the source, such as during forest fires, individual- or household-level interventions may be the primary option. In most cases, however, such interventions should be supplemental to emission reduction efforts that benefit entire communities.

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The Forest and the Trees: How Population-Level Health Protections Sometimes Fail the Individual

Cited by 5 publications

References 8 publications

Ambient Air Pollution and Clinical Implications for Susceptible Populations

Ambient Air Pollution and Clinical Implications for Susceptible Populations

Ethical Dilemmas in Protecting Susceptible Subpopulations From Environmental Health Risks: Liberty, Utility, Fairness, and Accountability for Reasonableness

Individual- and Household-Level Interventions to Reduce Air Pollution Exposures and Health Risks: a Review of the Recent Literature

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