John R. Goldsmith

Respiratory Exposure to Lead: Epidemiological and Experimental Dose-Response Relationships

Epidemiologic studies of blood lead levels in general and occupational groups show a logarithmic regression on estimated atmospheric exposure. Experimental results at the same and higher levels show a dose-response relationship which fits the same regression. The data imply that long-term increases in atmospheric lead will result in predictably higher blood lead levels in the exposed populations.

Carbon Monoxide: Association of Community Air Pollution with Mortality

Regression analysis of daily mortality in Los Angeles County shows that there is a significant association between community carbon monoxide concentrations and mortality. Cyclic variation and maximum temperature were the main contributors. No association was demonstrated between oxidant and mortality.

Carbon monoxide and survival from myocardial infarction.

To test the hypothesis that during high periods of carbon monoxide (CO) pollution, persons with acute cardiovascular disease would be adversely affected, we have studied case fatality rates for patients admitted with myocardial infarction (Ml) to 35 Los Angeles hospitals during 1958. The results indicate that there is an increased Ml case fatality rate in “high”-pollution areas and that this difference is only evident during periods of relatively increased CO pollution. At the present time, our interpretation of these findings is that an association could exist between ME case fatality rate and atmospheric CO pollution but we cannot draw any firm conclusions about causality at this time.

Contribution of motor vehicle exhaust, industry, and cigarette smoking to community carbon monoxide exposures.

The exposure of community populations to possibly hazardous levels of carbon monoxide (CO) includes exposure to this substance in cigarette smoke, in connection with certain occupations, in households particularly from heating and cooking, and in the general community where motor vehicle exhaust is the major source. This paper contrasts these various forms of exposure with respect to three major attributes: (1) the proportion of people affected, (2) the magnitude of shortand long-term exposure in relation to the possibility of illness, and (3) the time-course of exposure in relation to the possible hazards.

Health Effects of Air Pollution

This discussion, which is directed to informed laymen, physicians, and the staff and volunteers of the American Lung Association and its constitutents, is meant to outline the available knowledge about the effects of air pollution on human health. Particular attention is given to the respiratory system. Following an introductory section dealing with the purpose and scope of the monograph, the discussion turns to the effects of air pollution on human populations. Evidence that exposure to air pollution has been associated with excess mortality, acute and chronic respiratory disease, disturbances in ventilatory function, asthma, heart disease, sensory and central nervous system effects, and tissue residues is presented. Subsequent material is concerned with the health effects and mechanisms of action of specific air pollutants on affected organ systems and issues associated with the assessment of human health risks of exposure to air pollution. Examples of efforts to evaluate overall health risks are provided. A 403-item bibliography accompanies the text.

Air Pollution and Disease

Although air pollution does not produce a specific illness from which people die, it aggravates many preexisting cardiac and respiratory conditions, particularly (among the latter) asthma, emphysema, and chronic bronchitis. It may also add to the hazards of anesthesia. Guidelines are offered for evaluating the contribution air pollutants may make to a patients illness, especially when he is already at risk.