Advisory Panel Meeting Summary
10/13/2015 Meeting
Environmental Health Tracking and Biomonitoring Program
1:00 – 4:00 pm at the American Lung Association in Minnesota
490 Concordia Avenue, St. Paul, MN
Attendees: Bruce Alexander, Fred Anderson, Alan Bender, Melanie Ferris, Pat McGovern, Geary
Olsen, Gregory Pratt, Cathy Villas-Horns, Lisa Yost
Regrets: Thomas Hawkinson, Jill Heins Nesvold, Andrea Todd-Harlin and Steven Pedersen
Staff: Paul Allwood; Jeanne Ayers, Betsy Edhlund, Helen Goeden, Carin Huset, Jean Johnson,
Tess Konen, Paula Lindgren, Paul Moyer, Jessica Nelson, Christina Rosebush, Lucy Ross, Deanna
Scher, Chuck Stroebel, Janis Taramelli and Addis Teshome
Guests: Kristie Ellickson and Mary Jean Fenske, Minnesota Pollution Control Agency (MPCA); Raj
Mann, Minnesota Department of Agriculture (MDA); Allison Wolf, Minnesota Center for
Environmental Advocacy (MCEA)
Welcome and Introductions
Chair Pat McGovern welcomed everyone, introduced herself and noted that Jean Johnson
would be arriving late for the meeting in order to receive her service award from the Minnesota
Department of Health. Pat asked everyone to introduce themselves.
Tracking Updates
Chuck Stroebel provided a brief update on the tracking program. Background materials can be
found on pages 5-8 of the October 13, 2015 Advisory Panel book.
Chuck announced the receipt of the CDC award for the 2015-2016 grant year, which started
August 1st and will end July 31st, 2016.The work plan was being updated with data being added
to the portal, including traffic measures, a priority for the coming year. Also, portal staff would
be evaluating radon measures, childhood obesity data at the sub-county level, youth tobacco
and data for drinking water contaminants from community water systems statewide. The
collaborative project with the Great Lakes Inter Tribal Epidemiology Center and the Fond du Lac
Band would continue.
The communications plan had been updated and outreach would continue to communities with
a new portal tool, a touch screen monitor for people to explore the data. Outreach also would
continue with local public health departments, faculty and students and other target groups in
the plan. The plan’s emphasis was more on data utilization, such as the Air and Health Report,
the Economic Burden report, and public health actions.
Lyme disease data, a new content area, has been added to the portal. Chuck added that Lyme
disease is increasing in Minnesota and there is now a map that showed the geographic patterns
of how Lyme disease are changing over time.
The Be Air Aware website has been launched, hosted on MPCA’s website, as a toolkit and to
inform concerned communities about health and air quality. The project’s uniqueness stemmed
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from the fact that it is a joint agency website, maintained by a communications team from both
agencies, and MDH subject matter experts from asthma, tobacco, radon and the tracking
program. Chuck asked panel members to view it if they had not done so already.
Pat McGovern commented that she had visited the Be Air Aware website and it was very
impressive. She complimented Chuck and the group for their hard work.
MN FEET Sub-study comparing mercury test methods
Jessica Nelson updated the panel on the MN FEET study, measuring mercury, lead and
cadmium in Hmong, Latina, Somali and White pregnant women and newborns. The study,
launched in July, was at the end of the pilot phase. She reported that there were 77 women
recruited, 51 consented and 14 samples collected from those who gave birth. They were
assessing the pilot phase and adding another hospital, Abbott Hospital, in the near future,
which was important for Somali recruitment.
The proposed protocol for a sub-study of the MN FEET population comparing mercury levels in
matched newborn bloodspots and umbilical cord blood was then presented by Jessica.
Background material can be found on pages 9-14 of the October 13, 2015 Advisory Panel book.
Jessica reviewed the reasons for the sub-study. Measuring mercury in a small portion of the
bloodspots was a new, promising lab method, but it was experimental and only attempted in a
few state labs in the country, Minnesota being one of them. Questions remained whether it
was a reliable measure of newborn exposure to mercury.
The recent MN Biomonitoring study conducted with The Infant Development and Environment
Study (TIDES) found that mercury in paired bloodspot and cord blood samples was correlated,
but it appeared that bloodspots had underestimated cord blood measurements. A larger
sample size was necessary in order to answer the questions about the bloodspot methods.
The MN FEET Sub-study would take a subsample of the 600 MN FEET study women who had
mercury detected in their cord blood samples (approximately 200-300 women). They would be
mailed a consent asking for participation and the MDH Newborn Screening Program would be
able to find that baby’s bloodspot sample and get it to our MDH Public Health Lab for analysis.
We were looking into whether Vital Records could conduct a status analysis before we would
mail the recruitment letters to women in the unlikely event that the baby had passed away.
Two to four weeks after the woman received her individual results for the cord blood and urine,
she would get an invite letter with a consent form about the study. If the woman did not
respond within two weeks, staff would follow up by phone in appropriate languages. The
consent form had been lengthened by new legal requirements regarding newborn screening
bloodspots. The MDH legal department had advised us of the necessary language, which may
be challenging to put into accessible, translatable English. Once the woman had consented, the
Newborn Screening Program would match the bloodspot sample and send it to the Public
Health Lab.
The analysis portion included the following five components:
1. Determine the relationship between mercury concentrations in paired samples.
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2. Assess effectiveness of newborn bloodspot biomonitoring as a public health surveillance
tool for identifying exposure levels that exceed a threshold.
3. Assess effectiveness of newborn bloodspot biomonitoring as a public health surveillance
tool for characterizing population exposure.
4. Examine different statistical methods for managing non-detect values.
5. Compare results with other surveillance or research studies.
The next steps would be to finalize the protocol and materials, submit them to the IRB, and
then translate them into Hmong, Spanish and Somali, according to Jessica. She mentioned that
the sub-study would need a name and asked for suggestions, while noting that the name
chosen would be reviewed by the community member groups to see how it translated. She
hoped to begin the sub-study soon after the individual urine and cord blood results had been
mailed to participants.
Jessica then reviewed the rationale for proposing to not routinely send participants their results
from the bloodspot analysis, due to the method being experimental and participants having
previously received their cord blood and urine mercury results. Participants would be informed
in the consent process that they could request their individual results and would be given
instructions on how to make the request. They would also receive a summary of the overall
results.
Jessica asked the panel the following questions:
•
•
•
Do you agree with the protocol as it is presented?
What suggestions do you have for our recruitment messaging?
What suggestions do you have for the proposed analysis plan?
Discussion
Alan Bender noted his discussions with Jean Johnson regarding the need for the recruitment
issues to be fleshed out, due to MDH’s health disparities focus. He continued that sometimes
the assumption had been made that financially it was just as easy to work with one community
as another community, and it was not. He had asked Jean to keep track of this. Alan wondered
whether there would be any merit or resources for Jean to go back to some of these subjects to
find out what was successful, and to those who had not participated to find out what was not
successful in getting them to participate. He explained that we would only need to do more of
this in the future and we would need to get much better at it and have more information on
how much it costs. He was aware that it was not the direct focus of the study, but we would
have access to that kind of insight.
Jessica explained that there were really two issues they faced with recruitment. One was that
the size of the initial pool of women to recruit from was smaller than had been estimated, so
there were not enough women to start with, and then the participation rate had been lower
than we had hoped it would be. Jessica continued that we did a lot of work up front to try to
address what the community concerns might be and build them into our design. One of the key
pieces had been working with SoLaHmo, from West Side Community Health Services, because
they were a community-based research group made up of Somali, Latino and Hmong public
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health researchers from the communities in this study. They had given lots of great input along
the way, from our study materials to the design aspects of the study, and that was what we
would be reviewing with them with this pilot phase assessment of the study. We hadn’t talked
about costs as much. There was a refusal reason logged into our system, so that could be
assessed as part of our pilot phase review.
Pat McGovern suggested that different groups, like the Hmong, really liked the idea of having a
practitioner from their community endorsing the study and putting a photograph of that person
on communications with that particular group seemed to be particularly helpful. Sometimes it
was fear of how the data was going to be used and whether the data was going to be used
against them. Pat continued that the more it could be tailored to each group, the better it
would be. She felt the SoLaHmo group would be terrific with those kinds of tailoring. Jessica
responded that she had also worked with St. Paul-Ramsey County Public Health, and they had
been a huge resource: Amira Adawe, Mao Thao and Patricia Baker had been really helpful.
Amira had connected them with an Imam and a well-respected physician in the Somali
community, and there would be other ways to work with those folks, too. The plan was to keep
up the effort, change some things, and tailor and think of the groups as separate cultures that
needed different methods of information and recruitment.
Lisa Yost asked whether the women were compensated in any way. Jessica replied that for the
larger MN FEET study, they received a $25 gift card for the telephone survey and a $25 gift card
once their samples had been collected by hospital staff. The bloodspot sub-study would be
another $25 gift card.
Lisa added an idea for the name for the sub-study as Mini MN FEET. She thought you could just
put the Mini on the sub of the MN FEET name. Her other thought was about the way the
messaging was set up now for recruitment. She wondered whether the potential participants
were told that this study was trying to develop methods. Jessica responded that the larger MN
FEET study was much more active. We wanted to help women and their families protect
themselves and their babies from these chemicals.
Lisa thought that it would be really important to somehow avoid giving the impression that
something they were doing was going to result in exposure. She likened it to a stigma—that
they would be stigmatized by being involved in the study. She also thought that people would
be worried about how the data would be used.
Bruce Alexander asked how confident Jessica was that the bloodspot underestimated the cord
blood. Jessica answered that they were not that confident, because it was based on only 16
specimen pairs. TIDES had about 50 people, but we needed to look at it in the people who had
detectable mercury in both samples, which was only 16. It was a pretty consistent pattern, but
there were 3 or 4 where it was the opposite, and we do not know why that was. Jessica added
that they have had trouble getting that published, partly based on that small sample size. Bruce
said that that brought up a couple of questions, and it spoke directly to the utility of this as a
surveillance tool. He was not convinced that only including women with positive cord bloods
was going to allow MDH and others to confidently use the results to inform population
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surveillance methods. Jessica commented that we might be missing those people who had a
higher bloodspot.
Bruce continued that if you were starting with 300 women with detectable cord bloods, not all
of whom would agree to be in the sub-study, you should still have a relatively powerful sample
size for the levels being measured. He suggested revisiting the sample size calculations and that
perhaps the sub-study could be done with the same number of people, just including some
women with non-detectable cord bloods.
Jessica asked if Betsy Edhlund had any thoughts on that. Betsy said that the cord blood method
did have a lower detection limit than the bloodspot method, which might answer some of these
questions. The bloodspot detection limit was 0.7 µg/l and the whole blood was 0.3 µg/l.
Greg Pratt asked if ultimately it came down to a relationship between the two. If you got a
detection in the bloodspot, and you knew the relationship, then you knew what was in the cord
blood. If you did not get a detection in the bloodspot, depending upon what the relationship
was, you may or may not have missed something important in the cord blood.
Jeanne Ayers asked whether detection in the bloodspot was something that we reported to the
doctor. Jessica answered that we did not. Bruce Alexander and Lisa Yost both answered that
women were already getting their results. Lisa explained that they were getting their cord
blood results, which were more reliable. Bruce asked why they needed to have a separate
consent for bloodspots. Was it because of the special regulations on the bloodspots? Jessica
answered that we had planned initially to include bloodspots in the main study, but decided it
was too complicated given the Newborn Screening Program legal requirements and consent
form.
Pat McGovern suggested that we needed to move on because we were getting behind, so she
asked Jessica to be available in case people wanted to ask more questions during the break or
after the meeting.
Biomonitoring Updates
These updates on the East Metro PFC3 and MN FEET projects were provided in written form on
pages 15-17 of the October 13, 2015 Advisory Panel book. Panel members were invited to ask
questions and comment on the updates.
PFC Conference Recap: FLOUROS 2015 Conference Summary of Recent PFC
Epidemiology and Toxicology
Christina Rosebush and Helen Goeden briefly summarized epidemiology and toxicology
highlights from the FLUOROS 2015sessions they attended. Background materials can be found
on page 19 of the October 13, 2015 Advisory Panel book. Christina indicated that conference
posters from Ginny Yingling, Carin Huset, and herself would be available to view on the break.
A brief background of the international conference held in Golden, Colorado by the Colorado
School of the Mines was presented. It had been 10 years since the previous conference in
Toronto. Minnesota, including state agencies, were very well represented at the conference.
Nomenclature was a topic of discussion at the conference, specifically using “Per and Poly
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Fluoro Alkyl Acids (PFAAs)” or “Per and Poly Fluoro Alkyl Substances (PFASs)” instead of
perfluorochemicals (PFCs) for consistency in the literature.
MDH staff also attended a pre-conference symposium on highly fluorinated chemicals hosted
by the Green Policy Science Institute, Christina continued. Much of the conversation reflected
the Madrid Statement, a short document that documents potential for harm from PFASs and a
roadmap to prevent future harm, signed by 230 scientists from 40 countries. The document
called for limiting the production and use of PFASs and developing safer, non-fluorinated
alternatives. It also called for using shorter chain replacements, as capacity to destroy PFASs
was insufficient.
In the main symposium, Tony Fletcher, from the C8 Science Panel, gave a 20 minute update on
the current state of epidemiology. Being very brief, it focused on the limitations of our current
body of research. The three major limitations he presented were: predominant focus on crosssectional research, lack of replication in research findings, and unmeasured or unknown
confounders.
Helen Goeden was introduced by Christina as a toxicologist with the Minnesota Department of
Health who works on the development of health-based values for contaminants in Minnesota
drinking water and has consulted for MDH PFC East Metro biomonitoring studies. Helen
presented examples of PFAS alternatives.
A key focus was a discussion about the phasing out of some long-chain PFASs, but not much
was known about the alternatives. Ian Cousins presented on this topic, outlining some of the
major gaps and difficulties. One was that the identity of many alternatives was unknown;
companies were developing their own alternatives and there were many. The volumes
produced, used and emitted were not reported. For those identified, information on potential
human and environmental impacts was insufficient, even though some had been in use since
the 1980s.
Helen explained that even though toxicology was not the focus of the conference, she attended
a presentation by Dr. Sue Chang of 3M on the state of current toxicology research regarding
PFAAs (PFBS, PFHxS. PFOS, PFBA, PFNA and PFDA), highlighting the importance of toxicokinetic
information. Posters included new toxicity information on PFOS (neurodevelopmental
outcomes) as well as ‘alternatives’ ADONA, 6:3 fluorotelomer alcohol, polymeric commercial
products, and surfactant commercial products. Standard 90 day & reproductive/developmental
studies were typically conducted, with liver effects as the common endpoint, although blood
system and development were also mentioned.
Panel members were invited to ask questions and comment on the presentation.
Greg Pratt asked if there was a difference in the use and development of alternatives in Europe
and the United States. Helen responded that Sweden was leading the charge for greatly
restricting the use of PFASs, but it remained to be seen what this would look like in practice.
Helen continued that Tala Henry from the US Environmental Protection Agency gave a
presentation that drew many audience questions; she did acknowledge that through the Toxic
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Substances Control Act (TSCA) and new chemical use, that rarely was toxicokinetic
environmental fate information actually submitted with the report for new use.
Update on Joint MDH/MPCA Air and Health Initiative
There was no presentation, due to Jim Kelly’s absence.
Inequities in Air Pollution Exposure and Risk
Advisory Panel member Greg Pratt, of the Minnesota Pollution Control Agency, presented
information on his recently published 2015 paper entitled, Traffic, Air Pollution, Minority and
Socio-Economic Status: Addressing Inequities in Exposure and Risk. Background materials,
including a copy of the abstract and a link to the full paper, were included on pages 23-26 of the
October 13, 2015 Advisory Panel book.
Greg began by explaining where the idea for this study came from. He credited a 2014 study by
Lara Clark and Julian Marshall from Civil Engineering, and Dylan Millet from Soil, Water and
Climate at the University of Minnesota. They had used land use regression analysis across the
entire United States looking at NO2 concentrations; then they compared that to census
demography, and they found some interesting results.
Greg continued with some background as to why he had been interested in the spatial scale of
air pollution, which occurred on two scales, the graphic scale as well as the scale of particle
sizes. The indicator species that was in place for particles in the atmosphere when he began his
work in this area was total suspended particles. In 1987, the indicator species was changed to
PM10 and in 1997, it was changed to a mass of PM2.5.
Greg continued that in their conventional assessments of the risks and costs of air pollution,
regional models were relied upon, using a large grid-cell size, and everything within the grid cell
was thought to have the same concentration, so people within that grid cell would have the
same exposure.
However, because of the limitations of the spatial scale of these studies, the exposure
characterization was fairly poor. If we wanted to better understand the effects of air pollution,
we needed to better understand exposure.
In another study by Julian Marshall and Steve Hanke, while riding a bicycle equipped with
monitoring equipment around the streets of Minneapolis, Steve found very large differences in
some of the important pollutants. Greg reviewed the map explaining that a person’s exposure
depended on where they traveled and the time of day.
Greg continued that they using a comprehensive model that took into account emissions of all
sources of pollution that we knew about, MPCA estimated exposure and risk. They estimated
the concentrations at 60,000+ stations across the state, and along busy highways.
They analyzed the data and looked at different source categories and the sources that were
traditionally looked at in the regulatory programs, the point sources contributed a relatively
small amount of risk compared to other (non-point) sources, which meant that the regulatory
programs were working, but also that there was still work to be done.
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Greg added that they could also look at the spatial distribution of risk, by major source
category, and further, averaging the model results by census block. From the tables in the
report, he was able to show that two measures of environmental risk were correlated with nonwhite demographic by block group and were negatively correlated with vehicles per household.
After looking at the statistics, correlations and analyses, they found that census blocks with high
socio-economic status (SES) tended to have low indicators of air pollution exposure risk
[environmental harm]. Census blocks with low socio-economic status had higher risk. He
concluded that environmental risk inequities were really social justice issues.
Panel members were asked to hold their questions and discussion until the next presentation.
Monitoring Air Pollution at the Local Level
Kristie Ellickson, from the Minnesota Pollution Control Agency, presented information on two
special monitoring projects being conducted at the MPCA: namely, the Community Air
Monitoring Project (CAMP) and the Community Air Toxics EPA Grant Project: “Calibrating
Concern about PAHs (Polycyclic Aromatic Hydrocarbons) in Air Using Monitoring and
Modeling”. Background materials can be found on pages 27-30 of the October 13, 2015
Advisory Panel book.
Discussion
Alan Bender commented that one of the significant challenges for Greg’s study would be the
messaging for the public, to ensure that people understood that air pollution was not a major
driver of the cancer burden in that community. Greg agreed and noted that the reason they had
looked at risks was because it was a way that they could look at numerous pollutants
combined, and the cumulative impacts of all of them. Converting exposure to cancer risk was a
way to put all the pollutants together on the same scale.
Pat McGovern asked Kristie Ellickson about the messaging she had done with the community.
She wondered how it had gone and what feedback had they received? Kristie admitted that she
was not the person who had done the communicating, but she knew people were interested in
it. She recalled one college student from the Little Earth residents, a grandson of one of the
elected representatives, was very interested in it. A lot of people had odor complaints, and
what they were measuring did not have odor, but might be toxic regardless. People wanted to
know, “Was I safe, was it worse here or was it worse elsewhere, and what we did.”
Lisa Yost asked how they had integrated outdoor time and indoor time in their risk estimates.
Greg Pratt responded that the risks they calculated were only done outdoors, at a point in
space, as if a person stood in one spot for 24/7. Lisa noted that it could be different in two
places. Greg replied that EPA does have their new exposure model and in that model, the
indoor concentrations were less than the outdoor concentrations, but when we did an
exposure study years ago we found that the indoor concentrations were higher than the
outdoor concentrations. There also was a huge variability in indoor concentrations.
Pat McGovern wondered when they had looked at the disparities by ZIP code, whether there
would be any actions that might be taken to try to address that. Kristie responded that she had
been referring to higher naphthalene values in the center of three larger industries for an urban
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neighborhood, and that they would have to work that out and she was not sure what the
actions would be. Greg Pratt replied that they had suggested some ways to address that. One
would be to put a barrier between the source and the receptors. Another would be to change
the behaviors so that people are not in those areas as much; and a third way would be to
change the technology, so an example would be moving away from the internal combustion
engine as our sole means of transportation. Greg said that just in the last week he had received
inquiries from the public about the traffic levels in certain areas. He thought it was rising as a
public concern.
Melanie Ferris asked about the influences on city planning and how this information might
affect bike path routes, for example. She thought that would be an interesting overlay on the
maps that had been developed. Greg replied that there had been studies done on the exposure
to pedestrians and cyclists along traffic corridors. He added that as a bicycle commuter, he had
been affected by the spatial scale, when the nanoparticles aggregated to become larger
particles in a very short distance, and that he tried to get away from that as much as possible.
He continued that even 6-10 feet from the traffic made a difference in exposure, according to
some studies.
Pat McGovern commented that she couldn’t help but think of the placement of day care
centers and elementary schools, where the very young would be exposed. She asked if anyone
had tried mapping those as to air exposures. Greg answered that they had mapped schools, but
he was not sure whether they had mapped day care centers yet. Greg noted that he,
personally, tried to avoid schools when the buses are lined up, because it was really hard for a
biker to breathe.
Cathy Villas Horns asked what Kristie Ellickson assumed were sources of PAHs. Kristie
responded that combustion was the main one, so diesel and gasoline combustion, home
heating, oil combustion. There had been a study done by MPCA that showed more runoff from
coal tar sealant as a source, an evaporative coal tar sealant source in the summer heat when it
was freshly applied. For air it was combustion and all types of fuels. Cathy wondered whether
Kristie could try to match the sources. Kristie said when they tried to come up with an analyte
list, we had to balance what was possible to analyze chemically, and we had known sources.
PAHs tended to be ubiquitous, but some were known to be linked with sources. Greg added
that the Health Department was our analytical lab, and they developed methods to measure
the PAHs. Kristie commented that it was a very expensive study, as they had funded one
chemist and ended up with two and a half.
Pat McGovern reviewed the questions for Greg’s and Kristie’s presentations.
•
•
What conclusions can we make about variation in air pollution levels within ZIP codes?
Are the differences likely to impact community health?
What can EHTB do to better describe community exposure to air pollution for informing
public health policy and action? What additional data or information are needed?
Alan Bender referred to his earlier comment regarding engaging relative comparisons that were
made in the study and translating back to the impact on morbidity and mortality. He felt it was
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important to identify risks below those that translated generally in an epidemiologic way. He
acknowledged that this was what Greg was working on, but there was always a tension
between risk assessment, and the level of risk could be 1/10,000th, yet the community wants to
know if you could measure with precision the cancer risk. He stressed the importance of the
communication and messaging and noted that he was not diminishing in any way the
importance of identifying these because regulation could deal with the issues Greg was
addressing, whereas the major contributors to cancer risk were lifestyle and human behavior;
things that were so difficult to change. He felt it was almost a mythology in the community,
when people heard about risk, they thought they no longer had a responsibility and the
government could take care of my cancer burden for me. Greg agreed that cancer captured
people’s attention and it was one way to look at the cumulative impact. Greg asked whether
there was a different term that they should use, or a different way to show the cumulative
effect.
Lisa Yost commented on that same question of community health, it depended on the end
point. There were probably some end points where you could see it, but she did not know if it
could be seen at a Zip code level, based on the limitations that were described. She continued
that on the cancer risk, it was really helpful to come back to what the background level was and
putting it in context.
Pat McGovern felt it was very important, when talking about attributable risk, to find a way to
communicate it, for people in those communities affected and those people in communities
not affected, but associated with elevating the risk. There were important conversations that
needed to be held, and they had the greatest opportunity to change the minds of young people
regarding lifestyle habits in order to improve environmental quality and sustainability. She
believed the work being done was very important and thought there were probably people in
the Journalism School who could work with Greg Pratt and Kristie Ellickson to craft the public
health education messaging in a way that might make people change. She did not believe
regulation would necessarily be the answer, especially with the current bipartisan conflict
occurring in various venues.
Jean Johnson added that this topic would be important in the coming year, especially with the
Be Air Aware website and the Air and Health Initiative. A determination would have to be made
regarding how to transfer what Greg and Kristie presented into meaningful language for the
public.
Mary Manning asked Greg about his report, when looking at pollution and where the people
owned vehicles and where they did not, whether he could say that the pollution was caused by
the vehicles or by trucking. She did not know what people would infer by the vehicles being
owned outside and vehicles not being owned inside and what does that say about our societal
or global responsibility. Greg replied that it was a very good question, but at this time, they did
not have a good way to sort that out. He did know the percentages of diesel vehicles on the
roadways, which showed up higher in pollution in his study, so he could assess part of the risk.
The way they had done their analysis, there did seem to be a difference between those
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households with multiple vehicles and those households with no vehicles. There was a
difference in exposure across all types of vehicles that were contributing to pollution.
Paul Allwood noted feeling conflicted about discussions about behavior change, mostly because
his understanding was that there were folks perhaps creating more pollution and other folks
that were receiving the pollution, and he just wanted to get some clarity as to in which camps
the behavior change had to take place. Greg responded that in his opinion, change had to occur
in both camps, but it was not just an issue in our state, nor our metropolitan area, but it was a
global issue. Paul continued that we had been talking about the factors that create poor health
and the different descriptions of what contributions were made by behavior versus other
things. He thought it was really important that we made it clear that there were those
environmental conditions that we knew potentially disproportionately impacted members of
our society.
Pat McGovern agreed with Paul and discussed past work done in environmental health literacy.
There has been a huge body of literature on health literacy and how to achieve better health
outcomes with better health literacy; not so much on environmental health literacy. She felt
the work being done here was cutting edge in terms of taking it to the next level from the
science of what people are exposed to, to communicating to people what it means for their life
and what actions could be taken on both sides.
Proposed Measures of Traffic for MN Tracking
Jean Johnson described the rationale and purpose of complimentary work proposed by MN
Tracking to explore and develop new trackable measures of population exposure to mobile
sources of pollution, or traffic. Background materials can be found on pages 31-33 in the
October 13, 2015 Advisory Panel Book.
Jean began by presenting what MN Tracking has been working on and piloting to try to
contribute more to this discussion about the ways to look at, measure and monitor exposure to
air pollution at a finer resolution. MN Tracking, along with the CDC, has been developing
indicators for monitoring population exposure to traffic. The hope was that this measure would
inform and prioritize actions and policies for reducing traffic exposure in communities. It could
help promote our understanding of the relationship between these disparities and exposure
and health and provide a measure for tracking the progress of mobile source reduction
initiatives.
Jean introduced Paula Lindgren, who described and showed two proposed population-based
measures of traffic exposure that could be measured by county, Zip code or other geographic
units. Background materials can be found on pages 33-34 of the October 13, 2015 Advisory
Panel Book.
The following questions were posed to the panel:
•
•
•
Is a traffic indicator a valuable addition to the MN Tracking data portal?
How would the data be used?
Which metric is most useful for tracking population exposure to traffic-related air
pollutants?
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Discussion
Alan Bender wondered what message would be put out on the portal about this data. Jean
Johnson responded that the language of why this measure mattered was the first thing listed
before new data was put on the portal. We would explain the link between traffic and health
outcomes. The other components of the message were: Who was at risk, and What was being
done about it. We would have action steps and links to the Pollution Control Agency, what was
being done about traffic, and where you could go to get more information.
Alan Bender continued that the disease side of this was clearly one issue, but he suspected we
would be neglecting completely what he considered the more important issue—the
psychological component of living near high volumes and its implications on quality of life. We
could not address it, but we all knew it was important. Paula responded that there was noise
and stress, and those were different. Chuck Stroebel added injuries and safety, which could also
be addressed at some point.
Lisa Yost thought the answer to the first question was yes, and which indicator depended on
who was going to use it and how. She felt that the users would probably be city planners,
health officials, risk managers. Pat McGovern wondered about school kids. Lisa answered,
maybe, but she was trying to think of how the public would benefit from it. She added that she
thought everyone cared about how long their commute was, but MN DOT had that. Chuck
commented that, speaking as a parent, there might be parents with kids in schools that were
concerned about safe routes, and it would be useful for a health impact assessment analysis for
routes to schools. Melanie Ferris commented that with that in mind, the more local the data
could be, the more useful it became, because the groups doing the advocacy were the
neighborhood associations; it was the PTA; it was much more local than even the Zip code level.
And she did see some value in being able to break out larger vehicles, because that was one
area that there could be some regulations created, different kinds of roadways.
Lisa Yost commented that in terms of the indicator, there was discussion of looking at the data
from a zip code level, it seemed that the different pollutants were not all the same, that some
might be better represented than others in terms of extending beyond the monitoring location.
If extended data were shown, it would allow people to access those sampling locations
specifically, not just showing one way, but shown multiple ways.
Greg Pratt was glad to see traffic measure added to the mix, as it was an important measure of
environmental health. He believed that we were so used to traffic that we did not see it
anymore; we did not recognize it anymore. He agreed with Melanie Ferris’s comment that the
more localized it could be, perhaps the more useful it would be, because traffic was a local
phenomenon.
Kristie Ellickson was considering what Chuck Stroebel had said, about crossing guards and
schools, if it could be a finely resolved metric to place crossing guards for schools in an area.
They may have that information elsewhere, but that informed safe routes for schools and
walking. Pat McGovern thought that it would have a lot of public appeal and usability.
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Cathy Villas-Horns wondered whether it might be useful for air quality alerts, as people took it
seriously when there were fires in Canada and smoke coming in, to put it down to micro levels
for city or inner city traffic, how that affected it, or maybe we were not ready to do that
connection yet. Greg Pratt replied that last summer, MN DOT put out “Air pollution alert,
reduce driving ahead” on the screens along the freeways. He thought they had received plenty
of feedback about those, some of it being that the messages were not all clear. He continued
that if you were driving along the freeway and you saw a message to stop driving, what did that
mean?
Paula Lindgren thought that this data would be useful for the data visualizer on the portal,
where traffic, asthma, and air pollution could be plotted by Zip code. Lisa Yost was curious to
check the links to the California portal to see what had been done with their traffic data, and
wondered whether there were any ideas to take from that. Jean Johnson replied that they had
done both the density and proximity to road measure by Zip code. Paula noted that it had only
been done for major cities. Pat McGovern wondered if California had shared how much the
data had been used, and whether it had increased their following of people who wanted to
make public health change because they had seen the data.
Melanie Ferris commented on Alan Bender’s earlier statement, that sometimes when we do
not have the data to talk about quality of life or stress on communities, things like that, then we
do not make a statement about that. She suggested acknowledging that as a gap in data; that
things like traffic did contribute to a lower quality of life. If there could be some very deliberate
language that could elevate awareness about these issues, having broader implications, even if
there was not something to quantify around it, referring to the stress and noise. Alan Bender
added property values and that there was a whole cascade of things associated with traffic.
Lisa Yost thought that it gave people more information, which she felt was almost always more
helpful. Paula Lindgren added that she was surprised to find that there were some areas with
heavy commercial traffic in outstate Minnesota, not just in the metro area.
Hearing no public comments or questions from the audience and no new business, the meeting
was adjourned at 3:50 pm.
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