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RESEARCH BRIEFSStudy Quantifies Toll of Power Plant Pollution, Benefits from ControlPollution from coal-burning power plants in Illinois is responsible for hundreds of premature deaths and thousands of respiratory illnesses, most of which could be prevented with existing emissions control technology, according to a report by HSPH researchers. Using computer modeling to show how weather patterns disperse particulate matter, sulfur dioxide, and nitrogen dioxide, John Spengler, the Akira Yamaguchi professor of environmental health and human habitation, and Jonathan Levy, research fellow in environmental health, estimated that these three pollutants from the nine plants result in 300 premature deaths and 14,000 asthma attacks annually, and 440,000 incidents of upper respiratory symptoms daily among the 33 million people living in nine states within 250 miles. Risks are greatest for people living close to the plants (varying by plant from under one to about 25 miles) or who already have cardiovascular or respiratory disease. The findings are similar to those of a May 2000 study by Spengler and Levy on the Salem Harbor and Brayton Point power plants in Massachusetts (see Focus, May 19, 2000). The nine plants—in Chicago, Joliet, Waukegan, Pekin, Hennepin, Bartonville, and Romeoville—are all more than 28 years old, some nearly 50. Their operation has been "grandfathered," exempting them from the strict emission standards newer plants must meet. If all nine plants adopted the best available control technologies as required for newer plants by the 1990 Clean Air Act—cleaner, lower sulfur fuels, air cleaning devices, and aggressive energy conservation—Spengler and Levy estimate that about two thirds of the morbidity and mortality would be prevented. In fact, some of the plants introduced fuel changes and emission controls between 1998 and 2000, moves, they say, that will prevent about 80 premature deaths per year. The study did not assess the effects of other pollutants such as ozone, mercury, greenhouse gases, or acid rain. The report was prepared for the nonprofit Clean Air Task Force and is available on request from HSPH. Total Incremental Mortality Risk per Year Measured in Premature Deaths
The first column shows the estimated number of deaths associated with SO2, NO2, and particulate pollution from each plant. The second column gives the number of deaths expected with better emission controls, and the third column is the reduction in mortality—the first column numbers minus the second column numbers. (Note that columns do not add due to rounding.) Gene for Familial Dysautonomia DiscoveredMassachusetts General Hospital researchers have located the gene that causes familial dysautonomia (FD), a neurodegenerative disease that mainly targets Ashkenazi Jews. The disease, which affects one in every 3,600 members of this group, impairs the development of the sensory and autonomic nervous systems. Babies born with the disease often have trouble sucking and swallowing, forcing many to be tube fed. Nor can they taste or cry since they lack taste buds and tears. Those affected also have problems controlling their heart rate and blood pressure. Nearly half die before reaching their 30th birthday. The immediate result of this discovery, which is scheduled to appear in the March issue of The American Journal of Human Genetics, will be to make it possible to easily identify those who carry the FD gene. "While genetic testing for at-risk families has been going on for years, our discovery will now permit anyone in the general Jewish population to have carrier testing," said James Gusella, the Bullard professor of neurogenetics and head of the research team. One in 30 Ashkenazim is estimated to carry the FD gene. The discovery could lead to new therapies for the disease, which is currently incurable. Gusella's team has shown that expression of the mutant gene, IKBKAP, varies in different cells. "The fact that we see normal protein expressed in some patient cell types, despite the presence of the mutation, is unusual and important. By investigating this underlying mechanism, we may learn how to increase the amount of normal protein made in nerve cells, which could lead to a treatment for the progressive neuronal loss seen in FD," said Susan Slaugenhaupt, HMS instructor in neurology and lead author of the study. Fish May Reduce Risk of Stroke in WomenWomen who want to reduce their risk of developing stroke might consider eating fish more often. Brigham and Women's Hospital researchers have found that a diet rich in fish or other sources of omega-3 fatty acids can cut a woman's risk of developing the most common form of stroke by nearly half. The study appears in the Jan. 17 Journal of the American Medical Association. "Our research suggests that women can reduce their risk of thrombotic stroke by up to 48 percent by eating fish two to four times per week," said Kathryn M. Rexrode, HMS instructor in medicine. "The findings also indicate that higher intake of omega-3 fatty acids may help women reduce their risk of stroke." Previous studies have reported an inverse relationship between fish intake and risk of stroke, but this is the first large-scale study to examine the relationship between intake of fish and omega-3 fatty acids and the risk for particular kinds of stroke. Traditionally, strokes are divided into two main types—hemorraghic and ischemic. Ischemic strokes, which account for 83 percent of all these events, are divided into two main subtypes, thrombotic, due to a clot forming in the brain, and embolic, caused by a clot forming elsewhere and traveling to the brain. Using data on 79, 839 women participating in the BWH-based Nurses' Health Study, researchers found that women who ate fish once a week had a 22 percent lower risk of developing all kinds of stroke than people who ate fish less than once a month. Those who ate fish two to four times a week had a 27 percent lower risk. The researchers also found that women with the highest intake of omega-3 fatty acids had a 28 percent lower risk of overall stroke and a 33 percent reduced risk of thrombotic stroke. Veterans Hospital Care Matches Quality at Other HospitalsCritics have charged that patients in Veterans Health Administration (VHA) hospitals receive poorer care than those in other hospitals. But a new study offers evidence that at least for heart attack patients, VHA hospital care is as good as any. Led by Laura Petersen of Baylor College of Medicine and the Houston Veterans Affairs Medical Center, researchers examined records of male patients 65 years and older who were discharged with confirmed acute myocardial infarction: 2,486 veterans from 81 VHA hospitals and 29,249 Medicare patients from 1,530 non-VHA hospitals. HMS authors of the study, published in the Dec. 28 New England Journal of Medicine, are Sharon-Lise Normand, associate professor of biostatistics, Department of Health Care Policy; Jennifer Daley, associate professor of medicine at Massachusetts General Hospital; and Barbara McNeil, professor and chair, Department of Health Care Policy. Mortality rates 30 days after a heart attack were 17.3 percent for VHA patients and 18.1 percent for Medicare patients. At one year, the rates were 31.5 percent for VHA patients and 31.8 percent for Medicare patients. VHA patients were more likely to have co-existing conditions, including hypertension, chronic obstructive pulmonary disease, asthma, diabetes, or stroke, which might have been expected to result in higher mortality. The authors suggest that the comparable mortality rates in the two groups may reflect that VHA patients were more likely to receive beta-blockers, angiotensin-converting-enzyme inhibitors, or aspirin. "We have found no differences in mortality between VHA patients and fee-for-service Medicare patients," the authors write, "suggesting that VHA patients receive care of similar quality for acute myocardial infarction." |
