This is not a health impact study
The presentation refers to the following study: Community Health and Airport Operations Related Noise and Air Pollution: Report to the Legislature in Response to Washington State HOUSE BILL 1109
Mayor Sofia Aragon [57:17] Okay, so our next presentation is a public health presentation related to airport and aircraft exposure, and we have as our guest Dr. Kris Johnson, PhD, Public Health — Seattle & King County. I just want to give a little bit of background, in that this is information that the City of Burien shared with our airport city partners, and it was information that was found very compelling actually by our StART partners. So we wanted to bring it forward here to the city council, and because Boulevard Park is under the flight path and we’re moving toward a comprehensive plan in that area, I think this is information that the council should be aware of. So thank you, Dr. Johnson, for coming, and I’m just going to turn it over to you.
Dr. Kris Johnson [58:08] Well, thank you for having me. This was a study done by — here, you’re going to watch me practice the slides, it’s been a while. All right. I might need you to click for me. So I’ll say “next slide,” you’re going to have to tolerate that. Thank you for your patience.
So this was a study that Public Health — Seattle & King County conducted in 2019 and 2020. It was requested by the Washington State Legislature. We’re very grateful to Senator Keiser and Representative Orwall for their support designing the ask and then making sure there was funding for it. This is not a health impact study — the health impact assessments are much more formal. What we were asked to do is what you see on the screen. We were asked to do a comprehensive review of the literature: what do we know about airport-related pollution and its impact on human health? And then we were asked to use available data to look at community health in those communities within 10 miles of the airport.
The concentric circles that you see are what we looked at, and again this was based on the ask of the legislature. So the first circle, we looked at residents who lived within one mile of Sea-Tac Airport, between one and five miles, and then five and ten miles of Sea-Tac Airport. What we learned is there’s air pollution that comes from airport operations, both ground vehicle and also the airplanes themselves, aircraft. Within these concentric circles we also just need to acknowledge that there’s the King County Airport, municipal airport, and then I-5 and 99. So you’ve got other sources of pollution there.
Let’s see, did it work? Oh, you’re doing it, sorry. Did I do it too? This would be the comedy portion.
So one of the things that we learned right away — and I’m relatively new, I’ve been here about three years, from the Midwest — one of the things that we learned is the majority of King County’s people of color live within 10 miles of Sea-Tac Airport. If you look at it: 75 percent of Native Hawaiians and Pacific Islanders, almost 75 percent of Black and African American residents, and right over half of Hispanic or Latino residents live within this area. And from now on, when I say “airport communities,” I mean communities within 10 miles of Sea-Tac Airport. It’s also about half of our Asian residents living here compared to the rest of the county. This area also has a slightly higher but significant proportion of children and immigrants residing. So that was the first big find — that by and large it’s communities of color that we’re talking about.
Overall, what we saw compared to the rest of the county is that these communities face both health disparities and resource disparities. In some cases, for a few outcomes, we were actually able to see that the closer one resides to the airport, the worse the conditions. For example, hospitalization rates for heart disease were highest for those who live within one mile of Sea-Tac, slightly lower for one to five miles, slightly lower for five to ten miles, and then all three of those rates are significantly higher than the rest of the county. So for the outcomes that you see on the screen — life expectancy, rate of death from heart disease, rates of death overall, and hospitalization for heart disease — there was that correspondence where rates were highest when you were most proximal to the airport.
Now, this is a descriptive analysis, so this is not cause at all — at all. We can’t say that these outcomes come from pollution. We can only say that these communities are already at risk, because we don’t know — for example, heart disease, there’s other causes out there. So what we do know is that the communities face health disparities, and those health conditions that put them at risk run through the life course, from birth to death. For example, mothers in airport communities are 43 percent more likely to have a premature birth than mothers in the rest of the county. It’s not shown in the data, but it’s also true that they’re more likely to have children born with low birth weights. And airport communities have twice as many children living in poverty compared to the rest of the county. And again, not shown in the data, but also true of adults — there’s a higher percentage of adults living in poverty compared to the rest of the county. Adults are more likely to be uninsured in airport communities than in the rest of the county.
Airport communities also have a higher rate of hospitalization for a number of outcomes — heart disease, stroke, diabetes, and also asthma, which I’m not showing you, and COPD, that chronic obstructive pulmonary disorder. The bar charts — I want you to be able to see — the one on the left is the rate for the community that lives within one mile of Sea-Tac Airport. The next bar to the right is the one-to-five-mile range, the third is five-to-ten miles, and the last bar on the right is the rate for the rest of the county. There’s also a higher rate of deaths overall in these airport communities compared to the rest of the county, and that significant difference we also see within types — heart disease, stroke, and a few others.
So again, we’re seeing that these are communities already at risk. They’ve got health conditions that can be aggravated — like the asthma, diabetes — by exposures to pollutants.
We also conducted a literature review. When we did it, we used the same methods — because I’m going to talk to you about what is a causal relationship and what is not — the same methods that the EPA, the Environmental Protection Agency, uses when they do their impact assessments on pollutants. So we did a strength-of-evidence analysis, and when I talk to you about a causal relationship or a likely causal relationship, meaning one causes this to happen, that’s based on numerous studies with rigorous methods. So we adopted the same guidelines the EPA uses in their review.
And when we’re talking about pollution that comes out of airport operations, we’re talking about air pollution and noise pollution. The noise pollution, you all I’m sure are aware of what I’m talking about — I can stand at Saltwater Beach Park and count the flights going over me, we can all hear it. The FAA has a noise level threshold that is lower than what the World Health Organization recommends. So it’s just interesting that there is this fight around standards. But the noise pollution definitely has an effect on health. It primarily affects attention and focus, primarily through lack of sleep and stress.
The air pollution comes from a number of sources. We’ve got ozone and carbon dioxide, a number of hazardous air pollutants in there, and particulate matter, which comes from things like smoke but also from plane exhaust and vehicle exhaust, and it comes in different sizes. The air pollutants that stem from the exhaust from planes and vehicles cause respiratory problems, including asthma and the COPD I mentioned. The air pollution exposures also cause cardiovascular issues — hypertension, which is high blood pressure, heart disease, heart attacks, and stroke. There’s also nervous system implications — exposure to air pollution can cause dementia and oxidative stress. The oxidative stress system is what monitors our overall biology, and can change with different exposures. The metabolic issues — I mentioned diabetes. And reproductive health concerns — there are a number of studies out of Los Angeles right now showing that particulate matter at the size of 2.5, and then very, very small — all of it smaller than a grain of hair — some of that particulate matter can pass through the bloodstream, and so does cause preterm birth and low birth weight. There’s also a new study suggesting it causes brain cancer.
When I say exposure to these air pollutants, we don’t know exactly how much exposure, but through animal studies and studies of large populations, birth cohorts, we know that exposure causes harm. We might not know how much, but we know it causes harm. So that was the summary of the literature review — that we understand now that there is this causal impact on health that is negative.
What we also wanted to know — I mentioned exposure — we wanted to know, well, what do we know about exposure here. In the literature and in studies, we need to better understand what amount of exposure leads to these health conditions I mentioned. Locally, we know there was a 2018 Beacon Hill study that showed the noise levels resulting from planes going overhead did surpass that FAA threshold — and that threshold was set based on our health. So in 2018 we have data showing noise levels from planes surpassed levels that were set to protect our health. We also know the 2019 Puget Sound Clean Air Agency data shows that particulate matter levels were over EPA recommendations. So we basically had some early data showing that occasionally we’re surpassing limits set to protect our health.
We don’t know a lot. Also, that ultrafine particulate matter is not regulated by the EPA, so we don’t know as much about it. So at the same time the Washington State Legislature asked us to do this examination of existing data and the evidence — what do we know to date — they also asked a University of Washington–Seattle team, out of the Environmental and Occupational Sciences division, to look at this ultrafine particulate matter, because it’s very new.
Particulate matter comes when we burn things — burning fuel, wood stoves, it’s what makes the air hard to breathe during wildfires — and it comes in different sizes. What this team wanted to do was look at the concentration of ultrafine particulate matter and understand how present it is in plane exhaust and also ground vehicle exhaust, car and truck exhaust. So they studied it in two ways, basically trying to measure the concentration of UFPs, ultrafine particulate matter.
Why we’re worried about ultrafine particulate matter is because of what the animal studies have shown us — it is so small it actually can travel through the cell barriers, and it causes inflammation in the lungs and in the brain. So the ultrafine particulate matter most directly leads to inflammation, and again passes through cells, so it can travel through the bloodstream to different parts of the body. That’s why we’re worried about it, and why we’re worried that it’s not regulated right now and not very frequently measured.
So what the UW team did is, over the course of a year — there are some fixed air quality monitors, like I think there’s one at Beacon Hill — they looked at fixed measures and took them right from these systems that measure air regularly. They also did mobile measurement, driving the paths that you see back and forth over the course of a year to measure air quality. And at the same time they measured temperature, wind strength, etc. — all the things they need to know.
They learned a couple of things. One, the pollution that comes from plane exhaust really does look different than the pollution from cars and vehicles. That matters because it means we can track back sources. Prior to this, people were saying you couldn’t separate the difference, and that makes it hard to look at relationships. So it turns out we really can measure the difference, and there is ultrafine particulate matter that comes both from vehicle transportation and plane exhaust.
So their findings overall are that ultrafine particulate matter is a byproduct of burning both types of fuel — it comes out of plane exhaust and car and truck exhaust. The concentration overall doesn’t look distinguishable, but when we look at the type of pollution and the amount of ultrafine particulate matter, we can tell the difference between plane exhaust and vehicle exhaust. There’s more ultrafine particulate matter coming out of the plane exhaust, at a higher concentration. And the fixed-site monitoring was a way of double-checking the mobile monitoring, and it showed the same patterns. Mayor Aragon mentioned the flight path — the concentrations were highest when planes land compared to takeoff, and the UW team is not quite sure why.
So they’ve continued their work, in part with the city funding — so thank you. They did some work with schools the city has funded, including City of Burien, and thank you for that. They’ve looked at air pollution outside compared to inside. What that work showed is that, by and large, the air pollution we have outside is very easily traveling inside. For example, there were a number of schools where they tested the air quality, and the amount of air pollution found outside the building was equivalent to that found inside. We’re not sure — it depends, it can change different times of year — that might be because windows were open, it might be the ventilation system. But one thing they learned is that this air pollution is coming inside at high rates.
But the second piece they tested and shown is that portable HEPA air filtration cleaning units can effectively reduce the indoor air pollution. And again, they tested that primarily in schools. So there is a way to mitigate exposure to air pollution, particularly for children.
The other things they want to look at — a different team, the UW EarthLab, is looking at whether vegetation helps. In my opinion the field’s not very clear. Vegetation and trees help mitigate certain types of air pollution, but we don’t know yet. There’s some research that shows it might be some types of leaves, not other leaves, so you have to have the right type of leaf. And it might be that we need big areas of greenery and forest and vegetation in order to effectively clean the air, so having sporadic trees might not do it. There’s one study that basically hypothesized that we have to have 200 square meters of forest in order for green space or greenery to help with air pollution. But there’s a team at the UW that’s going to study that, so we’ll know more soon. And the other piece they want to do is look at the content and better understand what is coming out of plane exhaust versus vehicle exhaust, so we can understand that a bit more. So that’s some of the work they’re going to be doing.
We’re nearing the end, so if you have questions, let me know. I wanted to make the point, before we talk about next steps and recommendations, that we know airport communities face a number of challenges beyond the health disparities and resource disparities I talked about. What you’re going to see on the right is from a Seattle Times article about redlining. So we know there’s this correspondence between historical and structural racism and these airport communities. And that matters because it indicates we have some responsibility, maybe beyond general protection of human health — if we want to make progress toward equity, then we need to be able to protect health in these communities.
The graphs underneath the figure, in green — it’s very hard to see, but I wanted you to see the shape and understand that we’re talking about the same region of King County. The map with the green background is rates of asthma hospitalization, and where the darker colors are is where the rates are higher. And the map to the far left is King County’s Social Vulnerability Index, which is based on a number of factors including income, level of housing, things like that. The Social Vulnerability Index indicates that these are populations facing disparities and that have suffered from historical and structural racism.
And so this cumulative risk matters because there’s a lot of data out there — for example, when we all breathe in air pollution, those of us with asthma or respiratory issues or diabetes, or who are more obese, are going to struggle more and are more likely to suffer adverse health effects from breathing air pollution than other people are. So some of these health disparities put people at greater risk when they’re exposed to the same levels of air pollution. And we also know that people within these communities are more likely to be exposed compared to those of us who might live in downtown Seattle or other parts of King County.
So that was a quick overview. The recommendations are very general — again, this report came out in 2020. They’re general because it’s going to take action at multiple levels in order to protect human health from air pollution and noise pollution that is airport-related. There are things that can only be done at the federal level — they regulate the flight paths. And there are a number of programs — there’s a federal improvement, I always call it FIP, it’s Federal Improvement Project, but you basically can petition — so the Port of Seattle can petition FAA for money and then invest it in the communities as a way of mitigating adverse health effects. So there are options like that at the federal level. And then there are things that can be done at the state, and things the county can do.
But overall, what we recommend is addressing the health disparities of airport communities. If we improve basic health — if everyone’s got access to health insurance and health care — then we’re investing in protecting their health. So increasing health equity is going to protect people a little bit, so we should do that. We should also continue to think about how to mitigate the health impacts of airport exposure to pollutants. I think the other thing we can do is continue to do research. It would be great to further develop a systemic monitoring system so that we understand air pollution on a more comprehensive level — a systematic monitoring system. And then supporting research to further address our gaps in knowledge. But there’s certainly a lot we can do to mitigate exposures, and I think the HEPA portable air filter units are a move toward that direction.
There are references, if you want to share the presentation. The UW team has a number of pieces out there — policy briefs, web pages that are easy to digest, not long academic studies — and the report I mentioned is online with an executive summary, if it’s useful to folks. So the presentation — I don’t know if folks can access it, but there are notes in the notes section that link you to other materials. And just let me know if you have any questions.
Mayor Sofia Aragon [1:21:33] Any questions for Dr. Johnson? Okay, council member Sarah, then the deputy mayor.
Councilmember Sarah Moore [1:21:42] I don’t have a lot of questions, because you covered that pretty thoroughly. And I wish I could say that a lot of it was a surprise. A lot of it — I live about three miles from the airport and watch the flights come over, and I distinctly remember having a child having an asthma attack and keeping them calm by watching the planes landing — that sort of ironic disconnect of those two things at the same time.
It seems like many of the solutions are going to take concerted interlocal, state, national effort, and that those HEPA filters are something that can be done quickly and have returns really fast. That’s something we need to think about — how can we make that happen? Not because that’s the solution, but because it’s going to make people healthier quickly and address some of those immediate impacts.
I do have questions about the hyperlocality of things. How long do micro, or ultrafine, particles stay in the air, and where do they go when they come out of the air? And the trees that are really good at getting them out of the air — are they in the trees? And then when parts of those trees die in the fall and fall, are the leaves in the ground? So kind of this continuing cycle — it must be accumulating.
Dr. Kris Johnson [1:23:31] Yeah, no — thank you, that’s a great question. So there’s more to learn. When you talk about the ultrafine particulate matter and what happens to it, we have more to learn — and this is not my area of specialty, this is where I wish the UW team was here to talk to you, they’re much more articulate about this. It does sound like, when planes are 3,000 meters above us or below, that’s when we are seeing more air pollution fall down toward us. When they’re above the 3,000 meters, the air pollution tends to stay up above where the planes are and instead have an overall greenhouse effect rather than transmit down to us. But when the planes are lower than that 3,000 meters, then it is falling.
It’s interesting, because — you alluded to this — the air pollutants as they fall, they might recombine. So the hazardous air pollutants, the HAPs — things change in form, and that’s one of the reasons the UW wants to study concentrations and what makes up the air pollution and the particulate matter: to better understand how it’s changing as it falls downward. So I can’t tell you much more than that, because we need to study more to understand, but that’s a good question.
Language-access / Title VI question — speaker uncertain (likely Deputy Mayor Schilling; the chair cued “the deputy mayor” next, but the “no, it’s a question” interjection makes it unconfirmed) [1:24:50] Oh, I’m sorry — no, it’s a question. Yes. First of all, thank you very much for the information you’ve given. What I’m concerned about sometimes when I hear about the airport, living in the airport community — speaking of different languages, under Title VI, under the federal act, it talks about the rights that we have under the federal act of 1964. It says that English proficiency will be something that will not be a barrier when it comes to representing people in the community. And some of these reports that I’ve seen, I’ve just never seen them in a different language — and maybe I’m visiting them in the wrong place — but do you know anywhere else I could pick up this information, regardless if it’s in Vietnamese or Spanish, on being able to inform and educate some of the community around the airport that is not proficient in English?
Dr. Kris Johnson That’s a great point to bring up. We need to do more translation. And I’m remembering — I was listening to a community health worker talk during a listening session recently, and she was reminding me not to think about just interpreting it into different languages, but to make it accessible — English first, and then translate it into other languages — which is another valid point. I think you are right, we need to do more of that. The good news is, public health has some options for that. And I know one of the nonprofits in King County has put together a proposal for how to educate expecting mothers and families — has basically put together a project about proposing, how do we educate people about this and connect them to resources that already exist, like the asthma prevention or mitigation programs that exist in the county. So how do we make sure people have this information in lots of different languages and also know about services we can link them to. So I think you are right that the work needs to be done, and we have the help and can work on that in the next few months.
[Same speaker — Title VI question] Well, I would appreciate that, because I know that under Executive Order 13166, signed on August 11, 2000, the FAA says it’s reasonable for ensuring that limited-English-proficient individuals have meaningful access to the benefits and services of the airport receiving federal financial assistance. The FAA requires that airport sponsors identify possible limited English proficiency. And we can go on and on, but I just think this is long overdue. And being in an airport city, I would ask that the commissioners and the representatives of the airport continue to make this a priority. Although it costs money, at the end of the day, when we have the side effects of health impacts in our community, I think that does not have a price to it. So thank you very much, appreciate it.
Dr. Kris Johnson Thank you for the question and point.
Mayor Sofia Aragon Thank you. Any other questions for Dr. Johnson?
Closing comment — speaker uncertain (likely Mayor Aragon, given the health framing and that she had just opened the floor; could be another councilmember) [1:28:21] Well, thank you very much for your presentation. This is really important information to know. I’m really struck by the health disparities — particularly the one you noted for Black and African American moms for preterm birth — because that is a recognized health disparity nationwide. So it’s concerning if there are conditions that worsen that for that population.
Dr. Kris Johnson Yes, yes. Well, thank you for having me. Thank you.
Mayor Sofia Aragon [1:28:56] All right. So next on our agenda are council reports. Do any council members have anything to share? Okay, hearing none — the city manager’s report.
City Manager Adolfo Bailon [1:29:07] Thank you, Mayor. Just have a few items to share with council. The first is a request from the Port and from our StART committee. There is an effort to pull together what is being referred to as a “fly-in,” where member cities from StART visit Washington to essentially lobby on our own behalf — to make changes, to request improvements. The Port is requesting, if there is interest, to have two representatives from each city attend the fly-in. The proposed dates are mid-to-late April — I believe it is April 25th, 26th, and 27th. And I would like to ask if there are any members of council interested in attending; and if there are not two members interested, whether council is interested in having a staff member or two attend on their behalf.
Councilmember — speaker uncertain (one of the two who later volunteered, Moore or Schilling) [1:30:11] I’d be interested in attending. And also, for those of us who are going to the National League of Cities Congressional City Conference — we should set up meetings through our federal lobbyist, Mike Doubleday, to have meetings with Congressman Smith and Congresswoman Jayapal about this as well, because in previous lobbying Hill days we’ve done so. And that’s in March, so that’d be maybe a month before these fly-ins anyway, but it doesn’t hurt to keep us in front of people’s agendas.
Speaker uncertain [1:31:04] Is it possible for an Airport Committee member to attend, as well as potentially staff or a council member? And we do have a liaison to StART, also — I’m just throwing that out there, in terms of who should we be thinking about, given some of the folks have been pretty immersed for a while.
City Manager Adolfo Bailon [1:31:29] It is possible for the city to ask a member of committee to attend, or a representative to StART, that is not an employee or council. The challenge is reimbursement — they would have to travel on their own funding.
Mayor Sofia Aragon [1:31:46] Thank you, council member Sarah. [Confirmation re: availability — “should be able to swing the time” — appears to come from a councilmember here.] Great. So it looks like council member Sarah and Deputy Mayor Schilling are interested. Great, thank you both. I’ve taken note, and I will share your names with StART.