Review of the Primary National Ambient Air Quality Standards for Oxides of Nitrogen, 17226-17278 [2018-07741]
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Park, NC 27711; telephone: (919) 541–
2351; fax: (919) 541–0237; email:
alman.breanna@epa.gov.
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 50
[EPA–HQ–OAR–2013–0146; FRL–9976–78–
OAR]
RIN 2060–AR57
Review of the Primary National
Ambient Air Quality Standards for
Oxides of Nitrogen
Environmental Protection
Agency (EPA).
ACTION: Final action.
AGENCY:
Based on the Environmental
Protection Agency’s (EPA’s) review of
the air quality criteria addressing
human health effects of oxides of
nitrogen and the primary national
ambient air quality standards (NAAQS)
for oxides of nitrogen, as measured by
nitrogen dioxide (NO2), the EPA is
retaining the current standards, without
revision.
DATES: This final action is effective on
May 18, 2018.
ADDRESSES: The EPA has established a
docket for this action under Docket ID
No. EPA–HQ–OAR–2013–0146.
Incorporated into this docket is a
separate docket established for the
Integrated Science Assessment for this
review (Docket ID No. EPA–HQ–ORD–
2013–0232). All documents in these
dockets are listed on the
www.regulations.gov website. Although
listed in the index, some information is
not publicly available, e.g., CBI or other
information whose disclosure is
restricted by statute. Certain other
material, such as copyrighted material,
is not placed on the internet and will be
publicly available only in hard copy
form. It may be viewed, with prior
arrangement, at the EPA Docket Center.
Publicly available docket materials are
available either electronically in
www.regulations.gov or in hard copy at
the Air and Radiation Docket
Information Center, EPA/DC, WJC West
Building, Room 3334, 1301 Constitution
Ave. NW, Washington, DC. The Public
Reading Room is open from 8:30 a.m. to
4:30 p.m., Monday through Friday,
excluding legal holidays. The telephone
number for the Public Reading Room is
(202) 566–1744 and the telephone
number for the Air and Radiation
Docket Information Center is (202) 566–
1742.
FOR FURTHER INFORMATION CONTACT: Ms.
Breanna Alman, Health and
Environmental Impacts Division, Office
of Air Quality Planning and Standards,
U.S. Environmental Protection Agency,
Mail Code C504–06, Research Triangle
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SUMMARY:
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Availability of Information Related to
This Action
A number of the documents that are
relevant to this decision are available
through the EPA’s website at https://
www.epa.gov/naaqs/nitrogen-dioxideno2-primary-air-quality-standards.
These documents include the Integrated
Review Plan for the Primary National
Ambient Air Quality Standards for
Nitrogen Dioxide (U.S. EPA, 2011a),
available at https://www3.epa.gov/ttn/
naaqs/standards/nox/data/201406final
irpprimaryno2.pdf, the Integrated
Science Assessment for Oxides of
Nitrogen—Health Criteria (U.S. EPA,
2016a), available at https://cfpub.epa.
gov/ncea/isa/recordisplay.cfm?
deid=310879, and the Policy
Assessment for the Review of the
Primary National Ambient Air Quality
Standards for Oxides of Nitrogen (U.S.
EPA, 2017a), available at https://
www.epa.gov/naaqs/policy-assessmentreview-primary-national-ambient-airquality-standards-oxides-nitrogen.
These and other related documents are
also available for inspection and
copying in the EPA docket identified
above.
SUPPLEMENTARY INFORMATION:
Table of Contents
Executive Summary
I. Background
A. Legislative Requirements
B. Related NO2 Control Programs
C. Review of the Air Quality Criteria and
Standards for Oxides of Nitrogen
D. Summary of Proposed Decisions
E. Organization and Approach to Final
Decisions
II. Rationale for Decision on the Primary
Standards
A. Introduction
1. Characterization of NO2 Air Quality
2. Overview of the Health Effects Evidence
3. Overview of Risk and Exposure
Assessment Information
B. Conclusions on the Primary Standards
1. Basis for the Proposed Decision
2. The CASAC Advice in This Review
3. Comments on the Proposed Decision
4. Administrator’s Conclusions
C. Decision on the Primary Standards
III. Statutory and Executive Order Reviews
A. Executive Order 12866: Regulatory
Planning and Review and Executive
Order 13563: Improving Regulation and
Regulatory Review
B. Executive Order 13771: Reducing
Regulation and Controlling Regulatory
Costs
C. Paperwork Reduction Act (PRA)
D. Regulatory Flexibility Act (RFA)
E. Unfunded Mandates Reform Act
(UMRA)
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F. Executive Order 13132: Federalism
G. Executive Order 13175: Consultation
and Coordination With Indian Tribal
Governments
H. Executive Order 13045: Protection of
Children From Environmental Health
and Safety Risks
I. Executive Order 13211: Actions
Concerning Regulations That
Significantly Affect Energy Supply,
Distribution or Use
J. National Technology Transfer and
Advancement Act (NTTAA)
K. Executive Order 12898: Federal Actions
to Address Environmental Justice in
Minority Populations and Low-Income
Populations
L. Determination Under Section 307(d)
M. Congressional Review Act (CRA)
References
Executive Summary
This document describes the
completion of the EPA’s current review
of the primary NAAQS for oxides of
nitrogen, of which nitrogen dioxide
(NO2) is the component of greatest
concern for health and is the indicator
for the primary NAAQS. This review of
the standards and the air quality criteria
(the scientific information upon which
the standards are based) is required by
the Clean Air Act (CAA) on a periodic
basis. In conducting this review, the
EPA has carefully evaluated the
currently available scientific literature
on the health effects of NO2, focusing
particularly on the information newly
available since the conclusion of the last
review. This section briefly summarizes
background information about this
action and the Administrator’s decision
to retain the current primary NO2
standards. A full discussion of these
topics is provided later in this
document.
Summary of Background Information
There are currently two primary
standards for oxides of nitrogen: A 1hour standard established in 2010 at a
level of 100 parts per billion (ppb) based
on the 98th percentile of the annual
distribution of daily maximum 1-hour
NO2 concentrations, averaged over 3
years, and an annual standard,
originally set in 1971, at a level of 53
ppb based on annual average NO2
concentrations.
Sections 108 and 109 of the CAA
govern the establishment, review, and
revision, as appropriate, of the NAAQS
to protect public health and welfare.
The CAA requires the EPA to
periodically review the air quality
criteria—the science upon which the
standards are based—and the standards
themselves. This review of the primary
(health-based) NO2 NAAQS is being
conducted pursuant to these statutory
requirements. The schedule for
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completing this review is established by
a federal court order, which requires
signature of a notice setting forth the
EPA’s final decision by April 6, 2018.
The last review of the primary NO2
NAAQS was completed in 2010. In that
review, the EPA supplemented the
existing primary annual NO2 standard
by establishing a new short-term
standard with a level of 100 ppb, based
on the 3-year average of the 98th
percentile of the annual distribution of
daily maximum 1-hour concentrations
(75 FR 6474, February 9, 2010).
Revisions to the NAAQS were
accompanied by revisions to the data
handling procedures and the ambient
air monitoring and reporting
requirements, including the
establishment of requirements for states
to locate monitors near heavily
trafficked roadways in large urban areas
and in other locations where maximum
NO2 concentrations can occur.
Consistent with the review completed
in 2010, this review is focused on the
health effects associated with gaseous
oxides of nitrogen and on the protection
afforded by the primary NO2 standards.
The gaseous oxides of nitrogen include
NO2 and nitric oxide (NO), as well as
their gaseous reaction products. Total
oxides of nitrogen include these gaseous
species as well as particulate species
(e.g., nitrates). The EPA is separately
considering the health and nonecological welfare effects of particulate
species in the review of the NAAQS for
particulate matter (PM) (U.S. EPA,
2016b). In addition, the EPA is
separately reviewing the welfare effects
associated with NOX and SOX and the
ecological welfare effects associated
with PM. (U.S. EPA, 2017b).
Summary of Decision
In this action, the EPA is retaining the
current primary NO2 standards, without
revision. This decision has been
informed by a careful consideration of
the full body of scientific evidence and
information available in this review,
giving particular weight to the
assessment of the evidence in the 2016
NOX Integrated Science Assessment
(ISA); analyses and considerations in
the Policy Assessment (PA); the advice
and recommendations of the Clean Air
Scientific Advisory Committee
(CASAC); and public comments.
Based on these considerations, the
Administrator reaches the conclusion
that the current body of scientific
evidence and the results of quantitative
analyses supports his judgment that the
current 1-hour and annual primary NO2
standards, together, are requisite to
protect public health with an adequate
margin of safety, and do not call into
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question any of the elements of those
standards. These conclusions are
consistent with the CASAC
recommendations. In its advice to the
Administrator, the CASAC
‘‘recommend[ed] retaining, and not
changing the existing suite of
standards’’ (Diez Roux and Sheppard,
2017). The CASAC further stated that ‘‘it
is the suite of the current 1-hour and
annual standards, together, that provide
protection against adverse effects’’ (Diez
Roux and Sheppard, 2017, p. 9).
Therefore, in this review, the EPA is
retaining the current 1-hour and annual
NO2 primary standards, without
revision.
As in the last review, the strongest
evidence continues to come from
studies examining respiratory effects
following short-term NO2 exposures.1 In
particular, the 2016 NOX ISA concludes
that ‘‘[a] causal relationship exists
between short-term NO2 exposure and
respiratory effects based on evidence for
asthma exacerbation’’ (U.S. EPA, 2016a,
p. 1–17). The strongest support for this
conclusion comes from controlled
human exposure studies examining the
potential for NO2-induced increases in
airway responsiveness (AR) (which is a
hallmark of asthma) in individuals with
asthma. Additional supporting evidence
comes from epidemiologic studies
reporting associations between shortterm NO2 exposures and an array of
respiratory outcomes related to asthma
exacerbation (e.g., asthma-related
hospital admissions and emergency
department (ED) visits in children and
adults).
In addition to the effects of short-term
exposures, the 2016 NOX ISA concludes
that there is ‘‘likely to be a causal
relationship’’ between long-term NO2
exposures and respiratory effects, based
on the evidence for asthma development
in children. The strongest evidence
supporting this conclusion comes from
recent epidemiologic studies
demonstrating associations between
long-term NO2 exposures and asthma
incidence. Additional support comes
from experimental studies supporting
the biological plausibility of a potential
mode of action by which NO2 exposures
could cause asthma development.
While the evidence supports the
occurrence of adverse NO2-related
respiratory effects at ambient NO2
concentrations likely to have been above
those allowed by the current primary
NO2 NAAQS, that evidence, together
with analyses of the potential for NO2
1 The 2016 NO ISA defines short-term exposures
X
as those with durations of minutes up to 1 month,
with most studies examining effects related to
exposures in the range of 1 hour to 1 week (U.S.
EPA, 2016a, p. 1–15).
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exposures, does not call into question
the adequacy of the public health
protection provided by the current
standards. In particular, compared to
the last review when the 1-hour
standard was set, evidence from
controlled human exposure studies has
not altered our understanding of the
NO2 exposure concentrations that cause
increased AR. Analyses based on
information from these studies indicate
that the current standards provide
protection against the potential for NO2
exposures that could increase AR in
people with asthma. In addition, while
epidemiologic studies report relatively
precise associations with serious NO2related health outcomes (i.e., ED visits,
hospital admissions, asthma incidence)
in locations likely to have violated the
current 1-hour and/or annual standards
during portions of study periods,
studies do not indicate such
associations in locations with NO2
concentrations that would have clearly
met those standards.
After considering the current body of
scientific evidence, the results of
quantitative analyses, the CASAC
advice, and public comments, the
Administrator concludes that the
current 1-hour and annual NO2 primary
standards, together, are requisite to
protect public health with an adequate
margin of safety. Therefore, in this
review, the EPA is retaining the current
1-hour and annual NO2 primary
standards, without revision.
I. Background
A. Legislative Requirements
Two sections of the Clean Air Act
(CAA or the Act) govern the
establishment and revision of the
NAAQS. Section 108 (42 U.S.C. 7408)
directs the Administrator to identify and
list certain air pollutants and then to
issue air quality criteria for those
pollutants. The Administrator is to list
those air pollutants that in his
‘‘judgment, cause or contribute to air
pollution which may reasonably be
anticipated to endanger public health or
welfare;’’ ‘‘the presence of which in the
ambient air results from numerous or
diverse mobile or stationary sources;’’
and ‘‘for which . . . [the Administrator]
plans to issue air quality criteria . . . .’’
Air quality criteria are intended to
‘‘accurately reflect the latest scientific
knowledge useful in indicating the kind
and extent of all identifiable effects on
public health or welfare which may be
expected from the presence of [a]
pollutant in the ambient air . . . .’’ 42
U.S.C. 7408(b). Section 109 (42 U.S.C.
7409) directs the Administrator to
propose and promulgate ‘‘primary’’ and
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‘‘secondary’’ NAAQS for pollutants for
which air quality criteria are issued.
Section 109(b)(1) defines a primary
standard as one ‘‘the attainment and
maintenance of which in the judgment
of the Administrator, based on such
criteria and allowing an adequate
margin of safety, [is] requisite to protect
the public health.’’ 2 A secondary
standard, as defined in section
109(b)(2), must ‘‘specify a level of air
quality the attainment and maintenance
of which, in the judgment of the
Administrator, based on such criteria, is
requisite to protect the public welfare
from any known or anticipated adverse
effects associated with the presence of
[the] pollutant in the ambient air.’’ 3
The requirement that primary
standards provide an adequate margin
of safety was intended to address
uncertainties associated with
inconclusive scientific and technical
information available at the time of
standard setting. It was also intended to
provide a reasonable degree of
protection against hazards that research
has not yet identified. See Lead
Industries Association v. EPA, 647 F.2d
1130, 1154 (D.C. Cir. 1980); American
Petroleum Institute v. Costle, 665 F.2d
1176, 1186 (D.C. Cir. 1981); American
Farm Bureau Federation v. EPA, 559
F.3d 512, 533 (D.C. Cir. 2009);
Association of Battery Recyclers v. EPA,
604 F.3d 613, 617–18 (D.C. Cir. 2010).
Both kinds of uncertainties are
components of the risk associated with
pollution at levels below those at which
human health effects can be said to
occur with reasonable scientific
certainty. Thus, in selecting primary
standards that provide an adequate
margin of safety, the Administrator is
seeking not only to prevent pollution
levels that have been demonstrated to be
harmful but also to prevent lower
pollutant levels that may pose an
unacceptable risk of harm, even if the
risk is not precisely identified as to
nature or degree. The CAA does not
require the Administrator to establish a
primary NAAQS at a zero-risk level, see
Lead Industries Association, 647 F.2d at
2 The legislative history of section 109 indicates
that a primary standard is to be set at ‘‘the
maximum permissible ambient air level . . . which
will protect the health of any [sensitive] group of
the population,’’ and that for this purpose
‘‘reference should be made to a representative
sample of persons comprising the sensitive group
rather than to a single person in such a group.’’ See
S. Rep. No. 91–1196, 91st Cong., 2d Sess. 10 (1970).
3 As specified in section 302(h) (42 U.S.C.
7602(h)) effects on welfare include, but are not
limited to, ‘‘effects on soils, water, crops,
vegetation, man-made materials, animals, wildlife,
weather, visibility and climate, damage to and
deterioration of property, and hazards to
transportation, as well as effects on economic
values and on personal comfort and well-being.’’
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1156 n.51, but rather at a level that
reduces risk sufficiently so as to protect
public health with an adequate margin
of safety.
In addressing the requirement for an
adequate margin of safety, the EPA
considers such factors as the nature and
severity of the health effects involved,
the size of sensitive population(s) at
risk,4 and the kind and degree of the
uncertainties that must be addressed.
The selection of any particular approach
to providing an adequate margin of
safety is a policy choice left specifically
to the Administrator’s judgment. See
Lead Industries Association v. EPA, 647
F.2d at 1161–62.
In setting primary and secondary
standards that are ‘‘requisite’’ to protect
public health and welfare, respectively,
as provided in section 109(b), the EPA’s
task is to establish standards that are
neither more nor less stringent than
necessary for these purposes. In so
doing, the EPA may not consider the
costs of implementing the standards.
See generally, Whitman v. American
Trucking Associations, 531 U.S. 457,
465–472, 475–76 (2001). Likewise,
‘‘[a]ttainability and technological
feasibility are not relevant
considerations in the promulgation of
national ambient air quality standards.’’
American Petroleum Institute v. Costle,
665 F.2d at 1185.
Section 109(d)(1) requires that ‘‘not
later than December 31, 1980, and at 5year intervals thereafter, the
Administrator shall complete a
thorough review of the criteria
published under section 108 and the
national ambient air quality standards
. . . and shall make such revisions in
such criteria and standards and
promulgate such new standards as may
be appropriate . . . .’’ Section 109(d)(2)
requires that an independent scientific
review committee ‘‘shall complete a
review of the criteria . . . and the
national primary and secondary ambient
air quality standards . . . and shall
recommend to the Administrator any
new . . . standards and revisions of
existing criteria and standards as may be
appropriate . . . .’’ Since the early
1980s, this independent review function
has been performed by the Clean Air
Scientific Advisory Committee
(CASAC).5
4 As used here and similarly throughout this
document, the term population (or group) refers to
persons having a quality or characteristic in
common, such as a specific pre-existing illness or
a specific age or lifestage.
5 Lists of the CASAC members and members of
the NO2 Review Panel are available at: https://
yosemite.epa.gov/sab/sabproduct.nsf/WebCASAC/
CommitteesandMembership?OpenDocument.
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B. Related NO2 Control Programs
States are primarily responsible for
ensuring attainment and maintenance of
ambient air quality standards once the
EPA has established them. Under
section 110 of the Act, 42 U.S.C. 7410,
and related provisions, states are to
submit, for the EPA’s approval, state
implementation plans (SIPs) that
provide for the attainment and
maintenance of such standards through
control programs directed to sources of
the pollutants involved. The states, in
conjunction with the EPA, also
administer the Prevention of Significant
Deterioration permitting program that
covers these pollutants. See 42 U.S.C.
7470–7479. In addition, federal
programs provide for nationwide
reductions in emissions of these and
other air pollutants under Title II of the
Act, 42 U.S.C. 7521–7574, which
involves controls for automobile, truck,
bus, motorcycle, nonroad engine and
equipment, and aircraft emissions; the
new source performance standards
(NSPS) under section 111 of the Act, 42
U.S.C. 7411; and the national emission
standards for hazardous air pollutants
under section 112 of the Act, 42 U.S.C.
7412.
Currently there are no areas in the
United States that are designated as
nonattainment for the NO2 NAAQS (see
77 FR 9532 (February 17, 2012)). In
addition, there are currently no
monitors where there are design values
(DVs) 6 above either the 1-hour or
annual standard (U.S. EPA, 2017a,
Figure 2–5), with the maximum DVs in
2015 being 30 ppb (annual) and 72 ppb
(hourly) (U.S. EPA, 2017a Section,
2.3.1).
While NOX 7 is emitted from a wide
variety of source types, the top three
categories of sources of NOX emissions
are highway vehicles, off-highway
vehicles, and stationary fuel combustion
sources.8 The EPA anticipates that NOX
6 The metric used to determine whether areas
meet or exceed the NAAQS is called a design value
(DV). In the case of the primary NO2 NAAQS, there
are 2 types of DVs: The annual DV and the hourly
DV. The annual DV for a particular year is the
average of all hourly values within that calendar
year. The hourly DV is the three-year average of the
98th percentiles of the annual distributions of daily
maximum 1-hour NO2 concentrations. The
requirements for calculating DVs for the primary
NO2 NAAQS from valid monitoring data are further
specified in Appendix S to Part 50.
7 In this context, NO refers to the sum of NO and
X
NO2, as is common within air pollution research
and control communities. However, in the larger
context of this NAAQS review, the terms ‘‘oxides
of nitrogen’’ and ‘‘nitrogen oxides’’ generally refer
more broadly to gaseous oxides of nitrogen, which
include NO2 and NO, as well as their gaseous
reaction products.
8 Highway vehicles include all on-road vehicles,
including light duty as well as heavy duty vehicles,
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emissions will continue to decrease over
the next 20 years. For example, Tier 2
and Tier 3 emission standards for new
light-duty vehicles, combined with the
reduction of gasoline sulfur content,
will significantly reduce motor vehicle
emissions of NOX, with Tier 3 standards
phasing in from model year 2017 to
model year 2025. For heavy-duty
engines, new NOX standards were
phased in between the 2007 and 2010
model years, following the introduction
of ultra-low sulfur diesel fuel. More
stringent NOX standards for non-road
diesel engines, locomotives, and certain
marine engines are becoming effective
throughout the next decade. In future
decades, these vehicles and engines
meeting more stringent NOX standards
will become an increasingly large
fraction of in-use mobile sources,
leading to large NOX emission
reductions.9
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C. Review of the Air Quality Criteria and
Standards for Oxides of Nitrogen
In 1971, the EPA added oxides of
nitrogen to the list of criteria pollutants
under section 108(a)(1) of the CAA and
issued the initial air quality criteria (36
FR 1515, January 30, 1971; U.S. EPA,
1971). Based on these air quality
criteria, the EPA promulgated the NO2
NAAQS (36 FR 8186, April 30, 1971).
Both primary and secondary standards
were set at 53 ppb,10 annual average.
Since then, the Agency has completed
multiple reviews of the air quality
criteria and primary NO2 standards. In
the last review, the EPA made revisions
to the primary NO2 NAAQS in order to
provide requisite protection of public
health. Specifically, the EPA
supplemented the existing primary
annual NO2 standard by establishing a
new short-term standard with a level of
100 ppb, based on the 3-year average of
the 98th percentile of the annual
distribution of daily maximum 1-hour
concentrations (75 FR 6474, February 9,
2010). In addition, revisions to the
NAAQS were accompanied by revisions
to the data handling procedures and the
both gasoline- and diesel-powered, and on-highway
motorcycles. Off-highway engines, vehicles and
equipment include aircraft, marine vessels,
locomotives, off-highway motorcycles, recreational
vehicles and other non-road products (e.g.,
lawnmowers, portable generators, chainsaws,
forklifts). Fuel combustion sources includes electric
power generating units (EGUs), which derive their
power generation from all types of fuels.
9 Reductions in ambient NO concentrations
2
could also result from the implementation of
NAAQS for other pollutants (e.g., ozone, PM), to the
extent NOX emissions are reduced as part of the
implementation of those standards.
10 In 1971, primary and secondary NO NAAQS
2
were set at levels of 100 micrograms per cubic
meter (mg/m3), which equals 0.053 parts per million
(ppm) or 53 ppb.
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ambient air monitoring and reporting
requirements, including requirements
for states to locate monitors near heavily
trafficked roadways in large urban areas
and in other locations where maximum
NO2 concentrations can occur.
Industry groups filed petitions for
judicial review of the 2010 rule in the
U.S. Court of Appeals for the District of
Columbia Circuit. API v. EPA, 684 F.3d
1342 (D.C. Cir. 2012). The court upheld
the 2010 rule, denying the petitions’
challenges to the adoption of the 1-hour
NO2 NAAQS and dismissing, for lack of
jurisdiction, the challenges to
statements regarding permitting in the
preamble of the 2010 rule. Id. at 1354.
Subsequent to the 2010 rulemaking,
the Agency revised the deadlines by
which the near-road monitors were to be
operational in order to implement a
phased deployment approach (78 FR
16184, March 14, 2013), with a majority
of the network becoming operational by
2015. In 2016, after analyzing available
monitoring data, the Agency revised the
size requirements of the near-road
network, reducing the network to only
operate in Core Based Statistical Areas
(CBSAs) with populations of 1 million
or more (81 FR 96381, December 30,
2016).
In February 2012, the EPA announced
the initiation of the current periodic
review of the air quality criteria for
oxides of nitrogen and of the primary
NO2 NAAQS and issued a call for
information in the Federal Register (77
FR 7149, February 10, 2012). A wide
range of external experts as well as the
EPA staff representing a variety of areas
of expertise (e.g., epidemiology, human
and animal toxicology, statistics, risk/
exposure analysis, atmospheric science,
and biology) participated in a workshop
held by the EPA on February 29 to
March 1, 2012, in Research Triangle
Park, NC. The workshop provided an
opportunity for a public discussion of
the key policy-relevant issues around
which the Agency would structure this
primary NO2 NAAQS review and the
most meaningful new science that
would be available to inform the EPA’s
understanding of these issues.
Based in part on the workshop
discussions, the EPA developed a draft
plan for the NOX ISA and subsequently
a draft Integrated Review Plan (IRP)
outlining the schedule, process, and key
policy-relevant questions that would
guide the evaluation of the healthrelated air quality criteria for NO2 and
the review of the primary NO2 NAAQS.
The draft plan for the NOX ISA was
released in May 2013 (78 FR 26026) and
was the subject of a consultation with
the CASAC on June 5, 2013 (78 FR
27234). Comments from the CASAC and
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the public were considered in the
preparation of the first draft ISA and the
draft IRP. In addition, preliminary draft
materials for the NOX ISA were
reviewed by subject matter experts at a
public workshop hosted by the EPA’s
National Center for Environmental
Assessment (NCEA) in May 2013 (78 FR
27374). The first draft ISA was released
in November 2013 (78 FR 70040).
During this time, the draft IRP was also
in preparation and was released in
February 2014 (79 FR 7184). Both the
draft IRP and first draft ISA were
reviewed by the CASAC at a public
meeting held in March 2014 (79 FR
8701), and the first draft ISA was further
discussed at an additional
teleconference held in May 2014 (79 FR
17538). The CASAC finalized its
recommendations on the first draft ISA
and the draft IRP in letters dated June
10, 2014 (Frey, 2014a; Frey, 2014b), and
the final IRP was released in June 2014
(79 FR 36801).
The EPA released the second draft
ISA in January 2015 (80 FR 5110) and
the Risk and Exposure Assessment
(REA) Planning document in May 2015
(80 FR 27304). These documents were
reviewed by the CASAC at a public
meeting held in June 2015 (80 FR
22993). A follow-up teleconference with
the CASAC was held in August 2015 (80
FR 43085) to finalize recommendations
on the second draft ISA. The final ISA
was released in January 2016 (81 FR
4910). The CASAC recommendations on
the second draft ISA and the draft REA
planning document were provided to
the EPA in letters dated September 9,
2015 (Diez Roux and Frey, 2015a; Diez
Roux and Frey, 2015b), and the final
ISA was released in January 2016 (81 FR
4910).
After considering the CASAC advice
and public comments, the EPA prepared
a draft Policy Assessment (PA), which
was released on September 23, 2016 (81
FR 65353). The draft PA was reviewed
by the CASAC on November 9–10, 2016
(81 FR 68414), and a follow-up
teleconference was held on January 24,
2017 (81 FR 95137). The CASAC
recommendations, based on its review
of the draft PA, were provided in a letter
to the EPA Administrator dated March
7, 2017 (Diez Roux and Sheppard,
2017). The EPA staff took into account
these recommendations, as well as
public comments provided on the draft
PA, when developing the final PA,
which was released in April 2017.11
11 This document may be found at: https://
www.epa.gov/naaqs/policy-assessment-reviewprimary-national-ambient-air-quality-standardsoxides-nitrogen.
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On July 14, 2017, the proposed
decision to retain the NO2 NAAQS was
signed, and it was published in the
Federal Register on July 26 (82 FR
34792). The 60-day comment period
ended on September 25, 2017, and
comments were received from various
government, industry, and
environmental groups, as well as
members of the general public.
In addition, in July 2016, a lawsuit
was filed against the EPA that included
a claim that EPA had failed to complete
its review of the primary NO2 NAAQS
within five years, as required by the
CAA. Center for Biological Diversity et
al. v. McCarthy, (No. 4:16–cv–03796–
VC, N.D. Cal., July 7, 2016). Consistent
with CAA section 113(g), a notice of a
proposed consent decree to resolve this
litigation was published in the Federal
Register on January 17, 2017 (82 FR
4866). The EPA received two public
comments on the proposed consent
decree, neither of which disclosed facts
or considerations indicating that the
Department of Justice or the EPA should
withhold consent.12 The parties to the
litigation filed a joint motion asking the
court to enter the consent decree, and
the court entered the consent decree as
a consent judgment on April 28, 2017.
The consent judgment established July
14, 2017 as the deadline for signature of
a notice setting forth the proposed
decision in this review and April 6,
2018 as the deadline for signature of a
notice setting forth the final decision.
Consistent with the review completed
in 2010, this review is focused on health
effects associated with gaseous oxides of
nitrogen 13 and the protection afforded
by the primary NO2 standards. The
gaseous oxides of nitrogen include NO2
and NO, as well as their gaseous
reaction products. Total oxides of
nitrogen include these gaseous species
as well as particulate species (e.g.,
nitrates). Health effects and nonecological welfare effects associated
with the particulate species are
addressed in the review of the NAAQS
for PM (U.S. EPA, 2016b).14 The EPA is
separately reviewing the welfare effects
associated with NOX and SOX and the
12 One comment was received from the American
Petroleum Institute (API) and one was received
from an anonymous commenter. These comments
are available in the docket for the proposed consent
decree (EPA–HQ–OGC–2016–0719).
13 These gaseous oxides of nitrogen can also be
referred to as ‘‘nitrogen oxides’’ and include a broad
category of gaseous oxides of nitrogen (i.e., oxidized
nitrogen compounds), including NO2, NO, and their
various reaction products.
14 Additional information on the PM NAAQS is
available at: https://www.epa.gov/naaqs/
particulate-matter-pm-air-quality-standards.
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ecological welfare effects associated
with PM. (U.S. EPA, 2017a).15
D. Summary of Proposed Decisions
For reasons discussed in the proposal
and summarized in section II.B.1 below,
the Administrator proposed to retain the
current primary standards for NO2,
without revision.
E. Organization and Approach to Final
Decisions
This action presents the
Administrator’s final decision in the
current review of the primary NO2
standards. The final decision addressing
the primary NO2 standards is based on
a thorough review in the 2016 NOX ISA
of scientific information on known and
potential human health effects
associated with exposure to NO2
associated with levels typically found in
the ambient air. This final decision also
takes into account the following: (1)
Staff assessments in the PA of the most
policy-relevant information in the ISA,
as well as quantitative exposure and risk
information; (2) the CASAC advice and
recommendations, as reflected in its
letters to the Administrator and its
discussions of drafts of the ISA and PA
at public meetings; (3) public comments
received during the development of
these documents, both in connection
with the CASAC meetings and
separately; and (4) public comments
received on the proposal. The primary
NO2 standards are addressed in section
II below. Section III addresses statutory
and executive order reviews.
II. Rationale for Decision on the
Primary Standards
This section presents the rationale for
the Administrator’s decision to retain
the existing primary NO2 standards.
This rationale is based on a thorough
review in the 2016 NOX ISA of the latest
scientific information, generally
published through August 2014, on
human health effects associated with
NO2 and pertaining to the presence of
NO2 in the ambient air. This decision
also takes into account: (1) The PA’s
staff assessments of the most policyrelevant information in the ISA and staff
analyses of air quality, human exposure
and health risks, upon which staff
conclusions regarding appropriate
considerations in this review are based;
(2) the CASAC advice and
recommendations, as reflected in
discussions of drafts of the ISA and PA
at public meetings, in separate written
15 Additional information on the ongoing and
previous review of the secondary NO2 and SO2
NAAQS is available at: https://www.epa.gov/naaqs/
nitrogen-dioxide-no2-and-sulfur-dioxide-so2secondary-air-quality-standards.
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comments, and in the CASAC letters to
the Administrator; (3) public comments
received during the development of
these documents, either in connection
with the CASAC meetings or separately;
and (4) public comments received on
the proposal. Section II.A provides
background on the general approach for
review of the primary NO2 standards
and brief summaries of key aspects of
the currently available air quality
information, as well as health effects
and exposure/risk information. Section
II.B presents the Administrator’s
conclusions on the adequacy of the
current primary NO2 standards, drawing
on consideration of this information,
advice from the CASAC, and comments
from the public. Section II.C
summarizes the Administrator’s
decision on the primary NO2 standards.
A. Introduction
The Administrator’s approach to
reviewing the current primary NO2
standards is based, most fundamentally,
on using the EPA’s assessment of the
current scientific evidence and
associated quantitative analyses to
inform his judgment regarding primary
NO2 standards that protect public health
with an adequate margin of safety. In
drawing conclusions with regard to the
primary standards, the final decision on
the adequacy of the current standards is
largely a public health policy judgment
to be made by the Administrator. The
Administrator’s final decision draws
upon scientific information and
analyses about health effects,
population exposure and risks, as well
as judgments about how to consider the
range and magnitude of uncertainties
that are inherent in the scientific
evidence and analyses.
The approach to informing these
judgments is based on the recognition
that the available health effects evidence
generally reflects a continuum,
consisting of levels at which scientists
generally agree that health effects are
likely to occur, through lower levels at
which the likelihood and magnitude of
the response become increasingly
uncertain. This approach is consistent
with the requirements of the NAAQS
provisions of the Act and with how the
EPA and the courts have historically
interpreted the Act. These provisions
require the Administrator to establish
primary standards that, in the judgment
of the Administrator, are requisite to
protect public health with an adequate
margin of safety. In so doing, the
Administrator seeks to establish
standards that are neither more nor less
stringent than necessary for this
purpose. The Act does not require that
primary standards be set at a zero-risk
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level, but rather at a level that avoids
unacceptable risks to public health
including the health of sensitive groups.
The four basic elements of the NAAQS
(indicator, averaging time, level, and
form) are considered collectively in
evaluating the health protection
afforded by the current standards.
To evaluate whether it is appropriate
to consider retaining the current
primary NO2 standards, or whether
consideration of revision is appropriate,
the EPA has adopted an approach in
this review that builds upon the general
approach used in the last review and
reflects the broader body of evidence
and information now available. The
Administrator’s decisions in the prior
review were based on an integration of
information on health effects associated
with exposure to NO2 with information
on the public health significance of key
health effects, as well as on policy
judgments as to when the standard is
requisite to protect public health with
an adequate margin of safety and advice
from the CASAC and public comments.
These considerations were informed by
air quality and related analyses and
quantitative exposure and risk
information. Similarly, in this review, as
described in the PA, the proposal, and
elsewhere in this document, we draw on
the current evidence and quantitative
assessments of exposure pertaining to
the public health risk of NO2 in ambient
air. In considering the scientific and
technical information here, as in the PA,
we consider both the information
available at the time of the last review
and information newly available since
the last review, including most
particularly that which has been
critically analyzed and characterized in
the current ISA. In considering the
entire body of evidence presented in the
current ISA, as in the PA and as in the
last review, we focus particularly on
those health endpoints for which the
ISA finds associations with NO2 to be
causal or likely causal. The evidencebased discussions presented below draw
upon evidence from both controlled
human exposure studies and
epidemiologic studies. Sections II.A.1
through II.A.3 below provide an
overview of the current NO2 air quality,
health effects, and quantitative exposure
and risk information with a focus on the
specific policy-relevant questions
identified for these categories of
information in the PA (U.S. EPA, 2017a,
Chapter 3).
1. Characterization of NO2 Air Quality
This section presents information on
NO2 atmospheric chemistry and
ambient concentrations, with a focus on
information that is most relevant for the
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review of the primary NO2 standards.
This section is drawn from the more
detailed discussion of NO2 air quality in
the PA (U.S. EPA, 2017a, Chapter 2) and
the 2016 NOX ISA (U.S. EPA, 2016a,
Chapter 2).16 It presents a summary of
NO2 atmospheric chemistry (section
II.A.1.a), trends in ambient NO2
concentrations (section II.A.1.b),
ambient NO2 concentrations measured
at monitors near roads (section II.A.1.c),
the relationships between hourly and
annual ambient NO2 concentrations
(section II.A.1.d), and background
concentrations of NO2 (section II.A.1.e).
a. Atmospheric Chemistry
Ambient concentrations of NO2 are
influenced by both direct NO2 emissions
and by emissions of NO, with the
subsequent conversion of NO to NO2
primarily though reaction with ozone
(O3). The initial reaction between NO
and O3 to form NO2 occurs fairly
quickly during the daytime, with
reaction times on the order of minutes.
However, NO2 can also be photolyzed to
regenerate NO, creating new O3 in the
process (U.S. EPA, 2016a, Section 2.2).
A large number of oxidized nitrogen
species in the atmosphere are formed
from the oxidation of NO and NO2.
These include nitrate radicals (NO3),
nitrous acid (HONO), nitric acid
(HNO3), dinitrogen pentoxide (N2O5),
nitryl chloride (ClNO2), peroxynitric
acid (HNO4), peroxyacetyl nitrate and
its homologues (PANs), other organic
nitrates, such as alkyl nitrates
(including isoprene nitrates), and pNO3.
The sum of these reactive oxidation
products and NO plus NO2 comprise the
oxides of nitrogen.17 18
Due to the close relationship between
NO and NO2, and their ready
interconversion, these species are often
grouped together and referred to as
NOX. The majority of NOX emissions are
in the form of NO. For example, 90% or
more of tail-pipe NOX emissions are in
the form of NO, with only about 2% to
10% emitted as NO2 (Itano et al., 2014;
Kota et al., 2013; Jimenez et al., 2000;
16 The focus is on NO in this document, as this
2
is the indicator for the current standards and is
most relevant to the evaluation of health evidence.
Characterization of air quality for the broader
category of oxides of nitrogen is provided in the
2016 NOX ISA (U.S. EPA, 2016a, Chapter 2).
17 This follows usages in Clean Air Act section
108(c): ‘‘Such criteria [for oxides of nitrogen] shall
include a discussion of nitric and nitrous acids,
nitrites, nitrates, nitrosamines, and other
carcinogenic and potentially carcinogenic
derivatives of oxides of nitrogen.’’ By contrast,
within air pollution research and control
communities, the terms ‘‘nitrogen oxides’’ and NOX
are often restricted to refer only to the sum of NO
and NO2.
18 See Figure 2–1 of the NO PA for additional
2
information (U.S. EPA, 2017a).
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17231
Richmond-Bryant et al., 2016). NOX
emissions require time and sufficient O3
concentrations for the conversion of NO
to NO2. Higher temperatures and
concentrations of reactants result in
shorter conversion times (e.g., less than
one minute under some conditions),
while dispersion and depletion of
reactants result in longer conversion
times. The time required to transport
emissions away from a roadway can
vary from less than one minute (e.g.,
under open conditions) to about one
hour (e.g., for certain urban street
¨
canyons) (During et al., 2011;
Richmond-Bryant and Reff, 2012). These
factors can affect the locations where
the highest NO2 concentrations occur. In
particular, while ambient NO2
concentrations are often elevated near
important sources of NOX emissions,
such as major roadways, the highest
measured ambient concentrations in a
given urban area may not always occur
immediately adjacent to those sources.19
b. National Trends in NOX Emissions
and Ambient NO2 Concentrations
Ambient concentrations of NO2 in the
U.S. are due largely to NOX emissions
from anthropogenic sources.
Background NO2 is estimated to make
up only a small fraction of current
ambient concentrations (U.S. EPA,
2016a, Section 2.5.6; U.S. EPA, 2017a,
Section 2.3.4).20 Nationwide estimates
indicate that there has been a 61%
reduction in total NOX emissions from
1980 to 2016 (U.S. EPA, 2017a, Section
2.1.2, Figure 2–2). These reductions
have been driven primarily by decreases
in emissions from mobile sources and
fuel combustion (U.S. EPA, 2017a,
Section 2.1.2, Figure 2–3).
Long-term trends in NO2 DVs across
the U.S. show that ambient
concentrations of NO2 have been
declining, on average, since 1980 (U.S.
EPA, 2017a, Figure 2–4). Data have been
collected for at least some part of the
period since 1980 at 2099 sites in the
U.S., with individual sites having a
wide range in duration and continuity
of operations across multiple decades.
Overall, the majority of sampling sites
have observed statistically significant
downward trends in ambient NO2
19 Ambient NO concentrations around stationary
2
sources of NOX emissions are similarly impacted by
the availability of O3 and by meteorological
conditions, although surface-level NO2
concentrations can be less impacted in cases where
stationary source NOX emissions are emitted from
locations elevated substantially above ground level.
20 Background concentrations of a pollutant can
be defined in various ways, depending on context
and circumstances. Background concentrations of
NO2 are discussed in the 2016 NOX ISA (U.S. EPA,
2016a, Section 2.5.6) and the PA (U.S. EPA, 2017a,
Section 2.3.4).
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concentrations (U.S. EPA, 2017a, Figure
2–5).21 The annual and hourly DVs
trended upward in less than 4% of the
sites.22 Even considering the fact that
there are a handful of sites where
upward trends in NO2 concentrations
have occurred, the maximum DVs in
2015 across the whole monitoring
network were well below the NAAQS,
with the highest values being 30 ppb
(annual) and 72 ppb (hourly) (U.S. EPA,
2017a, Section 2.3.1).
c. Near-Road NO2 Air Quality
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The largest single source of NOX
emissions is on-road vehicles, and
emissions are primarily in the form of
NO, with NO2 formation requiring both
time and sufficient O3 concentrations.
Depending on local meteorological
conditions and O3 concentrations,
ambient NO2 concentrations can be
higher near roadways than at sites in the
same area but farther removed from the
road (and from other sources of NOX
emissions).
When considering the historical
relationships between NO2
concentrations at monitors near
roadways and monitors farther away
from roads, NO2 DVs are generally
highest at sampling sites nearest to the
road (less than 50 meters) and decrease
as distance from the road increases (U.S.
EPA, 2017a, Section 2.3.2, Figure 2–6).
This relationship is more pronounced
for annual DVs than for hourly DVs. The
general pattern of decreasing DVs with
increasing distance from the road has
persisted over time, though the absolute
difference (in terms of ppb) between
NO2 concentrations close to roads and
those farther from roads has generally
decreased over time (U.S. EPA, 2017a,
Section 2.3.2, Figure 2–6).
In addition, data from the recently
deployed network 23 of dedicated nearroad NO2 monitors indicate that daily
maximum 1-hour NO2 concentrations
are generally higher at near-road
monitors than at non-near-road
monitors in the same CBSA (U.S. EPA,
2017a, Figures 2–7 to 2–10). The 98th
percentiles of 1-hour daily maximum
concentrations (the statistic most
relevant to the 1-hour standard) were
highest at near-road monitors (i.e.,
higher than all non-near-road monitors
in the same CBSA) in 58% to 77% of the
21 Based on an analysis of data from sampling
sites with sufficient data to produce at least five
valid DVs.
22 It is not clear what specific sources may be
responsible for the upward trends in ambient NO2
concentrations at these sites. (See U.S. EPA, 2017a,
Section 2.1.2).
23 Prior to the 2010 rulemaking, monitors were
‘‘not sited to measure peak roadway-associated NO2
concentrations . . . .’’ (75 FR 6479).
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CBSAs evaluated, depending on the
year (U.S. EPA, 2017a, Section 2.3.2,
Figures 2–7 to 2–10).24
d. Relationships between Hourly and
Annual NO2 Concentrations
Control programs have resulted in
substantial reductions in NOX emissions
since the 1980s. These reductions in
NOX emissions have decreased both
short-term peak NO2 concentrations and
annual average concentrations (U.S.
EPA, 2017a, Section 2.3.1). Since the
1980s, the median annual NO2 DV has
decreased by about 65% and the median
1-hour DV has decreased by about 50%
(U.S. EPA, 2017a, Section 2.3.3, Figure
2–10). These DVs were measured
predominantly by NO2 monitors located
at area-wide monitoring sites; data from
the new near-road monitoring network
were not included the analysis of the
relationship between hourly and annual
NO2 concentrations due to the limited
amount of data available.25 At various
times in the past, a number of these
area-wide sites would have violated the
1-hour standard without violating the
annual standard. However, no sites
would have violated the annual
standard without also violating the 1hour standard (U.S. EPA, 2017a, p. 2–
21). Furthermore, examination of
historical data indicates that 1-hour DVs
at or below 100 ppb generally
correspond to annual DVs below 35
ppb, with many monitors recording
annual concentrations around 30 ppb.
(U.S. EPA, 2017a, p. 2–21, Figure 2–11).
Based on this, an area meeting the 1hour standard with its level of 100 ppb
would be expected to maintain annual
average NO2 concentrations well below
the 53 ppb level of the annual standard
(U.S. EPA, 2017a, Figure 2–11). It will
be important to re-evaluate the
relationship between 1-hour and annual
standards as more data become available
from recently deployed near-road
monitors.
2. Overview of the Health Effects
Evidence
This section summarizes the available
scientific evidence on the health effects
of NO2 exposures. These summaries are
based primarily on the assessment of the
evidence in the 2016 NOX ISA (U.S.
EPA, 2016a) and on the PA’s
consideration of that evidence in
24 The
upper end of this range (i.e., 77%) reflects
more recent years during which most near-road
monitors were in operation. The lower end of this
range (i.e., 58%) reflects the smaller number of
near-road monitors in operation during the early
years of the deployment of the near-road network.
25 Area-wide sites are intended to characterize
ambient NO2 concentrations at the neighborhood
and larger spatial scales.
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evaluating the public health protection
provided by the current primary NO2
standards (U.S. EPA, 2017a).
In the current review of the primary
NO2 NAAQS, the 2016 NOX ISA uses
frameworks to characterize the strength
of the available scientific evidence for
health effects attributable to NO2
exposures and to classify the evidence
for factors that may increase risk in
some populations 26 or lifestages (U.S.
EPA, 2016a, Preamble, Section 6). These
frameworks provide the basis for robust,
consistent, and transparent evaluation
of the scientific evidence, including
uncertainties in the evidence, and for
drawing conclusions on air pollutionrelated health effects and at-risk
populations. With regard to
characterization of the health effects
evidence, the 2016 NOX ISA uses a fivelevel hierarchy to classify the overall
weight of evidence into one of the
following categories: Causal
relationship; likely to be a causal
relationship; suggestive of, but not
sufficient to infer, a causal relationship;
inadequate to infer a causal
relationship; and not likely to be a
causal relationship (U.S. EPA, 2016a,
Preamble, Table II).27 As discussed
further below, in evaluating the public
health protection provided by the
current standards, the EPA’s focus is on
health effects determined to have a
‘‘causal’’ or a ‘‘likely to be causal’’
relationship with NO2 exposures. In the
ISA, a ‘‘causal’’ relationship is
supported when, ‘‘the consistency and
coherence of evidence integrated across
scientific disciplines and related health
outcomes are sufficient to rule out
chance, confounding, and other biases
with reasonable confidence’’ (U.S. EPA,
2016a, p. 1–5). A ‘‘likely to be causal’’
relationship is supported when ‘‘there
are studies where results are not
explained by chance, confounding, or
other biases, but uncertainties remain in
the evidence overall. For example, the
influence of other pollutants is difficult
to address, or evidence among scientific
disciplines may be limited or
inconsistent’’ (U.S. EPA, 2016a, p. 1–5).
Many of the health effects evaluated in
the ISA, have complex etiologies. For
instance, diseases such as asthma are
typically initiated by multiple agents.
For example, outcomes depend on a
26 The term ‘‘population’’ refers to people having
a quality or characteristic in common, including a
specific pre-existing illness or a specific age or
lifestage.
27 In this review, as in past reviews, there were
causal determination changes for different endpoint
categories. For more information on changes in
causal determinations from the previous review, see
below and Table 1–1 of the 2016 NOX ISA (U.S.
EPA, 2016a).
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variety of factors such as age, genetic
background, nutritional status, immune
competence, and social factors (U.S.
EPA, 2017a, Preamble, Section 5.b).
Thus, exposure to NO2 is likely one of
several contributors to the health effects
evaluated in the ISA.
With regard to identifying specific
populations or lifestages that may be at
increased risk of health effects related to
NO2 exposures, the 2016 NOX ISA
characterizes the evidence for a number
of ‘‘factors’’, including both intrinsic
(i.e., biologic, such as pre-existing
disease or lifestage) and extrinsic (i.e.,
non-biologic, such as diet or
socioeconomic status) factors. The
categories considered in classifying the
evidence for these potential at-risk
factors are ‘‘adequate evidence,’’
‘‘suggestive evidence,’’ ‘‘inadequate
evidence,’’ and ‘‘evidence of no effect’’
(U.S. EPA, 2016a, Section 5.c, Table II).
Within the PA, the focus is on the
consideration of potential at-risk
populations and lifestages for which the
2016 NOX ISA judges there is
‘‘adequate’’ evidence (U.S. EPA, 2016a,
Table 7–27).
The sections below summarize the
evidence for effects related to short-term
NO2 exposures (e.g., minutes up to 1
month) and the evidence for effects
related to long-term NO2 exposures (e.g.,
months to years).28 The final section
discusses the potential public health
implications of NO2 exposures, based on
the evidence for populations and
lifestages at increased risk of NO2related effects. The focus of these
sections is on health effects that the
2016 NOX ISA has determined to have
a ‘‘causal’’ or ‘‘likely to be causal’’
relationship with NO2. Health effects
whose causal determinations have
changed since the last review are also
briefly addressed. More information on
health effects for which causal
determinations are suggestive of, but not
sufficient to infer a causal relationship
or inadequate to infer a causal
relationship (i.e., health effects for
which the evidence is weaker) may be
found in section II.C of the proposal (87
FR 34792, July 26, 2017).
strength of the evidence supporting
various effects, based on the assessment
of that evidence in the 2016 NOX ISA.
Section II.B.2.a.ii discusses the NO2
concentrations at which health effects
have been demonstrated to occur, based
on the considerations and analyses
included in the PA. Section II.B.2.a.iii
discusses NO2 concentrations in
controlled human exposure studies,
while section II.B.2.a.iv. discusses NO2
concentrations in locations of
epidemiologic studies.
a. Health Effects With Short-Term
Exposure to NO2
This section discusses the evidence
for health effects following short-term
NO2 exposures. Section II.B.2.a.i
discusses the nature of the health effects
that have been shown to occur following
short-term NO2 exposures and the
i. Nature of Effects
Across previous reviews of the
primary NO2 NAAQS (U.S. EPA, 1993;
U.S. EPA, 2008a), evidence has
consistently demonstrated respiratory
effects attributable to short-term NO2
exposures. In the last review, the 2008
NOX ISA concluded that evidence was
‘‘sufficient to infer a likely causal
relationship between short-term NO2
exposure and adverse effects on the
respiratory system’’ based on the large
body of epidemiologic evidence
demonstrating positive associations
with respiratory symptoms and
hospitalization or ED visits as well as
supporting evidence from controlled
human exposure and animal studies
(U.S. EPA, 2008a, p. 5–6). Evidence for
cardiovascular effects and mortality
attributable to short-term NO2 exposures
was weaker and was judged ‘‘inadequate
to infer the presence or absence of a
causal relationship’’ and ‘‘suggestive of,
but not sufficient to infer, a causal
relationship,’’ respectively. The 2008
NOX ISA noted an overarching
uncertainty in determining the extent to
which NO2 is independently associated
with effects or whether NO2 is a marker
for the effects of another traffic-related
pollutant or mix of pollutants (U.S.
EPA, 2008a, Section 5.3.2.2 to 5.3.2.6).
For the current review, there is newly
available evidence for both respiratory
effects and other health effects that was
critically evaluated in the 2016 NOX ISA
as part of the full body of evidence
informing the nature of the relationship
between health effects and short-term
exposures to NO2 (U.S. EPA, 2016a).29
Chapter 5 of the 2016 NOX ISA presents
a detailed assessment of the evidence
for health effects associated with shortterm NO2 exposures (U.S. EPA, 2016a).
In considering the available evidence
and the causal determinations presented
in the 2016 NOX ISA, consistent with
the PA (U.S. EPA, 2017a), this action
focuses on respiratory effects described
28 Short-term exposures are defined as those with
durations of minutes up to 1 month, with most
studies examining effects related to exposures in
the range of 1 hour to 1 week (2016 NOX ISA, p.
1–15).
29 A list of causal determinations from the 2016
NOX ISA for the current review, and those from the
previous review, for respiratory effects,
cardiovascular effects, and mortality is presented in
Table 3–1 of the NO2 PA (U.S. EPA, 2017a).
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below. Cardiovascular effects and
mortality are also briefly addressed.
Respiratory Effects
The 2016 NOX ISA concludes that
evidence supports a causal relationship
between respiratory effects and shortterm NO2 exposures, primarily based on
evidence for asthma exacerbation. In
reaching this conclusion, the 2016 NOX
ISA notes that ‘‘epidemiologic,
controlled human exposure, and animal
toxicological evidence together can be
linked in a coherent and biologically
plausible pathway to explain how NO2
exposure can trigger an asthma
exacerbation’’ (U.S. EPA, 2016a, p. 1–
17). In the last review, the 2008 NOX
ISA described much of the same
evidence and determined it was
‘‘sufficient to infer a likely causal
relationship’’ with respiratory effects,
citing uncertainty as to whether the
epidemiologic results for NO2 could be
disentangled from effects related to
other traffic-related pollutants. In
contrast to the current review, the 2008
NOX ISA evaluated evidence for the
broad category of respiratory effects and
did not explicitly evaluate the extent to
which various lines of evidence
supported effects on more specific
endpoints such as asthma exacerbation
(i.e., asthma attacks). In the current
review, the 2016 NOX ISA states that
‘‘the determination of a causal
relationship is not based on new
evidence as much as it is on the
integrated findings for asthma attacks
with due weight given to experimental
studies’’ (U.S. EPA, 2016a, p. 1xxxiii).30
Strong evidence supporting this
causal determination in the 2016 NOX
ISA comes from a meta-analysis of
controlled human exposure studies that
evaluate the potential for increased
AR 31 following 20-minute to 1-hour
NO2 exposures (Brown, 2015).32 While
30 Experimental studies, such as controlled
human exposure studies, provide support for effects
of exposures to NO2 itself, and generally do not
reflect the complex atmospheres to which people
are exposed. Thus, unlike epidemiologic studies,
experimental studies that evaluate exposures to
NO2 itself are not subject to uncertainties related to
the potential for copollutant confounding.
31 The 2016 NO ISA states that AR is ‘‘inherent
X
responsiveness of the airways to challenge by
bronchoconstricting agents’’ (U.S. EPA, 2016a, p. 5–
9). Airway hyperresponsiveness refers to increased
sensitivity of the airways to an inhaled
bronchoconstricting agent. This is often quantified
as the dose of challenge agent that results in a 20%
reduction in forced expiratory volume for 1 second
(FEV1), but some studies report the change in FEV1
for a specified dose of challenge agent. The change
in specific airways resistance (sRaw) is also used to
quantify AR.
32 These studies evaluate the effect of inhaled
NO2 on the inherent responsiveness of the airways
to challenge by bronchoconstricting agents.
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individual controlled human exposure
studies can lack statistical power to
identify effects, the meta-analysis of
individual-level data combined from
multiple studies has greater statistical
power due to increased sample size.33
AR has been the key respiratory
outcome from controlled human
exposures in the previous and the
current review of the primary NO2
NAAQS. The 2016 NOX ISA specifically
notes that ‘‘airway hyperresponsiveness
can lead to poorer control of symptoms
and is a hallmark of asthma’’ (U.S. EPA,
2016a, p. 1–18). Brown (2015) examined
the relationship between AR and NO2
exposures in subjects with asthma
across the large body of controlled
human exposure studies,34 most of
which were available in the last review
(U.S. EPA, 2017a, Tables 3–2 and 3–3).
More specifically, the meta-analysis
identified the fraction of individuals
having an increase in AR following NO2
exposure, compared to the fraction
having a decrease, across studies.35 The
meta-analysis also stratified the data to
consider the influence of factors that
may affect results including exercise
versus rest and non-specific versus
specific challenge agents.36
The results from the meta-analysis
demonstrate that the majority of study
volunteers with asthma experienced
increased AR following resting exposure
to NO2 concentrations ranging from 100
to 530 ppb, relative to filtered air.
Limitations in this evidence result from
the lack of an apparent dose-response
relationship, uncertainty in the
potential adversity of responses, and the
general focus of available studies on
people with mild asthma, rather than
more severe asthma. These controlled
human exposure studies, the meta33 A meta-analysis synthesizes data from multiple
studies using statistical analyses.
34 These controlled human exposure studies were
conducted in people with asthma, a group at
increased risk for NO2-related effects. The severity
of asthma varied across studies, ranging from
inactive asthma up to severe asthma, with the
majority of study participants having a mild form
of asthma. (Brown, 2015).
35 More information on the distribution of study
subjects across NO2 concentrations can be found
below (section II.A.2.ii). Information on the fraction
of individuals who experienced an increase versus
a decrease stratified by concentration can also be
found in that section.
36 ‘‘Bronchial challenge agents can be classified as
nonspecific (e.g., histamine; SO2; cold air) or
specific (i.e., an allergen). Nonspecific agents can be
differentiated between ‘direct’ stimuli (e.g.,
histamine, carbachol, and methacholine) which act
on airway smooth muscle receptors and ‘indirect’
stimuli (e.g., exercise, cold air) which act on smooth
muscle through intermediate pathways, especially
via inflammatory mediators. Specific allergen
challenges (e.g., house dust mite, cat allergen) also
act ‘indirectly’ via inflammatory mediators to
initiate smooth muscle contraction and
bronchoconstriction.’’ (U.S. EPA, 2016a, p. 5–8).
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analysis, and uncertainties in this body
of evidence are discussed in greater
detail below.
The 2016 NOX ISA further
characterizes the clinical relevance of
these increases in AR, using an
approach that is based on guidelines
from the American Thoracic Society
(ATS) and the European Respiratory
Society (ERS) for the assessment of
therapeutic agents (Reddel et al., 2009).
Specifically, based on individual-level
responses reported in a subset of
studies, the 2016 NOX ISA considered a
halving of the provocative dose (PD) to
indicate responses that may be
clinically relevant.37 38 With regard to
this approach, the 2016 NOX ISA notes
that ‘‘in a joint statement of the [ATS]
and [ERS], one doubling dose change in
PD is recognized as a potential
indicator, although not a validated
estimate, of clinically relevant changes
in AR (Reddel et al., 2009)’’ (U.S. EPA,
2016a, p. 5–12).
Studies considered for inclusion into
the meta-analyses by Brown (2015) were
identified from the meta-analysis by
Goodman et al. (2009), the 2016 NOX
ISA, and a literature search for
controlled human exposure studies of
individuals with asthma exposed to NO2
that were published since the 2008 NOX
ISA. In one analysis, Brown (2015)
showed that NO2 exposures from 100 to
530 ppb resulted in a halving of the
dose of a challenge agent required to
increase AR (i.e., a halving of the PD) in
about a quarter of study volunteers.
While these results support the
potential for clinically relevant
increases in AR in some individuals
with asthma following NO2 exposures
within the range of 100 to 530 ppb,
uncertainty remains given that the
analysis of PD is limited to a subset of
the studies in which non-specific AR
was assessed in individuals following
resting exposures to NO2 and air.39 In
addition, compared to conclusions
based on the entire range of NO2
exposure concentrations evaluated (i.e.,
100 to 530 ppb), there is greater
37 PD is the dose of challenge agent required to
elicit a specified change in a measure of lung
function, typically a 20% decrease in FEV1 or a
100% increase in specific airway resistance (sRaw).
38 The 2016 NO ISA’s characterization of a
X
clinically relevant response is based on evidence
from controlled human exposure studies evaluating
the efficacy of inhaled corticosteroids that are used
to prevent bronchoconstriction and AR as described
by Reddel et al. (2009). Generally, a change of at
least one doubling dose is considered to be an
indication of clinical relevance. Based on this, a
halving of the PD is taken in the 2016 NOX ISA to
represent an increase in AR that indicates a
clinically relevant response.
39 Section 3.2.2.1 of the PA (U.S. EPA, 2017a)
includes additional discussion of these
uncertainties.
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uncertainty in reaching conclusions
about the potential for clinically
relevant effects at any particular NO2
exposure concentration within this
range.
Controlled human exposure studies
discussed in the 2016 NOX ISA also
evaluated a range of other respiratory
effects, including lung function
decrements, respiratory symptoms, and
pulmonary inflammation. The evidence
does not consistently demonstrate these
effects following exposures to NO2
concentrations at or near those found in
the ambient air in the U.S. However, a
subset of studies using NO2 exposures to
260 ppb for 15–30 min or 400 ppb for
up to 6 hours provide evidence that
study volunteers with asthma and
allergy can experience increased
inflammatory responses following
allergen challenge. Evidence for
pulmonary inflammation was more
mixed across studies that did not use an
allergen challenge following NO2
exposures ranging from 300–1,000 ppb
(U.S. EPA, 2016a, Section 5.2.2.5).
In addition to this evidence for NO2induced increases in AR and allergic
inflammation in controlled human
exposure studies, the 2016 NOX ISA
also describes evidence from
epidemiologic studies for positive
associations between short-term NO2
exposures and an array of respiratory
outcomes related to asthma. Thus,
coherence and biological plausibility is
demonstrated in the evidence integrated
between controlled human exposure
studies and the various asthma-related
outcomes examined in epidemiologic
studies. The 2016 NOX ISA indicates
that epidemiologic studies consistently
demonstrate NO2-health effect
associations with asthma hospital
admissions and ED visits among
subjects of all ages and children, and
with asthma symptoms in children (U.S.
EPA, 2016a, Sections 5.2.2.4 and
5.2.2.3). The robustness of the evidence
is demonstrated by associations found
in studies conducted in diverse
locations in the U.S., Canada, and Asia,
including several multicity studies. The
evidence for asthma exacerbation is
substantiated by several recent studies
with strong exposure assessment
characterized by measuring NO2
concentrations in subjects’ location(s).
Epidemiologic studies also
demonstrated associations between
short-term NO2 exposures and
respiratory symptoms, lung function
decrements, and pulmonary
inflammation, particularly for measures
of personal total and ambient NO2
exposures and NO2 measured outside
schools. This is important because there
is considerable spatial variability in NO2
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concentrations, and measurements in
subjects’ locations may better represent
variability in ambient NO2 exposures
compared to measurements at central
site monitors (U.S. EPA, 2016a, Sections
2.5.3 and 3.4.4). Epidemiologic studies
also consistently indicate ambient or
personal NO2-associated increases in
exhaled nitric oxide (eNO, a marker of
airway inflammation), which is
coherent with experimental findings for
allergic inflammation (U.S. EPA, 2016a,
Section 5.2.2.6).
In assessing the evidence from
epidemiologic studies, the 2016 NOX
ISA not only considers the consistency
of effects across studies, but also
evaluates other study attributes that
affect study quality, including potential
confounding and exposure assignment.
Regarding potential confounding, the
2016 NOX ISA notes that NO2
associations with asthma-related effects
persist with adjustment for temperature;
humidity; season; long-term time trends;
and PM10, SO2, or O3. Recent studies
also add findings for NO2 associations
that generally persist with adjustment
for a key copollutant, including PM2.5
and traffic-related copollutants such as
elemental carbon (EC) or black carbon
(BC), ultra-fine particles (UFPs), or
carbon monoxide (CO) (U.S. EPA,
2016a, Figures 5–16 and 5–17, Table 5–
38). Confounding by organic carbon
(OC), PM metal species, or volatile
organic compounds (VOCs) is rarely
studied, but NO2 associations with
asthma exacerbation tend to persist in
the few available copollutant models.
The 2016 NOX ISA recognizes, however,
that copollutant models have inherent
limitations and cannot conclusively rule
out confounding (U.S. EPA, 2015a,
Preamble, Section 4.b).
The 2016 NOX ISA also notes that
results based on personal exposures or
pollutants measured at people’s
locations provide support for NO2
associations that are independent of
PM2.5, EC/BC, organic carbon (OC), or
UFPs. Compared to ambient NO2
concentrations measured at central-site
monitors, personal NO2 exposure
concentrations and indoor NO2
concentrations exhibit lower
correlations with many traffic-related
copollutants (e.g., r = ¥0.37 to 0.31).
Thus, these health effect associations
with personal and indoor NO2 may be
less prone to confounding by these
traffic-related copollutants (U.S. EPA,
2016a, Section 1.4.3).
Overall, the strongest evidence
supporting the conclusion of the causal
relationship determined in the 2016
NOX ISA comes from controlled human
exposure studies demonstrating NO2induced increases in AR in individuals
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with asthma, with supporting evidence
for a range of respiratory effects from
epidemiologic studies. The conclusion
of a causal relationship in the 2016 NOX
ISA is based on this evidence and its
explicit integration within the context of
effects related to asthma exacerbation.
Most of the controlled human exposure
studies assessed in the 2016 NOX ISA
were available in the last review,
particularly studies of non-specific AR,
and thus do not themselves provide
substantively new information.
However, by pooling data from a subset
of studies, the newly available metaanalysis (Brown, 2015) has partially
addressed an uncertainty from the last
review by demonstrating the potential
for clinically relevant increases in AR
following exposures to NO2
concentrations in the range of 100 to
530 ppb.
Similarly, the epidemiologic evidence
that is newly available in the current
review is consistent with evidence from
the last review and does not alter the
fundamental understanding of the
respiratory effects related to ambient
NO2 exposures. New epidemiologic
evidence does, however, reduce some
uncertainty from the last review
regarding the extent to which effects
may be independently related to NO2, as
there is more evidence from studies
using measures that may better capture
personal exposure, as well as a more
robust evidence base examining
copollutant confounding. Some
uncertainty remains in the
epidemiologic evidence regarding
confounding by the most relevant
copollutants, as it can be difficult to
disentangle the independent effects of
highly correlated pollutants (i.e., NO2
and traffic-related pollutants).
Cardiovascular Effects
The evidence for a causal relationship
between cardiovascular health effects
and short-term NO2 exposures in the
2016 NOX ISA was judged ‘‘suggestive
of, but not sufficient to infer, a causal
relationship’’ (U.S. EPA, 2016a, Section
5.3.11), which reflects a conclusion that
the evidence for a causal relationship is
stronger in the last review, when the
conclusion was that the evidence was
‘‘inadequate to infer the presence or
absence of a causal relationship.’’ The
2016 determination was primarily
supported by consistent epidemiologic
evidence from multiple new studies
indicating associations between NO2
concentrations and myocardial
infarction. More information on these
health effects may be found in section
II.C.1.a.ii of the proposal (87 FR 34792,
July 26, 2017).
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Mortality
The 2016 NOX ISA concludes that the
evidence for a causal relationship
between short-term NO2 exposures and
total mortality is ‘‘suggestive of, but not
sufficient to infer, a causal relationship’’
(U.S. EPA, 2016a, Section 5.4.8), which
is the same conclusion reached in the
last review (U.S. EPA, 2008a). More
information on these health effects may
be found in section II.C.1.a.iii of the
proposal (87 FR 34792, July 26, 2017).
ii. Short-Term NO2 Concentrations in
Health Studies
In evaluating what the available
health evidence indicates with regard to
the degree of public health protection
provided by the current standards, it is
appropriate to consider the short-term
NO2 concentrations that have been
associated with various effects. The PA
explicitly considers these NO2
concentrations within the context of
evaluating the public health protection
provided by the current standards (U.S.
EPA, 2017a, Section 3.2). This section
summarizes those considerations from
the PA.
In evaluating the NO2 exposure
concentrations associated with health
effects within the context of considering
the adequacy of the current standards,
the PA focuses on the evidence for
asthma-related effects (i.e., the type of
effect for which there is the strongest
evidence supporting a causal
relationship, as discussed in the section
above). The PA specifically considers to
what extent the evidence indicates
adverse asthma-related effects
attributable to short-term exposures to
NO2 concentrations lower than
previously identified or below the
existing standards (U.S. EPA, 2017a, p.
3–11). In addressing this issue, the PA
considers the extent to which NO2induced effects have been reported over
the ranges of NO2 exposure
concentrations evaluated in controlled
human exposure studies and the extent
to which NO2-associated effects have
been reported for distributions of
ambient NO2 concentrations in
epidemiologic study locations that meet
existing standards. These considerations
are discussed below for controlled
human exposure studies and
epidemiologic studies.
iii. NO2 Concentrations in Controlled
Human Exposure Studies
Controlled human exposure studies,
most of which were available and
considered in the last review, have
evaluated various respiratory effects
following short-term NO2 exposures.
These include AR, inflammation and
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oxidative stress, respiratory symptoms,
and lung function decrements.
Generally, when considering respiratory
effects from controlled human exposure
studies in healthy adults without
asthma, the evidence does not indicate
respiratory symptoms or lung function
decrements following NO2 exposures
below 4,000 ppb, and limited evidence
indicates airway inflammation
following exposures below 1,500 ppb
(U.S. EPA, 2016a, Section 5.2.7).40
There is a substantial body of evidence
demonstrating increased AR in healthy
adults with exposures in the range of
1,500–3,000 ppb.
Evidence for respiratory effects
following exposures to NO2
concentrations at or near those found in
the ambient air is strongest for AR in
individuals with asthma (U.S. EPA,
2016a, Section 5.2.2 p. 5–7). As
discussed above, increased AR has been
reported in people with asthma
following exposures to NO2
concentrations as low as 100 ppb. In
contrast, controlled human exposure
studies evaluated in the 2016 NOX ISA
do not provide consistent evidence for
respiratory symptoms, lung function
decrements, or pulmonary inflammation
in adults with asthma following
exposures to NO2 concentrations at or
near those in ambient air (i.e., <1,000
ppb; U.S. EPA, 2016a, Section 5.2.2).
There is some indication of allergic
inflammation in adults with allergy and
asthma following exposures to 260–
1,000 ppb. However, the generally high
exposure concentrations in these studies
make it difficult to interpret the
likelihood that these effects could
potentially occur following NO2
exposures at or below the level of the
current standards.41
Thus, in considering the exposure
concentrations evaluated in controlled
human exposure studies, the PA focuses
on the body of evidence for NO2induced increases in AR in adults with
asthma. In evaluating the NO2 exposure
concentrations at which increased AR is
observed, the PA considers both the
group mean results reported in
individual studies and the results
evaluated across studies in the metaanalysis by Brown (2015; U.S. EPA,
2016a, Section 5.2.2.1). Group mean
responses in individual studies, and the
40 Exposure durations were from one to three
hours in studies evaluating AR and respiratory
symptoms, and up to five hours in studies
evaluating lung function decrements.
41 Despite the difficulty in interpreting the
likelihood that these effects would occur at
concentrations closer to the current standards, as
described later (section II.A.3) the current standards
are expected to protect against exposures at the
exposure concentrations used in these studies.
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variability in those responses, can
provide insight into the extent to which
observed changes in AR are due to NO2
exposures, rather than to chance alone,
having the advantage of being based on
the same exposure conditions. The
meta-analysis by Brown (2015) can also
provide insight into the extent to which
observed changes are due to NO2
exposures, with the additional benefit of
aiding in the identification of trends in
individual-level responses across
studies and the advantage of increased
power to detect effects, even in the
absence of statistically significant effects
in individual studies, although each
study in the meta-analysis may not be
based on the exact same exposure
conditions.42
Consideration of Group Mean Results
From Individual Studies
Individual controlled human
exposure studies have generally not
reported statistically significant
increases in AR following resting
exposures to NO2 concentrations from
100 to 200 ppb. In considering such
studies, the PA notes that the lowest
NO2 concentration to which individuals
with asthma have been exposed is 100
ppb, with an exposure duration of 60
minutes in all studies at this
concentration. Of the five studies
conducted at 100 ppb, a statistically
significant increase in AR following
exposure to NO2 was only observed in
the study by Orehek et al. (1976) (n =
20). Of the four studies that did not
report statistically significant increases
in AR following exposures to 100 ppb
NO2, three reported weak trends
towards decreased AR (n = 20, Ahmed
et al., 1983b; n = 15, Hazucha et al.,
1983; n = 8, Tunnicliffe et al., 1994),
and one reported a trend towards
increased AR (n = 20, Ahmed et al.,
1983a). Resting exposures to 140 ppb
NO2 resulted in increases in AR that
reached marginal statistical significance
(n = 20, Bylin et al., 1988). In addition,
the one study conducted at 200 ppb
demonstrated a trend towards increased
AR, but this study was small and its
results were not statistically significant
(n = 4, Orehek et al., 1976). Thus, as
42 Tables
3–2 and 3–3 in the NO2 PA (adapted
from the 2016 NOX ISA; U.S. EPA, 2016a, Tables
5–1 and 5–2) provide details for the studies
examining AR in individuals with asthma at rest
and with exercise, respectively. These tables note
various study details including the exposure
concentration, duration of exposure, type of
challenge (nonspecific or specific), number of study
subjects, number of subjects having an increase or
decrease in AR following NO2 exposure, average
PD: The dose of challenge agent required to elicit
a particular magnitude of change in FEV1 or other
measure of lung function) across subjects, and the
statistical significance of the change in AR
following NO2 exposures.
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noted above, individual controlled
human exposure studies have generally
not reported statistically significant
increases in AR following resting
exposures to NO2 concentrations from
100 to 200 ppb. Group mean responses
in these studies suggest a trend towards
increased AR following exposures to
140 and 200 ppb NO2, while trends in
the direction of group mean responses
were inconsistent following exposures
to 100 ppb NO2.
In considering studies in individuals
with asthma conducted with exercise
and at lower concentrations, the PA
notes that three studies evaluated NO2
exposure concentrations between 150
and 200 ppb (n = 19, Roger et al., 1990;
n = 31, Kleinman et al., 1983; n = 11,
Jenkins et al., 1999). Of these studies,
only Kleinman et al. (1983) reported a
statistically significant increase in AR
following NO2 exposure (i.e., at 200
ppb). Roger et al. (1990) and Jenkins et
al. (1999) did not report statistically
significant increases, but showed weak
trends for increases in AR following
exposures to 150 ppb and 200 ppb NO2,
respectively. Thus, as with studies of
resting exposures, studies that evaluated
exposures to 150 to 200 ppb NO2 with
exercise report trends toward increased
AR, though results are generally not
statistically significant.
Several studies evaluated exposures
of individuals with asthma to NO2
concentrations above 200 ppb. Of the
five studies that evaluated 30-minute
resting exposures to NO2 concentrations
from 250 to 270 ppb, NO2-induced
increases in AR were statistically
¨
significant in three (n = 14, Jorres et al.,
1990; n = 18, Strand et al., 1988; n = 20,
Bylin et al., 1988). Statistically
significant increases in AR are also more
consistently reported across studies that
evaluated resting exposures to 400–530
ppb NO2, with three of four studies
reporting a statistically significant
increase in AR following such
exposures. However, studies conducted
with exercise do not indicate consistent
increases in AR following exposures to
NO2 concentrations from 300 to 600 ppb
(U.S. EPA, 2017a, Table 3–3).43
Consideration of Results From the
Brown (2015) Meta-Analysis
As discussed above, the 2016 NOX
ISA assessment of the evidence for AR
43 There are eight additional studies with
exercising exposures to 300–350 ppb NO2 as
presented in Table 3–3 of the NO2 PA, with
exposure durations ranging from 30–240 minutes.
Results across these studies are inconsistent, with
only two of eight reporting statistically significant
results. Only one of four studies with exercising
exposures of 400 or 600 ppb reported statistically
significant increases in AR.
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in individuals with asthma also focuses
on a recently published meta-analysis
(Brown, 2015) investigating individuallevel data from controlled human
exposure studies. While individual
controlled human exposure studies can
lack statistical power to identify effects,
the meta-analysis of individual-level
data combined from multiple studies
(Brown, 2015) has greater statistical
power due to increased sample size. The
meta-analysis considered individuallevel responses, specifically whether
individual study subjects experienced
an increase or decrease in AR following
NO2 exposure compared to exposure to
filtered air.44 Evidence was evaluated
together across all studies and also
stratified for exposures conducted with
exercise and at rest, and for measures of
specific and non-specific AR. The 2016
NOX ISA notes that these
methodological differences may have
important implications with regard to
results (U.S. EPA, 2016a (discussing
Brown, 2015; Goodman et al., 2009)),
which informed the 2016 NOX ISA’s
emphasis on studies of resting
exposures and non-specific challenge
agents. Overall, the Brown metaanalysis presents the fraction of
individuals having an increase in AR
following exposure to various NO2
concentrations (i.e., 100 ppb, 100 ppb to
< 200 ppb, 200 ppb up to and including
300 ppb, and above 300 ppb) (U.S. EPA,
2016a, Section 5.2.2.1).45
When evaluating results from the
meta-analysis, the PA first considers
results across all exposure conditions
combined (i.e., resting, exercising, nonspecific challenge, and specific
challenge). For 100 ppb NO2 exposures,
Brown (2015) reported that, of the study
participants who experienced either an
increase or decrease in AR following
NO2 exposures, 61% experienced an
increase (p = 0.08). For 100 to < 200 ppb
NO2 exposures, 62% of study subjects
experienced an increase in AR following
NO2 exposures (p = 0.014). For 200 to
300 ppb NO2 exposures, 58% of study
subjects experienced an increase in AR
following NO2 exposures (p = 0.008).
For exposures above 300 ppb NO2, 57%
of study subjects experienced an
increase in AR following NO2
44 More specifically, the Brown (2015) metaanalysis combined information from the studies
presented in Tables 3–2 and 3–3 of the PA. It
compared the number of study participants who
experienced an increase in AR following NO2
exposures to the number who experienced a
decrease in AR. Study participants who
experienced no change in AR were not included in
comparisons. P-value refers to the significance level
of a two-tailed sign test.
45 The number of participants in each study and
the number having an increase or decrease in AR
is indicated in Tables 3–2 and 3–3 of the NO2 PA.
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exposures, though this fraction was not
statistically significantly different from
the fraction experiencing a decrease.
The PA also considers the results of
Brown (2015) for various subsets of the
available studies, based on the exposure
conditions evaluated (i.e., resting,
exercising) and the type of challenge
agent used (i.e., specific, non-specific).
For exposures conducted at rest, across
all exposure concentrations (i.e., 100–
530 ppb NO2, n = 139; U.S. EPA, 2017a,
Table 3–2), Brown (2015) reported that
a statistically significant fraction of
study participants (71%, p <0.001)
experienced an increase in non-specific
AR following NO2 exposures, compared
to the fraction that experienced a
decrease in AR. The meta-analysis also
presented results for various
concentrations or ranges of
concentrations. Following resting
exposure to 100 ppb NO2, 66% of study
participants experienced increased nonspecific AR. For exposures to
concentrations of 100 ppb to < 200 ppb,
200 ppb up to and including 300 ppb,
and above 300 ppb, increased nonspecific AR was reported in 67%, 78%,
and 73% of study participants,
respectively.46 For non-specific
challenge agents, the differences
between the fraction of individuals who
experienced increased AR following
resting NO2 exposures and the fraction
who experienced decreased AR reached
statistical significance for all of the
ranges of exposure concentrations
evaluated (p < 0.001).
In contrast to the results from studies
conducted at rest, the fraction of
individuals having an increase in AR
following NO2 exposures with exercise
was not consistently greater than 50%,
particularly when looking at the
allergen challenge group, and none of
the results were statistically significant
(Brown, 2015). Across all NO2
exposures with exercise, measures of
non-specific AR were available for 241
individuals, 54% of whom experienced
an increase in AR following NO2
exposures relative to air controls. There
were no studies in this group conducted
at 100 ppb, and for exercising exposures
to 150–200 ppb, 250–300 ppb, and 350–
600 ppb, the fraction of individuals with
increased non-specific AR was 59%,
55%, and 49%, respectively.
In addition to examining results from
studies of non-specific AR, the metaanalysis also considered results from
studies that evaluated changes in
specific AR (i.e., AR following an
46 For the exposure category of ‘‘above 300 ppb’’,
exposures included 400, 480, 500, and 530 ppb. No
studies conducted at rest used concentrations
between 300 and 400 ppb.
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allergen challenge; n = 130, U.S. EPA,
2017a, Table 3–3) following NO2
exposures. The results do not indicate
statistically significant fractions of
individuals having an increase in
specific AR following exposure to NO2
at concentrations below 400 ppb, even
when considering resting and exercising
exposures separately (Brown, 2015). Of
the three studies that evaluated specific
AR at concentrations of 400 ppb, one
was conducted at rest (Tunnicliffe et al.,
1994). This study reported that all
individuals experienced increased AR
following 400 ppb NO2 exposures
(Brown, 2015, Table 4). In contrast, for
exposures during exercise, most study
subjects did not experience NO2induced increases in specific AR. In
contrast, for exposures during exercise,
most study subjects did not experience
NO2-induced increases in specific AR.47
Overall, results across studies are less
consistent for increases in specific AR
following NO2 exposures.
Uncertainties in Evidence for AR
When considering the evidence for
NO2-induced increases in AR in
individuals with asthma, there are
important uncertainties that should be
considered. One uncertainty is that
available studies of NO2 and AR have
generally evaluated adults with mild
asthma, while people with more severe
asthma could experience more serious
effects and/or effects following
exposures to lower NO2
concentrations.48 Additional
uncertainties include the lack of an
apparent dose-response relationship and
uncertainty in the potential adversity of
the reported effects; each of these is
discussed below.
Both the meta-analysis by Brown
(2015) and an additional meta-analysis
and meta-regression by Goodman et al.
(2009) conclude that there is no
indication of a dose-response
relationship for exposures between 100
and 600 ppb NO2 and increased AR in
individuals with asthma. A doseresponse relationship generally
increases confidence that observed
effects are due to pollutant exposures
rather than to chance, and can be used
to inform the characterization of the
magnitude of the effects; however, the
lack of an apparent dose-response
relationship does not necessarily
47 48% experienced increased AR and 52%
experienced decreased AR, based on individuallevel data for study participants exposed to 350 ppb
(Riedl et al., 2012) or 400 ppb (Jenkins et al., 1999;
Witten et al., 2005) NO2.
48 Brown (2015) notes, however, that disease
status varied in the studies included in the metaanalysis, ranging from ‘‘inactive asthma up to
severe asthma in a few studies.’’
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indicate that there is no relationship
between the exposure and effect,
particularly in these analyses based
largely on between-subject comparisons
(i.e., as opposed to comparisons within
the same subject exposed to multiple
concentrations). As discussed in the
2016 NOX ISA, there are a number of
methodological differences across
studies that could contribute to
between-subject differences and that
could obscure or complicate a doseresponse relationship between NO2 and
AR (U.S. EPA, 2016a, section 5.2.2.1).49
These include subject activity level (rest
versus exercise) during NO2 exposure,
asthma medication usage, choice of
airway challenge agent, method of
administering the bronchoconstricting
agents, and physiological endpoint used
to assess AR. Such methodological
differences across studies likely
contribute to the variability and
uncertainty in results across studies and
complicate interpretation of the overall
body of evidence for NO2-induced AR.
Thus, while the lack of an apparent
dose-response relationship adds
uncertainty to the interpretation of
controlled human exposure studies of
AR and reduces the ability to fully
characterize the health risks associated
with these exposures, it does not
indicate the lack of an NO2 effect.
An additional uncertainty in
interpreting these studies within the
context of considering the adequacy of
the protection provided by the current
primary NO2 NAAQS is the potential
adversity of the reported NO2-induced
increases in AR. As discussed above, the
meta-analysis by Brown (2015) used an
approach that is consistent with
guidelines from the ATS and the ERS
for the assessment of therapeutic agents
(Reddel et al., 2009) to assess the
potential for clinical relevance of these
responses. Specifically, based on
individual-level responses reported in a
subset of studies, Brown (2015)
considered a halving of the PD to
indicate responses that may be
clinically relevant. With regard to this
approach, the 2016 NOX ISA notes that
‘‘one doubling dose change in PD is
recognized as a potential indicator,
although not a validated estimate, of
clinically relevant changes in AR
(Reddel et al., 2009)’’ (U.S. EPA, 2016a,
p. 5–12). While there is uncertainty in
using this approach to characterize
whether a particular response in an
individual is ‘‘adverse,’’ it can provide
49 For instance, Brown (2015) notes that the few
studies evaluating effects at multiple NO2
concentrations and at resting exposures may
indicate some support for a dose-response
relationship, as they show increasing AR with
increasing exposure concentrations.
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insight into the potential for adversity,
particularly when applied to a
population of exposed individuals.50
Five studies provided data for each
individual’s PD. These five studies
provided individual-level data for a
total of 72 study participants (116 AR
measurements) and eight NO2 exposure
concentrations, for resting exposures
and non-specific bronchial challenge
agents. Across exposures to 100, 140,
200, 250, 270, 480, 500, and 530 ppb
NO2, 24% of study participants
experienced a halving of the PD
(indicating increased AR) while 8%
showed a doubling of the PD (indicating
decreased AR). The relative
distributions of the PDs at different
concentrations were similar, with no
dose-response relationship indicated
(Brown, 2015). While these results
support the potential for clinically
relevant increases in AR in some
individuals with asthma following NO2
exposures within the range of 100 to 530
ppb, uncertainty remains given that this
analysis is limited to a subset of studies.
In addition, compared to conclusions
based on the entire range of NO2
exposure concentrations evaluated (i.e.,
100 to 530 ppb), there is greater
uncertainty in reaching conclusions
about the potential for clinically
relevant effects at any particular NO2
exposure concentration within this
range.
PA Conclusions on Short-Term NO2
Concentrations in Controlled Human
Exposure Studies
As in the last review, a meta-analysis
of individual-level data supports the
potential for increased AR in
individuals with generally mild asthma
following 30 minute to 1 hour exposures
to NO2 concentrations from 100 to 530
ppb, particularly for resting exposures
and measures of non-specific AR (n = 33
to 70 for various ranges of NO2 exposure
concentrations). In about a quarter of
these individuals, increases were large
enough to be of potential clinical
relevance. Individual studies most
consistently report statistically
significant NO2-induced increases in AR
following exposures to NO2
concentrations at or above 250 ppb.
Individual studies (n = 4 to 20)
generally do not report statistically
significant increases in AR following
exposures to NO2 concentrations at or
below 200 ppb, though the evidence
suggests a trend toward increased AR
following NO2 exposures from 140 to
50 As noted above, the degree to which
populations in U.S. urban areas have the potential
for such NO2 exposures is evaluated in Chapter 4
of the PA and described in Section II.A.3 below.
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200 ppb. In contrast, individual studies
do not indicate a consistent trend
towards increased AR following 1-hour
exposures to 100 ppb NO2. Important
limitations in this evidence include the
lack of an apparent dose-response
relationship between NO2 and AR and
uncertainty in the adversity of the
reported increases in AR. These
limitations become increasingly
important at the lower NO2 exposure
concentrations (i.e., at or near 100 ppb),
where the evidence for NO2-induced
increases in AR is not consistent across
studies. The PA placed weight on that
lack of consistency, when considered in
light of the lack of an apparent doseresponse relationship between NO2 and
increased AR, as well as the uncertainty
in the adversity of the reported effect.
iv. Consideration of NO2 Concentrations
in Locations of Epidemiologic Studies
In addition to considering the
exposure concentrations evaluated in
the controlled human exposure studies,
the PA also considers distributions of
ambient NO2 concentrations in locations
where epidemiologic studies have
examined NO2 associations with
asthma-related hospital admissions or
ED visits. These outcomes are clearly
adverse and study results comprise a
key line of epidemiologic evidence in
the determination of a causal
relationship in the 2016 NOX ISA (U.S.
EPA, 2016a, Section 5.2.9). As in other
NAAQS reviews (U.S. EPA, 2014; U.S.
EPA, 2011), when considering
epidemiologic studies within the
context of evaluating the adequacy of
the current standards, the PA
emphasizes those studies conducted in
the U.S. and Canada.51 For short-term
exposures to NO2, the PA emphasizes
studies reporting associations with
effects judged in the 2016 NOX ISA to
be robust to confounding by other
factors, including exposure to cooccurring air pollutants. In addition, the
PA considers the statistical precision of
study results and the inclusion of at-risk
populations for which the NO2-health
effect associations may be larger. These
considerations help inform the range of
ambient NO2 concentrations where
there is the most confidence for NO2associated health effects and the range
of concentrations over which
confidence in such effects is appreciably
51 Such studies are likely to reflect air quality and
exposure patterns that are generally applicable to
the U.S. In addition, air quality data corresponding
to study locations and study time periods are often
readily available for studies conducted in the U.S.
and Canada. Nonetheless, the PA recognizes the
importance of all studies, including other
international studies, in the 2016 NOX ISA’s
assessment of the weight of the evidence that
informs the causal determinations.
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lower. In consideration of these issues,
the PA specifically focuses on the
following question: To what extent have
U.S. and Canadian epidemiologic
studies reported associations between
asthma-related hospital admissions or
ED visits and short-term NO2
concentrations in study areas that
would have met the current 1-hour NO2
standard during the study period?
Addressing this question can provide
important insights into the extent to
which NO2-associated health effects are
present for distributions of ambient NO2
concentrations that would be allowed
by the current primary standards. The
presence of such associations would
support the potential for the current
standards to allow the NO2-associated
effects indicated by epidemiologic
studies. To the degree studies have not
reported associations in locations
meeting the current NO2 standards,
there is greater uncertainty regarding the
potential for the reported effects to
occur following the NO2 exposures
associated with air quality meeting
those standards.
The emphasis that the proposal and
this final action place on studies to
inform the question above is discussed
in more detail in the proposal for this
action (82 FR 34792, July 26, 2017,
section II.F.4). Briefly, in addressing the
question above, the PA places the
greatest emphasis on studies reporting
positive and relatively precise (i.e.,
relatively narrow 95% confidence
intervals (CI)) health effect associations.
In evaluating whether such associations
are likely to reflect NO2 concentrations
meeting the existing 1-hour standard,
the PA considers the 1-hour ambient
NO2 concentrations measured at
monitors in study locations during
study periods. The PA also considers
what additional information is available
regarding the ambient NO2
concentrations that could have been
present in the study locations during the
study periods (e.g., around major roads).
When considered together, this
information can provide important
insights into the extent to which NO2
health effect associations have been
reported for NO2 air quality
concentrations that likely would have
met the current 1-hour NO2 standard.
The PA evaluates U.S. and Canadian
studies of respiratory-related hospital
admissions and ED visits, with a focus
on studies of asthma-related effects
(studies identified from Table 5–10 in
U.S. EPA, 2016a).52 For each NO2
52 Strong support was also provided by
epidemiologic studies for respiratory symptoms, but
the majority of studies on respiratory symptoms
were only conducted over part of a year,
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monitor in the locations included in
these studies, and for the ranges of years
encompassed by studies, the PA
identifies the 3-year averages of the 98th
percentiles of the annual distributions
of daily maximum 1-hour NO2
concentrations.53 These concentrations
approximate the DVs that are used when
determining whether an area meets the
1-hour primary NO2 NAAQS.54 Thus,
these estimated DVs can provide
perspective on whether study areas
would likely have met or exceeded the
primary 1-hour NO2 NAAQS during the
study periods. Based on this approach,
study locations would likely have met
the current 1-hour standard over the
entire study period if all of the hourly
DV estimates were at or below 100 ppb.
A key limitation in these analyses of
NO2 DV estimates is that currently
required near-road NO2 monitors were
not in place during study periods. The
studies evaluated were based on air
quality from 1980–2006, with most
studies spanning the 1990s to early
2000s. There were no specific near-road
monitoring network requirements
during these years, and most areas did
not have monitors sited to measure NO2
concentrations near the most heavily
trafficked roadways. In addition, mobile
source NOX emissions were
considerably higher during the time
periods of the available epidemiologic
studies than in more recent years (U.S.
EPA, 2017a, section 2.1.2), suggesting
that the NO2 concentration gradients
around major roads could have been
more pronounced than indicated by
data from recently deployed near-road
monitors.55 This information suggests
that if the current near-road monitoring
network had been in operation during
study periods, NO2 concentrations
measured at near-road monitors would
complicating the evaluation of a DV based on data
from 3 years of monitoring data relative to the
respective health effect estimates. For more
information on these studies and the estimated DVs
in the study locations, see Appendix A of the PA
(U.S. EPA, 2017a).
53 All study locations had maximum annual DVs
below 53 ppb (U.S. EPA, 2017a, Appendix A).
54 As described in section I.B., a DV is a statistic
that describes the air quality status of a given area
relative to the NAAQS and that is typically used to
classify nonattainment areas, assess progress
towards meeting the NAAQS, and develop control
strategies. For the 1-hour NO2 standard, the DV is
calculated at individual monitors and based on 3
consecutive years of data collected from that site.
In the case of the 1-hour NO2 standard, the DV for
a monitor is based on the 3-year average of the 98th
percentile of the annual distribution of daily
maximum 1-hour NO2 concentrations. For more
information on these studies and the calculation of
the study area DVs estimates, see Appendix A of the
NO2 PA (U.S. EPA, 2017a).
55 Recent data indicate that, for most near-road
monitors, measured 1-hour NO2 concentrations are
higher than those measured at all of the non-nearroad monitors in the same CBSA (Section II.A.1.d).
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likely have been higher than those
identified in the PA (U.S. EPA, 2017a,
Figure 3–1). This uncertainty
particularly limits the degree to which
strong conclusions about whether an
area would have met the current 1-hour
standard during the study period can be
reached based on study areas with DV
estimates that are at or just below 100
ppb.56
With this key limitation in mind, the
PA considers what the available
epidemiologic evidence indicates with
regard to the adequacy of the public
health protection provided by the
current 1-hour standard against shortterm NO2 exposures. To this end, the PA
highlights the epidemiologic studies
examining associations between asthma
hospitalizations or ED visits and shortterm exposures to ambient NO2 that
were conducted in the U.S. and Canada
(U.S. EPA, 2017a, Figure 3–1). These
studies were identified and evaluated in
the 2016 NOX ISA and include both the
few recently published studies and the
studies that were available in the
previous review.
In considering the epidemiologic
information presented in the U.S. and
Canadian studies, the PA notes that
multicity studies tend to have greater
power to detect associations. The one
multicity study that has become
available since the last review (Stieb et
al., 2009) reported a null association
with asthma ED visits, based on study
locations with maximum estimated DVs
ranging from 67–242 ppb (six of seven
study cities had maximum estimated
DVs at or above 85 ppb). Of the singlecity studies identified, those reporting
positive and relatively precise
associations were conducted in
locations with maximum, and often
mean, estimated DVs at or above 100
ppb (i.e., Linn et al., 2000; Peel et al.,
2005; Ito et al., 2007; Villeneuve et al.,
2007; Burnett et al., 1999; Strickland et
al., 2010). Maximum estimated DVs
from these study locations ranged from
100 to 242 ppb (U.S. EPA, Figure 3–1).
For the other single-city studies, two
reported more mixed results in locations
with maximum estimated DVs around
90 ppb (Jaffe et al., 2003; ATSDR,
2006).57 Associations in these studies
56 Epidemiologic studies that evaluate potential
NO2 health effect associations during time periods
when near-road monitors are operational could
reduce this uncertainty in future reviews.
57 The study by the U.S. Agency for Toxic
Substances and Disease Registry (ATSDR) was not
published in a peer-review journal. Rather, it was
a report prepared by the New York State
Department of Health’s Center for Environmental
Health, the New York State Department of
Environmental Conservation and Columbia
University in the course of performing work
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were generally not statistically
significant, were less precise (i.e., wider
95% CI), and included a negative
association (Manhattan, NY). One
single-city study was conducted in a
location with 1-hour estimated DVs well
below 100 ppb (Li et al., 2011), though
the reported associations were not
statistically significant and were
relatively imprecise. Thus, of the U.S.
and Canadian studies that can most
clearly inform consideration of the
adequacy of the current NO2 primary
standards, the lone multicity study did
not report a positive health effect
association, and the single-city studies
reporting positive and relatively precise
associations were generally conducted
in locations with maximum 1-hour
estimated DVs at or above 100 ppb (i.e.,
up to 242 ppb). The evidence for
associations in locations with maximum
estimated DVs below 100 ppb is more
mixed and reported associations are
generally less precise.
An uncertainty in this body of
evidence is the potential for copollutant
confounding. Copollutant (twopollutant) models can be used in
epidemiologic studies in an effort to
disentangle the independent pollutant
effects, though there can be limitations
in these models due to differential
exposure measurement error and high
correlations with traffic-related
copollutants. For NO2, the copollutants
that are most relevant to consider are
those from traffic sources such as CO,
EC/BC, UFP, and VOCs such as
benzene, as well as PM2.5 and PM10
(U.S. EPA, 2016a, Section 3.5).58 Of the
studies examining asthma-related
hospital admissions and ED visits in the
U.S. and Canada, three examined
copollutant models (Ito et al., 2007;
Villeneuve et al., 2007; Strickland et al.,
2010). Ito et al. (2007) found that in
copollutant models with PM2.5, SO2, CO,
or O3, NO2 consistently had the
strongest effect estimates that were
robust to the inclusion of other
pollutants. Villeneuve et al. (2007)
utilized a model including NO2 and CO
(r = 0.74) for ED visits in the warm
season and reported that associations for
NO2 were robust to CO. Strickland et al.
(2010) found that the relationship
between ambient NO2 and asthma ED
visits in Atlanta, GA, was robust in
models including O3, but copollutant
models were not analyzed for other
pollutants, and the correlations between
NO2 and other pollutants were not
reported. Taken together, these studies
provide some evidence for independent
effects of NO2 for asthma-related
hospital admissions and ED visits, but
some important traffic-related
copollutants (e.g., EC/BC, VOCs) have
not been examined in this body of
evidence and the limitations of
copollutant models in demonstrating an
independent association are noted (U.S.
EPA, 2016a, section 3.5).
Considering this evidence together,
the PA notes the following observations.
First, the only recent multicity study
evaluated, which had maximum
estimated DVs ranging from 67 to 242
ppb, did not report a positive
association between NO2 and ED visits
(Stieb et al., 2009). In addition, of the
single-city studies reporting positive
and relatively precise associations
between NO2 and asthma hospital
admissions and ED visits, most
locations likely had NO2 concentrations
above the current 1-hour NO2 standard
over at least part of the study period.
Although maximum estimated DVs for
the studies conducted in Atlanta were
100 ppb (Peel et al., 2005; Strickland et
al., 2010), it is likely that those DVs
would have been higher than 100 ppb
if currently required near-road monitors
had been in place. For the study
locations with maximum estimated DVs
below 100 ppb, mixed results are
reported with associations that are
generally lack precision and are not
statistically significant, indicating that
associations between NO2
concentrations and asthma-related ED
visits are more uncertain in locations
that could have met the current
standards. Given that near-road
monitors were not in operation during
study periods, it is not clear that these
DVs below 100 ppb indicate study areas
that would have met the current 1-hour
standard.
Thus, while epidemiologic studies
provide support for NO2-associated
hospital admissions and ED visits at
ambient NO2 concentrations likely to
have been above those allowed by the
current 1-hour standard, the PA reaches
the conclusion that available U.S. and
Canadian epidemiologic studies do not
provide support for such NO2-associated
outcomes in locations with NO2
concentrations that would have clearly
met that standard.
contracted for and sponsored by the New York State
Energy Research and Development Authority and
the ATSDR.
58 In this case, differential exposure measurement
error occurs when exposure measurement error
varies by pollutant (e.g., within a model exposure
to PM2.5 may be estimated with higher accuracy
than exposure to SO2).
b. Health Effects With Long-Term
Exposure to NO2
This section discusses the evidence
for health effects associated with longterm NO2 exposures. Section II.A.2.b.i
discusses the nature of the health effects
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that have been shown to be associated
with long-term NO2 exposures and the
strength of the evidence supporting
various effects, based on the assessment
of that evidence in the 2016 NOX ISA.
Sections II.A.2.b.ii and II.A.2.b.iii
discuss the NO2 concentrations at which
health effects have been demonstrated
to occur based on the considerations
and analyses included in the PA.
i. Nature of Effects
In the last review of the primary NO2
NAAQS, evidence for health effects
related to long-term ambient NO2
exposure was judged ‘‘suggestive of, but
not sufficient to infer a causal
relationship’’ for respiratory effects and
‘‘inadequate to infer the presence or
absence of a causal relationship’’ for
several other health effect categories.
These included cardiovascular effects
and reproductive and developmental
effects, as well as cancer and total
mortality. In the current review, new
epidemiologic evidence, in conjunction
with explicit integration of evidence
across related outcomes, has resulted in
strengthening of some of the causal
determinations. Though the evidence of
health effects associated with long-term
exposure to NO2 is more robust than in
previous reviews, there are still a
number of uncertainties limiting
understanding of the role of long-term
NO2 exposures in causing health effects.
Chapter 6 of the 2016 NOX ISA
presents a detailed assessment of the
evidence for health effects associated
with long-term NO2 exposures (U.S.
EPA, 2016a). This evidence is
summarized briefly below for
respiratory effects. Cardiovascular
effects and diabetes, reproductive and
developmental effects, premature
mortality, and cancer are also briefly
addressed.
Respiratory Effects
The 2016 NOX ISA concluded that
there is ‘‘likely to be a causal
relationship’’ between long-term NO2
exposure and respiratory effects, based
primarily on evidence integrated across
disciplines for a relationship with
asthma development in children.59
Evidence for other respiratory outcomes
integrated across epidemiologic and
experimental studies, including
decrements in lung function and
partially irreversible decrements in lung
development, respiratory disease
severity, chronic bronchitis/asthma
incidence in adults, chronic obstructive
59 Asthma development is also referred to as
‘‘asthma incidence’’ in this document and
elsewhere. Both asthma development and asthma
incidence refer to the onset of the disease rather
than the exacerbation of existing disease.
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pulmonary disease (COPD) hospital
admissions, and respiratory infections,
is less consistent and has larger
uncertainty as to whether there is an
independent effect of long-term NO2
exposure (U.S. EPA, 2016a, Section
6.2.9). As noted above, NO2 is only one
of many etiologic agents that may
contribute to respiratory health effects
such as the development of asthma in
children.
The conclusion of a ‘‘likely to be
causal relationship’’ in the current
review represents a change from 2008
NOX ISA conclusion that the evidence
was ‘‘suggestive of, but not sufficient to
infer, a causal relationship’’ (U.S. EPA,
2008a, Section 5.3.2.4). This
strengthening of the causal
determination is due to the
epidemiologic evidence base, which has
expanded since the last review, and
biological plausibility from some
experimental studies (U.S. EPA, 2016a,
Table 1–1). This expanded evidence
includes several recently published
longitudinal studies that indicate
positive associations between asthma
incidence in children and long-term
NO2 exposures, with improved exposure
assessment in some studies based on
NO2 modeled estimates for children’s
homes or NO2 measured near children’s
homes or schools. Associations were
observed across various periods of
exposure, including first year of life,
year prior to asthma diagnosis, and
cumulative exposure. In addition, the
2016 NOX ISA notes several other
strengths of the evidence base including
the general timing of asthma diagnosis
and relative confidence that the NO2
exposure preceded asthma development
in longitudinal studies, more reliable
estimates of asthma incidence based on
physician-diagnosis in children older
than 5 years of age from parental report
or clinical assessment, as well as
residential NO2 concentrations
estimated from land use regression
models with good NO2 prediction in
some studies.
While the causal determination has
been strengthened in this review,
important uncertainties remain. For
example, the 2016 NOX ISA notes that,
as in the last review, a ‘‘key uncertainty
that remains when examining the
epidemiologic evidence alone is the
inability to determine whether NO2
exposure has an independent effect
from that of other pollutants in the
ambient mixture’’ (U.S. EPA, 2016a,
Section 6.2.2.1, p. 6–21). While a few
studies have included copollutant
models for respiratory effects other than
asthma development, the 2016 NOX ISA
states that ‘‘[e]pidemiologic studies of
asthma development in children have
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not clearly characterized potential
confounding by PM2.5 or traffic-related
pollutants [e.g., CO, BC/EC, volatile
organic compounds (VOCs)]’’ (U.S. EPA,
2016a, p. 6–64). The 2016 NOX ISA
further notes that ‘‘[i]n the longitudinal
studies, correlations with PM2.5 and BC
were often high (e.g., r = 0.7–0.96), and
no studies of asthma incidence
evaluated models to address copollutant
confounding, making it difficult to
evaluate the independent effect of NO2’’
(U.S. EPA, 2016a, p. 6–64). High
correlations between NO2 and other
traffic-related pollutants were based on
modeling, and studies of asthma
incidence that used monitored NO2
concentrations as an exposure surrogate
did not report such correlations (U.S.
EPA, 2016a, Table 6–1). This
uncertainty is important to consider
when interpreting the epidemiologic
evidence regarding the extent to which
NO2 is independently related to asthma
development.
The 2016 NOX ISA also evaluated
copollutant confounding in long-term
exposure studies beyond asthma
incidence to examine whether studies of
other respiratory effects could provide
information on the potential for
confounding by traffic-related
copollutants. Several studies examined
correlations between NO2 and trafficrelated copollutants and found them to
be relatively high in many cases,
ranging from 0.54–0.95 for PM2.5, 0.54–
0.93 for BC/EC, 0.2–0.95 for PM10, and
0.64–0.86 for OC (U.S. EPA, 2016a,
Tables 6–1 and 6–3). While these
correlations are often based on model
estimates, some are based on monitored
pollutant concentrations (i.e.,
McConnell et al. (2003) reported
correlations of 0.54 with PM2.5 and EC)
(U.S. EPA, 2016a, Table 6–3).
Additionally, three studies (McConnell
et al., 2003; MacIntyre et al., 2014;
Gehring et al., 2013) 60 evaluated
copollutant models with NO2 and PM2.5,
and some findings suggest that
associations for NO2 with bronchitic
symptoms, lung function, and
respiratory infection are not robust
because effect estimates decreased in
magnitude and became imprecise when
a copollutant was added in the model.
Overall, examination of evidence from
studies of other respiratory effects
60 In single-pollutant models for various health
endpoints, the studies reported the following effect
estimates (95% CI): McConnell et al., 2003
(Bronchitic symptoms) 1.97 (1.22, 3.18); MacIntyre
et al., 2014 (Pneumonia) 1.30 (1.02, 1.65), (Otitis
Media) 1.09 (1.02, 1.16), (Croup) 0.96 (0.83, 1.12);
Gehring et al., 2013 (forced expiratory volume in 1
second) ¥0.98 (¥1.70, ¥0.26), (FVC) ¥2.14
(¥4.20, ¥0.04), (peak expiratory flowF) ¥1.04
(¥1.94, ¥0.13).
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indicates moderate to high correlations
between long-term NO2 concentrations
and traffic-related copollutants, with
very limited evaluation of the potential
for confounding. Thus, when
considering the collective evidence, it is
difficult to disentangle the independent
effect of NO2 from other traffic-related
pollutants or mixtures in epidemiologic
studies (U.S. EPA, 2016a, Sections 3.4.4
and 6.2.9.5).
While this uncertainty continues to
apply to the epidemiologic evidence for
asthma incidence in children, the 2016
NOX ISA explains that the uncertainty
is partly reduced by the coherence of
findings from experimental studies and
epidemiologic studies. Experimental
studies demonstrate effects on key
events in the mode of action proposed
for the development of asthma and
provide biological plausibility for the
epidemiologic evidence. For example,
one study demonstrated that airway
hyperresponsiveness was induced in
guinea pigs after long-term exposure to
NO2 (1,000–4,000 ppb; Kobayashi and
Miura, 1995). Other experimental
studies examining oxidative stress
report mixed results, but some evidence
from short-term studies supports a
relationship between NO2 exposure and
increased pulmonary inflammation in
healthy humans. The 2016 NOX ISA
also points to supporting evidence from
studies demonstrating that short-term
exposure repeated over several days
(260–1,000 ppb) and long-term NO2
exposure (2,000–4,000 ppb) can induce
T helper (Th)2 skewing/allergic
sensitization in healthy humans and
animal models by showing increased
Th2 cytokines, airway eosinophils, and
immunoglobulin E (IgE)-mediated
responses (U.S. EPA, 2016a, Sections
4.3.5 and 6.2.2.3). Epidemiologic studies
also provide some supporting evidence
for these key events in the mode of
action. Some evidence from
epidemiologic studies demonstrates
associations between short-term
ambient NO2 concentrations and
increases in pulmonary inflammation in
healthy children and adults, giving a
possible mechanistic understanding of
this effect (U.S. EPA, 2016a, Section
5.2.2.5). Overall, evidence from
experimental and epidemiologic studies
provides support for a role of NO2 in
asthma development by describing a
potential role for repeated exposures to
lead to recurrent inflammation and
allergic responses.
To summarize, the 2016 NOX ISA
notes that there is new evidence
available that strengthens conclusions
from the last review regarding
respiratory health effects attributable to
long-term ambient NO2-exposure. The
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majority of new evidence is from
epidemiologic studies of asthma
incidence in children with improved
exposure assessment (i.e., measured or
modeled at or near children’s homes or
schools), which builds upon previous
evidence for associations of long-term
NO2 and asthma incidence and also
partly reduces uncertainties related to
measurement error. Explicit integration
of evidence for individual outcome
categories (e.g., asthma incidence,
respiratory infection) provides
improved characterization of biological
plausibility, including some new
evidence from studies of short-term
exposure supporting an effect on asthma
development. Although this partly
reduces the uncertainty regarding
independent effects of NO2, the
potential for confounding remains a
concern when interpreting these
epidemiologic studies as a result of the
high correlation with other trafficrelated copollutants and the general lack
of copollutant models including these
pollutants. In particular, it remains
unclear the degree to which NO2 itself
may be causing the development of
asthma versus serving as a surrogate for
the broader traffic-pollutant mix.
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Cardiovascular Effects and Diabetes
In the previous review, the 2008 NOX
ISA stated that the evidence for
cardiovascular effects attributable to
long-term ambient NO2 exposure was
‘‘inadequate to infer the presence or
absence of a causal relationship.’’ The
epidemiologic and experimental
evidence was limited, with
uncertainties related to traffic-related
copollutant confounding (U.S. EPA,
2008a). For the current review, the body
of epidemiologic evidence available is
substantially larger than that in the last
review and includes evidence for
diabetes. The conclusion on causality is
stronger in the current review with
regard to the relationship between longterm exposure to NO2 and
cardiovascular effects and diabetes, as
the 2016 NOX ISA judged the evidence
to be ‘‘suggestive, but not sufficient to
infer’’ a causal relationship (U.S. EPA,
2016a, Section 6.3). More information
on these health effects may be found in
section II.C.2.a.ii of the proposal (87 FR
34792, July 26, 2017).
Reproductive and Developmental
Effects
In the previous review, a limited
number of epidemiologic and
toxicological studies had assessed the
relationship between long-term NO2
exposure and reproductive and
developmental effects. The 2008 NOX
ISA concluded that there was not
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consistent evidence for an association
between NO2 and birth outcomes and
that evidence was ‘‘inadequate to infer
the presence or absence of a causal
relationship’’ with reproductive and
developmental effects overall (U.S. EPA,
2008a). In the 2016 NOX ISA for the
current review, a number of recent
studies added to the evidence base, and
reproductive effects were considered as
three separate categories: birth
outcomes; fertility, reproduction, and
pregnancy; and postnatal development
(U.S. EPA, 2016a, Section 6.4). Overall,
the 2016 NOX ISA found the evidence
to be ‘‘suggestive of, but not sufficient
to infer, a causal relationship’’ between
long-term exposure to NO2 and birth
outcomes and ‘‘inadequate to infer the
presence or absence of a causal
relationship’’ between long-term
exposure to NO2 and fertility,
reproduction and pregnancy as well as
postnatal development. More
information on these health effects may
be found in section II.C.2.a.iii of the
proposal (87 FR 34792, July 26, 2017).
Total Mortality
In the 2008 NOX ISA, a limited
number of epidemiologic studies
assessed the relationship between longterm exposure to NO2 and mortality in
adults. The 2008 NOX ISA concluded
that the scarce amount of evidence was
‘‘inadequate to infer the presence or
absence of a causal relationship’’ (U.S.
EPA, 2008a). The 2016 NOX ISA for the
current review concludes that evidence
is ‘‘suggestive of, but not sufficient to
infer, a causal relationship’’ between
long-term exposure to NO2 and
mortality among adults (U.S. EPA,
2016a, Section 6.5.3). More information
on these health effects may be found in
section II.C.2.a.iv of the proposal (87 FR
34792, July 26, 2017).
Cancer
The evidence evaluated in the 2008
NOX ISA was judged ‘‘inadequate to
infer the presence or absence of a causal
relationship’’ (U.S. EPA, 2008a) based
on a few epidemiologic studies
indicating associations between longterm NO2 exposure and lung cancer
incidence but lack of toxicological
evidence demonstrating that NO2
induces tumors. In the current review,
the conclusion drawn from the
integration of evidence is ‘‘suggestive of,
but not sufficient to infer, a causal
relationship’’ (U.S. EPA, 2016a, Section
6.6.9). More information on cancer
outcomes may be found in section
II.C.2.a.v of the proposal (87 FR 34792,
July 26, 2017).
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ii. Long-Term NO2 Concentrations in
Health Studies
In evaluating what the available
health evidence indicates with regard to
the degree of public health protection
provided by the current standards, the
EPA considers the long-term NO2
concentrations that have been
associated with various effects. The PA
explicitly considers these NO2
concentrations within the context of
evaluating the public health protection
provided by the current standards (U.S.
EPA, 2017a, Section 3.2). This section
summarizes those considerations from
the PA.
In evaluating the long-term NO2
concentrations associated with health
effects within the context of considering
the adequacy of the current standards,
the PA focuses on the evidence for
asthma incidence (i.e., the type of effect
for which there is the strongest evidence
supporting a ‘‘likely to be causal’’
relationship, as discussed above). The
PA specifically considers: (1) The extent
to which epidemiologic studies indicate
associations between long-term NO2
exposures and asthma development for
distributions of ambient NO2
concentrations that would likely have
met the existing standards; and (2) the
extent to which effects related to asthma
development have been reported
following the range of NO2 exposure
concentrations examined in
experimental studies. These
considerations are discussed below for
epidemiologic studies and experimental
studies.
Ambient NO2 Concentrations in
Locations of Epidemiologic Studies
As discussed above for short-term
exposures (Section II.A.2.a), when
considering epidemiologic studies of
long term NO2 exposures within the
context of evaluating the adequacy of
the current NO2 standards, the PA
emphasizes studies conducted in the
U.S. and Canada. The PA considers the
extent to which these studies report
positive and relatively precise
associations with long-term NO2
exposures and the extent to which
important uncertainties could impact
the emphasis placed on particular
studies. For the studies with potential to
inform conclusions on adequacy, the PA
also evaluates available air quality
information in study locations, focusing
on estimated DVs over the study
periods.
The epidemiologic studies available
in the current review that evaluate
associations between long-term NO2
exposures and asthma incidence are
summarized in Table 6–1 of the 2016
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NOX ISA (U.S. EPA, 2016a, p. 6–7). In
evaluating the adequacy of the current
NO2 standards, the PA places the
greatest emphasis on the three U.S. and
Canadian studies identified in the 2016
NOX ISA as providing key supporting
evidence for the causal determination.61
However, the PA also considers what
the additional three U.S. and Canadian
studies not identified as key studies in
the 2016 NOX ISA can indicate about
the adequacy of the current standards,
while noting the increased uncertainty
in these studies related to exposure
measurement and copollutant
confounding (Table 6–5 of the 2016
NOX ISA).
While it is appropriate to consider
what these studies can tell us with
regard to the adequacy of the existing
primary NO2 standards (see below), the
emphasis that is placed on these
considerations reflects important
uncertainties related to the potential for
confounding by traffic-related
copollutants and for exposure
measurement error.
While keeping in mind these
uncertainties, the PA next considers the
ambient NO2 concentrations present at
monitoring sites in locations and time
periods of U.S. and Canadian
epidemiologic studies. Specifically, the
PA considers the following question: To
what extent do U.S. and Canadian
epidemiologic studies report
associations with long-term NO2 in
locations likely to have met the current
primary NO2 standards?
As discussed above for short-term
exposures (Section II.A.2.a), addressing
this question can provide important
insights into the extent to which NO2health effect associations are present for
distributions of ambient NO2
concentrations that would be allowed
by the current primary standards. The
presence of such associations would
support the potential for the current
standards to allow the NO2-associated
asthma development indicated by
epidemiologic studies. To the degree
studies have not reported associations
in locations meeting the current primary
NO2 standards, there is greater
uncertainty regarding the potential for
the development of asthma to result
from the NO2 exposures associated with
air quality meeting those standards.
To evaluate this issue, the PA
compares NO2 estimated DVs in study
areas to the levels of the current primary
61 There are six longitudinal epidemiologic
studies conducted in the U.S. or Canada that vary
in terms of the populations examined and methods
used. Of the six studies, the 2016 NOX ISA
identifies three as key studies supporting the causal
determination (Carlsten et al., 2011; Clougherty et
al., 2007; Jerrett et al., 2008).
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NO2 standards. In addition to comparing
annual DVs to the level of the annual
standard, support for consideration of 1hour DVs comes from the 2016 NOX
ISA’s integrated mode of action
information describing the biological
plausibility for development of asthma
(section II.B.1, below). In particular,
studies demonstrate the potential for
repeated short-term NO2 exposures to
induce pulmonary inflammation and
development of allergic responses. The
2016 NOX ISA states that ‘‘findings for
short-term NO2 exposure support an
effect on asthma development by
describing a potential role for repeated
exposures to lead to recurrent
inflammation and allergic responses,’’
which are ‘‘identified as key early
events in the proposed mode of action
for asthma development’’ (U.S. EPA,
2016a, p. 6–66 and p. 6–64). More
specifically, the 2016 NOX ISA states
the following (U.S. EPA, 2016a,
p. 4–64):
The initiating events in the development of
respiratory effects due to long-term NO2
exposure are recurrent and/or chronic
respiratory tract inflammation and oxidative
stress. These are the driving factors for
potential downstream key events, allergic
sensitization, airway inflammation, and
airway remodeling, that may lead to the
endpoint [airway hyperresponsiveness]. The
resulting outcome may be new asthma onset,
which presents as an asthma exacerbation
that leads to physician-diagnosed asthma.
Thus, when considering the
protection provided by the current
standards against NO2-associated
asthma development, the PA considers
the combined protection afforded by the
1-hour and annual standards.62
To inform consideration of whether a
study area’s air quality could have met
the current primary NO2 standards
during study periods, the PA presents
DV estimates based on the NO2
concentrations measured at existing
monitors during the years over which
the epidemiologic studies of long-term
NO2 exposures were conducted.63 64
62 It is also the case that broad changes in NO
2
concentrations will affect both hourly and annual
metrics. This is discussed in more detail in Section
II.A.1 above, and in the CASAC letter to the
Administrator on the draft PA (Diez Roux and
Sheppard, 2017). Thus, as in the recent review of
the O3 NAAQS (80 FR 65292, October 26, 2015), it
is appropriate here to consider the extent to which
a short-term standard could provide protection
against longer-term pollutant exposures.
63 As discussed above for short-term exposures,
the DVs estimates reported here are meant to
approximate the values that are used when
determining whether an area meets the primary
NO2 NAAQS (U.S. EPA, 2017a, Appendix A).
64 The DV estimates for the epidemiologic studies
of asthma incidence conducted in the U.S. and
Canada are presented in Figure 3–2 of the NO2 PA
(U.S. EPA, 2017a).
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17243
In interpreting these comparisons of
DV estimates with the NO2 standards,
the PA also considers uncertainty in the
extent to which identified DV estimates
represent the higher NO2 concentrations
likely to have been present near major
roads during study periods (section
II.A.1, above). In particular, as discussed
above for short-term exposures, study
area DV estimates are based on NO2
concentrations from the generally areawide NO2 monitors that were present
during study periods. Calculated DV
estimates could have been higher if the
near-road monitors that are now
required in major U.S. urban areas had
been in place. On this issue, the PA
notes that the published scientific
literature supports the occurrence of
higher NO2 concentrations near
roadways and that recent air quality
information from the new near-road
NO2 monitoring network generally
indicates higher NO2 concentrations at
near-road monitoring sites than at non
near-road monitors in the same CBSA
(section II.A.c, above). In addition,
mobile source NOX emissions were
substantially higher during the majority
of study periods (1986–2006) than they
are today (section II.A.b, above), and
NO2 concentration gradients around
roadways were generally more
pronounced during study periods than
indicated by recent air quality
information. Thus, even in cases where
DV estimates during study periods are at
or somewhat below the levels of current
primary standards, it is not clear that
study areas would have met the
standards if the currently required nearroad monitors had been in place.65
In considering the epidemiologic
studies looking at long-term NO2
exposure and asthma development (U.S.
EPA, 2017a, Figure 3–2), the PA first
notes the information from the key
studies as identified in the 2016 NOX
ISA (Jerrett et al., 2008; Carlsten et al.,
2011, Clougherty et al., 2007). Jerrett et
al. (2008) reported positive and
relatively precise associations with
asthma incidence, based on analyses
across several communities in Southern
California. Of the 11 study communities
evaluated by Jerrett et al. (2008), most
(i.e., seven) had maximum annual
estimated DVs that were near (i.e., 46
ppb for the four communities
represented by the Riverside estimated
DVs) or above (i.e., 60 ppb for the three
communities represented by the Los
65 As noted above for studies of short-term NO
2
exposures (II.A.2.a), epidemiologic studies that
evaluate potential NO2 health effect associations
during time periods when near-road monitors are
operational could reduce this uncertainty in future
reviews.
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Angeles estimated DVs) 53 ppb.66 These
seven communities also had 1-hour
estimated DVs (maximum and mean)
that were well above 100 ppb. The other
key studies (i.e., Carlsten et al., 2011;
Clougherty et al., 2007), conducted in
single cities, reported positive but
statistically imprecise associations. The
annual estimated DVs in locations of
these studies during study years were
below 53 ppb, but maximum 1-hour
estimated DVs were near (Clougherty et
al., 2007) 67 or above (Carlsten et al.,
2011) 100 ppb.
The PA also considers the information
from the other U.S. and Canadian
studies available that, due to additional
uncertainties, were not identified as key
studies in the 2016 NOX ISA (Clark et
al., 2010; McConnell et al., 2010;
Nishimura et al., 2013). The multicity
study by Nishimura et al. (2013) reports
a positive and relatively precise
association with asthma incidence,
based on five U.S. cities and Puerto Rico
(see ‘‘combined’’ estimate in Figure 3–
2 of the NO2 PA). Annual estimated DVs
in all study cities were below 53 ppb,
while maximum 1-hour estimated DVs
were above 100 ppb in four of the five
study cities (mean 1-hour estimated DVs
were also near or above 100 ppb in most
study cities). Nishimura et al. (2013)
also reported mixed results in cityspecific effects estimates. McConnell et
al. (2010) also conducted a multicommunity study in Southern California
and reported a positive and relatively
precise association between asthma
incidence and long-term NO2 exposures
based on central-site measurements.
This study encompasses some of the
same communities as Jerrett et al.
(2008), and while the annual DV
estimates for these study years are more
mixed, the 1-hour DV estimates
representing 10 of 13 communities are
near or above 100 ppb. Finally, Clark et
al. (2010) reported a relatively precise
and statistically significant association
in a study conducted over a two-year
period in British Columbia, with annual
and hourly DV estimates of 32 ppb and
67 ppb, respectively. However, this
result was based on central-site NO2
measurements that have wellrecognized limitations in reflecting
variability in ambient NO2
66 For the studies by Jerrett et al. (2008) and
McConnell et al. (2010), the majority of
communities were located within the Los Angeles
and Riverside CBSAs. Because of this, DV estimates
for the Los Angeles and Riverside CBSAs were used
to represent multiple study communities.
67 As noted above, even in cases where DV
estimates during study periods are at or somewhat
below the levels of current standards, it is not clear
that study areas would have met the standards if the
currently required near-road monitors had been in
place during the study period.
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concentrations in a community and
variability in NO2 exposure among
subjects.
PA Conclusions on Ambient NO2
Concentrations in Locations of
Epidemiologic Studies
Based on the information discussed
above, while epidemiologic studies
provide support for NO2-associated
asthma development at ambient NO2
concentrations likely to have been above
those allowed by the current standards,
these studies do not report such
associations at ambient NO2
concentrations that would have clearly
met both of the current standards. Thus,
in evaluating the adequacy of the public
health protection provided by the
current 1-hour and annual NO2
standards, the PA concludes that
epidemiologic studies do not provide a
clear basis for concluding that ambient
NO2 concentrations allowed by the
current standards are independently
(i.e., independent of co-occurring
roadway pollutants) associated with the
development of asthma (U.S. EPA,
2017a, section 3.3.2). This conclusion
stems from consideration of the
available evidence from U.S. and
Canadian studies for NO2-associated
asthma incidence, the ambient NO2
concentrations present in study
locations during study periods, and the
uncertainties and limitations inherent in
the evidence and in the analysis of
study area DV estimates.
With regard to uncertainties in the
evidence, the PA particularly notes the
potential for confounding by cooccurring pollutants, as described
above, given the following: (1) The
relatively high correlations observed
between long-term concentrations of
NO2 and long-term concentrations of
other roadway-associated pollutants;
and (2) the general lack of information
from copollutant models on the
potential for NO2 associations that are
independent of another traffic-related
pollutant or mix of pollutants. This
uncertainty is an important
consideration in evaluating the potential
support for adverse effects occurring
below the levels of the current primary
NO2 standards.
Furthermore, the analysis of study
area estimated DVs does not provide
support for the occurrence of NO2associated asthma incidence in
locations with ambient NO2
concentrations clearly meeting the
current NAAQS. In particular, for most
of the study locations evaluated in the
lone key U.S. multi-community study
(Jerrett et al., 2008), 1-hour estimated
DVs were above 100 ppb, and annual
DVs were near or above 53 ppb. In
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addition, the two key single-city studies
evaluated reported positive, but
relatively imprecise, associations in
locations with 1-hour estimated DVs
near (Clougherty et al., 2007 in Boston)
or above (Carlsten et al., 2011 in
Vancouver) 100 ppb. Had currently
required near-road monitors been in
operation during study periods,
estimated DVs in U.S. study locations
would likely have been higher. Other
U.S. and Canadian studies evaluated
were subject to greater uncertainties in
the characterization of NO2 exposures.
Given this information and
consideration of these uncertainties, the
degree to which these epidemiologic
studies can inform whether adverse
NO2-associated effects (i.e., asthma
development) are occurring below the
levels of the current primary NO2
standards is limited.
iii. NO2 Concentrations in Experimental
Studies of Long-Term Exposure
In addition to the evidence from
epidemiologic studies, the PA also
considers evidence from experimental
studies in animals and humans.68
Experimental studies examining
asthma-related effects attributable to
long-term NO2 exposures are largely
limited to animals exposed to NO2
concentrations well above those found
in the ambient air (i.e., ≥1,000 ppb). As
discussed above, the 2016 NOX ISA
indicates that evidence from these
animal studies supports the causal
determination by characterizing ‘‘a
potential mode of action linking NO2
exposure with asthma development’’
(U.S. EPA, 2016a, p. 1–20). In particular,
there is limited evidence for increased
airway responsiveness in guinea pigs
with exposures to 1,000–4,000 ppb for
6–12 weeks. There is inconsistent
evidence for pulmonary inflammation
across all studies, though effects were
reported following NO2 exposures of
500–2,000 ppb for 12 weeks. Despite
providing support for the ‘‘likely to be
a causal’’ relationship, these
experimental studies, by themselves, do
not provide insight into the occurrence
of adverse health effects following
exposures below the levels of the
existing primary NO2 standards.69
68 While there are not controlled human exposure
studies for long-term exposures, the 2016 NOX ISA
and the PA consider the extent to which evidence
from short-term studies can provide support for
effects observed in long-term exposure studies (U.S.
EPA 2016a, chapter 6; U.S. EPA, 2017a, section 3).
69 In addition, the 2016 NO ISA draws from
X
experimental evidence for short-term exposures to
support the biological plausibility of asthma
development. Consideration of the NO2 exposure
concentrations evaluated in these studies is
discussed in Section II.A.2 above.
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Overall Conclusions for Long Term
Exposures
Taking all of the evidence and
information together, including
important uncertainties, the PA revisits
the extent to which the evidence
supports the occurrence of NO2attributable asthma development in
children at NO2 concentrations below
the existing standards. Based on the
considerations discussed above, the PA
concludes that the available evidence
does not provide support for asthma
development attributable to long-term
exposures to NO2 concentrations that
would clearly meet the existing annual
and 1-hour primary NO2 standards. This
conclusion recognizes the NO2 air
quality relationships, which indicate
that meeting the 1-hour NO2 standard
would be expected to limit annual NO2
concentrations to well below the level of
the current annual standard (Section
II.A.2.d, above). This conclusion also
recognizes the uncertainties in
interpreting the epidemiologic evidence
within the context of evaluating the
existing standards due to the lack of
near-road monitors during study periods
and due to the potential for confounding
by co-occurring pollutants. Thus, the PA
concludes that epidemiologic studies of
long-term NO2 exposures and asthma
development do not provide a clear
basis for concluding that ambient NO2
concentrations allowed by the current
primary NO2 standards are
independently (i.e., independent of cooccurring roadway pollutants)
associated with the development of
asthma. In addition, while experimental
studies provide support for NO2attributable effects that are plausibly
related to asthma development, the
relatively high NO2 exposure
concentrations used in these studies do
not provide insight into whether such
effects would occur at NO2 exposure
concentrations that would be allowed
by the current standards.
c. Potential Public Health Implications
Evaluation of the public health
protection provided against ambient
NO2 exposures requires consideration of
populations and lifestages that may be
at greater risk of experiencing NO2attributable health effects. In the last
review, the 2008 NOX ISA noted that a
considerable fraction of the U.S.
population lives, works, or attends
school near major roadways, where
ambient NO2 concentrations are often
elevated (U.S. EPA, 2008a, Section 4.3).
Of this population, the 2008 NOX ISA
concluded that ‘‘those with
physiological susceptibility will have
even greater risks of health effects
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related to NO2’’ (U.S. EPA, 2008a, p.
4–12). With regard to susceptibility, the
2008 NOX ISA concluded that
‘‘[p]ersons with preexisting respiratory
disease, children, and older adults may
be more susceptible to the effects of NO2
exposure’’ (U.S. EPA, 2008a, p. 4–12).
In the current review, the 2016 NOX
ISA again notes that because of the large
populations attending school, living,
working, and commuting on or near
roads, where ambient NO2
concentrations can be higher than in
many other locations (U.S. EPA, 2016a,
Section 7.5.6),70 there is widespread
potential for elevated ambient NO2
exposures. For example, Rowangould
(2013) found that over 19% of the U.S.
population lives within 100 m of roads
with an annual average daily traffic
(AADT) of 25,000 vehicles, and 1.3%
lives near roads with AADT greater than
200,000. The proportion is much larger
in certain parts of the country, mostly
coinciding with urban areas. Among
California residents, 40% live within
100 m of roads with AADT of 25,000
(Rowangould, 2013). In addition, 7% of
U.S. schools serving a total of 3,152,000
school children are located within 100
m of a major roadway, and 15% of U.S.
schools serving a total of 6,357,000
school children are located within 250
m of a major roadway (Kingsley et al.,
2014). Thus, as in the last review, the
available information indicates that
large proportions of the U.S. population
potentially have elevated NO2 exposures
as a result of living, working, attending
school, or commuting on or near
roadways.
The impacts of exposures to elevated
NO2 concentrations, such as those that
can occur around roadways, are of
particular concern for populations at
increased risk of experiencing adverse
effects. In the current review, the PA’s
consideration of potential at-risk
populations (U.S. EPA, 2017a, Section
3.4) draws from the 2016 NOX ISA’s
assessment of the evidence (U.S. EPA,
2016a, Chapter 7). The 2016 NOX ISA
uses a systematic approach to evaluate
factors that may increase risks in a
particular population or during a
particular lifestage, noting that
increased risk could be due to ‘‘intrinsic
or extrinsic factors, differences in
internal dose, or differences in
exposure’’ (U.S. EPA, 2016a, p. 7–1).
The 2016 NOX ISA evaluates the
evidence for a number of potential atrisk factors, including pre-existing
diseases like asthma (U.S. EPA, 2016a,
70 The 2016 NO ISA specifically notes that a
X
zone of elevated NO2 concentrations typically
extends 200 to 500 m from roads with heavy traffic
(U.S. EPA, 2016a, Section 2.5.3).
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17245
Section 7.3), genetic factors (U.S. EPA,
2016a, Section 7.4), sociodemographic
factors (U.S. EPA, 2016a, Section 7.5),
and behavioral and other factors (U.S.
EPA, 2016a, Section 7.6). The 2016 NOX
ISA then uses a systematic approach for
classifying the evidence for each
potential at-risk factor (U.S. EPA, 2015a,
Preamble, Section 6.a, Table III). The
categories considered are ‘‘adequate
evidence,’’ ‘‘suggestive evidence,’’
‘‘inadequate evidence,’’ and ‘‘evidence
of no effect’’ (U.S. EPA, 2016a, Table
7–1). Consistent with other recent
NAAQS reviews (e.g., the recently
completed review for ozone, 80 FR
65292, October 26, 2015), the PA
focuses the consideration of potential atrisk populations on those factors for
which the 2016 NOX ISA determines
there is ‘‘adequate’’ evidence (U.S. EPA,
2016a, Table 7–27). For NO2, the at-risk
populations identified include people
with asthma, children and older adults
(U.S. EPA, 2016a, Table 7–27), and this
information is based primarily on
evidence for asthma exacerbation or
asthma development as evidence for an
independent relationship of NO2
exposure with other health effects is
more uncertain.
The PA’s consideration of the
evidence supporting conclusions
regarding the populations at increased
risk of NO2-related effects specifically
focuses on the following question: To
what extent does the currently available
scientific evidence expand the
understanding of populations and/or
lifestages that may be at greater risk for
NO2-related health effects? (U.S. EPA,
2017a, p. 3–40).
In addressing this question, the PA
considers the evidence in the 2016 NOX
ISA for effects in people with asthma,
children, and older adults (U.S. EPA,
2016a, Chapter 7, Table 7–27),
respectively, as described below.
People With Asthma
Approximately 8.0% of adults and
9.3% of children (age <18 years) in the
U.S. currently have asthma (Blackwell
et al., 2014; Bloom et al., 2013), and it
is the leading chronic illness affecting
children (U.S. EPA, 2016a, Section
7.3.1). Individuals with pre-existing
diseases like asthma may be at greater
risk for some air pollution-related health
effects if they are in a compromised
biological state.
As in the last review, controlled
human exposure studies demonstrating
NO2-induced increases in AR provide
key evidence that people with asthma
are more sensitive than people without
asthma to the effects of short-term NO2
exposures. In particular, a meta-analysis
conducted by Folinsbee et al. (1992)
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demonstrated that NO2 exposures from
100 to 300 ppb increased AR in the
majority of adults with asthma, while
AR in adults without asthma was
increased only for NO2 exposure
concentrations greater than 1,000 ppb
(U.S. EPA, 2016a, Section 7.3.1). The
Brown (2015) meta-analysis showed that
following resting exposures to NO2
concentrations in the range of 100 to
530 ppb, about a quarter of individuals
with asthma experience clinically
relevant increases in AR to non-specific
bronchial challenge. Results of
epidemiologic studies are less clear
regarding potential differences between
populations with and without asthma
(U.S. EPA, 2016a, Section 7.3.1).
Additionally, studies of activity patterns
do not clearly indicate differences in
time spent outdoors to suggest
differences in NO2 exposure. However,
the Folinsbee et al. (1992) meta-analysis
of information from controlled human
exposure studies, which supported the
2016 NOX ISA’s determination of a
causal relationship between short-term
exposures and respiratory effects,
clearly demonstrates that adults with
asthma are at increased risk for NO2related respiratory health effects
compared to healthy adults. Thus,
consistent with observations made in
the 2008 NOX ISA (U.S. EPA, 2008a), in
the current review the 2016 NOX ISA
determines that the ‘‘evidence is
adequate to conclude that people with
asthma are at increased risk for NO2related health effects’’ (U.S. EPA, 2016a,
p. 7–7).
Children
According to the 2010 census, 24% of
the U.S. population is less than 18 years
of age, with 6.5% less than 6 years of
age (Howden and Meyer, 2011). The
National Human Activity Pattern Survey
shows that children spend more time
than adults outdoors (Klepeis et al.,
1996), and a longitudinal study in
California showed a larger proportion of
children reported spending time
engaged in moderate or vigorous
outdoor physical activity (Wu et al.,
2011b). In addition, children have a
higher propensity than adults for
oronasal breathing (U.S. EPA, 2016a,
Section 4.2.2.3) and the human
respiratory system is not fully
developed until 18¥20 years of age
(U.S. EPA, 2016a, Section 7.5.1). Higher
activity along with higher ventilation
rates relative to lung volume and higher
propensity for oronasal breathing could
potentially result in greater NO2
penetration to the lower respiratory
tracts of children; however, this effect
has not been examined for NO2 (U.S.
EPA, section 4.2.2.3). All of these factors
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could contribute to children being at
higher risk than adults for effects
attributable to ambient NO2 exposures
(U.S. EPA, 2016a, Section 7.5.1.1).
Epidemiologic evidence across
diverse locations (U.S., Canada, Europe,
Asia, Australia) consistently
demonstrates NO2-associated health
effects with both short- and long-term
exposures in children. In particular,
short-term increases in ambient NO2
concentrations are consistently
associated with larger increases in
asthma-related hospital admissions, ED
visits, or outpatient visits in children
than in adults (U.S. EPA, 2016a, Section
7.5.1.1, Table 7–13). These results seem
to indicate NO2-associated impacts that
are 1.8 to 3.4-fold larger in children
(Son et al., 2013; Ko et al., 2007;
Atkinson et al., 1999; Anderson et al.,
1998). In addition, asthma development
in children has been reported to be
associated with long-term NO2
exposures, based on exposure periods
spanning infancy to adolescence (U.S.
EPA, 2016a, Section 6.2.2.1). Given the
consistent epidemiologic evidence for
associations between ambient NO2 and
asthma-related outcomes, including the
larger associations with short-term
exposures observed in children, the
2016 NOX ISA concludes the evidence
‘‘is adequate to conclude that children
are at increased risk for NO2-related
health effects’’ (U.S. EPA, 2016a, p. 7–
32).
Older Adults
According to the 2012 National
Population Projections issued by the
U.S. Census Bureau, 13% of the U.S.
population was age 65 years or older in
2010, and by 2030, this fraction is
estimated to grow to 20% (Ortman et al.,
2014). Recent epidemiologic findings
expand on evidence available in the
2008 NOX ISA that older adults may be
at increased risk for NO2-related health
effects. (U.S. EPA, 2016a, Table 7–15).
While it is not clear that older adults
experience greater NO2 exposures or
doses, epidemiologic evidence generally
indicates greater risk of NO2-related
health effects in older adults compared
with younger adults. For example,
comparisons of older and younger
adults with respect to NO2-related
asthma exacerbation generally show
larger (one to threefold) effects in adults
ages 65 years or older than among
individuals ages 15–64 years or 15–65
years (Ko et al., 2007; Villeneuve et al.,
2007; Migliaretti et al., 2005; Anderson
et al., 1998). Results for all respiratory
hospital admissions combined also tend
to show larger associations with NO2
among older adults ages 65 years or
older (Arbex et al., 2009; Wong et al.,
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2009; Hinwood et al., 2006; Atkinson et
al., 1999). The 2016 NOX ISA
determined that, overall, the consistent
epidemiologic evidence for asthmarelated hospital admissions and ED
visits ‘‘is adequate to conclude that
older adults are at increased risk for
NO2-related health effects’’ (U.S. EPA,
2016a, p. 7–37).
PA Conclusions on At-Risk Populations
As described in the PA, and
consistent with the last review, the 2016
NOX ISA determined that the available
evidence is adequate to conclude that
people with asthma, children, and older
adults are at increased risk for NO2related health effects. The large
proportions of the U.S. population that
encompass each of these groups and
lifestages (i.e., 8% adults and 9.3%
children with asthma, 24% all children,
13% all older adults) underscores the
potential for important public health
impacts attributable to NO2 exposures.
These impacts are of particular concern
for members of these populations and
lifestages who live, work, attend school,
or otherwise spend a large amount of
time in locations of elevated ambient
NO2, including near heavily trafficked
roadways.
3. Overview of Risk and Exposure
Assessment Information
Beyond the consideration of the
scientific evidence, discussed above in
Section II.A.2, the EPA also considers
the extent to which new or updated
quantitative analyses of NO2 air quality,
exposures, or health risks could inform
conclusions on the adequacy of the
public health protection provided by the
current primary NO2 standards.
Conducting such quantitative analyses,
if appropriate, could inform judgments
about the public health impacts of NO2related health effects and could help to
place the evidence for specific effects
into a broader public health context. To
this end, in the REA Planning document
(U.S. EPA, 2015b) and in the PA (U.S.
EPA, 2017a), the staff evaluated the
extent to which the available evidence
and information provide support for
conducting new or updated analyses of
NO2 exposures and/or health risks,
beyond the analyses conducted in the
2008 REA (U.S. EPA, 2008b). In doing
so, staff carefully considered the
assessments developed as part of the
last review of the primary NO2 NAAQS
(U.S. EPA, 2008b) and the newly
available scientific and technical
information, particularly considering
the degree to which updated analyses in
the current review are likely to
substantially add to the understanding
of NO2 exposures and/or health risks. In
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developing the final PA, staff also
considered the CASAC advice and
public input received on the REA
Planning document (U.S. EPA, 2017a,
Chapter 4) and on the draft PA (Diez
Roux and Sheppard, 2017). Based on
these considerations, the PA included
updated analyses examining the
occurrence of NO2 air quality
concentrations (i.e., as surrogates for
potential NO2 exposures) that may be of
public health concern (see below and
Appendix B of U.S. EPA, 2017a). These
analyses, summarized below and
discussed in more detail in Chapter 4 of
the PA (U.S. EPA, 2017a), have been
informed by advice from the CASAC
and input from the public on the REA
Planning document (Diez Roux and
Frey, 2015b) and on the draft PA (Diez
Roux and Sheppard, 2017). Updated
risk estimates based on information
from epidemiology studies on
respiratory health effects associated
with short and long-term exposure to
NO2 were not conducted in the current
review given that these analyses would
be subject to the same uncertainties
identified in the 2008 REA (U.S. EPA,
2017a, Section 4–1). The CASAC agreed
with this conclusion on short-term NO2
exposures in its review of the REA
Planning document, and for long-term
exposures they agreed but encouraged
the EPA to consider the feasibility of
such an assessment for long-term
exposures (Diez Roux and Frey, 2015b,
p. 5). In its review of the draft PA the
CASAC agreed with the EPA’s
conclusions on the feasibility of an
epidemiologic risk assessment based on
evidence of long-term NO2 exposures
(Diez Roux and Sheppard, 2016, p. 2).71
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a. Overview of Approach to Estimating
Potential NO2 Exposures
To provide insight into the potential
occurrence of NO2 air quality
concentrations that may be of public
health concern, the PA included new
analyses comparing NO2 air quality to
health-based benchmarks in 23 study
areas (U.S. EPA, 2017a, Table 4–1). The
selection of study areas focused on
CBSAs with near-road monitors in
operation,72 CBSAs with the highest
71 After considering the factors discussed above,
we conclude that a quantitative risk assessment
based on epidemiologic studies of long-term NO2
exposures is not warranted in this review because
of a lack of U.S. epidemiologic studies identified by
the 2016 NOX ISA as being key studies, lack of
baseline incidence rates for the health effects of
interest, uncertainty regarding the shape of the
concentration-response function, and a lack of
studies that have controlled for potential
confounders, making it difficult to determine the
true magnitude of effect (U.S. EPA, 2017a, sections
4.4.2.2 and 4.4.2.3).
72 As discussed above, near-road monitors are
required within 50 m of major roads in large urban
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NO2 design values, and CBSAs with a
relatively large number of NO2 monitors
overall (i.e., providing improved spatial
characterization).73
Air quality-benchmark comparisons
were conducted in study areas with
unadjusted air quality and with air
quality adjusted upward to just meet the
existing 1-hour standard.74 Upward
adjustment was required because all
locations in the U.S. meet the current
NO2 NAAQS.
In identifying the range of NO2 healthbased benchmarks to evaluate, and the
weight to place on specific benchmarks
within this range, the PA considered
both the group mean responses reported
in individual studies of AR and the
results of a meta-analysis that combined
individual-level data from multiple
studies (Brown, 2015; U.S. EPA, 2016a,
Section 5.2.2.1). When taken together,
the results of controlled human
exposure studies and of the metaanalysis by Brown (2015) support
consideration of NO2 benchmarks from
100 to 300 ppb, based largely on studies
of non-specific AR in study participants
exposed to NO2 at rest.75 76 Given
uncertainties in the evidence, including
the lack of an apparent dose-response
relationship and uncertainty in the
areas that met certain criteria for population size or
traffic volume. 40 CFR part 58, appendix E, Sec.
6.4(a). Most near-road monitors are sited within
about 30 m of the road, and in some cases they are
sited almost at the roadside (i.e., as close as 2 m
from the road; https://www3.epa.gov/ttn/amtic/
nearroad.html) (U.S. EPA, 2017a, Section 2.2.2).
73 Based on these criteria, a total of 23 CBSAs
from across the U.S. were selected as study areas
(U.S. EPA, 2017a, Appendix B, Figure B2–1).
Further evaluation indicates that these 23 study
areas are among the most populated CBSAs in the
U.S.; they have among the highest total NOX
emissions and mobile source NOX emissions in the
U.S.; and they include a wide range of stationary
source NOX emissions (U.S. EPA, 2017a, Appendix
B, Figures B2–2 to B2–8).
74 In all study areas, ambient NO concentrations
2
required smaller upward adjustments to just meet
the 1-hour standard than to just meet the annual
standard. Therefore, when adjusting air quality to
just meet the current primary NO2 NAAQS, the PA
applied the adjustment needed to just meet the
1-hour standard. For additional information on the
air quality adjustment approach see Appendix B,
Section B2.4.1 in the PA (U.S. EPA, 2017a).
75 Benchmarks from the upper end of this range
are supported by the results of individual studies,
the majority of which consistently reported
statistically significant increases in AR following
NO2 exposures at or above 250 ppb, and by the
results of the meta-analysis by Brown (2015).
Benchmarks from the lower end of this range are
supported by the results of the meta-analysis, even
though individual studies generally do not report
statistically significant NO2-induced increases in
AR following exposures below 200 ppb.
76 While benchmarks between 100 to 200 ppb
were considered, analyses were only conducted on
concentrations between 100 to 200 ppb as even in
the worst-case years (i.e., the years with the largest
number of days at or above benchmarks), no study
areas had any days with 1-hour NO2 concentrations
at or above 200 ppb.
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potential adversity of reported increases
in AR, the risks of these exposures
cannot be fully characterized based on
existing studies and caution is
appropriate when interpreting the
potential public health implications of
1-hour NO2 concentrations at or around
these benchmarks. This is particularly
the case for the 100 ppb benchmark,
given the less consistent results across
individual studies at this exposure
concentration (see Section II.A.2 above
and U.S. EPA, 2017a, Section 4.2.1).
b. Results of Updated Analyses
In considering the results of these
updated analyses, the EPA focuses on
the number of days per year that 1-hour
NO2 concentrations at or above the
respective benchmarks could occur at
each monitoring site in each study area.
Based on the results of these analyses
(U.S. EPA, 2017a, Tables 4–1 and 4–2),
the EPA makes the following key
observations for study areas when air
quality was unadjusted (‘‘as-is’’) and
when air quality was adjusted to just
meet the current 1-hour NO2 standard
(U.S. EPA, 2017a, Section 4.2.1.2). For
unadjusted air quality:
• One-hour ambient NO2
concentrations in study areas, including
those near major roadways, were always
below 200 ppb, and were virtually
always below 150 ppb.
Æ Even in the worst-case years (i.e.,
the years with the largest number of
days at or above benchmarks), no study
areas had any days with 1-hour NO2
concentrations at or above 200 ppb, and
only one area had any days (i.e., one
day) with 1-hour concentrations at or
above 150 ppb.
• One-hour ambient NO2
concentrations in study areas, including
those near major roadways, only rarely
reached or exceeded 100 ppb. On
average in all study areas, 1-hour NO2
concentrations at or above 100 ppb
occurred on less than one day per year.
Æ Even in the worst-case years, most
study areas had either zero or one day
with 1-hour NO2 concentrations at or
above 100 ppb (7 days in the single
worst-case location and worst-case
year).
For air quality adjusted to just meet the
current primary 1-hour NO2 standard:
• The current standard is estimated to
allow no days in study areas with 1hour ambient NO2 concentrations at or
above 200 ppb. This is true for both
area-wide and near-road monitoring
sites, even in the worst-case years.
• The current standard is estimated to
allow almost no days with 1-hour
ambient NO2 concentrations at or above
150 ppb, based on both area-wide and
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near-road monitoring sites (i.e., zero to
one day per year, on average).
Æ In the worst-case years in most
study areas, the current standard is
estimated to allow either zero or one
day with 1-hour ambient NO2
concentrations at or above 150 ppb. In
the single worst-case year and location,
the current standard is estimated to
allow eight such days.
• At area-wide monitoring sites in
most of the study areas, the current
standard is estimated to allow from one
to seven days per year, on average, with
1-hour ambient NO2 concentrations at or
above 100 ppb. At near-road monitoring
sites in most of the study areas, the
current standard is estimated to allow
from about one to 10 days per year with
such 1-hour concentrations.
Æ In the worst-case years in most of
the study areas, the current standard is
estimated to allow from about 5 to 20
days with 1-hour NO2 concentrations at
or above 100 ppb (30 days in the single
worst-case location and year).
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c. Uncertainties
There are a variety of limitations and
uncertainties in these comparisons of
NO2 air quality with health-based
benchmarks. In particular, there are
uncertainties in the evidence underlying
the benchmarks themselves,
uncertainties in the upward adjustment
of NO2 air quality concentrations, and
uncertainty in the degree to which
monitored NO2 concentrations reflect
the highest potential NO2
concentrations. Each of these is
discussed below.
i. Health-Based Benchmarks
The primary goal of this analysis is to
inform conclusions regarding the
potential for the existing primary NO2
standards to allow exposures to ambient
NO2 concentrations that may be of
concern for public health. As discussed
in detail above (Sections II.A.2), the
meta-analysis by Brown (2015) indicates
the potential for increased AR in some
people with asthma following NO2
exposures from 100 to 530 ppb, while
individual studies show more consistent
results above 250 ppb. While it is
possible that certain individuals could
be more severely affected by NO2
exposures than indicated by existing
studies, which have generally evaluated
adults with mild asthma,77 there
remains uncertainty in the degree to
which the effects identified in
77 Brown (2015, p. 3) notes, however, that one
study included in the meta-analysis (Avol et al.,
1989) evaluated children aged 8 to 16 years and that
disease status varied across studies, ranging from
‘‘inactive asthma up to severe asthma in a few
studies.’’
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individual studies within the Brown
(2015) meta-analysis would be of public
health concern, specifically at lower
concentrations (e.g., 100 ppb). In
particular, the uncertainties regarding
the potential for adverse effects
following NO2 exposures at lower
concentrations when looking across
individual studies complicate the
interpretation of comparisons between
ambient NO2 concentrations and healthbased benchmarks. When considered in
the context of the less consistent results
observed across individual studies
following exposures to 100 ppb NO2, in
comparison to the more consistent
results at higher exposure
concentrations,78 these uncertainties
have the potential to be of particular
importance for interpreting the public
health implications of ambient NO2
concentrations at or around the 100 ppb
benchmark.79
With regard to the magnitude and
clinical relevance of the NO2-induced
increase in AR in particular, the metaanalysis by Brown (2015) attempts to
address this uncertainty and
inconsistency across individual studies.
Specifically, as discussed above
(Section II.A.2), the meta-analysis
evaluates the available individual-level
data on the magnitude of the change in
AR following resting NO2 exposures.
Brown (2015) reports that the magnitude
of the increases in AR observed
following resting NO2 exposures from
100 to 530 ppb was large enough to be
of potential clinical relevance in about
a quarter of the 72 study volunteers with
available data. This is based on the
fraction of exposed individuals who
experienced a halving of the PD of
challenge agent following NO2
exposures. This magnitude of change
has been recognized by the ATS and the
ERS as a ‘‘potential indicator, although
not a validated estimate, of clinically
relevant changes in [AR]’’ (Reddel et al.,
2009) (U.S. EPA, 2016a, p. 5–12).
Although there is uncertainty in using
this approach to characterize whether a
particular response in an individual is
‘‘adverse,’’ it can provide insight into
the potential for adversity, particularly
78 As discussed previously, while the metaanalysis indicates that a statistically significant
majority of study volunteers experienced increased
non-specific AR following exposures to 100 ppb
NO2, results were only marginally significant when
specific AR was also included in the analysis. In
addition, individual studies do not consistently
indicate increases in AR following exposures to 100
ppb NO2.
79 Sensitivity analyses included in Appendix B of
the PA (U.S. EPA, 2017a, Section 3.2, table B3–1)
also evaluated 1-hour NO2 benchmarks below 100
ppb (i.e., 85, 90, 95 ppb), though the available
health evidence does not provide a clear a basis for
determining what exposures to such NO2
concentrations might mean for public health.
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when applied to a population of
exposed individuals. While this analysis
by Brown (2015) indicates the potential
for some people with asthma to
experience effects of clinical relevance
following resting NO2 exposures from
100 to 530 ppb, it is based on a subset
of volunteers for which non-specific AR
was reported following exposures to
NO2 and air at rest, and the
interpretation of these results for any
specific exposure concentration within
the range of 100 to 530 ppb is uncertain
(see section II.A.2, above).
ii. Approach to Adjusting Ambient NO2
Concentrations
These analyses use historical air
quality relationships as the basis for
adjusting ambient NO2 concentrations to
just meet the current 1-hour standard
(U.S. EPA, 2017a, Appendix B). The
approach to adjusting ambient NO2
concentrations was supported by the
CASAC, who found the approach both
suitable and appropriate (Diez Roux and
Frey, 2015b, p.1). This approach is
meant to illustrate a hypothetical
scenario and does not represent
expectations regarding future air quality
trends. There are, however, some
uncertainties in this approach. If
ambient NO2 concentrations were to
increase in some locations to the point
of just meeting the current standards, it
is not clear that the spatial and temporal
relationships reflected in the historical
data would persist. In particular, as
discussed in Section 2.1.2 of the PA
(U.S. EPA, 2017a), ongoing
implementation of existing regulations
is expected to result in continued
reductions in ambient NO2
concentrations over much of the U.S.
(i.e., reductions beyond the
‘‘unadjusted’’ air quality used in these
analyses). Thus, if ambient NO2
concentrations were to increase to the
point of just meeting the existing 1-hour
NO2 standard in some areas, the
resulting air quality patterns may not be
similar to those estimated in the PA’s air
quality adjustments.
There is also uncertainty in the
upward adjustment of NO2 air quality
because three years of data are not yet
available from most near-road monitors.
In most study areas, estimated DVs were
not calculated at near-road monitors
and, therefore, near-road monitors were
generally not used as the basis for
identifying adjustment factors for just
meeting the existing standard.80 In
locations where near-road monitors
80 However, in a few study locations near-road
monitors did contribute to the calculation of air
quality adjustments, as described in Appendix B of
the PA (U.S. EPA, 2017a, Table B2–7).
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measure the highest NO2 DVs, reliance
on those near-road monitors to identify
air quality adjustment factors would
likely result in smaller adjustments
being applied to monitors in the study
area. Thus, monitors in such study areas
would be adjusted upward by smaller
increments, potentially reducing the
number of days on which the current
standard is estimated to allow 1-hour
NO2 concentrations at or above
benchmarks. Given that near-road
monitors in most areas measure higher
1-hour NO2 concentrations than the
area-wide monitors in the same CBSA
(U.S. EPA, 2017a, Figures 2–7 to 2–10),
this uncertainty has the potential to
impact results in many of the study
areas. While the magnitude of the
impact is unknown at present, the
inclusion of additional years of nearroad monitoring information in the
determination of air quality adjustments
could result in fewer estimated 1-hour
NO2 concentrations at or above
benchmarks in some study areas.
iii. Degree to Which Monitored NO2
Concentrations Reflect the Highest
Potential NO2 Exposures
To the extent there are unmonitored
locations where ambient NO2
concentrations exceed those measured
by monitors in the current network, the
potential for NO2 exposures at or above
benchmarks could be underestimated.
In the last review, this uncertainty was
determined to be particularly important
for potential exposures on and around
roads. The 2008 REA estimated that the
large majority of modeled exposures to
ambient NO2 concentrations at or above
benchmarks occurred on or near roads
(U.S. EPA, 2008b, Figures 8–17 and 8–
18). When characterizing ambient NO2
concentrations, the 2008 REA attempted
to address this uncertainty by estimating
the elevated NO2 concentrations that
can occur on or near the road. These
estimates were generated by applying
literature-derived adjustment factors to
NO2 concentrations at monitoring sites
located away from the road.
In the current review, given that the
23 selected study areas have among the
highest NOX emissions in the U.S., and
given the siting characteristics of
existing NO2 monitors, this uncertainty
likely has only a limited impact on the
results of the air quality-benchmark
comparisons. In particular, as described
above, mobile sources tend to dominate
NOX emissions within most CBSAs, and
the 23 study areas evaluated have
among the highest mobile source NOX
emissions in the U.S. (U.S. EPA, 2017a,
Appendix B, Section B2.3.2). Most
study areas have near-road NO2
monitors in operation, which are
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required within 50 m of the most
heavily trafficked roadways in large
urban areas. The majority of these nearroad monitors are sited within 30 m of
the road, and several are sited within 10
m (see Atlanta, Cincinnati, Denver,
Detroit, and Los Angeles in the EPA’s
database of metadata for near-road
monitors).81 Thus, as explained in the
PA, even though the location of highest
NO2 concentrations around roads can
vary (U.S. EPA, 2017a, Section 2.1), the
near-road NO2 monitoring network,
with monitors sited from 2 to 50 m away
from heavily trafficked roads, is likely to
effectively capture the types of locations
around roads where the highest NO2
concentrations can occur.82
This conclusion is consistent with the
2016 NOX ISA’s analysis of available
data from near-road NO2 monitors,
which indicates that near-road monitors
with target roads having the highest
traffic counts also had among the
highest 98th percentiles of 1-hour daily
maximum NO2 concentrations (U.S.
EPA, 2016a, Section 2.5.3.2). The 2016
NOX ISA concludes that ‘‘[o]verall, the
very highest 98th percentile 1-hour
maximum concentrations were
generally observed at the monitors
adjacent to roads with the highest traffic
counts’’ (U.S. EPA, 2016a, p. 2–66).
It is also important to consider the
degree to which air quality-benchmark
comparisons appropriately characterize
the potential for NO2 exposures near
non-roadway sources of NOX emissions.
As noted in the PA, the 23 selected
study areas include CBSAs with large
non-roadway sources of NOX emissions.
This includes study areas with among
the highest NOX emissions from electric
power generation facilities (EGUs) and
airports, the two types of non-roadway
sources that are associated with the
highest NOX emissions in the U.S (U.S.
EPA, 2017a, Appendix B, Section
B2.3.2).
81 This database is found at https://www3.epa.gov/
ttn/amtic/nearroad.html.
82 In the current review, sensitivity analyses
included in Appendix B of the PA use updated data
from the scientific literature (Richmond-Bryant et
al., 2016) to estimate ‘‘on-road’’ NO2 concentrations
based on monitored concentrations around a
roadway in Las Vegas (Appendix B, Section B2.4.2).
However, there remains considerable uncertainty in
the relationship between on-road and near-road
NO2 concentrations, and in the degree to which
they may differ. Therefore, in evaluating the
potential for roadway-associated NO2 exposures,
the PA focuses on the concentrations at locations
of near-road monitors (U.S. EPA, 2017a, Chapter 4).
However, it remains possible that some areas (e.g.,
street canyons in urban environments) could have
higher ambient NO2 concentrations than indicated
by near-road monitors. Sensitivity analyses
estimating the potential for on-road NO2 exposures
are described in Appendix B of the PA (U.S. EPA,
2017a).
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While it is difficult to isolate non-road
impacts from certain non-road sources
like ports and airports, looking at
monitors that are influenced by nonroad emissions can help characterize the
potential for such exposures. As
discussed below, several study areas
have non-near-road NO2 monitors sited
to better characterize the impacts of
such sources.
As described in the PA (U.S. EPA,
2017a, Section 4.1.2.3), table 2–12 in the
2016 NOX ISA (U.S. EPA, 2016a)
summarizes NO2 concentrations at
selected monitoring sites that are likely
to be influenced by non-road sources,
including ports, airports, border
crossings, petroleum refining, or oil and
gas drilling. For example, the Los
Angeles, CA, CBSA includes one of the
busiest ports and one of the busiest
airports in the U.S. Out of 18 monitors
in the Los Angeles CBSA, three of the
five highest 98th percentile 1-hour
maximum concentrations were observed
at the near-road site, the site nearest the
port, and the site adjacent to the airport
(U.S. EPA, 2016a, section 2.5.3.2). In the
Chicago, IL, CBSA, the highest hourly
NO2 concentration measured in 2014
(105 ppb) occurred at the Schiller Park,
IL monitoring site, located adjacent to
O’Hare International Airport, and very
close to a major rail yard (i.e., Bedford
Park Rail Yard) and to a four-lane
arterial road (US 12 and US 45) (U.S.
EPA, 2016a, Section 2.5.3.2). Thus,
beyond the NO2 near-road monitors,
some NO2 monitors in study areas are
also sited to capture high ambient NO2
concentrations around important nonroadway sources of NOX emissions. In
addition, one of the highest 1-hour daily
maximum NO2 concentrations recorded
in recent years (136 ppb) was observed
at a Denver, CO, site that is not part of
the near-road monitoring network. This
concentration was observed at a monitor
located one block from high-rise
buildings that form the edge of the highdensity central business district. This
monitor is likely influenced by
commercial heating and other activities,
as well as local traffic (U.S. EPA, 2016a,
Section 2.5.3.2).
d. Conclusions
As discussed above and in the REA
Planning document (U.S. EPA, 2015b,
Section 2.1.1), an important uncertainty
identified in the 2008 REA was the
characterization of 1-hour NO2
concentrations around major roadways.
In the current review, data from recently
deployed near-road NO2 monitors
improves understanding of such
ambient NO2 concentrations.
As discussed in Section I.B, recent
NO2 concentrations measured in all U.S.
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locations meet the existing primary NO2
NAAQS. Based on these recent (i.e.,
unadjusted) ambient measurements,
analyses estimate almost no potential
for 1-hour exposures to NO2
concentrations at or above benchmarks,
even at the lowest benchmark examined
(i.e., 100 ppb).
Analyses of air quality adjusted
upwards to just meet the current 1-hour
standard estimate no days with 1-hour
NO2 concentrations at or above the 200
ppb benchmark, and virtually none for
exposures at or above 150 ppb. This is
the case for all years, including worstcase years and in study areas with nearroad monitors sited within a few meters
of heavily trafficked roads. With respect
to the lowest benchmark evaluated,
analyses estimate that the current 1hour standard allows the potential for
exposures to 1-hour NO2 concentrations
at or above 100 ppb on some days (e.g.,
in most study areas, about one to 10
days per year, on average).83
These results are consistent with
expectations, given that the current 1hour standard, with its 98th percentile
form, is anticipated to limit, but not
eliminate, exposures to 1-hour NO2
concentrations at or above 100 ppb.84
These results are similar to the results
presented in the REA from the last
review (U.S. EPA, 2008b, tables 7–23
through 7–25), based on NO2
concentrations at the locations of areawide ambient monitors (U.S. EPA,
2017a, Appendix B, Section B5.9, Table
B5–66). In contrast, compared to the on/
near-road simulations in the last review,
these results indicate substantially less
potential for 1-hour exposures to NO2
concentrations at or above these
benchmarks, though there is some
uncertainty as to whether these results
fully characterize on and near-road
exposures, in part because most nearroad monitors do not yet have three
years of data. (U.S. EPA, 2017a,
Appendix B, Section B5.9, Table B5–
66).85
When these results and associated
uncertainties are taken together, the
current 1-hour NO2 standard is expected
to allow virtually no potential for
83 Because the results show almost no days with
1-hour ambient NO2 concentrations above 150 ppb,
the results for the 100 ppb benchmark are due
primarily to 1-hour NO2 concentrations that are
closer to 100 ppb than 200 ppb.
84 The 98th percentile generally corresponds to
the 7th or 8th highest 1-hour concentration in a
year.
85 On-/near-road simulations in the last review
estimated that a 1-hour NO2 standard with a 98th
percentile form and a 100 ppb level could allow
about 20 to 70 days per year with 1-hour NO2
concentrations at or above the 200 ppb benchmark
and about 50 to 150 days per year with 1-hour
concentrations at or above the 100 ppb benchmark
(U.S. EPA, 2017a, Appendix B, Table B5–66).
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exposures to the NO2 concentrations
that have been shown most consistently
to increase AR in people with asthma
(i.e., above 200 ppb), even under worstcase conditions across a variety of study
areas with among the highest NOX
emissions in the U.S. Such NO2
concentrations were not estimated to
occur, even at monitoring sites adjacent
to some of the most heavily trafficked
roadways. In addition, the current
standard is expected to limit, though not
eliminate, exposures to 1-hour
concentrations at or above 100 ppb.
Though the current standard is
estimated to allow 1-hour NO2
concentrations at or above 100 ppb on
some days, there is uncertainty
regarding the adversity of the reported
NO2-induced increases in AR following
exposures to 100 ppb NO2. However, by
limiting exposures to NO2
concentrations at or above 100 ppb, the
current standard provides protection
against exposures to higher NO2
concentrations, for which the evidence
of potentially adverse NO2-attributable
effects is more consistent, as well as
against exposures to NO2 concentrations
at 100 ppb, for which the evidence of
potentially adverse NO2-attributable
effects is less consistent, but where the
meta-analysis indicates that a
marginally significant majority of study
participants experienced an increase in
AR following exposures (Brown, 2015).
Given the results of these analyses,
and the uncertainties inherent in their
interpretation, the PA concludes that
there is little potential for exposures to
ambient NO2 concentrations that would
be of clear public health concern in
locations meeting the current 1-hour
standard. Additionally, while a lower
level for the 1-hour standard (i.e., lower
than 100 ppb) would be expected to
further limit the potential for exposures
to 100 ppb NO2, the public health
implications of such reductions are
unclear, particularly given that no
additional protection would be expected
against exposures to NO2 concentrations
at or above the higher benchmarks (i.e.,
200 ppb and above), as the REA
analyses already estimate no days with
1-hour NO2 concentrations at or above
the 200 ppb benchmark in areas just
meeting the current 1-hour standard.
Thus, the PA concludes that these
analyses comparing ambient NO2
concentrations to health-based
benchmarks do not provide support for
considering potential alternative
standards that provide a different degree
of public health protection.
Additionally, in its review of the PA,
the CASAC stated that it was ‘‘satisfied
with the short-term exposure health-
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based benchmark analysis presented in
the draft PA’’ and that it ‘‘support[ed]
the decision not to conduct any new or
updated quantitative risk analyses
related to long-term exposure to NO2’’
(Diez Roux and Sheppard, 2017).
B. Conclusions on the Primary
Standards
In drawing conclusions on the
adequacy of the current primary NO2
standards, in view of the advances in
scientific knowledge and additional
information now available, the
Administrator considers the evidence
base, information, and policy judgments
that were the foundation of the last
review and reflects upon the body of
evidence and information newly
available in this review. In so doing, the
Administrator has taken into account
both evidence-based and exposure- and
risk-based considerations, advice from
the CASAC, and public comment.
Evidence-based considerations draw
upon the EPA’s assessment and
integrated synthesis of the scientific
evidence from epidemiological studies
and controlled human exposure studies
evaluating health effects related to
exposures to NO2 as presented in the
ISA, with a focus on policy-relevant
considerations as discussed in the PA.
The exposure- and risk-based
considerations draw from the results of
the quantitative analyses presented in
the 2008 REA and the additional
updated analyses presented in the PA
(as summarized in section II.D of the
proposal and section II.A.3 above) and
consideration of these results in the PA.
As described in section II.A.2 of the
proposal, consideration of the evidence
and exposure/risk information in the PA
and by the Administrator is framed by
consideration of a series of key policyrelevant questions. Section II.B.1 below
summarizes the rationale for the
Administrator’s proposed decision,
drawing from section II.E.4 of the
proposal. Advice received from the
CASAC in this review is briefly
summarized in section II.B.2 below. A
fuller presentation of PA considerations
and conclusions, and advice from the
CASAC, which were all taken into
account by the Administrator, is
provided in sections II.E.1 through II.E.3
of the proposal. Public comments on the
proposed decision are addressed in
section II.B.3 below. The
Administrator’s conclusions in this
review regarding the current primary
standards are described in section II.B.4
below.
1. Basis for the Proposed Decision
At the time of the proposal, the
Administrator carefully considered the
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assessment of the current evidence and
the conclusions reached in the 2016
NOX ISA; the currently available
exposure/risk information, including
associated limitations and uncertainties;
considerations and staff conclusions
and associated rationales presented in
the PA; the advice and
recommendations from the CASAC; and
public comments that had been offered
up to that point. In reaching his
proposed conclusion on the primary
standard, the Administrator took note of
evidence-based considerations (as
summarized in section II.B.1.a below)
and exposure- and risk-based
considerations (as summarized in
section II.B.1.b below).
a. Evidence-Based Considerations
In considering the evidence available
in the current review with regard to
adequacy of the current 1-hour and
annual NO2 standards, the first topic of
consideration was the nature of the
health effects attributable to NO2
exposures, drawing upon the integrated
synthesis of the health evidence in the
2016 NOX ISA and the evaluations in
the PA (Chapter 3). The following
questions guided this consideration: (1)
To what extent does the currently
available scientific evidence alter or
strengthen conclusions from the last
review regarding health effects
attributable to ambient NO2 exposures?
(2) Are previously identified
uncertainties reduced or do important
uncertainties remain? (3) Have new
uncertainties been identified? These
questions were addressed in the
proposal for both short-term and longterm NO2 exposures, with a focus on
health endpoints for which the 2016
NOX ISA concludes that the evidence
indicates there is a ‘‘causal’’ or ‘‘likely
to be a causal’’ relationship.
With regard to short-term NO2
exposures, the proposal noted that, as in
the last review, the strongest evidence
continues to come from studies
examining respiratory effects. In
particular, the 2016 NOX ISA concludes
that evidence indicates a ‘‘causal’’
relationship between short-term NO2
exposure and respiratory effects, based
on evidence related to asthma
exacerbation. While this conclusion
reflects a strengthening of the causal
determination, compared to the last
review, this strengthening is based
largely on a more specific integration of
the evidence related to asthma
exacerbations rather than on the
availability of new, stronger evidence.
The proposal further noted that
additional evidence has become
available since the last review, as
summarized below. However, this
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evidence has not fundamentally altered
the understanding of the relationship
between short-term NO2 exposures and
respiratory effects.
The strongest evidence supporting
this ISA causal determination comes
from controlled human exposure studies
demonstrating NO2-induced increases in
AR in individuals with asthma. A metaanalysis of data from these studies
indicates the majority of exposed
individuals, generally with mild
asthma, experienced increased AR
following exposures to NO2
concentrations as low as 100 ppb, while
individual studies most consistently
report such increases following
exposures to NO2 concentrations at or
above 250 ppb. Most of the controlled
human exposure studies assessed in the
2016 NOX ISA were available in the last
review, particularly studies of nonspecific AR. As in the last review, there
remains uncertainty due to the lack of
an apparent dose-response relationship
between NO2 exposures and AR and
uncertainty in the potential adversity of
NO2-induced increases in AR.86
Supporting evidence for a range of
NO2-associated respiratory effects also
comes from epidemiologic studies. In
this regard, the proposal placed
particular focus on studies that have
examined NO2 associations with
asthma-related hospital admissions or
ED visits, outcomes which are clearly
adverse. While some recent
epidemiologic studies provide new
evidence based on improved exposure
characterizations and copollutant
modeling, these studies are consistent
with the evidence from the last review
and do not fundamentally alter the
understanding of the respiratory effects
associated with ambient NO2 exposures.
Due to limitations in the available
epidemiologic methods, uncertainty
remains in the current review regarding
the extent to which findings for NO2 are
confounded by traffic-related
copollutants (e.g., PM2.5, EC/BC, CO), as
well as regarding the potential for
exposure measurement error and the
extent to which near-road NO2
concentrations are reflected in the
available air quality data.
Thus, while some new evidence is
available in this review, the proposal
noted that that new evidence did not
substantially alter the understanding of
the respiratory effects that occur
following short-term NO2 exposures.
This evidence is summarized in Section
II.C.1 of the proposal, as well as in
Section II.A.2 above, and is discussed in
86 This is particularly true at low concentrations
(i.e., 100 ppb).
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detail in the 2016 NOX ISA (U.S. EPA,
2016a, section 5.2.2).
With regard to long-term NO2
exposures, the 2016 NOX ISA concludes
that there is ‘‘likely to be a causal
relationship’’ between long-term NO2
exposure and respiratory effects, based
largely on the evidence for asthma
development in children. New
epidemiologic studies of asthma
development have increasingly utilized
improved exposure assessment methods
(i.e., measured or modeled
concentrations at or near children’s
homes and followed for many years),
which partly reduces uncertainties from
the last review related to exposure
measurement error. Explicit integration
of evidence for individual outcome
categories (e.g., asthma incidence,
respiratory infection) provides an
improved characterization of biological
plausibility and mode of action. This
improved characterization includes the
assessment of new evidence supporting
a potential role for repeated short-term
NO2 exposures in the development of
asthma. Uncertainties in interpreting
associations with asthma development
include high correlations between longterm average ambient concentrations of
NO2 and long-term concentrations of
other traffic-related pollutants, together
with the general lack of epidemiologic
studies evaluating copollutant models
that include traffic-related pollutants.
Specifically, the extent to which NO2
may be serving primarily as a surrogate
for the broader traffic-related pollutant
mix remains unclear. Thus, while the
evidence for respiratory effects related
to long-term NO2 exposures has become
stronger since the last review, there
remain important uncertainties to
consider in evaluating this evidence
within the context of the adequacy of
the current standards. This evidence is
summarized in Section II.C.2 of the
proposal, as well as in Section II.A.2
above, and is discussed in detail in the
2016 NOX ISA (U.S. EPA, 2016a, section
6.2.2).
Given the evaluation of the evidence
in the 2016 NOX ISA, and the 2016 NOX
ISA’s causal determinations, the EPA’s
further consideration of the evidence in
the proposal focused on studies of
asthma exacerbation (short-term
exposures) and asthma development
(long-term exposures) and on what these
bodies of evidence indicate with regard
to the basic elements of the current
primary NO2 standards. In particular,
the EPA considered the following
question: To what extent does the
available evidence for respiratory effects
attributable to either short- or long-term
NO2 exposures support or call into
question the basic elements of the
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current primary NO2 standards? In
addressing this question, the sections
below summarize the proposal’s
consideration of the evidence in the
context of the indicator, averaging
times, levels, and forms of the current
standards.
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i. Indicator
The indicator for both the current
annual and 1-hour NAAQS for oxides of
nitrogen is NO2. While the presence of
gaseous species other than NO2 has long
been recognized (U.S. EPA, 2016a,
Chapter 2), no alternative to NO2 has
been advanced as being a more
appropriate surrogate for ambient
gaseous oxides of nitrogen. Both
previous and recent controlled human
exposure studies and animal toxicology
studies provide specific evidence for
health effects following exposure to
NO2. Similarly, the large majority of
epidemiologic studies report health
effect associations with NO2, as opposed
to other gaseous oxides of nitrogen. In
addition, because emissions that lead to
the formation of NO2 generally also lead
to the formation of other NOX oxidation
products, measures leading to
reductions in population exposures to
NO2 can generally be expected to lead
to reductions in population exposures to
other gaseous oxides of nitrogen.
Therefore, an NO2 standard can also be
expected to provide some degree of
protection against potential health
effects that may be independently
associated with other gaseous oxides of
nitrogen even though such effects are
not discernable from currently available
studies. Given these considerations, the
PA reached the conclusion that it is
appropriate in the current review to
consider retaining the NO2 indicator for
standards meant to protect against
exposures to gaseous oxides of nitrogen.
In its review of the draft PA, the CASAC
agreed with this conclusion (Diez Roux
and Sheppard, 2017). In light of these
considerations, EPA proposed to retain
the indicator for the current standards.
ii. Averaging Time
The current primary NO2 standards
are based on 1-hour and annual
averaging times. The proposal explained
that, together, these standards can
provide protection against short- and
long-term NO2 exposures.
In establishing the 1-hour standard in
the last review, the Administrator
considered evidence from both
experimental and epidemiologic
studies. She noted that controlled
human exposure studies and animal
toxicological studies provided evidence
that NO2 exposures from less than one
hour up to three hours can result in
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respiratory effects such as increased AR
and inflammation. These included five
controlled human exposure studies that
evaluated the potential for increased AR
following 1-hour exposures to 100 ppb
NO2 in people with asthma. In addition,
epidemiologic studies had reported
health effect associations with both 1hour and 24-hour NO2 concentrations,
without indicating that either of these
averaging periods was more closely
linked with reported effects. Thus, the
available experimental evidence
provided support for considering an
averaging time of shorter duration than
24 hours while the epidemiologic
evidence provided support for
considering both 1-hour and 24-hour
averaging times. Given this evidence,
the Administrator concluded that, at a
minimum, a primary concern with
regard to averaging time was the level of
protection provided against 1-hour NO2
exposures. Based on available analyses
of NO2 air quality, she further
concluded that a standard with a 1-hour
averaging time could also be effective at
protecting against effects associated
with 24-hour NO2 exposures (75 FR
6502, February 9, 2010).
Based on the considerations
summarized above, the Administrator
judged in the last review that it was
appropriate to set a new NO2 standard
with a 1-hour averaging time. She
concluded that such a standard would
be expected to effectively limit shortterm (e.g., 1- to 24-hours) NO2 exposures
that had been linked to adverse
respiratory effects. She also retained the
existing annual standard to continue to
provide protection against effects
potentially associated with long-term
exposures to oxides of nitrogen (75 FR
6502, February 9, 2010). These
decisions were consistent with the
CASAC advice in the last review to
establish a short-term primary standard
for oxides of nitrogen based on using 1hour maximum NO2 concentrations and
to retain the current annual standard
(Samet, 2008, p. 2; Samet, 2009, p. 2).
The proposal explained that, as in the
last review, support for a standard with
a 1-hour averaging time comes from
both the experimental and
epidemiologic evidence. Controlled
human exposure studies evaluated in
the 2016 NOX ISA continue to provide
evidence that NO2 exposures from less
than one hour up to three hours can
result in increased AR in individuals
with asthma (U.S. EPA, 2016a, Tables
5–1 and 5–2). These controlled human
exposure studies provide key evidence
supporting the 2016 NOX ISA’s
determination that ‘‘[a] causal
relationship exists between short-term
NO2 exposure and respiratory effects
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based on evidence for asthma
exacerbation’’ (U.S. EPA, 2016a, p. 1–
17). In addition, the epidemiologic
literature assessed in the 2016 NOX ISA
provides support for short-term
averaging times ranging from 1 hour up
to 24 hours (e.g., U.S. EPA, 2016a
Figures 5–3, 5–4 and Table 5–12). As in
the last review, the 2016 NOX ISA
concludes that there is no indication of
a stronger association for any particular
short-term duration of NO2 exposure
(U.S. EPA, 2016a, section 1.6.1). Thus,
a 1-hour averaging time reasonably
reflects the exposure durations used in
the controlled human exposure studies
that provide the strongest support for
the 2016 NOX ISA’s determination of a
causal relationship. In addition, a
standard with a 1-hour averaging time is
expected to provide protection against
the range of short-term exposure
durations that have been associated
with respiratory effects in epidemiologic
studies (i.e., 1 hour to 24 hours). Thus,
in the PA, staff reached the conclusion
that, when taken together, the combined
evidence from experimental and
epidemiologic studies continues to
support an NO2 standard with a 1-hour
averaging time to protect against health
effects related to short-term NO2
exposures. In its review of the draft PA,
the CASAC found that there continued
to be scientific support for the 1-hour
averaging time (Diez Roux and
Sheppard, 2017, p. 7). In light of these
considerations, EPA proposed to retain
the averaging time for the current 1-hour
standard.
With regard to protecting against longterm exposures, the proposal explained
that the evidence supports considering
the overall protection provided by the
combination of the annual and 1-hour
standards. The current annual standard
was originally promulgated in 1971 (36
FR 8186, April 30, 1971), based on
epidemiologic studies reporting
associations between respiratory disease
and long-term exposure to NO2. The
annual standard was retained in
subsequent reviews, in part to provide
a margin of safety against the serious
effects reported in animal studies using
long-term exposures to high NO2
concentrations (e.g., above 8,000 ppb)
(U.S. EPA, 1995, section 7).
As described above, evidence newly
available in the current review
demonstrates associations between longterm NO2 exposures and asthma
development in children, based on NO2
concentrations averaged over year of
birth, year of diagnosis, or entire
lifetime. Supporting evidence indicates
that repeated short-term NO2 exposures
could contribute to this asthma
development. In particular, the 2016
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NOX ISA states that ‘‘findings for shortterm NO2 exposure support an effect on
asthma development by describing a
potential role for repeated exposures to
lead to recurrent inflammation and
allergic responses,’’ which are
‘‘identified as key early events in the
proposed mode of action for asthma
development’’ (U.S. EPA, 2016a, pp. 6–
64 and 6–65). Taken together, the
evidence supports the potential for
recurrent short-term NO2 exposures to
contribute to the asthma development
that has been reported in epidemiologic
studies to be associated with long-term
exposures. For these reasons, the PA
reached the conclusion that, in
establishing standards to protect against
adverse health effects related to longterm NO2 exposures, the evidence
supports the consideration of both 1hour and annual averaging times. In its
review of the draft PA, the CASAC
supported this approach of considering
the protection provided against longterm NO2 exposures by considering the
combination of the annual and 1-hour
NO2 standards. With reference to the
current annual standard, the CASAC
specifically noted that ‘‘it is the suite of
the current 1-hour and annual
standards, together, that provide
protection against adverse effects’’ (Diez
Roux and Sheppard, 2017, p. 9). In light
of these considerations, EPA proposed
to retain the averaging time for the
current annual standard.
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iii. Level and Form
In evaluating the extent to which
evidence supports or calls into question
the levels or forms of the current NO2
standards, the EPA considered the
following question: To what extent does
the evidence indicate adverse
respiratory effects attributable to shortor long-term NO2 exposures lower than
previously identified or below the
existing standards? In addressing this
question, it is useful to consider the
range of NO2 exposure concentrations
that have been evaluated in
experimental studies (controlled human
exposure and animal toxicology) and
the ambient NO2 concentrations in
locations where epidemiologic studies
have reported associations with adverse
outcomes. The proposal’s consideration
of these issues is discussed below for
short-term and long-term NO2
exposures.
Short-Term
Controlled human exposure studies
demonstrate the potential for increased
AR in some people with asthma
following 30-minute to 1-hour
exposures to NO2 concentrations near
those in the ambient air (U.S. EPA,
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2017a, Section 3.2.2).87 In evaluating the
NO2 exposure concentrations at which
increased AR has been observed, the
proposal considered both the group
mean results reported in individual
studies and the results from a recent
meta-analysis evaluating individuallevel data (Brown, 2015; U.S. EPA,
2016a, Section 5.2.2.1).88
When individual-level data were
combined in a meta-analysis, Brown
(2015) reported that statistically
significant majorities of study
participants experienced increased AR
following resting exposures to NO2
concentrations from 100 to 530 ppb. In
some affected individuals, the
magnitudes of these increases were large
enough to have potential clinical
relevance. Following exposures to 100
ppb NO2 specifically, the lowest
exposure concentration evaluated, a
marginally statistically significant
majority of study participants
experienced increased AR.89 As
discussed in more detail in Section
II.C.1 of the proposal, and in Section
II.A.2 above, individual studies
consistently report statistically
significant NO2-induced increases in AR
following resting exposures to NO2
concentrations at or above 250 ppb but
have generally not reported statistically
significant increases in AR following
resting exposures to NO2 concentrations
from 100 to 200 ppb. Limitations in this
evidence include the lack of an apparent
dose-response relationship between NO2
and AR and remaining uncertainty in
87 As discussed in Section II.C of the proposal and
Section II.A.2 above, experimental studies have not
reported other respiratory effects following shortterm exposures to NO2 concentrations at or near
those found in the ambient air.
88 As noted earlier in this section, group mean
responses in individual studies, and the variability
in those responses, can provide insight into the
extent to which observed changes in AR are due to
NO2 exposures, rather than to chance alone,
allowing us to evaluate the strength of the NO2 and
AR relationship across different concentrations of
NO2 in each study, and these studies have the
advantage of being based on the same exposure
conditions. The meta-analysis by Brown (2015) can
also provide insight into the extent to which
observed changes are due to NO2 exposures, but has
the additional benefit of aiding in the identification
of trends in individual-level responses across
studies and has the advantage of increased power
to detect effects, even in the absence of statistically
significant effects in individual studies, though
each study in the meta-analysis may not be based
on the exact same exposure conditions.
89 Brown (2015) reported a p-value of 0.08 when
data were combined from studies of specific and
non-specific AR. When the analysis was restricted
only to non-specific AR following exposures to 100
ppb NO2, the percentage who experienced
increased AR was larger and statistically significant.
In contrast, when the analysis was restricted only
to specific AR following exposures to 100 ppb NO2,
the majority of study participants did not
experience increased AR (U.S. EPA, 2016a; Brown
2015).
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the adversity of the reported increases
in AR. These uncertainties become
increasingly important at the lower NO2
exposure concentrations (i.e., at or near
100 ppb), as the evidence for NO2induced increases in AR becomes less
consistent across studies at these lower
concentrations.
The epidemiologic evidence from U.S.
and Canadian studies, as considered in
the PA and summarized in the proposal,
provided information about the ambient
NO2 concentrations in locations where
such studies have examined
associations with asthma-related
hospital admissions or ED visits (shortterm) or with asthma incidence (longterm). In particular, these studies
informed consideration of the extent to
which NO2-health effect associations are
consistent, precise, statistically
significant, and present for distributions
of ambient NO2 concentrations that
likely would have met the current
standards. To the extent NO2-health
effect associations are reported in study
areas that would likely have met the
current standards, the evidence would
support the potential for the current
standards to allow the NO2-associated
effects indicated by those studies. In the
absence of studies reporting associations
in locations meeting the current NO2
standards, there would be greater
uncertainty regarding the potential for
reported effects to be caused by NO2
exposures that occur with air quality
meeting those standards. There are also
important uncertainties in the
epidemiologic evidence which warrant
consideration, including the potential
for copollutant confounding and
exposure measurement error and the
extent to which near-road NO2
concentrations are reflected in the
available air quality data.
With regard to epidemiologic studies
of short-term NO2 exposures conducted
in the U.S. or Canada, the proposal
noted the following. First, the only
recent multicity study evaluated (Stieb
et al., 2009), which had maximum 1hour DVs ranging from 67 to 242 ppb,
did not report a positive association
between NO2 and ED visits. In addition,
of the single-city studies (U.S. EPA,
2017a, Figure 3–1) that reported positive
and relatively precise associations
between NO2 and asthma hospital
admissions and ED visits, most
locations had NO2 concentrations likely
to have violated the current 1-hour NO2
standard over at least part of the study
period. Specifically, most of these
locations had maximum estimated DVs
at or above 100 ppb and, had near-road
NO2 monitors been in place during
study periods, DVs would likely have
been higher. Thus, it is likely that even
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the one study location with a maximum
DV of 100 ppb (Atlanta) would have
violated the existing 1-hour standard
during study periods.90 For the study
locations with maximum DVs below 100
ppb, mixed results have been reported,
with associations that are generally
statistically non-significant and
imprecise. As with the studies reporting
more precise associations, near-road
monitors were not in place during these
study periods. If they had been, 1-hour
DVs could have been above 100 ppb. In
drawing conclusions based on this
epidemiologic evidence, the proposal
also considered the potential for
copollutant confounding as ambient
NO2 concentrations are often highly
correlated with other pollutants. This
can complicate attempts to distinguish
between independent effects of NO2 and
effects of the broader pollutant mixture.
While this has been addressed to some
extent in available studies, uncertainty
remains for the most relevant
copollutants (i.e., those related to traffic
such as PM2.5, EC/BC, and CO). Taken
together, while available U.S. and
Canadian epidemiologic studies report
NO2-associated hospital admissions and
ED visits in locations likely to have
violated the current 1-hour NO2
standard, the proposal placed weight on
the PA’s conclusion that these studies
do not indicate the occurrence of such
NO2-associated effects in locations and
time periods with NO2 concentrations
that would clearly have met the current
1-hour NO2 standard (i.e., with its level
of 100 ppb and 98th percentile form).
In giving further consideration
specifically to the form of the 1-hour
standard, the proposal noted that the
available evidence and information in
this review is consistent with that
informing consideration of form in the
last review. The last review focused on
the upper percentiles of the distribution
of NO2 concentrations based, in part, on
evidence for health effects associated
with short-term NO2 exposures from
experimental studies which provided
information on specific exposure
concentrations that were linked to
respiratory effects (75 FR 6475, February
9, 2010). In that review, the EPA
specified a 98th percentile form, rather
than a 99th percentile, for the new 1hour standard. In combination with the
1-hour averaging time and 100 ppb
level, a 98th percentile form was judged
to provide appropriate public health
protection. In addition, compared to the
99th percentile, a 98th percentile form
was expected to provide greater
regulatory stability.91 In addition, the
proposal noted that a 98th percentile
form is consistent with the EPA’s
consideration of uncertainties in the
health effects that have the potential to
occur at 100 ppb. Specifically, when
combined with the 1-hour averaging
time and the level of 100 ppb, the 98th
percentile form limits, but does not
eliminate, the potential for exposures to
100 ppb NO2.92 In light of these
considerations, EPA proposed to retain
the level and form for the current 1-hour
standard.
90 Based on recent air quality information for
Atlanta, 98th percentiles of daily maximum 1-hour
NO2 concentrations are higher at near-road
monitors than non-near-road monitors (U.S. EPA,
2017a, Figures 2–9 and 2–10). These differences
could have been even more pronounced during
study periods, when NOX emissions from traffic
sources were higher (U.S. EPA, 2017a, Section
2.1.2).
91 As noted in the last review, a less stable form
could result in more frequent year-to-year shifts
between meeting and violating the standard,
potentially disrupting ongoing air quality planning
without achieving public health goals (75 FR 6493,
February 9, 2010).
92 The 98th percentile typically corresponds to
about the 7th or 8th highest daily maximum 1-hour
NO2 concentration in a year.
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Long-Term
With regard to health effects related to
long-term NO2 exposures, the proposal
first considered the basis for the current
annual standard. It was originally set to
protect against NO2-associated
respiratory disease in children reported
in some epidemiologic studies (36 FR
8186, April 30, 1973). In subsequent
reviews, the EPA has retained the
annual standard, judging that it
provides protection with an adequate
margin of safety against the effects that
have been reported in animal studies
following long-term exposures to NO2
concentrations well above those found
in the ambient air (e.g., above 8,000 ppb
for the development of lesions similar to
those found in humans with
emphysema) (60 FR 52879, October 11,
1995). In the 2010 review, the EPA
noted that, though some evidence
supported the need to limit long-term
exposures to NO2, the evidence for
adverse health effects attributable to
long-term NO2 exposures did not
support changing the level of the annual
standard (75 FR 6474, February 9, 2010).
In the current review, the
strengthened ‘‘likely to be causal’’
relationship between long-term NO2
exposures and respiratory effects is
supported by epidemiologic studies of
asthma development and related effects
demonstrated in animal toxicological
studies. While these studies strengthen
the evidence for effects of long-term
exposures, compared to the last review,
they are subject to uncertainties
resulting from the methods used to
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assign NO2 exposures, the high
correlations between NO2 and other
traffic-related pollutants, and the lack of
information regarding the extent to
which reported effects are
independently associated with NO2
rather than the overall mixture of trafficrelated pollutants. The potential for
such confounding is particularly
important to consider when interpreting
epidemiologic studies of long-term NO2
exposures given: (1) The relatively high
correlations observed between measured
and modeled long-term ambient
concentrations of NO2 and long-term
concentrations of other roadwayassociated pollutants; (2) the general
lack of information from copollutant
models on the potential for NO2
associations that are independent of
other traffic-related pollutants or
mixtures; and (3) the general lack of
supporting information from
experimental studies that evaluate longterm exposures to NO2 concentrations
near those in the ambient air. Thus, it
remains unclear the degree to which the
observed effects in these studies are
independently related to exposure to
ambient concentrations of NO2. The
epidemiologic evidence from some U.S.
and Canadian studies is also subject to
uncertainty with regard to the extent to
which the studies accurately
characterized exposures of the study
populations, further limiting what these
studies can tell us regarding the
adequacy of the current primary NO2
standards.
While the proposal recognized the
above uncertainties, it considered what
studies of long-term NO2 and asthma
development indicate with regard to the
adequacy of the current primary NO2
standards. As discussed above for shortterm exposures, the proposal considered
the degree to which the evidence
indicates adverse respiratory effects
associated with long-term NO2
exposures in locations that would have
met the current NAAQS. As
summarized in Section II.C.2 of the
proposal, and in Section II.A.2 above,
the causal determination for long-term
exposures is supported both by studies
of long-term NO2 exposures and by
studies indicating a potential role in
asthma development for repeated shortterm exposures to high NO2
concentrations.93
As such, when considering the
ambient NO2 concentrations present
during study periods, the proposal
considered these concentrations within
93 There remains some uncertainty as to whether
the health effects associated with long term
exposure to NO2 are due to repeated higher short
term exposures, a longer, cumulative exposure, or
some mixture of both.
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the context of both the 1-hour and
annual NO2 standards. Analyses of
historical data indicate that 1-hour DVs
at or below 100 ppb generally
correspond to annual DVs below 35
ppb.94 The CASAC noted this
relationship, stating that ‘‘attainment of
the 1-hour standard corresponds with
annual design value averages of 30 ppb
NO2’’ (Diez Roux and Sheppard, 2017).
Thus, meeting the 1-hour standard with
its level of 100 ppb would be expected
to maintain annual average NO2
concentrations below the 53 ppb level of
the current annual standard.
As discussed in Section II.C.1 of the
proposal, and in Section II.A.2 above,
while annual estimated DVs in study
locations were often below 53 ppb,
maximum 1-hour estimated DVs in most
locations were near or above 100 ppb.
Because these study-specific estimated
DVs are based on the area-wide NO2
monitors in place during study periods,
they do not reflect the NO2
concentrations near the largest
roadways, which are expected to be
higher in most urban areas. Had nearroad monitors been in place during
study periods estimated NO2 DVs based
on near-road concentrations likely
would have been higher in many
locations, and would have been more
likely to exceed the level of the annual
and/or 1-hour standard(s) (U.S. EPA,
2016a, section 2.5.3.1, e.g., Tables 2–6
and 2–8, Figures 2–16 and 2–17).
Given the paucity of epidemiologic
studies conducted in areas that were
close to or below the current standards,
and considering that no near-road
monitors were in place during the study
periods, the proposal placed weight on
the PA’s conclusion that the
epidemiologic evidence does not
provide support for NO2-attributable
asthma development in children in
locations with NO2 concentrations that
would have clearly met the current
annual and 1-hour NO2 standards. The
strongest epidemiologic evidence
informing the level at which effects may
occur comes from U.S. and Canadian
epidemiologic studies that are subject to
critical uncertainties related to
copollutant confounding and exposure
assessment. Furthermore, the proposal
noted the PA’s evaluation indicating
that most of the locations included in
epidemiologic studies of long-term NO2
exposure and asthma incidence would
likely have violated either one or both
of the current NO2 standards, over at
least parts of the study periods. In light
94 As noted in the PA, near-road monitors were
not included in this analysis due to the limited
amount of data available (U.S. EPA, 2017a, Figure
2–11).
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of these considerations, EPA proposed
to retain the level and form for the
current annual standard.
b. Exposure- and Risk-Based
Considerations
Exposure- and risk-based
considerations were also important to
the proposed decision and its rationale,
like the consideration of the health
evidence discussed in section II.B.1.a
above. As described in greater detail in
Section II.A.3 above, and in the REA
Planning document (U.S. EPA, 2015b,
Section 2.1.1) and the PA (U.S. EPA,
2017a, Chapter 4), the EPA conducted
updated analyses comparing ambient
NO2 concentrations (i.e., as surrogates of
potential exposures) to health-based
benchmarks, with a particular focus on
study areas where near-road monitors
have been deployed. These analyses
were presented in the PA. The staff
further concluded in the PA that
updated quantitative risk assessments
were not supported in the current
review, based on uncertainties in the
available evidence and the likelihood
that such analyses would be subject to
the same uncertainties identified in the
risk estimates in the prior review (U.S.
EPA, 2017a, Chapter 4). The CASAC
stated that it was ‘‘satisfied with the
short-term exposure health-based
benchmark analysis presented in the
draft PA’’ and that it ‘‘support[ed] the
decision not to conduct any new or
updated quantitative risk analyses
related to long-term exposure to NO2’’
(Diez Roux and Sheppard, 2017).
When considering analyses
comparing NO2 air quality with healthbased benchmarks, the proposal began
by noting the PA’s focus on the
following specific questions: (1) To
what extent are ambient NO2
concentrations that may be of public
health concern estimated to occur in
locations meeting the current NO2
standards? (2) What are the important
uncertainties associated with those
estimates?
As discussed in section II.A.3 above,
and in section II.D.1 of the proposal,
benchmarks are based on information
from controlled human exposure studies
of NO2 exposures and AR. In identifying
specific NO2 benchmarks, and
considering the weight to place on each,
the updated analyses in the PA consider
both the group mean results reported in
individual studies and the results of a
meta-analysis that combined data from
multiple studies (Brown, 2015; U.S.
EPA, 2016a, Section 5.2.2.1), as
described above.
When taken together, the results of
individual controlled human exposure
studies and of the meta-analysis by
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Brown (2015) support consideration of
NO2 benchmarks between 100 and 300
ppb, based largely on studies of nonspecific AR in people with asthma
exposed to NO2 at rest. As discussed in
more detail in section II.D of the
proposal, benchmarks from the upper
end of this range are supported by the
results of individual studies, the
majority of which reported statistically
significant increases in AR following
NO2 exposures at or above 250 ppb, and
by the results of the meta-analysis by
Brown (2015). Benchmarks from the
lower end of this range, including 100
ppb, are supported by the results of the
meta-analysis, even though individual
studies do not consistently report
statistically significant NO2-induced
increases in AR at these lower
concentrations. In particular, while the
meta-analysis indicates that the majority
of study participants with asthma
experienced an increase in AR following
exposures to 100 ppb NO2 (Brown,
2015), individual studies have not
generally reported statistically
significant increases in AR following
resting exposures to 100 ppb NO2.95
In further considering the potential
public health implications of exposures
to NO2 concentrations at or around
benchmarks, there are multiple
uncertainties, as discussed in section
II.C.I of the proposal and section II.A.3
above. As discussed in more detail in
those sections, these uncertainties
include the lack of an apparent a doseresponse relationship between NO2 and
AR in people with asthma, and
uncertainty in the potential adversity of
the reported NO2-induced increases in
AR.
As discussed in section II.D.2 of the
proposal, and in section II.A.3 above,
analyses of unadjusted air quality,
which meets the current standards in all
locations, indicate almost no potential
for 1-hour exposures to NO2
concentrations at or above any of the
benchmarks examined, including 100
ppb. Analyses of air quality adjusted
upwards to just meet the current 1-hour
standard 96 indicate virtually no
potential for 1-hour exposures to NO2
concentrations at or above 200 ppb (or
300 ppb) and almost none for exposures
95 Meta-analysis results for exposures to 100 ppb
NO2 were statistically significant when analyses
were restricted to non-specific AR, but not when
analyses were restricted to specific AR (Brown,
2015).
96 In all study areas, ambient NO concentrations
2
required smaller upward adjustments to just meet
the 1-hour standard than to just meet the annual
standard. Therefore, when adjusting air quality to
just meet the current NO2 NAAQS, the adjustment
needed to just meet the 1-hour standard was
applied (U.S. EPA, 2017a, Section 4.2.1).
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at or above 150 ppb.97 This is the case
for both estimates averaged over
multiple years and estimates in worstcase years, including at near-road
monitoring sites within a few meters of
heavily trafficked roads. With respect to
the lowest benchmark evaluated,
analyses estimate that there is potential
for exposures to 1-hour NO2
concentrations at or above 100 ppb on
some days (e.g., about one to 10 days
per year, on average, at near-road
monitoring sites). As described above,
this result is consistent with
expectations, given that the current 1hour standard, with its 98th percentile
form, is expected to limit, but not
eliminate, the occurrence of 1-hour NO2
concentrations of 100 ppb.
Section II.D.2 of the proposal noted
that these analyses indicate that the
current 1-hour NO2 standard is expected
to allow virtually no potential for
exposures to the NO2 concentrations
that have been shown most consistently
to increase AR in people with asthma,
even under worst-case conditions across
a variety of study areas with among the
highest NOX emissions in the U.S. Such
NO2 concentrations are not estimated to
occur, even at monitoring sites adjacent
to some of the most heavily trafficked
roadways. In addition, the current 1hour standard provides protection
against NO2 exposures that have the
potential to exacerbate asthma
symptoms, but for which the evidence
indicates greater uncertainty in the risk
of such effects occurring (i.e., at or near
100 ppb). Given the results of these
analyses, and the uncertainties inherent
in their interpretation, the proposal
placed weight on the PA’s conclusion
that there is little potential for
exposures to ambient NO2
concentrations that would be of public
health concern in locations meeting the
current 1-hour standard.
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2. The CASAC Advice in This Review
In the current review of the primary
NO2 standards the CASAC has provided
advice and recommendations based on
its review of drafts of the 2016 NOX ISA
(Frey, 2014a; Diez Roux and Frey,
2015a), of the REA Planning document
(Diez Roux and Frey, 2015b), and of the
draft PA (Diez Roux and Sheppard,
2017). This section summarizes key
CASAC advice regarding the strength of
the evidence for respiratory effects, the
quantitative analyses conducted and
presented in the PA, and the adequacy
97 Comparisons of NO air quality to health-based
2
benchmarks that estimated occurrences of NO2
concentrations exceeding the 150 and 200 ppb
health-based benchmarks are found in Figure 4–1
of the PA (U.S. EPA, 2017a).
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of the current primary NO2 standards to
protect the public health.
Briefly, with regard to the strength of
the evidence for respiratory effects, the
CASAC agreed with the 2016 NOX ISA
conclusions. In particular, the CASAC
concurred ‘‘with the finding that shortterm exposures to NO2 are causal for
respiratory effects based on evidence for
asthma exacerbation’’ (Diez Roux and
Sheppard, 2017, p. 7). It further noted
that ‘‘[t]he strongest evidence is for an
increase in airway responsiveness based
on controlled human exposure studies,
with supporting evidence from
epidemiologic studies’’ (Diez Roux and
Sheppard, 2017, p. 7). The CASAC also
agreed with the 2016 NOX ISA
conclusions on long-term exposures and
respiratory effects, specifically stating
the following (Diez Roux and Sheppard,
2017, p. 7):
Long-term exposures to NO2 are likely to
be causal for respiratory effects, based on
asthma development. The strongest evidence
is for asthma incidence in children in
epidemiologic studies, with supporting
evidence from experimental animal studies.
Current scientific evidence for respiratory
effects related to long-term exposures is
stronger since the last review, although
uncertainties remain related to the influence
of copollutants on the association between
NO2 and asthma incidence.
With regard to support for the
updated quantitative analyses
conducted in the current review, the
CASAC agreed with the conclusions in
the PA.98 In particular, the CASAC
noted that it was ‘‘satisfied with the
short-term exposure health-based
benchmark analysis presented in the
Draft PA and agree[d] with the decision
to not conduct any new model-based or
epidemiologic-based analyses’’ (Diez
Roux and Sheppard, 2017, p. 5). The
CASAC further supported ‘‘the decision
not to conduct any new or updated
quantitative risk analyses related to
long-term exposure to NO2,’’ noting
‘‘that existing uncertainties in the
epidemiologic literature limit the ability
to properly estimate and interpret
population risk associated with NO2,
specifically within a formal risk
assessment framework’’ (Diez Roux and
Sheppard, 2017, p. 5).
In addition, in its review of the draft
PA, the CASAC agreed with its
conclusion that the available evidence,
taken together, does not support the
need for increased protection against
short- or long-term NO2 exposures,
beyond that provided by the existing
standards, stating that ‘‘[t]he CASAC
98 The PA conclusions build upon the
preliminary conclusions presented in the REA
Planning document, which was also reviewed by
the CASAC (Diez Roux and Frey, 2015b).
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concurs with the EPA that the current
scientific literature does not support a
revision to the primary NAAQS for
nitrogen dioxide’’ (Diez Roux and
Sheppard, 2017, p. 9). Further, the
CASAC concurred with the draft PA’s
preliminary conclusion that it is
appropriate to consider retaining the
current primary NO2 standards without
revision, stating that, ‘‘the CASAC
recommends retaining, and not
changing the existing suite of
standards’’ (Diez Roux and Sheppard,
2017). The CASAC further provided the
following advice with respect to the
individual elements of the standards:
• Indicator and averaging time: The
CASAC stated ‘‘there is strong evidence
for the selection of NO2 as the indicator
of oxides of nitrogen’’ and ‘‘for the
selection of 1-hour and annual
averaging times’’ (Diez Roux and
Sheppard, 2017, p. 9). With regard to
averaging time in particular, the CASAC
stated that ‘‘[c]ontrolled human and
animal studies provide scientific
support for a 1-hour averaging time as
being representative of an exposure
duration that can lead to adverse
effects’’ (Diez Roux and Sheppard, 2017,
p. 7). The CASAC further concluded
that ‘‘[e]pidemiologic studies provide
support for the annual averaging time,
representative of likely to be causal
associations between long-term
exposures, or repeated short-term
exposures, and asthma development’’
(Diez Roux and Sheppard, 2017, p. 7).
• Level of the 1-hour standard: The
CASAC stated ‘‘there are notable
adverse effects at levels that exceed the
current standard, but not at the level of
the current standard. Thus, the CASAC
advises that the current 1-hour standard
is protective of adverse effects and that
there is not a scientific basis for a
standard lower than the current 1-hour
standard’’ (Diez Roux, and Sheppard
2017, p. 9).
• Form of the 1-hour standard: The
CASAC also ‘‘recommends retaining the
current form’’ for the 1-hour standard
(Diez Roux and Sheppard, 2017).
Recognizing that the form allowed for
some 1-hour concentrations that
exceeded 100 ppb, the CASAC
explained that ‘‘a scientific rationale for
this form is there is uncertainty
regarding the severity of adverse effects
at a level of 100 ppb NO2, and thus
some potential for maximum daily
levels to exceed this benchmark with
limited frequency may nonetheless be
protective of public health’’ (Diez Roux
and Sheppard, 2017, p. 10). It further
noted that the choice of form reflected
the Administrator’s policy judgment.
(Diez Roux and Sheppard, 2017, p. 10).
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• Level of the annual standard: In
providing advice on the level of the
annual standard, the CASAC
commented that the long-term
epidemiologic studies ‘‘imply the
possibility of adverse effects at levels
below that of the current annual
standard’’ (Diez Roux and Sheppard,
2017, p. 8). However, the CASAC
recognized that these studies ‘‘are also
subject to uncertainty, including
possible confounding with other trafficrelated pollutants’’ (Diez Roux and
Sheppard, 2017, p. 8). The CASAC also
commented that these epidemiologic
studies may have uncertainty related to
exposure error and pointed out that
estimated DVs in study areas do not
account for near-road monitoring.
Furthermore, the CASAC recognized the
causal associations between long-term
exposures, or repeated short-term
exposures, and asthma development
(Diez Roux and Sheppard, 2017, p. 7)
and the appropriateness of considering
the protection provided by the current
suite of standards together (Diez Roux
and Sheppard, 2017, p. 9). Therefore,
the CASAC advice on the annual
standard takes into account the degree
of protection provided by that standard,
in combination with the current 1-hour
standard. In particular, the CASAC
recognized that meeting the 1-hour NO2
standard can limit long-term NO2
concentrations to below the level of the
annual standard, observing that ‘‘an
hourly DV of 100 ppb NO2 is associated
with DV values that average
approximately 30 ppb NO2’’ and that
‘‘there is insufficient evidence to make
a scientific judgment that adverse effects
occur at annual DVs less than 30 ppb
NO2’’ (Diez Roux and Sheppard, 2017,
p. 9). Thus, in providing support for
retaining the existing annual standard,
the CASAC specifically noted that ‘‘the
current suite of standards is more
protective of annual exposures
compared to the annual standard by
itself’’ and that ‘‘it is the suite of the
current 1-hour and annual standards,
together, that provide protection against
adverse effects’’ (Diez Roux and
Sheppard, 2017, p. 9). Therefore, the
CASAC ‘‘recommends retaining the
existing suite of standards’’ (Diez Roux
and Sheppard, 2017, p. 9), including the
current annual standard.
In addition, the CASAC also provided
advice on areas for additional research
based on key areas of uncertainty that
came up during the review cycle (Diez
Roux and Sheppard, 2017, p. 10–12). As
part of this advice, the CASAC stated
that ‘‘[t]here is an ongoing need for
research in multipollutant exposure and
epidemiology to attempt to distinguish
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the contribution to NO2 exposure to
human health risk’’ (Diez Roux and
Sheppard, 2017, p. 10). More
specifically, the CASAC pointed to the
importance of further understanding the
effects of co-pollutant exposures and the
variability in ambient NO2
concentrations, particularly considering
‘‘locations of peak exposure occurrences
(e.g., on road in vehicles, roadside for
active commuters, in street canyons,
near other non-road facilities such as
rail yards or industrial facilities)’’ (Diez
Roux and Sheppard, 2017, p. 11). In
particular, the CASAC recognized the
importance of the new near-road
monitoring data in reducing those
uncertainties, stating that ‘‘[t]he amount
of data from near-road monitoring will
increase between now and the next
review cycle and should be analyzed
and evaluated’’ (Diez Roux and
Sheppard, 2017, p. 11).
3. Comments on the Proposed Decision
This section presents the responses of
the EPA to the public comments
received on the 2017 NO2 NAAQS
proposal (82 FR 34792, July 26, 2017).
All significant issues raised in timely
public comments have been addressed
in this document, as the EPA is not
preparing a separate Response to
Comments document. We have
additionally considered comments
submitted after the close of the public
comment period, to the extent
practicable.
Overall, the EPA received 17 sets of
comments, with the majority expressing
support for the Administrator’s
proposed decision to retain the current
primary standards, without revision.
Comments supporting the
Administrator’s proposed decision were
received from various industry
groups,99 individuals, and state
environmental or health agencies.100
These commenters generally note their
agreement with the Administrator’s
rationale provided in the proposal and
many note the CASAC concurrence with
the EPA that the current evidence does
not support revision to the standards.
Some of the commenters also agree with
the EPA and the CASAC statements that
99 Comments were received from the following
industry groups: The NAAQS Implementation
Coalition, the Utility Air Regulatory Group, Edison
Electric Institute, Interstate National Gas
Associations of America, Cleco Power, the
American Fuel and Petrochemical Manufacturers,
the American Petroleum Institute, The Tri-state
Generation and Transmission Association, and the
Class of ’85 Regulatory Response Group.
100 Comments were received from the following
state environmental or health agencies: Texas
Commission on Environmental Quality (TCEQ) and
Arkansas Department of Environmental Quality
(ADEQ).
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the information in this review has not
substantially altered our previous
understanding of the concentrations at
which effects can occur, and that the
scientific evidence does not support
standards more protective than the
current 1-hour and annual standards.
Several groups, including some that
support the Administrator’s proposed
decision to retain the current standards,
provided additional comments,
including on the EPA’s causal
determinations in the 2016 NOX ISA,
the margin of safety provided by the
current standards, and the potential for
the scientific information to support
alternative standards that are less
stringent than the current standards. In
addition, one organization (The
American Lung Association) argues for
more stringent primary NO2 standards,
noting the strong evidence for
respiratory effects following both shortand long-term NO2 exposures.
The following sections discuss the
public comments on the proposal and
the EPA’s responses to those comments.
Section II.B.3.a discusses comments on
the EPA’s assessment of the scientific
evidence. Section II.B.3.b discusses
comments on the degree of protection
provided by the current standards and
on the potential for the available
scientific information to support
standards that are less stringent than the
current standards. Section II.B.3.c
discusses comments recommending that
the EPA revise the current standards to
be more stringent. Section II.B.3.d
briefly explains the EPA’s approach to
comments related to implementation of
the NAAQS, which are outside the
scope of this action.
a. Comments on the Assessment of the
Scientific Evidence
There were several comments
submitted related to the EPA’s
assessment of the scientific evidence.
Some commenters agree with the causal
framework used in the 2016 NOX ISA
and with the ISA’s conclusions
regarding the strength of the evidence
for various health outcomes and for atrisk populations. Other commenters,
while agreeing with the overall
proposed decision to retain the existing
primary standards, assert that the ISA
framework for causal determinations
does not result in a systematic,
balanced, and rigorous evaluation of the
evidence. As discussed below, these
commenters generally claim that the
2016 NOX ISA does not adequately
address uncertainties and biases in the
evidence and recommend that the EPA
should strengthen its causal framework.
Some comments received on the
proposed decision express an overall
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objection to ISA conclusions that the
evidence linking NO2 exposures with a
variety of health effects has become
stronger in this review. A subset of these
comments further imply that the 2016
NOX ISA’s conclusions on the strength
of evidence, and the corresponding
discussions in the PA, are not entirely
consistent with the uncertainties noted
by the Administrator throughout the
discussion of his proposed decision on
the primary NO2 standards.
In responding to these comments, the
EPA notes that the ISA’s causal
framework has been implemented and
refined over multiple NAAQS reviews,
drawing from extensive interactions
with the CASAC and from the public
input received as part of the CASAC
review process. Based on application of
that framework in the current review,
the 2016 NOX ISA has made causal
determinations for a variety of health
outcomes. The ISA provides a careful
and detailed rationale for all of its
causal determinations, explicitly
characterizing the key evidence, the
reason for the change from the 2008
NOX ISA (if a change occurred), and the
uncertainties remaining in the body of
evidence (see, e.g., U.S. EPA, 2016a,
Table 1–1). In most cases where the
causal determination has changed since
the 2008 NOX ISA, the change has been
due to the availability, in the current
review, of additional studies that reduce
uncertainty or bias in the evidence (U.S.
EPA, 2016a, Table 1–1).101 The causal
determinations in the NOX ISA
underwent extensive CASAC review,
which included multiple opportunities
for public input. The EPA considered
the CASAC advice and the public input
in making final causal determinations.
The CASAC concurred with the 2016
NOX ISA’s causal determinations and
explained the reasons for its
concurrence (Diez Roux and Frey,
2015a, p.1; Diez Roux and Sheppard,
2017, p. 7).
For example, in concluding that a
‘‘causal relationship exists between
101 The exception to this is the 2016 NO ISA
X
determination that a causal relationship exists
between short-term NO2 exposure and respiratory
effects. This conclusion is strengthened from the
‘‘likely to be causal’’ relationship determined in the
2008 NOX ISA for Oxides of Nitrogen. Rather than
new evidence, the 2016 NOX ISA notes that
integrated experimental and epidemiologic
evidence for asthma exacerbation, with due weight
to controlled human exposure studies, supports a
causal relationship between short-term NO2
exposure and respiratory effects. Specifically, the
2016 NOX ISA explains that the conclusion is
strengthened from the previously determined
‘‘likely to be causal’’ relationship because the
combined controlled human exposure and
epidemiologic evidence can be linked in a coherent
and biologically plausible pathway to explain how
NO2 exposure can trigger an asthma exacerbation.
(U.S. EPA, 2016a, pp. 1–17 to 1–19).
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short-term NO2 exposure and
respiratory effects based on evidence for
asthma exacerbation’’ (U.S. EPA, 2016a,
p. 1–17), the ISA cites ‘‘epidemiologic
evidence for NO2-associated asthma
exacerbation and biological plausibility
from NO2-induced increases in [AR] and
allergic inflammation in adults with
asthma’’ (U.S. EPA, 2016a, p. 5–247). In
agreement with this causal
determination, the CASAC states the
following (Diez Roux and Sheppard,
2017, p. 7):
The CASAC concurs with the finding that
short-term exposures to NO2 are causal for
respiratory effects based on evidence for
asthma exacerbation. The strongest evidence
is for an increase in airway responsiveness
based on controlled human exposure studies,
with supporting evidence from
epidemiologic studies.
In addition, in concluding that
‘‘[t]here is likely to be a causal
relationship between long-term NO2
exposure and respiratory effects based
on evidence for the development of
asthma’’ (U.S. EPA, 2016a, p. 1–20), the
ISA notes that ‘‘[r]ecent epidemiologic
studies consistently indicate increases
in asthma incidence in children
particularly in association with NO2
exposures estimated at or near
children’s homes or schools’’ and that
experimental evidence ‘‘provides
biological plausibility by characterizing
a potential mode of action by which
long-term NO2 exposure may lead to
asthma development’’ (U.S. EPA, 2016a,
p. 6–67). In agreement with this causal
determination, the CASAC states the
following (Diez Roux and Sheppard,
2017, p. 7):
Long-term exposures to NO2 are likely to
be causal for respiratory effects, based on
asthma development. The strongest evidence
is for asthma incidence in children in
epidemiologic studies, with supporting
evidence from experimental animal studies.
Current scientific evidence for respiratory
effects related to long-term exposures is
stronger since the last review, although
uncertainties remain related to the influence
of co-pollutants on the association between
NO2 and asthma incidence.
Thus, based on the evidence
considered in the 2016 NOX ISA, and
consistent with the CASAC advice, we
disagree with comments that the
strengthening of the causal
determinations in the 2016 NOX ISA is
not justified.
The EPA further disagrees with
comments claiming that, in his
consideration of the levels of the
primary standards, the Administrator’s
discussion of uncertainties and
limitations in the scientific evidence is
inconsistent with the conclusions of the
2016 NOX ISA that the evidence for
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several health endpoints is stronger now
than in the last review. As an initial
matter, we note that the issues faced by
the EPA in drawing causal
determinations in the 2016 NOX ISA
differ from EPA’s considerations in
evaluating the public health protection
provided by the standards. In drawing
the causal determinations, the ISA
focuses on the degree to which the
available evidence indicates that NO2
exposures can cause specific health
effects. These causal determinations
reflect the ISA’s assessment of studies
spanning a relatively wide range of
exposure concentrations, encompassing
the full body of evidence relevant for
the review. In contrast, in the proposal
and in this final action, the EPA is
additionally tasked with determining
what the evidence can tell us about the
adequacy of the public health protection
provided by a particular standard or
standards. This step typically involves
focusing on the subset of studies that,
together with risk and exposure
information, can best inform the EPA’s
consideration of the public health
impacts associated with particular air
quality concentrations. Consideration of
uncertainties is important for both tasks,
but the nature of those uncertainties,
and exactly how the various
uncertainties factor into each aspect of
the review, may differ. For example,
strengthening of a causal determination
in the ISA may be based on studies that
clarify a proposed mode of action
linking exposures with an observed
effect, despite being conducted at
exposure concentrations that would not
be allowed by the current standards.
Such studies may reduce uncertainties
in a way that supports strengthening a
causal determination, but not revising
the standard. Thus, the Administrator’s
consideration of uncertainties in the
evidence when reaching conclusions on
the standards is not inconsistent with
the ISA conclusions that the evidence
supports strengthening some causal
determinations in this review.
We further note that, in reaching his
proposed and final decisions, the
Administrator’s consideration of the
evidence, including its limitations and
uncertainties, draws directly from the
2016 NOX ISA’s assessment of that
evidence and from the PA’s
considerations and conclusions related
to the adequacy of the public health
protection provided by the current
standards. Both the ISA and PA include
extensive discussion and consideration
of the scientific evidence and its
uncertainties. As noted above, Table 1–
1 in the ISA summarizes the key
evidence for various NO2-related health
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outcomes, including the remaining
uncertainties inherent in that evidence.
In addition, drawing from the ISA, the
PA includes extensive consideration of
uncertainties and limitations in the
evidence as they relate to conclusions
on the adequacy of the public health
protection provided by the current
primary NO2 NAAQS (U.S. EPA, 2017a,
sections 3.2.2.1, 3.2.2.2, 3.3.2.1).
Contrary to the comments noted above,
the Administrator’s proposed and final
decisions draw from the
characterization in those documents of
uncertainties and limitations in the
evidence (e.g., sections II.A.2, II.A.3,
II.B.4 of this final action). The
Administrator’s proposed and final
decisions to retain the current primary
NO2 standards are consistent with the
PA’s conclusions (U.S. EPA, 2017a,
section 5.4). Moreover, these decisions
are consistent with recommendations of
the CASAC to retain the current
standards (Diez Roux and Sheppard,
2017).
Some comments further criticize the
Agency’s characterization of the
evidence by asserting that the EPA
places too much emphasis on
epidemiologic studies that are
methodologically flawed and
insufficient for determining a standard.
While we agree that there are
uncertainties inherent in epidemiologic
studies, these uncertainties, which have
been extensively considered as part of
the assessment of the evidence in the
ISA and the evaluation of policy options
in the PA, as well as in the proposal and
this final action (e.g., summarized in
sections II.A.2 and II.B.1 above), do not
make the epidemiologic evidence
insufficient for informing decisions on
the primary NO2 standards. Rather,
conclusions in this review draw from
the consideration of scientific evidence
from a range of disciplines, each with its
own strengths and limitations.102 In
particular, the 2016 NOX ISA’s causal
determinations are based on the
integration of evidence across controlled
human exposure, epidemiologic, and
animal toxicological studies. The focus
of the ISA’s integration is on evaluating
the consistency and inconsistency in the
pattern of effects across studies and
endpoints as well as the strengths and
limitations of the evidence across the
various disciplines (U.S. EPA, 2016a, p.
1). For each study, the 2016 NOX ISA
systematically evaluates study design,
102 In
fact, relative to other types of evidence,
strengths of epidemiologic studies can include
providing information on the most serious
pollutant-associated effects in human populations,
including populations with pre-existing conditions,
or at particular life stages, that put them at
increased risk of such effects.
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populations evaluated, approach to
exposure assessment/assignment,
approach to outcome assessment,
potential for confounding, and
statistical methodology (U.S. EPA,
2016a, Table A–1). As described below,
and more fully in the ISA (see e.g., U.S.
EPA, 2016a, Table 1–1), uncertainties
and limitations in the evidence,
including in the evidence from
epidemiologic studies, are explicitly
considered in the ISA’s causal
determinations and can affect how
various aspects of the evidence are
weighed in making those
determinations.
For example, while the ISA concludes
that epidemiologic studies do indicate
the occurrence of NO2-associated
asthma exacerbation, it further
concludes that ‘‘epidemiologic evidence
on its own does not rule out the
influence of other traffic-related
pollutants’’ (U.S. EPA, 2016a, p. 1–18).
The ISA further concludes that ‘‘[t]he
key evidence that NO2 exposure can
independently exacerbate asthma are
the findings from previous controlled
human exposure studies for increases in
airway responsiveness in adults with
asthma’’ (U.S. EPA, 2016a, p. 1–18).
Thus, based in part on uncertainties in
the available epidemiologic evidence,
the ISA’s conclusion that ‘‘[a] causal
relationship exists between short-term
NO2 exposure and respiratory effects’’
(U.S. EPA, 2016a, p. 1–17) places the
greatest emphasis on information from
controlled human exposure studies (e.g.,
U.S. EPA, 2016a, p. 5–247). As noted
above, the CASAC endorsed this
emphasis, stating that ‘‘[t]he strongest
evidence is for an increase in airway
responsiveness based on controlled
human exposure studies, with
supporting evidence from epidemiologic
studies’’ (Diez Roux and Sheppard,
2017, p. 7). In fact, the CASAC
recommended that the controlled
human exposure studies, alone, are
sufficient to justify the causal
determination for short term NO2
exposures and respiratory effects (Diez
Roux and Frey, 2015a, cover letter at p.
2).103 Consistent with this, information
from controlled human exposure studies
is emphasized in the PA’s conclusions
on the public health protection
provided by the current standards
against short-term NO2 exposures (U.S.
EPA, 2017a, sections 3.2 and 5.4) and in
103 Specifically, the CASAC recommended that
‘‘the evidence supporting changes to the causal
determination status for oxides of nitrogen for
associations with short-term exposures be based
primarily on the findings from the controlled
human exposure studies, as they alone are
sufficient to justify the change’’ (Diez Roux and
Frey, 2015a, cover letter at p.2).
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the Administrator’s conclusion to retain
those standards in this final decision
(section II.B.4, below).
In addition, the 2016 NOX ISA’s
conclusion on long-term NO2 exposure
and respiratory effects recognizes
uncertainty in epidemiologic studies
due to potential confounding by other
traffic-related pollutants. The ISA
specifically concludes that uncertainty
remains ‘‘in identifying an independent
effect of NO2 exposure from trafficrelated copollutants because evidence
from experimental studies for effects
related to asthma development is
limited, and epidemiologic analysis of
confounding is lacking’’ (U.S. EPA,
2016a, p. 1–32).104 However, in making
its overall determination that ‘‘there is
likely to be a causal relationship
between long-term NO2 exposure and
respiratory effects’’ the ISA also notes
that support for biological plausibility
comes from experimental studies in
animals (e.g., U.S. EPA, 2016a, Table 1–
1). While recognizing remaining
uncertainties in the evidence, the
CASAC agreed with this ISA causal
determination, observing that ‘‘[t]he
strongest evidence is for asthma
incidence in children in epidemiologic
studies, with supporting evidence from
experimental animal studies’’ (Diez
Roux and Sheppard, 2017, p. 7).
Thus, the 2016 NOX ISA’s
conclusions reflect the consideration of
information from all lines of evidence,
not only epidemiologic studies,
including appropriate consideration of
the uncertainties and limitations in that
evidence. The CASAC reviewed and
endorsed the 2016 NOX ISA’s approach
to assessing the evidence, including
uncertainties and limitations in that
evidence, and its key conclusions based
on the application of that approach (e.g.,
Diez Roux and Frey, 2015a; Diez Roux
and Sheppard, 2017, p. 7). Additionally,
the ISA’s careful consideration of
scientific evidence from multiple
disciplines, and the uncertainties and
limitations in that evidence, including
in epidemiologic studies, informed the
PA’s conclusions on the public health
protection provided by the current
standards and the Administrator’s
decision to retain those standards,
without revision, in this review. Thus,
the EPA does not agree with comments
that undue emphasis was placed on
epidemiologic studies.
Several comments further contend
that the 2016 NOX ISA overstates the
consistency of results across
104 Such uncertainties also informed the PA’s
conclusions on the public health protection
provided by the current standards (U.S. EPA, 2017a,
section 5.4).
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epidemiologic studies and that it does
not adequately capture uncertainties in
the epidemiologic evidence. The EPA
disagrees with these comments. As
noted above, the 2016 NOX ISA
appropriately characterizes the
uncertainties and limitations in the
epidemiologic evidence, including
uncertainties resulting from inconsistent
results across studies (e.g., U.S. EPA,
2016a, Tables 5–39 and 6–5). For
endpoints where the epidemiologic
evidence is not consistent, the 2016
NOX ISA discusses the inconsistencies.
For example, the ISA states that
‘‘[e]pidemiologic evidence for NO2related decreases in lung function in
populations with asthma is inconsistent
as a whole’’ (U.S. EPA, 2016a, p. 5–241).
In contrast, the ISA appropriately
characterizes the consistent results of
epidemiologic studies that evaluate
asthma-related outcomes. In particular,
the 2016 NOX ISA notes that ‘‘[r]ecent
studies that examined the association
between short-term NO2 exposure and
asthma hospital admissions and ED
visits consistently report positive
associations and support the results of
U.S. and Canadian studies evaluated in
the 2008 ISA for Oxides of Nitrogen.’’
(U.S. EPA, 2016a, p. 5–91). Figures 5–
16 and 5–17 in the 2016 NOX ISA
illustrate the consistent, positive
associations reported in studies that
have evaluated the potential for
confounding of the NO2 association by
co-occurring pollutants, a key potential
uncertainty in NO2 epidemiologic
studies (U.S. EPA, 2016a, pp. 5–248 to
5–249). Based on its assessment of such
studies of short-term NO2 exposure and
asthma-related effects, the 2016 NOX
ISA concludes that ‘‘the pattern of
association observed for NO2 supports
the consistency of evidence and does
not indicate a high probability of
associations found by chance alone’’
(U.S. EPA, 2016a, p. 5–241).
Some comments criticizing the 2016
NOX ISA’s characterization of
consistency of results across
epidemiologic studies, and the ISA’s
consideration of uncertainties in those
studies, focus specifically on studies of
long-term NO2 exposures. Such
comments claim that the EPA overstates
the consistency of the epidemiologic
evidence, particularly given the
potential for copollutant confounding
and exposure measurement error in
studies of long-term NO2 exposures. As
discussed below, the EPA disagrees
with these comments.
Figure 6–1 in the 2016 NOX ISA
illustrates the consistently positive
associations between long-term
exposures and asthma incidence in
children. Based on such studies, the ISA
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concludes the following (U.S. EPA,
2016a, p. 6–63):
Multiple longitudinal studies demonstrate
associations between higher ambient NO2
concentrations measured in the first year of
life, in the year of diagnosis, or over a
lifetime and asthma incidence in children.
Results are consistent across locations based
on various study designs and cohorts.
In reaching this conclusion, the 2016
NOX ISA also thoroughly discusses the
uncertainties and limitations in these
studies, including uncertainties and
limitations stemming from the potential
for copollutant confounding and
exposure measurement error (U.S. EPA,
2016a, section 6.2.2.1). For example,
with respect to studies of long-term
exposures, the ISA notes that
‘‘[e]pidemiologic studies of asthma
development in children have not
clearly characterized potential
confounding by PM2.5 or traffic-related
pollutants’’ (U.S. EPA, 2016a, p. 6–64).
Drawing from this discussion in the
ISA, the potential for such confounding
is a key consideration in the PA’s
conclusions on the adequacy of the
public health protection provided by the
current primary NO2 NAAQS (U.S.,
EPA, 2017, section 5.4). The
Administrator has further considered
such uncertainty in reaching his
proposed and final decisions in this
review (82 FR 34792, July 26, 2017,
section II.F.4; and see section II.B.4
below). The 2016 NOX ISA also
characterizes the potential for exposure
measurement error in these studies and
uncertainties related to reliability of
asthma diagnosis and age of children
and temporality between diagnosis and
exposures (U.S. EPA, 2016a, section
6.2). Based on the broader body of
evidence (i.e., including controlled
human exposure and animal
toxicological studies), the 2016 NOX ISA
concludes that uncertainty in the
epidemiologic evidence base ‘‘is partly
reduced by the biological plausibility
provided by findings from experimental
studies’’ (U.S. EPA, 2016a, p. 6–64).
When taken together, the 2016 NOX ISA
concludes that the evidence supports a
relationship between long-term NO2
exposure and respiratory effects that is
‘‘likely to be causal,’’ and the CASAC
supported this conclusion in its review
of drafts of the 2016 NOX ISA and the
PA (Diez Roux and Frey, 2015a; Diez
Roux and Sheppard, 2017, p. 7).
Some comments additionally contend
that the ISA provides a skewed and
unbalanced picture of the scientific
record by failing to discuss null
associations in epidemiologic studies
and by focusing on results at the lag that
had the most positive and statistically
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significant association. These comments
assert that the ISA ignores temporal
differences in the lag at which the
strongest association was found.
With regard to reporting null
associations, the EPA agrees that the
assessment of the scientific evidence
should consider all relevant, wellconducted studies that meet the ISA’s
criteria for inclusion, regardless of
whether results are positive, null, or
negative. Accordingly, the EPA employs
a comprehensive approach to ensure
that all of the relevant literature is
identified for consideration and
evaluation in the ISA (U.S. EPA, 2015a,
Figure III, p. 6). As an initial step in the
development of the 2016 NOX ISA, a
call for information was published in
the Federal Register (77 FR 7149,
February 2, 2012). This call for
information invited members of the
public to provide information relevant
to the assessment, including the
identification of publications that
evaluate potential relationships between
pollutant exposures and health effects
or data from the fields of atmospheric or
exposure science. Subsequent to this
call for information, the EPA conducted
a comprehensive literature search and
an evaluation and integration of
evidence from the identified studies. As
part of this process, the EPA evaluated
study quality according to predefined
criteria that are consistent with widely
established methods in the field (U.S.
EPA, 2016a, Table A–1, p. A2). This
evaluation and assessment of the
evidence, which included studies that
reported null or negative results, was
presented in two drafts of the ISA, each
of which was reviewed by the CASAC
at a public meeting where there were
opportunities for members of the public
to provide comments. As discussed
above, in its advice to the
Administrator, the CASAC concurred
with key conclusions in the ISA
regarding the strength of the evidence
linking NO2 exposures with various
health outcomes (Diez Roux and Frey,
2015a, cover letter at p. 1; Diez Roux
and Sheppard, 2017, p. 7).
In addition, we note that there is
ample discussion throughout the ISA of
null and negative results when they are
reported in the studies, including
epidemiologic studies (e.g., U.S. EPA,
2016a, Figures 5–7 and 6–1, and
accompanying text).105 Summary tables
105 The 2016 NO ISA also recognizes the
X
potential for publication bias, stating that
‘‘[p]ublication bias is another source of uncertainty
that can impact the magnitude of estimated health
or welfare effects. It is well understood that studies
reporting non-null findings are more likely to be
published than reports of null findings’’ (U.S. EPA,
2016a p. li).
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of key evidence in the ISA for each
causal determination discuss outcomes
for which negative or inconsistent
results are observed (see Table ES–1 of
the 2016 NOX ISA for a comprehensive
list of summary tables included in the
ISA). Additionally, the EPA notes that
while these comments criticized the
EPA’s assessment of the evidence, they
did not identify well-conducted studies,
regardless of association observed, or
lack thereof, that were not included in
the 2016 NOX ISA. Thus, given the
extensive public process that the EPA
has used to identify and assess the
relevant scientific evidence, including
multiple opportunities for CASAC to
provide advice and for members of the
public to provide input, together with
the ISA’s discussion of all relevant,
well-conducted studies, regardless of
results, we do not agree with comments
claiming that the ISA provides an
unbalanced picture of the scientific
record by failing to account for studies
reporting null or negative associations.
Additionally, the EPA does not agree
with comments criticizing the 2016 NOX
ISA’s approach to identifying the most
appropriate lags in epidemiologic
studies of short-term NO2 exposures. We
note that lag structure can vary within
the population according to differences
among individuals in time-activity
patterns, pre-existing disease, or other
factors that influence exposure and
responses to exposure. The ISA
specifically notes that ‘‘[t]he lag
structure for associations with NO2
exposure may vary among health effects
depending on differences in the time
course by which underlying biological
processes occur’’ (U.S. EPA, 2016a, p.
1–39). In addition, differences in
associations among exposure lags may
be influenced by ‘‘differences in the
extent to which single-day and multiday
average ambient NO2 concentrations
represent people’s actual exposures’’
(U.S. EPA, 2016a, p. 1–39).
In assessing the support for specific
lags in epidemiologic studies of shortterm NO2 exposures and asthma-related
effects, the ISA notes support for sameday exposures and for exposures
averaged over multiple days (U.S. EPA,
2016a, section 1.6.2). The ISA further
notes support for these lags from
experimental studies (U.S. EPA, 2016a,
section 1.6.2). Specifically, controlled
human exposure studies found airway
responsiveness in adults with asthma to
increase immediately after, or 20
minutes to 4 hours after, a single NO2
exposure and over 4 days of repeated
exposure (U.S. EPA, 2016a, section
5.2.2.1). In experimental studies, NO2
exposure enhanced allergic
inflammation 30 minutes up to 19 hours
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after a single- or 2-day exposure in
humans and 7 days after exposure in
rats (U.S. EPA, 2016a, section 5.2.2.5).
Thus, based on its assessment of the
evidence, the ISA concludes that
‘‘findings from experimental studies
provide biological plausibility for the
asthma-related effects observed in
epidemiologic studies in association
with 2- or 5-hour exposures, same-day
NO2 exposures, as well as exposures
averaged over multiple days’’ (U.S. EPA,
2016a, p. 1–40). Accordingly, when
assessing epidemiologic studies of
short-term NO2 exposures, the ISA
focuses on the lags that are best
supported in the evidence, with a
recognition that the most appropriate
lag can vary according to the specific
endpoint evaluated, time-activity
patterns of members of the study
population, the prevalence of preexisting disease in the study population,
and other factors that influence
pollutant exposures or the responses to
those exposures.
Some comments recommend that the
EPA conduct quantitative analyses of
uncertainty whenever possible. As
discussed above and elsewhere in this
document (e.g., sections II.A.2, II.A.3,
II.B.1, II.B.4), the EPA has thoroughly
considered uncertainties in the evidence
and in available quantitative analyses
throughout this review of the primary
NO2 NAAQS. Uncertainties have been
evaluated through a combination of
qualitative and quantitative approaches,
with the specific approach depending
on the uncertainty being evaluated and
the data available for its evaluation. For
example, the 2016 NOX ISA’s
conclusions are based on an evaluation
of the strengths and weaknesses in the
overall collection of studies across
disciplines. The ISA’s approach to
evaluating the evidence and drawing
causal determinations generally
involves qualitative consideration of
uncertainties in the various lines of
evidence (U.S EPA, 2016a, preamble).
As noted above, this framework has
been implemented and refined over
multiple NAAQS reviews, drawing from
extensive interactions with the CASAC
and from the public input received as
part of the CASAC review process. The
CASAC has reviewed the causal
determinations in the NOX ISA,
including the ISA’s consideration of
uncertainties in the evidence, and has
concurred with those determinations
(Diez Roux and Frey, 2015a, cover letter
at p.1; Diez Roux and Sheppard, 2017,
p. 7).
With regard to analyses comparing
NO2 air quality and health-based
benchmarks, the PA includes both
quantitative and qualitative evaluation
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of uncertainties. For example,
quantitative sensitivity analyses were
used to evaluate the degree to which
study areas adequately reflect
influential factors that could contribute
to variability in NO2 concentrations and
potential exposures (U.S. EPA, 2017a,
Appendix B, section 2.3.2) and to
examine the potential impacts of NO2
exposures on or near roadways (U.S.
EPA, 2017a, Appendix B, section 2.4.2).
In addition, the PA includes extensive
qualitative discussion of uncertainties
in air quality-benchmark comparisons,
and the implications of these
uncertainties for the interpretation of
analysis results (U.S. EPA, 2017a,
section 4.2.1.3). This includes
consideration of uncertainties in
evidence underlying the health-based
benchmarks, in the approach to
adjusting ambient NO2 concentrations to
simulate just meeting the current
standard, and in the degree to which
monitored NO2 concentrations reflect
the highest potential NO2 exposures.
Thus, as part of this review, the EPA has
thoroughly considered uncertainties in
the evidence and in available
quantitative analyses, with the specific
approach depending on the uncertainty
being evaluated and the data available
for its evaluation.
b. Comments Relating to Consideration
of Less Stringent Standards
Though most commenters express
support for the proposed decision to
retain the current primary NO2
standards, some of these commenters
additionally encourage the
identification and consideration of less
stringent standards. Such comments are
often based on criticisms of the EPA’s
approach to assessing the scientific
evidence, as discussed in section II.B.3.a
above, with some comments contending
that the proposal understates the margin
of safety provided by the current 1-hour
and annual standards. Some comments
further conclude that limitations and
uncertainties in the body of scientific
evidence support the possibility that the
current standards are more protective
than is requisite, claiming that, in its
consideration of the adequacy of the
protection provided by the current
standards, the EPA failed to consider
whether the NO2 NAAQS should be
made less stringent. One comment
additionally asserts that the failure to
identify alternative, less stringent
standards is arbitrary and capricious,
stating that the EPA has not adequately
examined whether the uncertainties in
the evidence call into question the
proposed decision to retain the current
standards or whether the standard
level(s) should be less stringent. This
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comment contends that the EPA must
examine the possibility that the current
standards may be too stringent and that,
without such an examination, there is
not adequate foundation in the record to
support the proposed decision to retain
those standards.
The Administrator has carefully
considered whether standards less
stringent than the current standards
would be sufficient to protect public
health with an adequate margin of safety
and, thus, whether retaining the current
standards would not be requisite (see
discussion in proposal at 82 FR 34792,
July 26, 2017, section II.F.4, and below).
This consideration is informed by the
thorough discussions of the
uncertainties in the scientific evidence
in the 2016 NOX ISA, the PA, and
elsewhere in this document (U.S. EPA,
2016a, table 1–1; U.S. EPA, 2017a,
section 3; and section II.A.3, above). The
Administrator is not required to identify
or evaluate specific alternative
standards in order to make a
determination than an existing standard
or suite of standards provide the
requisite protection. To the contrary,
where the record supports a judgment
that the current standards are requisite
to protect public health with an
adequate margin of safety, and that more
or less stringent standards would not be
requisite, the EPA may conclude, as it
has here, that detailed evaluation of
specific alternative standards is not
warranted.106
Further, we disagree with the
suggestion that, by focusing on whether
the current standards adequately protect
public health, the EPA has failed to
consider the possibility that those
standards should be revised to be less
stringent in order to provide the
requisite level of protection. Comments
making this claim mistakenly presume
that, in considering the adequacy the
current primary NO2 NAAQS and the
public health protection they provided,
the EPA has not considered whether the
current standards should be revised to
be less stringent. In fact, the EPA’s
consideration of the adequacy of the
current standards and the public health
protection they provide is intended to
inform, and therefore substantively
overlaps with, the Administrator’s
consideration of whether more or less
stringent standards would, in his
judgment, be requisite under the Clean
Air Act. Accordingly, in considering the
adequacy of the current standards to
106 For example, in the final decision in the
recently completed review of the National Ambient
Air Quality Standards for Lead (81 FR 71906,
October 18, 2016), the standards were retained
without consideration of potential alternative
levels.
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satisfy the CAA’s requirements, the EPA
also evaluates whether identification of
potential alternative standards, either
more or less stringent, is warranted. As
described below, several considerations
support the EPA conclusion in this
review that standards less stringent than
the current standards would not be
requisite.
First, compared to the current
standards, less stringent standards
would be more likely to allow NO2
exposures that could exacerbate
respiratory effects in people with
asthma. The current NO2 standards are
expected to allow virtually no potential
for exposures to the NO2 concentrations
that have been shown most consistently
to increase AR in people with asthma
(i.e., 250 ppb and above). In addition,
the current standards provide a margin
of safety, in part by limiting the
potential for exposures to 1-hour NO2
concentrations at or above 100 ppb, an
exposure concentration with the
potential to exacerbate asthma
symptoms but for which the evidence
indicates uncertainty in the risk of such
effects occurring (U.S. EPA, 2017a,
sections 5.2, 5.4). Although limitations
in this evidence take on increased
importance when considering the
potential public health implications of
such exposures to 100 ppb, as discussed
in greater detail below (e.g, sections
II.B.3.c and II.B.4), the CAA requires
that a primary NAAQS protect the
public health even where, as here, the
risks from the pollutant cannot be
quantified or ‘‘precisely identified as to
nature or degree.’’ API v. EPA, 684 F.3d
at 1350 (internal citation omitted).
Further, in setting a standard with an
adequate margin of safety, the EPA is to
‘‘err on the side of caution.’’ Id. at 1352.
Thus, EPA places weight on the
consideration that less stringent
standards would be expected to be less
effective than the current standards at
protecting against these short-term
exposures to NO2 concentrations at or
above health-based benchmarks.
Second, less stringent standards
would be more likely to allow the
ambient NO2 concentrations that have
been reported in epidemiologic studies
to be associated with clearly adverse
effects. For example, such standards
would be more likely to allow the shortterm ambient NO2 concentrations that
have been shown in epidemiologic
studies conducted in the U.S. or Canada
to be associated with asthma-related
hospitalizations. In addition,
recognizing that the current 1-hour
standard contributes substantially to
protection against long-term NO2
exposures, less stringent standards
would also be more likely to allow the
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long-term ambient concentrations that
have been reported in epidemiologic
studies to be associated with asthma
development in children. While the
EPA recognizes the limitations and
uncertainties in these studies, they
provide evidence for associations with
asthma-related effects in locations likely
to have violated the current standards
(U.S. EPA, 2017a, sections 3.2.2.2 and
3.3.2.1). Therefore, the EPA also places
weight on the consideration that,
compared to the current standards, less
stringent standards would allow greater
risk of the serious health effects
reported in these studies.
Finally, the CASAC advice also
supports the EPA conclusion that a
detailed evaluation of less stringent
potential alternative standards is not
warranted in the current review.
Specifically, the CASAC advised that
the current primary NO2 standards, but
not less stringent standards, provide
protection against adverse effects
associated with both short- and longterm NO2 exposures. Based on its
consideration of the evidence, the
CASAC concluded that ‘‘there are
notable adverse effects at levels that
exceed the current standard, but not at
the level of the current standard’’ (Diez
Roux and Sheppard, 2017 p. 9) and that
it is ‘‘the suite of the current 1-hour and
annual standards, together, that provide
protection against adverse effects’’ (Diez
Roux and Sheppard, 2017, p. 9).
Therefore, for the reasons discussed
above, we disagree with comments
advocating for a detailed evaluation of
potential alternative standards that
would be less stringent than the current
standards and with comments
contending that EPA has not considered
whether the current standards are too
stringent and, thus, should not be
retained.
Comments advocating for the
identification of less stringent standards
often focus on specific uncertainties in
the available health evidence, claiming
that, because of these uncertainties, the
margin of safety provided by the current
primary NO2 standards is larger than
acknowledged in the proposal. For
example, some comments question the
EPA’s interpretation of controlled
human exposure studies examining AR,
claiming that these studies do not
demonstrate adverse effects at exposure
concentrations below 300 ppb. Such
comments contend that the EPA should
clearly articulate the limitations in
controlled human exposure studies of
AR following NO2 exposures, and in the
Brown (2015) meta-analysis of
individual-level data from these studies.
The EPA agrees that there are
uncertainties in the evidence from
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controlled human exposure studies of
NO2-induced changes in AR. These
uncertainties have been discussed and
considered extensively throughout this
review, including in the 2016 NOX ISA
and the PA (U.S. EPA, 2016a; U.S. EPA,
2017a), and in the Administrator’s
consideration of the evidence in both
the proposal (82 FR 34792, July 26,
2017, section II.F.4) and this final action
(section II.B.4, below). Specifically,
important limitations in the evidence
for increased AR following NO2
exposures include the lack of an
apparent dose-response relationship,
which limits our ability to fully
characterize the health risks associated
with these exposures, and uncertainty
in the adversity of the reported
increases in AR (e.g., see U.S. EPA,
2017a, section 3.2.2.1, and section
II.A.2.a.iii above). While we agree that it
is appropriate to consider these
uncertainties in reaching decisions on
the primary NO2 NAAQS, as described
below, we disagree that such
uncertainties indicate that the reported
effects do not have the potential to be
adverse to public health.
In particular, as discussed in the ISA,
increases in AR are considered to be a
hallmark of asthma and can lead to
poorer control of symptoms in people
with the disease. Drawing on guidelines
from the ATS and the ERS, analyses
discussed in the 2016 NOX ISA indicate
that the increases in AR reported
following exposures to NO2
concentrations from 100 to 530 ppb
have the potential to be clinically
relevant in some people with asthma (82
FR 34804, July 26, 2017; U.S., EPA,
2016a section 5.2.2.1). While there are
no universally agreed upon criteria for
determining whether such increases
should be considered adverse, they
represent respiratory effects that could
be of particular concern for people with
more severe cases of asthma than have
typically been evaluated in the available
studies of NO2 exposures. These studies
have generally evaluated people with
mild asthma, while people with
moderate or severe asthma could be
more susceptible to NO2-induced
increases in AR, and thus more likely to
exhibit adverse responses following NO2
exposures (Brown, 2015).107 Therefore,
the uncertainty over the adversity of the
response reported in controlled human
exposure studies and the Brown (2015)
meta-analysis does not mean that the
NO2-induced increase in AR is not
107 Furthermore,
the potential for such effects in
other at-risk populations that have generally not
been evaluated in NO2 controlled human exposure
studies (i.e., children and older adults) cannot be
well-characterized based on the available studies.
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adverse to any population. Rather, the
evidence indicates a risk of adversity for
some people, especially for those with
more than mild asthma, though this risk
cannot be fully characterized based on
existing studies. When considered at a
population level, these risks are
amplified and take on public health
significance.
In light of these observations, we
disagree with the assertion that
controlled human exposure studies do
not demonstrate effects that could be
adverse to public health following
exposures to NO2 concentrations below
300 ppb and with comments that the
proposal overstates the margin of safety
provided by the current standards.
Rather, while acknowledging
uncertainties in the evidence, and that
the risk cannot be fully characterized
based on existing studies, the EPA
remains concerned about the potential
for adverse respiratory effects following
exposures to such NO2 concentrations,
particularly in people with more severe
cases of asthma than have generally
been evaluated in the available studies
of NO2 exposures. Further, given the
large percentage of people with asthma
that experienced an NO2-induced
increase in AR in these studies,
including at exposures at and below 300
ppb,108 and the large size of the
asthmatic population in the United
States, the EPA concludes that it is
appropriate to place weight on NO2induced increases in AR in considering
the potential for adverse public health
effects following NO2 exposures.
Additionally, some comments support
placing more emphasis on a metaanalysis of information from controlled
human exposure studies by Goodman et
al. (2009). These comments assert that
Goodman et al. concluded that
exposures to NO2 concentrations up to
600 ppb are not associated with
clinically relevant effects.
The particular basis for these
comments appears to be the conclusions
reached by Goodman et al. (2009) that
there is no dose-response relationship
between NO2 exposures and increased
AR, and that the magnitude of any NO2
effect on airway responsiveness is too
small to be considered adverse. While
the EPA acknowledges the lack of an
apparent dose-response relationship
between NO2 exposures and increased
AR, potentially due to differences in
study protocols in the NO2-airway
response literature (U.S. EPA, 2016a,
108 For example, as discussed elsewhere in this
document (e.g., section II.A.2 above), the Brown
(2015) meta-analysis reported that following resting
NO2 exposure in the range of 200 ppb to 300 ppb,
increased non-specific AR was reported in 78% of
study participants.
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section 5.2.2.1), the EPA disagrees with
the approach taken in the Goodman
study to use existing data to attempt to
evaluate whether a dose-response
relationship exists. Specifically, the
EPA notes that while Goodman et al.,
(2009) did not observe a dose-response
relationship, this could be due to a
variety of factors inherent to the study
design rather than a true absence of a
dose-response relationship.109 Examples
of such differences between studies
include the NO2 exposure method (i.e.,
mouthpiece versus chamber), subject
activity level (i.e., rest versus exercise)
during NO2 exposure, choice of airway
challenge agent, and physiological
endpoint used to quantify airway
responses.
As a result of these differences in
study protocols, the 2016 NOX ISA
judged it appropriate to assess only the
fraction of study participants who
experienced increased or decreased
airway responsiveness following NO2
exposures. The CASAC endorsed this
approach of comparing the fractions of
study participants, which was adopted
in the meta-analysis by Brown (2015)
and was the focus of discussion in the
2016 NOX ISA (U.S. EPA, 2016a, section
5.2.2.1). When commenting on Brown
(2015) in the draft ISA, the CASAC
noted that it was ‘‘impressed with the
meta-analysis of controlled human
exposure studies’’ and found that ‘‘this
analysis facilitates the inferences that
can be drawn from the studies
contained in the analysis’’ (Diez Roux
and Frey, 2015a, p. 2 of cover letter, p.
7 of consensus comments).
When the fraction of study
participants who experienced increased
or decreased airway responsiveness was
analyzed, both Brown (2015) and
Goodman et al. (2009) reported that
exposures to NO2 concentrations at and
above 100 ppb increased airway
responsiveness in the majority of people
with asthma. Specifically, Table 4 of the
Goodman et al. (2009) study reports that
64% (95% CI: 58%, 71%) of resting
asthmatics exposed to NO2 experienced
an increase in airway responsiveness.
Furthermore, Figure 2a of the Goodman
et al. (2009) study reports that for
exposures less than 200 ppb, 61%
109CF. API v. EPA, 684 F.3d at 1350 (nothing in
the context of the last NO2 NAAQSreview that ‘‘the
[Goodman] study did not establish there was ‘no
dose-response relationship’’’). In a decision
upholding the 2010 primary NO2 NAAQS , the
court held that EPA was ‘‘justified in revising the
NAAQS considering the evidence of a statistically
significant relationship between relevant health
conditions and NO2 exposure at various
concentrations, even if the agency did not know the
precise dose-response relationship between V and
airway responsiveness, among other health effects.’’
Id. at 1351.
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experienced an increase in AR (95% CI:
52%, 70%), while for exposures of 200
to 300 ppb, 66% experienced an
increase (95% CI: 59%, 74%). These
findings are consistent with those
reported by Brown (2015) and discussed
in the 2016 NOX ISA (U.S. EPA, 2016a,
section 5.2.2.1).
Thus, both Goodman et al. (2009) and
Brown (2015) report that the majority of
study subjects experienced increased
AR following resting NO2 exposures. As
discussed further above, increases in AR
can lead to poorer control of symptoms
in people with asthma and analyses in
the 2016 NOX ISA indicate that the
increases in AR reported following
resting exposures to NO2 concentrations
from 100 to 530 ppb have the potential
to be clinically relevant in some people
with asthma. In addition, people with
more severe cases of asthma than have
typically been evaluated in the available
studies of NO2 exposures could be more
likely to exhibit adverse responses
following such exposures. Therefore,
while we agree with comments that it is
appropriate to consider the metaanalysis by Goodman et al. (2009), in
addition to that by Brown (2015), we do
not agree that such consideration
supports the conclusion that exposures
to NO2 concentrations up to 600 ppb are
not associated with clinically relevant
effects.
Some comments assert that the EPA
should place more emphasis on
controlled human exposure studies that
employ allergen challenge, rather than
those that use non-specific challenge
agents, because the commenters view
such studies as more relevant to real
world exposures. These comments
claim that the lack of effects in studies
that used allergen challenge increases
the uncertainty that NO2 in ambient air
causes effects of concern.
As an initial matter, we note that the
ATS and the ERS recognize increased
AR following exposure to non-specific
challenge agents (e.g., methacholine) as
a primary feature in the clinical
definition and characterization of
asthma severity (U.S. EPA, 2016a,
section 5.2.2.1; Reddel et al., 2009).
Thus, we do not agree with the
implication of these comments that nonspecific challenge agents are inherently
less relevant to the evaluation of NO2induced changes in AR.
We further disagree that people would
not have real world exposures to all of
the non-specific challenge agents used
in controlled human exposure studies.
Specifically, both cold dry air and SO2,
which have been evaluated in studies of
non-specific AR following NO2
exposures, are nonspecific stimuli that
people may encounter in the
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environment.110 Thus, when viewed
from a public health perspective, a
member of the public has the potential
to be exposed to a non-specific
challenge agent just as they have the
potential to be exposed to an allergen to
which they have been sensitized.
In addition, while we agree with the
potential public health significance of
increased AR to allergen challenges
(e.g., see U.S. EPA 2016a, pp. 5–24 and
5–25), relatively little individual-level
data on changes in AR following NO2
exposures was available from studies
using specific allergen challenges (i.e.,
about 30% of the AR data). With regard
to the allergen challenge studies that
were available, the 2016 NOX ISA (U.S.
EPA 2016a, p. 5–25) additionally notes
that, ‘‘. . . the response to an allergen
is not only a function of the
concentration of inhaled allergen, but
also the degree of sensitization as
measured by the level of allergenspecific IgE and responsiveness to
nonspecific agents,’’ making it difficult
to predict the level of responsiveness to
an allergen. The relatively small amount
of individual-level data from allergen
challenge studies, together with the
greater difficulty in predicting allergen
responsiveness, limits the degree to
which these studies, by themselves, can
inform conclusions on the potential
public health implications of NO2
exposures. Given this, in addition to
considering results of individual
studies, we consider the data from
studies of allergen challenge, together
with data from studies of non-specific
challenge, as part of the meta-analysis
by Brown (2015). When data from
studies of non-specific challenge were
combined with data from studies of
allergen challenge, Brown (2015)
reported that the majority of study
participants experienced increased AR
following resting exposures from 100 to
200 ppb, 200 to 300 ppb, and above 300
ppb (Table 5 in Brown, 2015). Thus,
based on the larger body of information
available, including information from
studies that evaluated AR following
allergen challenge, NO2 exposures at
and above 100 ppb have the potential to
increase AR in people with asthma.
Some comments additionally point
out the inconsistent results reported in
controlled human exposure studies
conducted in people who are exercising,
claiming that such inconsistency calls
into question the plausibility of a causal
association between NO2 and increased
110 Of the studies included in the meta-analysis
by Brown (2015), SO2 was used as a challenge agent
in a study of resting exposures to 250 ppb NO2
(Table 1 of Brown, 2015) and cold dry air was used
in several studies of NO2 exposures during exercise
(Table 2 of Brown, 2015).
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AR. With regard to these comments, the
EPA agrees that individual studies
conducted with exercise have not
consistently reported NO2-induced
increases in AR. However, the EPA does
not agree with commenters’ conclusion
that these inconsistencies call into
question the causal association between
NO2 and increased AR.
As noted above, the 2016 NOX ISA
has extensively considered all available
studies that have evaluated the potential
for NO2 to increase AR in people with
asthma. This includes studies
conducted with participants at rest as
well as studies with participants
engaged in exercise (U.S. EPA, 2016a,
section 5.2). As discussed in the ISA
(U.S. EPA, 2016a, p. 5–23), the presence
of a response in study participants at
rest, but not while engaged in exercise,
is not enough, in itself, to dismiss the
causal association between NO2 and
airway responsiveness. This issue is
discussed in detail in the Brown (2015)
meta-analysis, and in other publications
on NO2 by Folinsbee (1992) and Bylin
(1993), which were considered in the
ISA. As discussed in those publications,
the act of exercising may create a
refractory period which may lead to
diminished airway responsiveness to a
challenge. Therefore, observing a
response in participants at rest, but not
exercising, does not indicate that there
is no causal relationship between NO2
exposures and increased airway
responsiveness. The CASAC was aware
of this difference in results across study
protocols, but still agreed with EPA’s
determination that there was a causal
relationship between NO2 exposures
and increased airway responsiveness,
concluding that the Brown (2015) metaanalysis ‘‘provides confirmation of
causality for short-term effects’’ (Diez
Roux and Frey, 2015a, p. 6).
Some comments supporting the
consideration of less stringent standards
additionally focus on the epidemiologic
evidence. Specifically, some industry
groups comment that the EPA overstates
the consistency of the epidemiologic
evidence, particularly given the
potential for co-pollutant confounding
and exposure measurement error in
studies of long-term NO2 exposures, and
given the results of a U.S. multicity
study that reported no association
between short-term NO2 exposures and
ED visits (Stieb et al., 2009).
As discussed in greater detail above
(Section II.B.3.a), we do not agree with
comments criticizing the 2016 NOX
ISA’s assessment of the epidemiologic
evidence, including comments
criticizing the ISA’s characterization of
the consistency of results across studies
or comments criticizing the assessment
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of uncertainties in those studies.
Contrary to these comments, the ISA
thoroughly considers uncertainties and
limitations in the evidence, including
the potential for co-pollutant
confounding and exposure
measurement error in epidemiologic
studies (see e.g., U.S. EPA, 2016a,
sections 5.2.9.4 and 6.2.2.1). The PA
additionally considers such
uncertainties, and their implications for
conclusions on the degree of public
health protection provided by the
current primary NO2 standards (U.S.
EPA, 2017a, sections 3.2.2.2, 3.3.2.1,
5.4).
With regard to comments on the study
by Stieb et al. (2009) in particular,
commenters correctly point out that this
study reported no association between
short-term NO2 and ED visits. This lack
of a positive association was discussed
in the 2016 NOX ISA (U.S. EPA, 2016a,
p. 5–84). However, the ISA’s conclusion
regarding the overall consistency of the
broader body of available epidemiologic
studies is based on the generally
positive health effect associations
reported in studies conducted across the
U.S., Canada, Europe, and Asia (e.g.,
U.S. EPA, 2016a, Figure 5–7). The
relatively small number of studies in
this group that did not report such
positive associations, including the
study by Stieb et al. (2009), were
appropriately considered in reaching
this broader ISA conclusion and do not
call it into question. The lack of a
positive association in the study by
Stieb et al. (2009) was also specifically
discussed in the PA (U.S. EPA, 2017a,
p. 5–8), which noted that ‘‘the only
recent multicity study evaluated (Stieb
et al., 2009) . . . did not report a
positive association between NO2 and
ED visits’’ (U.S. EPA, 2017a, p. 5–8).
This observation, together with
information from other key
epidemiologic studies conducted in the
U.S. or Canada,111 informed the PA’s
conclusion that ‘‘available U.S. and
Canadian epidemiologic studies of
hospital admissions and ED visits do
not indicate the occurrence of NO2associated effects in locations and time
periods with NO2 concentrations that
would clearly have met the current 1hour NO2 standard’’ (U.S. EPA, 2017a,
p. 5–9). Thus, the lack of a positive
111 In considering the public health protection
provided by the current standards, the PA focused
on key studies assessed in the ISA that were
conducted in the U.S. or Canada. Such studies are
likely to reflect air quality and exposure patterns
that are generally more applicable to the U.S. In
addition, air quality data corresponding to study
locations and study time periods is often readily
available for studies conducted in the U.S. and
Canada (U.S. EPA, 2017a, p. 3–20).
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association with ED visits in the study
by Stieb et al. (2009) was discussed in
the ISA and informed the PA’s
conclusions on the adequacy of the
public health protection provided by the
current primary NO2 NAAQS.
Accordingly, we disagree with the
comments arguing, based on Stieb et al.
(2009) or on uncertainties and
limitations in the epidemiologic
evidence, as described more fully above
(II.B.3.a), that EPA has overstated the
consistency of the epidemiologic
evidence.
Some comments additionally note
that current ambient NO2 concentrations
are low, particularly compared to
concentrations that would be of concern
based on the health evidence, and are
showing a downward trend. These
comments contend that current
monitoring, including available nearroad monitoring, shows that NO2
concentrations remain well below the
levels of current standards, calling into
question the EPA’s analysis comparing
NO2 air quality with health-based
benchmarks and its resulting impact on
the Administrator’s determinations in
the proposed decision. They further
assert that the lack of real-world
exposures above benchmarks, together
with the downward trend in NO2
concentrations, contradicts EPA’s
rationale that the level of the current
NAAQS must be maintained to protect
against exposures at 100 ppb or 250
ppb. Based on current ambient NO2
concentrations, these commenters argue
that the EPA should consider how the
monitoring data, including from nearroad monitors, impacts its assessment of
exposures and should also examine
whether alternative, less stringent
standards are appropriate.
Insofar as these comments are
premised on the notion that exposureand risk-related considerations in the
NAAQS reviews should rely only on
actual air quality, we disagree. We
recognize that available monitoring data
indicates that recent ambient NO2
concentrations are below the NO2
exposure concentrations shown in
controlled human exposure studies to
increase AR. For example, the PA notes
that analyses based on recent NO2 air
quality ‘‘estimate almost no potential for
1-hour exposures to NO2 concentrations
at or above benchmarks, even at the
lowest benchmark examined (i.e., 100
ppb)’’ (U.S. EPA, 2017a, p. 4–19).
However, the observation that recent
NO2 air quality concentrations,
including from the near-road monitors,
are lower than the exposure
concentrations shown to cause effects
does not, in and of itself, answer the
question whether the current standards
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are more protective than necessary or
whether the EPA should consider less
stringent standards. Rather, it is
important to consider the potential NO2
exposures that would be permissible
under the current standards to inform
these questions.
In order to accomplish this, the PA
further considers the potential for
exposures to NO2 concentrations at or
above health-based benchmarks based
on analyses where air quality has been
adjusted upwards to simulate areas that
would ‘‘just meet’’ the current primary
NO2 NAAQS. These analyses provide
information on the public health
protection associated with allowable
NO2 air quality under the current
standards and, therefore, are clearly
useful for informing a decision on the
issue before the EPA. See American
Petroleum Institute v. EPA, 684 F.3d at
1353 (upholding EPA’s approach
‘‘comparing the benefits of the one-hour
standard against not only a scenario
based upon existing air quality but also
upon an alternate scenario in which
areas just meet the [existing
standard].’’); American Trucking
Associations v. EPA, 283 F.3d 355, 370–
71 (D.C. Cir. 2002) (existence of
evidence showing adverse effects
occurring at levels allowed by the
current standards justifies finding that it
is appropriate to revise the existing
NAAQS). This is a reasonable approach
to informing judgments regarding the
current standards, and it is consistent
with section 109 of the CAA, which
requires the EPA to review whether the
current primary standards—not current
air quality—are requisite to protect
public health with an adequate margin
of safety. CAA section 109(b)(1) and
109(d)(1); see also NEDA/CAP v. EPA,
686 F.3d 803, 813 (D.C. Cir. 2012)
(rejecting the notion that it would be
inappropriate for EPA to revise a
NAAQS if current air quality does not
warrant revision, stating ‘‘[n]othing in
the CAA requires EPA to give the
current air quality such a controlling
role in setting NAAQS’’). Furthermore,
although NO2 air quality has been
improving and is expected to continue
improving, there are inherent
uncertainties in predicting future air
quality. Accordingly, it is reasonable to
consider the NO2 exposures that could
occur under a pattern of air quality that
just meets the current standards. API v.
EPA, 684 F.3d at 1352.
In addition, the CASAC agreed with
considering analyses based on adjusted
air quality, stating that ‘‘[t]he EPA has
made a reasonable choice in looking
both at the number of [benchmark]
exceedances of the unadjusted data as
well as the level of exceedance of the
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c. Comments Supporting More Stringent
Standards
One commenter argues that the
current NAAQS do not protect public
health with an adequate margin of
safety, and that the standards should be
revised to be more stringent.
Specifically, these comments
recommend that the level of the 1-hour
NO2 standard be set at 50 ppb, with a
99th percentile form, and that the level
of the annual standard should be set at
30 ppb. These comments, and the EPA’s
responses, are discussed below. 112
Comments asserting that the current
1-hour standard does not protect public
health or provide any margin of safety
cite the meta-analysis by Brown (2015)
to support this position, arguing that
this meta-analysis clearly shows that the
majority of individuals with asthma
were adversely affected by a
concentration of NO2 that would meet
the current 1-hour standard. To support
this point, these comments state that
Brown (2015) reported increased AR
following 1-hour exposures to 100 ppb
NO2, and they point to several
uncertainties in the individual studies
(i.e., that no studies examined 1-hour
concentrations below 100 ppb, that
study subjects generally had mild
asthma rather than more severe cases of
disease, and that the studies do not
provide information about potential
effects of such exposures on children
and seniors, two groups EPA recognizes
as being particularly at risk). These
comments disagree with the weight that
EPA placed on the lack of consistency
in the individual controlled human
exposures studies at lower
concentrations, contending that the
Brown meta-analysis has greater
statistical power than the individual
studies. These comments further
disagree with EPA’s citation of
uncertainties related to lack of
exposures below 100 ppb as a rationale
for retaining the current level of the 1hour standard, contending that the
CAA’s requirement for an adequate
margin of safety is intended to protect
the population when information is
limited.
As discussed above (Sections II.A.2,
II.B.1), while the Brown meta-analysis
shows that most study participants (i.e.,
generally adults with mild asthma)
experienced increased AR following
resting NO2 exposures from 100 to 530
ppb,113 there are important limitations
in the underlying studies, particularly
in studies that evaluated NO2 exposure
concentrations at or near 100 ppb. Of
the five studies included in the metaanalysis that evaluated resting
exposures to 100 ppb NO2, a statistically
significant increase in AR following
exposure to NO2 was only observed in
one (U.S. EPA, 2017a, section 3.2.2.1).
Of the four studies that did not report
statistically significant increases in AR
following exposures to 100 ppb NO2,
three reported trends towards decreased
AR (U.S. EPA, 2017a, section 3.2.2.1).
Thus, individual controlled human
exposure studies have generally not
reported statistically significant
increases in AR following resting
exposures to NO2 concentrations at 100
ppb (U.S. EPA, 2017a, section 3.2.2.1),
indicating a greater uncertainty in the
risk of such effects at 100 ppb.114 When
considering this general lack of
consistent, statistically significant
results across these five individual
studies, limitations in the broader body
of evidence from controlled human
exposure studies (i.e., uncertainty in
adversity of reported responses and the
lack of an apparent dose-response
relationship), which are discussed
above and have been considered
throughout this review (e.g., U.S. EPA,
2017a, section 3.2.2.1), take on
increased importance when considering
the risk of adverse effects and the
potential public health implications of
exposures to 100 ppb NO2.
In light of the above information from
the Brown (2015) meta-analysis and
112 These comments also refer, for the full
discussion, to an attached comment letter submitted
during the 2010 review of the primary NO2 NAAQS.
This reference suggests that the commenter believed
the comments submitted as part of the 2010 review
are still relevant in the current review, given that
the 2016 NOX ISA focused much of its assessment
on studies that were also included in the 2008 NOX
ISA. We note that, to the extent a separate response
to those comments is required, we have already
responded to the prior comments in the 2010 final
decision on the primary NO2 NAAQS (75 FR 6474,
February 9, 2010; U.S. EPA, 2010).
113 As discussed above, the most consistent
evidence for NO2-induced increases in AR comes
from studies of resting exposures.
114 In addition, studies that evaluated resting
exposures to 140 ppb and 200 ppb NO2 did not
generally report statistically significant increases in
AR. Thus, individual controlled human exposure
studies have generally not reported statistically
significant increases in AR following resting
exposures to NO2 concentrations from 100 to 200
ppb, though this evidence suggests a trend toward
increased AR following NO2 exposures from 140 to
200 ppb (U.S. EPA, 2017a, section 3.2.2.1).
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adjusted data’’ (Diez Roux and
Sheppard, 2017, p. 5). Therefore, for all
of the reasons described above,
relatively low recent ambient NO2
concentrations, including those at nearroad monitors, do not call into question
analyses comparing NO2 air quality to
health-based benchmarks or the role
those analyses play in the
Administrator’s decision to retain the
existing standards.
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from the individual studies included in
that meta-analysis, the Administrator’s
judgment in the proposal was that while
it is appropriate to consider the degree
of protection provided by the current 1hour standard against exposures to NO2
concentrations as low as 100 ppb,115
emphasis should be placed on
protecting against the potential for
exposures to higher NO2 concentrations,
where individual studies generally
report statistically significant increases
in AR (i.e., at or above 250 ppb, as
discussed in U.S. EPA, 2017a, section
3.2.2.1). The more consistent results
across studies at such higher exposure
concentrations indicate greater concern
for the risk of an NO2-induced effect.
To this end, based on the results of
the NO2-air quality benchmark
comparisons reported in the PA (U.S.
EPA, 2017a, section 4.2.1), the current
1-hour standard is estimated to allow
virtually no potential for 1-hour
exposures to NO2 concentrations at or
above 200 ppb, even under worst-case
conditions across a variety of study
areas with among the highest NOX
emissions in the United States. Such
NO2 concentrations were not estimated
to occur, even at monitoring sites
adjacent to some of the most heavily
trafficked roadways. In addition, the
current 1-hour standard limits, but does
not eliminate, 1-hour exposures to NO2
concentrations at or above 100 ppb (U.S.
EPA, 2017a, section 4.2.1), an exposure
concentration where uncertainties in the
evidence take on increased importance.
Despite the importance of uncertainties
in the evidence for increased AR
following exposures to NO2
concentrations at or near 100 ppb, as
summarized above, a focus on limiting
such exposures gives weight to the
results of Brown (2015) at 100 ppb and
to the possibility that other at-risk
groups (e.g., people with more severe
asthma, children, older adults) could
experience more serious effects than
reported in available studies. As such,
the current 1-hour standard provides a
margin of safety by virtually eliminating
the potential for 1-hour exposures to
NO2 concentrations that have been
consistently shown to increase AR in
people with asthma and by limiting
exposures to NO2 concentrations that
have the potential to exacerbate asthma
115 Uncertainties in this evidence are of even
greater concern for NO2 exposure concentrations
below 100 ppb, for which there are no data
available in these studies. On this point, the CASAC
noted that ‘‘the lack of a clear dose-response model
based on available data is another source of
uncertainty that makes it difficult to extrapolate a
dose-response relationship at levels lower than
those measured in the controlled human studies.’’
(Diez Roux and Sheppard, 2017, pp. 7–8).
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symptoms, but for which the evidence
indicates greater uncertainty in the risk
of such effects.
While the EPA recognizes, as
discussed in section I.A. above, that
CAA section 109’s requirement for a
primary NAAQS to provide an adequate
margin of safety is intended to address
uncertainties associated with
inconclusive scientific and technical
information, it also notes that the CAA
does not require a primary NAAQS to be
established at a zero-risk level, or to
protect the most sensitive individual,
but rather at a level that avoids
unacceptable risks to public health. See
Lead Industries Association v. EPA, 647
F.2d at 1154, 1156 n.51. This approach
to considering the degree of protection
provided by the current NAAQS is
consistent with the governing case law.
The EPA further notes that under CAA
section 109, a primary standard must be
‘‘requisite’’—i.e., neither more nor less
stringent than necessary—to protect
public health with an adequate margin
of safety. See Whitman v. American
Trucking Associations, 531 U.S. at 465–
472, 475–76. Additionally, the selection
of any particular approach to providing
an adequate margin of safety is a policy
choice left to the Administrator’s
judgment. See Lead Industries
Association v. EPA, 647 F.2d at 1161–
62. As discussed above, the EPA’s
approach to the margin of safety in this
review reasonably considers both the
potential for adverse public health
effects following exposures to 100 ppb
NO2 and the uncertainties in the public
health implications of such exposures.
Thus, the EPA’s approach here
comports with CAA section 109 and the
case law described in section I.A above.
The EPA’s approach to considering
the degree of protection provided by the
current NO2 NAAQS is also consistent
with advice from the CASAC, which
recognized that ‘‘there is uncertainty
regarding the severity of adverse effects
at a level of 100 ppb NO2, and thus
some potential for maximum daily
levels to exceed this benchmark with
limited frequency may nonetheless be
protective of public health’’ (Diez Roux
and Sheppard, 2017, p. 10). The CASAC
additionally concluded that ‘‘there is
not a scientific basis for a standard
lower than the current 1-hour standard’’
(Diez Roux and Sheppard, 2017 p. 9).
Thus, for the reasons discussed above,
the EPA disagrees with comments
claiming that the Brown (2015) metaanalysis indicates adverse effects at NO2
concentrations meeting the current 1hour standard and with comments
claiming that the Brown (2015) metaanalysis shows that the 1-hour standard
provides no margin of safety.
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Comments advocating for a more
stringent 1-hour standard further state
that the current 98th percentile form
allows too many days with NO2
concentrations above 100 ppb,
undermining protection for people with
asthma, including children. These
comments contend that the EPA’s
rationale that the 98th percentile
provides more stability than the 99th
percentile has no substantive evidence
behind it.
In reviewing the NAAQS, the
Administrator’s foremost consideration
is the adequacy of the public health
protection provided by the combination
of all of the elements of the standard,
including the form. In particular, the
EPA notes that the benchmark analysis
presented in the PA, which informed
the Administrator’s proposed decision,
evaluates the potential for NO2
exposures with air quality just meeting
the current 1-hour standard, including
the 98th percentile form, and that
analysis found that there were no
exceedances of 200 ppb, and very few
exceedances of 100 ppb (1 to 10
annually, on average). Thus, as
described in more detail above, even
under worst-case conditions across a
variety of study areas with among the
highest NOX emissions in the U.S., the
current 1-hour standard, with its 98th
percentile form, virtually eliminates the
potential for exposures to the NO2
concentrations that have been shown
most consistently to increase AR in
people with asthma and to which the
Administrator gives most weight, and
greatly limits the potential for exposures
to lower NO2 concentrations with the
potential to exacerbate symptoms in
some people with asthma, but for which
uncertainties in the evidence take on
increased importance.
In addition, the CASAC advice
provides further support for the 98th
percentile form. The CASAC accepted
the protection provided by the current
98th percentile form, together with the
other elements of the 1-hour standard,
in recommending retention of the
current standard without revision. In
doing so, it provided the following
advice (Diez Roux and Sheppard, 2017,
p. 9):
For the 1-hour current standard, the form
is based on the 98th percentile of daily
maximum 1-hour concentrations, which
corresponds to the 7th or 8th highest daily
maximum 1-hour concentration in a year.
This form limits but does not eliminate
exposures at or above 100 ppb NO2. A
scientific rationale for this form is there is
uncertainty regarding the severity of adverse
effects at a level of 100 ppb NO2, and thus
some potential for maximum daily levels to
exceed this benchmark with limited
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frequency may nonetheless be protective of
public health.
Thus, in providing its advice to retain
the existing 1-hour standard, without
revision, the CASAC clearly considered
the implications of the 98th percentile
form of that standard.
With regard to stability, the proposal
explained that greater regulatory
stability was one consideration
supporting the selection of a 98th
percentile form in the last review. In
that review, the EPA established the
98th percentile form, noting ‘‘the
limited available information on the
variability in peak NO2 concentrations
near important sources of NO2 such as
major roadways’’ and ‘‘the
recommendation from the CASAC that
the potential for instability in the 99th
percentile concentration is cause for
supporting a 98th percentile form’’ (75
FR 6493, February 9, 2010).116 However,
in the proposal and in this final action,
the Administrator’s judgments focus
primarily on his consideration of the
public health protection provided by the
current standards: A 1-hour standard
with a level of 100 ppb and a 98th
percentile form, and an annual average
standard with a level of 53 ppb. The
degree of public health protection
provided by the current standards is a
function of the combination of all
elements of these standards (i.e.,
indicator, averaging times, forms,
levels). Thus, while judgments on
stability can be a legitimate
consideration, his decision to retain the
current primary NO2 NAAQS in this
review (see below) reflects his
judgments regarding public health
protection provided by these standards.
Given this, the EPA disagrees with
comments contending that the form of
the 1-hour standard should be revised to
the 99th percentile.117
Comments advocating for more
stringent standards also assert that the
EPA should adopt an annual standard
116 As noted in the last review, a less stable form
could result in more frequent year-to-year shifts
between meeting and violating the standard,
potentially disrupting ongoing air quality planning
without achieving public health goals (75 FR 6493,
February 9, 2010).
117 These comments also note that EPA
established a 99th percentile form when it revised
the SO2 primary NAAQS in 2010. The fact that EPA
concluded that the 99th percentile was appropriate
for one NAAQS, based on the combined elements
of that revised standard and the evidence and
information in the supporting record, does not
mean that such a form should be used for a different
NAAQS for a different pollutant. Rather, in
reviewing each NAAQS, EPA makes a
determination specific to the pollutant and standard
in question, in the course of which it evaluates the
public health protection it provides based on the
combination of all the elements of the standard and
based on the evidence and information in the
record for that review.
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level of 30 ppb. These comments note
the strengthened evidence linking longterm NO2 exposures with various health
effects, particularly asthma
development, arguing that it expands
the range of potential effects and at-risk
populations. They further note the
recognition by the EPA and the CASAC,
based on its review of analyses in the
PA, that the current 1-hour standard and
annual standard together are estimated
to maintain annual NO2 concentrations
well below 53 ppb. These comments
assert that both the EPA and the CASAC
recognized that the annual standard was
not sufficiently protective and, based on
the degree of control associated with the
1-hour standard, in effect used 30 ppb
as the effective standard for annual
exposure. These comments thus
conclude that EPA should lower the
level of the annual standard level to 30
ppb.
We agree with comments that the
evidence supporting associations
between long-term NO2 exposures and a
variety of effects, particularly the
development of asthma in children, has
become stronger in this review.118
While this evidence supports
associations with a clearly adverse
health outcome, given uncertainties in
key studies and the protection provided
by the 1-hour standard against long-term
NO2 exposures, we disagree with
comments that this strengthened
evidence supports a revised annual
standard with a level of 30 ppb. Our
consideration of these factors is
described below.
As discussed in the proposal (82 FR
34792, July 26, 2017, section II.F.4), and
in the Administrator’s final decision
below, uncertainties in studies of longterm NO2 exposures, and in the NO2 air
quality present in the locations of those
studies, limit their utility in identifying
a specific revised annual standard that
would provide the requisite protection.
Important uncertainties in key U.S. and
Canadian epidemiologic studies of long118 The ISA additionally concludes that,
compared to the last review, stronger evidence is
available in this review linking various nonrespiratory effects with long-term NO2 exposures
(see, e.g., U.S. EPA, 2016a, section 1.5.2). These
include cardiovascular effects and diabetes,
mortality, birth outcomes, and cancer. However,
compared to the evidence linking NO2 exposures
with the development of asthma, there is greater
uncertainty in the evidence for these nonrespiratory effects. Therefore, in considering the
public health protection provided by the current
standards, the focus in this review is on respiratory
effects (e.g., see U.S. EPA, 2017a, section 5.1). More
specifically, as noted in the PA ‘‘we consider the
full body of health evidence, placing the greatest
emphasis on the effects for which the evidence has
been judged in the ISA to demonstrate a ‘causal’ or
a ‘likely to be a causal’ relationship with NO2
exposures [i.e., respiratory effects]’’ (U.S. EPA,
2017a, p. 3–2).
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term NO2 exposures include the
potential for confounding by highly
correlated co-occurring pollutants and
for exposure measurement error (see,
e.g., sections II.A.2, II.B.1, II.B.4 of this
document).
With regard to potential confounding
by co-occurring pollutants, the 2016
NOX ISA concludes that
‘‘[e]pidemiologic studies of asthma
development in children have not
clearly characterized potential
confounding by PM2.5 or traffic-related
pollutants [e.g., CO, BC/EC, volatile
organic compounds (VOCs)]’’ (U.S. EPA,
2016a, p. 6–64). The 2016 NOX ISA
further notes that ‘‘[i]n the longitudinal
studies, correlations with PM2.5 and BC
were often high (e.g., r = 0.7–0.96), and
no studies of asthma incidence
evaluated copollutant models to address
copollutant confounding, making it
difficult to evaluate the independent
effect of NO2’’ (U.S. EPA, 2016a, p. 6–
64).
With regard to exposure measurement
error, while some studies used wellvalidated estimates of NO2 exposure
(U.S. EPA, 2016a, section 6.2.2.1), most
of the key epidemiologic studies
conducted in the U.S. or Canada, which
are the studies relevant for informing
decisions on the standard, employed
exposure models ‘‘with unknown
validation’’ or used ‘‘central-site
measurements that have wellrecognized limitations in reflecting
variability in ambient NO2
concentrations in a community and may
not well represent variability in NO2
exposure among subjects’’ (U.S. EPA,
2017a, p. 3–35). Thus, it is unclear the
extent to which most of the key studies
conducted in the U.S. or Canada
provide reliable estimates of asthma
incidence for particular NO2
concentrations that could be used in
identifying a specific revised annual
standard that would provide the
requisite protection.
In addition, as discussed in detail in
the PA, while epidemiologic studies
conducted in the U.S. or Canada
provide evidence for associations with
asthma-related effects in locations likely
to have violated the current standards,
they do not indicate associations of
asthma incidence with exposures to
long-term NO2 in locations that would
have clearly met the current standards
(U.S. EPA, 2017a, section 5.1). This is
particularly the case given that NO2
concentrations near the most heavily
trafficked roadways are not likely
reflected by monitors in operation
during study years. Had such monitors
been in place, NO2 design values in
these study areas may have been higher
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than indicated by the monitors that
were in operation during study periods.
Thus, uncertainties in studies of longterm NO2 exposures, together with
uncertainties in the NO2 air quality
present in the study locations, limit the
degree to which these studies can
inform the identification of a specific
revised annual standard that would
provide the requisite protection. Taken
together, these uncertainties limit what
studies of long-term NO2 and asthma
development can tell us with regard to
the adequacy of the public health
protection provided by the current NO2
standards.
Beyond the uncertainties discussed
above, the EPA further recognizes that,
as noted in comments, the current 1hour standard is expected to provide
substantial protection against long-term
NO2 exposures. Support for considering
protection provided by the 1-hour
standard against long-term NO2
exposures comes from the ISA’s
integrated mode of action information
describing the biological plausibility for
development of asthma. In particular,
the ISA states that ‘‘findings for shortterm NO2 exposure support an effect on
asthma development by describing a
potential role for repeated exposures to
lead to recurrent inflammation and
allergic responses,’’ which are
‘‘identified as key early events in the
proposed mode of action for asthma
development’’ (U.S. EPA, 2016a, pp. 6–
66 and 6–64).119 Given this, we note
that meeting the 1-hour standard with
its level of 100 ppb is expected to
maintain annual average NO2
concentrations well below the 53 ppb
level of the current annual standard.
With regard to this protection, the
CASAC notes that the PA’s analyses of
historical data indicate that ‘‘attainment
of the 1-hour standard corresponds with
annual design value averages of 30 ppb
NO2’’ (Diez Roux and Sheppard, 2017).
While the CASAC did not endorse the
degree of public health protection
provided by the annual standard alone
(Diez Roux and Sheppard, 2017, p. 9),
based on these air quality relationships
it concluded that ‘‘it is the suite of the
current 1-hour and annual standards,
together, that provide protection against
adverse effects’’ (Diez Roux and
Sheppard, 2017, p. 9). Thus, to the
degree the evidence supports additional
protection against long-term NO2
119 The ISA additionally recognizes that because
the experimental evidence is limited, there remains
some uncertainty as to whether long-term NO2
exposures have an independent effect on asthma
development or whether these health effects are due
to repeated short-term exposures, or a mixture of
long-term and short-term exposures (see U.S. EPA,
2016a, p. 6–67).
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exposures, beyond that provided by the
current annual standard alone, the 1hour standard is expected to result in
substantial additional protection against
such exposures.
Based on the above information, when
taken together, the EPA disagrees with
comments that the level of the annual
standard should be revised to 30 ppb. In
particular, based on the uncertainties in
the available key studies of NO2 and
asthma incidence conducted in the U.S.
or Canada, uncertainty in the NO2
concentrations present in locations of
these key studies, and the substantial
protection against long-term NO2
exposures that is provided by the
current 1-hour standard, we conclude
that the evidence does not support a
revised annual standard with a level of
30 ppb.
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d. Other Comments
In addition to the comments
presented above, the EPA received
several comments related to
implementation of the NO2 NAAQS,
including various comments on
AERMOD and its use in permitting, as
well as on the historical difficulty of
facilities demonstrating compliance
with the 1-hour NO2 standard in
permitting. As described in section I.A
above, this action is being taken
pursuant to CAA section 109(d)(1) and
relevant case law. Consistent with this
case law, the EPA has not considered
costs, including the costs or economic
impacts related to permitting or other
implementation concerns, in this action.
Under CAA section 109(d)(1) the EPA
has the obligation to periodically review
the air quality criteria and the existing
primary NAAQS and make such
revisions as may be appropriate. Thus,
the scope of this action is to evaluate
whether the existing NO2 primary
standards are requisite to protect public
health with an adequate margin of
safety, not to address concerns related to
implementation of the existing
standards. State and federal NO2 control
programs such as those discussed in
section I.B may provide an opportunity
for permitting and other implementation
concerns to be addressed.
4. Administrator’s Conclusions
Having carefully considered the
public comments, as discussed above,
and taking into consideration the large
body of evidence concerning NO2related health effects and available
estimates of the potential for NO2
exposures, including the uncertainties
and limitations inherent in the evidence
and those estimates, the Administrator
concludes that the current primary NO2
standards are requisite to protect the
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public health, with an adequate margin
of safety, and should be retained. The
Administrator’s conclusions are based
on a careful consideration of the full
body of information available in this
review, giving weight to the assessment
of the available policy-relevant
scientific evidence and the conclusions
contained in the 2016 NOX ISA; the
PA’s consideration of this evidence and
of analyses comparing NO2 air quality
with health-based benchmarks; the PA’s
conclusions regarding the public health
protection provided by the current
primary NO2 NAAQS and the rationale
supporting those conclusions; the
advice and recommendations from the
CASAC; the scientific and policy
judgments and conclusions discussed in
the proposal; and public comments on
the proposed action. The basis for the
Administrator’s conclusions on the
current primary NO2 standards is
discussed further below.
As an initial matter, the Administrator
takes note of the well-established body
of scientific evidence supporting the
occurrence of respiratory effects
following NO2 exposures, as described
in detail in the 2016 NOX ISA (U.S.
EPA, 2016a, chapter 5 and chapter 6)
and summarized in the PA (U.S. EPA,
2017a, chapter 3). As in the last review,
the clearest evidence indicates the
occurrence of respiratory effects
following short-term NO2 exposures.
The strongest support for this
relationship comes from controlled
human exposure studies demonstrating
NO2-induced increases in AR in
individuals with asthma. As discussed
above (section II.A.2), the Administrator
notes that most of the controlled human
exposure studies assessed in the 2016
NOX ISA were available in the last
review, with the addition in this review
of an updated meta-analysis that
synthesizes data from these studies. He
also notes that these studies provided an
important part of the body of evidence
supporting the decision in the last
review to establish the 1-hour NO2
standard with its level of 100 ppb.
Beyond the controlled human exposure
studies, additional supporting evidence
comes from epidemiologic studies
reporting associations between shortterm NO2 exposures and a range of
asthma-related respiratory effects,
including effects serious enough to
result in emergency room visits or
hospital admissions. While there is
some new evidence in the current
review from such epidemiologic studies,
the results of these newer studies are
generally consistent with the
epidemiologic studies that were
available in the last review.
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With regard to respiratory effects of
long-term NO2 exposures, the
Administrator notes that the evidence
supporting associations with asthma
development in children has become
stronger since the last review, though
uncertainties remain regarding the
degree to which estimates of long-term
NO2 concentrations in these studies are
serving as surrogates for exposures to
the broader mixture of traffic-related
pollutants (U.S. EPA, 2016a, table 1–1
and section 6.2.2). Supporting evidence
also includes studies indicating a
potential role for repeated short-term
NO2 exposures in the development of
asthma (U.S. EPA, 2016a, pp. 6–64 and
6–65).
In addition, the Administrator
acknowledges that the evidence for
some non-respiratory effects has
strengthened since the last review. In
particular, based on the assessment of
the evidence in the 2016 NOX ISA, he
notes the stronger evidence for NO2associated cardiovascular effects (shortand long-term exposures), premature
mortality (long-term exposures), and
certain reproductive effects (long-term
exposures) (U.S. EPA, 2016a, table 1–1).
As detailed in the 2016 NOX ISA, while
this evidence has generally become
stronger since the last review, it remains
subject to greater uncertainty than the
evidence of asthma-related respiratory
effects (U.S. EPA, 2016a, table 1–1 and
section 6.2.2). Thus, as described above
(section II.B.1), and consistent with
CASAC advice (Diez Roux and
Sheppard, 2017), the Administrator
places the greatest emphasis on the
evidence for respiratory effects
attributable to either short- or long-term
NO2 exposures, which the ISA has
determined demonstrates a ‘‘causal’’
and a ‘‘likely to be causal’’ relationship
with NO2 exposures, respectively.
The Administrator’s evaluation of the
public health protection provided
against ambient NO2 exposures also
involves consideration of populations
and lifestages that may be at greater risk
of experiencing NO2-attributable health
effects. In the current review, the
Administrator’s consideration of
potential at-risk populations draws from
the 2016 NOX ISA’s assessment of the
evidence (U.S. EPA, 2016a, Chapter 7).
Based on the ISA’s systematic approach
to evaluating factors that may increase
risks in a particular population or
during a particular lifestage, the
Administrator places greatest weight on
the potential effects of NO2 exposures in
people with asthma, children, and older
adults (U.S. EPA, 2016a, Table 7–27).
Support for potentially higher risks in
these populations is based primarily on
evidence for asthma exacerbation or
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asthma development. Evidence for other
health effects is subject to greater
uncertainty (U.S. EPA, 2017a, Section
3.4).
The Administrator further uses the
scientific evidence outlined above, and
described in detail in the 2016 NOX ISA,
to directly inform his consideration of
the adequacy of the public health
protection provided by the current
primary NO2 standards. Adopting the
approach taken in the PA, which has
been reviewed by the CASAC (Diez
Roux and Sheppard, 2017, pp. 6 to 9),
the Administrator specifically considers
the evidence within the context of the
degree of public health protection
provided by the current 1-hour and
annual standards together, including the
combination of all elements of these
standards (i.e., indicator, averaging
times, forms, levels).
In doing so, the Administrator focuses
on the results of controlled human
exposure studies of AR in people with
asthma and on the results of U.S. and
Canadian epidemiologic studies of
asthma-related hospital admissions,
asthma-related ED visits, and asthma
development in children. He
particularly emphasizes the results of
controlled human exposure studies,
which were identified in the 2016 NOX
ISA as providing ‘‘[t]he key evidence
that NO2 exposure can independently
exacerbate asthma’’ (U.S. EPA, 2016a, p.
1–18). The Administrator’s decision to
focus on these studies is in agreement
with the CASAC, which advised that, of
the evidence for asthma exacerbation,
‘‘[t]he strongest evidence is for an
increase in AR based on controlled
human exposure studies, with
supporting evidence from epidemiologic
studies’’ (Diez Roux and Sheppard,
2017, p. 7).
In considering the controlled human
exposure studies of AR, the
Administrator focuses both on the
results of an updated meta-analysis of
data from these studies (Brown, 2015)
and on the consistency of findings
across individual studies. As discussed
in sections II.A.2 and II.B.1 above, and
consistent with the evidence in the last
review, the Brown (2015) meta-analysis
indicates that statistically significant
majorities of study volunteers, generally
with mild asthma, experienced
increased AR following 30-minute to 1hour resting exposures to NO2
concentrations from 100 to 530 ppb. In
some affected individuals, the
magnitudes of these increases were large
enough to have potential clinical
relevance (sections II.A.2.a.i and II.B.3,
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above).120 Based on these results, the
Administrator notes the potential for
people with asthma to experience NO2induced respiratory effects following
exposures in this range, and that people
with more severe asthma could
experience more serious effects. The
Administrator further notes that
individual studies consistently report
statistically significant increases in AR
following exposures to NO2
concentrations at or above 250 ppb,
with less consistent results across
studies conducted at lower exposure
concentrations, particularly 100 ppb
(section II.A.2.a).121
Uncertainties in this evidence,
discussed in sections II.A.2.a, II.A.3,
and II.B.1 above, include the lack of an
apparent dose-response relationship
between NO2 exposures and increased
AR, which limits the degree to which
the health risks of these exposures can
be fully characterized, and uncertainty
regarding the potential adversity of the
reported responses. These uncertainties
take on increased importance when
considering the potential public health
implications of exposures to lower NO2
concentrations (i.e., at and near 100
ppb), where individual studies generally
do not report NO2-induced increases in
AR.
While the Administrator recognizes
uncertainty in the extent to which NO2induced increases in AR may be
adverse, he also notes the risk that such
increases could be adverse for some
people with asthma, particularly those
with more severe asthma than have
typically been evaluated in available
studies. He further notes that this risk
cannot be fully characterized based on
existing studies. However, given that the
majority of people with asthma
experienced an NO2-induced increase in
AR in the controlled human exposure
studies included in the Brown (2015)
meta-analysis,122 and given the large
size of the asthmatic population in the
120 As discussed in section II.A.2.a.i of this final
action, the consideration of clinical relevance by
Brown (2015) is based on the fraction of exposed
individuals who experienced a halving of the PD of
challenge agent following NO2 exposures. This
magnitude of change has been recognized by the
ATS and the ERS as a ‘‘potential indicator, although
not a validated estimate, of clinically relevant
changes in [AR]’’ (Reddel et al., 2009) (U.S. EPA,
2016a, p. 5–12). Although there is uncertainty in
using this approach to characterize whether a
particular response in an individual is ‘‘adverse,’’
it can provide insight into the potential for
adversity, particularly when applied to a
population of exposed individuals.
121 In addition, studies that evaluated resting
exposures to 140 ppb and 200 ppb NO2 did not
report statistically significant increases in AR,
though group mean responses in these studies
suggest a trend towards such an increase.
122 As described above (II.A.2, II.B.1, II.B.3), this
is the case for individuals exposed while at rest.
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United States, the Administrator
recognizes the potential for effects that
are adverse to public health following
the types of NO2 exposures evaluated in
the studies analyzed by Brown (2015).
Thus, while the Administrator is not
able to definitively determine whether
the increased AR reported in these
studies would be adverse for a given
individual, he concludes that, from a
public health perspective, it is
appropriate to provide protection from
the risk of adversity associated with
such increases. As noted above, this is
especially true for people with more
severe asthma and for other at-risk
populations that have generally not
been evaluated in available controlled
human exposure studies of NO2 and AR
(i.e., children and older adults).
Based on information from controlled
human exposure studies, which is
discussed in more detail in sections
II.A.2, II.B.1, and II.B.3 of this final
action, the Administrator is most
concerned about the potential for people
with asthma to experience adverse
respiratory effects following exposures
to NO2 concentrations at or above 250
ppb. As noted above, 250 ppb is an
exposure concentration where the
potential for NO2-induced respiratory
effects is supported both by results of
the meta-analysis and by consistent
results reported across individual
studies. Therefore, in reaching decisions
on the primary NO2 NAAQS, the
Administrator emphasizes the
importance of protecting against such
exposures.
Because results are less consistent
across individual studies that evaluated
lower exposure concentrations, the
Administrator places greater weight on
the uncertainties in the evidence as he
considers the potential public health
implications of such exposures.
However, the Administrator also
recognizes the potential for adverse
respiratory effects following exposures
to NO2 concentrations as low as 100
ppb, particularly in people with more
severe cases of asthma than have
generally been evaluated in the
available NO2 controlled human
exposure studies. Available studies have
generally evaluated people with mild
asthma, while people with moderate or
severe asthma could be more
susceptible to NO2-induced increases in
AR, and thus more likely to exhibit
adverse responses following NO2
exposures (Brown, 2015). As discussed
above, such effects have the potential to
be adverse to public health, in light of
the large size of the asthmatic
population in the United States.
Further, as noted above, the
Administrator also recognizes the
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potential for such effects in other at-risk
populations that have generally not
been evaluated in NO2 controlled
human exposure studies (i.e., children
and older adults). Thus, when the
evidence and uncertainties are taken
together, the Administrator judges that,
from a public health perspective, while
it is appropriate to emphasize the degree
of protection against the potential for
exposures at or above 250 ppb, it is also
appropriate to consider the degree of
protection provided against potential
exposures to NO2 concentrations as low
as 100 ppb.
In further considering the potential
public health implications of the
controlled human exposure studies, the
Administrator looks to the results of
quantitative comparisons between NO2
air quality and health-based
benchmarks. As discussed in the PA
(U.S. EPA, 2017a, section 4.2 and
section 5.2), these comparisons can help
to place the results of the controlled
human exposure studies, which provide
the basis for the benchmark
concentrations, into a broader public
health context. In considering the
results of the analyses comparing NO2
air quality to specific health-based
benchmarks, the Administrator first
recognizes that all areas of the U.S.
presently meet the current primary NO2
standards. When based on recent
unadjusted NO2 air quality, these
analyses estimate almost no days with
the potential for 1-hour exposures to
NO2 concentrations at or above healthbased benchmarks, including the lowest
benchmark examined (i.e., 100 ppb).
To inform his consideration of the
public health protection associated with
allowable NO2 air quality under the
current standards, the Administrator
takes note of the analyses in the PA
examining the potential for exposures to
NO2 concentrations at or above healthbased benchmarks when air quality has
been adjusted upwards to simulate areas
that would ‘‘just meet’’ the current
primary NO2 NAAQS. Drawing on the
discussion of these analyses in the PA
(U.S. EPA, 2017a, section 5.2), the
Administrator recognizes that, even
when ambient NO2 concentrations are
adjusted upward to just meet the
existing 1-hour standard, the analyses
estimate no days with the potential for
exposures to the NO2 concentrations
that have been shown most consistently
to increase AR in people with asthma
(i.e., above 250 ppb 123). Such NO2
concentrations were not estimated to
occur, even under worst-case conditions
123 As discussed above, analyses in the PA
estimate no occurrences of 1-hour NO2
concentrations at or above 200 ppb.
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across a variety of study areas with
among the highest NOX emissions in the
U.S. and at monitoring sites adjacent to
some of the most heavily trafficked
roadways in the U.S. In addition,
analyses with adjusted air quality
indicate a limited number of days with
the potential for exposures to 1-hour
NO2 concentrations at or above 100 ppb
(i.e., about one to 10 days per year, on
average) (U.S. EPA, 2017a, section
4.2.1). As discussed above, 100 ppb
represents an exposure concentration
with the potential to exacerbate asthmarelated respiratory effects in some
people, but for which uncertainties in
the evidence take on increased
importance.
Based on his consideration of these
results, the Administrator concludes
that evidence from controlled human
exposure studies, together with analyses
comparing ambient NO2 concentrations
to health-based benchmarks, supports
his overall judgment that the current
primary NO2 NAAQS are requisite to
protect public health with an adequate
margin of safety. In particular, as
discussed above, he is most concerned
about exposures to NO2 concentrations
at and above 250 ppb, where the
potential for NO2-induced respiratory
effects is supported both by results of
the meta-analysis and by consistent
results reported across individual
studies. With regard to this, the
Administrator notes that NO2 air quality
that just meets the current standards is
estimated to allow no potential for
exposures to such 1-hour NO2
concentrations. The Administrator also
recognizes the potential for effects that
are adverse to public health with
exposures to lower NO2 concentrations,
including as low as 100 ppb, although
he places greater weight on the
uncertainties in the evidence at these
lower exposure concentrations. In light
of these uncertainties, the Administrator
judges it appropriate to limit, but not to
eliminate, the potential for 1-hour
exposures to NO2 concentrations as low
as 100 ppb. With regard to this, he notes
that the current standard is estimated to
restrict the potential for exposures to 1hour NO2 concentrations at or above 100
ppb to a limited number of days per
year.
Thus, given that the current standards
are estimated to allow no exposures to
1-hour NO2 concentrations at or above
250 ppb, and only limited potential for
such exposures to concentrations as low
as 100 ppb, the Administrator concludes
that the scientific evidence, together
with the information from analyses
comparing NO2 air quality with healthbased benchmarks, supports his
judgment that that the current 1-hour
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and annual NO2 primary standards,
together, are requisite to protect public
health with an adequate margin of
safety. In reaching this conclusion, the
Administrator finds that retaining the 1hour NO2 standard with the level of 100
ppb reflects a cautious approach, which
is warranted given the CAA’s
requirement to for an adequate margin
of safety. However, uncertainties in the
evidence, especially those relating to the
adversity of the effect and its likelihood
to occur at exposures at or below 100
ppb, support the Administrator’s
conclusion that it is not necessary to
eliminate the potential for exposures to
100 ppb NO2.
The Administrator also considers
what the available epidemiologic
studies indicate with regard to the
adequacy of the public health protection
provided by the current NO2 standards,
noting that these studies often examine
more serious health effects than the
controlled human exposure studies. In
particular, he considers analyses of NO2
air quality in the locations, and during
the time periods, of available U.S. or
Canadian epidemiologic studies of
asthma-related hospital admissions or
ED visits. Although the NO2
epidemiologic evidence is subject to
greater uncertainty than the controlled
human exposure studies of NO2induced changes in AR, as discussed in
section II.B.1 above, these analyses can
provide insights into the extent to
which NO2-health effect associations are
present for distributions of ambient NO2
concentrations that would be allowed
by the current standards. The presence
of such associations would support the
potential for the current standards to
allow the NO2-associated effects
indicated by epidemiologic studies. To
the degree studies have not reported
associations in locations meeting the
current NO2 standards, there is greater
uncertainty regarding the potential for
reported effects to occur following the
NO2 exposures that are associated with
air quality meeting those standards.
With regard to studies of short-term
NO2 exposures, as discussed in greater
detail in section II.B.1 above, the
Administrator notes that epidemiologic
studies provide evidence for asthmarelated ED visits and hospital
admissions with exposure to NO2 in
locations likely to have violated the
current standards over at least parts of
study periods. In contrast, studies have
not consistently shown such NO2associated outcomes in areas that would
have clearly met the current standards.
In this regard, the Administrator
recognizes that the NO2 concentrations
identified in the locations of these
epidemiologic studies are based on an
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NO2 monitoring network that, during
study periods, did not include monitors
meeting the current near-road
monitoring requirements. This is
particularly important given that NO2
concentrations near the most heavily
trafficked roadways were likely to have
been higher than those reflected by the
NO2 concentrations measured at
monitors in operation during study
years. As such, the estimated DVs
associated with the areas at the times of
the studies could have been higher had
a near-road monitoring network been in
place. Thus, while these epidemiologic
studies provide evidence for
associations with asthma-related effects
in locations likely to have violated the
current standards, supporting the
decision to not set less stringent
standards (see section II.B.3, above),
they do not provide support for such
associations in locations that would
have clearly met those standards. As a
result, these studies additionally
support the decision to not set more
stringent standards.
With regard to studies of long-term
NO2 exposures, the Administrator notes
that the preponderance of evidence for
respiratory health effects comes from
epidemiologic studies evaluating
asthma development in children. While
recognizing important uncertainties
related to potential copollutant
confounding and exposure
measurement error (e.g., see U.S. EPA,
2017a, section 3.3.2.1), the
Administrator considers what these
studies could indicate with regard to the
public health protection provided by the
current standards. As discussed in
section II.A.2 above, these studies report
associations with long-term average NO2
concentrations, while the broader body
of evidence indicates the potential for
repeated short-term NO2 exposures to
contribute to the development of
asthma. Because of this, and because air
quality analyses indicate that meeting
the current 1-hour standard can also
limit annual NO2 concentrations (U.S.
EPA, 2017a, figure 2–11), when
considering these studies of asthma
development, the Administrator
considers the protection provided by the
combination of both the annual and 1hour standards.
In doing so, he notes that key
epidemiologic studies conducted in the
U.S. or Canada consistently report
associations between long-term NO2
exposures and asthma development in
children in locations likely to have
violated the current standards over at
least parts of study periods, but that
those studies do not indicate such
associations in locations that would
have clearly met the current annual and
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1-hour standards (U.S. EPA, 2017a,
section 5.1). As discussed above for
epidemiologic studies of short-term NO2
exposures, this is particularly the case
given that NO2 concentrations near the
most heavily trafficked roadways are not
likely reflected by monitors in operation
during study years. Thus, while the
Administrator recognizes the public
health significance of asthma
development in children, he concludes
that the available evidence supports his
decision to not revise the current
standards to be more stringent. In
addition, while there are important
uncertainties in these studies of longterm NO2 exposures, the Administrator
also concludes that, in light of the
requirement for an adequate margin of
safety, reported associations in locations
likely to have violated the current
standards support his decision to not
revise the current standards to be less
stringent.
Based on the above considerations,
with their attendant uncertainties and
limitations, and with consideration of
advice from CASAC and public
comment, the Administrator concludes
that the current body of scientific
evidence, in combination with the
results of the quantitative analyses
comparing NO2 air quality with healthbased benchmarks, supports his
judgment that the current 1-hour and
annual NO2 primary standards, together,
are requisite to protect public health
with an adequate margin of safety, and
does not call into question any of the
four basic elements of those standards
(i.e., indicator, averaging time, level,
and form). The Administrator considers
these four elements collectively in
evaluating the public health protection
afforded by the current primary NO2
standards, as discussed above (section
II.B.1.a). Based on this consideration,
and consistent with the CASAC advice
(see, e.g., Diez Roux and Sheppard,
2017, pp. 6–9), the Administrator judges
that each of the elements of the current
standards should be retained. In
particular, taking note of the more
detailed discussions elsewhere in this
document and in the proposal, he
judges the following:
• NO2 continues to be the appropriate
indicator for both the current annual
and 1-hour standards, and no alternative
to NO2 has been advanced as a more
appropriate surrogate for ambient oxides
of nitrogen (section II.B.1.a.i above; 82
FR 34792, July 26, 2017, section
II.F.1.a).
• The 1-hour and annual averaging
times of the current standards, together,
can provide protection against shortand long-term NO2 exposures and
should be retained (section II.B.1.a.ii
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above; 82 FR 34792, July 26, 2017,
section II.F.1.b).
• The levels and the forms of the
current short-term and long-term
standards should be retained (sections
II.B.1.a.iii and II.B.3 above; 82 FR
34792, July 26, 2017, section II.F.1.c).
In considering the requirement for an
adequate margin of safety, the
Administrator notes that the
determination of what constitutes an
adequate margin of safety is expressly
left to the judgment of the EPA
Administrator. See Lead Industries
Association v. EPA, 647 F.2d at 1161–
62; Mississippi, 744 F.3d at 1353. He
further notes that in evaluating how
particular standards address the
requirement to provide an adequate
margin of safety, it is appropriate to
consider such factors as the nature and
severity of the health effects, the size of
sensitive population(s) at risk, and the
kind and degree of the uncertainties
present. Consistent with past practice
and long-standing judicial precedent,
and as described in this section, the
Administrator takes the need for an
adequate margin of safety into account
as an integral part of his decisionmaking on a standard. See, e.g., NRDC
v. EPA, 902 F. 2d 962, 973–74 (D.C. Cir.
1990).
In reaching the conclusion that the
current primary NO2 standards,
together, are requisite to protect public
health with an adequate margin of
safety, the Administrator notes the
following with regard to effects
attributable to short-term NO2
exposures:
• Meeting the current 1-hour NO2
standard is expected to allow virtually
no potential for exposures to NO2
concentrations that have been shown
most consistently to increase AR in
people with asthma (i.e., at or above 250
ppb), even under worst-case conditions
across a variety of study areas with
among the highest NOX emissions in the
U.S. Based on analyses of air quality
adjusted upwards to just meet the
current 1-hour standard, such NO2
concentrations were not estimated to
occur, even at monitoring sites adjacent
to some of the most heavily trafficked
roadways (U.S. EPA, 2017a, section
4.2.1).
• Meeting the current 1-hour standard
limits the potential for exposures to 1hour concentrations at or above 100
ppb. Thus, the current standard protects
against NO2 exposures with the
potential to exacerbate symptoms in
some people with asthma, but for which
uncertainties in the evidence take on
increased importance (U.S. EPA, 2017a,
section 4.2.1).
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• Meeting the current 1-hour standard
is expected to maintain ambient NO2
concentrations below those likely to
have been present in locations where
key epidemiologic studies conducted in
the U.S. or Canada have reported
relatively precise and statistically
significant associations between shortterm NO2 and asthma-related
hospitalizations (U.S. EPA, 2017a,
section 3.2.2.2).
In addition, with regard to long-term
NO2 exposures, the Administrator notes
that the evidence supporting
associations with asthma development
in children has become stronger since
the last review, though important
uncertainties remain. As discussed in
section II.B.1 above, meeting the current
annual and 1-hour standards is expected
to maintain ambient NO2 concentrations
below those likely to have been present
in locations where key U.S. and
Canadian epidemiologic studies have
reported associations between long-term
NO2 and asthma development (U.S.
EPA, 2017a, section 3.3.2.1). In
considering the protection provided
against exposures that could contribute
to asthma development, the
Administrator recognizes the air quality
relationship between the current 1-hour
standard and the annual standard, and
that analyses of historical ambient NO2
concentrations suggest that meeting the
1-hour standard with its level of 100
ppb would be expected to maintain
annual average NO2 concentrations well
below the 53 ppb level of the annual
standard (U.S. EPA, 2017a, section
2.3.3).124 In this regard, the
Administrator takes note of the CASAC
conclusion that ‘‘attainment of the 1hour standard also implies that the
annual DV averages 30 ppb NO2’’ and its
advice that ‘‘[g]iven uncertainties in the
epidemiologic evidence related to lack
of near road monitoring and potential
confounding of traffic-related copollutants, there is insufficient evidence
to make a scientific judgment that
adverse effects occur at annual DVs less
than 30 ppb NO2’’ (Diez Roux and
Sheppard, 2017, p. 9). The
Administrator observes that, as
additional years of data become
available from the recently deployed
near-road NO2 monitors, it will be
important to evaluate the degree to
which this relationship is also observed
in the near-road environment, and the
degree to which the annual standard
provides additional protection, beyond
124 This air quality relationship was discussed in
the PA (U.S. EPA, 2017a, Figure 2–11), where it was
noted that the analysis did not include data from
near-road monitors due to the limited amount of
data available for the years analyzed (1980–2015).
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that provided by the 1-hour standard.
Such an evaluation could inform future
reviews of the primary NO2 NAAQS,
consistent with the CASAC advice that
‘‘in the next review cycle for oxides of
nitrogen . . . EPA should review the
annual standard to determine if there is
need for revision or revocation’’ (Diez
Roux and Sheppard, 2017, p. 9).
Based on the conclusions and
considerations described above in this
section, the Administrator concludes
that his proposed decision, and the
supporting rationale, analyses, and
scientific assessments, remain valid.
Accordingly, in this review, he judges
that it is appropriate to retain the
current 1-hour and annual primary NO2
standards, without revision. As
described in sections II.B.2 and II.B.3
above, the Administrator notes that his
decision to retain the current primary
NO2 standards in this review, without
revision, is consistent with the CASAC
advice. In particular, the Administrator
notes that in its letter on the draft PA,
the CASAC stated that it ‘‘recommends
retaining, and not changing the existing
suite of standards’’ (Diez Roux and
Sheppard, 2017, cover letter at p. 3).
The Administrator further observes that
in addressing the 1-hour standard the
CASAC ‘‘advise[d] that the current 1hour standard is protective of adverse
effects and that there is not a scientific
basis’’ for a more stringent standard
(Diez Roux and Sheppard, 2017, p. 9).
With respect to the annual standard, the
Administrator notes that the CASAC
specifically focused its conclusions on
the degree of protection provided by the
combination of the 1-hour and annual
standards, advising that ‘‘the suite of the
1-hour and annual standards is
protective against adverse effects’’ (Diez
Roux and Sheppard, 2017, p. 9). In light
of this advice from the CASAC, the
Administrator finds it appropriate to
focus on the degree of public health
protection provided by the current 1hour and annual NO2 standards together
in reaching his decision in this review
to retain the current primary NO2
NAAQS.
Inherent in the Administrator’s
conclusions are public health policy
judgments based on his consideration of
the available scientific evidence and
analyses. These public health policy
judgments include judgments related to
the appropriate degree of public health
protection that should be afforded
against risk of respiratory morbidity in
at-risk populations, such as the
potential for worsened respiratory
effects in people with asthma, as well
judgments related to the appropriate
weight to be given to various aspects of
the evidence and quantitative analyses,
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including how to weigh their associated
uncertainties. Based on these
considerations and the judgments
identified herein, the Administrator
concludes that the current standards
provide the requisite protection of
public health with an adequate margin
of safety, including protection of at-risk
populations, such as people with
asthma, children, and older adults.
In reaching this conclusion, the
Administrator recognizes that in
establishing primary standards under
the Act that are requisite to protect
public health with an adequate margin
of safety, he is seeking to establish
standards that are neither more nor less
stringent than necessary for this
purpose. The Act does not require that
primary standards be set at a zero-risk
level or to protect the most sensitive
individual, but rather at a level that
avoids unacceptable risks to public
health. In this context, the
Administrator’s conclusion is that the
current 1-hour and annual NO2
standards together provide the requisite
protection and that more or less
stringent standards would not be
requisite.
More specifically, given the increased
risk of adverse effects associated with
NO2 concentrations above the current
standards, the Administrator does not
believe standards less stringent than the
current standards would be sufficient to
protect public health with an adequate
margin of safety. In this regard, he
particularly notes that, compared to the
current standards, less stringent
standards would be more likely to
allow: (1) NO2 exposures that could
exacerbate respiratory effects in people
with asthma, particularly those with
more severe asthma; and (2) ambient
NO2 concentrations likely to have been
present in locations where
epidemiologic studies have reported
associations with asthma-related
hospitalizations and with asthma
development in children. Consistent
with these observations, the
Administrator further notes the CASAC
conclusion, based on its consideration
of the evidence, that ‘‘there are notable
adverse effects at levels that exceed the
current [1-hour] standard, but not at the
level of the current [1-hour] standard’’
(Diez Roux and Sheppard, 2017, p. 9)
and its recommendation to retain, ‘‘and
not change, the existing suite of
standards’’ (i.e., both 1-hour and
annual) (Diez Roux and Sheppard, 2017,
cover letter at p. 3). For these reasons,
the Administrator concludes that
standards less stringent than the current
1-hour and annual standards (e.g., with
levels higher than 100 ppb and 53 ppb,
respectively) would not be requisite to
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protect public health with an adequate
margin of safety.
The Administrator additionally
recognizes that the uncertainties and
limitations associated with the many
aspects of the estimated relationships
between respiratory morbidity and NO2
exposures are amplified with
consideration of progressively lower
ambient NO2 concentrations. In his
view, based on the scientific
information discussed throughout this
document (e.g., sections II.A.2, II.A.3,
II.B.1, II.B.3), including uncertainties
inherent in that information, there is
appreciable uncertainty in the extent to
which reductions in asthma
exacerbations or asthma development
would result from revising the primary
NO2 NAAQS to be more stringent than
the current standards. Therefore, the
Administrator also does not believe
standards more stringent than the
current standards would be appropriate.
With regard to this, the CASAC advised
that ‘‘there is not a scientific basis for
a standard lower than the current 1-hour
standard’’ (Diez Roux and Sheppard,
2017, p. 9). The CASAC also did not
advise setting the level of the annual
standard lower than the current level of
53 ppb, noting that the 1-hour standard
can generally maintain long-term NO2
concentrations well below the level of
the annual standard, and observing that
there is insufficient scientific evidence
to make a scientific judgment that
adverse effects occur at those lower
concentrations (Diez Roux and
Sheppard, 2017, cover letter p. 3).
Based on all of the above
considerations, and consistent with the
CASAC advice, the Administrator
concludes that it is appropriate to retain
the current standards, without revision,
in this review.
C. Decision on the Primary Standards
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For the reasons discussed above, and
taking into account information and
assessments presented in the ISA and
PA, the advice and recommendations
from CASAC, and consideration of
public comments, the Administrator
concludes that the current primary 1hour and annual NO2 standards together
are requisite to protect public health
with an adequate margin of safety,
including the health of at-risk
populations, and is retaining the
standards without revision.
III. Statutory and Executive Order
Reviews
Additional information about these
statutes and Executive Orders can be
found at https://www2.epa.gov/lawsregulations/laws-and-executive-orders.
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A. Executive Order 12866: Regulatory
Planning and Review and Executive
Order 13563: Improving Regulation and
Regulatory Review
This action is not a significant
regulatory action and was, therefore, not
submitted to the Office of Management
and Budget (OMB) for review.
B. Executive Order 13771: Reducing
Regulations and Controlling Regulatory
Costs
This action is not an Executive Order
13771 regulatory action because this
action is not significant under Executive
Order 12866.
C. Paperwork Reduction Act (PRA)
This action does not impose an
information collection burden under the
PRA. There are no information
collection requirements directly
associated with revising or retaining
NAAQS under section 109 of the CAA.
This action retains, without any
revisions, the current primary NAAQS
for oxides of nitrogen.
D. Regulatory Flexibility Act (RFA)
I certify that this action will not have
a significant economic impact on a
substantial number of small entities
under the RFA. This action will not
impose any requirements on small
entities. Rather, this action retains,
without revision, existing national
standards for allowable concentrations
of NO2 in ambient air as required by
section 109 of the CAA. See also
American Trucking Associations, 175
F.3d at 1044–45 (NAAQS do not have
significant impacts upon small entities
because NAAQS themselves impose no
regulations upon small entities).
E. Unfunded Mandates Reform Act
(UMRA)
This action does not contain any
unfunded mandate as described in the
UMRA, 2 U.S.C. 1531–1538, and does
not significantly or uniquely affect small
governments. This action imposes no
enforceable duty on any state, local or
tribal governments, or the private sector.
F. Executive Order 13132: Federalism
This action does not have federalism
implications. It will not have substantial
direct effects on the states, on the
relationship between the national
government and the states, or on the
distribution of power and
responsibilities among the various
levels of government.
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G. Executive Order 13175: Consultation
and Coordination With Indian Tribal
Governments
This action does not have tribal
implications, as specified in Executive
Order 13175. It does not have a
substantial direct effect on one or more
Indian tribes. This action does not
change existing regulations; it retains,
without revision, the current primary
NAAQS for oxides of nitrogen. The
primary NAAQS protect public health,
including the health of at-risk or
sensitive groups, with an adequate
margin of safety. Thus, Executive Order
13175 does not apply to this action.
H. Executive Order 13045: Protection of
Children From Environmental Health
and Safety Risks
This action is not subject to Executive
Order 13045 because it is not
economically significant as defined in
Executive Order 12866. We note,
however, that the standards retained
with this action provide protection for
children and other at-risk populations
against adverse health effects. The
health effects evidence and risk
assessment information for this action,
which focuses on children and other atrisk populations, is summarized in
section II.A.2 and II.A.3 above and
described in the ISA and PA, copies of
which are in the public docket for this
action.
I. Executive Order 13211: Actions
Concerning Regulations That
Significantly Affect Energy Supply,
Distribution or Use
This action is not subject to Executive
Order 13211, because it is not a
significant regulatory action under
Executive Order 12866.
J. National Technology Transfer and
Advancement Act (NTTAA)
This action does not involve technical
standards.
K. Executive Order 12898: Federal
Actions To Address Environmental
Justice in Minority Populations and
Low-Income Populations
The EPA believes that this action does
not have disproportionately high and
adverse human health or environmental
effects on minority, low-income
populations and/or indigenous peoples,
as specified in Executive Order 12898
(59 FR 7629, February 16, 1994). This
action is to retain without revision the
existing primary NAAQS for oxides of
nitrogen.
The NAAQS decisions are based on
an explicit and comprehensive
assessment of the current scientific
evidence and associated exposure/risk
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analyses. More specifically, the EPA
expressly considers the available
information regarding health effects
among at-risk populations, including
that available for low-income
populations and minority populations,
in decisions on the primary (health
based) NAAQS. Where low-income
populations or minority populations are
among the at-risk populations, the
decision on the standard is based on
providing protection for these and other
at-risk populations and lifestages.
Where such populations are not
identified as at-risk populations,
NAAQS that are established to provide
protection to the at-risk populations
would also be expected to provide
protection to all other populations,
including low-income populations and
minority populations.
As discussed in sections II.A.2 and
II.B.1 above, and in sections II.F and II.C
of the proposal, the EPA expressly
considered the available information
regarding health effects among at-risk
populations in reaching the decision
that the existing primary (health-based)
standards for oxides of nitrogen are
requisite. The ISA and PA for this
review, which include identification of
populations at risk from NO2 health
effects, are available in the docket, EPA–
HQ–OAR–2013–0146. Based on
consideration of this information and
the full evidence base, quantitative
exposure/risk analyses, advice from the
CASAC and consideration of public
comments, the Administrator concludes
that the existing standards protect
public health, including the health of atrisk or sensitive groups, with an
adequate margin of safety (as discussed
in section II.B.4 above).
L. Determination Under Section 307(d)
Section 307(d)(1)(V) of the CAA
provides that the provisions of section
307(d) apply to ‘‘such other actions as
the Administrator may determine.’’
Pursuant to section 307(d)(1)(V), the
Administrator determines that this
action is subject to the provisions of
section 307(d).
amozie on DSK30RV082PROD with RULES2
M. Congressional Review Act (CRA)
The EPA will submit a rule report to
each House of the Congress and to the
Comptroller General of the United
States. This action is not a ‘‘major rule’’
as defined by 5 U.S.C. 804(2).
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Flanders, WD; Sarnat, JA; Waller, LA;
Sarnat, SE; Mulholland, JA; Tolbert, PE.
(2010). Short-term associations between
ambient air pollutants and pediatric
asthma emergency department visits. Am
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Tunnicliffe, WS; Burge, PS; Ayres, JG. (1994).
Effect of domestic concentrations of
nitrogen dioxide on airway responses to
inhaled allergen in asthmatic patients.
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dx.doi.org/10.1016/s0140-6736(94)
92886-x.
U.S. EPA (1971). Air Quality Criteria for
Nitrogen Oxides. U.S. Environmental
Protection Agency. Air Pollution Control
Office, Washington, DC January 1971.
Air Pollution Control Office Publication
No. AP–84.
U.S. EPA (1993). Air Quality Criteria for
Oxides of Nitrogen. Office of Health and
Environmental Assessment,
Environmental Criteria and Assessment
Office. Research Triangle Park, NC. EPA–
600/8–91–049aF–cF, August 1993.
Available at: https://cfpub.epa.gov/ncea/
cfm/recordisplay.cfm?deid=40179.
U.S. EPA (1995). Review of the National
Ambient Air Quality Standards for
Nitrogen Oxides: Assessment of
Scientific and Technical Information,
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95–005, September 1995. Available at:
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standards/nox/data/noxsp1995.pdf.
U.S. EPA (2008a). Integrated Science
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Health Criteria. U.S. EPA, National
Center for Environmental Assessment
and Office, Research Triangle Park, NC.
EPA/600/R–08/071. July 2008. Available
at: https://cfpub.epa.gov/ncea/cfm/
recordisplay.cfm?deid=194645.
U.S. EPA (2008b). Risk and Exposure
Assessment to Support the Review of the
NO2 Primary National Ambient Air
Quality Standard. U.S. EPA, Office of Air
Quality Planning and Standards.
Research Triangle Park, NC. EPA 452/R–
08–008a/b. November 2008. Available at:
https://www.epa.gov/ttn/naaqs/
standards/nox/s_nox_cr_rea.html.
U.S. EPA (2010). Responses to Significant
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and Standards. Research Triangle Park,
NC. EPA. January 2010. Available at:
https://www3.epa.gov/ttn/naaqs/
standards/nox/data/20100122rtc.pdf.
U.S. EPA (2011). Policy Assessment for the
Review of the Particulate Matter National
Ambient Air Quality Standards. Office of
Air Quality Planning and Standards, U.S.
Environmental Protection Agency,
Research Triangle Park, NC. EPA 452/R–
11–003. April 2011. Available at: https://
www3.epa.gov/ttn/naaqs/standards/pm/
s_pm_2007_pa.html.
U.S. EPA (2014a). Integrated Review Plan for
the Primary National Ambient Air
Quality Standards for Nitrogen Dioxide.
U.S. EPA, National Center for
Environmental Assessment and Office of
Air Quality Planning and Standards,
Research Triangle Park, NC. EPA–452/R–
14–003. June 2014. Available at: https://
www.epa.gov/ttn/naaqs/standards/nox/
data/201406finalirpprimaryno2.pdf.
U.S. EPA (2014b). Policy Assessment for the
Review of the Ozone National Ambient
Air Quality Standards. Office of Air
Quality Planning and Standards, U.S.
Environmental Protection Agency,
Research Triangle Park, NC. EPA 452/R–
14–006. August 2014. Available at:
https://www3.epa.gov/ttn/naaqs/
standards/ozone/s_o3_2008_pa.html.
U.S. EPA (2015a). Preamble to the Integrated
Science Assessments. U.S. EPA,
Washington, DC, EPA/600/R–15/067.
November 2015. Available at: https://
cfpub.epa.gov/ncea/isa/recordisplay.
cfm?deid=310244.
U.S. EPA (2015b). Review of the Primary
National Ambient Air Quality Standards
for Nitrogen Dioxide: Risk and Exposure
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EPA, Office of Air Quality Planning and
Standards, Research Triangle Park, NC.
EPA–452/D–15–001. May 13, 2015.
Available at: https://www3.epa.gov/ttn/
naaqs/standards/nox/data/
20150504reaplanning.pdf.
U.S. EPA (2016a). Integrated Science
Assessment for Oxides of Nitrogen—
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amozie on DSK30RV082PROD with RULES2
Health Criteria (2016 Final Report). U.S.
EPA, National Center for Environmental
Assessment, Research Triangle Park, NC.
EPA/600/R–15/068. January 2016.
Available at: https://cfpub.epa.gov/ncea/
isa/recordisplay.cfm?deid=310879.
U.S. EPA (2016b). Integrated Review Plan for
the National Ambient Air Quality
Standards for Particulate Matter. U.S.
EPA, National Center for Environmental
Assessment and Office of Air Quality
Planning and Standards, Research
Triangle Park, NC. EPA/452/R–16/005.
December 2016. Available at: https://
www3.epa.gov/ttn/naaqs/standards/pm/
data/201612-final-integrated-reviewplan.pdf.
U.S. EPA (2017a). Policy Assessment for the
Review of the Primary National Ambient
Air Quality Standards for Oxides of
Nitrogen U.S. EPA, National Center for
Environmental Assessment, Research
Triangle Park, NC. EPA–452/R–17–003.
April 2017. Available at: https://
www.epa.gov/sites/production/files/
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U.S. EPA (2017b). Integrated Review Plan for
the Secondary National Ambient Air
Quality Standards for Ecological Effects
of Oxides of Nitrogen, Oxides of Sulfur,
and Particulate Matter U.S. EPA,
National Center for Environmental
Assessment, Research Triangle Park, NC.
EPA–452/R–17–002. January 2017.
Available at: https://ofmpub.epa.gov/
eims/eimscomm.getfile?p_download_
id=530335.
Villeneuve, PJ; Chen, L; Rowe, BH; Coates, F.
(2007). Outdoor air pollution and
emergency department visits for asthma
among children and adults: A casecrossover study in northern Alberta,
Canada. Environ Health 6: 40. https://
dx.doi.org/10.1186/1476-069X-6-40.
Witten, A; Solomon, C; Abbritti, E;
Arjomandi, M; Zhai, W; Kleinman, M;
Balmes, J. (2005). Effects of nitrogen
dioxide on allergic airway responses in
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subjects with asthma. J Occup Environ
Med 47: 1250–1259. https://dx.doi.org/
10.1097/01.jom.0000177081.62204.8d.
Wong, CM; Yang, L; Thach, TQ; Chau, PY;
Chan, KP; Thomas, GN; Lam, TH; Wong,
TW; Hedley, AJ; Peiris, JS. (2009).
Modification by influenza on health
effects of air pollution in Hong Kong.
Environ Health Perspect 117: 248–253.
https://dx.doi.org/10.1289/ehp.11605.
List of Subjects in 40 CFR Part 50
Environmental protection, Air
pollution control, Carbon monoxide,
Lead, Nitrogen dioxide, Ozone,
Particulate matter, Sulfur oxides.
Dated: April 6, 2018.
E. Scott Pruitt,
Administrator.
[FR Doc. 2018–07741 Filed 4–17–18; 8:45 am]
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[Federal Register Volume 83, Number 75 (Wednesday, April 18, 2018)]
[Rules and Regulations]
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[FR Doc No: 2018-07741]
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Vol. 83
Wednesday,
No. 75
April 18, 2018
Part II
Environmental Protection Agency
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40 CFR Part 50
Review of the Primary National Ambient Air Quality Standards for Oxides
of Nitrogen; Final Rule
Federal Register / Vol. 83 , No. 75 / Wednesday, April 18, 2018 /
Rules and Regulations
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ENVIRONMENTAL PROTECTION AGENCY
40 CFR Part 50
[EPA-HQ-OAR-2013-0146; FRL-9976-78-OAR]
RIN 2060-AR57
Review of the Primary National Ambient Air Quality Standards for
Oxides of Nitrogen
AGENCY: Environmental Protection Agency (EPA).
ACTION: Final action.
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SUMMARY: Based on the Environmental Protection Agency's (EPA's) review
of the air quality criteria addressing human health effects of oxides
of nitrogen and the primary national ambient air quality standards
(NAAQS) for oxides of nitrogen, as measured by nitrogen dioxide
(NO2), the EPA is retaining the current standards, without
revision.
DATES: This final action is effective on May 18, 2018.
ADDRESSES: The EPA has established a docket for this action under
Docket ID No. EPA-HQ-OAR-2013-0146. Incorporated into this docket is a
separate docket established for the Integrated Science Assessment for
this review (Docket ID No. EPA-HQ-ORD-2013-0232). All documents in
these dockets are listed on the www.regulations.gov website. Although
listed in the index, some information is not publicly available, e.g.,
CBI or other information whose disclosure is restricted by statute.
Certain other material, such as copyrighted material, is not placed on
the internet and will be publicly available only in hard copy form. It
may be viewed, with prior arrangement, at the EPA Docket Center.
Publicly available docket materials are available either electronically
in www.regulations.gov or in hard copy at the Air and Radiation Docket
Information Center, EPA/DC, WJC West Building, Room 3334, 1301
Constitution Ave. NW, Washington, DC. The Public Reading Room is open
from 8:30 a.m. to 4:30 p.m., Monday through Friday, excluding legal
holidays. The telephone number for the Public Reading Room is (202)
566-1744 and the telephone number for the Air and Radiation Docket
Information Center is (202) 566-1742.
FOR FURTHER INFORMATION CONTACT: Ms. Breanna Alman, Health and
Environmental Impacts Division, Office of Air Quality Planning and
Standards, U.S. Environmental Protection Agency, Mail Code C504-06,
Research Triangle Park, NC 27711; telephone: (919) 541-2351; fax: (919)
541-0237; email: [email protected].
Availability of Information Related to This Action
A number of the documents that are relevant to this decision are
available through the EPA's website at https://www.epa.gov/naaqs/nitrogen-dioxide-no2-primary-air-quality-standards. These documents
include the Integrated Review Plan for the Primary National Ambient Air
Quality Standards for Nitrogen Dioxide (U.S. EPA, 2011a), available at
https://www3.epa.gov/ttn/naaqs/standards/nox/data/201406finalirpprimaryno2.pdf, the Integrated Science Assessment for
Oxides of Nitrogen--Health Criteria (U.S. EPA, 2016a), available at
https://cfpub.epa.gov/ncea/isa/recordisplay.cfm?deid=310879, and the
Policy Assessment for the Review of the Primary National Ambient Air
Quality Standards for Oxides of Nitrogen (U.S. EPA, 2017a), available
at https://www.epa.gov/naaqs/policy-assessment-review-primary-national-ambient-air-quality-standards-oxides-nitrogen. These and other related
documents are also available for inspection and copying in the EPA
docket identified above.
SUPPLEMENTARY INFORMATION:
Table of Contents
Executive Summary
I. Background
A. Legislative Requirements
B. Related NO2 Control Programs
C. Review of the Air Quality Criteria and Standards for Oxides
of Nitrogen
D. Summary of Proposed Decisions
E. Organization and Approach to Final Decisions
II. Rationale for Decision on the Primary Standards
A. Introduction
1. Characterization of NO2 Air Quality
2. Overview of the Health Effects Evidence
3. Overview of Risk and Exposure Assessment Information
B. Conclusions on the Primary Standards
1. Basis for the Proposed Decision
2. The CASAC Advice in This Review
3. Comments on the Proposed Decision
4. Administrator's Conclusions
C. Decision on the Primary Standards
III. Statutory and Executive Order Reviews
A. Executive Order 12866: Regulatory Planning and Review and
Executive Order 13563: Improving Regulation and Regulatory Review
B. Executive Order 13771: Reducing Regulation and Controlling
Regulatory Costs
C. Paperwork Reduction Act (PRA)
D. Regulatory Flexibility Act (RFA)
E. Unfunded Mandates Reform Act (UMRA)
F. Executive Order 13132: Federalism
G. Executive Order 13175: Consultation and Coordination With
Indian Tribal Governments
H. Executive Order 13045: Protection of Children From
Environmental Health and Safety Risks
I. Executive Order 13211: Actions Concerning Regulations That
Significantly Affect Energy Supply, Distribution or Use
J. National Technology Transfer and Advancement Act (NTTAA)
K. Executive Order 12898: Federal Actions to Address
Environmental Justice in Minority Populations and Low-Income
Populations
L. Determination Under Section 307(d)
M. Congressional Review Act (CRA)
References
Executive Summary
This document describes the completion of the EPA's current review
of the primary NAAQS for oxides of nitrogen, of which nitrogen dioxide
(NO2) is the component of greatest concern for health and is
the indicator for the primary NAAQS. This review of the standards and
the air quality criteria (the scientific information upon which the
standards are based) is required by the Clean Air Act (CAA) on a
periodic basis. In conducting this review, the EPA has carefully
evaluated the currently available scientific literature on the health
effects of NO2, focusing particularly on the information
newly available since the conclusion of the last review. This section
briefly summarizes background information about this action and the
Administrator's decision to retain the current primary NO2
standards. A full discussion of these topics is provided later in this
document.
Summary of Background Information
There are currently two primary standards for oxides of nitrogen: A
1-hour standard established in 2010 at a level of 100 parts per billion
(ppb) based on the 98th percentile of the annual distribution of daily
maximum 1-hour NO2 concentrations, averaged over 3 years,
and an annual standard, originally set in 1971, at a level of 53 ppb
based on annual average NO2 concentrations.
Sections 108 and 109 of the CAA govern the establishment, review,
and revision, as appropriate, of the NAAQS to protect public health and
welfare. The CAA requires the EPA to periodically review the air
quality criteria--the science upon which the standards are based--and
the standards themselves. This review of the primary (health-based)
NO2 NAAQS is being conducted pursuant to these statutory
requirements. The schedule for
[[Page 17227]]
completing this review is established by a federal court order, which
requires signature of a notice setting forth the EPA's final decision
by April 6, 2018.
The last review of the primary NO2 NAAQS was completed
in 2010. In that review, the EPA supplemented the existing primary
annual NO2 standard by establishing a new short-term
standard with a level of 100 ppb, based on the 3-year average of the
98th percentile of the annual distribution of daily maximum 1-hour
concentrations (75 FR 6474, February 9, 2010). Revisions to the NAAQS
were accompanied by revisions to the data handling procedures and the
ambient air monitoring and reporting requirements, including the
establishment of requirements for states to locate monitors near
heavily trafficked roadways in large urban areas and in other locations
where maximum NO2 concentrations can occur.
Consistent with the review completed in 2010, this review is
focused on the health effects associated with gaseous oxides of
nitrogen and on the protection afforded by the primary NO2
standards. The gaseous oxides of nitrogen include NO2 and
nitric oxide (NO), as well as their gaseous reaction products. Total
oxides of nitrogen include these gaseous species as well as particulate
species (e.g., nitrates). The EPA is separately considering the health
and non-ecological welfare effects of particulate species in the review
of the NAAQS for particulate matter (PM) (U.S. EPA, 2016b). In
addition, the EPA is separately reviewing the welfare effects
associated with NOX and SOX and the ecological
welfare effects associated with PM. (U.S. EPA, 2017b).
Summary of Decision
In this action, the EPA is retaining the current primary
NO2 standards, without revision. This decision has been
informed by a careful consideration of the full body of scientific
evidence and information available in this review, giving particular
weight to the assessment of the evidence in the 2016 NOX
Integrated Science Assessment (ISA); analyses and considerations in the
Policy Assessment (PA); the advice and recommendations of the Clean Air
Scientific Advisory Committee (CASAC); and public comments.
Based on these considerations, the Administrator reaches the
conclusion that the current body of scientific evidence and the results
of quantitative analyses supports his judgment that the current 1-hour
and annual primary NO2 standards, together, are requisite to
protect public health with an adequate margin of safety, and do not
call into question any of the elements of those standards. These
conclusions are consistent with the CASAC recommendations. In its
advice to the Administrator, the CASAC ``recommend[ed] retaining, and
not changing the existing suite of standards'' (Diez Roux and Sheppard,
2017). The CASAC further stated that ``it is the suite of the current
1-hour and annual standards, together, that provide protection against
adverse effects'' (Diez Roux and Sheppard, 2017, p. 9). Therefore, in
this review, the EPA is retaining the current 1-hour and annual
NO2 primary standards, without revision.
As in the last review, the strongest evidence continues to come
from studies examining respiratory effects following short-term
NO2 exposures.\1\ In particular, the 2016 NOX ISA
concludes that ``[a] causal relationship exists between short-term
NO2 exposure and respiratory effects based on evidence for
asthma exacerbation'' (U.S. EPA, 2016a, p. 1-17). The strongest support
for this conclusion comes from controlled human exposure studies
examining the potential for NO2-induced increases in airway
responsiveness (AR) (which is a hallmark of asthma) in individuals with
asthma. Additional supporting evidence comes from epidemiologic studies
reporting associations between short-term NO2 exposures and
an array of respiratory outcomes related to asthma exacerbation (e.g.,
asthma-related hospital admissions and emergency department (ED) visits
in children and adults).
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\1\ The 2016 NOX ISA defines short-term exposures as
those with durations of minutes up to 1 month, with most studies
examining effects related to exposures in the range of 1 hour to 1
week (U.S. EPA, 2016a, p. 1-15).
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In addition to the effects of short-term exposures, the 2016
NOX ISA concludes that there is ``likely to be a causal
relationship'' between long-term NO2 exposures and
respiratory effects, based on the evidence for asthma development in
children. The strongest evidence supporting this conclusion comes from
recent epidemiologic studies demonstrating associations between long-
term NO2 exposures and asthma incidence. Additional support
comes from experimental studies supporting the biological plausibility
of a potential mode of action by which NO2 exposures could
cause asthma development.
While the evidence supports the occurrence of adverse
NO2-related respiratory effects at ambient NO2
concentrations likely to have been above those allowed by the current
primary NO2 NAAQS, that evidence, together with analyses of
the potential for NO2 exposures, does not call into question
the adequacy of the public health protection provided by the current
standards. In particular, compared to the last review when the 1-hour
standard was set, evidence from controlled human exposure studies has
not altered our understanding of the NO2 exposure
concentrations that cause increased AR. Analyses based on information
from these studies indicate that the current standards provide
protection against the potential for NO2 exposures that
could increase AR in people with asthma. In addition, while
epidemiologic studies report relatively precise associations with
serious NO2-related health outcomes (i.e., ED visits,
hospital admissions, asthma incidence) in locations likely to have
violated the current 1-hour and/or annual standards during portions of
study periods, studies do not indicate such associations in locations
with NO2 concentrations that would have clearly met those
standards.
After considering the current body of scientific evidence, the
results of quantitative analyses, the CASAC advice, and public
comments, the Administrator concludes that the current 1-hour and
annual NO2 primary standards, together, are requisite to
protect public health with an adequate margin of safety. Therefore, in
this review, the EPA is retaining the current 1-hour and annual
NO2 primary standards, without revision.
I. Background
A. Legislative Requirements
Two sections of the Clean Air Act (CAA or the Act) govern the
establishment and revision of the NAAQS. Section 108 (42 U.S.C. 7408)
directs the Administrator to identify and list certain air pollutants
and then to issue air quality criteria for those pollutants. The
Administrator is to list those air pollutants that in his ``judgment,
cause or contribute to air pollution which may reasonably be
anticipated to endanger public health or welfare;'' ``the presence of
which in the ambient air results from numerous or diverse mobile or
stationary sources;'' and ``for which . . . [the Administrator] plans
to issue air quality criteria . . . .'' Air quality criteria are
intended to ``accurately reflect the latest scientific knowledge useful
in indicating the kind and extent of all identifiable effects on public
health or welfare which may be expected from the presence of [a]
pollutant in the ambient air . . . .'' 42 U.S.C. 7408(b). Section 109
(42 U.S.C. 7409) directs the Administrator to propose and promulgate
``primary'' and
[[Page 17228]]
``secondary'' NAAQS for pollutants for which air quality criteria are
issued. Section 109(b)(1) defines a primary standard as one ``the
attainment and maintenance of which in the judgment of the
Administrator, based on such criteria and allowing an adequate margin
of safety, [is] requisite to protect the public health.'' \2\ A
secondary standard, as defined in section 109(b)(2), must ``specify a
level of air quality the attainment and maintenance of which, in the
judgment of the Administrator, based on such criteria, is requisite to
protect the public welfare from any known or anticipated adverse
effects associated with the presence of [the] pollutant in the ambient
air.'' \3\
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\2\ The legislative history of section 109 indicates that a
primary standard is to be set at ``the maximum permissible ambient
air level . . . which will protect the health of any [sensitive]
group of the population,'' and that for this purpose ``reference
should be made to a representative sample of persons comprising the
sensitive group rather than to a single person in such a group.''
See S. Rep. No. 91-1196, 91st Cong., 2d Sess. 10 (1970).
\3\ As specified in section 302(h) (42 U.S.C. 7602(h)) effects
on welfare include, but are not limited to, ``effects on soils,
water, crops, vegetation, man-made materials, animals, wildlife,
weather, visibility and climate, damage to and deterioration of
property, and hazards to transportation, as well as effects on
economic values and on personal comfort and well-being.''
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The requirement that primary standards provide an adequate margin
of safety was intended to address uncertainties associated with
inconclusive scientific and technical information available at the time
of standard setting. It was also intended to provide a reasonable
degree of protection against hazards that research has not yet
identified. See Lead Industries Association v. EPA, 647 F.2d 1130, 1154
(D.C. Cir. 1980); American Petroleum Institute v. Costle, 665 F.2d
1176, 1186 (D.C. Cir. 1981); American Farm Bureau Federation v. EPA,
559 F.3d 512, 533 (D.C. Cir. 2009); Association of Battery Recyclers v.
EPA, 604 F.3d 613, 617-18 (D.C. Cir. 2010). Both kinds of uncertainties
are components of the risk associated with pollution at levels below
those at which human health effects can be said to occur with
reasonable scientific certainty. Thus, in selecting primary standards
that provide an adequate margin of safety, the Administrator is seeking
not only to prevent pollution levels that have been demonstrated to be
harmful but also to prevent lower pollutant levels that may pose an
unacceptable risk of harm, even if the risk is not precisely identified
as to nature or degree. The CAA does not require the Administrator to
establish a primary NAAQS at a zero-risk level, see Lead Industries
Association, 647 F.2d at 1156 n.51, but rather at a level that reduces
risk sufficiently so as to protect public health with an adequate
margin of safety.
In addressing the requirement for an adequate margin of safety, the
EPA considers such factors as the nature and severity of the health
effects involved, the size of sensitive population(s) at risk,\4\ and
the kind and degree of the uncertainties that must be addressed. The
selection of any particular approach to providing an adequate margin of
safety is a policy choice left specifically to the Administrator's
judgment. See Lead Industries Association v. EPA, 647 F.2d at 1161-62.
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\4\ As used here and similarly throughout this document, the
term population (or group) refers to persons having a quality or
characteristic in common, such as a specific pre-existing illness or
a specific age or lifestage.
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In setting primary and secondary standards that are ``requisite''
to protect public health and welfare, respectively, as provided in
section 109(b), the EPA's task is to establish standards that are
neither more nor less stringent than necessary for these purposes. In
so doing, the EPA may not consider the costs of implementing the
standards. See generally, Whitman v. American Trucking Associations,
531 U.S. 457, 465-472, 475-76 (2001). Likewise, ``[a]ttainability and
technological feasibility are not relevant considerations in the
promulgation of national ambient air quality standards.'' American
Petroleum Institute v. Costle, 665 F.2d at 1185.
Section 109(d)(1) requires that ``not later than December 31, 1980,
and at 5-year intervals thereafter, the Administrator shall complete a
thorough review of the criteria published under section 108 and the
national ambient air quality standards . . . and shall make such
revisions in such criteria and standards and promulgate such new
standards as may be appropriate . . . .'' Section 109(d)(2) requires
that an independent scientific review committee ``shall complete a
review of the criteria . . . and the national primary and secondary
ambient air quality standards . . . and shall recommend to the
Administrator any new . . . standards and revisions of existing
criteria and standards as may be appropriate . . . .'' Since the early
1980s, this independent review function has been performed by the Clean
Air Scientific Advisory Committee (CASAC).\5\
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\5\ Lists of the CASAC members and members of the NO2
Review Panel are available at: https://yosemite.epa.gov/sab/sabproduct.nsf/WebCASAC/CommitteesandMembership?OpenDocument.
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B. Related NO2 Control Programs
States are primarily responsible for ensuring attainment and
maintenance of ambient air quality standards once the EPA has
established them. Under section 110 of the Act, 42 U.S.C. 7410, and
related provisions, states are to submit, for the EPA's approval, state
implementation plans (SIPs) that provide for the attainment and
maintenance of such standards through control programs directed to
sources of the pollutants involved. The states, in conjunction with the
EPA, also administer the Prevention of Significant Deterioration
permitting program that covers these pollutants. See 42 U.S.C. 7470-
7479. In addition, federal programs provide for nationwide reductions
in emissions of these and other air pollutants under Title II of the
Act, 42 U.S.C. 7521-7574, which involves controls for automobile,
truck, bus, motorcycle, nonroad engine and equipment, and aircraft
emissions; the new source performance standards (NSPS) under section
111 of the Act, 42 U.S.C. 7411; and the national emission standards for
hazardous air pollutants under section 112 of the Act, 42 U.S.C. 7412.
Currently there are no areas in the United States that are
designated as nonattainment for the NO2 NAAQS (see 77 FR
9532 (February 17, 2012)). In addition, there are currently no monitors
where there are design values (DVs) \6\ above either the 1-hour or
annual standard (U.S. EPA, 2017a, Figure 2-5), with the maximum DVs in
2015 being 30 ppb (annual) and 72 ppb (hourly) (U.S. EPA, 2017a
Section, 2.3.1).
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\6\ The metric used to determine whether areas meet or exceed
the NAAQS is called a design value (DV). In the case of the primary
NO2 NAAQS, there are 2 types of DVs: The annual DV and
the hourly DV. The annual DV for a particular year is the average of
all hourly values within that calendar year. The hourly DV is the
three-year average of the 98th percentiles of the annual
distributions of daily maximum 1-hour NO2 concentrations.
The requirements for calculating DVs for the primary NO2
NAAQS from valid monitoring data are further specified in Appendix S
to Part 50.
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While NOX \7\ is emitted from a wide variety of source
types, the top three categories of sources of NOX emissions
are highway vehicles, off-highway vehicles, and stationary fuel
combustion sources.\8\ The EPA anticipates that NOX
[[Page 17229]]
emissions will continue to decrease over the next 20 years. For
example, Tier 2 and Tier 3 emission standards for new light-duty
vehicles, combined with the reduction of gasoline sulfur content, will
significantly reduce motor vehicle emissions of NOX, with
Tier 3 standards phasing in from model year 2017 to model year 2025.
For heavy-duty engines, new NOX standards were phased in
between the 2007 and 2010 model years, following the introduction of
ultra-low sulfur diesel fuel. More stringent NOX standards
for non-road diesel engines, locomotives, and certain marine engines
are becoming effective throughout the next decade. In future decades,
these vehicles and engines meeting more stringent NOX
standards will become an increasingly large fraction of in-use mobile
sources, leading to large NOX emission reductions.\9\
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\7\ In this context, NOX refers to the sum of NO and
NO2, as is common within air pollution research and
control communities. However, in the larger context of this NAAQS
review, the terms ``oxides of nitrogen'' and ``nitrogen oxides''
generally refer more broadly to gaseous oxides of nitrogen, which
include NO2 and NO, as well as their gaseous reaction
products.
\8\ Highway vehicles include all on-road vehicles, including
light duty as well as heavy duty vehicles, both gasoline- and
diesel-powered, and on-highway motorcycles. Off-highway engines,
vehicles and equipment include aircraft, marine vessels,
locomotives, off-highway motorcycles, recreational vehicles and
other non-road products (e.g., lawnmowers, portable generators,
chainsaws, forklifts). Fuel combustion sources includes electric
power generating units (EGUs), which derive their power generation
from all types of fuels.
\9\ Reductions in ambient NO2 concentrations could
also result from the implementation of NAAQS for other pollutants
(e.g., ozone, PM), to the extent NOX emissions are
reduced as part of the implementation of those standards.
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C. Review of the Air Quality Criteria and Standards for Oxides of
Nitrogen
In 1971, the EPA added oxides of nitrogen to the list of criteria
pollutants under section 108(a)(1) of the CAA and issued the initial
air quality criteria (36 FR 1515, January 30, 1971; U.S. EPA, 1971).
Based on these air quality criteria, the EPA promulgated the
NO2 NAAQS (36 FR 8186, April 30, 1971). Both primary and
secondary standards were set at 53 ppb,\10 \annual average. Since then,
the Agency has completed multiple reviews of the air quality criteria
and primary NO2 standards. In the last review, the EPA made
revisions to the primary NO2 NAAQS in order to provide
requisite protection of public health. Specifically, the EPA
supplemented the existing primary annual NO2 standard by
establishing a new short-term standard with a level of 100 ppb, based
on the 3-year average of the 98th percentile of the annual distribution
of daily maximum 1-hour concentrations (75 FR 6474, February 9, 2010).
In addition, revisions to the NAAQS were accompanied by revisions to
the data handling procedures and the ambient air monitoring and
reporting requirements, including requirements for states to locate
monitors near heavily trafficked roadways in large urban areas and in
other locations where maximum NO2 concentrations can occur.
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\10\ In 1971, primary and secondary NO2 NAAQS were
set at levels of 100 micrograms per cubic meter ([mu]g/m\3\), which
equals 0.053 parts per million (ppm) or 53 ppb.
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Industry groups filed petitions for judicial review of the 2010
rule in the U.S. Court of Appeals for the District of Columbia Circuit.
API v. EPA, 684 F.3d 1342 (D.C. Cir. 2012). The court upheld the 2010
rule, denying the petitions' challenges to the adoption of the 1-hour
NO2 NAAQS and dismissing, for lack of jurisdiction, the
challenges to statements regarding permitting in the preamble of the
2010 rule. Id. at 1354.
Subsequent to the 2010 rulemaking, the Agency revised the deadlines
by which the near-road monitors were to be operational in order to
implement a phased deployment approach (78 FR 16184, March 14, 2013),
with a majority of the network becoming operational by 2015. In 2016,
after analyzing available monitoring data, the Agency revised the size
requirements of the near-road network, reducing the network to only
operate in Core Based Statistical Areas (CBSAs) with populations of 1
million or more (81 FR 96381, December 30, 2016).
In February 2012, the EPA announced the initiation of the current
periodic review of the air quality criteria for oxides of nitrogen and
of the primary NO2 NAAQS and issued a call for information
in the Federal Register (77 FR 7149, February 10, 2012). A wide range
of external experts as well as the EPA staff representing a variety of
areas of expertise (e.g., epidemiology, human and animal toxicology,
statistics, risk/exposure analysis, atmospheric science, and biology)
participated in a workshop held by the EPA on February 29 to March 1,
2012, in Research Triangle Park, NC. The workshop provided an
opportunity for a public discussion of the key policy-relevant issues
around which the Agency would structure this primary NO2
NAAQS review and the most meaningful new science that would be
available to inform the EPA's understanding of these issues.
Based in part on the workshop discussions, the EPA developed a
draft plan for the NOX ISA and subsequently a draft
Integrated Review Plan (IRP) outlining the schedule, process, and key
policy-relevant questions that would guide the evaluation of the
health-related air quality criteria for NO2 and the review
of the primary NO2 NAAQS. The draft plan for the
NOX ISA was released in May 2013 (78 FR 26026) and was the
subject of a consultation with the CASAC on June 5, 2013 (78 FR 27234).
Comments from the CASAC and the public were considered in the
preparation of the first draft ISA and the draft IRP. In addition,
preliminary draft materials for the NOX ISA were reviewed by
subject matter experts at a public workshop hosted by the EPA's
National Center for Environmental Assessment (NCEA) in May 2013 (78 FR
27374). The first draft ISA was released in November 2013 (78 FR
70040). During this time, the draft IRP was also in preparation and was
released in February 2014 (79 FR 7184). Both the draft IRP and first
draft ISA were reviewed by the CASAC at a public meeting held in March
2014 (79 FR 8701), and the first draft ISA was further discussed at an
additional teleconference held in May 2014 (79 FR 17538). The CASAC
finalized its recommendations on the first draft ISA and the draft IRP
in letters dated June 10, 2014 (Frey, 2014a; Frey, 2014b), and the
final IRP was released in June 2014 (79 FR 36801).
The EPA released the second draft ISA in January 2015 (80 FR 5110)
and the Risk and Exposure Assessment (REA) Planning document in May
2015 (80 FR 27304). These documents were reviewed by the CASAC at a
public meeting held in June 2015 (80 FR 22993). A follow-up
teleconference with the CASAC was held in August 2015 (80 FR 43085) to
finalize recommendations on the second draft ISA. The final ISA was
released in January 2016 (81 FR 4910). The CASAC recommendations on the
second draft ISA and the draft REA planning document were provided to
the EPA in letters dated September 9, 2015 (Diez Roux and Frey, 2015a;
Diez Roux and Frey, 2015b), and the final ISA was released in January
2016 (81 FR 4910).
After considering the CASAC advice and public comments, the EPA
prepared a draft Policy Assessment (PA), which was released on
September 23, 2016 (81 FR 65353). The draft PA was reviewed by the
CASAC on November 9-10, 2016 (81 FR 68414), and a follow-up
teleconference was held on January 24, 2017 (81 FR 95137). The CASAC
recommendations, based on its review of the draft PA, were provided in
a letter to the EPA Administrator dated March 7, 2017 (Diez Roux and
Sheppard, 2017). The EPA staff took into account these recommendations,
as well as public comments provided on the draft PA, when developing
the final PA, which was released in April 2017.\11\
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\11\ This document may be found at: https://www.epa.gov/naaqs/policy-assessment-review-primary-national-ambient-air-quality-standards-oxides-nitrogen.
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[[Page 17230]]
On July 14, 2017, the proposed decision to retain the
NO2 NAAQS was signed, and it was published in the Federal
Register on July 26 (82 FR 34792). The 60-day comment period ended on
September 25, 2017, and comments were received from various government,
industry, and environmental groups, as well as members of the general
public.
In addition, in July 2016, a lawsuit was filed against the EPA that
included a claim that EPA had failed to complete its review of the
primary NO2 NAAQS within five years, as required by the CAA.
Center for Biological Diversity et al. v. McCarthy, (No. 4:16-cv-03796-
VC, N.D. Cal., July 7, 2016). Consistent with CAA section 113(g), a
notice of a proposed consent decree to resolve this litigation was
published in the Federal Register on January 17, 2017 (82 FR 4866). The
EPA received two public comments on the proposed consent decree,
neither of which disclosed facts or considerations indicating that the
Department of Justice or the EPA should withhold consent.\12\ The
parties to the litigation filed a joint motion asking the court to
enter the consent decree, and the court entered the consent decree as a
consent judgment on April 28, 2017. The consent judgment established
July 14, 2017 as the deadline for signature of a notice setting forth
the proposed decision in this review and April 6, 2018 as the deadline
for signature of a notice setting forth the final decision.
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\12\ One comment was received from the American Petroleum
Institute (API) and one was received from an anonymous commenter.
These comments are available in the docket for the proposed consent
decree (EPA-HQ-OGC-2016-0719).
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Consistent with the review completed in 2010, this review is
focused on health effects associated with gaseous oxides of nitrogen
\13\ and the protection afforded by the primary NO2
standards. The gaseous oxides of nitrogen include NO2 and
NO, as well as their gaseous reaction products. Total oxides of
nitrogen include these gaseous species as well as particulate species
(e.g., nitrates). Health effects and non-ecological welfare effects
associated with the particulate species are addressed in the review of
the NAAQS for PM (U.S. EPA, 2016b).\14\ The EPA is separately reviewing
the welfare effects associated with NOX and SOX
and the ecological welfare effects associated with PM. (U.S. EPA,
2017a).\15\
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\13\ These gaseous oxides of nitrogen can also be referred to as
``nitrogen oxides'' and include a broad category of gaseous oxides
of nitrogen (i.e., oxidized nitrogen compounds), including
NO2, NO, and their various reaction products.
\14\ Additional information on the PM NAAQS is available at:
https://www.epa.gov/naaqs/particulate-matter-pm-air-quality-standards.
\15\ Additional information on the ongoing and previous review
of the secondary NO2 and SO2 NAAQS is
available at: https://www.epa.gov/naaqs/nitrogen-dioxide-no2-and-sulfur-dioxide-so2-secondary-air-quality-standards.
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D. Summary of Proposed Decisions
For reasons discussed in the proposal and summarized in section
II.B.1 below, the Administrator proposed to retain the current primary
standards for NO2, without revision.
E. Organization and Approach to Final Decisions
This action presents the Administrator's final decision in the
current review of the primary NO2 standards. The final
decision addressing the primary NO2 standards is based on a
thorough review in the 2016 NOX ISA of scientific
information on known and potential human health effects associated with
exposure to NO2 associated with levels typically found in
the ambient air. This final decision also takes into account the
following: (1) Staff assessments in the PA of the most policy-relevant
information in the ISA, as well as quantitative exposure and risk
information; (2) the CASAC advice and recommendations, as reflected in
its letters to the Administrator and its discussions of drafts of the
ISA and PA at public meetings; (3) public comments received during the
development of these documents, both in connection with the CASAC
meetings and separately; and (4) public comments received on the
proposal. The primary NO2 standards are addressed in section
II below. Section III addresses statutory and executive order reviews.
II. Rationale for Decision on the Primary Standards
This section presents the rationale for the Administrator's
decision to retain the existing primary NO2 standards. This
rationale is based on a thorough review in the 2016 NOX ISA
of the latest scientific information, generally published through
August 2014, on human health effects associated with NO2 and
pertaining to the presence of NO2 in the ambient air. This
decision also takes into account: (1) The PA's staff assessments of the
most policy-relevant information in the ISA and staff analyses of air
quality, human exposure and health risks, upon which staff conclusions
regarding appropriate considerations in this review are based; (2) the
CASAC advice and recommendations, as reflected in discussions of drafts
of the ISA and PA at public meetings, in separate written comments, and
in the CASAC letters to the Administrator; (3) public comments received
during the development of these documents, either in connection with
the CASAC meetings or separately; and (4) public comments received on
the proposal. Section II.A provides background on the general approach
for review of the primary NO2 standards and brief summaries
of key aspects of the currently available air quality information, as
well as health effects and exposure/risk information. Section II.B
presents the Administrator's conclusions on the adequacy of the current
primary NO2 standards, drawing on consideration of this
information, advice from the CASAC, and comments from the public.
Section II.C summarizes the Administrator's decision on the primary
NO2 standards.
A. Introduction
The Administrator's approach to reviewing the current primary
NO2 standards is based, most fundamentally, on using the
EPA's assessment of the current scientific evidence and associated
quantitative analyses to inform his judgment regarding primary
NO2 standards that protect public health with an adequate
margin of safety. In drawing conclusions with regard to the primary
standards, the final decision on the adequacy of the current standards
is largely a public health policy judgment to be made by the
Administrator. The Administrator's final decision draws upon scientific
information and analyses about health effects, population exposure and
risks, as well as judgments about how to consider the range and
magnitude of uncertainties that are inherent in the scientific evidence
and analyses.
The approach to informing these judgments is based on the
recognition that the available health effects evidence generally
reflects a continuum, consisting of levels at which scientists
generally agree that health effects are likely to occur, through lower
levels at which the likelihood and magnitude of the response become
increasingly uncertain. This approach is consistent with the
requirements of the NAAQS provisions of the Act and with how the EPA
and the courts have historically interpreted the Act. These provisions
require the Administrator to establish primary standards that, in the
judgment of the Administrator, are requisite to protect public health
with an adequate margin of safety. In so doing, the Administrator seeks
to establish standards that are neither more nor less stringent than
necessary for this purpose. The Act does not require that primary
standards be set at a zero-risk
[[Page 17231]]
level, but rather at a level that avoids unacceptable risks to public
health including the health of sensitive groups. The four basic
elements of the NAAQS (indicator, averaging time, level, and form) are
considered collectively in evaluating the health protection afforded by
the current standards.
To evaluate whether it is appropriate to consider retaining the
current primary NO2 standards, or whether consideration of
revision is appropriate, the EPA has adopted an approach in this review
that builds upon the general approach used in the last review and
reflects the broader body of evidence and information now available.
The Administrator's decisions in the prior review were based on an
integration of information on health effects associated with exposure
to NO2 with information on the public health significance of
key health effects, as well as on policy judgments as to when the
standard is requisite to protect public health with an adequate margin
of safety and advice from the CASAC and public comments. These
considerations were informed by air quality and related analyses and
quantitative exposure and risk information. Similarly, in this review,
as described in the PA, the proposal, and elsewhere in this document,
we draw on the current evidence and quantitative assessments of
exposure pertaining to the public health risk of NO2 in
ambient air. In considering the scientific and technical information
here, as in the PA, we consider both the information available at the
time of the last review and information newly available since the last
review, including most particularly that which has been critically
analyzed and characterized in the current ISA. In considering the
entire body of evidence presented in the current ISA, as in the PA and
as in the last review, we focus particularly on those health endpoints
for which the ISA finds associations with NO2 to be causal
or likely causal. The evidence-based discussions presented below draw
upon evidence from both controlled human exposure studies and
epidemiologic studies. Sections II.A.1 through II.A.3 below provide an
overview of the current NO2 air quality, health effects, and
quantitative exposure and risk information with a focus on the specific
policy-relevant questions identified for these categories of
information in the PA (U.S. EPA, 2017a, Chapter 3).
1. Characterization of NO2 Air Quality
This section presents information on NO2 atmospheric
chemistry and ambient concentrations, with a focus on information that
is most relevant for the review of the primary NO2
standards. This section is drawn from the more detailed discussion of
NO2 air quality in the PA (U.S. EPA, 2017a, Chapter 2) and
the 2016 NOX ISA (U.S. EPA, 2016a, Chapter 2).\16\ It
presents a summary of NO2 atmospheric chemistry (section
II.A.1.a), trends in ambient NO2 concentrations (section
II.A.1.b), ambient NO2 concentrations measured at monitors
near roads (section II.A.1.c), the relationships between hourly and
annual ambient NO2 concentrations (section II.A.1.d), and
background concentrations of NO2 (section II.A.1.e).
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\16\ The focus is on NO2 in this document, as this is
the indicator for the current standards and is most relevant to the
evaluation of health evidence. Characterization of air quality for
the broader category of oxides of nitrogen is provided in the 2016
NOX ISA (U.S. EPA, 2016a, Chapter 2).
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a. Atmospheric Chemistry
Ambient concentrations of NO2 are influenced by both
direct NO2 emissions and by emissions of NO, with the
subsequent conversion of NO to NO2 primarily though reaction
with ozone (O3). The initial reaction between NO and
O3 to form NO2 occurs fairly quickly during the
daytime, with reaction times on the order of minutes. However,
NO2 can also be photolyzed to regenerate NO, creating new
O3 in the process (U.S. EPA, 2016a, Section 2.2). A large
number of oxidized nitrogen species in the atmosphere are formed from
the oxidation of NO and NO2. These include nitrate radicals
(NO3), nitrous acid (HONO), nitric acid (HNO3),
dinitrogen pentoxide (N2O5), nitryl chloride
(ClNO2), peroxynitric acid (HNO4), peroxyacetyl
nitrate and its homologues (PANs), other organic nitrates, such as
alkyl nitrates (including isoprene nitrates), and pNO3. The
sum of these reactive oxidation products and NO plus NO2
comprise the oxides of nitrogen.17 18
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\17\ This follows usages in Clean Air Act section 108(c): ``Such
criteria [for oxides of nitrogen] shall include a discussion of
nitric and nitrous acids, nitrites, nitrates, nitrosamines, and
other carcinogenic and potentially carcinogenic derivatives of
oxides of nitrogen.'' By contrast, within air pollution research and
control communities, the terms ``nitrogen oxides'' and
NOX are often restricted to refer only to the sum of NO
and NO2.
\18\ See Figure 2-1 of the NO2 PA for additional
information (U.S. EPA, 2017a).
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Due to the close relationship between NO and NO2, and
their ready interconversion, these species are often grouped together
and referred to as NOX. The majority of NOX
emissions are in the form of NO. For example, 90% or more of tail-pipe
NOX emissions are in the form of NO, with only about 2% to
10% emitted as NO2 (Itano et al., 2014; Kota et al., 2013;
Jimenez et al., 2000; Richmond-Bryant et al., 2016). NOX
emissions require time and sufficient O3 concentrations for
the conversion of NO to NO2. Higher temperatures and
concentrations of reactants result in shorter conversion times (e.g.,
less than one minute under some conditions), while dispersion and
depletion of reactants result in longer conversion times. The time
required to transport emissions away from a roadway can vary from less
than one minute (e.g., under open conditions) to about one hour (e.g.,
for certain urban street canyons) (D[uuml]ring et al., 2011; Richmond-
Bryant and Reff, 2012). These factors can affect the locations where
the highest NO2 concentrations occur. In particular, while
ambient NO2 concentrations are often elevated near important
sources of NOX emissions, such as major roadways, the
highest measured ambient concentrations in a given urban area may not
always occur immediately adjacent to those sources.\19\
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\19\ Ambient NO2 concentrations around stationary
sources of NOX emissions are similarly impacted by the
availability of O3 and by meteorological conditions,
although surface-level NO2 concentrations can be less
impacted in cases where stationary source NOX emissions
are emitted from locations elevated substantially above ground
level.
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b. National Trends in NOX Emissions and Ambient
NO2 Concentrations
Ambient concentrations of NO2 in the U.S. are due
largely to NOX emissions from anthropogenic sources.
Background NO2 is estimated to make up only a small fraction
of current ambient concentrations (U.S. EPA, 2016a, Section 2.5.6; U.S.
EPA, 2017a, Section 2.3.4).\20\ Nationwide estimates indicate that
there has been a 61% reduction in total NOX emissions from
1980 to 2016 (U.S. EPA, 2017a, Section 2.1.2, Figure 2-2). These
reductions have been driven primarily by decreases in emissions from
mobile sources and fuel combustion (U.S. EPA, 2017a, Section 2.1.2,
Figure 2-3).
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\20\ Background concentrations of a pollutant can be defined in
various ways, depending on context and circumstances. Background
concentrations of NO2 are discussed in the 2016
NOX ISA (U.S. EPA, 2016a, Section 2.5.6) and the PA (U.S.
EPA, 2017a, Section 2.3.4).
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Long-term trends in NO2 DVs across the U.S. show that
ambient concentrations of NO2 have been declining, on
average, since 1980 (U.S. EPA, 2017a, Figure 2-4). Data have been
collected for at least some part of the period since 1980 at 2099 sites
in the U.S., with individual sites having a wide range in duration and
continuity of operations across multiple decades. Overall, the majority
of sampling sites have observed statistically significant downward
trends in ambient NO2
[[Page 17232]]
concentrations (U.S. EPA, 2017a, Figure 2-5).\21\ The annual and hourly
DVs trended upward in less than 4% of the sites.\22\ Even considering
the fact that there are a handful of sites where upward trends in
NO2 concentrations have occurred, the maximum DVs in 2015
across the whole monitoring network were well below the NAAQS, with the
highest values being 30 ppb (annual) and 72 ppb (hourly) (U.S. EPA,
2017a, Section 2.3.1).
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\21\ Based on an analysis of data from sampling sites with
sufficient data to produce at least five valid DVs.
\22\ It is not clear what specific sources may be responsible
for the upward trends in ambient NO2 concentrations at
these sites. (See U.S. EPA, 2017a, Section 2.1.2).
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c. Near-Road NO2 Air Quality
The largest single source of NOX emissions is on-road
vehicles, and emissions are primarily in the form of NO, with
NO2 formation requiring both time and sufficient
O3 concentrations. Depending on local meteorological
conditions and O3 concentrations, ambient NO2
concentrations can be higher near roadways than at sites in the same
area but farther removed from the road (and from other sources of
NOX emissions).
When considering the historical relationships between
NO2 concentrations at monitors near roadways and monitors
farther away from roads, NO2 DVs are generally highest at
sampling sites nearest to the road (less than 50 meters) and decrease
as distance from the road increases (U.S. EPA, 2017a, Section 2.3.2,
Figure 2-6). This relationship is more pronounced for annual DVs than
for hourly DVs. The general pattern of decreasing DVs with increasing
distance from the road has persisted over time, though the absolute
difference (in terms of ppb) between NO2 concentrations
close to roads and those farther from roads has generally decreased
over time (U.S. EPA, 2017a, Section 2.3.2, Figure 2-6).
In addition, data from the recently deployed network \23\ of
dedicated near-road NO2 monitors indicate that daily maximum
1-hour NO2 concentrations are generally higher at near-road
monitors than at non-near-road monitors in the same CBSA (U.S. EPA,
2017a, Figures 2-7 to 2-10). The 98th percentiles of 1-hour daily
maximum concentrations (the statistic most relevant to the 1-hour
standard) were highest at near-road monitors (i.e., higher than all
non-near-road monitors in the same CBSA) in 58% to 77% of the CBSAs
evaluated, depending on the year (U.S. EPA, 2017a, Section 2.3.2,
Figures 2-7 to 2-10).\24\
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\23\ Prior to the 2010 rulemaking, monitors were ``not sited to
measure peak roadway-associated NO2 concentrations . . .
.'' (75 FR 6479).
\24\ The upper end of this range (i.e., 77%) reflects more
recent years during which most near-road monitors were in operation.
The lower end of this range (i.e., 58%) reflects the smaller number
of near-road monitors in operation during the early years of the
deployment of the near-road network.
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d. Relationships between Hourly and Annual NO2
Concentrations
Control programs have resulted in substantial reductions in
NOX emissions since the 1980s. These reductions in
NOX emissions have decreased both short-term peak
NO2 concentrations and annual average concentrations (U.S.
EPA, 2017a, Section 2.3.1). Since the 1980s, the median annual
NO2 DV has decreased by about 65% and the median 1-hour DV
has decreased by about 50% (U.S. EPA, 2017a, Section 2.3.3, Figure 2-
10). These DVs were measured predominantly by NO2 monitors
located at area-wide monitoring sites; data from the new near-road
monitoring network were not included the analysis of the relationship
between hourly and annual NO2 concentrations due to the
limited amount of data available.\25\ At various times in the past, a
number of these area-wide sites would have violated the 1-hour standard
without violating the annual standard. However, no sites would have
violated the annual standard without also violating the 1-hour standard
(U.S. EPA, 2017a, p. 2-21). Furthermore, examination of historical data
indicates that 1-hour DVs at or below 100 ppb generally correspond to
annual DVs below 35 ppb, with many monitors recording annual
concentrations around 30 ppb. (U.S. EPA, 2017a, p. 2-21, Figure 2-11).
Based on this, an area meeting the 1-hour standard with its level of
100 ppb would be expected to maintain annual average NO2
concentrations well below the 53 ppb level of the annual standard (U.S.
EPA, 2017a, Figure 2-11). It will be important to re-evaluate the
relationship between 1-hour and annual standards as more data become
available from recently deployed near-road monitors.
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\25\ Area-wide sites are intended to characterize ambient
NO2 concentrations at the neighborhood and larger spatial
scales.
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2. Overview of the Health Effects Evidence
This section summarizes the available scientific evidence on the
health effects of NO2 exposures. These summaries are based
primarily on the assessment of the evidence in the 2016 NOX
ISA (U.S. EPA, 2016a) and on the PA's consideration of that evidence in
evaluating the public health protection provided by the current primary
NO2 standards (U.S. EPA, 2017a).
In the current review of the primary NO2 NAAQS, the 2016
NOX ISA uses frameworks to characterize the strength of the
available scientific evidence for health effects attributable to
NO2 exposures and to classify the evidence for factors that
may increase risk in some populations \26\ or lifestages (U.S. EPA,
2016a, Preamble, Section 6). These frameworks provide the basis for
robust, consistent, and transparent evaluation of the scientific
evidence, including uncertainties in the evidence, and for drawing
conclusions on air pollution-related health effects and at-risk
populations. With regard to characterization of the health effects
evidence, the 2016 NOX ISA uses a five-level hierarchy to
classify the overall weight of evidence into one of the following
categories: Causal relationship; likely to be a causal relationship;
suggestive of, but not sufficient to infer, a causal relationship;
inadequate to infer a causal relationship; and not likely to be a
causal relationship (U.S. EPA, 2016a, Preamble, Table II).\27\ As
discussed further below, in evaluating the public health protection
provided by the current standards, the EPA's focus is on health effects
determined to have a ``causal'' or a ``likely to be causal''
relationship with NO2 exposures. In the ISA, a ``causal''
relationship is supported when, ``the consistency and coherence of
evidence integrated across scientific disciplines and related health
outcomes are sufficient to rule out chance, confounding, and other
biases with reasonable confidence'' (U.S. EPA, 2016a, p. 1-5). A
``likely to be causal'' relationship is supported when ``there are
studies where results are not explained by chance, confounding, or
other biases, but uncertainties remain in the evidence overall. For
example, the influence of other pollutants is difficult to address, or
evidence among scientific disciplines may be limited or inconsistent''
(U.S. EPA, 2016a, p. 1-5). Many of the health effects evaluated in the
ISA, have complex etiologies. For instance, diseases such as asthma are
typically initiated by multiple agents. For example, outcomes depend on
a
[[Page 17233]]
variety of factors such as age, genetic background, nutritional status,
immune competence, and social factors (U.S. EPA, 2017a, Preamble,
Section 5.b). Thus, exposure to NO2 is likely one of several
contributors to the health effects evaluated in the ISA.
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\26\ The term ``population'' refers to people having a quality
or characteristic in common, including a specific pre-existing
illness or a specific age or lifestage.
\27\ In this review, as in past reviews, there were causal
determination changes for different endpoint categories. For more
information on changes in causal determinations from the previous
review, see below and Table 1-1 of the 2016 NOX ISA (U.S.
EPA, 2016a).
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With regard to identifying specific populations or lifestages that
may be at increased risk of health effects related to NO2
exposures, the 2016 NOX ISA characterizes the evidence for a
number of ``factors'', including both intrinsic (i.e., biologic, such
as pre-existing disease or lifestage) and extrinsic (i.e., non-
biologic, such as diet or socioeconomic status) factors. The categories
considered in classifying the evidence for these potential at-risk
factors are ``adequate evidence,'' ``suggestive evidence,''
``inadequate evidence,'' and ``evidence of no effect'' (U.S. EPA,
2016a, Section 5.c, Table II). Within the PA, the focus is on the
consideration of potential at-risk populations and lifestages for which
the 2016 NOX ISA judges there is ``adequate'' evidence (U.S.
EPA, 2016a, Table 7-27).
The sections below summarize the evidence for effects related to
short-term NO2 exposures (e.g., minutes up to 1 month) and
the evidence for effects related to long-term NO2 exposures
(e.g., months to years).\28\ The final section discusses the potential
public health implications of NO2 exposures, based on the
evidence for populations and lifestages at increased risk of
NO2-related effects. The focus of these sections is on
health effects that the 2016 NOX ISA has determined to have
a ``causal'' or ``likely to be causal'' relationship with
NO2. Health effects whose causal determinations have changed
since the last review are also briefly addressed. More information on
health effects for which causal determinations are suggestive of, but
not sufficient to infer a causal relationship or inadequate to infer a
causal relationship (i.e., health effects for which the evidence is
weaker) may be found in section II.C of the proposal (87 FR 34792, July
26, 2017).
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\28\ Short-term exposures are defined as those with durations of
minutes up to 1 month, with most studies examining effects related
to exposures in the range of 1 hour to 1 week (2016 NOX
ISA, p. 1-15).
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a. Health Effects With Short-Term Exposure to NO2
This section discusses the evidence for health effects following
short-term NO2 exposures. Section II.B.2.a.i discusses the
nature of the health effects that have been shown to occur following
short-term NO2 exposures and the strength of the evidence
supporting various effects, based on the assessment of that evidence in
the 2016 NOX ISA. Section II.B.2.a.ii discusses the
NO2 concentrations at which health effects have been
demonstrated to occur, based on the considerations and analyses
included in the PA. Section II.B.2.a.iii discusses NO2
concentrations in controlled human exposure studies, while section
II.B.2.a.iv. discusses NO2 concentrations in locations of
epidemiologic studies.
i. Nature of Effects
Across previous reviews of the primary NO2 NAAQS (U.S.
EPA, 1993; U.S. EPA, 2008a), evidence has consistently demonstrated
respiratory effects attributable to short-term NO2
exposures. In the last review, the 2008 NOX ISA concluded
that evidence was ``sufficient to infer a likely causal relationship
between short-term NO2 exposure and adverse effects on the
respiratory system'' based on the large body of epidemiologic evidence
demonstrating positive associations with respiratory symptoms and
hospitalization or ED visits as well as supporting evidence from
controlled human exposure and animal studies (U.S. EPA, 2008a, p. 5-6).
Evidence for cardiovascular effects and mortality attributable to
short-term NO2 exposures was weaker and was judged
``inadequate to infer the presence or absence of a causal
re