Intervention

Effective interventions are based on knowing how and why exposure to elevated fine PM concentration levels with or without ecological hazards increase respiratory-cardiovascular-cerebrovascular chronic diseases.

Air pollution intervention can include decreasing the ambient fine PM concentration level, avoiding exposure to elevated PM, or both. Similarly, ecological hazard abatement can proceed concurrently or sequentially with respect to decreasing air pollution in the workplace.

Weight reduction through a decreased intake of excess calories and a change from a sedentary to a more active lifestyle is another way to mitigate the adverse impacts of elevated PM on asthmatic persons who are also obese or have developed the metabolic syndrome.

Higher ambient temperature contributes to increases in ambient air pollution particles (fine PM) and gases (ozone) as well as resulting in more asthma hospital events.

DAI's intervention approach includes these steps:

• First, the intervention design phase includes scientific knowledge specific to each organization and what is known about contributing variables and mechanisms. This emphasis on the inclusion of physiologic mechanisms should help to identify the more important conditions that resulted in the organization-specific environmental hazard- health outcome association.

• Second, organization epidemiologic study results will make available specific information about the air pollution and ecological hazards present in the workplace and the characteristics of the adverse health outcomes shown by organization members or service recipients.

• Third, by having organization specific environmental hazard exposure-health outcome (including the presence of lower-level hazards in the workplace, i.e., ecological hazards) it will be possible to formulate an appropriate intervention strategy that will decrease or eliminate the ecological hazard in the workplace and lower or eliminate adverse health outcomes of organizational members or service recipients.

Intervention strategies relevant to organizations dealing with environmental hazard-health outcome issues can include the following:

Lower Ambient Air Pollution

One approach will be to work with regulatory agencies to lower ambient PM or ozone concentration levels. Organization specific approaches will include identification, measurement, and lowering of indoor air pollution concentration levels.

Decrease Personal Exposure to Air Pollution

Regardless of the ambient air pollution concentration levels in the workplace, it should be possible to decrease personal exposure to PM and gases by not going outside on days when ambient air pollution levels are higher.

Another intervention strategy can include not engaging in strenuous physical activity at work or not exercising strenuously on days when ambient air pollution levels are higher.

Use of these and other best practices should contribute to lowering indoor air pollution.

Decrease Indoor Temperature

To the extent that higher temperatures (and higher temperature change from personal baseline) adversely contribute to increases in respiratory-cardiovascular-cerebrovascular hospital events, lowering room temperature in the workspace can be included as part of the organization specific intervention strategy. For example, access to air conditioning is one way to avoid personal exposure to extreme ambient temperature on hotter days.

Weight Loss

Losing weight through a structured program of increased energy expenditure and decreased caloric intake is one intervention method that can make it possible for persons to mitigate some of the risk factors that contribute to increases in chronic disease hospital events on days when both ambient air pollution and ambient temperature are higher.

Asthma Management

Another intervention procedure is to utilize media sources to inform persons with asthma how to manage this respiratory chronic disease on days when ambient air pollution is elevated. Organization public service announcements can be made on warmer days so that persons with asthma are aware that higher ambient temperature can be a risk factor for the future occurrence of an asthma attack, followed by a required visit to the emergency department, a health care provider, or the necessity of taking a sick day from work.