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The Public Health Impact of Air Quality Regulations Through Change in Ambient PM2.5

*Chanmin Kim, Harvard T.H. Chan School of Public Health 
Corwin Zigler, Harvard School of Public Health 
Christine Choirat, Harvard University 

Keywords: Air quality regulations, PM2.5, Ambient air quality, Public health conditions

Pollutant emissions from coal-burning power plants have been deemed to adversely affect ambient air quality and public health conditions. Over the last few decades, many air quality control strategies targeting emissions have been adopted at power plants, which cost billions of dollars. Despite noticeable reduction in emissions and the improvement of air quality since the U.S. Environmental Protection Agency (EPA) set the Clean Air Act (CAA), the public health benefits from specific control strategies have not been widely studied. In terms of the chain of accountability, the link between air quality regulations and public health conditions with counting for changes in emissions and ambient air quality, we provide the first epidemiological assessment of the health effect of a specific regulatory decision mediated through change in ambient air quality. Specifically, we pursue the link from SO2 scrubber installation status at smoke stacks (intervention) to ambient PM2.5 measured at nearby monitors (intermediate variable) and from ambient PM2.5 to rates of cardiovascular---and respiratory-related hospitalizations (outcomes).