Loading...
HomeMy WebLinkAboutAgenda Report - February 16, 2005 I-01 PHAGENDA ITEM 14 CITY OF LODI ,. COUNCIL COMMUNICATION TM AGENDA TITLE: Continued public hearing to consider appeal filed on 12113104 by Timothy Cremin of the firm Steefel, Levitt 8 Weiss to the Planning Commission decision on 12/08/04 regarding two conditions: 1)Condition R of the use permit and tentative map approval resolution requiring signed leases for 50% of the existing Wal-Mart store before a building permit is issued for the new Supercenterand prohibits tenant restrictions; and 2) Condition EE requiring the project developer to fund the commercial linkage fee nexus study under Program 11 of the Housing Element and pay any adopted fees MEETING DATE: February 16,2005 PREPARED BY: Community Development Director RECOMMENDED ACTION: That the City Council adopt the revised Resolution modifying Conditions R and EE as outlined in this staff report. BACKGROUND INFORMATION: As the Council is aware, this item was continued from the Special meeting held on February 3,2005 with specific direction given to staff to negotiate a revised Condition R. The City Attorney and Community Development Director have discussed several different options for this condition with the project proponent and appellant and have agreed on the following language for Condition R: Prior to the issuance of a building permit for the new Wal-Mart Supercenter, the applicant shall ensure one of the following with respect to the existing Wal-Mart building located at 2350 West Kettleman Lane ("Building"): a) The owner of the Building shall have entered into signed lease(s) with bona -fide tenant(s) for at least 50% of the Building square footage (not including the fenced, outdoor garden center). The signed lease(s) required hereunder shall include a lease(s) with a bona -fide retailer(s) or restaurant for a minimum of two-thirds of the Building frontage (not including the fenced, outdoor garden center); or b) The owner of the Building shall have entered into a fully executed purchase agreement for the Building with a bona -fide retailer; or APPROVED: J `' Blair King, City Manager Council Communication February 16,2005 Page 2 c) The Applicant shall present to the City a cash escrow account, subject to the approval of the City Attorney, which account shall be for the purpose of securing applicant's obligation to demolish the Building not later than 90 days after the opening to the general public of the new Wal-Mart Supercenter (the "Opening Date"). The amount of the deposit shall be equal to the City estimated reasonable costs to demolish the Building (based on a licensed contractor estimate) plus $100,000. The escrow account shall be paid to City in the event that Option (a), (b) or (c) is not satisfied within 90 days of the Opening Date. If Option (a), (b) or (c) is satisfied within 90 days after the Opening Date, the cash in the escrow account shall be refunded in full to the Applicant. If the Applicant does not satisfy this condition under Option (a), (b) or (c) within 90 days after the Opening Date, the City shall use the funds to demolish the Building with any balance reverting to the City as compensation for its expense and inconvenience incurred to demolish the Building. The owner of the Building shall present evidence that any lender on the Building consents to the demolition in a form subject to the approval of the City Attorney. This condition shall be recorded against the property as a deed restriction, which runs with the land. Applicant and Wal-Mart agree to enter into any agreements that are necessary in order to implement this condition. We feel this new language meets the intent of the Planning Commission action while providing some additional flexibility to the applicant in finding new tenant(s) for the space. With respect to Condition EE, staff is recommending that the condition be modified slightly. The change in this condition provides for the reimbursement of costs that might occur beyond what the ultimate fee would require. With this change, the condition will be more akin to the way in which the City does business regarding other fee payment. The end result will still require the applicant to pay for the entire nexus study. The amount paid will be credited against the final fee amount decided by the City Council. Any additional amount paid by the applicant for the study will be reimbursed out of program proceeds. The applicant and appellant are in concurrence with the revision. The condition would now read as follows: Developer shall pay for the linkage study that the City is required to do based on Program 11 of the recently adopted Housing Element of the General Plan. The developer shall receive a credit for the amount paid against the final fee as adopted by the City Council. FUNDING: :( i ; Konr Bartlam Community Development Director KB/1w cc: City Attorney RESOLUTION NO. 2005-38 A RESOLUTION OF THE LODI CITY COUNCIL APPROVING USE PERMIT FILE NO. U-02-12, TO ALLOW THE CONSTRUCTION OF A COMMERCIAL SHOPPING CENTER I N THE C -S ZONE AND SALE OF ALCOHOLIC BEVERAGESAT THE WAL-MART SUPERCENTER, AND TENTATIVE PARCEL MAP 03-P-001, TO CREATE 12 PARCELS FOR THE PROJECT RELATING TO THE LODI SHOPPING CENTER WHEREAS, an application was filed by Browman Development Company for a commercial shopping center at 2640 W. Kettleman Lane more particularly described as Assessor's Parcel Numbers 058-030-08 and 058-030-02 and portion of 058-030-09; and WHEREAS, the application's are for the following approvals: Use Permits for the construction of commercial structures as required by the C -S Commercial Shopping District and for the sale of alcoholic beverages, as well as a Parcel map to create 12 parcels for the project; and WHEREAS, the Planning Commission of the City of Lodi has reviewed and considered the Final Environmental Impact Report prepared on the Lodi Shopping Center; and WHEREAS, the Planning Commission of the City of Lodi, after more than ten (10) days published notice, held a public hearing before said Commission on December 8,2004; and WHEREAS, the Lodi City Council has reviewed and considered the approval of Use Permit File No. U-02-12, to allow the construction of a commercial shopping center in the C -S Zone and sale of alcoholic beverages at the Wal-Mart Supercenter, and tentative parcel map 03-P-001, to create 12 parcels for the project relating to the Lodi Shopping Center; and WHEREAS, the project is consistent with all elements of the General Plan. In particular, the following Goals and Policies: A Land Use and Growth Management Element, Goal E, "To provide adequate land and support for the development of commercial uses providing goods and services to Lodi residents and Lodi's market share." B. Land Use and Growth Management Element, Goal E, Policy 7,"In approving new commercial projects, the City shall seek to ensure that such projects reflect the City's concern for achieving and maintaining high quality." C. Land Use and Growth Management Element, Goal E, Policy 3, "The City shall encourage new large-scale commercial centers to be located along major arterials and at the intersections of major arterials and freeways." D. Housing Element, Goal C, "To ensure the provision of adequate public facilities and services to support existing and future residential development". E. Circulation Element, Goal G, "To encourage a reduction in regional vehicle miles traveled." \\Cvcadc01 \admin\Co\CITY\RES\Res 2005\9992005-36.doc F. Circulation Element, Goal A, Policy 1, "The City shall strive to maintain Level of Service C on local streets and intersections. The acceptable level of service goal will be consistent with financial resources available and the limits of technical feasibility." G. Noise Element, Goal A, "To ensure that City residents are protected from excessive noise." H. Conservation Element, Goal C, Policy 1, "The City shall ensure, in approving urban development near existing agricultural lands, that such development will not constrain agricultural practices or adversely affect the economic viability of adjacent agricultural practices." I. Health and Safety Element, Goals A, B, C, and D, "To prevent loss of lives, injury and property damage due to flooding." "To prevent loss of lives, injury, and property damage due to the collapse of buildings and critical facilities and to prevent disruption of essential services in the event of an earthquake." "To prevent loss of lives, injury, and property damage due to urban fires." "To prevent crime and promote the personal security of Lodi residents." J. Urban Design and Cultural resources, Goal C, `To maintain and enhance the aesthetic quality of major streets and public/civic areas." WHEREAS, the design and improvement of the site is consistent with all applicable standards adopted by the City. Specifically, the project has met the requirements of the Lodi Zoning Ordinance with particular emphasis on the standards for large retail establishments; and WHEREAS, the design of the proposed project and type of improvements are not likely to cause public health or safety problems in that all improvements will be constructed to the City of Lodi standards; and WHEREAS, these findings, as well as the findings made within Resolution No. P.C. 04-64 certifying Final Environmental Impact Report EIR-03-01, are supported by substantial evidence in the record of this proceeding and before this body. NOW, THEREFORE, BE IT RESOLVED, DETERMINED, AND ORDERED as follows: 1. The foregoing recitals are true and correct. 2. Said Tentative Parcel Map complies with the requirements of the City Subdivision Ordinance, and the Subdivision Map Act. 3. Said Site Plan complies with the requirements of the Commercial Shopping (C- S) Zoning District. 4. The submitted plans, including site plot plan and architectural elevations for the major anchor building, for the project is approved subject to the following conditions. A. The approval of the Use Permit expires within 24 months from the date of this Resolution. Should any litigation be filed regarding this project, the time limit shown shall be tolled during the pendency of the litigation. Parcel Map \ \Cvcadc01 \odmin \Ca \CITY\RES\ Res 2005\Pes2005-38.doc 2 conforming to this conditionally approved Tentative Parcel Map shall be filed with the City Council in time so that the Council may approve said map before its expiration, unless prior to that date, the Planning Commission or City Council subsequently grants a time extension for the filing of the final map, as provided for in the City's Subdivision Ordinance and the Subdivision Map Act. It is the developer's responsibility to track the expiration date. Failure to request an extension will result in a refilling of the Tentative Parcel Map and new review processing of the map. B. Prior to submittal of any further plan check or within 90 days of the approval of this project, whichever occurs first, the applicant shall sign a notarized affidavit stating that "I (we), , the owner(s) or the owner's representative have read, understand, and agree to implement all mitigation measures identified in the Final Environmental Impact Report for the Lodi Shopping Center and the conditions of the Planning Commission approving U-02-12 and 03-P-001." Immediately following this statement will appear a signature block for the owner or the owner's representative, which shall be signed. Signature blocks for the Community Development Director and City Engineer shall also appear on this page. The affidavit shall be approved by the City prior to any improvement plan or final map submittal. C. Prior to issuance of any building permit on the site, each building shall be reviewed by the Site Plan and Architectural Review Committee for consistency with this resolution as well as all applicable standards of the City. D. All applications for Site Plan and Architectural Review Committee consideration shall comply with the following conditions: 1. All buildings shall meet the required setbacks for the C -S zoning district. All buildings shall implement building elements and materials illustrated on the submitted elevation or otherwise consistent with the architectural theme presented on the submitted elevation of the majortenant building. 2. Submit a construction landscape plan consistent with the submitted conceptual landscape plan. The applicant shall also insure that the overall ratio of trees, including perimeter landscaping is equal to one tree for every four parking spaces. Further, said plan shall demonstrate that the City's requirement for parking lot shading is met. 3. The applicant shall select and note on all plans common tree species for the parking lot and perimeter areas from the list of large trees as identified in the Local Government Commission's "Tree Guidelinesfor the San Joaquin Valley". 4. All drive-through eating facilities shall have a "double service window" configuration and pullout lane to minimize auto emissions. 5. Cart corrals shall to be provided in the parking lot adjacent to Wal- Mart and distributed evenly throughout the lots rather than concentrated along the main drive aisle. In addition, a cart corral \\Cvcadc01 \admin\Ca1CITY\RES\Res 2005\Res2005-38.doc shall be provided as close as possible to the two bus stop/shelters provided on-site. Further, cart corrals shall be permanent with a design that is consistent with the theme of the center. Portable metal corrals shall be prohibited. 6. Trash enclosures shall be designed to accommodate separate facilities for trash and recyclable materials. Trash enclosures having connections to the wastewater system shall install a sand/grease trap conforming to Standard Plan 205 and shall be covered. 7. Hardscape items, including tables, benches/seats, trashcans, bike racks, drinking fountains, etc. shall be uniform for all stores throughout the shopping center. 8. All signage shall be in compliance with a detailed Sign Program that shall be submitted to SPARC for review and approval with the first building plan review. 9. Said program shall require all signs to be individual channel letter at the standards provided by the zoning ordinance. 10. Any bollards installed in a storefront location shall be decorative in style and consistent with the theme of the shopping center. Plain concrete bollards, or concrete filled steel pipe bollards shall not be permitted. E. All landscaped area shall be kept free from weeds and debris, maintained in a healthy growing condition and shall receive regular pruning, fertilizing, mowing, and trimming. Unhealthy, dead, or damaged plant materialsshall be removed and replaced within 30 days following written notice from the Community Development Director. F. The following items are conditions of approval for the vesting tentative parcel map, all to be accomplished prior to, or concurrent with, final parcel map filing unless noted otherwise: 1. Dedication of street right-of-way as shown on the parcel map with the following changes/additions: a) Street right-of-way dedications on Westgate Drive shall be in conformance with the traffic study for the project and City of Lodi requirements and shall be consistent with the West Side Facility Master Plan. The north and south legs of Westgate Drive must be in alignment through the intersection at Kettleman Lane. Construction of full width street improvements to and including the west curb and gutter is required. Acquisition of additional right-of- way from adjacent parcels to the west is the responsibility of the developer and must be supplied prior to recordation of any final parcel map. In the event the developer is unable to acquire the additional right-of-way from adjacent property owners, the project site plan and proposed parcel boundaries shall be modified to provide the required street right-of-way dedications within the boundaries of the map. \ \ CvcadcO 1 \admin \Ca \CITY\ RES \ Res 2005\Res2005-38.doc 4 b) Right-of-way dedications on Lower Sacramento Road and Kettleman Lane shall be in conformance with the project traffic study and City of Lodi street geometric requirements for this project and to the approval of the Public Works Department and Caltrans. The right-of-way width and lane geometry for Kettleman Lane need to be compatible with the improvement plans prepared by Mark Thomas & Company for the Vintner's Square Shopping Center on the north side of Kettleman Lane. Right-of-way dedications on Kettleman Lane shall be made to Caltrans in conformance with their requirements. Separate parcels shall be created for Caltrans dedications. It should be anticipated that Caltrans will require street widening improvements west of the project boundary. Acquisition of any right-of-way necessary to meet Caltrans requirements shall be the responsibility of the developer. c) Lower Sacramento Road is an established STAA route and turning movements to and from the roadway into private driveways and intersecting streets are required to demonstrate that accommodation has been made for the truck turning movement in conformance with Public Works requirements. At the signalized intersection and the driveway immediately north, the right-of-way dedications and driveway design shall provide for 60 -foot radius truck turning movements as set forth in the Caltrans Highway Design Manual. d) The right-of-way dedication and driveway design at the south project driveway on Lower Sacramento Road shall accommodate and be in conformance with the California Semitrailer wheel track (18m/60ft radius) turning template. e) Right-of-way dedications at all proposed project driveway locations shall be sufficient to accommodate the handicap ramps and public sidewalks at the crosswalk locations. In addition, the right-of-way dedication at the proposed traffic signal location on Lower Sacramento Road shall be sufficient to allow installation of the traffic signal improvements with in the public right-of-way. 2. Dedication of public utility easements as required by the various utility companies and the City of Lodi, including, but not limited to, the following: a) An existing public utility easement (PUE) lies within the proposed Westgate Drive right-of-way. The existing PUE shall be abandoned and an equal replacement PUE conforming to City of Lodi requirements shall be provided immediately adjacent to and west of the west right-of-way line of Westgate Drive. Acquisition of the replacement PUE from adjacent parcels to the west is the responsibility of the developer and must be accomplished prior to recordation of any final parcel map. In the event the developer is unable to acquire the replacement PUE from adjacent property owners, the project site plan and proposed parcel boundaries shall be modified to provide the required PUE dedications within the boundariesof the map. \ \Cvcodc01\admin\Ca\CiTY\RES\ Res 2005\Res2005-38.doc 5 b) A PUE along the southerly property line sufficient to accommodate the installation of electric utility overhead transmission lines and underground conduit bank outside proposed landscape areas, and the extension of water, wastewater and industrial waste transmission lines between Lower Sacramento Road and Westgate Drive. We anticipate the required PUE along the south project boundarywill be on the order of 65 to 75 feet. It may be possibleto reduce the width of the PUE by realigning some of the pipes through the shopping center site. The actual alignment and width will be to the approval of the Public Works Department and City of Lodi Electric Utility. c) A PUE at the proposed signalized project driveway to accommodate the installation of traffic signal loops. d) A PUE at the existing southerly Sunwest Plaza (Food 4 Less) driveway to accommodate the installation of traffic signal loops. Acquisition of the PUE is the responsibility of the developer and must be accomplished prior to recordation of any final parcel map. 3. In order to assist the City in providing an adequate water supply, the property owner is required to enter into an agreement with the City that the City of Lodi be appointed as its agent for the exercise of any and all overlying water rights appurtenant to the proposed Lodi Shopping Center, and that the City may charge fees for the delivery of such water in accordance with City rate policies. The agreement establishes conditions and covenants running with the land for all lots in the parcel map and provides deed provisionsto be included in each conveyance. Submit final map per City requirements including the following: a) Preliminary title report. b) Standard note regarding requirements to be met at subsequent date. 4. Payment of the following: a) Filing and processing fees and charges for services performed by City forces per the Public Works Fee and Service Charge Schedule. G. The following items are conditions of approval for the vesting tentative parcel map and use permitthat will be deferred until the time of development: 1 _ Engineering and preparation of improvement plans and estimate per City Public Improvement Design Standards for all public improvements for all parcels at the time of development of the first parcel. Plansto include: a) Detailed utility master plans and design calculations for all phases of the development, including the proposed temporary storm drainage detention basin. Detailed utility master plans have not been developed for the area between Kettleman Lane on the north, Harney Lane on the south, Lower Sacramento Road on the east and the current General Plan boundary on the west. The project site is at the upstream boundary of the storm drain and wastewater utilities for this area. The developer's engineer shall provide \ \Cvcadcal \admin\Ca\CITY\RES\Res 2005\Res2005-38.doc 6 detailed drainage master plans, including engineering calculations, for the entire area as well as all phases of the proposed project. City staff will assist in this process to the extent practicable. Should City staff be unable to meet developer's schedule, developer shall have the option to pay the City to contract for supplemental outside consultant services to expedite review and approval of the master planning work. b) Current soils report. If the soils report was not issued within the past three (3) years, provide an updated soils report from a licensed geotechnical engineer. c) Grading, drainage and erosion control plan. d) Copy of Notice of Intent for NPDES permit, including storm water pollution prevention plan (SWPPP). e) All utilities, including street lights and electrical, gas, telephone and cable television facilities. f) Landscaping and irrigation plans for street medians and parkway areas in the public right-of-way. g) Undergrounding of existing overhead utilities, excluding transmission lines. h) Installation of the proposed traffic signal at the main project driveway on Lower Sacramento Road. The traffic signal shall be designed to operate as an eight phase signal. i) Modification of the existing southerly Sunwest Plaza (Food 4 Less) driveway to widen the driveway to the south as shown on the site plan and construct a driveway return comparable to the existing driveway return. j) Installation/modification of the traffic signal at the Kettleman Lane/Westgate Drive intersection as required by the project. k) Traffic striping for Lower Sacramento Road, Westgate Drive and Kettleman Lane. A complete plan check submittal package including all the items listed above plus engineering plan check fees is required to initiate the Public Works Department plan review process for the engineered improvement plans. 2. There is limited wastewater capacity in the wastewater main in Lower Sacramento Road. The area of the shopping center site containing the proposed Wal-Mart store lies outside the service area for the Lower Sacramento Road wastewater line. Developer shall perform a capacity analysis using flow monitoring protocols to assess the viability of utilizing the Lower Sacramento Road wastewater line on an interim basis. Wastewater facilities outside the Lower Sacramento Road service area shall be designed to allow future connection to the wastewater main in Westgate Drive. If the capacity analysis indicates that interim capacity in the Lower Sacramento Road wastewater line is not availabte, master plan wastewater facilities shall be constructed to serve the project. \\CvcadcO1 \admin\Ca\CITY\RES\Res 2005\Res2U05-38.doc 7 3. Installation of all public utilities and street improvements in conformance including, but not limited to, the following: a) Installation of all curb, gutter, sidewalk, traffic signal and appurtenant facilities, traffic control or other regulatory/street signs, street lights, medians and landscaping and irrigation systems. All improvements on Kettleman Lane shall be in conformance with City of Lodi and Caltrans requirements and require Caltrans approval. Additional right-of-way acquisition outside the limits of the map may be required and shall be the responsibilityof the developer. b) The extension/installation of all public utilities, including, but not limited to, the extension of master plan water, wastewater, storm drainage and reclaimed water mains to the south end of Westgate Drive and the extension of water, wastewater and industrial waste transmission lines through the shopping center site from Lower Sacramento Road to Westgate Drive. The developer's engineer shall work with Public Works Department staff to resolve public utility design issues. C) Relocation of existing utilities, as necessary, and undergrounding of existing overhead lines, excluding electric (64 kv) transmission lines. d) Storm drainage design and construction shall be in compliance with applicable terms and conditions of the City's Stormwater Management Plan (SMP) approved by the City Council on March 5, 2003, and shall employ the Best Management Practices (BMPs) identified in the SMP. If bioswales are to be used, they need to be clearly delineated and detailed on the site plan and the landscape plan. Most trees are not compatible with bioswales. e) The lane configuration for Westgate Drive shall be consistent with the West Side Facility Master Plan. The street improvements will include a landscaped median and parkways. Improvements on Westgate Drive shall extend to and include the installation of the westerly curb and gutter. Acquisition of street, public utility and construction easements from the adjoining property may be necessary to allow this construction and shall be the responsibility of the developer. Street improvements for Westgate Drive shall be constructed from the signalized intersection on Kettleman Lane to the south boundaryof the parcel map. Modification of the existing southerly Sunwest Plaza (Food 4 Less) driveway in conformance with the California Semitrailer wheel track (18m/60ft radius) turning template to accommodate northbound right turns. Acquisition of additional right-of-way and construction easements from the adjacent property to the south may be necessary to accomplish this work and shall be the responsibility of the developer. All public improvements to be installed under the terms of an improvement agreement to be approved by the City Council prior to development of the first parcel. \ \CvcodcOl \ admin \Ca\CITY\RES\Res 2005\Qes2005-38.doc 4. The proposed temporary storm drainage basin shall be designed in conformance with City of Lodi Design Standards §3.700 and must be approved by the City Council. Acquisition of property to accommodate the construction of the temporary drainage basin is the responsibility of the developer. All drainage improvements shall be designed for future connection to permanent public drainage facilities when they become available. If a temporary outlet from the drainage basin to the public storm drain system in Lower Sacramento Road is desired, developer's engineer shall contact the Public Works Department to coordinate this work with the City's Lower Sacramento Road Widening Project. 5. A Caltrans encroachment permit is required for all work in the Kettleman Lane right-of-way, including landscape and irrigation improvements in the median and parkway along the site frontage. Based on past experience, Caltrans will only allow landscape and irrigation improvements within their right-of-way if the City enters into an agreement with Caltrans covering maintenance responsibilitiesfor those improvements. The City is willing to execute such an agreement, however, the developer will be required to execute a similar landscape maintenance agreement with the City assuming the city's responsibilities for the landscape and irrigation improvements in the parkways. The City will accept maintenance responsibilities for all landscape and irrigation improvements in the median. 6. Design and installation of public improvements to be in accordance with City master plans and the detailed utility master plans as previously referenced above. Note that the developer may be eligible for reimbursementfrom others for the cost of certain improvements. It is the developer's responsibility to request reimbursement and submit the appropriate information per the Lodi Municipal Code (LMC) §16.40. 7. Parcels 1 through 12 are zoned C -S to allow development of a commercial shopping center. The following improvements shall be constructed with the development of the first parcel zoned for commercial development: a) Installation of all street improvements on Lower Sacramento Road, Kettleman Lane and Westgate Drive. Street improvementsfor Lower Sacramento Road and Westgate Drive shall be constructed from the signalized intersections on Kettleman Lane to the south boundary of the parcel map. Street improvements along the frontages of Parcels 1, 12 and "A shall extend to and include the installation of the westerly curb and gutter. b) Modification of the existing southerly Sunwest Plaza (Food 4 Less) driveway in conformance with the California Semitrailer wheel track (18m/60ft radius) turning template to accommodate northbound right turns. c) The extension/installation of all public utilities necessary to serve the commercial development and/or required as a condition of development. \1CvcadcOl \admin\Ca\CITY\RES\Res 2005\Res2005-38.doc 9 d) Temporary storm drainage detention basin to serve the project. 8. Acquisition of street right-of-way, public utility easements and/or construction easements outside the limits of the map to allow the installation of required improvements on Kettleman Lane, Lower Sacramento Road and Westgate Drive. 9. Abandonment/removal of wells, septic systems and underground tanks in conformance with applicable City and County requirements and codes prior to approval of public improvement plans. Payment of the following: a) Filing and processing fees and charges for services performed by City forces per the Public Works Fee and Service Charge Schedule. b) Development Impact Mitigation Fees per the Public Works Fee and Service Charge Schedule at the time of payment and as provided by Resolution 2004-238 adopted by the City Council on November 3, 2004. c) Wastewater capacityfee at building permit issuance. d) Reimbursement fees per existing agreements: I. Reimbursement Agreement RA -02-02. The reimbursement fee for 2004 is $32,307.78. The fee is adjusted annually on January 1. The fee to be paid will be that in effect at the time of payment. II. The Vintner's Square shopping center on the north side of Kettleman Lane is currently under construction. We anticipate that the developer of the Vintner's Square project will submit a request for reimbursement in conformance with LMC 16.40 Reimbursements for Construction covering public improvements in Kettleman Lane and Westgate Drive constructed with that development which benefit the Lodi Shopping Center project when the Vintner's Square improvements are complete. Upon submittal, the reimbursement agreement will be prepared by City staff and presented to the City Council for approval. Any reimbursement fees approved by the City Council that affect the Lodi Shopping Center site will have to be paid in conjunction with the development of the first parcel. e) Reimbursement to the City for the installation and/or design costs for the following improvements to be included in City's Lower Sacramento Road project: I. Installation of 10 -inch water main and storm drain lines, including appurtenant facilities, in Lower Sacramento Road in conformance with LMC 516.40 Reimbursements for Construction. II. Water, wastewater and storm drain stubs to serve the shopping center project. III. Any other costs associated with changes/additions necessary to accommodate the Lodi Shopping Center project, including, but not limited to, any utility alignment changes for public utilities to be \ \CvcadcOl \admin\Ca\CIiY\RES\Res 2005\Qes2405-38.doc 10 extended through the site and the proposed dual northbound left turn lanes and conduit crossings for the traffic signal improvements at the main shopping center driveway. f) The project shall contribute its fair share cost to the installation of a permanent traffic signal at Lower Sacramento Road and Harney Lane. Until the intersection improvements are made and traffic signals are installed, the project applicant shall contribute its fair share cost for the installation of a temporary traffic signal with left -turn pockets on all four approaches to the Lower Sacramento Road/ Harney Lane intersection. The above fees are subject to periodic adjustment as provided by the implementing ordinance/resolution. The fee charged will be that in effect at the time of collection indicated above. 10. Obtain the following permits: a) San Joaquin County well/septic abandonment permit. b) Caltrans Encroachment Permit for work in Caltrans right-of-way. 11. The City will participate in the cost of the following improvements in conformance with LMC§16.40 Reimbursements for Construction: a) Master plan storm drain lines. b) Master plan water mains. c) Master plan reclaimed water mains d) Industrialwaste Please note that construction of master plan wastewater facilities to serve the project site is not included in the City's Development Impact Mitigation Fee Program and is not subject to impact mitigation fee credits for sewer facilities or reimbursement by the City. H. Install fire hydrants at locations approved by the Fire Marshal. I. Shopping carts shall be stored inside the buildings or stored in a cart storage area adjacent to the entrance of the building. J. No outdoor storage or display of merchandise shall be permitted at the project unless a specific plan for such display is approved by SPARC. At no time shall outdoor storage or display be allowed within the parking area, drive aisle or required sidewalks of the center. K. Vending machines, video games, amusement games, children's rides, recycling machines, vendor carts or similar items shall be prohibited in the outside area of all storefronts. The storefront placement of public telephones, drinking fountains and ATM machines shall be permitted subject to the review and approval of the Community Development Director. L. All storage of cardboard bales and pallets shall be contained within the area designated at the rear of the Wal-Mart building for such use. No storage of cardboard or pallets may exceed the height of the masonry enclosure at any time. \ \Cvcadc01 \admin \ Ca\ CITY \ RES \ Res 2005 \ Res200.5-38.doc 11 M. The loading area shown in front of the Wal-Mart building shall be stripped and posted with "NO PARKING — LOADING ONLY" signs to the satisfaction of the Community Development Director. N. A photometric exterior lighting plan and fixture specification shall be submitted for review and approval of the Community development Director prior to the issuance of any building permit. Said plans and specification shall address the following: 1. All project lighting shall be confined to the premises. No spillover beyond the property line is permitted. 2. The equivalent of one (1) foot-candle of illumination shall be maintained throughout the parking area. O. Exterior lighting fixtures on the face of the buildings shall be consistent with the theme of the center. No wallpacks or other floodlights shall be permitted. All building mounted lighting shall have a 90 -degree horizontal flat cut-off lens unless the fixture is for decorative purposes. P. All parking light fixtures shall be a maximum of 25 feet in height. All fixtures shall be consistent throughout the center. Q. All construction activity shall be limited to the hours of 7:00 a.m. to 6:00 p.m. Monday through Saturday. No exterior construction activity is permitted on Sundays or legal holidays. R. Prior to the issuance of a building permit for the new Wal-Mart Supercenter, the applicant shall ensure one of the following with respect to the existing Wal-Mart building located at 2350 West Kettleman Lane ("Building"): a) The owner of the Building shall have entered into signed lease(s) with bona -fide tenant(s) for at least 50% of the Building square footage (not including the fenced, outdoor garden center). The signed lease(s) required hereunder shall include a lease(s) with a bona -fide retailer(s) or restaurant for a minimum of two-thirds of the Building frontage (not includingthe fenced, outdoor garden center); or b) The owner of the Building shall have entered into a fully executed purchase agreement for the Building with a bona -fide retailer; or c) The Applicant shall present to the City a cash escrow account, subject to the approval of the City Attorney, which account shall be for the purpose of securing applicant's obligation to demolish the Building not later than 90 days after the opening to the general public of the new Wal-Mart Supercenter (the "Opening Date"). The amount of the deposit shall be equal to the City estimated reasonable costs to demolish the Building (based on a licensed contractor estimate) plus $100,000. The escrow account shall be paid to City in the event that Option (a), (b) or (c) is not satisfied within 90 days of the Opening Date. If Option (a), (b) or (c) is satisfied within 90 days after the Opening Date, the cash in the escrow account shall be refunded in full to the Applicant. \ \Cvcadc0l \admin\Ca\CETY\RES\Res 2905\Res2005-38.doc 12 If the Applicant does not satisfy this condition under Option (a), (b) or (c) within 90 days after the Opening Date, the City shall use the funds to demolish the Building with any balance reverting to the City as compensation for its expense and inconvenience incurred to demolish the Building. The owner of the Building shall present evidence that any lender on the Building consents to the demolition in a form subject to the approval of the City Attorney. This condition shall be recorded against the property as a deed restriction, which runs with the land. Applicant and Wal-Mart agree to enter into any agreements that are necessary in order to implement this condition. S. No materials within the garden or seasonal sales area shall be stored higher than the screen provided. T. Wal-Mart shall operate and abide by the conditions of the State of California Alcoholic Beverage Control license Type 21, off sale -general. U. Wal-Mart shall insure that the sale of beer and wine does not cause any condition that will result in repeated activities that are harmful to the health, peace or safety of persons residing or working in the surrounding area. This includes, but is not limited to: disturbances of the peace, illegal drug activity, public drunkenness, drinking in public, harassment of passerby, assaults, batteries, acts of vandalism, loitering, illegal parking, excessive or loud noise, traffic violations, lewd conduct, or police detention and arrests. V. This Use Permit is subject to periodic review to monitor potential problems associated to the sale of alcoholic beverages. W. Prior to the issuance of a Type 21 license by the State of California Alcoholic Beverage Control Department, the management of the Wal-Mart store shall complete the Licensee Education on Alcohol and Drugs (LEAD) as provided by the State Alcoholic Beverage Control Department. In the event that Wal- Mart has training that is equivalent to the LEAD program, such documentation shall be submitted to the Community Development Director for review and approval. X. The project shall incorporate all mitigation measures as specified in the adopted Final Environmental Impact Report EIR-03-01 for the project. Y. The submitted Use Permit, Parcel Map and associated plot plan are hereby approved subject to the conditions set forth in this resolution. Z. No variance from any City of Lodi adopted code; policy or specification is granted or implied by the approval of this Resolution. AA. The sliding gates that are shown in the rear of the Wal-Mart building shall have a knox box system at each gate for Fire Department access. BB. Buildings, which are fire sprinkled, shall have Fire Department connections within 50 feet of a fire hydrant, subject to the Fire Marshall's approval. CC. Fire lanes shall be identified per Lodi Municipal Code 10.40.100 and marked in locations specified by the Fire Marshall. All fire lanes shall be a minimum of 24 -foot -wide. \\Cvcadc01 \admin\Ca\CIN\RE5\Res 2005NRes2005-38.doc 13 DD. The water supply for the project shall meet the requirementsfor fire hydrants and fire sprinkler demand and system approved by the Fire Marshall. EE. Developer shall pay for the linkage study that the City is required to do based on Program 11 of the recently adopted Housing Element of the General Plan. The developer shall receive a credit for the amount paid against the final fee as adopted by the City Council. FF. Wal-Mart shall provide proof of sale, to a non Wal-Mart related entity, of the existing Wal-Mart property located at 2350 W. Kettleman Lane prior to the issuance of the building permitfor the new Wal-Mart Supercenter without condition on the right of purchaserto lease or sell the existing Wal-Mart building. 5. The City Council certifies that a copy of this Resolution, and Final Environmental Impact Report are kept on file with the City of Lodi Community Development Department, 221 West Pine Street, Lodi, CA 95240. Dated: February 16, 2005 hereby certify that Resolution No. 2005-38 was passed and adopted by the City Council of the City of Lodi in a regular meeting held February 16, 2005, by the following vote: AYES: COUNCIL MEMBERS— Hansen, Hitchcock, Johnson, and Mounce NOES: COUNCIL MEMBERS — None ABSENT: COUNCIL MEMBERS— None ABSTAIN: COUNCIL MEMBERS — Mayor Beckman SUSAN I BLACKSTON City Clerk \\Cvcadc01 \admin\Ca\CITY\RES\Res 2005\Res2005-38.doc 14 CITY COUNCIL JOHN BECKMAN, Mayor CITY OF L O D I SUSAN HITCHCOCK, Mayor Pro Tempore CITY HALL, 221 WEST PINE STREET LARRY 0. HANSEN P.O. BOX 3006 BOB JOHNSON LOOT. CALIFORNIA 95241-1910 JOANNE MOUNCE (209) 333-6702 FAX (209) 333-6807 cilycirk@lodi.gov February 7, 2005 Steefel, Levitt & Weiss Timothy Cremin One Embarcadero Center, 301' Floor San Francisco, CA 94111-3719 NOTICE OF CONTINUED PUBLIC HEARING— February 16.2005 BLAIR KING, City Manager SUSAN J. BLACKSTON City Clerk O. STEPHEN SCHWABAUER City Allorney This letter is to notify you that the February 3, 2005 public hearing to consider your appeal of the Planning Commission decision on 12/08/04 regarding two conditions: 1) Condition R of the use permit and tentative map approval resolution requiring signed leases for 50% of the existing Wal-Mart store before a building permit is issued for the new Supercenter and prohibits tenant restrictions; and 2) Condition requiring the project developer to fund the commercial linkage fee nexus study under Program 11 of the Housing Element and pay any adopted fees has been continued to Wednesday, February 16, 2005, at 7:00 p.m., or as soon thereafter as the matter can be heard, at the Carnegie Forum, 305 W. Pine Street. Lodi. If you challenge the proposed action in court, you may be limited to raising only those issues you or someone else raised at the public hearing described in this notice, or in written correspondence delivered to the City Council at, or prior to, the public hearing. Note: Written correspondence for the City Council maybe mailed in clothe City Clerk's Office, P.O. Box 3006, Lodi, CA 95241-1910, or delivered to the City Clerk at 221 West Pine Street, Lodi, California. Should you have any questions, please contact my office or Community Development Director Konradt Bartlam at (209) 333-6711. Susan J. Blackston City Clerk cc: Community Development Director NOTICE OF CONTINUED PUBLIC HEARING CITY COUNCIL CITY OF LODI NOTICE IS HEREBY GIVEN that the February3,2005, public hearing of the City Council of the City of Lodi to consider appeal filed on 12/13/04 by Timothy Cremin of the firm Steefel, Levitt & Weiss to the Planning Commission decision on 12/08/04 regarding two conditions: 1) Condition R of the use permit and tentative map approval resolution requiring signed leases for 50% of the existing Wal-Mart store before a building permit is issued for the new Supercenter and prohibits tenant restrictions; and 2) Condition requiring the project developer to fund the commercial linkage fee nexus study under Program 11 of the Housing Element and pay any adopted fees has been continued to February 16,2005 at the hour of 7:00 p.m. in the Council Chamber, Carnegie Forum, 305 W. Pine Street, Lodi, California. Posted February 4, 2005 AIL A r SAN J BLACKSTON _, CITY CLERK Of the -City of Lodi +-IC- RLIM February 16,2005 Lodi City Council City of Lodi City Hall 21 West Pine Street Lodi, California 95241 VIA HAND DELIVERY Re: Additional Documents Related to Lodi Wal-Mart Supercenter Dear Honorable Members of the Lodi City Council: 1-i 2-E(6-ems L --Ovv L- I Steven A. Herum sherurn@herumerabtree.com Enclosed please find the following documents related to the proposal to develop a Wal-Mart Supercenter -anchored shopping center in Lodi. 1. CEQA Guidelines Section 15030 and OPR/Resources Agency discussion. As this document explains, "The cumulative impact analysis requires a discussion of projects with related cumulative impacts where required EIRs, Negative Declarations, or were exempt from CEQA...The court in SFFRG took note of the problem of where to draw the line on projects undergoing environmental review since application of new projects are constantly being submitted. A reasonable point might be after the preparation of the draft EIR." 2. Documents Regarding Approval of Hammer Lane Supercenter. The following documents show that the Hammer Lane Supercenter was approved in Stockton over two years prior to Lodi's decision to contact the San Joaquin County Planning Department regarding related projects to be included in the EIR's List of Projects. These documents were obtained from the City of Stockton Planning Department on February 15,2005. a. City of Stockton Planning Commission Staff Report UP4-02. (2/28102) Recommends approval of a use permit for 207,559 sq ft retail store, including sale of alcoholic beverages, at the NW comer of the intersection of Hammer Lane and Holman Road in Stockton. 2291 WestJWarch Lane Suite 13100 Stockton, CA 95207 • Tel 209,472,7700 • Fox 7 209,472,7986 • Modesfo Tel. 209,525,8444 .A p—ofessioVlQl Covpovafiovt T Honorable Members of the t odi City Council February 16,2005 Page 2 b. Notice of Determination for UP4-02. (311102) Announces Stockton's determination to approve UP4-02. c. Stockton Use Permit No. UP4-02. (3/12/02) Approves 207,559 sq ft retail store, including sale of alcoholic beverages, at the NW comer of the intersection of Hammer Lane and Holman Road in Stockton. 3. Documents Regarding Trinity Way (Spanos Park) Supercenter. The following documents show that the north Stockton Trinity Way Supercenter was approved by the Stockton Planning Commission several weeks prior to Lodi's decision to contact the San Joaquin County Planning Department regarding related projects to be included in the EIR's List of Projects. These documents were obtained from the City of Stockton Planning Department and from the City of Stockton Internet website on February 15,2005. a. City of Stockton Planning Commission Staff Report UP15-04, (4/8/04) Recommends approval of a use permit for 207,160 sq ft retail store, including sale of alcoholic beverages, at the NW comer of the intersection of Trinity Parkway and Consumnes Drive in Stockton. b. Minutes of City of Stockton Planning Commission re UP15-04. (418104) Shows Planning Commission approval of a use permit for 207,160 sq ft retail store, including sale of alcoholic beverages, at the NW comer of the intersection of Trinity Parkway and Consumnes Drive in Stockton. c. Minutes of Stockton City Council Meeting re Appeal of UP 15-04. (6/22104) Shows City Council approval of a use permit for 207,160 sq fi Wal-Mart Supercenter, including sale of alcoholic beverages, at the NW comer of the intersection of Trinity Parkway and Consumnes Drive in Stockton. d. Notice of Exemption for UP15-04, (6/30104) Announces Stockton's determination that UP4-15 was exempt from CEQA. 4. Documents Regarding Human Health Impacts from Significant Air Quality Impacts. The following studies demonstrate that a causal link may be established between the quantity of air pollution that will be directly or indirectly emitted from the project and the potential magnitude of certain public health effects. a. C. Arden Pope I1, PhD; Richard T. Burnett, PhD; Michael J. Thun, MD; Eugenia E. Calle, PhD; Daniel Kreski, PhD; Kazuhiko Ito, PhD; George D. Thurston, ScD, Lung Cancer. Cardiopulmonary Mortality. and Long-term Exposure to Fine Particulate Air Pollution, The Journal of the American Medical Association, Vol. 287 No. 9 (March 6,2002) \\nt_oas\prolaw\documents\2146-002\SAH\42537. doc Honorable Members of the Lodi City Council February 16,2005 Page 3 This study assessed the relationship between long-term exposure to fine particulate air pollution and all cause, lung cancer, and cardiopulmonary mortality. The study resulted in the following findings: "[f]ine particulate and sulfur oxide -related pollution were associated with all -cause, lung cancer, and cardiopulmonary mortality. Each 10-4Q/m3 elevation in fine particulate air pollution was associated with approximately a 4%. 6%, and 8% increased risk of all -cause, cardiopulmonary. and lung cancer mortali , . respectively. Measures of coarse particle fraction and total suspended particles were not consistently associated with mortality." (Emphasis added). The study concludes that "long- term exposure to combustion -related fine particulate air pollution is an important environmental risk factor for cardiopulmonary and lung cancer mortality." h. Janneane F. Gent, PhD; Elizabeth W. Triche, PhD; Theodore R. Holford, PhD; Kathleen Belanger, PhD; Michael Bracken, PhD; William S. Beckett, MD; Brian P. Leaderer, PhD, Association of Low -Level Ozone and Fine Particles with Respiratory Symptoms in Children with Asthma, The Journal of the American Medical Association, Vol. 290 No. 14 (October 8,2003) This study examined the simultaneous effects of ozone and PM2 5 at levels below EPA standards on daily respiratory symptoms and rescue medication use among children with asthma. The professors studied asthmatic children from the New Haven, Connecticut and Springfield, Massachusetts, areas including 130 children who used maintenance medications for asthma and 141 children who did not; the former group was considered to have more severe asthma. The study found that "[m]ean (SD) levels were 59 (19� ppb (1 -hour average) and 51 (16) ppb (8 -hour average for ozone and 13(8) gglm for PM2 5. In copollutant models, ozone level but not PM2 5 was significantly associated with respiratory symptoms and rescue medication use among children using maintenance medication; a 50 -ppb increase in 1 -hour ozone was associated with increased likelihood of wheeze (by 35%) and chest tightness (by 47%). The highest levels of ozone (1 -hour or 8 -hour averages) were associated with increased shortness of breath and rescue medication use. No significant, exposure -dependent associations were observed for any outcome by any pollutant among children who did not use maintenance medication." (Emphasis added). The study concludes "asthmatic children using maintenance medication are particularly vulnerable to ozone, controlling for exposure to fine particles, at levels below EPA standards." c. Nino Kunzli, Michael Jerret, Wendy J. Mack, Bernardo Beckerman, Laurie LaBree, Frank Gilliland, Duncan Thomas, John Peters, and Howard N. Hodis, Ambient Air Pollution and Atherosclerosis in Los Angeles, Environmental Health Perspectives, Vol. 113 No. 2 (February 2005) (From the University of Southern California in Los Angeles) \\nt_oas\prodaw\documents\2146-002\SAH\4253 7. doe Honorable Members of the Lodi City Council February 16,2005 Page 4 The professors studied around 800 men and women in the Los Angeles area. The study investigated the association between long-term exposure to air pollution and an increased risk of atherosclerosis, a form of cardiovascular disease. Results of the study showed that participants living the areas with the highest levels of PM2.5 had the most narrowing of their carotid arteries. For every 10 -point increase in PM2.5, carotid arteries were approximately 4% narrower. Results also showed a higher percentage increase of narrowing for persons on lipid -lowering medication at study entry (approximately 15%). Effect estimates for women were determined to be statistically significant and typically in the range of 69 %per 10 [.g/m3 PM2.5. The study found that associations were strongest among women over sixty years old, leading to crude estimates of 19.2%(9-31%). Very truly yours ;SEVEN A. HERUM Attorney -at -Law SAH/BSJ Enclosures \\nt_oas\prolaw\documents\2146-002\SAH\42537. doc Title 14 s Page 1 of 3 1 15130. Discussion of Cumulative Impacts (a) An EIR shall discuss cumulative impacts of a project when the project's incremental effect is cumulatively considerable, as defined in section 15065(c). Where a lead agency is examining a project with an incremental effect that is not "cumulatively considerable," a lead agency need not consider that effect significant, but shall briefly describe its basis for concluding that the incremental effect is not cumulatively considerable. (1) As defined in Section 15355, a cumulative impact consists of an impact which is created as a result of the combination of the project evaluated in the EIR together with other projects causing related impacts An EIR should not discuss impacts which do not result in part from the project evaluated in the EIR. (2) When the combined cumulative impact associated with the project's incremental effect and the effects of other projects is not significant, the EIR shall briefly indicate why the cumulative impact is not significant and is not discussed in further detail in the EIR. A lead agency shall identify facts and analysis supporting the lead agency's conclusion that the cumulative impact is less than significant. (3) An EIR may determine that a project's contribution to a significant cumulative impact will be rendered less than cumulatively considerable and thus is not significant. A project's contribution is less than cumulatively considerable if the project is required to implement or fund its fair share of a mitigation measure or measures designed to alleviate the cumulative impact. The lead agency shall identify facts and analysis supporting its conclusion that the contribution will be rendered less than cumulatively considerable. (b) The discussion of cumulative impacts shall reflect the severity of the impacts and their likelihood of occurrence, but the discussion need not provide as great detail as is provided for the effects attributable to the project alone. The discussion should be guided by standards of practicality and reasonableness, and should focus on the cumulative impact to which the identified other projects contribute rather than the attributes of other projects which do not contribute to the cumulative impact. The following elements are necessary to an adequate discussion of significant cumulative impacts: (1) Either: (A) A list of past, present, and probable future projects producing related or cumulative impacts, including, if necessary, those projects outside the control of the agency, or (B) A summary of projections contained in an adopted general plan or related planning document, or in a prior environmental document which has been adopted or certified, which described or evaluated regional or areawide conditions contributing to the cumulative impact. Any such planning document shall be referenced and made available to the public at a location specified by the lead agency. (2) When utilizing a list, as suggested in paragraph (1) of subdivision (b), factors to consider when determining whether to include a related project should include the nature of each environmental resource being examined, the location of the project and its type. Location may he important, for example, when water quality impacts are at issue since projects outside the watershed would probably not contribute to a cumulative effect. Project type may be important, for example, when the impact is specialized, such as a particular air pollutant or mode of traffi r- (3) Lead agencies should define the geographic scope of the area affected by the cumulative effect and provide a reasonable explanation for the geographic limitation used. (4) A summary of the expected environmental effects to be produced by those projects with specific reference to additional information stating where that information is available; and (5) A reasonable analysis of the cumulative impacts of the relevant projects. An EIR shall examine reasonable, feasible options for mitigating or avoiding the project's contribution to any significant cumulative effects. (c) With some projects, the only feasible mitigation for cumulative impacts may involve the adoption of ordinances or regulations rather than the imposition of conditions on a project -by -project basis. http://ceres.ca.gov/topic/env_law/cega/guidelines/art9.htm1 2/15/2005 Title 14 .-. Page 2 of 3 (d) Previously approved land use documents such as general plans, specific plans, and local coastal plans may he used in cumulative impact analysis. A pertinent discussion of cumulative impacts contained in one or more previously certified EIRs may be incorporated by reference pursuant to the provisions for tiering and program EIRs. No further cumulative impacts analysis is required when a project is consistent with a general, specific, master or comparable programmatic plan where the lead agency determines that the regional or areawide cumulative impacts of the proposed project have already been adequately addressed, as defined in section 15152(f)O�, in a certified EIR for that plan. (e) If a cumulative impact was adequately addressed in a prior EIR for a community plan, zoning action, or general plan, and the project is consistent with that plan or action, then an EIR for such a project should not further analyze that cumulative impact, as provided in Section 151830). Note: Authority cited: Sections 21083 and 21087, Public Resources Code. Reference: Sections 21083(b), 21093,21094 and 21100, Public Resources Code; Whitmanv. Board of Supervisors, (1979) 88 Cal. App. 3d 397; San Franciscansfor Reasonable Growth v. City and County of San Francisco (1984) 151 Cal.App.3d 61; Kings CountyFarm Bureau v. City of Hanford (1990) 221 Cal.App.3d 692; Laurel Heights Homeowners Association v. Regents of the University of California (1988) 47 Cal.3d 376; Sierra Club v. Gilroy(1990) 220 Cal.App.3d 30; Citizens to Preserve the Ojai v. County of Ventura (1985) 176 Cal.App.3d 421; Concerned Citizens of South Cent. LosAngeles v. Los Angeles UnifiedSch. Dist. (1994) 24 Ca1.App.4th 826; Las VirgenesHomeowners Fed'n v. CountyofLosAngeles (1986) 177Cal.App.3d 300; San Joaquin Raptor/Wildlife Rescue Ctr v. County ofStanislaus (1994) 27 Cal.App.4th 713; Fort Mojave Indian Tribev. Cal. Dept. Of Health Services (1995) 38 Cal.App.4th 1574; and Communitiesfor a Better Environment v. California Resources Agency (2002) 103Cal.App.4th 98. Discussion: This section is necessary to explain how to discuss cumulative impacts in an EIR. The section limits the discussion to situations where the cumulative effects are found to be significant. Further, the section codifies the requirements for analysis of cumulative effects as spelled out in Whitman v. Board of Supervisors, cited in the note, but the section allows the alternative approach of summarizing projections from a planning document. The options allow the Lead Agency to choose the method of analysis that may be best suited to the situation at hand. Essential guidance is also provided on approaches to mitigating cumulative effects, since cumulative effects can rarely be mitigated in the same way as the primary effects of an individual project. When analyzing the cumulative impacts of a project under 15130 (b)(1)(A), the Lead Agency is required to discuss not only approved projects under construction and approved related projects not yet under construction, but also unapproved projects currently under environmental review with related impacts or which result in significant cumulative impacts. This analysis should include a discussion of projects under review by the Lead Agency and projects under review by other relevant public agencies, using reasonable efforts to discover, disclose, and discuss the other related projects. The cumulative impact analysis requires a discussion of projects with related cumulative impacts which required EIRs, Negative Declarations, or were exempt from CEQA. (See: San Franciscansfor Reasonable Growth v. City and County of San Francisco, (1984) 151 Cal. App, 3d 61.) The court in SFFRG took note of the problem of where to draw the line on projects undergoing environmental review since application of new projects are constantly being submitted. A reasonable point might be after the preparation of the draft EIR. Additional project information could he included in the final EIR if cumulative impacts were originally analyzed in the draft EIR and if the new project information doesn't warrant the preparation of a subsequent or supplemental EIR as required by Section 15162 of the Guidelines. Subsection (b)(1)(B) authorizes a lead agency to limit its analysis of probable future projects to those which are planned or which have had an application made at the time the NOP is released for review. This describes a reasonable point in time at which to begin the cumulative impact analysis. Without this guideline, the cumulative impact analysis may suffer frequent revision as new, incremental projects are identified. If additional projects are identified later, they may be addressed during completion of the final EIR. Cumulative impacts analysis must include reasonably anticipated future activities of a project or associated with the project. Whether these activities are addressed in the cumulative impact analysis section or in the impacts associated with the project, as defined, if there is substantial evidence indicating reasonable foreseeable future projects or activities, an EIR must analyze the impacts of those future activities. The Court in Laurel Heights set forth the following two pronged test to determine whether an EIR must include http://ceres.ca.gov/topic/env_law/cega/guidelines/art9.htmi 2/15/2005 Title 14 — 1- Page 3 of 3 an analysis of the environmental effects of future activities: (1) it is a reasonably foreseeable consequence of the initial project; and (2) the future action will be significant in that it will likely change the scope or nature of the initial project or its environmental effects. Absent these two circumstances, potential future expansion need not be considered. Laurel Heights Improvement Association v. Regents d the University d California (1988) 47 Cal. 3d 376. Consistent with the holding in Antioch v. Pittsburg (see discussion with Section 15126), a cumulative impact analysis should address the most probable development patterns. This section describes the analysis necessary where a project will make a considerable contribution to a cumulative effect (see also section 15064). Based on the holding in San Joaquin Raptor/Wildlife Rescue Center v. County of Stanislaus (1996) 42 Cal.App.4th 608, subdivision (a) provides that when the lead agency determines that a project makes only a de minimus contribution to a cumulative effect no analysis of the cumulative effect is needed. This subsection also provides that an EIR may determine that a projectis contribution, originally thought to be considerable, is less than considerable with mitigation. Any such conclusion must be documented in the EIR. Subsection (b) discusses the elements necessary for an adequate discussion of significant cumulative impacts. It recommends that the discussion focus on the particular cumulative impact to which other projects contribute rather than on the non-contributing aspects of those projects. This subsection offers further guidance on focusing the discussion on impacts rather than on other projects per se. Subsection (d) links cumulative impact analysis to tiering and other similar approaches which seek to limit redundant analyses. Where cumulative impacts have been adequately addressed in the EIR certified for a general plan or other programmatic plan, and the project is consistent with that plan, the discussion contained in the prior EIR may be incorporated by reference. No further cumulative impact analysis would be necessary. http: //ceres. ca. govltcpic/ermlaw/cega/guidelines/art9.htm1 2/15/2005 2a EXHIBIT 1 STAFF REPORT P.C. Agenda February 28, 2002 STAFF REPORT Item E-3: PUBLIC HEARING- Use Permit Case No. UP4-02, Holman Investors, LLC Data: Holman Investors, LLC, is requesting a Use Permitto allow the off -sale of general alcoholic beverages in a proposed retail store near the northwest corner of Holman Road and Hammer Lane. The vacant, 21.16 -acre site is zoned C-2, General Business District, and is bounded to the: ■ north across Wakeman Drive by single-family homes and vacant land zoned R-1, Single -Family District; • east across Holman Road by vacant land zoned C-2; • southeast by a self-service gasoline station with a mini -mart and fast-food restaurant zoned C-2; south across Hammer Lane by a variety of retail uses zoned C-2 and C -A , Commercial -Auto District; and ■ west by vacant land zoned R-1 and C-R, Commercial -Residential District (Zoning Map pages 17 and 19). See attached exhibits. General Plan: The General Plan Diagram designates this site for Commercial uses Environmental Clearance: The environmental consequences of developing this site for commercial uses were adequately examined in the previously -approved Final Supplemental Environmental Impact Report (FSEIRI-9011S4-99) for the Morada Ranch Commercial Project. Based on a review of those documents, no further environmental analysis is necessary. Discussion: The applicant is proposing to develop a retail store with the off -sale of general alcoholic beverages. The applicant's proposal is to construct a 207,559 -square foot Hoiman investors, LLC U P4-02 Staff Report February 28,2002 Page 2 building on the north portion of the project site. The building will contain a retail center, a garden center, an auto center and a seasonal sales area. A majority Cf the building will be occupied by the retail center. The garden center, auto center and seasonal sales area will be located on the east side of the commercial building. Because the retail center does not have a specific tenant, the proposed business hours for the center will be tentatively 24 hours, seven days a week. With respect to parking, the proposed retail center is required to have a total of 823 spaces. The project site will be provided with a 1,031 -space parking lot, which exceeds the City parking requirement. The project site is located in Census Tract 35.00. Based upon the population in that geographic area, the State Department of Alcoholic Beverage Control (ABC) has determined that six off -sale alcoholic beverage establishments are allowed within the census tract. There are currently seven active off -sale establishments within the census tract. Since the number of approved off -sale liquor licenses exceeds the limit set by ABC, an "undue concentration" exists and a special finding of public convenience or necessity is required from the Planning Commission in order to approve the Use Permit. Section 16-086.Aof the Zoning Code lists the off -sale of alcoholic beverages as a "problem use" and Section 16-086.B requires that the following criteria be considered before the Use Permit can be approved: 1. The proposed use with respectto the proximity and type of other enumerated uses; 2. The effect of dispersal or concentration cf enumerated uses in the general area; 3. The effect that the proposed use is likely to have on the neighborhood; 4. The compatibility of the proposed use with the surrounding institutional, business and residential uses with respect to noise and/or traffic and/or visual impact and other relevant factors; 5. The potential of the proposed use to create or increase loitering or vandalism in the area; and 6. The degree that traffic safety both on and off-site will be adversely affected by the proposed activity. Holman Investors, LLC U P4-02 Staff Report February 28,2002 Page 3 The Police Department, other City departments, the State Department of Alcoholic Beverage Control and the surrounding neighborhood have been notified of this request. The Public Works and Police Departments have recommended that the Use Permit, if approved, be subject to specific conditions that have been included in the proposed Conditions of Approval. As of the writing of the staff report, no letters of opposition have been received from any of the notified agencies or from the surrounding neighborhood. Recommendation: Approval based on the following findings and subject to the proposed conditions as enumerated below: The proposed use is consistent with applicable General Plan Policies and with the site's Commercial General Plan designation. 2. The proposed use meets zoning code requirements, subject to approval of a Use Permit, and has been reviewed in accordance with Sections 16-083.B and 16-086.13 of the Stockton Municipal Code and the affirmative findings required under Section 16-086.0 are hereby adopted. 3. The proposed use is expected to be compatible with existing and planned land uses in the vicinity of the project site and is not likely to interfere with the comfortable enjoyment of life or property in the area. 4. The proposed use will not be detrimental to the health, safety, peace or general welfare of persons residing or working in the neighborhood or be detrimental or injurious to the health, safety, peace or general welfare of the City. 5. Public convenience will be served by the issuance of this Use Permit. 6. The City of Stockton has reviewed and considered the Final Supplemental Environmental Impact Report for the Morada Ranch Commercial Project (SEIR1-90/IS4-99) and has certified the document as being adequate for approval of the proposed project. With the exception of the unavoidable or unresolved adverse effects of the project, all other potentially adverse environmental effects of the subsequent development of the area will mitigated to an acceptable level through project design and/or by enforceable conditions of approval on associated discretionary permits. Holman Investors, LLC U P4-02 Proposed Conditions: Staff Report February 28,2002 Page 4 1. Comply with applicable Federal, State, County and City codes. regulations and adopted standards and pay all applicable fees. 2. In the event the sale of alcoholic beverages or operation of this use proves detrimental to the health, safety, peace or general welfare of the surrounding neighborhood, this Use Permit shall be subject to revocation or modification as provided in the Zoning Code. 3. The sale of alcohol for consumption on the premises shall not be permitted. 4. All outside pay phones shall be restricted to outgoing calls only. 5. The business shall post E.A.S.Y. (EliminateAlcohol Sales to Youth) materials that are visible from outside of the business. 6. Any graffiti on the property shall be removed within twenty-four (24) hours. 7. Every new employee involved in the sale of alcoholic beverages shall complete L.E.A.D. (Licensing Education of Alcohol and Drugs) training through the local office of the State Department of Alcoholic Beverage Control within six months of the employee's hire date. 8. The Use Permit shall be posted in a conspicuous place and shall be immediately made available to City personnel upon inspection of the premises. 9. Comply with all applicable conditions of TM3-92 10. The Hammer Lane driveway located approximately 350 feet west of Holman Road shall be designed and constructed to prevent cross traffic for a minimum of 100 feet on the west side of the driveway measured from the ultimate Hammer Lane right-of-way. 11. The proposed eastern Wakeman Drive access shall be reduced to a maximum width of 40 feet. The proposed western Wakeman Drive access shall be reduced to a maximum width of 35 feet. In order to accommodate truck traffic the City of Stockton Standard Drawing No. 38 driveway can be modified to include 20 -foot radius curb returns. 12. Outdoor storage containers or trailers on the premises shall not be permitted. Trucks and trailers may only use or access the site for loading and unloading Holman Investors, LLC U P4-02 Staff Report February 28,2002 Page 5 purposes. After completion of the loading and unloading on the loading docks, the trucks and/or trailers shall be removed from the premises within 24 hours. 13. A minimum six-foot and eight -foot high masonrywall shall be installed along the west property line, from the south side of P.U.E. on Wakeman Drive, south for a distance of approximately 560 feet, as shown on the site plan, to buffer the adjacent R-1 zoned property from the C-2 zoned project site. A minimum ten -foot high solid and continuous masonrywall, or a combination berm and masonry wall shall be installed along the south side of Wakeman Drive (south of ten -foot P.U.E.), between the two proposed driveways on Wakeman Drive. In addition, the masonry wall, or combination berm and masonry wall, shall be reduced to six -feet in height between the east property line and the easterly driveway on Wakeman Drive. Graffiti -resistant paint shall be applied to both sides of the masonry wall. A minimum ten -foot wide landscaped strip (existing ten -foot wide P.U.E.) shall be installed between the property line and the wall on Wakeman Drive. A three-foot high vegetative screen containing evergreen shrubs, groundcover and vines shall be provided along the street side of the wall. In addition, evergreen trees (at a minimum of 15 gallon size), of no less than 30 feet in height at maturity and spaced no more than 30 feet apart, shall be planted between the back of the sidewalk and the wall. The portion of the landscaped strip behind (south of) the masonry wall shall be planted with evergreen shrubs and groundcover. A timed, automatic irrigation system shall be installed and maintained in the landscaped strip. The masonry wall, landscaping and irrigation system shall be maintained in a manner so as not to be blighted or deteriorated. 14. All masonry walls and landscaped areas shall comply with applicable requirements of the Stockton Municipal Code. Masonry wall, landscaping and irrigation plans shall be submitted to the Community Development Department, Planning Division, for review and approval by the Community Development Director, the Public Works Director and the City's Landscape Architect prior to the issuance of building permits. Masonry walls and landscaped areas, including irrigation systems, shall be installed prior to the issuance of the Certificate of Occupancy for the project. 15_ All signs shall be subject to approval by the Community Development Director or Planning Commission. 16. There shall be no chain-link fencing or similar material visible from a public right-of-way. There shall be no barbed/concertina wire or similar material located on the property. Holrnan Investors, LLC U P4-02 Staff Report February 28,2002 Page 6 17. Structures and other improvements shall be constructedlinstalled in accordance with the approved site plan, floor plans, elevations, conditions of approval and color rendering and be maintained in a manner so as not to be blighted or deteriorated. 18 All lighting on the subject site shall be shielded so as not to shine onto nearby/adjacent residential properties. 19. Pursuantto Section 15074 of the State CEQA Guidelines, the project shall be subject to all applicable mitigation measures identified in the City -adopted Final Supplemental Environmental Impact Report (FSEIRI-9011S4--99) and the Findings and Mitigation Monitoring/Reporting Program for the Morada Ranch Commercial Project. 20. A minimum of two state -licensed, insured and uniformed security officers shall be provided and on duty during all hours of operation. At least one of the officers shall provide security to the immediate area surrounding the exterior of the building and including the parking areas. February 20, 2002 Note: Staff reports are prepared well in advance of the Planning Commission consideration of the proposal and reflect the staffs view based on the best available information at the time the report was formulated. Evidence submitted during the course of the public hearing may require a re-evaluation of the staffs position. Staff Report prepared by Associate Planner Jenny Liaw. -.QDMAIGRPWISEICOS.CDD CDD—Library-.20554.1 RA r m N O 446 M RYRTATT 12 PAGE I Community Development L nt/Pfanning Division 425 North El Dorado Street Stockton. CA 95202-1997 CITY OF S T O C K T O N Tel: (209) 937-8266 Fax: (209) 937-8893 USE PERMIT NO. UP4-02 DATEAPPROVED: February 28,2002 ISSUED TO: Holman Investors, LLC Attn: Matt Arnaiz 3158 Auto Center Circle, Suite E Stockton, CA 95212 DESCRIPTION OF USE: To allow the off -sale of general alcoholic beverages in a proposed retail store PROPERTY LOCATION: Near the northwest corner of Hammer Lane and Holman Road PROPERTY ZONED: C-2 APN: 092-080-22 CT: 34.10 TZ: 14 BL: 01 PA: 80 CONDITIONS OF APPROVAL: NOTE: THIS PERMIT IS ISSUED PURSUANT TO THE PROVISIONS OF PART Il, CHAPTER 16, SMC AND IS SUBJECT TO THE CONDITIONS OF APPROVAL AND ATTACHED DEVELOPMENT PLAN. USE OR CONSTRUCTION MUST BE COMMENCED WITHIN ONE YEARAFTER THE DATE OFAPPROVAL OR AN EXTENSION MUST BE GRANTED AS PROVIDED IN THIS CHAPTER: OTHERWISE, THIS PERMITSHALL BE NULL AND VOID. THIS PERMIT IS SUBJECT TO REVOCATION AND/OR MODIFICATIONS AS PROVIDED IN THIS CHAPTER. Comply with applicable Federal, State, County and City codes, regulations and adopted standards and pay al I applicable fees. 2. In the event the sale of alcoholic beverages or operation of this use proves detrimental to the health, safety, peace•or general welfare of the surrounding neighborhood, this Use Permit shall be subject to revocation or modification as provided in the Zoning Code. 1 The sale of alcohol for consumption on the premises shall not be permitted. 4. All outside pay phones shall be restricted to outgoing calls only. 5. The business shall post EASY. (Eliminate Alcohol Sales to Youth) materials that are visible from outside of the business. 6. Any graffiti on the property shall be removed within twenty-four (24) hours. 7. Every new employee involved in the sale of alcoholic beverages shall complete L.EAD. (Licensing Education of Alcohol and Drugs) training through the local office of the State Department of Alcoholic Beverage Control within six months of the employee's hire date. PAGE 1 OF 3� �_,_ FILE ORJ 2b U P4-02 PAGE 2 March 12,2002 Page 2 8. The Use Permit shall be posted in a conspicuous place and shall immediately be made available to City personnel upon inspection of the premises. 9. Comply with all applicable conditions of TM3-92. 10. The Hammer Lane driveway located approximately 350 feet west of Holman Road shall be designed and constructed to prevent cross traffic for a minimum of 100 feet on the west side of the driveway measured from the ultimate Hammer Lane right-of-way. 11. The proposed eastern Wakeman Drive access shall be reduced to a maximum width of 40 feet. The proposed western Wakeman Drive access shall be reduced to a maximum width of 35 feet. In order to accommodate truck traffic, the City of Stockton Standard Drawing No. 38 driveway can be modified to include 20 -foot radius curb returns. 12. Outdoor storage containers or trailers on the premises shall not be permitted. Trucks and trailers may only use or access the site for loading and unloading purposes. After completion of the loading and unloading on the loading docks, the trucks andlor trailers shall be removed from the premises within 24 hours. 13. A minimum six-foot and eight -foot high masonry wall shall be installed along the west property line, from the south side of the P.U.E. on Wakeman Drive, south for a distance of approximately 560 feet, as shown on the site plan, to buffer the adjacentR-1 zoned property from the C-2 zoned project site. A minimum ten -foot high solid and continuous masonry wall, or a combination berm and masonry wall, shall be installed along the south side of Wakeman Drive (south of the ten -foot P.U.E.), between the two proposed driveways on Wakeman Drive. In addition, the masonry wall, or combination berm and masonry wall, shall be reduced to six feet in height between the east property line and the easterly driveway on Wakeman Drive. Graffiti -resistant paint shall be applied to both sides Cf the masonry wall. A minimum ten -foot wide landscaped strip (existingten-foot wide P.U.E.) shall be installed between the property line and the wall on Wakeman Drive. A three-foot high vegetative screen containing evergreen shrubs, groundcover and vines shall be provided along the street side of the wall. In addition, evergreen trees (at a minimum of 15 gallon size), of no less than 30 feet in height at maturity and spaced no more than 30 feet apart, shall be planted between the back of the sidewalk and the wall. The portion of the landscaped strip behind (south of) the masonry wall shall be planted with evergreen shrubs and groundcover. A timed, automatic irrigation system shall be installed and maintained in the landscaped strip. The masonry wall, landscaping and irrigation system shall be maintained in a mannerso as notto be blighted or deteriorated. 14. All masonry walls and landscaped areas shall comply with applicable requirements of the Stockton Municipal Code. Masonry wall, landscaping plans and irrigation plans shall be submitted to the Community Development Department, Planning Division, for review and approval by the Community Development Director, the Public Works Director and the City's Landscape Architect prior to the issuance of building permits. Masonry walls and landscaped areas, including irrigation systems, shall be installed prior to the issuance of the Certificate of Occupancy for the project. PAGE 2 OF 3 N&ZT 12rAtia .3 U P4-02 March 12,2002 Page 3 15. All signs shall be subject to approval by the Community Development Director or Planning Commission. 16. There shall be no chain-link fencing or similar material visible from a public right-of-way. There shall be no barbed lconcertina wire or similar material located on the property. 17. Structures and other improvements shall be constructedlinstal led in accordance with the approved site plan, floor plans, elevations, conditions of approval and color rendering and be maintained in a manner so as not to be blighted or deteriorated. In addition, an appropriate parking lot maintenance and litter control program shall be implemented. 18. All lighting on the subject site shall be shielded so as not to shine onto nearbyladjacent residential properties. 19. Pursuant to Section 15074 of the State CEQA Guidelines, the project shall be subject to all applicable mitigation measures identified in the City -adopted Final Supplemental Environmental Impact Report (FSEIRI-90IIS4-99) and the Findings and Mitigation Monitoring/Reporting Program for the Morada Ranch Commercial Project. cc: Doucet & Associates, Inc. Attn: Rick Chavez 3300 Douglas Boulevard, Suite 475 Roseville, CA 95661 APPROVED/ DATE ISSUED: MARCH 12,2002 CC: PUB C WORKS -T CH PLANNING F BUSINESS LICENSE FIRE POLICE ABC FILE COPY J L.- NOTICE : NOTICE To protestthe imposition of any developmentfee, dedication, reservation or other exaction imposedon your project you must file written notice with the City Clerk's office within 90 days after approval of the project or imposition of the fees, dedications. reservations or other exactions stating that the required payment is tendered or will be tendered when due, or that any conditions which have been imposed are provided for or satisfied, under protest, along with a statement of the factual elements of the dispute and the legal theory forming the basis for the protest. PAGE 3 OF 3 ::ODMA1GRPWiSEICOS.CDD.CDD—Library:20730.1 NOISSIWWOO JNINNVId A113 NOINOOIS 4 L_ fly .014! vyu3c; zo-Q do -1 `SIO;SGAUI uetUlOH Nd-ld 31lS ti IISIHX3 ATICE OF DETERMINATION TO: ®County Clerk []Office of Planning and Research San Joaquin County P.O. Box3044 Sacramento, CA 95812-3044 FROM:ii City of Stockton c/o Community Development Department ASSESSCOR RECORDER COU'Hi- r CLERK (;t'P4 4l- r:i.F..14JN N 02 MAR -4 PM 3: 49 1. The project (Z will) (❑ will not) have asignificant effect on the environment. 2. ® An environmental impact report was prepared and of Ci=(A. ❑ A Negative Declaration was prepared and adopted for this project pursuant to the provisions of CEQA. 3. Findings (0 were) (❑ were not) made pursuant to Cal. Code of Regulations, Title 14, Section (❑15091-EIR) (❑ 15075-Neg Dec) and Mitigation measures (® were) (0 were not) incorporated as part of the approval of the project. 4. Mitigation Monitoring and Reporting Program (E was) (0 was not) adopted for this project. 5. Statement of Overriding Considerations (® was) (❑ was not)adopted for this project. 6. Pursuant to Cal. Code of Regulations, Title 14, Sections 753.5(a) or 753.5(c): ❑ California Departmentof Fish and Game (CDFG)fees are required, as applicable, and will be filed with this Notice of Determination (NOD); or ❑ This project is exempt from the CDFG fees and a Certificate of Fee Exemption has been prepared and will be filed with this NOD. ❑ CDFG Feeswere filed with a prior NOD for this project/proposal (see attached receipt). This isto certiii that the environmental documentation and determinations for the projecffaction and any related mitigation measures, monitoring provisions, findings and statementsofoverridingconsideration have beenadoptedon the basisof the whole record before the Ci and reflectthe C i s independentjudgement and analysis. The environmental review record and record of project approval may be examined at the abovenoted Ligd RM address. ROGERA. STOREY DEPUTYCITY MANAGER/ INTERIM COMMUNITY DEVELOPMENT DIRECTOR By: JENNY LIAW, ASSOPIATE PLANN Date: March 1,2002 of AFFIDAVIT OF FILINGAND POSTING Ideclare that on th ate stamped above, I received and posted this notice as required by California Public Resources Code Section 2115 c). Said notice II remain postedfor30 days from the filing date. Signature: Title: DEPUTY COUNTY CLERK Posting Period Ending Date:::ODMAIGRPWISE%COS.CDD.CDD_Library:20336.1 Copy mailed .to APPZicavrt 3/6/02 3a EXHIBIT 1 STAFF REPORT P. C. Agenda April 8,2004 STAFF REPORT Item E-4: PUBLIC HEARING — Use Permit Case Nos. UP15-04, A.G. Spanos Construction, Inc. Data: A.G. Spanos Construction, Inc., on behalf of Doucet and Associates, Inc., is requesting a Use Permitto allow the off -sale of beer and wine (Phase 1) and general alcohol beverages (Phasell) in conjunctionwith an approved by -right retail store on propertygenerally located at the northwest corner of Trinity Parkway and Consumnes Drive (10355 Trinity Parkway). The approximately22.4-acre site is currentlyvacant, zoned M -X, Mixed Use District, and is bounded to the: north by a vacant parcel zoned M -X; east across Trinity Parkway by the Park West Place shopping center, zoned M -X; south across Consumnes Drive by a vacant parcel intended for an eventual public park use and an apartment complex zoned M -X; and west across a one -hundred foot landscaped buffer area and power line easement by single-family residences zoned R-1, Single -Family District (Zoning Map page 1). See attached exhibits. General Plan: The General Plan designates this site for Mixed Uses. Environmental Clearance: The environmental consequences of developingthe Spanos Park West Projectwere adequately examined in a previously -approved Supplemental Environmental Impact Report/Initial Study (SE IR3-8711S13-00). Based on a review of those documents, the proposed project has been adequately addressed and no further environmental analysis is necessary. Discussion: As background, General Plan amendment (GPA3-00), rezoning (Z-4-00), Master Development Plan (MDP1-00), and Development Agreement (DA1-00) applications were recommended for approval by the Planning Commission on December 20, 2001, and approved by the City Council on January 29, 2002. The noted approvals allow for the establishment and operation of a retail store as a by -right use, subject to site plan review in order to verify consistencywith the A.G. Spanos Business Park Master Development Plan. Staff conducted a site plan review on the project to assure that it is in substantial conforma n cewith the noted Master Development (M D P 1 -00). However, MDP1 -00 requires that a Use Permit be approved bythe Planning Commission to allow the off -sale of alcoholic beverages. The proposed use is consistentwith MDP1-00 and the Planning and Zoning Code subject to approval of this Use Permit. A.G. Spanos Construction, Inc. UP15-04 Staff Report April 8,2004 Page 2 The 1 38,272 -sq uare foot initial phase of the retail store will be located on the south end of the project site. The applicant has requested a Use Permitto allow the off -sale of beer and wine (Type 20 license) for Phase I of the project. However, the applicant has indicated during Phase I, the tenant will only sell wine and wine coolers, and no beer will be sold. Phase I I will involve the expansion of the retail store by adding 68,888-squarefeet, for a total of 207,160 -square feet. In conjunction with Phase II of the project, the applicant has requested the off -sale of general alcoholic beverages. The applicant has indicated that the each phase of the retail store will operate 24 hours a day, seven days a week although alcoholic beverage sales will be prohibited between 2 a. m. and 6 a.m. With respectto parking, the overall 207,160 -square foot retail store, is required byMDPI -00 (consistent with the Planning and Zoning Code) to provide a total of 822 on-site parking spaces, based upon the requirementfor thirteen spaces plus one additional space for each 250 square feet of gross floor area (GFA) in excess of five thousand square feet for the retail uses. The project site will be provided with a 1.037 -space parking lot, which exceeds the noted parking requirements. Access to the site will be provided by three proposed driveways on the west side of Trinity Parkway and one driveway on the north side of the Consumnes Drive. According to SMC Section 16-086, the off -sale of beer, wine and general alcohol are considered "problem uses" and the following criteria must be considered before the uses can be approved: 1. The proposed use with respect to the proximity and type of other enumerated uses; 2. The effect of dispersal or concentration of enumerated uses in the general area: 3. The effect that the proposed use is likelyto have on the neighborhood: 4. The compatibility of the proposed use with the surrounding institutional, business and residential uses with respect to noise and/or traffic and/or visual impact and other relevant factors; 5. The potential of the proposed use to create or increase loitering or vandalism in the area: and 6. The degree that traffic safety both on and off-site will be adversely affected by the proposed activity. The project site is located in Census Tract 40.02. Based upon the population in that geographic area, the State Alcoholic Beverage Control Department (ABC) has determined that two off -sale alcoholic beverage establishments are allowed in the census tract. There is one active off -sale establishment within the census tract. The applicant is proposing to secure a Type 20 license (off-saleof beer and wine) from the State Departmentof Alcoholic Beverage Control for Phase I, and subsequently replace itwith a Type 21 license (off-saleof general alcoholic beverages)for Phase II. If approved, the applicant's requestwill not result in an "undue concentration." The Police Department, the Public Works Department, other City departments, the State Departmentof Alcoholic Beverage Control and the neighborhood have been notified of this request. As of the writing of this staff report, no objections have been received concerning A.G. Spanos Construction, Inc. U P 15-04 Staff Report April 8, 2004 Page 3 this request. The Police Department and the Public Works Department have submitted memorandums with recommended conditions that have been incorporated into the staff report's "Proposed Conditions." Recommendation: Approval based on the following findings: The proposed use is consistent with all applicable goals, policies and standards of the Citys adopted General Plan Policy Document, the site's Mixed Use General Plan Diagram designation, and MDP 1-00 for the A.G. Spanos Business Park. 2. The proposed use is in compliance with the Zoning Code requirements, subject to approval of a Use Permit, and has been reviewed in accordance with Sections 16- 083.8 and 16-086.0 of the Stockton Municipal Code and the affirmative findings required under Sections 16-086.13 are hereby adopted. 3. The proposed use is expected to be compatible with the surrounding land uses and is not likelyto interferewith the comfortable enjoyment of life or propertyin the area, subject to any applicable mitigation measures specified in SEIR3-87/IS13-00 and the previously adopted "Findings and Mitigation Monitoring and Reoortina Program for the Saanos Park West Proiect." 4. The proposed use will not be detrimental to the health, safety or general welfare of persons residing or working in the neighborhood or be detrimental or injuriousto the health, safety, peace or general welfare of the City. 5. The environmental consequences of development within the Spanos Park West Project area have been previously considered by Supplemental Environmental Impact Report/l n itial Study (SEIR3-87/IS13-00) which was certified bythe Planning Commission on December 20,200 1, and the City Council on January 29, 2002, for their respective approvals. With the exception of the unavoidable or unresolved adverse effects of the project, all other potentially adverse environmental effects of the subsequent development of the area will be mitigated to an acceptable level through project design and/or by enforceable conditions of approval on associated discretionary permits. Proposed Conditions for Use Permit No. UP15-04: 1. Comply with all applicable Federal, State, County and City codes, regulations and adopted standards and pay all applicable fees. 2. In the event that the sale of alcoholic beverages or operation of this use proves detrimental to the health, safety, peace or general welfare of the surrounding neighborhood, this Use Permit shall be subject to revocation or modification as provided in the Zoning Code. 3. The consumption of alcoholic beverages on the premises shall not be permitted. A.G. Spanos Construction, Inc. UP15-04 Staff Report April 8,2004 Page 4 4. The business shall post E.A.S.Y. (Eliminate Alcohol Sales to Youth) materials that are visible from outside of the business. 5. Everyemployee involved in the sale of alcoholic beverages shall complete L.E.A.D. training (Licensing Education of Alcohol and Drugs) through the local office of the State Department of Alcoholic Beverage Control within six (6) months of the employee's hire date. 6. There shall be nochain-linkfencing,barbed/concertina wireor similar materialvisible from a public right-of-way. 7. Structures and other improvementsshall be constructed, installed and maintained in accordance with the site plan, floor plans, elevations, color renderingsapproved with MDP1-00 and with this Use Permit's conditions of approval and be maintained in a manner so as not to be blighted or deteriorated. 8. This Use Permit shall be posted in a conspicuous place and shall be immediately made available to City personnel upon inspection of the premises. 9. Pursuantto Sections 15091, 15093 of the State CEQA Guidelines, approval of this Use Permit is subject to the previously adopted CEQA findings and to the implementation of any applicable required mitigation measures and mitigation monitoring and reporting provisions, respectively, as specified in the "Findings and Mitigation Monitoring/Reporting Program for the Spanos Park West Project" (December 2001). March 30,2004 Note: Staff reports are prepared well in advance of the Planning Commission consideration of the proposal and reflect the staffs view based on the best available information at the time the report was formulated. Evidence submitted during the course of the public hearing may require a re-evaluation of the staffs position. Staff Report prepared by Senior Planner David Stagnaro, AICP. :ODMAIGRPW ISEICOS.CD D.CDD_Library:37125.1 3b MINUTES OF THE CITY PLANNING COMMISSION A regular meeting of the City Planning Commission was held on Thursday, April 8, 2004 at 7 p.m., in the Council Chambers, second floor, City Hall, with Chair Emily Bruce presiding. PRESENT: Chair Emily Bruce, Vice Chair Christopher Kontos, Planning Commissioners Ashland Brown, Frank Cusumano, Salvador Charles Lauron and George Lucas; Community Development Director James Glaser, Deputy Director Michael Niblock and Deputy City Attorney Guy Petzold; Senior Planner David Stagnaro, and Associate Planners Jenny Liaw and Denise Jefferson. ABSENT: Commissioner Lowery. Consent Items: Deputy Director Michael Niblock indicated that the minutes of the regular Planning Commission meetings of January 8, February 26, and March 25 were not available and requested they be removed from the Consent Calendar. MOTION: It was duly moved (Lauron), seconded (Cusumano) and carried 6 to 0 (Lowery absent) to approve the following consent items: Approval of the minutes for the meetings of January 22 and February 12,2004. 2. HOME OCCUPATION PERMIT REVIEW (SIX-MONTH) CHRISTOPHER BAKER (HOP102-03) - Home occupation to allow a home office for a DVD/video editing and reproduction business with no on-site customers, storage of merchandise, commercial editing, copying equipment or non-resident employees at 9538 Battleview Court. Item E-1: Public hearina reaardina the reauest of Saae and Kumi Sunaail for a Home Occupation Permit to allow a home office for an accounting. bookkeel2ing, tax preparation and l2rivate investiaation business with no on-site customers or non- resident emolovees at 4240 Inlet Road (HOPE -04). P.C. Minutes April 8,2004 Page 2 The public hearing was declared open and the Affidavit of Mailing was filed. Associate Planner Jenny Liaw summarized the staff report. Commissioner Kontos stepped down due to a potential conflict of interest. Sage Sungail, 4240 Inlet Road, spoke briefly in favor of the application and explained further the nature of his business. He assured the Commission that there would be no on-site customers and respectfully requested their approval of the request. No one else desired to be heard and the public hearing was closed. MOTION: It was duly moved (Lauron), seconded (Cusumano) and carried 5 to 0 (Lowery absent, Kontos abstaining) to approve the home occupation request of Sage and Kumi Sungail (HOP6-04), based on the findings and subject to the conditions as listed in the staff report. Item E-2: Public hearina reaardina the reciuest of GTA Thornton Road Venture, for a tentative subdivision map to subdivide an approximately one -acre parcel into two parcels. for property located on the west side of Thornton Road. approximately 290 feet south of Hacienda Drive (TM4-04). The public hearing was declared open and Affidavits of Mailing and Publication were filed. Associate Planner Denise Jefferson summarized the staff report. Zachary Wong, Wong Engineers, Inc. 4578 Feather River Drive, spoke briefly in favor of the application, answered questions regarding parking and requested the Commission's approval. No one else desired to be heard and the public hearing was closed. MOTION: It was duly moved (Lauron), seconded (Cusumano) and carried 6 to 0 (Lowery absent) to approve the tentative map request of GTA Thornton Road Venture (TM4-04), based on the findings and subject to the conditions as listed in the staff report. P.C. Minutes April 8, 2004 Page 3 Item E-3: Public hearina reaardina the reauest of Lawren Ali Brice for a tentative subdivision map to subdivide a 14.434 -square foot parcel into two parcels, for moperty located on the west side of Mary Avenue. approximately 250 feet north of Wait Avenue (3507 Mary Avenue) (TM5-04). The public hearing was declared open and Affidavits of Mailing and Publication were filed. Associate Planner Jenny Liaw summarized the staff report. Applicant Lawren Ali Brice, 3507 Mary Avenue, spoke briefly in favor of the application and explained the reason for the request. No one else desired to be heard and the public hearing was closed. MOTION: It was duly moved (Cusumano), seconded (Kontos) and carried 6 to 0 (Lowery absent) to approve the tentative map request of Lawren Ali Brice (TM5-04), based on the findings and subject to the conditions as listed in the staff report. (The Commission recessed at 7:20 p.m. and reconvened at 7:25 (Guy Petzold arrived at the meeting at 7:25 p.m.) Item E4: Public hearing regarding the request of A. G. Spanos Construction. Inc.. for a Use Permit to allow the off -sale of beer and wine (Phase 1) and aeneral alcoholic beveraaes (Phase 2) in conjunction with a 207,000± square foot retail store located at 10355 Trinity Parkwav within the Spanos Park West Proiect (U P15-04). The public hearing was declared open and the Affidavit of Mailing was filed. Senior Planner David Stagnaro summarized the staff report and recommended that Condition No. 6 be removed, as it is unnecessary. Commissioners Kontos, Brown and Chair Bruce indicated they were contacted by a representative of the applicant regarding this application. The applicant's representative, Gerald Sperry, 1340 West Robinhood Drive, Suite B5, spoke briefly in favor of the application and explained more P.C. Minutes April 8, 2004 Page 4 about the project pointing out that the matter before the Commission was a request for a Use Permit to allow the off -sale of beer and wine and general alcoholic beverages in conjunction with a 207,000± square foot retail store. Attorney William D. Kopper, 417 E Street, Davis, representing the Stockton Citizens for Sensible Planning, spoke briefly in objection to the application. He presented a supplemental traffic report stating that it differed from the one in the Commissioners packets, in that it provided a look at the traffic upon the completion of Phases I and II. He then provided an aerial picture showing parking and open space as it relates to this project and stated that the Environmental Impact Report does not support 207,000 square feet of retail in this location. Brian Kenny, 6705 Montauban Avenue, spoke briefly and stated that he was in opposition to the project. Lawrence Maykel, 1604 South American, Apt. #2, spoke briefly from a neutral position. He spoke on behalf of several docents at the Oak Grove Nature Center, expressing concerns with traffic already generated from existing developments. He requested more time be allowed to review this application before a decision is made. Mr. Sperry then provided a brief rebuttal indicating a plan is included for future traffic improvements which should relieve the current situation. He also provided the Commission with more information regarding the group being represented by Attorney Kopper and suggested how he might better address the issues his clients had regarding this application. Commissioner Lucas then asked Deputy City Attorney Petzold for clarification as to what specifically the Commission would be voting on in regards to this application. Deputy Attorney Petzold responded that this application was basically a request for a Use Permit to sell alcohol. Commissioner Kontos questioned what the City's position would be in the event of any legal action that might be taken. Deputy Attorney Petzold stated that in regards to the legality of this application, it is a legal use, subject to the approval of a Use Permit for the sale of alcoholic beverages. No one else desired to be heard and the public hearing was closed MOTION: It was duly moved (Lucas), seconded (Kontos) and carried 5 to 1 (Lowery absent, Bruce dissenting) to approve the Use Permit request of A. G. Spanos Construction, Inc. (UP15-04), based on the findings and subject to the conditions as listed in the staff report, including the elimination of Condition No. 6. P.C. Minutes April 8, 2004 Page 5 OTHER BUSINESS Chair Bruce indicated that her schedule during the following month would not allow for her to attend any Monday, Tuesday or Wednesday night meetings. She respectfully requested this be taken into consideration when scheduling any future meetings/workshops during that period. Director Glaser reminded the Commission of the Special Workshop on the General Plan that will be held in the Council Chambers at 5:30 p.m. prior to the regular Planning Commission meeting on April 22, 2004. Director Glaser added that the final draft of the Development Code, reflecting all of the changes as approved by the Commission, will be available at the next regular Planning Commission meeting on April 22, 2004, for their final decision and recommendation to Council. Director Glaser stated that a summary of the projects involved in the Capital Improvement Program (CIP) will be provided to the Commission as soon as it is available. He added that the Commission's main role in this process is reviewing this program for it's consistency with the General Plan. Chair Bruce recommended that on the CIP project and others in the future where the timeframe is limited, staff submit the information to the Commissioners via e-mail when possible to facilitate the process and any Commissioners not having access to e-mail could have a copy mailed or hand - delivered to them. She then requested her fellow Commissioners provide their e-mail addresses to the recording secretary at the close of the meeting. Director Glaser indicated that future information, when applicable, would be e-mailed to the Commissioners in order to expedite the review process, with copies being delivered to the Commissioners not having e-mail. COMMISSIONER'S SUGGESTION Chair Bruce expressed the desire to end most future meetings by 9:30 p.m. Deputy City Attorney Petzold indicated that Planning Commission policy states that after 11 p.m. no new items be addressed unless it is the desire of the Commission. P.C. Minutes April 8, 2004 Page 6 ADJOURNMENT There being no further business, the meeting was adjourned at 8:30 p.m. Respectfully submitted, James E. Glaser, Secretary City Planning Commission ODMAIGRPWISEICOS.CDD.CDD—Library:37352.1 Minutes for City Council/Rede- opment Concurrent Meeting MINUTES CONCURRENT CITY COUNCIL/ REDEVELOPMENTAGENCY JUNE 22,2004 1. CC/RD CALL TO ORDERIRO, LL CALL (05:32 PM) Roll Call (05:33 PM) Present: Podesto, Mayor Bestolarides, Councilmember Nomura, Vice -Mayor Nickerson, Councilmember Ruhstaller, Councilmember Martin, Councilmember Giovanetti, Councilmember Page 1 of 12 3c CITY HALL CITY COUNCIL CHAMBERS STOCKTON, CALIFORNIA 2. CCIRED REPORT OF ACTION TAKEN IN CLOSED SESSION - None. (05:32 PM) 3. INVOCATION/PLEDGE TO FLAG -Vice—Mayor Nomura/Councilmemer Nickerson 10.5:33 PM) 4. PROCLAMATIONS/COMMENDATIONS/CITY ANNOUNCEMENTS OR INVITATIONS /~05:35 PM) 4 01 SERVICE PIN PRESENTATION: Paula Cazale - 30 Years Janet Salvetti - 35 Years (05:34 PM) Paula Cazale Service Pin presentation (05:34 PM Janet Salvetti Service Pin_presentation 05G__.,,`39 RM) 4.02) CERTIFICATES OF RECOGNITION: GIRL SCOUTS OF AMERICA GOLD AWARD & SENIOR ROSEAWARD Recipients,. -Susannah Stoffelss_Giri Scout Troop -220 ana Clarissa Thomas, Girl Scout Troop 220 (05:45 PM) 5- CITIZENS' COMMENTS. ANNOUNCEMENTS OR INVITATIONS (05:47 PM) BettyWiIson (05:48 PM) Ms. Wilson of Driftwood Place spoke on the bus situation, stating that the bus company has not grown with the City and she has had to wait as long as an hour for a ride. She said she wrote Ms. Donna Kelsey of the San Joaquin Regional Transit District (SJRTD) but has not received a response. She complained that while fares are being increased service is cut back. She noted that as of July 1 transfers will not be allowed and this will create problems for the drivers. She added that taking almost a year to iron out a contract is too long. Eric Orinqdulph (05:49 PM) http://stockton.granicus.corn/MinutesViewer.php?view_id=4&clip_id=158 2/15/2005 Minutes for City Council/Rede- —)pment Concurrent Meeting Page 2 of 12 Mr. Oringduiph spoke on the Spanos Park West Master Development Plan, particularly of the Planning Commission's acceptance of the 207,000 square foot retail Wai Marl Superstore. He expressed his dismay that the project received such smooth passagewithout regard to the residents of Spanos West. He said that the project is not compatible with existing land use in the area and that the potential negative effect on neighborhood aesthetics is unquestionable. He said that this project in its entirety will be destructive to the quality of life, and added that the effect on traffic patterns is also unquestionable. He pointed out that the modifications to Eight Mile Road to accomodate retail defy rational forethought and are incapable of absorbing current traffic. He asked Counciimember Bestolarides to listen to his constituents in District 1. Vince Contino (05:53 PM) Vince Contino, President and Business Agent of the Amalgamated Transit Union, said he is speaking for 300 drivers and mechanics as a Union Representative and fellow driver. He said that SJ RTD's proposed contract is the beginning of a major laborwar, which the County cannot afford. Mr. Contino said that the proposed pay cut for the average driver who makes $12.90 an hourwould result in a wage of $12.04 per hour, while inflation has risen 3% a year. He said that SJRTD is not able to attract competent drivers and claimed that it is illegally firing union officers. He said that drivers are understaffed by approximately 20 drivers and are working 10 to 15 hours, counting spread times, which is against State and Federal law, and which he considers it union -busting. He said that runs are being pulled and people wait for buses that never arrive. He claimed that this Spring SJRTD passed a $26 million budget with no public scrutiny in a closed session. The Board aiso approved pay increases for management, a 37% in salary adjustments since 2000, and a 12.5% increase in raises and salary adjustments since the contract ran out a year ago. Mr. Contino said that the City Council appointed that SJRTD Board so it is responsible and asked that the Council ensure that the Board carries out its assigned duties. He said that the District's proposed medical plan changes employee's doctors, makes them go without medications, which could affect public safety, and has increased employee costs. Nancv Steele (05:58 PM) Ms. Steele, speaking for her husband, a driver for SJRTD, said that as a result of Ms. Kelsey's change in health care co -pays, they cannot afford most of their medications. She said that the co -pay for her medications has gone from $75 to $246.35 a month. She asked that the Council act on this issue. In response to Mayor Podesto, Mr. Contino verified that they are in arbitration. Carmen Hughes (06:00 PM) Ms. Huqhes read a letter from an employee: "...this is written to let you know how much the insurance changes ... made during contract negotiations has been hurting us. Before the change, my spouse co -pay costs were running approximately $65 a month, now..1hey are running approximately $235. The specialist co -pay increased from $10 to $40 ... In the last four months this has cost us over $1,000 ... Donna Kelsey has arbitrarily taken the insurance portion of the past contract, that should still be in existence, and readjusted.." Ms. Hughes claimed that the letterwriter has been unable to switch over to Kaiser HMO because of her work schedule and was charged for taking off work to keep medical appointments. She continued reading the letter: "it seems that the longer I am employed here, the harder it is to get decent work shifts ... It is very frustrating without a contract and we implore you, as City Council, to speak with our Board..." Chantil Cripps (06:02 PM) Ms. Cripps said that drivers have been working 15 hour spreads with 10 hours drive time without breaks. Bathroom breaks must be called in and there is not adequate time to eat lunch. She spoke of employees who cannot afford the co -pay for their medications, which was increased before the contractwas settled. She said that drivers feel unappreciated and management is unavailable. Ms. Cripps said that employees want a contract and want managementto do itsjob. Justin Mendoza (06:05 PM) Mr. Mendoza, an SJRTD passenger, said that he supports ATU Local 276. He read a statement supporting the Union and asking for a fair contract to provide a fair living wage and decent health benefits. Mr. Mendoza noted that the SJRTD Board of Directors is appointed by the City Council and claimed that the Board approved a substantial pay raise for SJRTD administrators. He said that Ms. Kelsey told him last week, that Mr. Contino does not want to work with her on this situation. Mr. Mendoza denied this, stating Mr. Contino has been working hard to resolve this issue. Mayor Podesto clarified that the City appoints some of the Board members and the County appoints http : / /stockton . granicus . com/MinutesViewer . php'>viewid=4&clip_id=15 8 2/15/2005 Minutes for City Council/Rede—'-)pment Concurrent Meeting Page 3 of 12 some, the Council does not appointthe entire board. Referring to previous speakers' references to closed sessions of the Board, Councilmember Martin was informed that the Board is compliantwith the Brown Act and is required to hold public hearings. Anna Marie Bozarth (06:09 PM) Ms. Bozarth, a bus passenger, said that her route is being eliminated and voiced her support of the drivers. ToCan Nguyen (06:10 PM) Ms. Nguyen agreed with previous speakers, stating that she has repeatedly complained of crimes on buses. She continued her allegations of conspiracy, poisoning, and misuse of funding by government agencies. She complained of immoral behavior by minorities at her motel. She said that she has itemized her complaints and charges for the County Public Defender. Marvin Bolin (06:15 PM) Mr. Bolin voiced his support of Local 276, the union, and the drivers. He said that he has been a regular passenger and has noted that drivers are treated very rudely. He added that there is no air contiditioning on his bus and the heater rarely works. He voiced his hope that the contract is settled soon. Larry Baker(06:18 PM) Mr. Baker said that he and other members of the TaftCommunity Center involved in the Juneteenth Celebration wish to present a Certificate of Appreciation to the Councilmemberswho volunteered to help register 31 new voters last Saturday. He noted that youth from the California Youth Authority and correctional facilities also were of assistance. He introduced Gloria Allen, who presented the cerficates. Gloria Allen (06:20 PM) Ms. Allen thanked the Mayor and Council for their support of the Tafl Community Center and oresented Certificates of Appreciation from the Tafl Community Center Juneteenth Committee, 2004. Janet Lillv (06:22 PMj Ms. Lilly thanked the Council for its support of the Juneteenth Celebration at Weber Point. She noted that the Juneteenth Celebration is the oldest celebration commemorating the end of slavery and the County has three celebrations yearly. In July 2002, Governor Davis designatedthe third Saturday in June as Juneteenth, National Freedom Day. She praised the local talent that was displayed at the Celebration, noting that there were no incidents and good community support. She thanked Councilmembers Giovanetti and Martin for emceeing part of the event. Carol Ornelas (06:25 PM) Ms. Ornelas announced that Union Safe Deposit Bank is being bought out by Bank of the West and invited the Council to a meeting with CRA compliance officers to share what type of Community commitment is desired from Bank of the West. She noted that Union Safe Deposit has been very beneficial for Community, not only in lending but with charitable contributions and economic development. Ms. Ornelas said that this is an opportunity to voice concerns related to the Bank of the West's commitment to and funding for the Community. The meeting will be held Monday at 1 p. m. at the ACLC office, 315 North San Joaquin Street. Councilmember Martin asked if this meeting is open to all groups. Ms. Ornelas said that the entire community is being invited as it is importantto ensure that Bank of the West understands the commitment and support required of it. CouncilmemberRuhstallerobserved that the biggest problem that occurs when big banks buy out small community banks is that they may give the same amount of money but they do not give it in the same geographical locations. Most of those charitable and reinvestment dollars are used on the Coast and not in the Central Valley. Ms. Ornelas agreed, adding that the Bank of the West headquarters is in France. She said that the goal is to obtain a serious commitment to the Community. 6. CC/RD CONSENT AGENDA City Council: 6101*, 6.02**. 6.03.6.04 6.05.6.06. 6.07, 6.08, 6.09.6.10. 6.11 6.12**. 6.13.6.14**. 6.15.6.16 Concurrent City Council/Redevelopment Aaency: 6.17 http://stockton.granicus.com/MinutesViewer.php?view id=4&clip_id=158 2/15/2005 Minutes for City CouncillReder''opment Concurrent Meeting Page 4 of 12 (06:29 PM) *Note: Councilmember Ruhstaller commented on Item 6.01 and noted that the City is putting unpaid code violations and fines to the tune of $1 million on tax rolls. He observed that there are many small amounts but there are a few that have continuous large fines and penalties. He asked if this money is ever collected. City Manager Lewis explained that after an amount is placed on the tax rolls, it becomes a lien on the property and is eventually collected when the property is sold or a collection is forced by the City. "Note: Mayor Podesto asked that Items 6.02, 6.12,and 6.14 be removed from the consent calendar and heard as Items 7.01, 7.02 and 7.03 respectively. 6.01)CC Resolution 04-0372 authorizing the assessment of the delinquent code enforcement charges listed in Exhibit A "Delinquent Accounts That Will Receive Notices Combined Past Due Amounts" to the San Joaquin County tax roll. (POL) (Pages 1— 25) LINK TO 2004-06-22 Council Agenda Item 6.01 LINK TO 2004-06-22 Council Resolution 04-0372 Aaenda Item 6.01 6.02) CC Approve a $600,000 amendment to the Community Development Block Grant (CDBG) loan between the City of Stockton and DIAMOND COVE II ASSOCIATES, a California Limited Partnership, with ACLC, Inc. as the general partner, for additional construction costs for the Diamond Cove II Project; authorize the City Manager to make any necessary administrative changes and to execute the necessary documents required to implement Council direction. (H&RD) (Pages 26 — 27) Mayor Podesto requested that this item be removed from Consent and heard as Item 7.01. 6.03)CC Resolution 04-0373 authorizing the City Manager to execute the subdivision agreement, accepting on behalf of the public all offers of dedication; authorizing the recordation of the map —OAKMORE MEADOWS, UNIT NO.2 —TRACT NO. 2500. (PW) (Pages 28 — 32) LINK TO 2004-06-22 Council Aaenda Item 6.03 LINK TO 2004-06-22 Council Resolution 04-0373 Agenda Item 6.03 6.04) CC Resolution 04-0374 authorizing the City Manager to execute the subdivision agreement, accept on behalf of the public all offers of dedication; authorizing the recordation of the map — NINFATINO ESTATES - - TRACT NO. 3309. (PW) (Pages 33 — 36) LINK TO 2004-06-22 Council Aaenda Item 6.04 LINK TO 2004-06-22 Council Resolution 04-0374 Aaenda Item 6.04 6.05) CC Resolution 04-0375 accepting the completed public improvements for maintenance by the City of Stockton — MAYFAIR ESTATES --TRACT NO. 3166. (PW) (Pages 37 — 39) LINK TO 2004-06-22 Council Agenda Item 6.05 LINK TO 2004-06-22 Council Resolution 04-0375 Aaenda Item 6.05 6.06) CC Resolution 04-0376 approving specifications and awarding a contract in the amount of $216,150to REED AND GRAHAM, INC., for the purchase of Polymer -modified Asphalt Surface Sealer (PASS) emulsion for fiscal year 2004-05. (PW) (Pages 40 — 43) LINK TO 2004-06-22 Council Aaenda Item 6.06 6.07) CC Resolution 04-0377 approving plans and specifications and awarding a contract in the amount of $894,369to BDS CONSTRUCTION for Curb, Gutter, Sidewalk and Wheelchair Ramp Repair Project (Project Number 04-14). (PW) (Pages 44-48) LINK TO 2004-06-22 Council Agenda Item 6.07 L1NKTO2004-06-22 Council Resolution 04-0377 Aaenda Item 6.07 6.08) CC Resolution 04-0378 approving the plans and specifications and awarding a contract in the amount of $576,950to GRAHAM CONTRACTORS, INC., for the 2004 Street Cape -Seal Project (Project No. 04-13). (PW) (Pages 49 — 53) LINK TO 2004-06-22 Council Aaenda Item 6.08 LINK TO 2004-06-22 Council Resolution 04-0378 Aaenda Item 6.08 6.09) CC Resolution 04-0379 approving the plans and specifications and awarding a contract in the amount of $1,194,570to VALLEY SLURRY SEAL, INC., for the 2004 Street Microsurfacing Project (Project No. 04-12). (PW) (Pages 54 —58) LINK TO 2004-06-22 Counci Agenda Item 6.09 LINK TO 2004-06-22 Council Resolution 04-0379 Agenda Item 6_09 6.10)CC STORM DRAINAGE BASIN MAINTENANCE DISTRICTS—adopt the following resolutions to http://stockton.granicus.com/MinutesViewer.php?view_id=4&clip_id=158 2/15/2005 Minutes for City Council/Rede,-)pment Concurrent Meeting --- Page 5 of 12 provide preliminary approval of the proposed budgets and set the public hearing LINK TO 2004-06-22 Council Aaenda Item 6.10 a) Resolution 04-0380 - Charter Way Industrial Site Storm Drainage Basin Maintenance District, Project No. 86-4; LINK TO 2004-06-22 Council Resolution 04-0380 Agenda Item 6.10 a b) Resolution 04-0381 - Arch Road Ind..strial Park Storm Drainage Basin Maintenance District, Project No. 84-2; LINK TO 2004-06-22 Council Resolution 04-0381 Agenda Item 6.10 b c) Resolution 04-0382 - Western Pacific Industrial Park Storm Drainage Basin Maintenance District, Project No. 81-1: LINK TO 2004-06-22 Council Resolution 04-0382 Agenda Item 6.10 c d) Resolution 04-0383 - Stockton Airport Business Center Storm Drainage Basin Maintenance District, Project No. 84-1; LINK TO 2004-06-22 Council Resolution 04-0383 Aaenda Item 6.10 d e) Resolution 04-0384 -Airport Gateway Center Storm Drainage Basin Maintenance District. (Hearing will be held July 20,2004.)(PW) (Pages 59 — 76) LINK TO 2004-06-22 Council Resolution 04-0384 Agenda Item 6.10 e 6.11) CC Resolution 04-0385 that provides for the preliminary approval of the Stockton Consolidated Landscape Maintenance District No. 96-2 Annual Engineer's Report for the 2004-2005 fiscal year; provides for the preliminary approval of the proposed budget; setting the time and place of a public hearing to be held Julj 13.2004. (P&R) (Pages 77 — 93) LINK TO 2004-06-22 Council Aaenda Item 6.11 LINK TO 2004-06-22 Council Resolution 04-0385 Agenda Item 6.11 6.12) CC INITIATIVE MEASURE SUBMITTED BY ERIC PARFREY, ROSEMARY ATKINSON. AND PATRICK JOHNSTON - STOCKTON GREENBELT AND AGRICULTURAL LANDS PROTECTION INITIATIVE MEASURE. Recommended Action: That the Council order a report pursuant to California Elections Code Section 9212 on the potential effects of the measure. The report shall be prepared within the time prescribed by the Council, but no later than 30 days after the City Clerk certifies to the Council the sufficiency of the petition. When the report is presented to the Council, the Council shall either adopt the ordinance within ten (10)days or order an election. (Pages 94 — 118) Mayor Podesto requested that this item be removed from Consent. This Item was heard as Item 7.02, Unfinished Business. 6.13)CC RESOLUTION 04-0386 SUPPORTING SENATE BILL 1266 -AN ACT TO AMEND SECTION 56375.3 OF THE GOVERNMENT CODE RELATING TO ANNEXATION, and: 1)forwarding correspondence to the appropriate parties; and 2) authorizing the City Manager to report the City Council's position and provide factual information regarding the Measure.) (CM) (Pages 119 — 126) LINK TO 2004-06-22 Council Aqenda Item 6.13 LINK TO 2004-06-22 Council Resolution 04-0386 Agenda Item 6.13 6.14) CC MULTI -FAMILY DWELLING ANNUAL ADMINISTRATIVE FEE (Recommendation: None. Information Only) (CM) (Pages 127— 128) Mayor Podesto requested that this item be removed from Consent. This Item was heard as Item 7.03, Unfinished Business. 8.15)CC Resolution 04-0387 authorizing the City Managerto issue a Request for Proposal (RFP) for a Coffee Service Provider for the Chavez Central Librarv. Department of Library Services. (LIB) (Pages 129-138) LINK TO 2004-06-22 Council Aqenda Item6.15 LINK TO 2004-06-22 Council Resolution 04-0387 Aqenda Item 6.15 6.16) CC Resolution 04-0388 amending the class specifications for Assistant City Auditor; Deputy City Auditor 1111, and Senior Deputy City Auditor. (HR) (Pages 139— 156) LINK TO 2004-06-22 Council Aqenda Item 6.16 LINK TO 2004-06-22 Council Resolution 04-0388 Aqenda Item 6.16 6.17) CC MOTION TO APPROVE THE OF MINUTES OF CONCURRENT CITY COUNCIL/ REDEVELOPMENT AGENCY MEETINGS HELD JUNE 8,2004. (CC) (Pages 157— 168) LINK TO 2004-06-22 Council Agenda Item 6.17 Motion: Approve consent calendar save items 6.02, 6.12 and 6.14 Moved by Nomura, Vice -Mayor, seconded by Martin, Councilmember Vote: Motion carried 7-0. http://stockton.granicus.com/MinutesViewer.php?view_id=4&clip id=158 2/15/2005 Minutes for City Council/RedeV— ,)pment Concurrent Meeting -- Page 6 of 12 Yes: Podesto, Mayor; Bestolarides, Councilmember; Nomura, Vice -Mayor; Nickerson, Councilmember; Ruhstaller, Councilmember; Martin, Councilmember; Giovanetti, Councilmember 7. UNFINISHED BUSINESS (06:30 PM) 7.01 (formerly Item 6.02) CC Approve a $600.000 amendment to the Communitv Development Block Grant (CDBG) loan between the City of Stockton and DIAMOND COVE 11 ASSOCIATES, a California Limited Partnership, with ACLC, Inc. as the general partner. for additional construction costs for the Diamond Cove II Proiect; authorize the Citv Manager to make any necessary administrative chanaes and to execute the necessary documents reauired to implement Council direction. (H&RD) (Pages 26 — 27) (06:30 PMl LINK TO 2004-06-22 Council Aaenda Item 6.02 7.01 Mayor Podesto asked for documentation of increased costs and why the $600,000 amendment is necessary. He asked if bids were solicited to determine this amount. He requested that staff return with this information relative to this item. City Manager Lewis indicated that this would be brought back. Item 7.02 (formerly Item 6.12) CC INITIATIVE MEASURE SUBMITTED BY ERIC PARFREY ROSEMARY ATKINSON. AND PATRICK JOHNSTON - STOCKTON GREENBELT AND AGRICULTURAL LANDS PROTECTION INITIATIVE MEASURE. Recommended Action: That the Council order a reportpursuant to California Elections Code Section 9212 on the potential effects of the measure. The report shall be prepared within the tim. e_prscribed by the Council, but no later than 30 days afler the Citv Clerk certifies to the Council the sufficiency of the petition. When the report is presented to the Council. the Council shall either adopt the ordinance within ten (10) days or order an election. (Pages 94 — 118) (06:31 PMl LINK TO 2004-06-22 Council Aqenda Item 6.12 7.02 LINK TO 2004-06-22 Council Aqenda Item 7.02 (formerly Item 6.12) Powerpoint Memorandum dated June 22, 2004 from City Clerk Katherine Meissner clarifying that regardless of which of the three options the Council chooses in regard to Item 6.12, the Council's action must and will include accepting the City Clerk's Certificate of Sufficency. City Clerk Katherine Meissner gave the staff report with the aide of the powerpoint presentation (filed). City Manager Lewis explained the recommended Option 3 relative to the fiscal impact report, Public comment: Dale Stocking spoke on this matter Council discussion ensued regarding the timeline for presenting the fiscal impact report Motion: Approve acceptance of the City Clerk's Certificate of Sufficiency and ordering a report pursuant to California Elections Code Section 9212 on the potential effects of the measure; the report is to be presented to the Council on July 20, 2004. When the report is presented to the Council, the Council shall either adopt the ordinance within ten (10) days or order an election. Moved by Podesto, Mayor, seconded by Nomura, Vice -Mayor. Vote: Motion carried 7-0. Yes: Podesto, Mayor; Bestolarides, Councilmember; Nomura, Vice -Mayor; Nickerson, Councilmember; Ruhstaller, Councilmember; Martin, Councilmember; Giovanetti, Councilmember Item 7.O�merly Item 6.14) CC MULTI -FAMILY DWELLING ANNUAL ADMINISTRATIVE FEE (Recommendation: None. Information Only) (CM)(Paces 127 — 128) (06:51 PM1 LINK TO 2004-06-22 Council Aaenda Item 6.14 7.03 LINK TO 2004-06-22 Council Aqenda Item 6.14 7.03 Powerpoint City Fire Inspection Survey dated June 10, 2004 submitted by Eileen St. Yves, San Joaquin County http://stockton.granicus.convMinutesViewer.php?view id=4&clip_id=158 2/15/2005 Minutes for City Council/Redel-)pment Concurrent Meeting - Page 7 of 12 Rental property Association (filed) Mayor Podesto indicated that the Council had asked previouslythat this item be reconsidered. Interim City Attorney Jayne Williams clarified that the Council can direct this item come back as an action item, Motion: Approve that staff bring this item back for Council reconsideration at an upcoming meeting. Moved by Podesto, Mayor, seconded by Giovanetti, Councilmember. No public comment was taken at this meeting relative to this item. Vote: Motion carried 7-0. Yes: Podesto, Mayor; Bestolarides, Councilmember; Nomura, Vice -Mayor; Nickerson. Councilmember; Ruhstaller, Councilmember; Martin, Councilmember; Giovanetti, Councilmember 8. NEW BUSINESS - None (06:54 PMJ 9. PUBLIC HEARINGS (06:54 PM) 9.01) CC Hearinq to consider public comments/testimony regarding the appeal of a Planninq Commission approval of a Use Permit to allow the off -sale of beer and wine (Phase 1) and General Alcoholic Beveraqes Phase 2) in coniunction with a 207,000 square foot retail super center, located at the northwest corner of Trinity Parkway and Consumnes Drive (10355 Trinitv Parkway) (UP1 5-04). NOTE: At the conclusion of the hearing a resolution will be available denying the appeal and upholding the Planning Commission's approval of a Use Permit (U P1 5-04) to allow the off -sale of beer and wine and general alcoholic beverages in conounction with an approved by -right retail store on property located at the northwest turner of Trinitv Parkway and Consumnes Drive (10355 Trinity Parkway). (C D)(Pages 169 — 225) (06:54 PM) LINK TO 2004-06-22 Council Aqenda Item 9.01 LINK TO 2004-06-22 Council Aqenda Item 9.01 PowerPoint LINK TO 2004-06-22 Council Resolution 04-0389 Aqenda Item 9.01 Mayor Podesto declared the public hearinq open. (06:54 PMS Correspondence filed: June 17, 2004 letter from Jim Watt, Vice Presidentof Real Estate, SaveMart Supermarkets regarding the Liquor License/Conditional Use Permit, Wal-Mart Supercenter- Spanos Park West, Stockton, CA. AFFIDAVIT OF MAILING IS ON FILE IN THE CITY CLERKS OFFICE. The Council recessed at this time until 7 p.m. (06:55 PM) The Council reconvened at this time. (07:02 PM) Community Development Director James Glaser introduced Senior Planner David Stagnaro who gave the staff report and aided by the powerpoint presentation (filed). Mr. Glaser presented additional information regarding this project. The following appellant representative spoke: William Kopper, attorney representing Rosemary Atkinson, Paul Diaz, Susan Rutherford, Larin Essex, and Stockton Citizens for Sensible Planning. He submitted a letter dated April 6, 2004 regarding the application of A.G. Spanos Construction, Inc. to allow the Off -Sale of General Alcoholic Beverages in conjunction with a 207,000 square foot Wal-Mart Supercenter (UP15-04); propertly location: 10355 Trinity Parkwaywithin the Spanos Park West Project. Councilmember Martin asked questions of Mr. Copper relative to his representation against other WalMart cases. The following individuals spoke in support of the appeal: http://stockton.granicus.com/MinutesViewer.php?view id=4&clip_id=158 2/15/2005 Minutes for City Council/Rede- )pment Concurrent Meeting Jim Watt Steve Gaines Brian Kenney The following Project Proponent spoke: Gerry Sperry, attorney representing A. G. Spanos Construction East No one else spoke in support of the project. Rebuttal: William Copper Page 8 of 12 Mayor Podesto asked questions about the appellant's grounds for the protest. Councilmember Marlin asked about the building permit. Mayor Podesto closed the public hearinq at this time and reserved the right to ask additional questions of individuals who have spoken during this public hearing 007:41 PM Mayor Podesto asked about the MX Zone designation. Councilmembers Ruhstaller and Giovanetti asked questions relative to traffic and parking. Public Works Program Manager III Gregg Meissner answered questions relative to traffic. Mayor Podesto and Councilmember Ruhstaller expressed concern about the independents versus WalMart, but this cannot be a concern before the Council. Councilmember Bestolarides stated this is academic being that this is a by -right use absent the alcohol issue or an Environmental Impact Report (EIR) issue, which is the greater issue. The rules are clearly stated in the EIR and how they're followed. Mayor Podesto stated he understands the concerns of the opposition Motion: Approve 9.01) Resolution04-0389denying the appeal and upholding the Planning Commission's approval of a Use Permit (UP15-04) to allow the off -sale of beer and wine and general alcoholic beverages in conjunction with an approved by -right retail store on property located at the northwest corner of Trinity Parkway and Consumnes Drive (10355 Trinity Parkway). Moved by Podesto, Mayor, seconded by Nomura, Vice -Mayor. Vote: Motion carried 6-1. Yes: Podesto, Mayor; Nomura, Vice -Mayor; Nickerson, Councilmember; Councilmember; Giovanetti, Councilmember No: Bestolarides, Councilmember Ruhstaller, Councilmember; Martin, 9.02) CC Hearing to consider public commentsitestimony regardinVjyi redevelopment RD plan. and the California-Environmenta Quai'ty_Act for the North Stockton Redeyelopment Plan Proposed City Council Action. http: Stockton.granicus.com/MinutesViewer.php?view_id=4&clip_id=158 2/15/2005 Minutes for City Council/Rede—)pment Concurrent Meeting Page 9 of 12 Pursuant to Health and Safetv Code Section 33363 (California Communitv Redevelopment Law). prior to adopting a redevelopment plan the leqislative body is required to make written findinqs in response to each written obiection to the Redevelopment Plan made prior to the close of the public hearing. The findings cannot be adopted until at least one week afler the noticed public hearing date. One written obiection to the North Stockton Redevelopment Plan has been received. Therefore. it is recommended that afler receivinq thepublic testimonv. that the public hearing be closed and continued to July 13, 2004, at which time recommendations regarding the adoption of the Redevelopment Plan will be presented -and considered for adoption. It is also recommended that the City Council consider adoption of a resolution certifying the Final Environmental Impact Report FEIR) and adopting the California Environmental Quality Act Findings and Mitiqation Monitoring and Reporting Program -s for the North Stockton Redevelopment Plan on July 13, 2004. Proposed Redevelopment Agency Action: Pursuant to Health and Safetv Code Section 33363 (California Communitv Redevelooment Law). prior to adopting a redevelopment plan. the leqislative body is required to make written findings in response to each written obiection to the Redevelopment Plan made prior to the close of the public hearinq. The findings cannot he -adopted until at least one week afler the noticed public hearing date. One written obiection to the North Stockton Redevelopment Plan has been received. Therefore, it is recommended that after receivinq the public testimonv. that the public hearinq be closed and continued to July 13. 2004, at which time recommendations regarding the adoption of the Redevelopment Plan will be presented and considered for adoption. It is also recommended that the Redevelopment Agency consider ad-Qption of a resolution certifying the Final Environmental Impact Report (FEIR) and adopt the California Environmental Qualitv Act Findings and Mitigation Monitoring and Reportinq Programs for the North Stockton Redevelopment Plan on July 13, 2004. H&RD (Pages 226 - 235 07:53 PM LINK TO 2004-06-22 Council Aqenda Item 9.02 AFFIDAVIT OF PUBLICATION IS ON FILE IN THE CITY CLERKS OFFICE LINK TO 2004-06-22 Council Aqenda Item 9.02 PowerPoint Mavor Podesto declared the public hearinq open. (07:54 Housing and Redevelopment Director Steve Pinkerton gave the staff report and filed the powerpoint presentation. The following individuals also gave presentations supporting the staff report: James C. Simon, Rosenow Spevacek Group, Inc. Lynn Hutchins, Goldfarb & Lipman, filed the proof of publication regarding this item. Podesto, Mayor lefl the meeting at 08:00 PM Podesto, Mayorjoined the meeting at 08:01 PM Mr. Pinkerton summarized the presentation and filed the following letters received in response to the plan: 1) June 10, 2004 letter from John M. Rau, Managing General Partner of Normandy Village (relunctantly in support); 2) June 20,2004 letter from Harvey Christensen (opposed); and 3) May 24, 2004 letter from Minh Huynh (opposed). Those speaking in support of the plan: Philip Hawtin, North Stockton Redevelopment Committee http: //st ockton. cjranicus . co m/MinutesViewer. php?vievid=4&clip_id=158 2/15/2005 Minutes for City Council/Rede- )pment Concurrent Meeting 1-1 Page 10of 12 Tony Zeiter John Rau, Manager Partner cf Normandy Village Sovanna Koeurt, Project Area Community Member Teresa Bryant Heidi Wilson Jeff Heitman Carol Ornelas ToCan Nguyen spoke in opposition to the plan. Martin, Councilmember left the meeting at 08:30 PM Additional speakers in support of the plan: Jim Nyland, President of Nyland Properties Jan Meyer Mavor Podesto closed the public hearinq at this time. (08:36 PM) Motion: Approve 1) the Council Action as follows: closing the public hearing and continuing it to July 13, 2004, at which time recommendations regarding the adoption of the Redevelopment Plan will be presented and considered for adoption. The City Council will consider adoption of a resolution certifying the Final Environmental Impact Report (FEIR) and adopting the California Environmental Quality Act Findings and Mitigation Monitoring and Reporting Programs for the North Stockton Redevelopment Plan on July 13, 2004; and 2) the Redevelopment Agency Action as follows: closing ano continuing the public nearing to July 13 2004, at which time recommendations regarding the adoption of the Redevelopment Plan will be presented and considered for adoption. The Redevelopment Agency will consider adoption of a resolution certifying the Final Environmental Impact Report (FEIR) and adopt the Ca ifornia Environmental Quality Act Findings and Mitigation Monitoring and Reporting Programs for the North Stockton Reoeve opment Plan on July 13. 2004. Moved oy Rihstaller. Councitmember seconded by Nomura. Vice -Mayor. Vote Motion carried -6:Q - Yes Podesto Mayor; Bestoiarides, Councilmember; Nomura, Vice -Mayor; Nickerson, Counc Imember; Rihstaller, Councilmember; Giovanetti. Counc member Absent. Martin, Counci memoer 9,03) CC Hearing to consider public comments/testimony regarding the Proposed Solid Waste Rate. Schedule Amendments. -NOTE .At the conclusion of the. hear ng a resolution will be available_ approv'ng an amended so d waste. collection rate sched .leeftect ve Ag -gust. 2004, adding rates for extra -green waste col ection services and_a 5% rate discount for disablea residential customers under age 66 with income below Stoc_Kton's median income, CPWI_(Paq_es 236 - 238) (08 3-7PM) LINK TO 2004-06-22 Counci Agenda Item 9.03 AFFIDAVIT OF PUBLICATION IS ON FILE IN THE CITY CLERKS OFFICE. http://stockton.granicus.com/NlinutesViewer.php?view_id=4&clip_id=15 8 2/15/2005 Minutes for City Council/Rede-` )pment Concurrent Meeting --- Page 11 of 12 LINK TO 2004-06-22 Council Agenda Item 9.03 powerpoint LINK TO 2004-06-22 Council Resolution 04-0390—Agenda Item 9.03 Mayor Podesto-declaredtnMub is hearing open. (08:37 PM) Pub ic Works Director James Giottonini gave the staff report and filed the powerpoint presentation Councilmember Bestolarides clarified that the proposal is not changing what had been approved, but is an additional service. Mayor Podesto asked questions about discounts for seniors and why they are not considered for discounts. Mavor Podesto declared the public hearina closed. (08:45 PM) Motion: Approve 9.03) CC Resolution 04-0390, as revised, approving an amended solid waste collection rate schedule, effective August 1, 2004, adding rates for extra green waste collection services and a 10% (revised from 5%) rate discount for disabled residential customers under age 65 with income below Stockton's median income. Moved by Bestolarides, Councilmember, seconded by Nomura, Vice -Mayor. Vice Mayor Nomura stated her support for a senior discount along with the discount for disabled customers. Vote: Motion carried 6-0. Yes: Podesto, Mayor; Bestolarides, Councilmember; Nomura, Vice -Mayor; Nickerson, Councilmember; Ruhstaller. Councilmember: Giovanetti. Councilmember Absent: Martin, Councilmember 10. COUNCUREDEVELOPMENT AGENCY COMMENTS AND COMMITTEE REPORTS O�PM) _.. ._ _ Councilmember Ruhstaller (08:48 PM) 1. Councilmember Ruhstaller reported that last week he went on a three day water tour of the Delta and parts of the San Francisco Bay. He noted that over the last week there have been numerous articles printed on water and the levee. He said that the hidden danger to the economy of our area is related to the Delta and the water supply, as the water for 22 million Californians comes through the Delta, and the levee break pointed out that there are issues that need to be addressed related to the water supply. He said that he hoped that Councilmember Giovanetti can keep the new Councilmembers advised of the situation. 2. He noted that The Record had three very nice articles on people that work for their fathers Vice Mayor Nomura (CM to follow up) (08:50 PM) Vice Mayor Nomura referred to citizen complaints about the minature "pocket" scooters running rampant in the street. She asked for a review of City policy related to this issue. Mayor Podesto noted that Modesto has outlawed the scooters on their public streets. Interim City Attorney Jayne Williams added that there are Vehicle Code statutes that regulate motorized scooters. 1"DJOURNMENT0•1P http://stockton.granicus.com/MinutesViewer.php?view_id=4&clip_id=158 2/15/2005 Minutes for City Council/Rede- -)pment Concurrent Meeting w Page 12 of 12 KATHERINE GONG MEISSNER CITY CLERK OF THE CITY OF STOCKTON SECRETARY REDEVELOPMENTAGENCY http://stockton.granicus.com/N4inutesViewer.php?view id=4&elip_id=158 2/15/2005 CITY OF STOCKTON NOTICE OF EXEMPTION TO: COUNTY CLERK FROM: Lead Agency COUNTY OF SAN JOAQUIN City of Stockton 6 South EI Dorado Street, 2"d Floor c/o Community Development Dept Stockton, CA 95202 Planning Division 425 North EI Dorado Street Stockton, CA 95202-1997 NOTICE OF EXEMPTION PURSUANTTO PUBLIC RESOURCESCODE SECTION21152(B) AND CALIFORNIA CODE OF REGULATIONS TITLE 14. SECTION 15062 PROJECT DATA Project Title: A.G. Spanos Construction —Use Permit Proiect CEQA Exemption File No.: CE221-04 Applicant: A.G. Spanos Construction Project Description/Location: Use Permit to allow the off -sale of beer and wine (Phase 1) and general alcoholic beveraqes (Phase 2) in conjunction with a 207,000± square foot retail store located at 10355Trinity Parkwavwithin Spanos Park West Proiect(UP15-04). DETERMINATION/FINDING OF EXEMPTION The above-described activity/project is exempt from the environmental assessment requirements of the California Environmental QualityAct (CEQA) pursuantto the following section(s) of the State CEQA Guidelines (California Code of Regulations, Title 14): The activity is not a "project" as defined in Section 15378. The activity is exempt under the "general rule"that CEQAapplies onlyto projectswhich havethe potentialfor causing significant environmental effects, as specified in Section 15061(6)(3), The project has been granted a "Statutory Exemption" under Article 18 and, specifically, bySection(s): X The project has been granted a "Categorical Exemption" under Article 19 and, specifically, by Section(s): 15301CL( ASS 1). BASIS FOR FINDING OF EXEMPTION The activity does notqualify as a project and/or clearlycould not have a significant effect on the environment and, therefore, CEQA does not apply. X The activity constitutes a discretionary project underthe City'sjurisdiction and qualifies as a projectwhich has been determined not to have a significant effect on the environment and, therefore, is exempt from the provisions of CEQA under the above -noted statutory or categorical exemption(s). June 30.2004 (DATE OF PREPARATION) JAMES E. GLASER, DIRECTOR (DATE OF FINALAPPROVAL) COMMUNITY DEVELOPMENT DEPARTMENT AFFIDAVIT OF FILINGAND POSTIN I declare that on the date stamped above, I received and posted this noticeor included it on a list of such noticeswhich was posted as required by California Public Resources Code Section 21152(B). Said notice or list of notices will remain posted for 35 days from the filing date. Signature Posting Period Ending Date Title ::ODMAIGRP W! SEICOS.CDD.CDD_Library.39339.1 Rev. 7-19-02 3d V -JAMA --Lung Cancer, CardiopulmonaryMortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,2002, ...Page 1 of 23 Select Journal or ResourceA SERRCH THIS JOURNRL M u0m GO TO ROURNCED SERRCH > The Jouurnal of the American MedicalAssnciation —To Promate the Science and Art of 1a1L!dinne and the Betterment; of the Public Health Access via PURCHASEACCESS Vol. 287 No. !a March C 2002 TABLE CF CDNTENTS > Featured Link Original Contribution • E-mail Alerts Article Options Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to .Abstract POF Fine Particulate Air Pollution •Send to a Friend *Related articles in this C. Arden Pope PhD; Richard T. Burnett PhD; Michael]. Thun, MD; Eugenia E. Calle, PhD; issue p � r ! � g r *Similar articles in this Daniel Krewski, PhD; Kazuhiko Ito, PhD; George D. Thurston, ScD journal Literature Track JAMA. 2002;287-.1132-1141. 'Add to File Drawer *Download to Citation ABSTRACT Manager • PubMed citation *Articles in PubMed by Context Associations have been found between day-to-day particulate air pollution and increased risk of -Pope III CA various adverse health outcomes, including cardiopulmonary mortality. However, studies of health effects of -Thurston GD long-term particulate air pollution have been less conclusive. 'Articles that cite this article • ISI Web of Science Objective To assess the relationship between long-term exposure to fine particulate air pollution and all- (264) cause, lung cancer, and cardiopulmonary mortality. ,Contact me article s cited this Design, Setting, and Participants Vital status and cause of death data were collected by the American Topic Collections - Pulmonary Diseases, Cancer Society as part of the Cancer Prevention II study, an ongoing prospective mortality study, which Other enrolled approximately 1.2 million adults in 1982. Participants completed a questionnaire detailing individual 'Occupational and Environmental Medicine risk factor data (age, sex, race, weight, height, smoking history, education, marital status, diet, alcohol .Oncology consumption, and occupational exposures). The risk factor data for approximately 500 000 adults were linked -Lung Cancer with air pollution data for metropolitan areas throughout the United States and combined with vital status and -Topic Collection Alerts cause of death data through December 31, 1998. t%+J -11,0 .—r .ten ___ /— -: 1.. 14f'-, 11!'10'11h/ 1 111 .JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine ParticulateAir Pollution, March 6,2002, ...Page 2 of 23 Main Outcome Measure All -cause, lung cancer, and cardiopulmonary mortality, Results Fine particulate and sulfur oxide -related pollution were associated with all -cause, lung cancer, and cardiopulmonary mortality. Each 10-Ng/m3 elevation in fine particulate air pollution was associated with approximately a 4%, 6%, and 8$ increased risk of all -cause, cardiopulmonary, and lung cancer mortality, respectively. Measures of coarse particle fraction and total suspended particles were not consistently associated with mortality. Conclusion Long-term exposure to combustion -related fine particulate air pollution is an important environmental risk factor for cardiopulmonary and lung cancer mortality. INTRODUCTION Jump to Section Based on several severe air pollution events," a temporal correlation between extremely high .Top concentrations of particulate and sulfur oxide air pollution and acute increases in mortality was well • Introduction established by the 1970s. Subsequently, epidemiological studies published between 1989 and 1996 '. Methods Results reported health effects at unexpectedly low concentrations of particulate air pollution.' The convergence of • comment data from these studies, while controversial,5 prompted serious reconsideration of standards and health • Author information guidelines6-10 and led to a long-term research program designed to analyze health-related effects due to - References particulate pollution.11-13 I n 1997, the Environmental Protection Agency adopted new ambient air quality standards that would impose regulatory limits on fine particles measuring less than 2.5 pm in diameter (PMS 5). These new standards were challenged by industry groups, blocked by a federal appeals court, but ultimately upheld by the US Supreme Court. 14 Although most of the recent epidemiological research has focused on effects of short-term exposures, several studies suggest that long-term exposure may be more important in terms of overall public health .4 The new standards for long-term exposure to PMZ s were originally based primarily on 2 prospective cohort studies, 15-16 which evaluated the effects of long-term pollution exposure on mortality. Both of these studies have been subjected to much scrutiny,5 including an extensive independent audit and reanalysis of the original data." The larger of these 2 studies linked individual risk factor and vital status data with national ambient air pollution data .16 Our analysis uses data from the larger study and (11 )doubles the follow-up time to more than 16 years and triples the number of deaths; (2) substantially expands exposure data, including gaseous copollutant data and new PMz 5 data, which have been collected since the promulgation of the new air quality standards; (3) improves control of occupational exposures; (4) incorporates dietary variables that account for total fat consumption, and consumption of vegetables, citrus, and high -fiber grains; and (5) uses recent advances in statistical modeling, including the incorporation of random effects and nonparametric spatial smoothing components in the Cox proportional hazards model. JAMA-- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,2002, ...Page 3 of 23 METHODS Study Population Jump to Section Top • Introduction The analysis is based on data collected by the American Cancer Society (ACS) as part of the Cancer 'Methods • Results Prevention Study II (CPS -11), an ongoing prospective mortality study of approximately 1.2 million • Comment adults.1$-19 Individual participants were enrolled by ACS volunteers in the fall of 1982. Participants resided ' Author information in all 50 states, the District of Columbia, and Puerto Rico, and were generally friends, neighbors, or - References acquaintances of ACS volunteers. Enrollment was restricted to persons who were aged 30 years or older and who were members of households with at least 1 individual aged 45 years or older. Participants completed a confidential questionnaire, which included questions about age, sex, weight, height, smoking history, alcohol use, occupational exposures, diet, education, marital status, and other characteristics. Vital status of study participants was ascertained by ACS volunteers in September of the following years: 1984, 1986, and 1988. Reported deaths were verified with death certificates. Subsequently, through December 31, 1998, vital status was ascertained through automated linkage of the CPS -II study population with the National Death Index.") Ascertainment of deaths was more than 98% complete for the period of 1982-1988 and 93% complete after 1988.19 Death certificates or codes for cause of death were obtained for more than 98% of all known deaths. Cause of death was coded according to the International Classification of Diseases, Ninth Revision (ICD-9). Although the CPS -II cohort included approximately 1.2 million participants with adequate questionnaire and cause -of -death data, our analysis was restricted to those participants who resided in US metropolitan areas with available pollution data. The actual size of the analytic cohort varied depending on the number of metropolitan areas for which pollution data were available. Table 1 provides the number of metropolitan areas and participants available for each source of pollution data. View this table: Table 1. Summary of Alternative Pollution Indices* [in this window] [in a new window] Air Pollution Exposure Estimates Each participant was assigned a metropolitan area of residence based on address at time of enrollment and 3 -digit ZIP code alrea.20 Mean (SD) concentrations of air pollution for the metropolitan areas were compiled from various primary data sources (Table 1). Many of the particulate pollution indices, including PM2 5, were available from data from the Inhalable Particle Monitoring Network for 1979-1983and data from the National Aerometric Databasefor 1980-1981,periodsjust prior to or at the beginning of the follow-up period. An additional data source was the Environmental Protection Agency Aerometric Information JAMA --Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,2002, ...Page4 of 23 Retrieval System (AIRS). The mean concentration of each pollutant from all available monitoring sites was calculated for each metropolitan area during the 1 to 2 years prior to enrollment.17 Additional information on ambient pollution during the follow-up period was extracted from the AIRS database as quarterly mean values for each routinely monitored pollutant for 1982 through 1998. All quarterly averages met summary criteria imposed by the Environmental Protection Agency and were based on observations made on at least 50% of the scheduled sampling days at each site. The quarterly mean values for all stations in each metropolitan area were calculated across the study years using daily average values for each pollutant except ozone. For ozone, daily 1 -hour maximums were used and were calculated for the full year and for the third quarter only (ie, July, August, September). While gaseous pollutants generally had recorded data throughout the entire follow-up period of interest, the particulate matter monitoring protocol changed in the late 1980s from total suspended particles to particles measuring less than 10 lam in diameter M resulting in the majority of total suspended particle data being available in the early to mid-1980s and PMO data being mostly available in the early to mid-1990s. As a consequence of the new PM2 5 standard, a large number of sites began collecting PMz 5 data in 1999. Daily PMz 5 data were extracted from the AIRS database for 1999 and the first 3 quarters of 2000. For each site, quarterly averages for each of the 2 years were computed. The 4 quarters were averaged when at least 1 of the 2 corresponding quarters for each year had at least 50% of the sixth -day samples and at least 45 total sampling days available. Measurements were averaged first by site and then by metropolitan area. Although no network of PM... monitoring existed in the United States between the early 1980s and the late 1990s, the integrated average of PM2 5 concentrations during the period was estimated by averaging the PMS., concentration for early and later periods. Mean sulfate concentrations for 1980-1981 were available for many cities based on data from the Inhalable Particle Monitoring Network and the National Aerometric Database. Recognizing that sulfate was artifactually overestimated due to glass fiber filters used at that time, season and region -specific adjustments were made." Since few states analyzed particulate samples for sulfates after the early 1980s, individual states were directly contacted for data regarding filter use. Ion chromatography was used to analyze FM filters and this data could be obtained from metropolitan areas across the United States. Filters were collected for a single reference year (1990) in the middle of the 1982-1998 study period. The use of quartz filters virtually eliminated the historical overestimation of sulfate. Mean sulfate concentrations for 1990 were estimated using sulfate from AIRS, data reported directly from individual states, and analysis of archived filters. Statistical Analysis The basic statistical approach used in this analysis is an extension of the standard Cox proportional hazards survival model," which has been used for risk estimates of pollution -related mortality in previous longitudinal cohort studies.15-16 The standard Cox model implicitly assumes that observations are statistically independent after controlling for available risk factors, resulting in 2 JAMA-- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine ParticulateAir Pollution, March 6,2002, ...Page5 of 23 concerns with regard to risk estimates of pollution -related mortality.22 First, if the assumption of statistical independence is not valid, the uncertainty in the risk estimates of pollution -related mortality may be misstated. Second, even after controlling for available risk factors, survival times of participants living in communities closer together may be more similar than participants living in communities farther apart, which results in spatial autocorrelation. If this spatial autocorrelation is due to missing or systematically mismeasured risk factors that are spatially correlated with air pollution, then the risk estimates of pollution -related mortality may be biased due to inadequate control of these factors. Therefore, in this analysis, the Cox proportional hazards model was extended by incorporating a spatial random -effects component, which provided accurate estimates of the uncertainty of effect estimates. The model also evaluated spatial autocorrelation and incorporated a nonparametric spatial smooth component (to account for unexplained spatial structure). A more detailed description of this modeling approach is provided elsewhere.22 The baseline analysis in this study estimated adjusted relative risk (RR) ratios for mortality by using a Cox proportional hazards model with inclusion of a metropolitan -based random -effects component. Model fitting involved a 2 -stage process. In the first stage, survival data were modeled using the standard Cox proportional hazards model, including individual level covariates and indicator variables for each metropolitan area (without pollution variables). Output from stage 1 provided estimates of the metropolitan -specific logarithm of the RRs of mortality (relative to an arbitrary reference community), which were adjusted for individual risk factors. The correlation between these values, which was induced by using the same reference community, was then removed .23 1 n the second stage, the estimates of adjusted metropolitan -specific health responses were related to fine particulate air pollution using a linear random -effects regression model.24 The time variable used in the models was survival time from the date of enrollment. Survival times of participants who did not die were censored at the end of the study period. To control for age, sex, and race, all of the models were stratified by 1 -year age categories, sex, and race (white vs other), which allowed each category to have its own baseline hazard. Modelswere estimated for all -cause mortality and for 3 separate mortality categories: cardiopulmonary (ICD-9 401-440 and 460-519), lung cancer (ICD-9 162), and all others. Models were estimated separately for each of the 3 fine particle variables, PM,,, (1979-1983), PM2 5 (1999-2000), and PM2 5 (average). Individual level covariates were included in the models to adjust for various important individual risk factors. All of these variables were classified as either indicator (ie, yes/no, binary, dummy) variables or continuous variables. Variables used to control for tobacco smoke, for example, included both indicator and continuous variables. The smoking indicator variables included: current cigarette smoker, former cigarette smoker, and a pipe or cigar smoker only (all vs never smoking) along with indicator variables for starting smoking before or after age 18 years. The continuous smoking variables included: current smoker's years of smoking, current smoker's years of smoking squared, current smoker's cigarettes per day, current smoker's cigarettes per day squared, former smoker's years of smoking, former smoker's years of smoking squared, former smoker's cigarettes per day, former smoker's cigarettes per day squared, and the number of hours per day exposed to passive cigarette smoke. To control for education, 2 indicator variables, which indicated completion of high school or education beyond high school, were included. Marital status variables included indicator variables for single and other vs married. Both body mass index (BMI) values and BMI values squared were included as continuous variables. Indicator variables for beer, liquor, and wine drinkers and JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposureto Fine Particulate Air Pollution, March 6,2002, ...Page 6 of 23 nonresponders vs nondrinkers were included to adjust for alcohol consumption. Occupational exposure was controlled for using various indicator variables: regular occupational exposure to asbestos, chemicals/acids/solvents, coal or stone dusts, coal tar/pitch/asphalt, diesel engine exhaust, or formaldehyde, and additional indicator variables that indicated 9 different rankings of an occupational dirtiness index that has been developed and described elsewhere. 17, 25 Two diet indices that accounted for fat consumption and consumption of vegetables, citrus, and high -fiber grains were derived based on information given in the enrollment questionnaire. 18 Quintile indicator variables for each of these diet indiceswere also included in the models,l$ I n addition to the baseline analysis, several additional sets of analysis were conducted. First, to more fully evaluate the shape of the concentration -response function, a robust locally weighted regression smoother 26 (within the generalized additive model framework27) was used to estimate the relationship between particulate air pollution and mortality in the second stage of model fitting. Second, the sensitivity of the fine particle mortality risk estimates compared with alternative modeling approaches and assumptions was evaluated. Standard Cox proportional hazards models were fit to the data including particulate air pollution as a predictor of mortality and sequentially adding (in a controlled forward stepwise process) groups of variables to control for smoking, education, marital status, BMI, alcohol consumption, occupational exposures, and diet. I n addition, to evaluate the sensitivity of the estimated pollution effect while more aggressively controlling for spatial differences in mortality, a 2-dimensional term to account for spatial trends was added to the models and was estimated using a locally weighted regression smoother. The "span" parameter, which controls the complexity of the surface smooth, was set at 3 different settings to allow for increasingly aggressive fitting of the spatial structure. These included a default span of 50%, the span that resulted in the lowest unexplained variance in mortality rate between metropolitan areas, and the span that resulted in the strongest evidence (highest P value) to suggest no residual spatial structure. The risk estimates and SEs (and thus the confidence intervals) were estimated using generalized additive modeling27 with S -Plus statistical software, 28 which provides unbiased effect estimates, but may underestimate SEs if there is significant spatial autocorrelation and significant correlations between air pollution and the smoothed surface of mortality. Therefore, evidence of spatial autocorrelation was carefully evaluated and tested using the Bartlett test.29 The correlations of residual mortality with distance between metropolitan areas were graphically examined. Analyses were also conducted of effect modification by age, sex, smoking status, occupational exposure, and education. Finally, models were fit using a variety of alternative pollution indices, including gaseous pollutants. Specifically, models were estimated separately for each of the pollution variables listed in Table 1, while also including all of the other risk factor variables. RESULTS Jump to Section Fine particulate air pollution generally declined in the United States during the follow-up period of this .Top study. Figure 1 plots mean PM2 5 concentrations for 1999-2000 over mean PMZ 5 concentrations for 1979- . Introduction . Methods }�}}�•/�iorf�a .err... ..nn., ..«,-1...-: 1.._�a_�./L _17 fnnrrn �. .'. r. JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,2 002, ...Page 7 of 23 1983 for the 51 cities in which paired data were available. The concentrations of PMz 5 were lower in 1999- Results . Comment 2000 than in 1979-1983 for most cities, with the largest reduction observed in the cities with the highest .Author information concentrations of pollution during 1979-1983. Mean PMZ 5 levels in the 2 periods were highly correlated (r .References = 0.78). The rank ordering of cities by relative pollution levels remained nearly the same. Therefore, the relative levels of fine particle concentrations were similar whether based on measurements at the beginning of the study period, shortly following the study period, or an average of the 2. FA m View larger version (28K): [in this window] [in a new window] Figure 1. Mean Fine Particles Measuring Less Than 2.5 dim in Diameter (PMZ s) Mean PMZ 5 concentrations in micrograms per meters cubed for 1999-2000 are plotted along with concentrations for 1979-1983 for the 51 metropolitan areas with paired pollution data. The dotted line is a reference 450 -equality line. As reported in Table 2, all 3 indices of fine particulate air pollution were associated with all -cause, cardiopulmonary, and lung cancer mortality, but not mortality from all other causes combined. Figure 2 presents the nonparametric smoothed exposure response relationships between cause -specific mortality and PMZ 5 (average). The log RRs for all -cause, cardiopulmonary, and lung cancer mortality increased across the gradient of fine particulate matter. Goodness -of -fit tests indicated that the associations were not significantly different from linear associations (P>.20). View this table: [in this windowl Table 2. Adjusted Mortality Relative Risk (RR) Associated With a 10-pg/m3 Change in Fine Particles [in a new window] Measuring Less Than 2.5 dim in Diameter 11�}Y1•IIf /1w./1 �wr.n .annw..—�/...��l.....�a..�alA.77Mo�f Ml� � �n . JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,2002, ...Page 8 of 23 Figure 2. Nonparametric Smoothed Exposure Response Relationship a - Vertical lines along x-axes indicate rug or frequency plot of mean fine particulate d Z pollution; PM2 5, mean fine particles measuring less than 2.5 pm in diameter; RR, relative risk; and Cl, confidence interval. �f View larger version (29K): [in this window] [in a new window] The fine particle mortality RR ratios from various alternative modeling approaches and assumptions are presented in Figure 3. After controlling for smoking, education, and marital status, the controlled forward stepwise inclusion of additional covariates had little influence on the estimated associations with fine particulate air pollution on cardiopulmonary and lung cancer mortality. As expected, cigarette smoking was highly significantly associated with elevated risk of all -cause, cardiopulmonary, and lung cancer mortality (P<.001). Estimated RRs for an average current smoker (men and women combined, 22 cigarettes/day for 33.5 years, with initiation before age 18 years) were equal to 2.58, 2.89, and 14.80for all -cause, cardiopulmonary, and lung cancer mortality, respectively. Statistically significant, but substantially smaller and less robust associations, were also observed for education, marital status, BMI, alcohol consumption, occupational exposure, and diet variables. Although many of these covariates were also statistically associated with mortality, the risk estimates of pollution -related mortality were not highly sensitive to the inclusion of these additional covariates. Figure 3. Mortality Relative Risk (RR) Ratio Associated With 10-tag/m3 Differences of PM2 5 Concentrations Data presented are for 1979-1983 for the different causes of death, with various levels of controlling for individual risk factors, and using alternative modeling approaches. The 3 models with spatial smoothing allow for increasingly aggressive fitting of the spatial structure. Plus sign indicates model included previous variables (ie, smoking included stratification by age, sex, and race); PM2 S, mean fine particles measuring less than 2.5 Pm in diameter; and CI, confidence interval. JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,2002, ...Page 9 of 23 I; View largerversion (14K): [in this window] [in a new window] Figure 3 also demonstrates that the introduction of the random -effects component to the model resulted in larger SEs of the estimates and, therefore, somewhat wider 95% confidence intervals. There was no evidence of statistically significant spatial autocorrelation in the survival data based on the Bartlett test (P>.20) aftercontrolling for fine particulate air pollution and the various individual risk factors. Furthermore, graphical examination of the correlations of the residual mortality with distance between metropolitan areas did not reveal significant spatial autocorrelation (results not shown). Nevertheless, the incorporation of spatial smoothing was included to further investigate the robustness of the estimated particulate pollution effect. Effect estimates were not highly sensitive to the incorporation of spatial smoothing to account for regional clustering or other spatial patterns in the data. Figure 4 presents fine particle air pollution -related mortality RR ratios after stratifying by age, sex, education, and smoking status, and adjusting for all other risk factors. The differences across age and sex strata were not generally consistent or statistically significant. However, a consistent pattern emerged from this stratified analysis: the association with particulate pollution was stronger for both cardiopulmonary and lung cancer mortality for participants with less education. Also, for both cardiopulmonary and lung cancer mortality, the RR estimates were higher for nonsmokers. Figure 4. Adjusted Mortality Relative Risk (RR) Ratio Associated With 10-p9/m3 Differences of PMz s Concentrations L"-.. It...-..... ___ ......« I,. 1n 111 nn JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200 ... Page 10 of 23 Data presented are For 1979-1983 For the different causes of death stratified by age, sex, �- education, and smoking status. PMI., indicates mean fine particles measuring less than o 2.5 Nm in diameter; Cl, confidence interval. View larger version (21K): [in this window] [in a new window] Figure 5 summarizes the associations between mortality risk and air pollutant concentrations listed in Table 1. Statistically significant and relatively consistent mortality associations existed for all measures of fine particulate exposure, including 13142 .5 and sulfate particles. Weaker less consistent mortality associations were observed with FM and FM Measures of the coarse particle fraction (PM,, -2,,) and total suspended particles were not consistently associated with mortality. Of the gaseous pollutants, only sulfur dioxide was associated with elevated mortality risk. Interestingly, measures of PMz 5 were associated with all -cause cardiopulmonary, and lung cancer mortality, but not with all other mortality. However, sulfur oxide pollution (as measured by sulfate particles and/or sulfur dioxide) was significantly associated with mortality from all other causes in addition to all -cause, cardiopulmonary, and lung cancer mortality. Figure 5. Adjusted Mortality Relative Risk (RR) Ratio Evaluated at Subject -Weighted Mean Concentrations PMI, indicates particles measuring less than 2.5 Nm in diameter; FAq particles measuring less than 10 dim in diameter; PM15, particles measuring less than 15 pm in diameter; PM15_I.S, particles measuring between 2.5 and 15 ]gym in diameter; and Q, confidence interval. Lai__/7_____ _____ _____ . –f__'r .- . . m f f ii+__—,...... JAMA --Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200 ... Page 11 of 23 — View larger version (18K): [in this window] [in a new window] COMMENT Jump to Section This study demonstrated associations between ambient fine particulate air pollution and elevated risks of . Top both cardiopulmonary and lung cancer mortality. Each 10-Ng/m3 elevation in long-term average PMz 5 . Introduction . Methods ambient concentrations was associated with approximately a 4%, 6%, and 8% increased risk of all -cause, . Results cardiopulmonary, and lung cancer mortality, respectively, although the magnitude of the effect somewhat • Comment depended on the time frame of pollution monitoring. I In addition, this analysis addresses many of the •Author information References important questions concerning the earlier, more limited analysis of the large CPS -II cohort, including the following issues. First, does the apparent association between pollution and mortality persist with longer follow-up and as the cohort ages and dies? The present analysis more than doubled the follow-up time to more than 16 years, resulting in approximately triple the number of deaths, yet the associations between pollution and mortality persisted. Second, can the association between fine particulate air pollution and increased cardiopulmonary and lung cancer mortality be due to inadequate control of important individual risk factors? After aggressively controlling for smoking, the estimated fine particulate pollution effect on mortality was remarkably robust. When the analysis was stratified by smoking status, the estimated pollution effect on both cardiopulmonary and lung cancer mortality was strongest for never smokers vs former or current smokers. This analysis also controlled for education, marital status, BMI, and alcohol consumption. This analysis used improved variables to control for occupational exposures and incorporated diet variables that accounted for total fat consumption, as well as for JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 12 of 23 consumption of vegetables, citrus, and high -fiber grains. The mortality associations with fine particulate air pollution were largely unaffected by the inclusion of these individual risk factors in the models. The data on smoking and other individual risk factors, however, were obtained directly by questionnaire at time of enrollment and do not reflect changes that may have occurred following enrollment. The lack of risk factor follow-up data results in some misclassification of exposure, reducesthe precision of control for risk factors, and constrains our ability to differentiate time dependency. Third, are the associations between fine particulate air pollution and mortality due to regional or other spatial differences that are not adequately controlled for in the analysis? I f there are unmeasured or inadequately modeled risk factors that are different across locations, then spatial clustering will occur. I f this clustering is independent or random across metropolitan areas, then the spatial clustering can be modeled by adding a random -effects component to the Cox proportional hazards model as was done in our analysis. The clustering may not be independent or random across metropolitan areas due to inadequately measured or modeled risk factors (either individual or ecological). I fthese inadequately measured or modeled risk factors are also spatially correlated with air pollution, then biased pollution effects estimates may occur due to confounding. However, in this analysis, significant spatial autocorrelation was not observed after controlling for fine particulate air pollution and the various individual risk factors. Furthermore, to minimize any potential confounding bias, sensitivity analyses, which directly modeled spatial trends using nonparametric smoothing techniques, were conducted. A contribution of this analysis is that it included the incorporation of both random effects and nonparametric spatial smoothing components to the Cox proportional hazards model. Even after accounting for random effects across metropolitan areas and aggressively modeling a spatial structure that accountsfor regional differences, the association between fine particulate air pollution and cardiopulmonary and lung cancer mortality persists. Fourth, is mortality associated primarily with fine particulate air pollution or is mortality also associated with other measures of particulate air pollution, such as PMXo, total suspended particles, or with various gaseous pollutants? Elevated mortality risks were associated primarily with measures of fine particulate and sulfur oxide pollution. Coarse particles and gaseous pollutants, except for sulfur dioxide, were generally not significantly associated with elevated mortality risk. Fifth, what is the shape of the concentration -response function? Within the range of pollution observed in this analysis, the concentration -response function appears to be monotonic and nearly linear. However, this does not preclude a leveling off (or even steepening) at much higher levels of air pollution. Sixth, how large is the estimated mortality effect of exposure to fine particulate air pollution relative to other risk factors?A detailed description and interpretation of the many individual risk factors that are controlled for in the analysis goes well beyond the scope of this report. However, the mortality risk associated with cigarette smoking has been well documented using the CPS -II Cohort. 16 The risk imposed by exposure to fine particulate air pollution is obviously much smaller than the risk of cigarette smoking. Another risk factor that has been well documented using the CPS -II cohort data is body mass as measured by BM 1.30 The Word Health Organization has categorized B M I values between 18.5-24.9 kg/m2 as normal; 25-29.9 kg/m2, grade 1 overweight; 30-39.9 kg/m2, grade 2 overweight; and 40 kg/m2 or higher, grade 3 overweight.31 I n the present analysis, BMI . JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 13 of 23 values and BMI values squared were included in the proportional hazards models. Consistent with previous ACS analysis,30 BMI was significantly associated with mortality, optimal BMI was between approximately 23.5 and 24.9 kg/m2,, and the RR of mortality for different BMI values relative to the optimal were dependent on sex and smoking status. For example, the RRs associated with BMI values between 30.0 and 31.9 kg/mz(vs optimal) would be up to approximately 1.33 for never smokers. Based on these calculations, mortality risks associated with fine particulate air pollution at levelsfound in more polluted US metropolitan areas are less than those associated with substantial obesity (grade 3 overweight), but comparable with the estimated effect of being moderately overweight (grade Ito 2). In conclusion, the findings of this study provide the strongest evidence to date that long-term exposure to fine particulate air pollution common to many metropolitan areas is an important risk factor for cardiopulmonary mortality. I In addition, the large cohort and extended follow-up have provided an unprecedented opportunity to evaluate associations between air pollution and lung cancer mortality. Elevated fine particulate air pollution exposures were associated with significant increases in lung cancer mortality. Although potential effects of other unaccountedfor factors cannot be excluded with certainty, the associations between fine particulate air pollution and lung cancer mortality, as well as cardiopulmonary mortality, are observed even after controlling for cigarette smoking, BMI, diet, occupational exposure, other individual risk factors, and after controlling for regional and other spatial differences. AUTHOR INFORMATION Jump to Section Author Contributions: Study concept and design: Pope, Burnett, Krewski, Thurston. . Top • Introduction Acquisition of data: Thun, Calle, Krewski, Ito, Thurston. .Methods Ac q •Results . Comment Analysis and interpretation of data: Pope, Burnett, Krewski, Thurston. .Author information . References Drafting of the manuscript: Pope, Burnett, Ito, Thurston. Critical revision of the manuscript for important intellectual content: Pope, Thun, Calle, Krewski, Thurston. Statistical expertise: Pope, Burnett, Krewski. Obtained funding: Pope, Thun, Thurston. Administrative, technical, ormaterial support: Pope, Calle, Krewski, Ito, Thurston. JAMA --Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200 ... Page 14 of 23 Study supervision: Pope, Krewski. Funding/Support: The research for this article was supported largely by grant ES09560-01A1 from the National Institutes of Health/National Institute of Environmental Health Sciences (NIEHS). It was also supported in part by grant ES00260 from the New York University Center/NIEHS, grant R-827351 from the Environmental Protection Agency RVI Health Effects Research Center, and funding from the R. Samuel McLaughlin Centre for Population Health Risk Assessment at the University of Ottawa. Acknowledgment: We thank Morton Lippmann, PhD, for his help in developing the research grant application and various comments and suggestions and Yuanli Shi, MD, for computer programming and statistical analysis support. Corresponding Author and Reprints: C. Arden Pope III, PhD, Department of Economics, Brigham Young University, 142 FOB, Provo, UT 84602 (e-mail: cap3@email.byu.edu). Author Affiliations: Brigham Young University, Provo, Utah (Dr Pope); Health Canada, Ottawa, Ontario (Dr Burnett); University of Ottawa, Ottawa, Ontario (Drs Burnett and Krewski); American Cancer Society, Atlanta, Ga (Drs Thun and Calle); and New York University School of Medicine, Tuxedo, NY (Drs Ito and Thurston). REFERENCES Jump to Section 1. FirketJ. The cause of the symptoms found in the Meuse Valley during the fog of December, 1930. Bull .Top Acad R Med Belgium. 1931;11:683-741. . Introduction 2. Ciocco A Thompson DJ. A follow-up of Donora ten ears after: methodology and findings. Am J Public Methods p p Y gY g Results Health. 1961;51:155-164. . Comment 3. Logan WPD, Glasg MD. Mortality in London fog incident, 1952. Lancet. 1953;1:336-338. • Author information • 4. Pope III CA, Dockery DW. Epidemiology of particle effects. I n: Holgate ST, Koren H, Maynard R Samet References J, eds. Air Pollution and Health. London, England: Academic Press; 1999:673-705. 5. Kaiser J. Showdown over clean air science. Science. 1997;277:466-469. FULL TEXT 6. World Health Organization -European Region. Update and Revision of the Air Quality Guidelines for Europe. Copenhagen, Denmark: World Health Organization -European Region; 1995. Document EUR/ICP/EHAZ 94 05/PB01. 7. CEPA/FPAC Working Group on Air Quality Objectives and Guidelines. National Ambient Air Quality Objectives for Particulate Matter. Ottawa, Ontario: Public Works and Government Services; 1998. Category No. H46-2/98-220, 8. Committee of the Environmental and Occupational Health Assembly of the American Thoracic Society. Health effects of outdoor air pollution. Am J Respir Crit Care Med. 1996;153:3-50. ABSTRACT 9. Committee on the Medical Effects of Air Pollution. Non -Biological Particles and Health. London, England: United Kingdom Dept of Health; 1995. JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200 ... Page 15 of 23 10. Environmental Protection Agency. Air Quality Criteria for Particulate Matter, Washington, DC: Environmental Protection Agency; 1996. Document EPA/600/P-95/001cf. 11. Samet JM, Dominici F, Curriero FC, Coursac I, Zeger SL. Fine particulate air pollution and mortality in 20 US cities. N Engl J Med. 2000;343:1742-1749. ABSTRACT/ FULL TEXT 12. National Research Council. Research Priorities forAirborne Particulate Matter, I: Immediate Priorities anda Long -Range Research Portfolio. Washington, DC: National Academy Press; 1998. 13. National Research Council. Research Priorities forAirborne Particulate Matter, III: Early Research Progress. Washington, DC: National Academy Press; 2001. 14. Whitman v American Trucking Associations Inc, 532 US 457 (2001). 15. Dockery DW, Pope III CA, Xu X, et al. An association between air pollution and mortality in six US cities. N Engl J Med. 1993;329:1753-1759. ABSTRACT/ FULL TEXT 16. Pope III CA, Thun MJ, Namboodiri MM, et al. Particulate air pollution as a predictor of mortality in a prospective study of US adults. Am J Respir Crit Care Med. 1995;151:669-674. ABSTRACT 17. Krewski D, Burnett RT, Goldberg MS, et al. Reanalysis of the Harvard Six Cities Study and the American Cancer Society Study of Particulate Air Pollution and Mortality: Special Report. Cambridge, Mass: Health Effects Institute; 2000. 18. Chao A, Thun MJ, Jacobs E, Henley SI, Rodriguez C, Calle EE. Cigarette smoking and Colorectal cancer mortality in the Cancer Prevention Study II. J Natl Cancer Jnst. 2000;92:1888-1896. ABSTRACT/FULL TEXT 19. Calle EE, Terrell DD. Utility of the National Death Index for ascertainment of mortality among Cancer Prevention Study II participants. Am 3 Epidemiol. 1993;137:235-241. ABSTRACT 20. US Postal Service. 1989 National Five Digit Zip Code and Post Office Directory. Washington, DC: National Information Data Center; 1989. 21. Fleming TR, Harrington DP. Counting Processes and Survival Analysis. New York, NY. John Wiley & Sons; 1991. 22. Burnett R Ma R Jerrett M, et al. The spatial association between community air pollution and mortality: a new method of analyzing correlated geographic cohort data. Environ Health Perspect. 2001;109(suppl 3) :375-380. 23. Easton DF, Peto I, Babiker GAG. Floating absolute risk: an alternative to relative risk in survival and case -control analysis avoiding an arbitrary reference group. Stat Med. 1991;10:1025-1035. isz I MEDLINE 24. Burnett RT, Ross WH, Krewski D. Non-linear mixed regression models. Environmetrics. 1995;6:85-99. isz 25. Siemiatycki J, Nadon L, Lakhani R Beegin D, Geerin M. Exposure assessment. In: Siemiatycki J, ed. Risk Factors for Cancer in the Workplace. Baton Rouge, La: CRC Press; 1991:45-114. 26. Cleveland WS, Devlin SJ. Robust locally weighted regression and smoothing scatterplots. IAm StatAssoc. 1988;74:829-836. 27. Hastie T, Tibshirani R. Generalized Additive Models. London, England: Chapman & Hall; 1990. 28. S -Plus 2000 Programmer's Guide. Seattle, Wash: Math Soft; 2000. 29. Priestly MB. Spectral Analysis and Time Series. London, England: Academic Press; 1981. 30. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr. Body -mass index and mortality in a prospective cohort of US adults. N Engl J Med. 1999; 341:1097-1105. ABSTRACT/FULL TEXT i.i-F,.•//invw�n n.,,., ..n......«..l...�:/...._.a.---i1L_111•la�llnlz i �n JAMA --Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 16 of 23 31. Physical status: the use and interpretation of anthropometry: report of a WHO expert committee. World Health Organ Tech Rep Ser. 1995;854:1-452. ISI I MEDLINE RELATED ARTICLES I N JAMA This Week in JAMA JAMA. 2002;287:1079. FULL TEXT March Q 2002 JAMA. 2002;287:1193-1194. EXTRACT i FULL TEXT THIS ARTICLE HAS BEEN CITED BY OTHERARTICLES Inflammation, Neurodegenerative Diseases, and Environmental Exposures CAMPBELL Annals NYAS Online 2004;1035:117-132. ABSTRACT I FULL TEXT Breast Cancer Risk and Exposure in Early Life to Polycyclic Aromatic Hydrocarbons Using Total Suspended Particulates as a Proxy Measure Bonner et al. Cancer Epidemiol Siomarkers Prev 2005;14:53-60. ABSTRACT I FULL TEXT Effects of air pollution on blood pressure and heart rate variability: a panel study of vehicular traffic controllers in the city of Sao Paulo, Brazil de Paula Santos et al. Eur Heart Journal 2005; 26:193-200. ABSTRACT I FULL TEXT Interactions between CYP1A1 polymorphisms and exposure to environmental tobacco smoke in the modulation of lymphocyte bulky DNA adducts and chromosomal aberrations Georgiadis et al. Carcinogenesis 2005;26:93-101. ABSTRACT I FULL TEXT t.... -..If.*--- ----- - - --- - -- I j I ......._--• . JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200 ... Page 17 of 23 Ambient Air Pollution: Health Hazardsto Children Committee on Environmental Health Pediatrics 2004; 114:1699-1707. ABSTRACT j FULL TEXT Accuracy and Repeatability of Commercial Geocoding Whitsel et al. Am. J. Epidemiol. 2004;160:1023-1029. ABSTRACT I FULL TEXT Apheis: public health impact of PM10 in 19 European cities Medina et al. J Epidemiol Community Health 2004;58:831-836. ABSTRACT I FULL TEXT Air Pollution and Health -- Good News and Bad Pope N Engl J Med 2004;351:1132-1134. FULL TEXT What is responsible for the carcinogenicity of PM2.5? Harrison et al. Occup Environ Med 2004;61:799-805. ABSTRACT I FULL TEXT Fine particles and lung cancer Forastiere Occup Environ Med 2004;61:797-798. FULL TEXT Transfer of particulate matter pollution from smoking to non-smoking coaches: the explanation for the smoking ban on Italian trains Invernizzi et al. Tob Control 2004; 13.319-320. FULL TEXT Particulate matter from tobacco versus diesel car exhaust: an educational perspective Invernizzi et al. Tob Control 2004; 13:219-221. ABSTRACT I FULL TEXT JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 18 of 23 DEVELOPMENT OF A PREDICTIVE MODEL FOR ROSS RIVER VIRUS DISEASE I N BRISBANE, AUSTRALIA HU et al. Am J Trop Med Hyg 2004;71:129-137. ABSTRACT I FULL TEXT Occupational and environmental exposures and lung cancer in an industrialised area in Italy Fano et at. Occup Environ Med 2004;61:757-763. ABSTRACT I FULL TEXT Particulate air pollution and hospital admissions for cardiorespiratory diseases: are the elderly at greater risk? Anderson et al. Eur Respir J 2003; 21:39S -46s. ABSTRACT I FULL TEXT Oral communications J Epidemiol Community Health 2004; 58:A3 -A63. FULL TEXT Traffic Air Pollution and Mortality Rate Advancement Periods Finkelstein et al. Am. J. Epidemiol. 2004;160:173-177. ABSTRACT E FULL TEXT Air Pollution and Cardiovascular Disease: A Statement for Healthcare Professionals From the Expert Panel on Population and Prevention Science of the American Heart Association Brook et al. Circulation 2004; 109:2655-2671. ABSTRACT I FULL TEXT Reduction of Particulate Air Pollution Lowers the Risk of Heritable Mutations in Mice Somers et al. Science 2004;304: 1008-1010. ABSTRACT I FULL TEXT Problems in Deciding the Effectof the Airborne Particulate Load in Hospitals on Patient Health Hoskins Indoor and Built Environment 2003; 12:69-72. ABSTRACT i!ttn./gismo ft—-_ _1INlnnI^t..— JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 19 of 23 Cost Analysis of the Built Environment: The Case of Bike and Pedestrian Trials in Lincoln, Neb Wang et al. Am J Public Health 2004;94:549-553. ABSTRACT I FULL TEXT Association of Higher Levels of Ambient Criteria PolIutantswith Impaired Cardiac Autonomic Control: A Population - based Study Liao et al. Am. J. Epidemiol. 2004; 159:768-777. ABSTRACT I FULL TEXT Effect of Ambient Air Pollution on Pulmonary Exacerbations and Lung Function in Cystic Fibrosis Goss et al. Am J Respir Crit Care Med 2004;169.816-82 1. ABSTRACT I FULL TEXT Effects of sham air and cigarette smoke on A549 lung cells: implications for iron -mediated oxidative damage Mayo et al. Am. J. Physiol. 2004;286:L866-876. ABSTRACT I FULL TEXT TRPV1 receptors mediate particulate matter -induced apoptosis Agopyan et al. Am. J. Physiol. 2004;286:L563-572. ABSTRACT ! FULL TEXT Contribution of environmental factors to cancer risk Boffetta and Nyberg Sr Med Bull 2003;68:71-94. ABSTRACT I FULL TEXT Ambient air pollution and health Katsouyanni Br Med Bull 2003;68:143-156. ABSTRACT I FULL TEXT Predicted health impacts of urban air quality management Mindell and loffe J Epidemioi Community Health 2004;58:103-113. ABSTRACT I FULL TEXT l�+ir.•/1; o.r,n ........ ...,.,.. ,.�,-1,.,-: I,. ,.,��,._a/L_I1 /n orr Jn» � �n JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200 ... Page 20 of 23 Cardiovascular pathophysiology of environmental pollutants Bhatnagar Am. 1. Physiol. 2004;286:H479-485. FULL TEXT Cardiovascular Mortality and Long -Term Exposure to Particulate Air Pollution: Epidemiological Evidence of General Pathophysiological Pathways of Disease Pope et al. Circulation 2004; 109:71-77. ABSTRACT I FULL TEXT Pulmonary Inflammation and Thrombogenicity Caused by Diesel Particles in Hamsters: Role of Histamine Nernrnaret al. Am J Respir Crit Care Med 2003;168:1366-1372. ABSTRACT I FULL TEXT Lung cancer and air pollution: a 27 year follow up of 16 209 Norwegian men Nafstad et al. Thorax 2003; 58:1071-1076. ABSTRACT I FULL TEXT Air pollution and lung cancer: what more do we need to know? Cohen Thorax 2003;58:1010-1012. FULL TEXT Why cardiologists should be interested in air pollution Routledge et al. Heart 2003;89:1383-1388. ABSTRACT I FULL TEXT Oxidative DNA damage and defence gene expression in the mouse lung after short-term exposure to diesel exhaust particles by inhalation Risorn et al. Carcinogenesis 2003; 24:1847-1852. ABSTRACT I FULL TEXT Changes in lung permeability and lung mechanics accompany homeostatic instability in senescent mice Tankersley et al. 3. Appl. Physiol. 2003;95:1681-1687. httn-//;0V"0 La_33r/3nn1-1. - JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 21 of 23 ABSTRACT I FULL TEXT Relation between income, air pollution and mortality: a cohort study Finkelstein et al, Can Med Assoc 3 2003;169:397-402. ABSTRACT I FULL TEXT Air Pollution Particles Produce Airway Wall Remodeling in Rat Tracheal Explants Dai et al. Am J Respir Cell Mol Biel 2003;29:352-358. ABSTRACT I FULL TEXT Mortality from Obstructive Lung Diseases and Exposure to Polycyclic Aromatic Hydrocarbons among Asphalt Workers Burstyn et al. Am. J. Epidemiol. 2003; 158:468-478. ABSTRACT I FULL TEXT Particulate Matter Induces Alveolar Epithelial Cell DNA Damage and Apoptosis: Role of Free Radicals and the Mitochondria Upadhyay et al. Am J Respir Cell Mol Biol 2003;29:180-187. ABSTRACT I FULL TEXT Temporal variation of hydroxyl radical generation and 8 -hydroxy -2' -deoxyguanosine formation by coarse and fine particulate matter Shi et al. Occup Environ Med 2003; 60:315-32 1. ABSTRACT I FULL TEXT The biological effects of coarse and fine particulate matter Donaldson Occup Environ Med 2003; 60.313-314. FULL TEXT Personal Exposure to PM2.5 and Biomarkers of DNA Damage Sorensen et al. Cancer Epidemiol Biomarkers Prev 2003; 12:191-196. ABSTRACT I FULL TEXT JAMA --Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6, 200... Page 22 of 23 Measuring the accumulated hazards of smoking: global and regional estimates for 2000 Ezzati and Lopez Job Control 2003;12:79-85. ABSTRACT I FULL TEXT Diesel Exhaust Particles in Lung Acutely Enhance Experimental Peripheral Thrombosis Nemmar et al. Circulation 2003; 107:1202-1208. ABSTRACT I FULL TEXT Primary Prevention Protects Public Health TO M ATIS Annals NYAS Online 2002;982:190-197. ABSTRACT I FULL TEXT Global Climate Change and Air Pollution: Common Origins With Common Solutions Bransford and Lai JAMA 2002; 287:2285-2285. FULL TEXT OTHER ARTICLES NOTED (Nov 01 to 18 Oct 02) Evid Based Nurs 2003;5:e1-1. FULL TEXT Pollution -Related Mortality and Educational Level Finkelstein et al. JAMA 2002;288:830-830. FULL TEXT Quantification of health effects of exposure to air pollution Krzyzanowski et al. Occup Environ Med 2002;59:791-793. FULL TEXT Mutagenicity and in Vivo Toxicity of Combined Particulate and Semivolatile Organic Fractions of Gasoline and Diesel Engine Emissions Seagrave et al. Toxicol. Sci. 2002,70:212-225. ABSTRACT I FULL TEXT JAMA -- Lung Cancer, Cardiopulmonary Mortality, and Long-term Exposure to Fine Particulate Air Pollution, March 6,200... Page 23 of 23 How important is personal exposure assessment in the epidemiology of air pollutants? Cherrie Occup Environ Med 2002;59:653-654. FULL TEXT Air Pollution: An Insidious and Pervasive Component of Cardiac Risk Verrier et al. Circulation 2002;106:890-892. FULL TEXT On the Use of Generalized Additive Models in Time -Series Studies of Air Pollution and Health Dominici et al. Am. J. Epidemiol. 2002;156:193-203. ABSTRACT I FULL TEXT Expanding the health care debate Suzuki Can MedAssoc J 2002;166:1678-1679. FULL TEXT HOME i CURRENT ISSUE l PAST ISSUES i COLLECTIONS � CME i CAREERNET i CONTACT US i HELP © 2002 JAMA &Archives. All Rights Reserved. httn-//iama ama-amen _rerl....; 1'10171n /y t in 9 JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 1 of 16 Select Journal or Resource A lits SERRCH THIS JOURNRL BO TO ADVANCER SERRCH > The .Journal of the American Medi nal ASsouiation — To Promote the Science and Art of Medicine and the Betterment of the Public Health Access via PURCHASE ACCESS Vol. 290 No. 14, October 8, 2003 TRBLE OF CONTENTS > Featured Link Original Contribution • E-mail Alerts Article Options Association of Low -Level Ozone and Fine Particles With Respiratory 'Abstract p • Y .PDF Symptoms in Children With Asthma .Send to a Friend .Related articles in this issue Janneane F. Gent, PhD; Elizabeth W. Triche, PhD; Theodore R. Holford, PhD; Kathleen Belanger, PhD; • Similar articles in this Michael B. Bracken, PhD; William S. Beckett, MD; Brian P. Leaderer, PhD journal Design, Setting, and Participants Daily respiratory symptoms and medication use were examined 'Allergy prospectively fo°. 271 children younger than 12 years with physician -diagnosed, active asthma residing in 'Occupational and southern New England. Exposure to ambient concentrationsof ozone and PM from April through ril 1 2.5Environmental'Pediatrics September 30, 2001, was assessed using ozone (peak 1 -hour and 8 -hour) and 24-hour PMz S. Logistic 'Pediatrics, Other regression analyses using generalized estimating equations were performed separately for maintenance 'Topic Collection Alerts medication users (n = 130) and nonusers (n = 141). Associations between pollutants (adjusted for temperature, controlling for Literature Track JAMA. 2003;290:1859-1867. 'Add to File Drawer .Download to Citation ABSTRACT Manager • PubMed citation .Articles in PulaMed by Context Exposure to ozone and particulate matter of 2.5 Nm or less (PMz 5) in air at levels above current US -GentJF Environmental Protection Agency (EPA) standards is a risk factor for respiratory symptoms in children with •Leaderer BP asthma. Ar}iClps that cite this • dl LA •151 Web of Science (11) Objective To examine simultaneous effects of ozone and PM at levels below EPA standards on dail � 2,5 y Contact mit when this article is cited respiratory symptoms and rescue medication use among children with asthma. Topic Collections 'Asthma Design, Setting, and Participants Daily respiratory symptoms and medication use were examined 'Allergy prospectively fo°. 271 children younger than 12 years with physician -diagnosed, active asthma residing in 'Occupational and southern New England. Exposure to ambient concentrationsof ozone and PM from April through ril 1 2.5Environmental'Pediatrics September 30, 2001, was assessed using ozone (peak 1 -hour and 8 -hour) and 24-hour PMz S. Logistic 'Pediatrics, Other regression analyses using generalized estimating equations were performed separately for maintenance 'Topic Collection Alerts medication users (n = 130) and nonusers (n = 141). Associations between pollutants (adjusted for temperature, controlling for JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 2 of 16 same- and previous -day levels) and respiratory symptoms and use of rescue medication were evaluated. Main Outcome Measures Respiratory symptoms and rescue medication use recorded on calendars by subjects' mothers. Results Mean (SD) levels were 59 (19) ppb (1 -hour average) and 51 (16) ppb (8 -hour average) for ozone and 13 (8) pg/m3 for PMz 5. I n copollutant models, ozone level but not PMZ 5 was significantly associated with respiratory symptoms and rescue medication use among children using maintenance medication; a 50 -ppb increase in 1 -hour ozone was associated with increased likelihood of wheeze (by 35%) and chest tightness (by 47%). The highest levels of ozone (1 -hour or 8 -hour averages) were associated with increased shortness of breath and rescue medication use. No significant, exposure -dependent associations were observed for any outcome by any pollutant among children who did not use maintenance medication. Conclusion Asthmatic children using maintenance medication are particularly vulnerable to ozone, controlling for exposure to fine particles, at levels below EPA standards. INTRODUCTION I u m p to Section Children with asthma are particularly vulnerable to the adverse health effects of high levels of air . Top pollution. Studies of children with asthma living in some of the most highly polluted regions of the world ,Introduction conclude that exposure to levels of ozone or particulate matter (especially particles 12.5 pm in diameter ' Methods . Results [PMz 5]) regularly in excess of US Environmental Protection Agency (EPA) air quality standards (120 ppb .Comment [1 -hour average] and 80 ppb [8 -hour average] for ozone and 65 pg/m3 for 24-hour PMz 5) significantly -Author information . References enhances the risk of respiratory symptoms, asthma medication use, and reduced lung function. 1-5 Studies of children with asthma living in regions with levels of pollution within or near compliance with EPA air quality standards suggest that the current standards do not protect these more vulnerable members of the population.6-10 Asthma severity, as measured by symptoms, medication use, restrictions in activity, or use of medical services, has been shown to be affected by exposure to ozone (1 -hour maximum measurement6-10 or 8 -hour average6-9), particles 10 pm or smaller (PM10),6, 8 or PMz 5 (12 - hour total).6 Of interest in many recent studies of children with asthma are the simultaneous effects of ozone and particulates on asthma severity. 2-3,8 Simultaneous exposure to high levels of both ozone and PMz 5 (fine particles)z or PM10(coarse particles)3 found in Mexico City, Mexico, contributed to increased respiratory symptoms among children with asthma. I in a region of lower pollution, asthma symptoms were associated with both ozone and course particles.s I in the current study, we examined the simultaneous JAMA-- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 3 of 16 effects of ozone and fine particles on daily respiratory symptoms and rescue medication use of children with asthma residing in southern New England during spring and summer 2001. METHODS Participants Jump to Section . Top Introduction The study participants were 271 children from a cohort of families living in Connecticut and the Springfield •Methods 11-12 'Results area of Massachusetts who were participating in a study of asthma development. From 1997 through • Comment 1999, 1002 infants born to families with at least 1 child with physician -diagnosed asthma were enrolled in .Author information the original birth cohort. Beginning in 2000, eligible asthmaticsiblings (1 per cohort family) were identified ' References and invited to participate in a 1 -year prospective study of asthma severity. Eligibility criteria were that the child was younger than 12years at the time of enrollment and had exhibited respiratory symptoms or used asthma medication within the previous 12 months. Included in the current analysis are subjects enrolled for all or part of the 183 -day sampling period (April 1through September 30, 2001), which includesthe summertime, high -ozone pollution months in this region. Of 357 children identified as being eligible for inclusion in the current analysis, 56 refused follow-up, 16 were lost to follow-up, and 14 withdrew before April 1, 2001, leaving a total of 271 (76%). The Human Investigation Committee of Yale University, New Haven, Conn, approved this study, and all respondents (mothers of study subjects) gave informed consent before participation. Data Collection Demographic information and medical histories were collected during a home interview with the mother at enrollment. Daily respiratory symptoms (wheeze, persistent cough, chest tightness, shortness of breath) and medication use (maintenance medications, including inhaled or systemic steroids, cromolyn sodium, and leukotriene inhibitors, and rescue medications, including bronchodilators) were recorded on symptom and medication calendars by the child's mother and collected through monthly telephone interviews. Additional information about the previous 12 months was collected at an exit interview (eg, dates the child had been away from the southern New England region during the study year). Air Quality Assessment Study subjects resided in a 6691 -square mile area in Connecticutand the Springfield area of Massachusetts. All ambient air quality monitoring sites (14 sites for ozone, 10 in Connecticut and 4 in Massachusetts; 4 sites for daily PM2.,, 2 in Connecticut and 2 in Massachusetts; 13 temperature sites, 12 in Connecticutand 1 in Massachusetts) were located within a 52.5 -mile radius centered at Southington, Conn (14 miles southwest of Hartford). The maximum distance between sites was 105 miles; the minimum distance was 4 miles. The Departments of Environmental Protection (DEPS) of Connecticut and Massachusetts provided measurements for hourly ozone concentrations and temperatures and daily 24-hour PM2 5 (total PM2 5 accumulated during 24 1 .. 1/- , , . - .. --- ,- . .- - - JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page of 16 hours). Since both ozone and fine particle pollutants, as well as meteorological variables, tend to be regional,13 the maximum daily 1 -hour average (mean over 1 hour) and the 8 -hour rolling average (mean over previous 8 hours) for ozone, daily PM2.5 concentration, and maximum daily temperature were averaged across monitoring sites. Between -site correlation coefficients (Pearson r) were high for the 4 daily PM2 5 sites (median r = 0.91; range, 0.84-0.95) and the 13 temperature sites (median r = 0.97; range, 0.85-0.99). There was more variability among the 14 ozone monitoring sites (median r = 0.83; range, 0.50-0.97 for the 1 -hour average; and median r = 0.81; range, 0.47-0.97 for the 8 -hour average). Fortechnical details on ambient air quality monitoring, see the Web sites for the Connecticut DE p14 and the Massachusetts DEP-15 Data Analysis To examine the effects of ozone and PM2 5 on children with different degrees of asthma severity, children were divided into 2 groups: those who used any maintenance medication during the 183 -day observation period (n = 130) and those who did not (n = 141). Use of maintenance medication was used as a proxy for asthma severity to avoid using the outcome measures (respiratory symptoms and rescue medication use) in the assessment of severity. Logistic regression analyses, using generalized estimating equations (PROC GENMOD with AR1 autoregressive structure in SAS statistical software) 16-18 and adjusted for maximum daily temperature, were used to evaluate the association between levels of ozone and PM..,, with presence or absence of specific respiratory symptoms or rescue medication use. Using a repeated -measures technique permitted each subject to serve as his or her own control; therefore, personal variables (eg, race and other sociodemographic factors) that would not change during the study were not included in the models. Subgroup analysis, which included either 17 160 observations (an average of 132 days of data for 130 users of maintenance medication) or 19 035 observations (135 days for 141 nonusers of maintenance medication), focused directly on the association between exposures and health effects. Exposure variables were categorized into quintiles, then entered into the model as dummy variables. The reference category for each was the lowest quintile. Both same-day and previous -day levels of ozone and PM2 5 were examined. Analyses were performed separately for each severity group and each outcome. I n single -pollutant models, a test for linear trend was performed by examining the model when the pollutant was entered as a continuous variable instead of as quintiles. I n copollutant models, a test for goodness of fit was performed using the Hosmer-Lemeshow statistic for logistic regression. Significance level for all tests was set at .05. RESULTS Descriptive Statistics Jump to Section p .Top . Introduction Levels of ozone, PMz 5, and temperature from April through September 2001 are summarized in Table 1 . Methods • Results and Figure 1. The EPA 1 -hour standard (120 ppb) was exceeded on 3 days, and the 8 -hour ozone standard .Comment Ia -J If- ___ _ _.___ _____ _.._ I .i . .1r 1. 1-'. 11.., - ,- ____ ... ,.. --- ___--__ JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page S of 16 • (80 ppb) was exceeded on 10 days of the 183 days of observation. There were no days when the level of Author information PMZ 5 exceeded the EPA 24-hour standard of 65 p9/m3. There was a strong correlation between ozone and References fine particles (PMZ 5 vs 1 -hour average ozone r = 0.77 vs 8 -hour average r = 0.74) (Table 2). View this table: Table 1.Ozone, Particulate Matter of 2.5 pm or Less PM [in this window] ( 2.5), and Temperature in Southern New England, [in a new window] April 1 to September 30, 2001 Figure. Daily Levels of Ozone (Both 1 -Hour Average and 8 -Hour Average), Particulate Matter of 2.5 pm or Less (PM2,5), and Daily Maximum Temperature, With Daily 6" Prevalence of Respiratory Symptoms for Users of Asthma Maintenance Medication (n = 130) for Southern New England, April 1 through September 30, 2001 i Dotted lines at 80 ppb and 120 ppb indicate Environmental Protection Agency standards w for 8 -hour average and 1 -hour average ozone, respectively. Note that daily exposure levels shown here are the result of averaging over regional monitoring sites (14 ozone, 4 PMZ 5, and 13 temperature sites). View larger version (99K): [in this window] [in a new window] View this table: Table 2. Pearson Correlation Coefficients for Same Day and PrevioLls Day Levels of Ozone and Particuli3te [in this window] [in a new window] Matter Of 2.5 Nm or Less (P142.0 There were no significant differences between the users (n = 130) of maintenance medication and nonusers (n = 141) for mean (SD) age of study subjects (age on April 1, 2001, for users, 8.8 [2.0] years [range, 2.4-12.7 years]; age of nonusers, 8.3 [2.2] years [range, 2.0-12.6 years]; ttest P = .71) or mean days of participation (mean participation for users, 132 [48] days [range, 3-183 days]; mean participation for nonusers, 135 [51] days [range, 5-183 days]; ttest P = .50). Sex and ethnicity did not differ by medication use. Nearly two thirds of each group were male (users, 64.6%; nonusers, 64.5%; X2 test P = .99), and most JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 6 of 16 children in each group were white, with smaller numbersof black and Hispanic children (users, 80.0%, 8.5%, and 11.5%, respectively; nonusers, 70,9%, 11.4%, and 17.7%, respectively; XZ test P = .22). Compared with nonusers of maintenance medication, users had significantly more days of all respiratory symptoms and rescue medication use: 50% of this group experienced approximately 1 week of persistent cough or wheeze, had 2 to 3 days of chest tightness or shortness of breath, and used rescue medication for nearly 3 weeks during the 26 -week study period. At least half of all nonusers experienced no symptoms and did not use rescue medication during this same period (Table 3). Daily prevalence of symptoms for users of maintenance medication is shown in Figure 1. With the exception of somewhat higher rates of symptoms in the early spring and late summer when the temperatures tended to be lowest, there was overall conformity of reporting all 4 symptoms across the observation period. View this table: Table 3. Rates of Respiratory Symptoms and Rescue Medication Use for Study Subjects Stratified by Use [in this windo w] of Maintenance Medication (Southern New England, April 1 -September 30, 2001)* [in a new Single -Pollutant Modelsfor Users of Maintenance Medication Ozone (1 -Hour Average). An ozone concentration of 51.6 ppb or higher (the top 3 quintiles of the distribution of the maximum 1 -hour average) on the same day as the reported symptom was the only exposure variable associated with an increased likelihood of wheeze (by 16%, 16%, and 22%, respectively) (Table 4, model 1).A 4% increase in bronchodilator use was also associated with same-day levels of ozone (51.6-58.8 ppb) (Table 4, model 1). Previous -day levels of maximum 1 -hour average ozone were associated with increased likelihoods of persistent cough (16% increase for levels 272.7 ppb), chest tightness (by 21%, 30%, and 37% for levels 251.6 ppb), and shortness of breath (by 22% and 30% for levels 258.9 ppb) (Table 4, Model 2). The effects of previous -day levels on chest tightness and shortness of breath were significant in an exposure -dependent way: for each 50 -ppb increase in previous -day, 1 -hour ozone levels, the likelihood of these symptoms increased by 2611/6 (odds ratio [OR], 1.26; 95% confidence interval [CI], 1.0-1.48) and 22% (OR, 1.22; 95% Cl, 1.02-1.45), respectively. View this table; Table 4. Odds Ratios From 6 Single -Pollutant Logistic Regression Models of Respiratory Symptoms or [in this window] Rescue Medication Use of Maintenance Medication Users (n = 130) (Southern New England, April 1 to [in a new window] September 30, 2001) * Ozone (8 -Hour Average). An ozone concentration of 63.3 ppb or higher, measured as the maximum 8 -hour average on the same day as the reported symptom, was associated with a 30% increase in chest tightness (Table 4, model 3). Previous -day levels of 52.1 ppb or higher were associated with increased chest tightness, persistent cough, and shortness of breath (Table 4, model 4). As was the case with 1 -hour ozone levels, the associations with the symptoms of chest tightness and shortness of JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 7 of 16 breath were exposure dependent: a 50 -ppb increase in previous -day, 8 -hour ozone level increased the likelihood of chest tightness (OR, 1.33; 95% Cl, 1.09-1.62) and shortness of breath (OR, 1.30; 95% Cl, 1.05-1.61). PM2.5. Increased likelihood of chest tightness was associated with same-day levels of PMz 5 from 12.1 to 18.9 lag/m3 (Table 4, model 5). Previous -day levels of 19.0 lag/m3 or higher were associated with persistent cough, chest tightness, and shortness of breath (Table 4, model 6). Copollutant Models for Users of Maintenance Medication I n logistic regression models of both ozone and tine particles for children taking maintenance medication, an increased likelihood of respiratory symptoms was associated with levels of ozone on the same day, previous day, or both; and increased bronchodilator use was associated with the highest level of same-day ozone. Neither respiratory symptoms nor bronchodilator use were associated with level of fine particles. Ozone (1 -Hour Average) and PM2.5. Increased likelihood of wheeze was associated with same-day levels of 1 -hour average ozone of 43.2 ppb or higher in an exposure -dependent manner (Table 5). When ozone is entered into this same model as a continuous variable, a 50 -ppb increase in same-day ozone increases the likelihood of wheeze by 35% (OR, 1.35; 95% Q, 1.11- 1.65). None of the exposure variables was associated with an increased likelihood of persistent cough, and only 1 -hour average ozone levels between 43.2 and 51.5 ppb were associated with a decreased likelihood of cough (OR, 0.88; 95% Cl, 0.78-0.99). The likelihood of chest tightness was significantly increased by same-day (158.9 ppb) and previous -day (151.6 ppb) levels of ozone in an exposure -dependent way. The likelihood of chest tightness increases by 47% (OR, 1.47; 95% Cl, 1.18-1.84) for each 50 -ppb increase in same-day levels of ozone, and by 42% (OR, 1.42; 95% Cl, 1.14-1.78) for each 50 -ppb increase in previous -day levels. Shortness of breath and ozone were similarly associated; likelihood of the symptom was increased by same-day levels of 72.7 ppb or higher and previous -day levels from 58.9 to 72.6 ppb (by 32%). Increased likelihood of bronchodilator use was associated with same-day levels of 72.7 ppb or higher (Table 5). View this table: Table 5. Odds Ratios From the Copollutant Logistic Regression Model for Same -Day and Previous -Day [in this window] Levels of Ozone 1 -Hour Average) and Particulate Matter of 2.5 lam or Less (PM2,S) Related to Each fin a new window] ( g ) Z,s Respiratory Symptom or Rescue Medication Use of Maintenance Medication Users (n = 130) (Southern New England, April 1 to September 30, 2001)* Ozone (8 -Hour Average) and PM2.5. For 8 -hour average ozone levels, the likelihood of chest tightness was increased by same- day (OR, 1.64; 95% Cl, 1.23-2.17) and previous -day (OR, 1.45; 95% Cl, 1.10-1.92) levels of 63.3 ppb or higher. Shortness of breathwas similarly associated; likelihood of the symptom was increased by same-day (OR, 1.45; 95% Cl, 1.10-1.91) and Lai_ _ 1I' - —_ - - ... _ _, _ 1 • 1 i n .. �........ ..... - .... JAMA --Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 8 of 16 previous -day (OR, 1.31; 95% Cl, 1.00-1.71) levels of 63.3 ppb or higher. As seen for the highest 1 -hour ozone level, increased bronchodilator use was associated with same-day levels of 63.3 ppb or higher for 8 -hour ozone measurements (OR, 1.09; 95% Cl, 1.02-1.17). Nonusers of Maintenance Medication Single -Pollutant Models. Similar analyses for nonusers of maintenance medication revealed no significant associations among the top 3 concentration quintiles for the exposure variables and respiratory symptoms or bronchodilator use. For example, chest tightness was not significantly associated with same-day, 1 -hour ozone levels of 72.7 ppb or higher (OR, 0.92; 95% Cl, 0.68- 1.25), same-day, 8 -hour ozone levels of 63.3 ppb or higher (OR, 1.17; 95% Cl, 0.72-1.92), or previous -day, 8 -hour ozone levels of 63.3 ppb or higher (OR, 0.99; 95% Cl, 0,74-1.35). The only significant association was an increased likelihood of wheeze (OR, 1.20; 95% Cl, 1.00-1.43) in the presence of previous -day, 8 -hour average ozone between 39.1 and 45.8 ppb (the second quintile). Copollutant Models. For the children who were not users of asthma maintenance medication, neither fine particles nor 1 -hour average ozone levels were associated with increased likelihoods of respiratory symptoms in copollutant models. Increased bronchodilator use was associated with previous -day fine particle concentrations between 9.0 and 12.0 ug/m3 in the model with 1 - hour ozone levels (Table 6) and with these same levels in the model with 8 -hour ozone (OR, 1.30; 95% Cl, 1.02-1.65). An increase in the likelihood of wheeze was associated with 8 -hour ozone, but only for concentrations between 39.1 and 45.8 ppb on the same day (OR, 1.33; 95% Cl, 1.00-1.77) or the previous day (OR, 1.31; 95% Cl, 1.05-1.63) and between 52.1 and 63.2 ppb for same-day levels (OR, 1.35; 95% Cl, 1.00-1.81). View this table: Table 6. Odds Ratios From the Copollutant Logistic Regression Model for Same -Day and Previous -Day [in this window] [in a new window] Levels of Ozone (1 -Hour Average) and Particulate Matter of 2.5 ilm or Less (PM 2 $) Related to Respiratory Symptoms and Rescue Medication Use of Maintenance Medication Nonusers (n = 141) (Southern New England, April 1 to September 30, 2001)* COMMENT Jump to Section In models controlling for ambient fine particle concentration and typically at levels below EPA air quality .Top standards, daily ambient ozone was found to be significantly associated with increased risk of respiratory Introduction symptoms and increased use of rescue medication among children with asthma severe enough to require • Methods . Results maintenance medication. Study strengths include frequent telephone follow-up to collect information on .Comment daily calendar -recorded symptoms and medication use; absence of reporting bias between symptoms and ' Author information JAMA --Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, October ... Page 9 of 16 regionally collected ambient air quality data; the use of both the maximum 1 -hour average (sensitive to - References spikes in concentration) and 8 -hour average (a measure of short-term, cumulative exposure) to assess daily ambient ozone levels; use of PMz 5 levels measured daily; and examination of the simultaneous effects of ozone and PMz 5 at levels near or below current EPA ambient standards. Our results contribute to the limited literature examining the simultaneous effects of ozone and suspended particles on daily respiratory symptoms for a sensitive subpopulation in models adjusted for daily temperature. One potential limitation of the study is that ambient ozone and particle concentrations were represented as means over regional sites. For the 14 ozone sites on any particular day, the mean (SD) ratio of maximum to minimum reading was 1.70 (0.50), which is similar to the mean ratio of upper to lower limit of each quintile of the summer ozone distribution of 1.38 (0.30) from our study. This suggests that the analysis using quintiles of the ozone distribution captures the variability that exists in the study region. Variability among PMz 5 sites was less, but a potential limitation is that there were only 4 sites with daily measurements. However, a comparison between readings from these 4 sites and readings from the 10 sites with PMz 5 readings every 3 days revealed good agreement. For the 61 days all sites had in common, the 10 -site mean (SD) was 13.8 (8.2) compared with 12.8 (7.7) p9/m3 for the 4 sites, and the Pearson correlation was 0.97. Another potential limitation is the lack of personal variables (eg, race) in the regression models. However, by taking advantage of the repeated measurements we had for each subject, we were able to use each subject as his or her own control. The sample of 271 children contributed 36 195 person -days of observations to the analyses. Our within -subjects analytic approach permitted a strong test of the associations between ambient air pollution and health outcomes, and personal variables, since they would not vary within subjects, could be excluded from the models. I n this study, we did not consider medical care utilization as an outcome. Since this was not a clinic -based study, we did not have access to records to confirm medical visit dates. However, medical records are not necessarily more objective than reports of symptoms and medication use, since a number of factors unrelated to symptom severity also influence utilization. Symptoms and medication use vary from day to day and may be a more sensitive indicator of the effects of daily changes in air pollution on respiratory health, since not all symptoms result in a physician visit. I n our copollutant models, ozone but not fine particles significantly predicted increased risk of respiratory symptoms and rescue medication use among children using asthma maintenance medication. We found an immediate (same-day) effect of ozone on wheeze (with the 1 -hour ozone metric), chest tightness, and shortness of breath (with both the 1 -hour and 8 -hour ozone metrics). We also found that previous -day levels of ozone (both metrics) were significantly associated with increased risk of chest tightness and shortness of breath. Goodness -of -fit tests for copollutant models suggest that the models with significant findings (wheeze, chest tightness, and shortness of breath) are reasonably good fits to the data. There were no systematic patterns to the lack of fit for models for persistent cough and bronchodilator use. However, because of repeated measurements, Observations were not independent in any of the models, which may affect the interpretation of the Hosmer-Lemeshowstatistic. I t is possible that the JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, Octob... Page 10 of 16 more frequently reported events of persistent cough and bronchodilator use may be associated with ambient air pollution in combination with other factors (eg, activity level) not included in the current study. Effects of 1 -hour ozone among children using asthma maintenance medication, especially the association of same-day ozone with wheeze and previous -day ozone with chest tightness, appear to be more exposure dependent than the effects of small particles. I n copollutant models for wheeze and chest tightness, a 50 -ppb increase in same-day, 1 -hour ozone level increased the likelihood of wheeze by 35% and chest tightness by 47%. However, since particles and ozone were positively correlated, it is difficult to separate their effects in the copollutant models. I n the single -pollutant model for chest tightness, a 50 -ppb increase in previous - day levels of 1 -hour ozone resulted in a 26% increase in the likelihood of having the symptom. When same-day levels of 1 -hour ozone were added to the model, the likelihood of this symptom went up to 3211/b. I n the copollutant model, a 50 -ppb increase in previous -day, 1 -hour ozone level increased the likelihood of chest tightness by 42%. Levels of PMz 5 happened to be relatively low and never exceeded EPA standards for the duration of the study period, which likely contributed to the lack of significant particle effects observed in the copollutant models. For our region, an examination of the association between symptoms and particle levels in winter months when ozone is not a factor would help us better understand the role of exposure to small particles on respiratory health. There is little doubt that children with asthma are especially vulnerable to high levels of air pollution. Among a group of asthmatic children (n = 71) living in Mexico City, where levels of ozone have regularly exceeded the EPA standard, multivariate regression analyses of same-day ambient air pollution and separate models of previous -day pollution all revealed significant effects of ozone and fine particles on the likelihood of cough (an increase of 8% for each 50 -ppb increase in ozone on either the same day or previous day; an increase of 6% or 8% for each 10-pg/m3 increase in PMz 5 on the same day or previous day) and lower respiratory tract illness (by 7% for each pollutant on the same day or previous day).z The effects seen for PMz 5 in Mexico City, but not in our study, could be explained by the large difference between the mean (SD) 24-hour concentration of PM2.5 in Mexico City (85.7 [30.2] lag/m3), which was above the EPA standard of 65 lag/m3 and was well above the mean of 13.1 (7.9) pg/m3 observed in the current study. I n addition, the chemical composition of the fine particles in each region may be different.z, io The larger effect of 1 -hour ozone that we found could be explained in part by the fact that we stratified our analysis by asthma severity, thereby observing a consistent pattern of increased likelihood of some symptoms of more than 40% in the group with more severe disease and no significant effects among the group with less severe disease. Our results are consistent with recent studies7, 10 that suggest exposure to lower levels of ozone is associated with respiratory symptoms in children with asthma. Children with asthma who attended a week-long asthma summer camp (a total of 166 children during three 1 -week periods compared with our 183 -day observation period) in the Connecticut River Valley (the same geographic area as the current study) were exposed to levels of ozone somewhat higher than the current study (mean [SD] 1 -hour average, 84 [38} ppb; range, 20-160 Ppb).. 11h single -pollutant models, daily levels of same-day ozone were significantly associated with increased chest symptoms, Nagonist use, and decreased lung function. 10 These associations did not change when same-day JAMA-- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, Octob... Page 11 of 16 levels of sulfate (a primary constituent of PMZ 5 in this region) were added to the model. I n a recent study' of 846 children with asthma living in 8 urban areas around the country, ozone at levels comparable to those observed in the current study (mean 8 - hour average of 48 ppb compared with our mean of 51 ppb with <5% of the days exceeding the EPA standard of 80 ppb in both studies) was associated, in single -pollutant models, with morning respiratory symptoms (wheeze, cough, or chest tightness). Although the data were not shown, the authors of each study also noted that adding copollutants to their models did not appreciably confound the effect of ozone. Both studies concluded that ozone, even at levels lower than current EPA standards, is strongly associated with adverse respiratory health effects in children with asthma. Previous environmental chamber studies19-21 of adults with asthma exposed to ozone for 1 to a few hours have shown relatively little effect on symptoms or lung function. On the other hand, short-term exposure to elevated levels of ozone and particulates in outdoor air has been associated with reduced pulmonary function in otherwise healthy children.', 22-23 Our study of asthmatic { children under ambient exposure conditions in areas of lower pollution suggests that the more prolonged exposures associated with summertime ozone produce a greater stimulus than chamber exposures, that asthmatic children are more susceptible than asthmatic adults, that effects are delayed and not captured by short-term chamber studies, or that coexposures to other unidentified constituents of ambient air enhance the responseto ozone. A recent study supporting this view examined the impact of traffic -reducing changes in Atlanta, Ga, during the 1996summer Olympic Games, 24 Significant reductions in ozone and particles were associated with significant reductions in acute asthma care events (physician, clinic, or hospital visits) among children aged 1 to 16 years. I n analyses including days before, during, and after the Olympics, an increase in daily acute asthma events was associated with levels of 1 -hour ozone concentrations beginning at 60 to 89 ppb. Our findings indicate that comparable levels were associated with an increased likelihood of wheeze (->58.9 ppb), chest tightness 058.9 ppb), shortness of breath, and rescue medication use (172.7 ppb). I n our study, we defined 2 levels of asthma severity based on maintenance medication use. We reasoned that since we were examining the association of air pollution and symptoms, we did not want to use symptoms to define severity. Instead, we used maintenance medication as a proxy for disease severity even though medication use and symptoms will be related. Maintenance medication users had significantly more wheeze, persistent cough, chest tightness, and shortness of breath than the nonusers and used rescue medication significantly more often. Our results strongly suggest that this definition of asthma severity divides the group into 2 levels of vulnerability to air pollution. Our study is a unique combination of a sample of asthmatic children with detailed symptom and medication use followed for a long period and well -measured daily ambient copollutants. These results add to others that suggest that, even at low levels of ambient ozone and controlling for ambient fine particle concentration, children with severe asthma are at a significantly increased risk of experiencing respiratory symptoms. AUTHOR INFORMATION JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, Octob... Page 12 of 16 Corresponding Author and Reprints: Janneane F. Gent, PhD, Yale University Center for Perinatal, Pediatric, and Environmental Epidemiology, 1 Church St, Sixth Floor, New Haven, CT 06510 (e-mail: janneane,gent@yale.edu ). Author Contributions: Study concept and design: Holford, Bracken, Beckett, Leaderer. Acquisition of data: Belanger, Bracken, Leaderer. Analysis and interpretation of data: Gent, Triche, Holford, Belanger, Bracken, Leaderer. Dratting of the manuscript. Gent, Bracken, Leaderer. Jump to Section .Top . introduction . Methods . Results Comment .Author information References Critical revision of the manuscript for important intellectual content: Gent, Triche, Holford, Belanger, Bracken, Beckett, Leaderer. Statistical expertise: Gent, Triche, Holford, Bracken, Leaderer. Obtained funding: Holford, Bracken, Beckett, Leaderer. Administrative, technical, or material support: Belanger, Bracken, Leaderer. Study supervision: Bracken, Leaderer. Organization of manuscript: Gent. Funding/Support: Work on this study was funded by grants ES07456, ES05410, ES11013, and ES01247 from the National Institute of Environmental Health Sciences. Acknowledgment: We thank the Departments of Environmental Protection in the states of Connecticut and Massachusetts for their cooperation in providing air quality measurements. Author Affiliations: Center for Perinatal, Pediatric, and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn (Drs Gent, Triche, Holford, Belanger, Bracken, and Leaderer); Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY (Dr Beckett). REFERENCES JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, Octob... Page 13 of 16 Jump to Section 1. Gold DR, Damokosh Al, Pope CA III, et al. Particulate and ozone pollutant effects on the respiratory • Top function of children in southwest Mexico City. Epidemiology. 1999;10:8-16. 151 1 MEDLINE Introduction 2. Romieu I, Meneses F, Ruiz S, et al. Effects of air pollution on the respiratory health of asthmatic Methods • Results children living in Mexico City. Am J Respir Crit Care Med. 1996;154:300-307. ABSTRACT • Comment 3. Romieu I, Meneses F, Ruiz S, et al. Effects of intermittent ozone exposure on peak expiratory flow and ' Author information respiratory symptoms among asthmatic children in Mexico City. Arch Environ Health. 1997;52:368-376. isi References [ MEDUNE 4. PetersA Dockery DW, Heinrich ,1, Wichmann HE. Medication use modifies the health effects of particulate sulfate air pollution in children with asthma. Environ Health Perspect. 1997;105:430-435. ISI I MEDLINE 5. Ostro BD, Lipsett MJ, Mann A Braxton -Owens H, White MC. Air pollution and asthma exacerbations among African-American children in Los Angeles. Inhal Toxicol. 1995;7:711-722. isi 6. Ostro B, Lipsett M, Mann J, Braxton -Owens H, White M. Air pollution and exacerbation of asthma in African-American children in Los Angeles. Epidemiology. 2001;12:200-208. CrossRef I ISI I MEDLINE 7. Mortimer KM, Tager IB, Dockery DW, Neas LM, Redline S. The effect of ozone on inner-city children with asthma: identification of susceptible subgroups. Am J Respir Crit Care Med. 2000;162:1838-1845. ABSTRACT/FULL TEXT 8. Delfino RJ, Zeiger RS, Seltzer JM, Street DH. Symptoms in pediatric asthmatics and air pollution: differences in effects by symptom severity, anti-inflammatory medication use and particulate averaging time. Environ Health Perspect. 1998;106:751-761. ISI I MEDLINE 9. Gielen MH, van der Zee SC, van Wijnen JH, van Steen CJ. Acute effects of summer air pollution on respiratory health of asthmatic children. Am J Respir Crit Care Med. 1997;155:2105-2108. ABSTRACT 10. Thurston GD, Lippmann M, Scott MB, Fine JM. Summertime haze air pollution and children with asthma. Am J Respir Crit Care Med. 1997;155:654-660. ABSTRACT 11. Gent IF, Ren P, Belanger K, et al. Levels of household mold associated with respiratory symptoms in the first year of life in a cohort at risk for asthma. Environ Health Perspect. 2002;110:A781 -A786. ISI I MEDLINE 12. Belanger K Beckett W, Triche E, et al. Symptoms of wheeze and persistent cough in the first year of life: associations with indoor allergens, air contaminants, and maternal history of asthma. Am J Epidemiol. 2003;158:195-202. ABSTRACT/FULL TEXT 13. US Environmental Protection Agency. Air Quality Criteria for Ozone and Related Photochemical Oxidants. Research Triangle Park, NC: Office of Health and Environmental Assessment, Environmental Criteria and Assessment Office; 1996. EPA report EPA/600/AP-93/004a-c. 14. State of Connecticut Department of Environmental Protection. Annual Air Quality Summary (1999). Available at: http://dep.state.ct.us/air2/ozone/99ags.pdL Accessed November 18, 2002. 15. Commonwealth of Massachusetts Department of Environmental Protection. Air Quality Report (2000). Available at: http://www.mass.gov/dep/bwp/dagc. Accessed November 18, 2002. 16. SAS Version 8. Cary, NC: SAS Institute Inc; 2001. 17. Liang K -Y, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13-22, is1 JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, Octob... Page 14 of 16 18. Allison PD. Logistic Regression Using the SAS System: Theory and Application. Cary, NC: SAS Institute Inc; 1999. 19. Silverman F. Asthma and respiratory irritants (ozone). Environ Health Perspect. 1979;29:131-136. isi I MEDLINE 20. Hanania NA, Tarlo SM, Silverman F, Urch q Senathirajah N Zamel N Corey P. Effect of exposure to low levels of ozone on the response to inhaled allergen in allergic asthmatic patients. Chest. 1998,114:752-756. ABSTRACT/FULL TEXT 21. Kehrl HR, Peden DB, Ball B, Folinsbee U, Horstman D. Increased specific airway reactivity of persons with mild allergic asthma after 7.6 hours of exposure to 0.16 ppm ozone. J Allergy Clin ImmunoL 1999;104:1198-1199. ISI I MEDLINE 22. Spektor DM, Lippmann M, Lioy PJ, et al. Effects of ambient ozone on respiratory function in active normal children. Am Rev Respir Dis. 1988;137:313-320. m I MEDLINE 23. Ulmer C, Kopp M, (horst G, FrischerT, Forster J, KuehrJ. Effects of ambient ozone exposures during the spring and summer of 1994 on pulmonary function of schoolchildren. Pediatr Pulmonol. 1997; 23:344-353, CrossRef I ISI I MEDLINE 24. Friedman MS, Powell KE, Hutwagner L, Graham LM, Teague WG. Impact of changes in transportation and commuting behaviors during the 1996 summer Olympic Games in Atlanta on air quality and childhood asthma. JAMA. 2001;285:897-905. ABSTRACT/FULL TEXT RELATED ARTICLES I N JAMA This Week in JAMA JAMA. 2003;290:1817. FULL TEXT Air Pollution as an Underappreciated Cause of Asthma Symptoms George D. Thurston and David V. Bates JAMA. 2003;290:1915-1917. EXTRACT I FULL TEXT Health Effects of Ozone Sharon Parmet, Cassio Lynrn, and Richard M. Glass JAMA. 2003;290:1944. EXTRACT I FULL TEXT THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Role of interleukin-6 in murine airway responses to ozone Johnston et al. Am. J. Physiol. 2005;288:L390 -L397. ABSTRACT I FULL TEXT i,++-.ir;..._- __ - -_--- - -- I- - , .___ .- .._ - --- JAMA -- Association of Low -Level Ozone and Fine Particles With Respiratory Symptoms in Children With Asthma, Octob... Page 15 of 16 CXCR2 is essential for maximal neutrophil recruitment and methacholine responsiveness after ozone exposure Johnston et al. Am. J. Physiol. 2005;288:L61 -L67. ABSTRACT I FULL TEXT Ambient Air Pollution: Health Hazards to Children Committee on Environmental Health Pediatrics 2004; 114:1699-1707. ABSTRACT E FULL TEXT Chronic effects of ozone in children Sunyer Eur Respir J 2003;23:185-186. FULL TEXT Differential effects of ozone on airway and tissue mechanics in obese mice Rivera -Sanchez et al. J. Appl. Physiol. 2004;96:2200-2206. ABSTRACT I FULL TEXT Ozone and Asthma --Reply Thurston and Bates JAMA 2004; 291:423-424. FULL TEXT Asthma Symptoms Associated with Low Levels of Air Pollution Journal Watch (General) 2003;2003:2-2. FULL TEXT Air Pollution as an Underappreciated Cause of Asthma Symptoms Thurston and Bates JAMA 2003;290:1915-1917. FULL TEXT HOME I CURRENT ISSUE I PAST ISSUES I COLLECTIONS I CME I CAREERNET I CONTACT US I HELP ep 2003 JAMA &Archives. All Rights Reserved. Ambient Air Pollution and Atherosclerosis in Los Angeles Page 1 of 9 Errvironmenfa! Health Pers ectiveg Volume 113. Number 2 February 2905 Research Article Ambient Air Pollution and Atherosclerosis in Los Angeles Nino Onzli, Michael Jerrett, Wendy J. Mack, Bernardo Beckerman, Laurie LaBree, Frank Gilliland, Duncan Thomas, John Peters, and Howard N. Hodis Divisions of Environmental Health and Biostatistics, Department of Preventive Medicine, and Atherosclerosis Research Unit, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California. Los Angeles. California, USA • Introdu_ction • Materials and Methods • Results • Discussion Abstract Associations have been found between long-term exposure to ambient air pollution and cardiovascular morbidity and mortality. The contribution of air pollution to atherosclerosis that underlies many cardiovascular diseases has not been investigated. Animal data suggest that ambient particulate matter(PM) may contribute to atherogenesis. We used data on 798 participants from two clinical trials to investigate the association between atherosclerosis and long-term exposureto ambient PM up to 2.5 pm in aerodynamic diameter (PM2 0. Baseline data included assessment of the carotid intima -media thickness (CIMT). a measure of subclinical atherosclerosis. We geocoded subjects' residential areas to assign annual mean concentrations of ambient PMZ 5. Exposure values were assigned from a PM2 s surface derived from a geostatistical model. Individually assigned annual mean PMZ 5 concentrations ranged from 5.2 to 26.9 pglm3 (mean, 20.3). For a cross-sectional exposure contrast of 10 pg/m3 PM2 5, CIMT increased by 5.9% (95% confidence interval, 1-11 %). Adjustment for age reduced the coefficients.but further adjustment for wvariates indicated robust estimates in the range of 3.943% (p -values, 0.05-0.1). Among older subjects (' 60 years of age), women, never smokers, and those reporting lipid -lowering treatment at baseline, the associations of PM2 5 and CIMT were largerwith the strongest associations in women > 60 years of age (15.7%. 5.7-26.6%). These results representthe first epidemiologicevidence of an association between atherosclerosis and ambient air pollution. Given the leading role of cardiovascular disease as a cause of death and the large populations exposed to ambient PMZ 5, these findings may be important and need further confirmation. Key words: air pollution, atherosclerosis, particulate matter. Environ Health Perspect 113:201-206 (2005). doL10,1289fehp.7523 available via hltpY/dx.doi.org/ [Online22 November2004j Address correspondence to N. KOnzli, Keck School of Medicine Universityof Southern California, Division of Environmental Health, 1540AIcazar St. CHP 236, Los Angeles, CA 90033-9013 USA. Telephone: (323) 442- 2870. Fax: (323) 442-3272. E-mail: kuenzk@usc.edu This work was supported in part by the National Institute on Aging [grants R01AG-13860 (Vitamin E Atherosclerosis Prevention Study) and R01 AG -17160 (B -Vitamin Atherosclerosis Intervention Trial)], the National Institute of Environmental Health Sciences (grants P30ES07648, 5P01ES11627), the Wright Foundation,the Hastings Foundation, and the Health Effects Institute. The authors declare they have no competing financial interests. Received 26 August 2004; accepted 22 November 2004. Introduction A large body of epidemiologicevidence suggests associations between ambient air pollution and cardiovascular mortality and morbidity (Peters and Pope 2002; Pope et al. 2004), All of these studies focus on events occurring at a late stage of vascular disease processes. The impact of air pollution on the underlying preclinical conditions remains poorly understood. http://ehp.niehs.nih.gov/members/2004/7523/7523.html 2/15/2005 4c Ambient Air Pollution and Atherosclerosis in Los Angeles Page 2 of 9 We hypothesize that current levels of ambient particulate matter (PM) up to 2.5 pm in aerodynamic diameter (PM2 0 may contribute to atherosclerosis, leading to subclinical anatomical changes that playa major role in cardiovascular morbidity and mortality later in life. Animal studies support our hypothesis by showing that inhalation of ambient PM promotes oxidative lung damage, including alveolar and systemic inflammatory responses (Beckeret al. 1996; Dye et al, 2001; Fujii et al. 2002; Goto et al. 2004; Suwa et al. 2002; van Eeden et al. 2001). We investigated the association between residential ambient PM2 5 and carotid artery inti ma -media thickness (CIMT) using prerandomization baseline data from two recent clinical trials conducted in Los Angeles, California (Hodis et al. 2002). CIMT is a well-established quantitative measure of generalized atherosclerosis that correlates well with all of the major cardiovascular risk factors, with coronary artery atherosclerosis, and with clinical cardiovascular events (Mack et al. 2000) It is an established tool for investigating the contribution of long-term exposures such as smoking or passive smoking to subclinical stages of atherosclerosis at any given age (Diez -Roux et al. 1995: Howard et al. 1994. 1998). This is the first study to assess the association of atherosclerosis with air pollution. Materials and Methods Population and health assessment. We used baseline health data from two randomized. double-blind, placebo- controlled clinical trials conducted at the University of Southern California Atherosclerosis Research Unit (Hodis et al. 2002). The Vitamin E Atherosclerosis Progression Study (VEAPS) investigated the effects of vitamin E on the progression of atherosclerosis measured by CIMT. The 6 -Vitamin Atherosclerosis interventionTrial (BVAiT) focused on the effect of vitamin B supplements on the progression of atherosclerosis (trial in progress). Baseline assessment in both trials included CIMT measured between 1998 and 2003 using the same standardized methods (Hodis et al. 2002; Selzer et al. 1994, 2001). Recruitment of volunteers occurred over the entire Los Angeles Basin. covering a geographic area of approximately 64,000 km2. Eligible subjects for the VEAPS trial (n = 353) were men and women'- 40 years of age with slightly increased LDL cholesterol (-' 3.37 mmol/L) but with no clinical signs or symptoms of cardiovascular disease (CVD) (Hodis et al. 2002). Subjectswith diabetes, diastolic blood pressures 100 mm Hg. thyroid disease, serum creatinines 0.065 mmol/L, life- threatening diseases, or high alcohol intake were excluded. BVAIT (n = 506) had a similar design to that of VEAPS. Men and women n 40 years of age were prescreened to meet study criteria (fasting plasma homocysteine'- 8.5 pmol/L; postmenopausal for women: no evidence of diabetes, heart disease, stroke, or cancer). Subjects were excluded on the basis of any clinical signs or symptoms of CVD, diabetes or fasting serum glucose'- 140 mg/dL, triglyceride levels'- 150 mgldL, serum creatinine > 1.6 mgldL, high blood pressure, untreated thyroid disease, life-threateningdiseasewith prognosis < 5 years, or high alcohol intake. Thus, our study included "healthy" subjects with biomarkers (elevated LDL cholesterol or homocysteine) that suggested an increased risk of future CVDs (n= 859). Fifty-eight subjects were excluded in the exposure assignment process because they lived outside the area with PM2 5 data. Three subjects had missing data in at least one of the covariates used in the models. Our total sample consisted of 798 participants Health measures, including CIMT,Our main outcome of interest is CIMT. In both trials, high-resolution B-mode ultrasound images of the right common carotid artery were obtained before the intervention (baseline) with a 7.5 -MHz linear array transducer attached to an ATL Ultramark-4 Plus Ultrasound System (Ultramark. Bothell, WA). We used this baseline CIMT measurement as the outcome. Details of this highly reproducible method are published (Hodis et al. 2002; Selzer et al. 1994.2001). Blood pressure, height, and weight were measured with standard procedures. The baseline questionnaires included an assessment of all major CVD risk factors and covariates. including clinical events, diet, use of prescription medications. physical activity, current and past smoking and passive smoking, and vitamin supplements. Age, education, and other sociodemographicfactors were available for each subject. Fasting blood samples were also drawn for lipid measurements. Data used in our analyses were collected with the same tools in both trials Exposure assignment. To assess exposure we chose a novel approach derived from a geographic information system (GIS) and geostatistics. This method allows for assignment of long-term mean ambient concentrations of PM2 5 to the ZIP code area of each subject's residential address (Kunzli and Tager 2000). The resulting surface of PM2 5 covered the entire Los Angeles metropolitan area. The surface is derived from a geostatistical model and data from 23 state and local district monitoring stations (during 2000). These monitors are located across the Los Angeles region to characterize urban levels of pollution. To assign exposure, PM2 5 data were interpolated using a combination of a universal kriging model http://ehp.niehs.nih.gov/members/2004/7523/7523ml 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles with a quadratic drift and a multiquadric radial basis function model (Bailey and Gatrelf 1995; Burrough and McDonnell 1998). We averaged the two surfaces based on 25-m grid cells. Examination of errors from the universal model showed that > 50% of the study area had assigned values within 15% of monitored concentrations, whereas 67% were within 20%. The larger errors were on the periphery of our study area, where the density of study participants was the lowest We linked the ZIP code centroids of each sub,ect with the exposure surface through a geocoding database [Environmental Systems Research Institute (ESRI) 20041 Figure 1 illustrates the FM, 5 surface with the geolocated ZIP codes Individually assigned PM2 5 data had a range from 5.2 to 26.9 pg/m3 (mean. 20.3), thus exceeding the range observed across 156 metropolitan areas used in the largest cohort study of air pollution and mortality (Pope et al. 2002). All models were implementedwith ArcScript from ESRI (Redlands, CA). Page 3 of 9 Figure 1. ZIP code locations of the study population geocoded on the Statistical analyses. We tested the univanate and multivariate associations PM2.5 surface, modeledwith 2(300 between CIMT and ambient PM2 5 using linear regression analyses. Extensive PM2.5 data, and distribution of residual diagnostics indicated some hel,eroskedasbcity, which was rectifiedwith individually assigned concentrations. the natural log -transformed CIMT We adjusted for factors that were statistically associated with both CIMT and ambient PM, 5 (age, male sex, low edocation, and low income). Next, we expanded the models using covariates that were associated with either PM= or CIMT. including indicatorvariables for current second- hand smoke exposure and current and former personal smoking. We then added covariates that playa role in atherosclerosis such as blood pressure, LDL cholesterol, or proxy measures such as reporting treatment with ant+hypertens.ves or lipid -lowering medications at stuay entry These factors may affectthe pathophysiologic pathways linking air pollution exposure and atherosclerosis (Ross 1999); thus. such models may overadjust the coefficients. We chose this conservaf ve approach to test the sensitivity of the effect estimates under a broad range of model assumptions. There is increasing evidence that host factors such as age, sex. or underlying disease and risk profiles may modify the effectsof air pollution (Pope et al 2002; Zanobetti and Schwartz 2002). Furthermore,the finding of atherosclerosis in PM - exposed rabbitswas based on a hyperlipidemic rrait (Suwa et ai. 2002). Therefore, we also stratified by sex. age (c60 years,'- 60 years). smoking status. and .ipid-lowering drug therapy Results Table 1 summarizesthe main characteristicsof the study population and among main subgroups. Table 2 presentsthe percentchange in CIMT in association with a 10 pg/m3 contrast in ambient FBA concentrations for three cross- sectional regression models. The unadjusted model indicates a 5.9% [95% confidence i nterval (CI), 1-11 %) increase in CIMT per 10 pg/m3 PM2 5. Forthe observed contrast between lowest and highest exposure (20 Ng1m3 PM2 5), this correspondsto a 12.1% (2.0-23.1 %) increase in CIMT. The only covariatewith a substantial effect on the point estimatewas age, which reducedthe effectfrom 5.9 to 4.3% (0.4-9%) per 10 pglm3 PMz 5. This change agrees with the age- related effect modification. Otherwise, effect estimates across the models remained robust, in the range of 3.9-4.3% with p -values from 0.05 to 0.1. To corroboratethe exposure -response relationship, we also categorized PM2 5 levels into quartiles. Figure 2 shows the adjusted mean CIMT across these four groups of equal sample size at the mean levels of the covariates (age, sex, education, and income). The trend across the exposure groups was statistically significant (p = 0.041). The unadjusted means of CIMT among these quartiles of exposure were 734, 753, 758, and 774 lam, respectively. The associations between CIMT and PM2 5 were substantially stronger among 109 subjects reporting lipid -lowering medicationat study entry, both in men and i n women (Table 2, Figure 3). The crude effect reached 15.8% (2-31 %) per 10 pg/m3 PM2 5, with adjusted values ranging between 12 and 16%. Despitethe Small sample size, p -values of all modelswere mostly < 0.1 and often < 0.05. Results also suggest significant age and sex interactions, with much larger effects in women and in the older age group (Figure 3). Effect estimates in Table 1. Table 2. rZ M 1$1-014 rE74t-a1 M an -no int-xx a.rrw..rra�„� http://ehp.niehs.nih.gov/members/200417523n523.htmi 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles women were statistically significant and typically in the range of 69% per 10 pglm3 PM2 5. Associations were strongest among women' 60 years of age (n = 186). leading to crude estimates of 19.2% (9-31 %). Adjusted coefficients ranged from 14 to 19%, being statistically significant in all models and sensitivity analyses. Among never smokers (n =502), the effect estimate reached 6.6%(1.0-12.39/0). The estimatewas small and not significant in current (n = 30) and former smokers (n = 265). Discussion Our study presentsthe first evidence for an association between CIMT and long- term exposure to ambient air pollution. As recently reviewed in a statement of the American Heart Association (Brook et al. 2004) substantial epidemiologic and experimental evidence suggests a contribution of ambient air pollutants on cardiovascular mortality and morbidity. However, these studies focus on acute and subacute effects on cardiac autonomic function, inflammatory or thrombogenic markers, arrhythmia, myocardial infarction, cardiovascular hospital admission, and death. The only outcome considered in long-term air pollution studies has been mortality. The relative risks for acute effects on mortality have been substantially smaller than those observed for long-term associations (Pope et al. 2002; Samet et al. 2000). As shown previously, cohort studies are capable of capturing acute and chronic effects of air pollution on the course of diseases that ultimately lead to premature death (Kunzli et al. 2001). In contrast, time - series and panel studies investigate only the associations of event occurrence with the most recent exposure (Kunzli et al. 2001). Thus, if air pollution has both acute and cumulative long-term effects. one expects larger mortality coefficients in cohort studies. CIMT reflects long-term past exposure; thus, we provide the first evidence for chronic effects of air pollution on atherogenesis that may in part explain the above mentioned discrepancy between acute and long-term risk estimates (Pope et al. 2002; Samet et al. 2000). Page 4 of 9 Figure 2 Mean CIMT* 1 SE among quartiles of the PM2 5 distribution. T taxis hows mean Clhl levels a population average o he adjustment covariates (age, sex, education. and income). The first quartile isthe reference group. Figure3. Percent difference and 95% CI in CIMT associated with a 10 pg/m3 contrast in ambient PM in all subjects and in subgroups. LipU LT, lipid -lowering therapy, All estimates are based on the cross-sectional linear model with log intima -media thickness as the dependent variable and home outdoor PM2 5 as the independentvariable, adjusted for sex, age, education, and income. Numbers in parentheses are numbers of subjects per group. Data are ordered by size of point estimate; the null effect line is indicated by a dash. There are several major aspects to be considered in the interpretation of this new finding, mainly the strength in the exposure assignment, the limited evidence for bias, the differences in effects within subgroups,and plausibility. Exposure assignment. The individual residence -based assignment of exposure represents a substantial improvement over most studies that have relied on central monitors or on binary road buffers combined with basic interpolation (Hoek et al. 2002, Pope et al. 2004). As a sensitivity analysis, we used weighted least-squaresmodelswith the weights specified as the inverse of the standard errors from the universal kriging model to down -weight estimates with larger error. I n addition, we implemented models based solely on the universal kriging estimate. in both instances results were robust and similar to what we found with our main model. Time -activity studies show that people spend most of their time in or around home, and our restriction of exposure assessment on residential address captures the most relevant part of exposure (Leech et al. 2002). PM2 5 generally displays spatially homogeneousdistributions across small areas such as neighborhoods and blocks, and as a result. the ambient conditions at the ZIP code centroid likely reflectthe levels expected at home outdoors (Roosli et al. 2000). PM2 5 of outdoor origin will also penetrate indoors, and correlations between long-term outdoor PM concentrations and indoor levels of PM from outdoor origin is high (Sarnat et al. 2000). Exposure to ambient air pollution while working and during commute are not included in our exposure term but are considered to be a relevant source of exposure (Riediker et al. 2003). Although most likely a random misclassificationwith biasestoward the null, the errors may affect subgroups differently, thus explaining part of the observed interactions. In Los Angeles, no clear trends have been observed in PM2 5 concentrations over the past 5-10 years. The year 2000 surface characterizes the prevailing mean PM2 5 concentrations across several years and can be considered a measure of long-term past exposure. This year also sits in the middle of the baseline recruitment period. Overall, the various limitations in our exposure assignment may add some random error, biasing results toward weaker associations (Thomas et al. 1993) We also assigned ambient ozone to ZIP code centroids. Inclusion of ozone in the models had no impact on the PM2 5 coefficients or the SEs. Ozone and PM2 5 were not correlated (r=-0.17), and the PM2 5 estimates were not substantially httpa/ehp.niehs.nih.gov/members/2004/7523/7523,ht:ml 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles Page 5 of 9 different in low- and high -ozone regions. The estimates of association for ozone were positive but not statistically significant and much smallerthan for PMZ 5. This finding must be put in context of the specific challenges in determining long-term exposure to ozone. which are substantially different than in the case of PM exposure. I n contrastto PMZ 5 from outdoor origin, ambient ozone levels have lower correlations with personal exposure (Avol et al. 1998: Sarnat et al. 2000, 2002); therefore, the abilityto detect effects of ozone will likely be reduced due to greater misclassification. Biases. Our subjects were a nonrandom sample of "healthy" volunteers with above-average education, meeting strict inclusion criteria for the two clinicaltrials. Althoughwe cannot exclude some systematic selection biases affecting the cross-sectional data, it is unlikely that subjects with preclinical signs of atherosclerosis would have been more likely to volunteer if they lived in more polluted areas. Although the selection of subjects limits the generalization to other populations, we do notexpect this to lead to over- or underestimating the cross-sectional associations. The two trials recruited subjects independently; thus, the effects may be compared across trials to evaluate the potential influence of selecting volunteers. The populations differed with regard to age, smoking habits, baseline LDL and treatment. blood pressure, active and passive smoking, and other relevant factors; thus, the PM2 5 coefficientswere smaller and were not statistically significant in the VEAPS trial with its younger population. However, after taking these factors into account, the associations with ambient PMZ 5 were similar. For example, among elderly women of VEAPS (n = 70) and BVAIT (n = 116), the effect estimate was 18.1 % (-0.1 to 36.3.%) and 13.6% (2-8-24.4.%), respectively. There is some evidence for larger effects in subjects with cardiovascular risk factors, indicated by prescriptions of lipid-loweringtreatment. Our trials excluded subjects with clinically manifest CVDs. Moreover, if air pollution amplifies systemic inflammation among those prone to atherosclerosis, exclusion of subjects with high LDL may be a source of bias. One may expect effect estimates in a less selected, less healthy population to be largerthan those reported. The wealth of baseline data from these clinical trials offeredthe opportunity to control for a broad array of covariates. Apart from the effect of age adjustment, estimates were robust to numerous combinations of covariates, including income, education, active and passive tobacco smoke, cardiovascular prescriptions, vitamin intake, and physical activity. Uncontrolledor residual confounding appears to be an unlikely explanation for these results. Among women, adjustment for hormone replacement therapies did not affect the PM2 s estimates. In previous studies, we found that spatial autocorrelationin the residuals could affectthe size and significance of pollution coefficients(Jerrettet al. 2003a). We investigated spatial autocorrelation of the unstandardized residuals. We assessed autocorrelationwith first -order, adjusted first -order. and second-orderspatial weight matrices based on nearest neighbor contiguity, but we found no evidence of spatial autocorrelation. This supports the conclusion that the models supply efficient unbiased estimates (Jerrettet ai. 2003b). As part of our sensitivity analyses, we also derived PM,, 5 surfaces using different interpolationsand weighted least squares with weights equal to the inverse of the standard error of the exposure estimate. All approaches produced very similar results. Evidence for effect modification. The data suggest substantial interactions with age, sex, smoking, and underlying cardiovascular risk factors. Given the reduced sample size among subgroups, the recruitment of volunteers. and the cross- sectional nature of the data, it is difficult to fully explore the causes of the observed modifications of associations and to establish susceptibility profiles. if the exposure misclassifications differed across subgroups, part of the interactions may be explained by differential exposure error. The sex and age difference could also be an artifact due to measurement error in the assigned exposure because time spent in commuting and location of work places may be different in men and women and in the young and elderly. Empirical studies on mobility suggestwomen have smaller activity spaces than men and younger groups, meaning they tend to spend more time in and around the home (Kwan and Lee 2004). and the same is probably true of the elderly compared with younger groups. Exposure measurement error may be reduced in those spending more time at home, leading to stronger effects (Thomas et al. 1993). Moreover, differences in statistical power may play a role as well; as shown at least for the 25 -40 -year age range, power to detect effects on CIMT is larger in women than in men (Stein et al. 2004). The finding that those reporting prescriptions of lipid -lowering medications at baseline showed stronger associations of CIMT with PM2 5 merits further investigation. This result agrees with the observed effects of PM on atherosclerosis in experiments conducted in hyperlipidemic rabbits (Coto et al. 2004; Suwa et al. 2002). The systemic inflammatory and atherogenic reaction in these rabbits was related to the amount of PM contained in the alveolar macrophages. In our study, being under lipid-loweringtherapy is an indicatorfor risk profiles prone to atherogenesis. Those subjects were mostly men (64%) and, on average, older, more often active or passive smokers, and almost twice as likely to report antihypertensive treatment. The systemic response to ambient PM may amplify and expand the oxidation of LDL cholesterol among these susceptible subjects, consequently contributing to injury in the artery wall (Goto et al. 2004, Ross 1999). Investigationsof short-term effects of ambient air pollution on mortality also suggest that underlying risk profiles such as diabetes may amplify susceptibility to ambient PM (Zanobetli and Schwartz 2002). and similar findings have been shown with smoking and diabetes mellitus in association with CIMT (Karim et al. 2005). To clarify the relevanceof lipid status, it would be interestina to investigate our hypothesis amona cohorts with familial hvpercholesteremiaCVViegman et al. 2004; VVittekoek et al. 1999). http://ehp.nieis.nih.gov/members/2004/7523/752iiml 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles Page 6 of 9 As shown in Figure 3, the size of the point estimate was larger among the older subjects. Future research needs to clarify whether air pollution contributes to atherosclerosis only after a certain age or early on. Effects of air pollution on lung development have been observed during adolescence and may be a result of both pulmonary and chronic systemic inflammatory effects (Gauderman et al. 2002); thus. it is conceivable that atherogenic responses may occur early in life, The age dependence of the effects may also be codetermined by genetic factors (Humphries and Morgan 2004; Ross 1999). We also observed larger effects in women. If other cardiovascular risk factors such as occupational exposures dominate atherosclerosis in men, we would expect a smaller effect signal and less precision in the estimates among men. We also hypothesizethat interactions may reflect biologiccauses. If premenopausal women are protected against atherosclerosis by endogenous hormones, loss of hormonal protectionwould lead to increased vulnerability afler menopause(Kannel et al. 1976). This could explain part of the interaction by both age and sex. Active and passive smoking did not confound results in either the total sample or among subgroups. Adjustment for active tobacco smoke led to a slight increase in the effect estimate; thus, residual confounding is unlikely to overestimatethe effects. However, PM2 5 associations were clearly stronger in never smokers compared with smokers (data not shown). This gradient was also observed in all subgroups with significant PM2 5 associations (Figure 3). Oxidative and inflammatory effects of smoking may dominateto such an extent that the additional exposure to ambient air pollutants may not further enhance effectsalong the same pathways. The difference in the effects of PM2 5 in smokers and nonsmokers needs further investigation. The American Cancer Society cohort study does not reveal a clear pattern of a smoking interaction for the association of ambient air pollution and cardiovascular death (Krewski et al. 2004; Pope et al. 2004). In the Study on Air Pollution and Lung Diseases in Adults (SAPALDIA), associations between air pollution and level of pulmonary function did not differ by smoking status (Ackermann-Liebrichet al. 1997). Some U.S. studies indicate effect modification of air pollution by socioeconomic status (SES) with much stronger effects among the less educated (Pope et al. 2002). The cause of this interaction pattern is not well understood. SES statuswas rather homogeneous in these mostly well-educated volunteers, providing little powerto investigate interactions of pollution with SES. If lower SES also positively modifies effects of air pollution on atherosclerosis, our populationwould provide an underestimate of the health effects in the general population (O'Neill et al. 2003). Further research on samples representative of the population will be needed to assess whether the high SES in the clinical trials biasesthe effects toward the null. Future research should focus on identifyingfactors that determine susceptibility to PM2 5. We are initiating studies on subjects with inflammatory metabolic syndromes prone to accelerated atherosclerosis such as postmenopausal women, diabetics, or obese or physically inactive people. To corroborate the cross-sectionalfindings, follow-up studies are ultimately needed to investigate the association of concurrent levels of air pollution exposurewith the progression of CIMT. Plausibility. From a biologic perspective, our results support the hypothesis that long-term exposure to ambient PM contributesto systemic inflammatory pathways, which are a relevant aspect of atherogenesis (Ross 1999). The findings indicate a biologically plausible link between the observed acute effects of ambient air pollution on systemic inflammation (Glantz 2002) and the long-term consequences of sustained vascular inflammation leading to increased atherosclerosis and, ultimately, cardiovascular death (Hoek et al. 2002; Pope et al. 2004). Among susceptible people, this may lead to arterywall lesions similar to those observed in the rabbit model (Fujii et al. 2002; Suwa et al. 2002). In these hypertipidemic rabbits, 4 -week PM exposure was associated with the progression of atherosclerotic lesions, coupled with an enhanced release of bone marrow monocytes. These precursors of macrophages play an important role in the atherogenic inflammatory responses(Goto et al. 2004; Ross 1999; Suwa et al. 2002). Given the central role of oxidized LDL in the initiation and progressionof atherogenesis, suggestions that the plasma of automotive workers with high exposure to traffic exhaust is more susceptible to oxidation is also of interest (Sharman et al. 2002). As a quantitative plausibility check, we compared the size of the PM2 5 effects with effects of other riskfactors on CIMT Using smoking and environmental tobacco smoke (ETS) as a model for air pollution exposure, the size of our estimates appear plausible (Diez -Roux et al, 1995; Howard et al. 1994). Associations of ETS and current levels of air pollution with various respiratory outcomes are similar and support the notion of common underlying pathways (Kunzli 2002). Smoking and ETS associate with stiffer and thicker artery walls, reflecting the systemic effectof these exposures (Howard et al. 1994; Mack et al. 2003). Exposure to ETS was associated with 2-3% thicker intima -media, which approximate the effects observed for a 10 pg/m3 change in PM2 5 (Diez -Roux et al. 1995; Howard et al. 1994). Using never smokers without ETS exposure as the referentgroup in our data, never smokerswith ETS at home had 0.9% (-2.7 to 4.5%) thicker artery walls; former smokers' CIMT was increased on average by 3.4% (0.7-6.3%), and the 30 current smokers had 5% (-1.5 to 11.6°/x) thicker CIMT. The trend across these four categories of tobacco exposure was statistically significant. As shown in Table 1, smokers were underrepresented in these volunteers of well-educated participants. The observed percent change in CIMT correspondsto an increase in the thickness of approximately 20-40 pm per 10 http://ehp.niehs.nih.gov/members/2004/7523/752&nl 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles Page 7 of 9 pg/m3 contrast in PM2 5. This difference in CIMT translates into some 3-6% increase in the long-term risk for myocardial infarction (O'Leary et al. 1999). Popeet al, (2004) reported that long-term exposureto PM2 5 was assodated with an 18% (14-23%) increase in ischemic heart disease. Effect sues reported here concur with these findings, indicating that a fraction of the total effect of ambient PM on cardiovascular mortality may be mediated through sustained long-term effects of air pollution on atheroselerosis(KOnzli et al, 2001). This is in linewith the proposed model (Kunzli et al. 2001) inwhich some of the effectsobserved in cohort studies must reflect long-term contributionsof air pollutionto the underlying disease progression, whereas in other cases, air pollution contributes only to triggering of cardiovascularevents or death (Bell et al. 2004; Kunzli et al, 2001; Peters and Pope 2002). From a biologicand policy perspective, we emphasize that PM2 5 probably serves as a surrogate for the mixture of urban air pollution and constituentsof PM. It is prematureto concludethat PM2 5 and its constituentsare the atherogenic culprit per se. Atherosclerosis results from complex processesthat may include a combination of various urban pollutants, host factors, and pathways that ultimately lead to the findings of a CIMT-PM2 5 association. In conclusion, we have presented the first epidemiologic evidence supporting the idea of a chronic vascular response to respiratory and systemic effects of PM exposure. Given the leading role of heart disease as a cause of death in most westernized countries and the growing contribution in developing countries. these findings may be of high public health relevance. Further investigations need to focus on susceptible groups and follow-up of cohorts to investigate the effect of air pollution on the progression of CIMT References Ackermann-Liebrtch U, Leuenberger P,SchWartz J, Schindler C. Monn C, Bolegnini G, elal, 1997, Lung function and longterm exPosuretoair pollutants in Switzerland. Study on Air Pollution and Lung Diseases in Adults (SAPALDIA) Team. Am J Respir Crit Can Med 155{1): 122-129, Avol EL, Navidi wC, Golome SO. 1996. Modeling ozone levels in and around SouthernCelifomia homer. Environ ScilTee WKA 32'.463-4b8. Bailey T. Gatrell A. 1995.Interactive Spatial Data Analysis. New YorkLengman Becker S, Soukup JM. Gilmour MI, Devlin RB. 1996 Stimulation of human and rat alveolar macrophages by urban air particulates: effects onoxfda.nt radical generation and cytokine p m d u t i i . To*col Appl Pharmaooi 141(2):537-640 Bell ML. Samet J et, Dominici F.2044. Time -series studies of particulate matter. An nu Rev Public Health 25:247-280 Brook IRO.Franklin B, Cascio W, Hang Y, Howard G. Lipsett M,et al, 2304 Air potation and cardiovascuiardsease: a statement for healthcare professionals fmm the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation 109(21):2655.2671. Burrough P, McDonnell R. 1998 Principles of Geographical Informaton Systems. New York: Oxford University Pre$$ Diez -Roux AV. Nieto FJ. Comstock GVV, Howard G, $zklo M. 1995. The relationship ofadNe and passive smoking to carotid atherosclerosis 12-14years later. Prey Med 24(1):48-55. Dye JA, Lehmann JR. McGee JK, Winsett OW, Ledbetter AD. Everitt JI, et al. 2001 Acute pulmonary toxicity of particulate matter filter extracts in rats: coherence with epidemiologic studies in Utah Valley residents. Envimn Heakh Perspect 109(suppl 3)',395-4C3. ESR 1. 2004. ArcGIS, Redlands, CA: Environmental Systems Research Institute, Available: htt�l( .d.moist(l sla[SgsSCti1_d_6X.hSt1]1[accessad 29December 20041. F*T, Hayashi S, Hogg JC. Mukae H,Suwa T, Goto Y, at al. 2002, Interaction of alveolar macrophages and airwayeplthelial calfs following exposure to particulate matter produces mediators that stimulatethe tone marrow. Am J Respir Cell Mol Biol 27(1):34-41. Gauderman WJ, Gilliland GF, Vora H, Avol E. $tram D, McConnell R, et al. 2002. Association between air pollutionand lung function growth in Southern California children: results from asecond cohort, Am J Respir Crit Care Med 166(1):76-84. Glantz SA. 2002. Air pollutionas a cause of heart disease. Timeforaetion. J Am Coll Cardiol 39(6): 943-945. Goto Y. Hogg JC. Shih CH. Ishii H, Vincent R, van Eeden SF, 2004. Exposure to ambient particles accelerates monocyte release from the bone marrow in atherosclerotic rabbits. Am J Physkol Lung Cell Mol Physiol 287: L79-85. Hodis HN. Mack W.l, LaBres L Mahrer PR. SevsNan A Liu CR. et af. 20g2. Alpha-tocopherol supplementation o healthy individuals reduces low-density lipoprotein oxidation but notatherosclerosls, the Vitamin EAtherosderosis Prevention Study(VEAAPS). Circulation 106(12): 1453-1459. Hoek G, Brunekreef B, Gotdbahm S, Fischer P,van den Brandt PA. 2002.Assodation between mortality and indicators of traffic -related air pollution in the http://ehp.niehs.nih.gov/members/2004/7523/7523.htrnl 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles Page of 9 Netherlands: a cohort study. Lancet 360(9341):1203-1209. Howard G, Burke GL. Szklo M, Tell GS, Ecideldt J, Evans G, et al. 1994, Aciive and passive smoking are associated With increased camtid wall thickness. The Atherosclerosis Risk in Communities Study. Arch Intern Med 154(11):1277.1282. Howard G. Wagenknecht LE, Burke GL. Diez -Roux A Evans GW, McGovern P. el al. 1998. Cigarette Smoking and progression of athemsdemsir: the Atherosclerosis Risk inCommunities (AR IC) Study , JAMA 279(2);119-124. Humphries SE, Morgan 12004. Genetic riskfactors for stroke and camtidatherosolerosis insights into pathophysiology from candidate gene approaches, Lancet Neurol 3(4),227-235. Jerrett M, Burnett R, Goldberg M, Sears M. Krewski I Catalan R. et ai. 2003a. Spatial analysis for environmental health research: concepts, methods, and examples. J Toxicof Environ Health A 66(16-19)',1783-1810, Jarrett M, Burnett RT, Willis A, Krewski D, Goldberg MS, DeLuca P, eta[. 20031 Spatial analysis of the air polIution-mortality relationship in the context of ecologic confounders, JToxicol EnvimnHealth A56(16-19): 1735-1777, Kannel WB, Hjortland MC,McNamara PM,GordonT. 1976. Menopauseancl of cardiovasculardisease the Framingham study.Ann Intern 185(4)447-452 Karim R. Buchanan TA Hodis HN. Li Y, MackWJ.2005.The association of smoking andsubcllnical atherosclerosis in type 2diabetes: modifiication bydurationof diabetes. Dia bet Med 22 (1):81-67. Krewski D, Bumett RT. Goldberg MS, Hoover K, Siemiatycki J, Abrahamowicz M, et al, 2004. Validation ofths Harvard Six Cities Study of part ce late airpellution and mortality. N EngIJ Med 350(2),198.199. Kunzli12002 Thepubiichealth relevance ofair pollution abatement. EurRespirJ20(1) 198-209 Kunzli N,MedinaS, Kaiser R, Quenel P,Horak FJ,Studnicka M 2001, Assessment of deaths attributable to air pollution: should weuse risk estimates ba sed on time series or an cohort studies? Am J Epidemioll53(11),1050-1055, Ku nz I i N, Tager 1.2000. Long-term health effects of particulateand Other ambient air polludo n: research can progress faster N we want it to. Envimn Health Perspest 108:915.918. Kwan MP, LeeJ.2004. Geovisualization of human activity patterns using3D GIS: a time -geographic approach, In: Spatially Integrated Social Science: Examples in BestPractice (Goodchild MF,Janelie DG, eds). NevvYork:Oxbordllniveraity press, 48-66. Leech JA, Nelson WC, Burnett RT,Aamn S, Raizenne ME. 2002. It's about time: a comparison of Canadian and Americanbme-activlty pattems. J Expn Anal Environ Epidemio[ 12(6}'.427-432, Mack WJ, Islam T, Leet, Selzer I Hodis HN.2003. Environmental tobacco smoke and carotiderterlal stiffness, Prev Med 37(2).146-154 MBckWJ. LaSree L, Liu C, Selzer RH, Hodis HN. 2000.Conelatioos between measuresof atherosclerosis change using carotid ultrasonography andcoronary angiography, Ath.eroscletosi8 150(2):371.379, O'Leary DH, Polak JF, Kronmal RA, Manolio TA Burke GL. Wolfson SK Jr. 1999, Carotid -artery intima and mediathickness as a riskfactor for myocardial infarcdion and stroke in older adults, Cardiovascular Health StudyCollatwrative Research Group. N EngIJ Med 340(1): 14-22. O'Neill MS, Jerrett M, Kawachi I, 1 Cohen ALT, Gouveia N, et al. 2003. Health,wealth, ani pollution: advancing theory and methods. EnvimnHeaIO Perspect 111:1861-1870, Peters A, Pope CA. 2002. Cafdlopulrnonary mortality and air pollution. Lancet360(9341):1184-1185 Pope CA Bumett RT. Thun MJ, Calle EE Krewski D. Ito K, et al 2002. Lung cancer, cardiop u lmonary mortality, and ions-termexposure to fine particulate air pollution. JAMA 287(9),1132-1141 Pope CA Burnett RT. Ti0, Thun MJ. Calle EE. Kmwski I et a1. 2094. Cw6ovascuiar mortality and long -tern exposure to particulate air pollution: epidemiological evidence ofgenersl pathophysiolcglcal pathways of disease. Circulatic n 109(l)71-77 Riediker M, VVflliams R, Devi}n R. Gnggs T, Bromberg P, 2003. Exposure to particulate matter, volatile organic compounds, and other air pol I utants inside patrol cam. EnvimnScilrechnol 37(10)2084.2093, Rocsil M, Braun-Fahnander C,Kunzli Ni L, Theis G,Camenzind M, elal. 2000. Spatial variability ofdifierent fractions of particulate matterwithinan urban environment and between urban and ruralsites. JAir Waste Manag Assoc 50(7):1115-1124, Ross R. 1999.Atheroscerosls—an inflammatory disease. Ni Med340(2):115-125. Samet JM,Dom[nici F,Curriero FC,Coursac I,Zeger Si Finsparticulate airpollution and mortaliin20U S. cities, 1987-1994, 11 Mad343(24): 1742- 1749, http-//ehp.niehs.nih,govlmembers/2004/7523/7523.html 2/15/2005 Ambient Air Pollution and Atherosclerosis in Los Angeles _, Page 9 of 9 $arnat J. Koutrakis P, Suh H 2000. Assessing the relationship between personal palk-ulate and gaseous exposures of senior citizens living in Baltimore, MD. JAir Waste Manag Assoc 50(7):1184-1198. Sarni JA. Long CM. Kcutrakis P,Coull BA, Schwartz J, Suh HH. 2002. Using sulfur as a tracer ofoutdoorfine particulate matter. Environ SG Technol 36(24): 5305- 5314. Selzer RK Hodis HN. Kwong-Fu H, Mack WJ, Lee PL. Liu CR, et al. 1994. Evaluation of computerized edge tracking for quantifying intima-mediathickness of the wmmon camtidartery from B-mode ultrasound imager.Atherosclerosis 1i 1(1):1-11. Selzer RH, Mack WJ, Lee PL, Kwong-Fu H, Hodis HN. 2OO1.Improved common camtidelasticityand intima-mediathickness measurementsfrom computer analysis of sequential ultrasound frames. Atherosclerosis 154(1): 186193. Sharman JE, Coombes JS, Geraghty DP, Fraser DI. 2002. Exposureto automotive pollution increases plasma susceptibility to oxidation. Arch Environ Health57(6): 536.540. Stein JH, Douglas PS, Snnivasan SR, Bond MG. Tang R, Li S, et al. 2004. Distribution and cross-sectional age-related increasesofcarotid artery intima -media thickness in young adults. The Bogalusa Heart Study. Stroke 35: 2782-2787, Suwa T, Hogg JC. Quinlan KB, Ohgami A Vincent R. van Eeden SF. 2002. Particulate air pollution inducer prog ression of atherosclerosis, JAm Coil CardiN 39(6): 935-942, Thomas D, Stram D, Dwyer J. 1993. Exposure measurement error: influenceon exposure -disease relationships and methodsof wrrection. Annu Rev Publ Health 14:69-93. van Eeden SF, Tan WC, Suwa T, Mukae H,Terashima T, Fujii T, et al. 2001. Cytokines involved in the systemic inflammatory response induced byexposureto particulate matter air pollutants (PiM10). Am J Respir Crit Care Med 154(5):825.830. Wiegman A, Hutien BA, de Groot E. Rodenburg J, Bakker HD, Buller HR, at al. 2004. Efficacy and safety of statin therapy in Children with familial hypercholesterolern a, a randomized controlled trial. JAMA292(3):331-337. VNttekoek ME, de Groot E, Prins MH. Trip MD. Buller HR,Kastelel JJ. 1999. Differences in intima-mediathicknessin the carotid and femoral arteries in familial hypercholestemlemic heterozygotes with and Wiilhoutclinical manifestationsofcardiovascular disease. Atherosclerosis 146(2):271-279. Zan obettt A Schwartz J. 2002. Cardiovascular damage by airborne pa rtici es: are diabetics more susceptible? Epidemiologyl 3(5):586-592. Last Updated: January 12.2005 http://ehp.niehs.nih.gov/members/2004/7523/7523.html 2/15/2005