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Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (particulate matter with an aerodynamic diameter < 2.5 μm) exposure is the fifth leading risk factor for death in the world, accounting for 4.2 million deaths and > 103 million disability-adjusted life years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body. It can cause, complicate, or exacerbate many adverse health conditions. Tissue damage may result directly from pollutant toxicity because fine and ultrafine particles can gain access to organs, or indirectly through systemic inflammatory processes. Susceptibility is partly under genetic and epigenetic regulation. Although air pollution affects people of all regions, ages, and social groups, it is likely to cause greater illness in those with heavy exposure and greater susceptibility. Persons are more vulnerable to air pollution if they have other illnesses or less social support. Harmful effects occur on a continuum of dosage and even at levels below air quality standards previously considered to be safe.

Although air pollution is well known to be harmful to the lung and airways, it can also damage most other organ systems of the body. It is estimated that about 500,000 lung cancer deaths and 1.6 million COPD deaths can be attributed to air pollution, but air pollution may also account for 19% of all cardiovascular deaths and 21% of all stroke deaths. Air pollution has been linked to other malignancies, such as bladder cancer and childhood leukemia. Lung development in childhood is stymied with exposure to air pollutants, and poor lung development in children predicts lung impairment in adults. Air pollution is associated with reduced cognitive function and increased risk of dementia. Particulate matter in the air (particulate matter with an aerodynamic diameter < 2.5 μm) is associated with delayed psychomotor development and lower child intelligence. Studies link air pollution with diabetes mellitus prevalence, morbidity, and mortality. Pollution affects the immune system and is associated with allergic rhinitis, allergic sensitization, and autoimmunity. It is also associated with osteoporosis and bone fractures, conjunctivitis, dry eye disease, blepharitis, inflammatory bowel disease, increased intravascular coagulation, and decreased glomerular filtration rate. Atopic and urticarial skin disease, acne, and skin aging are linked to air pollution. Air pollution is controllable and, therefore, many of these adverse health effects can be prevented.

The science has become clear and convincing that the Earth's climate is rapidly changing [e.g., Intergovernmental Panel on Climate Change (IPCC), 2014]. Along with the overall changes in climate, there is strong evidence of an increasing trend over recent decades in the frequency, intensity, and duration of some types of extreme weather events, with resulting effects on U.S. society.

Given the increases in spatial resolution and other improvements in climate modeling capabilities over the last decade since the CMIP3 simulations were completed, CMIP5 provides a unique opportunity to assess scientific understanding of climate variability and change over a range of historical and future conditions. With participation from over 20 modeling groups and more than 40 global models, CMIP5 represents the latest and most ambitious coordinated international climate model intercomparison exercise to date. Observations dating back to 1900 show that the temperatures in the twenty-first century have the largest spatial extent of record breaking and much above normal mean monthly maximum and minimum temperatures. The 20-yr return value of the annual maximum or minimum daily temperature is one measure of changes in rare temperature extremes.

Weather and climate extremes profoundly affect society and the environment, resulting in the loss of life, property, and habitat. The extremes discussed herein are causally related: extratropical storms account for the majority of extreme winds during the cold season, and extreme waves are largely driven by extreme winds. For assessment purposes, extremes are defined based on meteorological principles rather than physical destructiveness. Nevertheless, each of these extremes can result in substantial societal impacts. Estimates of extratropical storm activity primarily derive from two sources: atmospheric reanalyses and pressure-based indices. Reanalysis products have the advantage of uniform space and time fields on which to locate pressure minima or vorticity maxima, facilitating the identification of storm tracks. In contrast, pressure-based indices have the advantage of being directly computed from in situ observations, which often extend further back in time than most reanalyses.

China is the worlds largest emitter of anthropogenic air pollutants, and measurable amounts of Chinese pollution are transported via the atmosphere to other countries, including the United States. However, a large fraction of Chinese emissions is due to manufacture of goods for foreign consumption. Here, we analyze the impacts of trade-related Chinese air pollutant emissions on the global atmospheric environment, linking an economic-emission analysis and atmospheric chemical transport modeling. We find that in 2006, 36% of anthropogenic sulfur dioxide, 27% of nitrogen oxides, 22% of carbon monoxide, and 17% of black carbon emitted in China were associated with production of goods for export. For each of these pollutants, about 21% of export-related Chinese emissions were attributed to China-to-US export. Atmospheric modeling shows that transport of the export-related Chinese pollution contributed 3-10% of annual mean surface sulfate concentrations and 0.5-1.5% of ozone over the western United States in 2006. This Chinese pollution also resulted in one extra day or more of noncompliance with the US ozone standard in 2006 over the Los Angeles area and many regions in the eastern United States. On a daily basis, the export-related Chinese pollution contributed, at a maximum, 12-24% of sulfate concentrations over the western United States. As the United States outsourced manufacturing to China, sulfate pollution in 2006 increased in the western United States but decreased in the eastern United States, reflecting the competing effect between enhanced transport of Chinese pollution and reduced US emissions. Our findings are relevant to international efforts to reduce transboundary air pollution.

Some of the long-term changes in weather and climate extremes across the US have occurred as expected in the warming climate, but the trends vary throughout the country and easily detected due to multiyear and decadal variations. The US National Climate Assessment has to address extremes, as these are changing and anthropogenic climate change has a role in altering the probabilities of some of the extreme events. Extreme events also drive changes in natural and human systems more than average climatic conditions. Four workshops have been held to provide technical input to the US National Climate Assessment writing team where leading scientists in the field worked jointly to determine how best to assess the state of the science in understanding the decadal- to century-scale variability and changes in various types of extreme events.

Review of the climate science for severe convective storms, extreme precipitation, hurricanes and typhoons, and severe snowstorms and ice storms in the US shows that the ability to detect and attribute trends varies, depending on the phenomenon. A specific subset of extreme weather and climate types affecting the country is discussed to examine these extreme weather conditions. The categories of storms described were selected as they caused property damage and loss of life. The identification of an extreme occurrence was based on meteorological properties in place of the destructiveness. The primary purpose was to examine the scientific evidence for the prevailing capability to detect trends and understand their causes for certain weather types, including severe convective storms and hurricanes and typhoons.