The following is excerpted from a document to be found on the EPA's website, as follows:

“Proposal of Emission Control Area Designation for Geographic Control of Emissions from Ships”, EPA-420-F-09-015, March 2009; the complete, very lengthy document can be read online at . Below are excerpts from that document.
"Proposal to Designate an Emission Control Area for Nitrogen Oxides, Sulphur Oxides and Particulate Matter Submitted by the United States and Canada - Annex 1
{\author U.S. EPA}..................4.2.1, The United States Human Health Impacts, paragraph 1:
The United States government estimates that emissions from ships operating in the proposed ECA are responsible (every year in the United States) for up to 11,500 premature mortalities, 12,000 hospital admissions, 580,000 days of work lost, 810,000 days of missed school, and 5,700,000 days of restricted physical activity. The United States based its analysis on peer-reviewed studies of air quality and human health effects (see U.S. EPA, 2006 and U.S. EPA, 2008). These methods are described in detail in the related Technical Support Document referenced in the Information Document."

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