Doctor's corner Why clean air is important to your health now - Part 2

In Part I, we talked about the importance of the Clean Air Act, the causes of air pollution, and its impact on our health. In this segment, we will further explore the health risks behind pollution, why the Clean Air Act is at risk, and what can be done to preserve our clean air.

Why is pollution of special concern?

For one thing, pollution is an issue year-round, whereas ozone is of greatest concern in the summer, so pollution exposure tends to be prolonged. According to Dr. George Thurston, a leading scholar in the area of human health effects and air pollution, a professor of Environmental Medicine and Population Health at the New York University School of Medicine, and chair of the American Thoracic Society'sEnvironmental Health Policy Committee, another reason is that pollution particles tend to contain some very nasty substances that are highly toxic to the body, such as lead, selenium, and arsenic; many of these are known carcinogens.

Because we are breathing them in and they are so small, they are being carried deep into our lung tissue and from there, can migrate elsewhere in the body, thus being a conduit for spreading disease.

"These particles overrun the body's natural defenses," explains Thurston. "Our bodies are designed to protect us from bigger particles thanks to our nasal hairs and the mucus in our noses and mouths.

Bigger particles get caught and then sneezed out or blown out of our nose, but small particles from combustion pollution get inhaled deep into our lungs and therein lies the danger."

Why children are at risk when it comes to air pollution?

Children are most at risk for several reasons. For one thing, they breathe in more oxygen; they have faster respiratory rates and take in more air per body weight. They also tend to spend more time out of doors and to be more active with play or sports.

In addition, their lungs are still developing and have not yet reached full growth. This will not happen until they are in their teens, so being in the developmental stage makes them vulnerable to outside influences. Dr. Rice notes that children who are consistently exposed to higher levels of air pollution have slower lung growth, achieve lower lung function by adulthood, and are at increased risk of serious respiratory infections and asthma.

"Exposure to air pollution as a child sets you up for a lifetime of respiratory issues and keeps you from developing the lung capacity that you would have reached if you were not exposed to pollutants," she says.

Why is the Clean Air Act at risk?

Proposed changes by Congress and the Trump administration will alter not only how often the Clean Air standards are reviewed, but also cut critical funds. Currently, the EPA is required to look at the criteria for the six key pollutants every five years to see if the standard requirements for each one need to change.

A panel of experts is convened and the latest scientific evidence is examined.

However, many Clean Air Act standards are reviewed less frequently, and often the environmental community must get a court order to force the EPA to review the standards in a timely manner, according to Ewart.

"One of the proposed changes would alter the standard review process to every 10 years, which means that in all likelihood, standards would not get reviewed until every 15 or even 20 years. Many of us in the medical community feel that this is too long a period. Advances in scientific knowledge and in technology are already outpacing bureaucracy, and we need to make sure that our citizens are benefiting from the latest information.

If air quality is changing, a decade is too long to wait to fix things. A lot of damage can be done in that time."

Thurston adds, "Reviewing standards more frequently can actually benefit industry, as information the EPA has gathered in the past has, in several cases, resulted in certain standards being relaxed. Accurate scientific information benefits everyone and does not necessarily work against industry.

It can tighten standards in some areas, relax them in others and make them more focused on other things causing health problems."

Another key change proposed by Congress is allowing the cost of plans required to bring states into compliance with Clean Air standards to be a driving factor. This change undermines a fundamental principle of the Act, which is that the bar should always be set based on public health.

The Trump Administration also proposes cutting EPA dollars by 31 percent, which would eliminate much of the funding for scientific research and enforcement. "If you don't do the science to understand where the pollution stands or how its impact on health may be changing, then you cannot set accurate standards for safety," says Ewart. "And, without enforcement, polluters will not comply even if standards are in place. You have to have some sort of hammer, even if it's rarely used. Just having that threat of a big stick if you need it is essential for any program to succeed."

How will we be affected by changes to the Clean Air Act?

"We won't immediately roll back to the polluted air of the 1960s, but as climate change progresses, we will find it more challenging to maintain our current standards. More frequent heat waves and rising temperatures will produce more ozone, and without efforts to mitigate that effect, we will see our air quality start to diminish," says Ewart. Thurston notes that, without a strong Clean Air Act such as we have at present, "things won't get any better. You will not see a reduction in deaths, in hospital admissions or in heart attacks, like you would have if clean air was maintained and improved. With lack of enforcement, there will be more polluters. There will be no incentive to uphold the law, no one to tell states to get their monitors fixed or to remind industries to update their anti-pollution technology. Things will gradually backslide."

How does climate change relate to the Clean Air Act?

With climate change, heat waves are more likely to occur. Heat waves produce more ozone, which is harmful to our lungs, as noted earlier. More forest fires are predicted due to warmer temperatures and prolonged drought conditions and such fires can also produce more pollution. The more efforts we make to reduce air pollution, particularly ozone, the more the impact of climate change can be lessened.

The steps we take to improve air quality also help in the fight against climate change, such as reducing our dependency on fossil fuels, improving vehicle and power plant emission controls, supporting public transportation, and planting more trees and creating more green spaces.

What else can we do to preserve and expand clean air?

First, write or call your legislators and let them know that you want to see our clean air programs maintained and strengthened. You can track when key legislation is coming up by visiting www.countable.us. Second, educate yourself about what air quality is like in your state. Go to www.airnow.gov, a site developed by the EPA, to check air pollutants in your area on any given day. You can also visit www.healthoftheair.gov, a site developed by the American Thoracic Society to provide national, state and local estimates of the health effects of ozone and pollution. Supporting the items noted under the previous question will help keep our air clean and reduce the effects of climate change. On a personal level, you can do your part to reduce your carbon dioxide footprint by walking, biking or using a "greener" car.

- Dr. Mark R. Windt is an allergist, immunologist and pulmonologist who has been treating allergies, including food allergies, and respiratory illnesses, for more than 30 years. He is the medical director for the Center for Asthma, Allergy and Respiratory Disease in North Hampton, NH, a facility he started in 1985. Dr. Windt is also an adjunct professor at the University of New Hampshire'sSchool of Nutrition and founder of the Probiotic Cheese Company (www.theprobioticcheesecompany.com). For information, visit www.caard.com or call 964-3392.

-Crystal Ward Kent is a freelance writer and owner of Kent Creative, an award-winning writing, design and marketing firm in Dover. For information, call 742-0800 or visit www.kentcreativeweb.com.