Labored Breathing

As I sat in the audience of the NC BREATHE Conference in Raleigh a few weeks ago, I sensed a certain amount of schizophrenia between the science and policy of air pollution in North Carolina. Unfortunately, a similar dichotomy is found in many states across the country.

On the one hand, I was surrounded by a room-full of physicians and scientists who relayed data about the link between air pollution and common human ailments, such as asthma, emphysema and pneumonia, and who talked about the state-led, bipartisan innovation, the NC Clean Smokestacks Act, that connected science and policy and resulted in reduced emissions, cleaner air, and better public, environmental, and economic health.

On the other, despite an explicit invitation for them to join us, across the street sat the state legislature, many of whom were intent on relaxing air pollution standards and reducing the requirement of tailpipe emissions testing for cars in North Carolina.

The link between air pollution and human health goes back more than half-a-century—to early observational studies in London.  Fine particulate matter and ozone are linked to increased cardiovascular disease and stroke. More recently, short-periods when automobiles and industrial activities were curtailed during the Olympics in Atlanta (1996) and Beijing (2008) were accompanied by marked reductions in the hospital admissions for respiratory and cardiovascular disease.  And as shown by Drs. Julia Kravchenko and Kim Lyerly of the Duke University Medical Center, reductions in air pollution that followed the Clean Smokestacks Act in North Carolina have resulted in significantly fewer deaths from respiratory illness. Dirty air counts, and the count is a body count.

Yet, a large number of state legislators across the nation insist that clean air comes only at an unacceptable economic cost—air pollution standards must be rolled back to allow cheap electricity, attract industry, and increase employment.  These are all laudable goals, but the dichotomy is a false one.

Professor Drew Shindell of the Nicholas School of the Environment at Duke University has demonstrated that air pollutants have a significant cost to society that is not normally borne by those emitting toxics to the environment. When air pollution standards are strict and enforced, North Carolina has shown and will show significant benefits – not only for health and the environment, but also for the economy.

Air pollution is not just an urban problem. East of the Interstate-95 corridor in North Carolina, a major source of particulates in air stems from agriculture. Fine particles form in the atmosphere as a result of emissions of ammonia from fertilized agricultural fields and hog farms.  These are difficult to regulate, but we must not simply ignore them by assuming that agriculture is a “green” activity.

State legislators should also embrace national air pollution standards set by the Environmental Protection Agency, aimed to control carbon emissions from fossil-fuel power plants and pollution from upwind regions, even from overseas. Control of nitric oxide (NOx) at the local, state and national level results in lower regional ozone levels, with benefits to all who breathe. The EPA will release new standards for ozone later this year; these should form a baseline for more stringent state regulations.

For air pollution, the science needs to inform policy.  When it does, good things happen in every realm:  people get healthier, the environment gets healthier, and so does the economy. Policy makers cannot claim that the science is too difficult to understand or that they have no experience in chemistry. The link between dirty air and bad health is clear and simple, and it affects everyone.  You can’t move away from air pollution.

June Blotnick, Executive Director of Clean Air Carolina, helped to coauthor this entry.



Kravchenko. J., I. Akushevich, A.P. Abernethy, S. Holman, W.G. Ross, and H.K. Lyerly.  2014.  Long-term dynamics of death rates of emphysema, asthma, and pneumonia and improving air quality.   International journal of COPD 9: 613-627.

Roy, A., J.C Gong, D.C.Thomas, J.F. Zhang et al. 2013. The cardiopulmonary effects of ambient air pollution and mechanistic pathways: A comparative hierarchical pathway analysis. Plos One 9 doi: 10.1371/journal.pone.0114913

Shindell, D.T. 2015.  The social cost of atmospheric release.   Climatic Change doi 10.1007/s10584-015-1342-0

West, J. J., S. J. Smith, R. A. Silva, V. Naik, Y. Zhang, Z. Adelman, M. M. Fry, S. Anenberg, L. W. Horowitz, and J.-F. Lamarque (2013) Co-benefits of global greenhouse gas mitigation for future air quality and human health, Nature Climate Change, 3, 885-8

One thought on “Labored Breathing

  1. Not long ago, I spoke with the business law/ethics professor at Mars Hill University, the institution I retired from three years ago. The topic of our conversation was global warming & climate change and he framed these issues in terms of generational justice — that our behavior today can be viewed in consideration of the generation of students in our classes as well as generations to follow. The same forces that perpetuate the CO2 congestion in the upper atmosphere fill the air closer to the ground with particulates you mention in your article.

    I struggle to make sense of how responsible citizens, business persons, educators, and politicians can be dismissive of the effects of these emissions – arguing rather simplistically in support of short term financial gain and assumed negative effects on employment – when there are so many generations of people who will not give a hoot about our financial status. The usual culprit behind such thinking seems to be fossil fuel money that buys off politicians and corrupts decision-making but I’m beginning to regard this explanation as insufficient.

    In an aim to explore these dynamics at another level I have been rereading several books by David Korten, former Harvard professor and active in international development throughout his life. I’m also slowly making my way through Capital in the Twenty-first Century, by Thomas Piketty. And most recently I got my hands on the Spring 2015 issue of The Nonprofit Quarterly that focuses on underlying systemic reasons for social inequality/inequity. Each of these sources point toward the misdirected focus of the current form of capitalism practiced in and advocated by the United States. The reliance on self-interest and personal gain that drive much of the economic and social policy thinking within our culture disregards environmental externalities and social inequality as side events in the pursuit of profit.

    While I have studied personal and organizational development quite expensively, my grounding in the nature of social/political/economic development is more limited. But that is where I’m beginning to sense answers to the existence of the divide between the legislative and scientific sides of the street. Ordinary good people are in the middle of that street and their behavior is impacted by a mix of trust, disgust, partial knowing, peer-connected ideology, absorption in the challenges of living their lives, and feelings of being responsible first to themselves, and second to others. I prefer to give that they are doing the best they can, based on the forces at play in their lives. Lots of invisible systems surround us and we are generally in tune with only those directly in our line of sight.

    My bias is toward generating knowledge and putting it out there so that its impact can whittle away at ignorance, partial knowing, and indecision. Sound knowledge stands as a foundation for efforts toward a healthy democracy and a caring/responsive economic system that is sensitive to both the environment and people. We certainly have a way to go, but we also have come a long way.

    Shifts in trends of thinking have of course happened repeatedly throughout history. Today though we are not only facing human tragedy in the form of vulnerable individuals succumbing to air pollution, but also anticipating incredible upheavals ahead related to climate disruption.

    Bill, your work and that of your fellow scientist travelers is so important. Your “products” provide a basis upon which society can continue to evolve bit by bit, local program by local program, election by election.

    Can world societies evolve “in time”? The answer depends on what deadline we choose. Change happens in its own time and is certainly facilitated (made easier) by solid data. Just as we move ahead with our challenges, those who follow us will certainly deal with theirs.

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