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Clearing the air around human health and air pollution

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Many years after completing medical school, I am still haunted by the first memories of caring for emergency department patients with full-blown asthma attacks. In particular, the terror and panic of young children gasping for breath leaves a lasting impression on every doctor and clinician. For all of us, if you can't breathe, nothing else really matters. Providers know that days of poor air quality can trigger spikes in emergency department visits for patients with asthma or other respiratory conditions. Yet air pollution is seldom, if ever, officially listed as a cause of a person's hospital admission or death.

That's why the EPA's Clean Power Plan, released this week, represents a step forward for public health as well as the environment. It's projected that the proposal to cut carbon emissions from the power sector by 30 percent nationwide from 2005 levels will help save as many as 6,500 lives each year, and prevent as many as 150,000 asthma attacks annually among America's children. Limiting carbon emissions from existing power plants, just as the U.S. already limits other known health hazards such as mercury and arsenic, can protect kids and the public and make a difference for health.

Recent scientific reports help us appreciate that environmental pollution and global climate change are inextricably linked with human health. Just last month, the United States National Climate Assessment concluded that "climate change threatens human health and well-being in many ways, including impacts from increased extreme weather events, wildfire, decreased air quality, threats to mental health, and illnesses transmitted by food, water, and disease-carriers such as mosquitoes and ticks." A study released just last week by Syracuse and Harvard Universities showed that tougher limits on carbon emissions from existing power plants would lead to added health benefits associated with reducing air pollutants. And the World Health Organization recently released estimates that seven million people died worldwide in 2012 as a result of air pollution exposure. This translates into one in eight global deaths, placing air pollution as a major public health risk and the world's largest single environmental health risk.

The United States already limits other toxins that are known health hazards such as mercury and arsenic, but many power plants currently release as much carbon as they choose.

We know that climate change, of which carbon pollution is a major contributor, threatens human health and well-being in many ways, including through more extreme weather events and wildfire, decreased air quality, and diseases transmitted by insects, food, and water. We also know that that certain people and communities are especially vulnerable to the health effects of climate change, including children, the elderly, those with chronic illnesses, the poor, and some communities of color.

The EPA's Clean Power Plan will reduce carbon and additional air pollutants known to adversely affect human health. Air pollution, also known as 'particulate matter' pollution, includes dust, dirt, soot and smoke, exhaust, and little drops of liquid. The larger, visible particles like smoke and soot may irritate your eyes, nose and throat, but they are generally too large to penetrate deeply into your lungs. But the smaller, invisible (to the naked eye) fine particle air pollution poses the greatest health risks. Fine particle air pollution is most commonly created by power plants, motor vehicle exhaust, and wood burning. Such particles are so small (less than one-seventh the average width of a human hair) that they can penetrate deep into the lungs.

The health consequences extend to so many areas of disease. The U.S. Centers for Disease Control and Prevention (CDC) has documented a significant association between exposure to fine particle air pollution and premature death. Other significant health effects include lung disease, decreased lung function, asthma attacks, and certain cardiovascular problems such as heart attacks and cardiac arrhythmia. Children, with their increased activity levels, older adults with decreased lung function and individuals with heart and lung disease are particularly vulnerable to fine particle air pollution. All this suffering is preventable.

As health care providers, we routinely note for our patients how health is affected by the food we eat. We should now expand this discussion to include the quality of the air that we breathe. The nation is taking steps now both to improve air quality and to prepare for changes in our climate that will protect the health of children. Improving awareness of these health risks -- and steps people can take to protect themselves -- will help make the nation more resilient. We can act now to protect the gift of breath and health for all kids, now and in the future.