RACINE, Ohio -- Anger and frustration flicker across Elisa Young's face as she stands on the bank of the Ohio River to illustrate "transport" pollution.
It's the pollution generated in one state that pollutes other states.
She is in Racine, but behind her, across the river in West Virginia, sit the Mountaineer and Philip Sporn power plants. Their smokestacks billow pollution that refuses to stay on the West Virginia side of the river.
Pollution does not acknowledge state borders. In fact, much of the air pollution emitted in both West Virginia and Ohio finds its way into Western Pennsylvania on prevailing winds.
Ms. Young, who created Meigs Citizen Action Now, has been battling power plants and pollution for years. Meigs County, where she lives, claims some of Ohio's worst mortality rates, according to state health statistics, with heart, respiratory, lung cancer and total cancer deaths that exceed state averages by a range of 21 to 48 percent.
"The first time it caught my attention was when I just kept seeing the prayer list getting bigger and bigger at church," she said.
Two power plants are situated along the Ohio River in western Meigs County, with the West Virginia plants to the east. Ms. Young, who has her own health problems at 44, now plans to sell the 444-acre farm that's been in her family for seven generations. It's the only way to avoid pollution exposure, she says.
"I'm frustrated," she said, her back still to the power plants. "Is there a limit on how many power plants can be built here? Four, five, 10 ... 20? We have fulfilled our obligation to society."
During impassioned debate years ago, anti-smoking advocates equated smoking sections in restaurants with having designated areas in swimming pools where people could urinate.
The comparison made its point: Diners couldn't avoid secondhand smoke any more than swimmers could avoid a repulsive form of water pollution.
Those same dynamics hold true on a much larger scale with smokestack pollution.
Wind, meteorological conditions, terrain -- but mostly the wide-open atmosphere -- all conspire to spread pollution great distances.
Wind patterns add to the understanding of the Pittsburgh Post-Gazette's ecological study mapping major sources of pollution together with death rates of heart and respiratory diseases and lung cancer, three pollution-related diseases.
As air is swept into the region, it encounters an array of hills and river valleys. Wind blowing perpendicular to a valley traps pollution there. Wind blowing parallel to the valley disperses the pollution. Temperature inversions, in which a layer of warm air prevents the rise of cooling air, also can trap pollution in pockets of the region's hilly terrain, according to the National Weather Service.
Prevailing winds also can dictate pollution's impact. Communities east or downwind of Neville Island's industrial plants, in the Ohio River, show high mortality rates -- including Sewickley at 44 percent higher than the national level for the three pollution-associated diseases and Bellevue at 43 percent higher. Robinson, Stowe and Kennedy, generally upwind of the island's major sources of pollution, have mortality rates equal to the national average.
Wind moves pollution across municipal, county, state and national borders, and even sends it across continents. China's pollution reaching the California coastline is one example.
People living great distances from smokestacks can face health consequences, and even death, from long-distance exposure. Each year, air pollution kills 20,000 to 60,000 people in the United States. The excess number of deaths each year in the 14-county region of southwestern Pennsylvania from diseases that have been linked to pollution exposure is 1,435, based on the Post-Gazette ecological study.
A report released last week, "Expensive Neighbors: the Hidden Cost of Harmful Pollution to Downwind Employers and Businesses," found that pollution from coal-fired power plants that have failed to install pollution controls costs businesses in downwind states nearly $6 billion a year in higher labor and insurance costs, lost work days and lost productivity.
The report, written by Charles J. Cicchetti, a senior adviser to Navigant Consulting Inc., concludes that pollution created between 2005 and 2012 will cost downwind states $47 billion, leading to the loss of 360,000 jobs, while state and local governments will lose $9.3 billion in tax revenues, among other impacts.
Pollution throughout the eastern United States travels in one big swirl -- like water in a flushed toilet.
Smoke puffing from a Pittsburgh-area smokestack can surf the wind eastward then bend south along the East Coast, eventually turning westward to Baton Rouge where it swings northward through the Midwest before prevailing winds can carry it back through Pennsylvania, said Neil Donahue, a chemistry professor at Carnegie Mellon University.
In that fashion, Pennsylvania sends pollution to Iowa, Wisconsin, Tennessee, Missouri and many other states. It receives transport pollution from 15 states as distant as Missouri, Georgia and Michigan, said Deb Brown, chief executive officer of the American Lung Association of the Mid-Atlantic.
Those 15 states and the District of Columbia, which share pollution with Pennsylvania, are home to 288 coal-fired power plants, among other major sources of pollution. But transport pollution most strongly affecting this region originates in coal-burning plants lining the Ohio River for hundreds of miles, including those surrounding Meigs County.
That puts the Greater Pittsburgh area in the cross-hairs of one of pollution's deadliest arrows.
One unresolved mystery is what in fine particles makes them deadly.
Dr. Donahue participated in the 2001 Pittsburgh Air Quality Study that analyzed the makeup of particles, then traced them during their journey in the air throughout the eastern United States.
Rainfall removes particulates from air, but the average time lapse between rainfalls is a week, allowing particulates to travel great distances.
While Los Angeles is the nation's most polluted city, largely due to vehicle pollution, other cities rated among the nation's most polluted sit upwind of Pittsburgh and send transport pollution this way, according to a 2009 health study by environmental experts.
Those cities include Steubenville, Ohio, due west of Pittsburgh, Cincinnati and Charleston, W.Va. All three are surrounded by power plants and other major sources of pollution.
Pennsylvania, a victim of transport, also is a polluting bully with its 40 coal-fired power plants, among other sources.
High volumes of pollution generated throughout the Midwest and Pennsylvania prompted U.S. Sen. Tom Carper to describe his own state of Delaware as "the end of America's tailpipe."
Pollution transport accounts for 50 percent of total particulate pollution in southwestern Pennsylvania, or 12 micrograms of particulates per cubic meter -- the common measurement of pollution levels.
Current federal air-quality standards, based on the Clean Air Act, set an annual limit of 15 micrograms per cubic meter, putting the 14-county region near the brink of federal limits, even before pollution generated by its own 16 coal-fired power plants and 150 other major sources is included.
It leaves little doubt why the region chronically struggles to meet pollution standards.
If the EPA lowers the annual standard to 12 micrograms, which is under consideration, compliance would become a more formidable challenge.
To combat transport pollution, the EPA has proposed its Transport Rule to reduce the amount of particulate and ozone pollution that cross state lines. If enacted, the proposal would force power plants -- especially those lacking modern pollution controls -- to reduce emissions or close.
The EPA said the Transport Rule would cut sulfur dioxide emissions by 71 percent and nitrogen oxide emissions by 52 percent, as compared with 2005 levels. The rule would affect 31 states and the District of Columbia.
Ms. Brown said proposed reductions would save up to 36,000 lives a year and prevent 23,000 heart attacks and 26,000 hospital or emergency room visits. Annual health benefits from the rule could reach $290 billion versus $2.8 billion in costs.
If so, the investment offers enormous returns: For every dollar spent to reduce pollution, according to the EPA and other sources, society would receive $100 in health benefits.
The Transport Rule would require all states east of the Mississippi River to reduce pollution, save for Maine, Vermont and New Hampshire, which produce low levels of pollution. Pennsylvania and surrounding states would be required to reduce sulfur dioxide, nitrogen oxide and ozone.
Debate over transport pollution has generated lawsuits.
New Jersey, New York, Connecticut, Maryland and Pennsylvania joined a successful 2005 federal lawsuit filed by Citizens for Pennsylvania's Future, known as PennFuture, against Allegheny Energy and its three coal-fired power plants in the region -- Hatfield's Ferry in eastern Greene County, the Mitchell plant in eastern Washington County and the Armstrong generating plant in northern Armstrong County.
Allegheny Energy settled the suit in 2006 by agreeing to spend $550 million on pollution upgrades including a scrubber system at Hatfield's Ferry, which had been responsible for 15 percent of Pennsylvania's particulate pollution and was one of the nation's top producers of sulfur dioxide pollution.
Then, on July 20, New York Attorney General Andrew M. Cuomo announced plans to sue the Homer City power plant in Indiana County for violations of the Clean Air Act. He described the plant as one of the largest out-of-state producers of sulfur dioxide pollution affecting the health of New York residents.
The Homer City power plant claims the nation's tallest smokestack at 1,217 feet -- nearly a quarter-mile high. When the plant opened in 1969, the idea was to send pollution high into the atmosphere to dilute it before it returned to Earth. But the design also spread pollution greater distances.
The 1,884-megawatt plant is owned by a consortium of eight limited-liability corporations with EME Homer City Generation L.P. listed as plant operator.
"The owners of Homer City Station have ignored their legal obligations while their power plant pollutes our skies and our lungs with over 100,000 tons of emissions each year," Mr. Cuomo said in a summertime news release. "We will hold the owners of the Homer City power plant accountable for breaking clean-air laws and for endangering the health and environment of New Yorkers."
David Doyle, attorney general spokesman, said the state investigation remains active but a suit has not been filed.
Charley Parnell, spokesman for Edison Mission Energy, the parent company of EME Homer City Generation, said the company has been working to reduce emissions since it acquired the plant in 1999, with plans to add emissions controls such as scrubbers to meet the EPA's anticipated pollution transport regulations.
During the EPA Transport Rule hearing in Philadelphia in August, utility industry representatives voiced general acceptance of the Transport Rule but asked for more time to implement it.
The Transport Rule may not be a quick fix. If approved, the rule won't bring air-quality improvements until 2014.