Children still run and play in the Kerona neighborhood of Shippingport, the Beaver County community that lies along the smokestack-studded valley of the Ohio River.
But they aren't Chad Hysong's kids.
The 35-year-old father of two young girls moved his family west, into Ohio, five years ago to get out of the pollution plumes from all those smokestacks that he claims caused them an endless cycle of respiratory problems; out of a place where white ash falling from the sky pitted his car's paint and chrome and where high concentrations of arsenic were found in the soil around his house and the water in his hot tub.
Others haven't been so lucky, said Ralph Hysong, Chad's father.
"In Shippingport people don't die of old age, they die of cancer or heart attacks or lung disease," said Mr. Hysong, who's 64 and has a history of heart problems and high blood pressure. "I'm happy Chad and his family got out."
This month the nation celebrates the 40th anniversary of the federal Clean Air Act and its clear and widespread successes. Throughout the region too, the skies are blue and that sulfuric "Pittsburgh smell" is mostly a bad memory along with soot-dirtied shirts and streetlights lit throughout the day.
But health risks linger in what many of us can't see and can't smell.
Numerous studies show that southwestern Pennsylvania has poor air quality and a yearlong Pittsburgh Post-Gazette investigation has found that those pollution problems remain far from solved in communities such as Shippingport and Monaca, Bellevue and Sewickley, Masontown and Clearfield, Cranberry and Bridgeville, Pittsburgh and hundreds of others.
At the same time, the Post-Gazette's review and analysis of state Department of Health mortality statistics shows that 14,636 more people died from heart disease, respiratory disease and lung cancer in the region from 2000 through 2008 than national mortality rates for those diseases would predict.
Those diseases have been linked to air pollution exposure.
After adjusting for slightly higher smoking rates in Pennsylvania, the total number of excess deaths from those three diseases is 12,833. That's still a more than 10 percent higher mortality rate overall than would be expected in the population of approximately 3 million people in 14 counties, based on national risk rates for those three diseases.
And the overlapping statistics raise a troubling question: Are the region's higher mortality rates linked to air pollution?
The risk of dying from those three diseases in 13 of the 14 counties exceeded the national rate by a statistically significant rate and in Indiana County is equal to it.
All 14 counties have heart disease deaths ranging from 8 percent to 25 percent over the national average rate. Twelve of the 14 have higher respiratory disease death rates ranging from 7 percent to 45 percent above the national rate. Only three counties, including Allegheny, had higher lung cancer rates than the national average, but because the rates in those three counties were so high, the region as a whole had 600 more lung cancer deaths than national rates would have predicted.
"The U.S. Environmental Protection Agency still views the region as a [pollution] hot spot," said John Graham, senior scientist with the Clean Air Task Force, a 16-year-old national nonprofit research and advocacy organization focused on air quality and climate issues. Mr. Graham is doing air pollution research in southwestern Pennsylvania for the Heinz Endowments.
"There have been a lot of air quality improvements in the region but they haven't happened at a consistent pace," he said. "Based on the latest PM [airborne particulate matter] data it still ranks as one of the worst urban areas of the country.
"The air is not clean, and it's killing people."
Despite federal, state and local regulatory efforts, the region's air still contains high concentrations of fine airborne particles or soot, and ozone, a precursor to unhealthy smog. And most of its population lives in an area that does not meet federal health standards limiting those pollutants.
One reason for that is the region's high level of industrialization and continuing reliance on burning an abundant domestic coal resource to generate half of its electric power and for myriad other industrial processes. Those emissions pile on to an already heavy load of fossil fuel pollution carried into the region by prevailing winds from utilities and industries to the west.
The black rock is touted in advertising campaigns by mining and utility industries as a cheap energy source. But the region's continuing reliance on coal has also contributed to high pollution levels and produced hidden but high health costs for its residents as well as premature death, health experts say.
Air pollution at present levels could be causing as much as $9.4 billion a year in damage to the health of the region's population, based on an environmental health risk formula developed by Dr. Jonathan Levy, professor of environmental health at the Harvard School of Public Health and a member of the EPA's science advisory board staff.
And a report released this summer by the National Research Council, part of the federally chartered National Academy of Sciences, found that the additional health care and mortality costs caused by air pollution linked to burning coal total $62 billion a year nationwide.
George Leikauf, a researcher in the University of Pittsburgh's Graduate School of Public Health who has studied pollution's health effects in Ohio, said the Post-Gazette ecological study of mortality supports a valid argument that regional sources of pollution are part of the public health problem and deserve further study and control.
To test the study's validity, he said, ask the question: If you take your suspected cause away, will the situation improve?
"If you do improve the air quality, would there be less kids in our emergency rooms? So the answer is yes," he said. "And it's doable now. ... The technology to control unhealthy emissions doesn't have to be invented."
While it's known the risks of getting and dying from heart and lung diseases and lung cancer are heightened by occupational exposures, socioeconomic status, genetic predisposition and a variety of lifestyle factors including smoking, alcohol consumption, diet and obesity, numerous peer-reviewed scientific studies have also conclusively documented their links to air pollution exposure.
That pollution can come from many sources: coal-burning industries and utilities, vehicle emissions and other hazardous chemical emissions from industry.
"What the [Post-Gazette] numbers show is that the science behind the Clean Air Act is very solid. Sulfur dioxide, nitrogen oxides and soot are regulated because the real evidence is overwhelming that they can sicken and kill people," said Pennsylvania Department of Environmental Protection Secretary John Hanger.
"The emissions numbers are on their way down but not yet at the levels they need to be to protect human health."
The Post-Gazette's investigation, including interviews with more than 150 people around the region, also found that great uncertainty remains about local air quality. More and better monitoring, scientific review and study of industrial air pollution by county, state and federal health and environmental agencies are needed to better understand and pinpoint causes of the region's higher mortality rates.
And while those rates may in part reflect the legacy of decades of dirty industrial pollution, several air pollution experts said the rates may also be a smoking gun, signaling that existing regulations and enforcement are not adequate to protect human health and should be strengthened.
Jan Jarrett, president and chief executive officer of Citizens for Pennsylvania's Future (PennFuture), a statewide environmental advocacy organization, said the higher mortality in the southwestern part of the state is unacceptable.
"Clearly these laws are not working for everybody," she said. "And the job isn't done in terms of cleaning up the air."
The Post-Gazette mapped the mortality rates for heart and lung disease and lung cancer for each of 746 municipalities in the 14-county region and found higher rates around many of the region's 16 coal-fired power plants and 150 other companies considered by the EPA as major stationary sources of pollution emissions. High mortality rates also turned up irregularly in the "plume shadows" of the utilities and industrial sources, that is the downwind area where their emissions can be transported.
The mortality mapping, while not establishing any direct cause-and-effect link to any single or specific pollution source, shows associations that are consistent with accepted scientific health risk models and formulas used by the EPA and other pollution research scientists. It indicates that pollution may play as big a role in the region's high mortality rates for those three diseases as Pall Malls, pilsners and pierogies.
"The maps do actually form some evidence that reinforces the literature that coal burning does have those effects," said Conrad Dan Volz, director of the University of Pittsburgh's Center for Healthy Environments and Communities and an assistant professor of environmental and occupational health.
He noted that the mortality rates from 2000 through 2008 are "lagging indicators" that could reflect past pollution exposure for the region's population. But they might also show the health impacts of continuing exposure and that regulations aren't as effective as they could be.
"Look at Bruce Mansfield," Dr. Volz said, referring to FirstEnergy Corp.'s Bruce Mansfield coal-fired power plant in Shippingport, the largest in the state. "The wind direction seems to have an influence on health outcomes for respiratory and heart and elevated cancer," he said referring to patterns of death rates on the maps.
"There's an indication there should be a long-term epidemiological study done to look at the effect of emissions on those populations, including the effect of plant emissions transported from the west and from out of state."
The Post-Gazette's review of mortality data for Beaver County, where Bruce Mansfield is located, found heart disease deaths 19 percent above the national average, respiratory deaths 17 percent higher and lung cancer the same as the national average.
The region's coal-fired power plants contribute significantly to the region's higher than normal mortality rates, according to the Clean Air Task Force's September report titled "The Toll from Coal." Its projections show the Bruce Mansfield power plant causes 69 deaths a year; Allegheny Energy's Hatfield's Ferry power plant along the Monongahela River in Greene County, causes 89 deaths annually, and RRI Inc.'s Shawville power plant in Clearfield County, which causes 61 deaths a year.
None of the companies contacted by the Post-Gazette would comment on the Post-Gazette's study. But Doug Biden, president of the Electric Power Generation Association, a Harrisburg-based lobbying group for the industry, said there is a "whole soup of emissions," including diesel and other mobile sources, that contribute to the region's air quality problems.
"It's not just the power plants," Mr. Biden said. "The EPA relies on a small handful of studies that establish an association between power plant emissions and these diseases, but an association does not prove cause and blame.
"We understand the concern here, and certainly emissions from power plants are something we take seriously. ... We're getting to the point that every power plant is going to have maximum controls or cease to operate."
In Allegheny County, air pollutants are generated by 32 industries and utilities classified by the county Health Department as "major sources" because they emit, or have the potential to emit, 25 tons or more a year of a "criteria pollutant" -- defined by the EPA as ozone, carbon monoxide, lead, nitrogen oxides, sulfur dioxides, particulate matter -- or 10 tons or more of a hazardous air pollutant.
Of particular concern are tiny airborne particles known as PM2.5, for particulate matter measuring 2.5 micrometers or less. Those tiny particles, one-seventieth the diameter of a typical human hair, can be breathed deeply into the lungs and are known to cause heart and respiratory sickness and mortality.
"The public is not concerned because the worst pollution is largely invisible and making the case that it causes health problems is hard," said Jennifer Iriti, co-chair of the North Fayette grassroots citizens group Action for Change Today, formed to oppose Robinson Power Co.'s proposed Beech Hollow waste coal power plant in nearby Robinson, Washington County.
"But if people were able to see the tiny particles today as purple floaty dots in the air, we would be in a whole different place because it would be much easier to see the relationship between the dots and health."
According to the Allegheny County Health Department, the top nine PM2.5 polluters in the county in 2008, in order of particulate production, were U.S. Steel's Clairton Coke Works, Allegheny Ludlum Steel in Brackenridge, Cheswick Power Station in Springdale, Bellefield boiler plant in Oakland, Edgar Thomson Steel plant in Braddock, Bay Valley Foods on the North Side, Allied Waste landfill in Imperial, U.S. Steel Irvin Works in Dravosburg, and Shenango Inc. coke works on Neville Island.
Dan Bricmont, an attorney, former mayor of Avalon and chairman of the county Health Department's Air Quality Citizens Advisory Committee, said he is both surprised and concerned by the high mortality rates for Avalon, which regularly receives pollution from nearby Neville Island industries. But he's not ready to condemn local industry and utilities.
"I would be more comfortable if the Pitt Graduate School of Public Health applies its academic rigor to what you've developed here, but you've certainly lifted up the corner of the carpet to uncover what's underneath," Mr. Bricmont said about the Post-Gazette's analysis.
He urged health agencies "to take the next epidemiological step."
Another "hot spot" is the Mon Valley, where emissions from the Elrama and Mitchell power plants in northern Washington County add to those from coke, chemical and steel industry sources.
"From where I live I can see the smog and haze, the pollution bubble in the morning, over the Mon Valley, and it's worse in late fall and winter," said state Rep. Dave Levdansky, D-Forward, who lives on the ridge above Elizabeth and the industrialized river corridor.
He said the air may be cleaner than it was 10 or 20 years ago but it's not clean yet, a fact he demonstrated by walking across his recently washed deck in a white sock and lifting his foot to show a sooty black sole.
That pollution, he said, is still taking a heavy toll on the health and longevity of Mon Valley residents. Many of his friends and neighbors have died at young ages from lung and heart disease.
"Those who have lived here a while know it's cleaner, and sometimes we lapse into a false sense of security," Mr. Levdansky said. "We need to compare what we have to the national average. It's better here, yes, but it's better in the rest of the country, too."
Bruce Dixon, director of the Allegheny County Health Department, defended the department's regulatory approach as a "balancing act" between public health and economic realities in an area of uncommon industrialization.
"We could get the air quality of Montana, but we wouldn't have any jobs around here," Dr. Dixon said. "The reality is we have the world's largest coke works, steel mills and a coal-fired power plant, and that's not a common scene across the United States. You wouldn't do that today -- you wouldn't co-locate that number of emissions sources, and you wouldn't put them in a river valley."
He said new scrubbers installed by RRI on its Cheswick power station in Springdale Borough and a billion-dollar reconstruction and replacement project at the Clairton Coke Works will reduce pollution significantly if not quickly. The Clairton coking operations won't be in compliance with its emissions permits until 2013, according to the Health Department.
He said the mortality mapping done by the Post-Gazette could help "pinpoint areas" for study and enforcement.
"The paper's study raises some interesting issues that merit further investigation, and we will look at those," Dr. Dixon said.
Some other southwestern Pennsylvania counties also have high mortality rates in communities near power plants and coal-burning industrial sources or downwind from them. And especially in more rural counties, such as Armstrong, Indiana, Greene and Clearfield, power plants are the predominant generators of particulate and sulfur dioxide pollution, according to the DEP.
For example, three Indiana County power plants -- the Homer City, Conemaugh and Seward generating stations -- produce 88 percent of all airborne particulates generated in that county. And in Beaver County, the Bruce Mansfield power plant and AES Beaver Valley generation plant in Monaca, both situated along the Ohio River, account for 90.3 percent of the small particle pollution produced by the county's top eight pollution sources.
FirstEnergy said Bruce Mansfield, which opened in 1975, has environmental controls, including scrubbers, that reduce airborne particle emissions by 99.5 percent, sulfur dioxide emissions by 95 percent and nitrogen oxide emissions by 85 percent.
"While we are proud of our progress in helping to improve the air quality around our facilities, we believe that there should be a better understanding of the relationship between air quality and public health," FirstEnergy said in a written response to the Post-Gazette's study findings.
The power company said that through its membership in the Electric Power Research Institute it is helping to sponsor a study, now in its 10th year, to determine the health impact of air pollutants in general and the particular components of airborne particles. The research -- which was recently expanded to include the Pittsburgh metropolitan area -- will, FirstEnergy's response stated, "provide valuable information on how best to continue improving air quality in the most cost-effective manner possible."
Ralph Hysong, a Shippingport resident, sued the company in 2007 to force FirstEnergy to clean up the power plant's emissions.
According to the lawsuit, which was also brought by PennFuture, the power plant violated federal air pollution standards more than 250 times from 2002 to 2007. It also caused several black rain events that caused ash to blanket a 10-square-mile area around the power plant in 2006 and 2007, and during that time was classified by the EPA as a "high-priority violator."
Mr. Hysong, in a recent interview, said he was satisfied with a consent order in August 2009 in which the company agreed to add pollution controls and reduce emissions.
"People need to wake up and do something," he said. "It can be done. I proved it."
Correction/Clarification: (Published December 13, 2010) Fine-particle pollution size is measured as 2.5 microns or micrometers or less. The measuring unit was incorrect in the Mapping Mortality story in Sunday's paper.