When the traffic light at an intersection turns yellow, you are forced to make a critical split-second decision: Do you push through or stop? What you decide in that instant affects your safety and the well-being of other motorists.
When it comes to the air we breathe in the Pittsburgh region, we live in a “yellow light” moment for two-thirds of the year, when levels of fine particulate matter and ozone threaten the health of many people who live here.
According to an analysis by the Boston-based Clean Air Task Force, our region experienced 245 “yellow light” days in 2012 when its air quality was not rated “good,” as determined by the U.S. Environmental Protection Agency.
Often our air quality is even worse. Our region violated federal health standards for either ozone or fine particulate matter nearly 10 percent of the time — 35 days — in 2012. On these days, we are warned that the air is unhealthy, especially for children, people with heart and lung disease, older adults and those who are active outdoors.
Perhaps these statistics don’t seem so terrible when compared to the dark, smoky days of our industrial past. Indeed, Pittsburgh has undergone a dramatic transformation since James Parton in 1866 called the city “Hell with the lid taken off.”
But a closer look at our air quality and what it means for our health reveals a very different, and alarming, narrative.
A report published in March titled “The Health Impacts of Pittsburgh Air Quality: A Review of the Scientific Literature, 1970-2012” surveyed the extensive scientific research on outdoor air pollution in the Pittsburgh area and how it affects human health.
Not just last century’s smoke-choked skies were a problem. The report found that modern-day levels of air pollution lead to a broad range of very serious — and potentially fatal — health effects, from cradle to grave. These include heart and lung disease, asthma, poor birth outcomes (fetal development problems, premature birth and infant mortality), stroke, lung cancer and early death.
Since we all have to breathe, no one is safe from these kinds of health effects. And some of our most vulnerable citizens — children, the elderly, the sick and those living in poverty — are at even higher risk, the report found.
These are the terrified children we treat in the ER gasping for every breath, their caregivers unable to afford pricey asthma meds. These are the premature infants who spend months in the neonatal intensive care unit until they are strong enough to leave the hospital. These are the families struggling financially when a parent can no longer work after a stroke or a diagnosis of chronic obstructive pulmonary disease. These are the beloved grandparents who die well before their time.
All of these heartbreaking scenarios are part of our daily reality as physicians.
The situation in Pittsburgh becomes even grimmer when gauged against the lens of more stringent World Health Organization standards. By WHO guidelines, fine particulate matter and ozone levels in the Pittsburgh region were unhealthy for nearly 16 percent and 37 percent of last year, respectively. If the EPA had followed the recommendations of its own advisory scientists to implement more health-protective standards, Pittsburgh would be in violation for these pollutants more than twice as many days.
Speaking in May at The Air We Breathe conference Downtown on World Asthma Day, renowned environmental epidemiologist Joel Schwartz of the Harvard School of Public Health noted that there is no evidence to suggest there is a threshold below which air pollution has no health effects. Particulate air pollution kills more people in the United States each year than AIDS, breast cancer and prostate cancer combined. “The difference,” Dr. Schwartz said, “is we know how to cure it.”
We know how to put scrubbers on coal-burning power plants and how to reduce air pollution from large industrial sources. We know how to retrofit diesel school buses and trucks and how to control wood smoke. We know how to improve energy efficiency and make smarter transportation choices. We know how to harness the energy of the wind and sun to make cleaner power.
The light is yellow, signaling that the moment has come for Pittsburgh to make a decision. Our air quality was among the worst in the United States during the days of Big Steel — and it remains so today. Nine of 10 monitored areas in Allegheny County rank in the worst third in the nation for particle pollution. The county ranks in the top two-tenths of 1 percent with respect to cancer risk from large industrial sources and power plants.
Scratch just under the surface of these statistics, and you’ll find your neighbor’s heart attack or your daughter’s asthma attack, your father’s chronic bronchitis or your best friend’s long and painful battle with lung cancer.
If we truly want to be the most livable city, then it is time to slam the brakes on our air pollution problem. All of us need and deserve to breathe clean, healthy air every day. If we succeed, then every family in southwestern Pennsylvania will enjoy better health, longer lives and lower health care bills.
The light is yellow most of the time in Pittsburgh — and often red. History will judge our success as a region by whether we decide to push through recklessly or to stop putting our children’s lives in jeopardy. There’s really only one choice.
Deborah Gentile is director of research in the Division of Allergy, Asthma and Immunology at Allegheny General Hospital. Keith Somers is a pediatrician with CCP-GIL (Children’s Community Pediatrics). Jonathan Spahr is clinical director in the Division of Pediatric Pulmonary Medicine at Children’s Hospital of Pittsburgh of UPMC.