Cover Story: Hold your breath
Despite a decade of fighting pollution, Atlanta’s air quality is about to get severe
“I start wheezing a lot, and it feels like a house fell on my chest. Then I start to cough.” The coughing can last for so long that 9-year-old Lauren Johnson’s chest muscles become sore and achy. Lauren lies in a bed on the second floor in the Children’s Healthcare of Atlanta hospital. She’s been there since Monday, July 22. That’s when she started wheezing. Her doctor says at the time that her hospital stay might stretch to a week.It’s the second time this summer Lauren’s been admitted to the hospital for an asthma attack. Her treatment includes steroids and bronchial dilators, which open up airways that become inflamed because of the ozone smog that envelops Atlanta and the surrounding area through much of the summer.
Lauren’s mother, Cindy Johnson, didn’t pay much attention to Atlanta’s air quality until Lauren began having problems breathing, when she was 2. Now, Johnson watches the news every night to see how bad the air will get the next day.
“On some days, her grandma will call, and neighbors will call, when they see that there’s going to be a bad smog day,” Johnson says. Lauren absolutely has to stay inside on those kinds of days. Lots of kids do.
Atlanta’s air problems send thousands of asthmatics, senior citizens, and anyone sensitive to respiratory problems, to emergency rooms and allergy clinics every year. Sometimes, scientists say, Atlanta’s air actually kills people.
City, state and federal brains have been trying to fix the metro area’s air pollution for more than a decade. But the best claim they can make is that air quality hasn’t gotten worse.
And, now, even as more evidence mounts about the human toll of Atlanta’s smog, the sheer complexity of the solutions makes it difficult to see how the air will get healthy anytime soon. In one likely scenario, an intended solution could even make the air worse.
Lauren thinks it would be a good idea just to put a plug on the exhaust pipes of every car and truck around here — something the agencies dealing with air pollution would probably love to do, sort of.
Lauren and Cindy Johnson live in Monticello, which is southeast of Covington. On days when the air wafting over from Atlanta isn’t too bad, Lauren likes to go swimming at her friend’s house. She’s been swimming a lot less this summer.
When a hospital administrator tells her, “Well, maybe the hospital should get a pool,” Lauren’s eyes double in size, she turns her head around to face her mother and speaks for the first time above a strained whisper. “Oh cool!” Then, the exertion sets off a coughing spell fitting for a lifelong chain smoker than a child of 9.
Lauren is one of three patients of Dr. LeRoy Graham at the Children’s Healthcare of Atlanta.
“I’d say on the worst day, there are at least a dozen, sometimes a couple dozen more kids that are brought in because of problems, easily,” Graham says.
Graham treats asthma attacks triggered by air pollution the same as he does any asthma attack. But over the last few years, he’s become more upfront about telling his patients how to avoid attacks in the summer.
“We’re giving patients fairly direct advice of what to avoid, and basically we’re telling people not to go outdoors, and that’s pretty bad,” he says.
Graham’s constant interaction with kids suffering because of Atlanta’s air pollution has emboldened him to move beyond his role as a pediatric pulmonologist. He’s an outspoken critic of developers; he’s not afraid to say that politicians could be doing far more to get cars off the roads.
“Our political leadership is irresponsible in respect to air pollution,” Graham says. “There’s a wealth of scientific evidence saying that in a metropolis such as Atlanta we need to have transportation alternatives.
“We cannot let people continue development without the supporting infrastructure, and by that, I mean not just the roads leading into your subdivision but the ability to have feeder routes into MARTA, to have light rail, to have things like that. In my opinion, basically there’s a lot of big money to be made in Atlanta, and money makes you forget about a lot of stuff. We can solve big problems; we can dig a hole and build a bigger sewer in a heartbeat if it means more development. Well, why can’t we have that same kind of motivation to come up with transit solutions?”
The acronyms of the agencies that help fight Atlanta’s battle against dirty air could fill a bowl of alphabet soup.They include the Atlanta Regional Commission, the Georgia Regional Transportation Authority, the Georgia Department of Transportation, the Georgia Environmental Protection Division and the U.S. Environmental Protection Agency.
Georgia regulators (EPD) clash with industries over pollution controls that businesses say are too expensive. Federal regulators (EPA) sometimes butt heads with the state regulators, EPD.
The transit agencies — ARC, GRTA and DOT — are supposed to be working together to come up with a plan that will ease congestion, cut down on automobile trips and reduce the pollution that comes from cars and trucks. Often though, the separate agencies carry on with their own plans without coordination with the other two.
Environmentalists sue the state EPD and federal EPA to get better laws, better enforcement, cleaner air. Environmentalists also sue the ARC, GRTA and DOT when those agencies’ transportation plans don’t do enough to clean up the air, or when the plans rely on what the greenies consider overly optimistic projections.
It’s the EPA that sets the standards for what constitutes clean air. For years, the EPA has said Atlanta’s air quality did not meet those standards when it came to ground-level ozone. The federal agency has pushed the state EPD to clean up Atlanta’s air.
The state EPD has tried just about everything short of plugging exhaust pipes to clean Atlanta’s air. It’s banned outdoor homeowners from burning yard trimmings. It’s required dozens of polluters, including Georgia Power, to install emission controls. It’s forced gas stations in more than 40 counties to sell cleaner gasoline.
The kind of results that would help Lauren Johnson, though, have remained well beyond EPD’s reach. For a decade or so, Atlanta’s air quality has stayed just about the same.
“There hasn’t been any noticeable increase or decrease over the years,” says Michael Chang, a Georgia Tech researcher and one of the region’s leading air quality experts.
Twelve stations scattered across Atlanta allow the EPD, EPA, Chang and other scientists to track Atlanta’s air quality. The stations are equipped with monitors that periodically take in samples to see how much pollution is in the air. (Results can be seen at www.air.dnr.state.ga.us/amp/index.html.)
“There’s a lot being done [to curb pollution], but we are just not seeing the improvements at the monitors,” Chang says. “Even though the state has implemented specific controls on pollution that have led to lower emissions, at the same time, that reduction is competing with continued growth, with increased demand for energy, increased demand for mobility, and that pushes it back in the other direction. Long term, those pressures will win out if everything stays the same, and we’ll be back in the same boat we’re in right now.”
Right now, that boat is rushing toward a giant waterfall. The EPA currently classifies our ozone problem as “serious,” which is why the region has had to put up with tougher auto emission controls, cleaner gasoline and even road-building restrictions. Atlanta is on the verge of being bumped up to “severe,” a status with a new set of even more stringent rules.
The EPA actually was required by law to reclassify Atlanta as “severe” when the state missed a deadline to meet federal ozone standards back in 1999. Instead, the federal agency extended the deadline until 2004, prompting environmentalists statewide to throw up their hands in frustration.
Wesley Woolf of the Southern Environmental Law Center is the lead attorney in four lawsuits that aim to force the EPA to bump Atlanta up to severe status. Doing so, Woolf contends, would force the EPD, which has to implement the EPA’s regulations, to clean the air faster. Under “severe” status, gas stations in the 13 metro counties that don’t meet federal air standards would have to sell what’s called federally reformulated gasoline, a fuel designed to reduce emissions of volatile organic compounds. (VOCs combine with nitrous oxides and sunlight to create ozone.)
The severe rating also would change the definition of a “major source” of pollution. Up to 50 metro companies that currently aren’t considered major sources could be forced to install more stringent pollution controls.
If Atlanta was reclassified as severe and failed to meet federal air standards in 2005, major polluters would have to pay a $5,000 penalty for every ton of ozone-causing pollution above a certain level.
Plus, if certain emissions didn’t drop by 3 percent a year, the state could be subject to more far-reaching sanctions, including another interruption in federal highway funds.
It seems inevitable that metro Atlanta will be dubbed severe by year’s end. Woolf’s lawsuits are almost identical to a Washington, D.C., lawsuit that resulted in the Washington metro area being reclassified as severe. The D.C. Circuit Court of Appeals ruled in early July that it was illegal for the EPA to extend the area’s air quality deadline, which is the same thing the EPA did for Atlanta. Georgia Attorney General Thurbert Baker intervened to try to convince the courts not to rule with the environmentalists.
But Baker lost, which doesn’t bode well for his chances against Woolf this fall in the 11th Circuit Court of Appeals in Atlanta.
“The 11th Circuit is likely to give substantial deference to the D.C. circuit because the docket of that Court of Appeals has more cases involving the interpretation of agency rules and actions than any other Court of Appeals in the country,” Woolf says.
He expects a ruling in at least one of his cases that would bump Atlanta up to severe by the end of October.
There’s just one problem: The EPA and EPD are convinced federally reformulated gas actually would make Atlanta’s air quality worse.
The gas we use now is low in sulfur, which the Georgia EPD requires because low-sulfur gas helps a car’s catalytic converter reduce emissions of nitrous oxides. The EPD has focused on reducing nitrous oxides because of the chemical mix in metro Atlanta’s polluted air. Weather patterns and vegetation here make it more effective to reduce ozone smog by cutting nitrous oxides than by cutting VOCs.
In most air-beleaguered towns, the chemical mix makes it more effective to clean the air by reducing volatile organic compounds rather than nitrous oxides. So federally reformulated gasoline is designed to reduce VOCs.
But the federally reformulated gas isn’t low-sulfur so it doesn’t cut nitrous oxides. And if we used the federal gas, all the experts agrees, our ozone problem would get worse.
“That could be problematic,” Kay Prince, chief of the EPA’s air section for the Southeast, says in an understatement.
Woolf knows about the gas problem, too. “It could happen, in the worst of all possible scenarios,” he concedes. “The other provisions of the severe rating will improve air quality. That specific provision may cause air quality degradation.”
Woolf says EPD could skirt the problem by ordering a reformulated gas that’s also low-sulfur. “It would be our view that the agencies have demonstrated an unending capacity to creatively interpret the Clean Air Act and they should be able to creatively interpret the act to address the problem of reformulated gas.”
EPD air protection branch chief Ron Methier has looked for ways around the gas issue. He’s gone to the Georgia Petroleum Council to ask if a low-sulfur, reformulated gas — a mixture of Georgia gas and the federal gas — could be made. But that, he was told, was too much of a hassle.
“It would lead to all sorts of disruptions if we tell the fuel people, ‘Well, we’re required to have federal reformulated gasoline in 13 counties [the ones that don’t meet federal air standards], but we aren’t required to have it anywhere else.’ We need to pick one fuel and stick with it,” Methier says.
Methier argues that his agency is ratcheting down emissions where it can.
“There is a perception that more is required than what we’re doing now,” he says. “We’re doing everything we have been able to do. Every year, we roll out something new, whether it’s stricter vehicle testing, new gasoline, wider open-burning bans, stricter power plant requirements. Hopefully, we’re going to start seeing results.”
Don’t hold your breath. Even if Methier, Prince, Woolf and all the other players figure out a way to make the federally reformulated gas work, the root of the problem will continue to grow bigger. In other words, Atlanta’s sprawl will continue to spawn more pollution from cars.Every year, the average Atlantan’s commute gets longer and longer.
When it came to smog, we lucked out last year. Atlanta had one of its mildest ozone seasons in a decade. But that was due to the weather, not because Atlantans actually made an effort to drive less, or because transportation and environmental officials did anything special.
August sees some of the worst ozone concentrations. In 1999, the worst ozone day was Aug. 17. In 2000, the two days with the highest ozone levels were Aug. 16 and 17. On days like that, pediatric asthma clinics are swamped.
So far this year, Atlanta is on course to match ozone levels of 1999 and 2000. To date, levels have exceeded federal standards 20 days.
A groundbreaking study, conducted by a five-member team of local asthma specialists and Centers for Disease Control and Prevention doctors, analyzed air quality and asthma attacks in the four weeks before the 1996 Olympics, the 17 days during the Games and the four weeks after.
During the Games, the city brought in 1,000 extra buses for park-and-ride use. Organizers also emphasized public transit and telecommuting. The result? Miraculously light traffic.
The impact was seen in the city’s emergency rooms. During the Olympics, the daily average of asthma hospitalizations and emergencies citywide dropped 42 percent for Medicaid patients age 1 to 16, compared to the four weeks before and after the Games. For HMO enrollees in the same age group, the daily average dropped 44 percent.
The drop in asthma attacks, the study concludes, is no coincidence: “The alternative transportation plan in Atlanta during the Olympic Games reduced ozone and other air pollutants and was associated with a significant, albeit temporary, decrease in the burden of asthma among Atlanta’s children.”
Other studies — conducted by Paige Tolbert, Howard Frumkin and a handful of other Emory professors — are responsible for a good deal of what we know about ozone’s affects on asthmatic children. Two of their studies, both published in 2000 — one in the American Journal of Epidemiology and the other in the Journal of Exposure Analysis and Environmental Epidemiology — supplied the first links between high pollution and asthma attacks.
Tolbert is presenting a new study this month during the annual meeting for the Society for Epidemiological Research in Palm Desert, Calif., that links air pollution and heart problems.
Once again, the team looked at air pollution data and the reasons behind more than 1 million visits to 31 emergency rooms in Atlanta. They found evidence linking congestive heart failure and other acute cardiovascular problems with air pollution. That study will continue for at least another year.
“A decade ago,” Tolbert says, “people didn’t believe there could be a biological basis for problems from air pollution. That information is really now coming out.”
The bigger question, though, is will that information help? Will it finally spur transit and environmental officials to action? Or will it be ignored for another decade?
“It’s very easy to think, ‘What is our air going to be like three years, five years, seven years from now?’” Dr. Graham says.
Yet even the man who every day sees the worst of what Atlanta’s air can do has hope.
“Some of us are becoming increasingly aware,” he says. “It’s not just the politicians. It’s our individual responsibility when we sit on 285 and we look and every car around us has one person in it. The same soccer moms who are upset when I tell them their kids can’t play, maybe need to think that they don’t need to hop in the SUV to go to Kroger. Maybe they need to take the smaller car.”
Lauren’s mother, Cindy Johnson, didn’t pay much attention to Atlanta’s air quality until Lauren began having problems breathing, when she was 2. Now, Johnson watches the news every night to see how bad the air will get the next day.
“On some days, her grandma will call, and neighbors will call, when they see that there’s going to be a bad smog day,” Johnson says. Lauren absolutely has to stay inside on those kinds of days. Lots of kids do.
Atlanta’s air problems send thousands of asthmatics, senior citizens, and anyone sensitive to respiratory problems, to emergency rooms and allergy clinics every year. Sometimes, scientists say, Atlanta’s air actually kills people.
City, state and federal brains have been trying to fix the metro area’s air pollution for more than a decade. But the best claim they can make is that air quality hasn’t gotten worse.
And, now, even as more evidence mounts about the human toll of Atlanta’s smog, the sheer complexity of the solutions makes it difficult to see how the air will get healthy anytime soon. In one likely scenario, an intended solution could even make the air worse.
Lauren thinks it would be a good idea just to put a plug on the exhaust pipes of every car and truck around here — something the agencies dealing with air pollution would probably love to do, sort of.
Lauren and Cindy Johnson live in Monticello, which is southeast of Covington. On days when the air wafting over from Atlanta isn’t too bad, Lauren likes to go swimming at her friend’s house. She’s been swimming a lot less this summer.
When a hospital administrator tells her, “Well, maybe the hospital should get a pool,” Lauren’s eyes double in size, she turns her head around to face her mother and speaks for the first time above a strained whisper. “Oh cool!” Then, the exertion sets off a coughing spell fitting for a lifelong chain smoker than a child of 9.
Lauren is one of three patients of Dr. LeRoy Graham at the Children’s Healthcare of Atlanta.
“I’d say on the worst day, there are at least a dozen, sometimes a couple dozen more kids that are brought in because of problems, easily,” Graham says.
Graham treats asthma attacks triggered by air pollution the same as he does any asthma attack. But over the last few years, he’s become more upfront about telling his patients how to avoid attacks in the summer.
“We’re giving patients fairly direct advice of what to avoid, and basically we’re telling people not to go outdoors, and that’s pretty bad,” he says.
Graham’s constant interaction with kids suffering because of Atlanta’s air pollution has emboldened him to move beyond his role as a pediatric pulmonologist. He’s an outspoken critic of developers; he’s not afraid to say that politicians could be doing far more to get cars off the roads.
“Our political leadership is irresponsible in respect to air pollution,” Graham says. “There’s a wealth of scientific evidence saying that in a metropolis such as Atlanta we need to have transportation alternatives.
“We cannot let people continue development without the supporting infrastructure, and by that, I mean not just the roads leading into your subdivision but the ability to have feeder routes into MARTA, to have light rail, to have things like that. In my opinion, basically there’s a lot of big money to be made in Atlanta, and money makes you forget about a lot of stuff. We can solve big problems; we can dig a hole and build a bigger sewer in a heartbeat if it means more development. Well, why can’t we have that same kind of motivation to come up with transit solutions?”
The acronyms of the agencies that help fight Atlanta’s battle against dirty air could fill a bowl of alphabet soup.They include the Atlanta Regional Commission, the Georgia Regional Transportation Authority, the Georgia Department of Transportation, the Georgia Environmental Protection Division and the U.S. Environmental Protection Agency.
Georgia regulators (EPD) clash with industries over pollution controls that businesses say are too expensive. Federal regulators (EPA) sometimes butt heads with the state regulators, EPD.
The transit agencies — ARC, GRTA and DOT — are supposed to be working together to come up with a plan that will ease congestion, cut down on automobile trips and reduce the pollution that comes from cars and trucks. Often though, the separate agencies carry on with their own plans without coordination with the other two.
Environmentalists sue the state EPD and federal EPA to get better laws, better enforcement, cleaner air. Environmentalists also sue the ARC, GRTA and DOT when those agencies’ transportation plans don’t do enough to clean up the air, or when the plans rely on what the greenies consider overly optimistic projections.
It’s the EPA that sets the standards for what constitutes clean air. For years, the EPA has said Atlanta’s air quality did not meet those standards when it came to ground-level ozone. The federal agency has pushed the state EPD to clean up Atlanta’s air.
The state EPD has tried just about everything short of plugging exhaust pipes to clean Atlanta’s air. It’s banned outdoor homeowners from burning yard trimmings. It’s required dozens of polluters, including Georgia Power, to install emission controls. It’s forced gas stations in more than 40 counties to sell cleaner gasoline.
The kind of results that would help Lauren Johnson, though, have remained well beyond EPD’s reach. For a decade or so, Atlanta’s air quality has stayed just about the same.
“There hasn’t been any noticeable increase or decrease over the years,” says Michael Chang, a Georgia Tech researcher and one of the region’s leading air quality experts.
Twelve stations scattered across Atlanta allow the EPD, EPA, Chang and other scientists to track Atlanta’s air quality. The stations are equipped with monitors that periodically take in samples to see how much pollution is in the air. (Results can be seen at www.air.dnr.state.ga.us/amp/index.html.)
“There’s a lot being done [to curb pollution], but we are just not seeing the improvements at the monitors,” Chang says. “Even though the state has implemented specific controls on pollution that have led to lower emissions, at the same time, that reduction is competing with continued growth, with increased demand for energy, increased demand for mobility, and that pushes it back in the other direction. Long term, those pressures will win out if everything stays the same, and we’ll be back in the same boat we’re in right now.”
Right now, that boat is rushing toward a giant waterfall. The EPA currently classifies our ozone problem as “serious,” which is why the region has had to put up with tougher auto emission controls, cleaner gasoline and even road-building restrictions. Atlanta is on the verge of being bumped up to “severe,” a status with a new set of even more stringent rules.
The EPA actually was required by law to reclassify Atlanta as “severe” when the state missed a deadline to meet federal ozone standards back in 1999. Instead, the federal agency extended the deadline until 2004, prompting environmentalists statewide to throw up their hands in frustration.
Wesley Woolf of the Southern Environmental Law Center is the lead attorney in four lawsuits that aim to force the EPA to bump Atlanta up to severe status. Doing so, Woolf contends, would force the EPD, which has to implement the EPA’s regulations, to clean the air faster. Under “severe” status, gas stations in the 13 metro counties that don’t meet federal air standards would have to sell what’s called federally reformulated gasoline, a fuel designed to reduce emissions of volatile organic compounds. (VOCs combine with nitrous oxides and sunlight to create ozone.)
The severe rating also would change the definition of a “major source” of pollution. Up to 50 metro companies that currently aren’t considered major sources could be forced to install more stringent pollution controls.
If Atlanta was reclassified as severe and failed to meet federal air standards in 2005, major polluters would have to pay a $5,000 penalty for every ton of ozone-causing pollution above a certain level.
Plus, if certain emissions didn’t drop by 3 percent a year, the state could be subject to more far-reaching sanctions, including another interruption in federal highway funds.
It seems inevitable that metro Atlanta will be dubbed severe by year’s end. Woolf’s lawsuits are almost identical to a Washington, D.C., lawsuit that resulted in the Washington metro area being reclassified as severe. The D.C. Circuit Court of Appeals ruled in early July that it was illegal for the EPA to extend the area’s air quality deadline, which is the same thing the EPA did for Atlanta. Georgia Attorney General Thurbert Baker intervened to try to convince the courts not to rule with the environmentalists.
But Baker lost, which doesn’t bode well for his chances against Woolf this fall in the 11th Circuit Court of Appeals in Atlanta.
“The 11th Circuit is likely to give substantial deference to the D.C. circuit because the docket of that Court of Appeals has more cases involving the interpretation of agency rules and actions than any other Court of Appeals in the country,” Woolf says.
He expects a ruling in at least one of his cases that would bump Atlanta up to severe by the end of October.
There’s just one problem: The EPA and EPD are convinced federally reformulated gas actually would make Atlanta’s air quality worse.
The gas we use now is low in sulfur, which the Georgia EPD requires because low-sulfur gas helps a car’s catalytic converter reduce emissions of nitrous oxides. The EPD has focused on reducing nitrous oxides because of the chemical mix in metro Atlanta’s polluted air. Weather patterns and vegetation here make it more effective to reduce ozone smog by cutting nitrous oxides than by cutting VOCs.
In most air-beleaguered towns, the chemical mix makes it more effective to clean the air by reducing volatile organic compounds rather than nitrous oxides. So federally reformulated gasoline is designed to reduce VOCs.
But the federally reformulated gas isn’t low-sulfur so it doesn’t cut nitrous oxides. And if we used the federal gas, all the experts agrees, our ozone problem would get worse.
“That could be problematic,” Kay Prince, chief of the EPA’s air section for the Southeast, says in an understatement.
Woolf knows about the gas problem, too. “It could happen, in the worst of all possible scenarios,” he concedes. “The other provisions of the severe rating will improve air quality. That specific provision may cause air quality degradation.”
Woolf says EPD could skirt the problem by ordering a reformulated gas that’s also low-sulfur. “It would be our view that the agencies have demonstrated an unending capacity to creatively interpret the Clean Air Act and they should be able to creatively interpret the act to address the problem of reformulated gas.”
EPD air protection branch chief Ron Methier has looked for ways around the gas issue. He’s gone to the Georgia Petroleum Council to ask if a low-sulfur, reformulated gas — a mixture of Georgia gas and the federal gas — could be made. But that, he was told, was too much of a hassle.
“It would lead to all sorts of disruptions if we tell the fuel people, ‘Well, we’re required to have federal reformulated gasoline in 13 counties [the ones that don’t meet federal air standards], but we aren’t required to have it anywhere else.’ We need to pick one fuel and stick with it,” Methier says.
Methier argues that his agency is ratcheting down emissions where it can.
“There is a perception that more is required than what we’re doing now,” he says. “We’re doing everything we have been able to do. Every year, we roll out something new, whether it’s stricter vehicle testing, new gasoline, wider open-burning bans, stricter power plant requirements. Hopefully, we’re going to start seeing results.”
Don’t hold your breath. Even if Methier, Prince, Woolf and all the other players figure out a way to make the federally reformulated gas work, the root of the problem will continue to grow bigger. In other words, Atlanta’s sprawl will continue to spawn more pollution from cars.Every year, the average Atlantan’s commute gets longer and longer.
When it came to smog, we lucked out last year. Atlanta had one of its mildest ozone seasons in a decade. But that was due to the weather, not because Atlantans actually made an effort to drive less, or because transportation and environmental officials did anything special.
August sees some of the worst ozone concentrations. In 1999, the worst ozone day was Aug. 17. In 2000, the two days with the highest ozone levels were Aug. 16 and 17. On days like that, pediatric asthma clinics are swamped.
So far this year, Atlanta is on course to match ozone levels of 1999 and 2000. To date, levels have exceeded federal standards 20 days.
A groundbreaking study, conducted by a five-member team of local asthma specialists and Centers for Disease Control and Prevention doctors, analyzed air quality and asthma attacks in the four weeks before the 1996 Olympics, the 17 days during the Games and the four weeks after.
During the Games, the city brought in 1,000 extra buses for park-and-ride use. Organizers also emphasized public transit and telecommuting. The result? Miraculously light traffic.
The impact was seen in the city’s emergency rooms. During the Olympics, the daily average of asthma hospitalizations and emergencies citywide dropped 42 percent for Medicaid patients age 1 to 16, compared to the four weeks before and after the Games. For HMO enrollees in the same age group, the daily average dropped 44 percent.
The drop in asthma attacks, the study concludes, is no coincidence: “The alternative transportation plan in Atlanta during the Olympic Games reduced ozone and other air pollutants and was associated with a significant, albeit temporary, decrease in the burden of asthma among Atlanta’s children.”
Other studies — conducted by Paige Tolbert, Howard Frumkin and a handful of other Emory professors — are responsible for a good deal of what we know about ozone’s affects on asthmatic children. Two of their studies, both published in 2000 — one in the American Journal of Epidemiology and the other in the Journal of Exposure Analysis and Environmental Epidemiology — supplied the first links between high pollution and asthma attacks.
Tolbert is presenting a new study this month during the annual meeting for the Society for Epidemiological Research in Palm Desert, Calif., that links air pollution and heart problems.
Once again, the team looked at air pollution data and the reasons behind more than 1 million visits to 31 emergency rooms in Atlanta. They found evidence linking congestive heart failure and other acute cardiovascular problems with air pollution. That study will continue for at least another year.
“A decade ago,” Tolbert says, “people didn’t believe there could be a biological basis for problems from air pollution. That information is really now coming out.”
The bigger question, though, is will that information help? Will it finally spur transit and environmental officials to action? Or will it be ignored for another decade?
“It’s very easy to think, ‘What is our air going to be like three years, five years, seven years from now?’” Dr. Graham says.
Yet even the man who every day sees the worst of what Atlanta’s air can do has hope.
“Some of us are becoming increasingly aware,” he says. “It’s not just the politicians. It’s our individual responsibility when we sit on 285 and we look and every car around us has one person in it. The same soccer moms who are upset when I tell them their kids can’t play, maybe need to think that they don’t need to hop in the SUV to go to Kroger. Maybe they need to take the smaller car.”