# Presentation: 212850

## Slide 1

## Why Color the Days?

**Janice E. Nolen, MS**
**Director, National Policy**
**American Lung Association**

## Why Color the Days?

**Why do we bother?**
**What could we do to improve the air?**
**What should we do?**

## “Change Air Quality    Index”

***Change requires public support***

## Some need to know more than others

**Some need to know ****more than others**

**Notes:**
From the Atlanta Journal  Constitution around the time we published State of the Air 2002. Atlanta ranked #6 that year in the list of the most ozone polluted cities.

## What do people need to know? 

**When/ how to protect themselves**
**Millions are at risk**
**137 million live counties where ozone levels are unhealthy **
***American Lung Association State of the Air 2003***
**Risks are severe**
**Air can be cleaner**
**They can push for cleaner air**

**Notes:**
The first and most essential is to tell the public when and how to protect themselves from bad air. We can tell them they can do things in their community to reduce air pollution, such as taking advantage of free or reduced bus fare on code red days.

But we can do more. Let them know that they and others in their communty and millions in the nation are at risk.  In our State of the Air report for 2003, we cited 137 million living in counties with monitors showing unhealthy levels of ozone. In SOTA 2004, we ‘ll report on particle pollution for the first time as well.
They need to understand the health risks associated with air pollution and realize that people in their family may be at increased risk.
They need to understand that the air can be cleaner and that they can work to make it so, by not only reducing the emissions they help to create, by driving less or filling up after dark, but by supporting measures to clean up our cities and towns.

## Dirty Air Makes People Sick

**Asthma attacks**
**Increased **
**medication use**
**Doctor visits**
**Hospitalization**
**Increased risk of death**

**Notes:**
Studies clearly show pollution causes serious harm ranging from asthma attacks to increased risk of death. New studies showing increased risk of lung cancer.

## Cleaner Air = Better Health

**Studies show reduced pollution results in significantly improved public health **
**Atlanta, 1996**
**Dublin, Ireland, 1990s**

**Notes:**
What we have fewer studies on is the impact of less pollution. But they do show improved health in the communities where pollution is reduced, even, as in Atlanta,for a short time.

## Atlanta Olympics, 1996

**Concern over Olympics traffic led Atlantans to reduce driving**
**Telecommuted**
**Took mass transit**
**Ozone pollution declined over 25%**
**Fewer people hospitalized for asthma**
**Up to 44% drop in Medicaid claims**
***Journal of the American Medical Association, 2001***** **

**Notes:**
Impact of Changes in Transportation and Commuting Behaviors During the 1996 Summer Olympic Games in Atlanta on Air Quality and Childhood Asthma     Michael S. Friedman, MD; Kenneth E. Powell, MD, MPH; Lori Hutwagner, MS; LeRoy M. Graham, MD; W. Gerald Teague, MD 
Results  During the Olympic Games, the number of asthma acute care events decreased 41.6% (4.23 vs 2.47 daily events) in the Georgia Medicaid claims file, 44.1% (1.36 vs 0.76 daily events) in a health maintenance organization database, 11.1% (4.77 vs 4.24 daily events) in 2 pediatric emergency departments, and 19.1% (2.04 vs 1.65 daily hospitalizations) in the Georgia Hospital Discharge Database. The number of nonasthma acute care events in the 4 databases changed –3.1%, +1.3%, -2.1%, and +1.0%, respectively. In multivariate regression analysis, only the reduction in asthma events recorded in the Medicaid database was significant (relative risk, 0.48; 95% confidence interval, 0.44-0.86). Peak daily ozone concentrations decreased 27.9%, from 81.3 ppb during the baseline period to 58.6 ppb during the Olympic Games (P<.001). Peak weekday morning traffic counts dropped 22.5% (P<.001). Traffic counts were significantly correlated with that day's peak ozone concentration (average r = 0.36 for all 4 roads examined). Meteorological conditions during the Olympic Games did not differ substantially from the baseline period.
Conclusions  Efforts to reduce downtown traffic congestion in Atlanta during the Olympic Games resulted in decreased traffic density, especially during the critical morning period. This was associated with a prolonged reduction in ozone pollution and significantly lower rates of childhood asthma events. These data provide support for efforts to reduce air pollution and improve health via reductions in motor vehicle traffic.

## Dublin, 1990s

**1980s Dublin switched from oil to coal for home heating; pollution increased**
**1990 Irish Government banned coal marketing and distribution**
**Study tracked health effects before and after ban**
**Significant drop in death rates after ban**
***Clancey et al, Lancet 2002.; Goodman et al, Environ Health Persp 2003.***

## A world where no one lives in a place with unhealthy air
If we’re going to get there, what do we do?

**If we’re going to get there, what do we do?**

**What could we do?**

## What should we do? Current tools

**Protect  the Clean Air Act**
**No undermining of existing protections**
**Support adequate funding for the work **
**Delays in NAAQS review risks health**
**Clean up power plants **
**Interstate transport regulations will help **
**Clean up dirty diesel **

**Notes:**
We have some powerful measures we can use right now.
First, don’t undermine the Clean Air Act.  Provisions such as the revisions to new source review adopted last year weaken the ability of states and the nation to clean up the air. We are taking legal action to reverse that.
The NAAQS are the linchpin for all the protections to public health, but they don’t protect the public if they don’t reflect what we know about the health threats.  The process is seriously delayed.  Among other things we need adequate funding to do the analysis needed to set these standards.
Old, dirty coal-fired power plants are a clear source of pollution.  The proposed interstate transport regulations will help tackle that problem, though they could be stronger.
Diesel is another source that we’ve made good strides on, but could be cleaned up more.  Cleaner diesel fuel and cleaner trucks and buses are in the pipeline, but that program needs to be carefully monitored to ensure compliance. Controls for other types of diesel, like bulldozers, generators are proposed. Controls on marine and locomotive diesel are needed.

## What could we do?

**National Research Council report, Air Quality Management in the United States, 2004**
**Evaluated air quality systems and resources **
**Recommended major**** evolutionary changes**

**Notes:**
While the ALA has not completed our review of the recommendations made in the January 2004 report, we do see within it many recommendations we can support:
I’ll cover three major areas:
Strengthen scientific/ technical capacity
Expand control strategies
Transform State Air Management Plans

## Strengthen scientific/ technical capacity

**Improve emissions tracking**
**New techniques and better inventories**
**Enhance monitoring**
**Expanded geographic coverage**
**Improve modeling**
**Access & monitor health effects**
**Advance multi-pollutant approaches **

**Notes:**
While the ALA has not completed our review of the recommendations made in the January 2004 report, we do see within it many recommendations we can support:
Improve emissions tracking
	including new emissions monitoring techniques and regularly updated emissions inventories
Enhance monitoring
	New monitoring methods, expanded geographic coverage (airshed coverage), improved trend analysis, and enhanced data accessibility.
Improved modeling, 
Develop & implement a system to assess & monitor human health effects
Additional changes that could enhance our scientific and technical capacity
Tackling multiple pollutants is a better way to handle these sources, but we need more research to examine the how they interact and how they can be addressed.

## Expand control strategies

**Expand emissions-control measures**
**Especially heavy equipment diesel**
**Reduce emissions from existing sources, especially power plants**
**“****regardless of their age, status, or fuel.”**
**Address multi-state transport **

**Notes:**
Expand the national & multi-state missions control measures
	Including nonroad mobile sources, area sources, and building and consumer products
Reduce emissions from existing sources, including plants and vehicles.
NRC urges we set standards for existing facilities “regardless of their age, status, or fuel.”
Multi-state transport
	EPA needs greater authority to address multistae air quality issues on an ongoing basis. But EPA needs to use the existing authority it has to address these issues.

## Transform State Air Management Plans

**Make SIPs address multiple pollutants**
**Retain & strengthen transportation conformity**
**More resources for NAAQS review**
**Especially if multiple pollutants targeted**

**Notes:**
Most sources produce multiple pollutants. They should be addressed in one plan.
Transportation conformity can be one of the most important tools to prevent building in future pollution. It is at risk in the Early Action Compact process and in the Congress and needs to be protected and enhanced.

NRC recommends addressing multiple pollutants in the NAAQS review. Under the current funding and staffing, that would be impossible and could delay the process further.  Even if no change is made in the process, more resources need to be allocated here.

## Why do we color the days?

**We help people protect themselves **
**We build support that is essential to improve the air we breathe. **
***We color the days so everyone can see the problems clearly.***

## Celebrating its 100th anniversary, the American Lung Association works to prevent lung disease and promote lung health. Lung diseases and breathing problems are the leading causes of infant deaths in the United States today, and asthma is the leading serious chronic childhood illness. Smoking remains the nation’s leading preventable cause of death. Lung disease death rates continue to increase while other leading causes of death have declined. 

- Celebrating its 100th anniversary, the American Lung Association works to prevent lung disease and promote lung health. Lung diseases and breathing problems are the leading causes of infant deaths in the United States today, and asthma is the leading serious chronic childhood illness. Smoking remains the nation’s leading preventable cause of death. Lung disease death rates continue to increase while other leading causes of death have declined.
- The American Lung Association has long funded vital research on the causes of and treatments for lung disease.  It is the foremost defender of the Clean Air Act and laws that protect citizens from secondhand smoke.  The Lung Association teaches children the dangers of tobacco use and helps teenage and adult smokers overcome addiction. It educates children and adults living with lung diseases on managing their condition. With the generous support of the public, the American Lung Association is “Improving life, one breath at a time.”
- For more information about the American Lung Association or to support the work it does, call **1-800-LUNG-USA (1-800-586-4872**) or log on to **www.lungusa.org.**