My name is Alan S. Peterson M.D., Emeritus Director of Environmental and Community 

Medicine of Lancaster General Health. I am representing my family as well as those 

generations yet to come. 

I am in full support of the EPA's proposed standard to decrease carbon pollution and help 

decrease climate change. This needs to be implemented now and without any weakening 

amendments. 

There are many personal reasons that I feel this way, as well as professional ones. I 

myself have asthma which is getting significantly worse as I live in Lancaster County, 

Pennsylvania. The American Lung Association has listed Lancaster County with a grade 

of "D" with our "particle pollution 24-hour". 

An article last year in Lancet Oncology 2013; DOl: 10. 1016/Sl474-2045 (13) 7927 9-1 

synthesizes data from 17 cohorts studies in 9 European countries. They found that risk 

exists even when the levels of particulate matter air pollution were below the current 

European limit values. They found no threshold below which there was no risk. There is 

no reason to think that the study would have a different outcome in the United States. It is 

one of the largest studies of its kind, including data on more than 300,000 individuals and 

2,095 lung cancer cases with a median follow-up of 12.8 years. 

Even though the lung cancer risk associated with air pollution is much lower than that 

associated with smoking, the editorialist points out that everybody is exposed to air 

pollution; therefore, the public health effect is quite large. The World Health 

Organization has estimated that air pollution caused 1.2 million deaths and 8% of lung 

cancer worldwide in 2004. 

For every increase of 5 meg per cubic meter of PM2.5pollution, the risk for lung cancer 

increased by 18%, and for every increase of I 0 meg per cubic meter in PM 10 pollution, 

the risk increased by 22%. The risks were even higher for specific adenocarcinomas of 

the lung. 

This new study overcame several limitations of previous air pollution studies and 

benefited from a high follow-up rate and adjustment of potential confounders, including 

a set of smoking variables. I believe this article is very important in our significant 

ongoing accumulation of scientific research literature demonstrating the significant risks 

of particle pollution from the burning of coal and other fossil fuels. 

Additional new research from the Journal of Gerontology: Series 8, on-line June 6, 2014, 

links cognitive (intellectual) decline in older adults. The authors state that based on the 

Page 1 of2 
results, improvements in air quality may be an important strategy for reducing agerelated cognitive decline. There has been in the past some evidence that people living in 

more polluted areas have greater rates of cognitive decline and the link is not explained 

by wealth or other social factors. They gathered information in this study from one wave 

of a large ongoing survey started in 1986. They focused their analysis on 780 participants 

who were 55 years of age and older at the time of the 2001/2002 survey. Cognitive 

function was measured by math and memory tests. Air pollution levels for each 

participant's neighborhood were calculated using fine particulate levels reported by the 

EPA's Air Quality System. 

The emerging evidence showing a link between air pollution and cognitive function 

suggests air pollution may harm the brain as well as the heart and the lungs. They felt that 

the most important action to take is one we take as a society, by regulating the amount of 

pollution that gets emitted into our air. We need to continue to attempt to reduce air 

pollution by reducing the burning of coal and petroleum products in our atmosphere. 

Once again I give my full support for the proposed standard and thank the EPA for the 

opportunity to be heard. 

Dr. Alan Peterson, ASPeters@lghealth.org 

Page 2 of2