EPA Docket Center (Air Docket) U.S. Environmental Protection Agency 1200 Pennsylvania Avenue Washington, D.C. 20460 RE: Docket ID No. EPA-HQ-OAR-2011-0660; FRL-9668-9
May 24, 2011

Good Afternoon, myname is PamelaM. Ortner, MS, RN; I am the Michigan Environmental HealthNurse Advocate for Health Care Without Harm. Health Care Without Harm is an international coalition ofmore than 430 organizations in 52 countries, working to transform the health care sectorworldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source ofharm to public health and the environment. I appreciate this opportunity to comment onthe proposed carbonpollution standard that would limit carbonpollution from newpower plants. HCWH supports the Environmental Protection Agency's efforts to protect the public's health through the implementation ofthis rule.

This first-ever national industrial carbon pollution standard for newpowerplants is essential to protect public health. By advancing several clean air safeguards that address carbon, mercury, soot, smog and othertoxic pollutants, the EPA is holding big polluters accountable andprotecting our kids and families from deadly, dangerous airpollution. As oftoday, more than I Million comments have been generated in support ofthe EPA Carbon Rule, a historic number; health providers and advocates, community members, environmental advocates and industry leaders have added their voice ofsupportto this rule. I have brought over 300 cards supportingthe rule from nurses and community members from Michiganthat I have collected.

Carbonpollution is most dangerous for children and the most vulnerable ofour population. Rising temperatures are likelyto increase smogpollution, which will be a trigger for asthma attacks and can cause permanent damage to and reduce to the function ofa child's lungs. Asthma is a chronic, often debilitating conditionthat has no cure. During an asthma episode, the airways become constricted and swollen, the chest feels

RE: Docket ID No. EPA-HQ-OAR-2011-0660; FRL-9668-9, Pamela Ortner, MS, RN Itight and it is difficult to breathe. Data from the Centers for Disease Control and Prevention and from the American Lung Associationdetail the prevalence and costs of asthma inthe United States. In2008, more than 688,000 childrenhad to go to the emergency room because ofasthma. The total estimated incremental direct cost of asthma in the United States is more than $53 billion a year. We carmot forget the personal cost. As anurse for over 35 years, I will never forget the face ofa child with asthma gasping for air. The economic impact does not end withmedical costs. Parents, most often mothers, must find a wayto stay home withtheir child who is ill whichcanbe a financial hardship, but ifthe home does not have air conditioning, the child will still be exposed to unhealthy air. According to the Centers for Disease Control and Prevention, asthma episodes keep children out ofschool (about l0.5 million lost school days in2008) and takes adults out ofthe workplace (accounting for more than 14 millionlost work days in 2008). An estimated 7 million children and over 17 million adults inthe United States have asthma. As you know, my state ofMichigan, as inmany other states is suffering My state ofMichiganhome to more than 225,000 children andmore than 744,000 adults with asthma. The estimated incremental direct cost ofasthma in Michigan to childrenand adults is almost $2 billion. Children, however are not the only ones negatively impacted. Exposure to carbondioxide increases the likelihood that seniors withhealthproblems wouldbe hospitalized. The elderly, those most likely to have heart and lung ailments, those who already have diminished lung capacity andthose who are poor and live in more highly polluted areas will be disproportionately affected.

There is little scientific debate about the harmful effects ofclimate change. The proposed rule will save lives, protect the health ofmillions and bring about an action that is long overdue. We can andmust act to ensure we protectthe mostvulnerable among us.

Thank you.

Pamela Ortner, MS, RN Health Care Without Harm Michigan Environmental HealthNurse Advocate

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