Clean Air & Climate Change Advocacy for Busy People

Last month, I had the opportunity to speak at the American College of Chest Physicians conference in Hawaii. My sister (pictured above) has become the de facto Air Health Our Health mascot on some of these climate change slides.  It was on the beautiful island of Oahu, and obviously the horror of what had unfolded on the neighboring island of Maui and Lahaina was fresh on my mind. I was there to speak about a variety of topics, but in particular, on wildfires and their impact on health, as well as climate change and clean air advocacy.. It’s really important to me as a physician to try to step out of my ICU and clinic and think about the things in our world that are driving patients to need my care in the first place.

One of the talks I gave was called “Clean Air and Climate Advocacy for the Busy Clinician” and as I was working on it, I realized that this applies to all of us, not just clinicians. Most of us have very full busy lives and multiple competing obligations. Many of us have children or elderly relatives for whom we are caring. Many of us have jobs and often more than one job. It can all feel really overwhelming, in the midst of our busy lives, to consider the fact that we really only have 7 years to get our CO2 emissions down to half of what they were in 2010, and we have until 2050 to get to net zero carbon emissions if we want to have any hope of having a stable climate or a habitable planet in a 100 years.

Like many parents, I lie awake at night worried about the future of the planet that we are leaving to our children. Sometimes that seems so long-term and I need to worry about the short-term of the day today of getting people to school to their appointments to their after school activities and more. I’ve struggled to figure out how best to include clean air and climate advocacy into my life and my family life. On the podcast episode I released on this topic, I share some ways I have found that work for me and offer some potential suggestions for other busy people worried about clean air and the climate but who don’t know how to work advocacy for it into their lives.

My daughter's drawing of a mama bunny losing her babies in a fire- climate change affects mental health.

This podcast episode provided is just one person’s perspective (mine), and there are many other options out there, but listen to the episode if it is helpful to you. I include many studies in the episode and there is a comprehensive list of references at the end of the post. 

In the first part of the podcast, I go through “Climate Change and Air Pollution 101.” Here are some of the key points and studies with their figures in case they are helpful. Listen to the episode for more studies and more information on each.

CO2 emission basics from the IPCC- all is not lost, and there is much we can do in the next 7 years

In the podcast episode, I review many of the different health impacts of climate change from heat events to increased pollen and allergy burden, catastrophic fire and flood events and more. If we continue to emit high levels of CO2, much of the US will become increasingly deadly by the end of the century.

I also go over “Air Pollution 101”- emphasizing that there is a significant death and disease burden to air pollution levels below those deemed “safe” according to EPA standards. 

Di et al. NEJM. 2017 study showing risk of death for increases in PM2.5 and ozone concentrations
That risk is not shared equally- it is very important to understand the history of redlining and environmental injustice
Lemke et al 2014- risk of hospitalization or ER visit for asthma at NO2 levels well below EPA limit of 53 ppb
Gauderman et al NEJM 2015- Policy works to lower air pollution exposure- in this study at schools
As pollutants fell, kids exposed to lower pollution levels and more normal lung function
Over time, kids exposed to lower pollution were less likely to have stunted lungs.

I end the podcast with some examples of how policy works. You can also go back to the Season One episode about cleaning up old diesel school buses and how that helped kids miss fewer sick days. I also cover how people can start to look at their own community networks to weave advocacy into their own lives. If not you, who?

I know, in my lifetime we will continue to have catastrophic wildfires and floods and hurricanes and increasing conflict due to the climate change and its resultant climate and economic migration.  But I sincerely hope if we plant a bunch of these seeds of change with our advocacy and action, that our children and grandchildren will see a better world.

What can you do? 

Pick one below per week or month if possible, or just pick one! Whatever works for you!

1- Find out who represents you at the city council, county, state and federal level. Send them an e-mail and introduce yourself- remember to connect on values. Lead with stories about how you see clean air and climate change affecting you and your loved ones. Ask to meet with someone on at least one of those levels whether virtually or in person. 

2- Reflect on your current community and relationships- what are you already doing that could meld easily with climate and clean air advocacy?

  • Working on planting (non-pollen generating) trees in parks and in historically red-lined areas? b. Solar panels, EV chargers, more in work/school/community 
  • Joining a church or workplace green committee or starting one? 
  • Look at the supply chain in your work- is there a big target that could be greener? Can you talk to that business about what steps they are taking to improve? 
  • Greening your next meeting or get together- low methane menu options, energy efficiency, water bottle fill stations, etc

3- Scroll Air Health Our Health podcast episodes for topics of interest to you – each one has some action items and resources in the show notes and references in the associated blog link.

  • Hate noise/pollution and climate impact of leaf blowers? look into ordinances to help replace/retire them with an eye on avoiding negative impact to vulnerable communities. Listen to the “Yards on Fire” episode from Season Three.
  • Passionate about EVs? Learn how the American Lung Association can help you calculate how many asthma exacerbations can be avoided and money saved in your community with the clean energy transition for transportation! Listen to the “Road to Clean Air” episode from Season One to learn more.
  • Concerned about racial inequities? Learn about the history of redlining in your community, and learn how you can clean up the legacy of unhealthy air. Listen to the “Hidden in Plain Sight” episode from last season to learn more.
  • Worried about wildfires? Learn what you can do to make your community more resilient and prepare yourself and your family. There are a host of wildfire episodes from which to choose, but you can start with the “Our Health in Widlfire Season” episode from Season 2 or the “Fighting Fire with Fire” episode from season 3 to learn more.

 4- Find national organizations working on clean air and a stable climate. Of course, I am fond of the American Lung Association. For parents, Moms Clean Air force is also an option in addition to many more.

5- Advocacy is an individual journey- bring your whole self to it and also remember to put your own oxygen mask on. You don’t have to do everything, but you can do something.

5- Consider a donation to the Hawaii Community Foundation Maui Strong Fund to help those affected by the wildfire in Lahaina, which was spurred on by drought and hurricane force winds- both exacerbated by climate change. You can also learn about other ways to donate to address climate change here.

6- Finally, please consider leaving this podcast a 5 star review wherever you listen. I have been informed that it helps people find the podcast. Please also share an episode with friends if you find one that is helpful. If you have concerns and don’t think you can leave a 5 star review, email those concerns to me at airhealthourhealth@gmail.com. 

TLDR= Don't Light Things on Fire and Breathe them into your Lungs

References:

Lots for this episode because we cover a great deal of ground!

  • Adar et al. “Adopting Clean Fuels and Technologies on School Buses: Pollution and Health Impacts in Children.” Am J Respir Crit Care Med.. 191(12) 2015.​
  • American Cancer Society summary: https://www.cancer.org/cancer/cancer-causes/diesel-exhaust-and-cancer.html. Last Medical Review: July 24, 2015 Last Revised: July 27, 2015. Accessed Feb 2018. ​
  • American Lung Association. “Road to Clean Air.” 2020.​
  • Andersen ZJ et al. Chronic Obstructive Pulmonary Disease and Long-Term Exposure to Traffic-related Air Pollution: A Cohort Study. Am J Respir Crit Care Med. 2011: 183: 455-461.​
  • Behrentz et al. “Relative importance of school bus-related microenvironments to children’s pollutant exposure.” J Air Waste Manag Assoc. 2005 Oct;55(10):1418-30.​
  • Berger. “Air Pollution still Kills.” NEJM June 2017.​
  • Braun JM, Kahn RS, Froehlich T, Auinger P, Lanphear BP. 2006. Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children. Environ Health Perspect 114:1904–1909.​
  • Calderón-Garcidueñas L, Mora-Tiscareño A, Ontiveros E, Gómez-Garza G, Barragán-Mejia G, Broadway J, et al. 2008a. Air pollution, cognitive deficits and brain abnormalities: a pilot study with children and dogs. Brain Cogn 68:117–127.​
  • Carlsten, C.; Dybuncio, A.; Becker, A.; Chan-Yeung, M.; Brauer, M. Traffic-Related Air Pollution and Incident Asthma in a High-Risk Birth Cohort. Occup. Environ. Med. 2011, 68 (4), 291−295​
  • Finklestein MM et al. Traffic Air Pollution and Mortality Rate Advancement Periods. Am J Epidemiol. 2004; 160: 173-177; ​
  • Gauderman. “Association of Improved Air Quality with Lung Development in Children.” NEJM 2015; 372:905-913​
  • Health Effects Institute Panel on the Health Effects of Traffic-Related Air Pollution, Traffic-Related Air Pollution: A Critical Review of the Literature on Emissions, Exposure, and Health Effects. Health Effects Institute: Boston, 2010. Available at www.healtheffects.org.​
  • Hoek G, Brunkreef B, Goldbohn S, Fischer P, van den Brandt. Associations between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. Lancet. 2002; 360: 1203-1209.​
  • Intergovernmental Panel on Climate Change. “IPCC Special Report on Global Warming of 1.5 degrees C.” IPCC ​
  • Khreis et al. “Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis.” Environ Int. 2017 Mar;100:1-31​
  • Kulkarni et al. “Carbon in Airway Macrophages and Lung Function in Children.” N Engl J Med 2006; 355:21-30​
  • Lemke LD, Lamerato LE, Xu X, et al. Geospatial relationships of air pollution and acute asthma events across the Detroit-Windsor international border: study design and preliminary results. J Expo Sci Environ Epidemiol. 2014;24(4):346-357. doi:10.1038/jes.2013.78​
  • Mazaheri, M.; Clifford, S.; Jayaratne, R.; Megat Mokhtar, M. A.; Fuoco, F.; Buonanno, G.; Morawska, L. School Children’s Personal Exposure to Ultrafine Particles in the Urban Environment. Environ. Sci. Technol. 2014, 48 (1), 113−120.​
  • Nardone A, Casey JA, Morello-Frosch R, Mujahid M, Balmes JR, Thakur N. Associations between historical residential redlining and current age-adjusted rates of emergency department visits due to asthma across eight cities in California: an ecological study. Lancet Planet Health. 2020 Jan;4(1):e24-e31​
  • Mapping inequality​
  • Oudin et al. “Traffic-Related Air Pollution and Dementia Incidence in Northern Sweden: A Longitudinal Study.” Environ Health Perspect. 2016 Mar;124(3):306-12. doi: 10.1289/ehp.1408322.​
  • Peters A et al. Exposure to Traffic and the Onset of Myocardial Infarction. N Engl J Med. 2004; 351: 1721-1730.​
  • Prada et al. Association of air particulate pollution with bone loss over time and bone fracture risk: analysis of data from two independent studies. The Lancet Planetary Health , Volume 1 , Issue 8 , e337 – e347​
  • Rao M, George LA, Shandas V, Rosenstiel TN. Assessing the Potential of Land Use Modification to Mitigate Ambient NO₂ and Its Consequences for Respiratory Health. Int J Environ Res Public Health. 2017;14(7):750. Published 2017 Jul 10.  ​
  • Rivas, I.; Basagana, X.; Cirach, M.; Lopez-Vicente, M.; SuadesGonzalez, E.; Garcia-Esteban, R.; Alvarez-Pedrerol, M.; Dadvand, P.; Sunyer, J. Association between Early Life Exposure to Air Pollution and Working Memory and Attention. Environ. Health Perspect. 2019, 127 (5), 057002 .​
  • Rothstein, Richard. “The Color of Law.” Liveright Publishing 2017.​
  • Smith et al. Impact of London’s road traffic air and noise pollution on birth weight: retrospective population based cohort study BMJ 2017; 359 :j5299​
  • Suglia et al. “Association of Black Carbon with Cognition among Children in a Prospective Birth Cohort Study.” American Journal of Epidemiology, Volume 167, Issue 3, 1 February 2008, Pages 280–286,​
  • Suglia SF et al. Association between Traffic-Related Black Carbon Exposure and Lung Function among Urban Women. Environ Health Perspect. 2008;116 (10): 1333-1337.​
  • Wang M, Aaron CP, Madrigano J, et al. Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function. JAMA. 2019;322(6):546–556
  • Washington, Harriet. A Terrible Thing to Waste: Environmental Racism and Its Assault on the American Mind.  July 23, 2019.​
  • Weaver et al. Traffic-Related Pollutants: Exposure and Health Effects Among Hispanic Children. Am J Epidemiol. 2018 Jan; 187(1): 45–52.​
  • WHO- Components of Air Pollution. https://www.who.int/airpollution/ambient/pollutants/en/ Accessed 10/13/2020​
  • WHO- Health Effects of Black Carbon. 2012. https://www.euro.who.int/__data/assets/pdf_file/0004/162535/e96541.pdf​
  • Yang WS. “An evidence‐based appraisal of global association between air pollution and risk of stroke.” Int J Cardiol. 2014;175:307–313.

 

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