There are many elements of air pollution that can affect our health. I have often covered the health impacts of PM2.5, which makes up part of the air quality index or AQI. The other main component of the AQI is ozone. Ozone is interesting because it is actually a secondary pollutant- it forms as a chemical reaction when NOx and VOCs, which are emitted from vehicle exhaust, industry, and more react with other chemicals in the air in the presence of sunlight and heat to form ozone. Ozone is “Good up high and bad nearby.” It is a very reactive compound. It can cause irritation to the airways including cough and sore throat, but it also makes it hard to breathe and worsens lung disease and increases the risk of infection. One study even showed that exposure to certain levels of ozone over 10 years was associated with the same impact on lung destruction in the form of emphysema as 29 pack years of cigarette smoking!
I worry a great deal about people with asthma and other lung diseases, and I wanted to discuss ozone with someone who researches the links between ozone and asthma.
On the podcast episode for this topic, I was joined by Dr. Nicholas Nassikas of Harvard University. He obtained his MD at Brown University, where he also did his internal medicine residency as well as his fellowship in pulmonary and critical care medicine. He is now on faculty at Beth Israel Deaconess Medical Center and a member of the Center for Environmental Health at the Harvard School of Public Health. He also serves on the ATS Environmental Health Policy Committee and studies the impact of climate change and air pollution on health.
He researches the impact of ozone on asthma, and has studied how ozone can cause people with asthma to have to go to the ER. For example, in 2010 there were anywhere from 2192 to 6866 extra ER visits for asthma exacerbation due to summertime ozone across New England. That is just the tip of the iceberg, because for everyone whose asthma gets so bad they have to go to the ER, there are many more who have to miss work or school or go to the doctor or urgent care and fill additional medication prescriptions, also generating significant healthcare costs. Dr. Nassikas has also done research showing that we could save millions of dollars spent on ER visits for asthma by decreasing our ozone emissions, especially in a warming climate.
I struggle to talk to patients about the impact of ozone and climate change in the clinic. It just doesn’t seem fair that people who may have disease that developed and worsened because of emissions, which they often had no part in generating, should have to stay indoors and monitor air quality to avoid having their disease worsen further.
It is staggering to think about the financial cost of all these adverse health impacts. Dr. Nassikas reviewed data from the Center for Research on Energy and Clean Air. Their analysis has revealed the stunning fact that we are spending 2.9 trillion dollars globally on the health impacts of air pollution, including $380 billion dollars per year on health impacts of ozone. Experts say we could solve world hunger with a fraction of that. The amount we are paying now for air pollution is around 3.3% of global GDP, which is far more than the cost of a rapid transition off fossil fuels.
When I think about what else we could achieve with the $790 billion we are spending on air pollution health impacts in the United States, it really does fire the imagination. Cleaning up the air saves lives and money- not only is it better for our population to have fewer people with asthma for those individuals, but also for their employers, the economy, and our healthcare costs in general. Air Health. Our Health. Our Wealth.
We all need to raise our voices about how much we are already paying to keep polluting as we are, and how much life, joy and money we could save by rapidly transitioning off fossil fuels.
What can you do?
1- Download the Airnow app or go to the airnow.gov website to become familiar with the Air Quality index, which incorporates ozone and PM2.5.
2- To learn more about PM2.5 standards and history, listen to the “What’s in a Standard” episode with Dan Costa from Season Two.
3- For more on how to use the Air Quality Index, listen to the “What’s in an Index” episode with Dr. Franziska Rosser from last season.
4- Vote for elected officials committed to addressing climate change. Write to them regularly about your concern regarding topics like ozone, which causes disease and can increase in the setting of rising temperatures.
5- Advocate for policies in your communities that can reduce ozone by decreasing use of combustion for transportation, such as more bike lanes, public transit, increased walkability and more.
6- Consider a donation to the American Lung Association, who advocates tirelessly for clean air.
7- Consider buying an Air Health Our Health T-shirt, mug, hat or tote that emphasizes the health benefits of clean air. This can help spark a conversation with those in your community. Proceeds go to the American Lung Association as well.
