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The Air That We Breathe: Addressing the Risks of Global Urbanization on Health
The Air That We Breathe: Addressing the Risks of Global Urbanization on Health
Source: PLoS Medicine
More than half of the world’s population now live in cities [1], and while urbanization has the potential to allow greater access to health care for all, huge discrepancies in how resources are allocated within cities result in major inequities in health [2]. Addressing these discrepancies and improving health require accurate assessment. To that point, earlier this month PLOS Medicine published a Policy Forum article by Jason Corburn and Alison Cohen that focused on the urbanizing planet and the need for health equity indicators to guide public health policy in cities and urban areas [2].
The major theme of Corburn and Cohen’s argument is that if societies are to ensure those living in the poorest urban slums have the same right to health as people living on the richest boulevards, health indicators must allow for the identification of where health inequities exist. For example, while indicators in Nairobi measure population access to communal toilet blocks, they give no information as to whether the toilet blocks are hygienic or safe to use and therefore mask inequity within the city. Such indicators, however, would have little value in cities like London or New York, which illustrates the need for context-specific measures.
Effect of Inhaled Glucocorticoids in Childhood on Adult Height
Effect of Inhaled Glucocorticoids in Childhood on Adult Height
Source: New England Journal of Medicine
The initial decrease in attained height associated with the use of inhaled glucocorticoids in prepubertal children persisted as a reduction in adult height, although the decrease was not progressive or cumulative.
See: Children Taking Steroids for Asthma Are Slightly Shorter Than Peers, Study Finds (Science Daily)
Health Benefits From Large Scale Ozone Reduction in the United States
Health Benefits From Large Scale Ozone Reduction in the United States
Source: Environmental Health Perspectives
Background:
Exposure to ozone has been associated with adverse health effects, including premature mortality, cardiopulmonary and respiratory morbidity. In 2008, the U.S. Environmental Protection Agency (EPA) lowered the primary (health-based) National Ambient Air Quality Standard (NAAQS) for ozone to 75ppb, expressed as the fourth-highest daily maximum 8-hr average over a 24-hr period. Based on recent monitoring data, U.S. ozone levels still exceed this standard in numerous locations resulting in avoidable adverse health consequences.
Objectives:
To quantify the potential human health benefits from achieving the current primary NAAQS standard of 75ppb and two alternative standard levels, 70 and 60ppb, representing the range recommended by the EPA Clean Air Scientific Advisory Committee (CASAC).
Methods:
We apply health impact assessment methodology to estimate numbers of deaths and other adverse health outcomes that would have been avoided during 2005, 2006 and 2007 if the current NAAQS ozone standards (or lower standards) had been met. Estimated reductions in ozone concentrations were interpolated according to geographic area and year, and concentration-response functions were obtained or derived from the epidemiological literature.
Results:
We estimated that annual numbers of avoided ozone-related premature deaths would have ranged from 1,410-2,480 at 75ppb to 2,450-4,130 at 70ppb and 5,210-7,990 at 60ppb. Acute respiratory symptoms would have been reduced by 3 million cases and school-loss days by one million cases annually if the current 75ppb standard had been attained. Substantially greater health benefits would have resulted if the CASAC recommended range of standards (70 to 60ppb) had been met.
Conclusions:
Attaining a more stringent primary ozone standard would significantly reduce ozone-related premature mortality and morbidity.
Racial/Ethnic Disparities in the Prevalence of Selected Chronic Diseases Among US Air Force Members, 2008
Racial/Ethnic Disparities in the Prevalence of Selected Chronic Diseases Among US Air Force Members, 2008
Source: Preventing Chronic Disease (CDC)
Introduction
Few studies have evaluated possible racial/ethnic disparities in chronic disease prevalence among US Air Force active-duty members. Because members have equal access to free health care and preventive screening, the presence of health disparities in this population could offer new insight into the source of these disparities. Our objective was to identify whether the prevalence of 4 common chronic diseases differed by race/ethnicity in this population.Methods
We compiled de-identified clinical and administrative data for Air Force members aged 21 or older who had been on active duty for at least 12 months as of October 2008 (N = 284,850). Multivariate logistic regression models were used to determine the prevalence of hypertension, dyslipidemia, type 2 diabetes, and asthma by race/ethnicity, controlling for rank and sex.Results
Hypertension was the most prevalent chronic condition (5.3%), followed by dyslipidemia (4.6%), asthma (0.9%), and diabetes (0.3%). Significant differences were noted by race/ethnicity for all conditions. Compared with non-Hispanic whites, the prevalence of all chronic diseases was higher for non-Hispanic blacks; disparities for adults of other minority race/ethnicity categories were evident but less consistent.Conclusion
The existence of racial/ethnic disparities among active-duty Air Force members, despite equal access to free health care, indicates that premilitary health risks continue after enlistment. Racial and ethnic disparities in the prevalence of these chronic diseases suggest the need to ensure preventive health care practices and community outreach efforts are effective for racial/ethnic minorities, particularly non-Hispanic blacks.
Youth Risk Behavior Surveillance — United States, 2011
Youth Risk Behavior Surveillance — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)
Problem: Priority health-risk behaviors, which are behaviors that contribute to the leading causes of morbidity and mortality among youth and adults, often are established during childhood and adolescence, extend into adulthood, and are interrelated and preventable.
Reporting Period Covered: September 2010–December 2011.
Description of the System: The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults: 1) behaviors that contribute to unintentional injuries and violence; 2) tobacco use; 3) alcohol and other drug use; 4) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection; 5) unhealthy dietary behaviors; and 6) physical inactivity. In addition, YRBSS monitors the prevalence of obesity and asthma. YRBSS includes a national school-based Youth Risk Behavior Survey (YRBS) conducted by CDC and state and large urban school district school-based YRBSs conducted by state and local education and health agencies. This report summarizes results from the 2011 national survey, 43 state surveys, and 21 large urban school district surveys conducted among students in grades 9–12.
Results: Results from the 2011 national YRBS indicated that many high school students are engaged in priority health-risk behaviors associated with the leading causes of death among persons aged 10–24 years in the United States. During the 30 days before the survey, 32.8% of high school students nationwide had texted or e-mailed while driving, 38.7% had drunk alcohol, and 23.1% had used marijuana. During the 12 months before the survey, 32.8% of students had been in a physical fight, 20.1% had ever been bullied on school property, and 7.8% had attempted suicide. Many high school students nationwide are engaged in sexual risk behaviors associated with unintended pregnancies and STDs, including HIV infection. Nearly half (47.4%) of students had ever had sexual intercourse, 33.7% had had sexual intercourse during the 3 months before the survey (i.e., currently sexually active), and 15.3% had had sexual intercourse with four or more people during their life. Among currently sexually active students, 60.2% had used a condom during their last sexual intercourse. Results from the 2011 national YRBS also indicate many high school students are engaged in behaviors associated with the leading causes of death among adults aged ≥25 years in the United States. During the 30 days before the survey, 18.1% of high school students had smoked cigarettes and 7.7% had used smokeless tobacco. During the 7 days before the survey, 4.8% of high school students had not eaten fruit or drunk 100% fruit juices and 5.7% had not eaten vegetables. Nearly one-third (31.1%) had played video or computer games for 3 or more hours on an average school day.
Interpretation: Since 1991, the prevalence of many priority health-risk behaviors among high school students nationwide has decreased. However, many high school students continue to engage in behaviors that place them at risk for the leading causes of morbidity and mortality. Variations were observed in many health-risk behaviors by sex, race/ethnicity, and grade. The prevalence of some health-risk behaviors varied substantially among states and large urban school districts.
Public Health Action: YRBS data are used to measure progress toward achieving 20 national health objectives for Healthy People 2020 and one of the 26 leading health indicators; to assess trends in priority health-risk behaviors among high school students; and to evaluate the impact of broad school and community interventions at the national, state, and local levels. More effective school health programs and other policy and programmatic interventions are needed to reduce risk and improve health outcomes among youth.
Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers
Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers
Source: Environmental Health Perspectives
Background: Diesel exhaust has been considered to be a probable lung carcinogen based on studies of occupationally exposed workers. Efforts to define lung cancer risk in these studies have been limited in part by lack of quantitative exposure estimates.
Objectives: We conducted a retrospective cohort study to assess lung cancer mortality risk in US trucking industry workers. Elemental carbon (EC) was used as a surrogate of exposure to engine exhaust from diesel vehicles, traffic, and loading dock operations.
Methods: Work records were available for 31,135 male workers employed in the unionized US trucking industry in 1985. A statistical model based on a national exposure assessment was used to estimate historical work-related exposures to EC. Lung cancer mortality was ascertained through 2000 and associations with cumulative and average EC were estimated using proportional hazards models.
Results: Duration of employment was inversely associated with lung cancer risk consistent with a healthy worker survivor effect and a cohort comprised of prevalent hires. Adjusting for employment duration, there was suggestion of a linear exposure-response relationship. For each 1000 µg/m3-months of cumulative EC, based on a 5-year exposure lag, the Hazard Ratio (HR) = 1.07 (95%CI: 0.99, 1.15) with a similar association for a 10-year exposure lag, HR=1.09 (95%CI: 0.99, 1.20). Average exposure was not associated with relative risk.
Conclusions: Lung cancer mortality in trucking industry workers increased in association with cumulative exposure to EC after adjustment for negative confounding by employment duration.
Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001–2010
Trends in Asthma Prevalence, Health Care Use, and Mortality in the United States, 2001–2010
Source: National Center for Health Statistics
Key findings
- Asthma prevalence increased from 7.3% in 2001 to 8.4% in 2010, when 25.7 million persons had asthma.
- For the period 2008–2010, asthma prevalence was higher among children than adults, and among multiple-race, black, and American Indian or Alaska Native persons than white persons.
- From 2001 to 2009, health care visits for asthma per 100 persons with asthma declined in primary care settings, while asthma emergency department (ED) visit and hospitalization rates were stable.
- For the period 2007–2009, black persons had higher rates for asthma ED visits and hospitalizations per 100 persons with asthma than white persons, and a higher asthma death rate per 1,000 persons with asthma. Compared with adults, children had higher rates for asthma primary care and ED visits, similar hospitalization rates, and lower death rates.
Adults experiencing mental illness have higher rates of certain chronic physical illnesses
A new report shows that adults (aged 18 and older) who had a mental illness in the past year have higher rates of certain physical illnesses than those not experiencing mental illness. According to the report by the Substance Abuse and Mental Health Services Administration (SAMHSA), adults aged 18 and older who had any mental illness, serious mental illness, or major depressive episodes in the past year had increased rates of high blood pressure, asthma, diabetes, heart disease, and stroke.For example, 21.9 percent of adults experiencing any mental illness (based on the diagnostic criteria specified in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)) in the past year had high blood pressure. In contrast, 18.3 percent of those not experiencing any mental illness had high blood pressure. Similarly, 15.7 percent of adults who had any mental illness in the past year also had asthma, while only 10.6 percent of those without mental illness had this condition.Adults who had a serious mental illness (i.e., a mental illness causing serious functional impairment substantially interfering with one or more major life activities) in the past year also evidenced higher rates of high blood pressure, asthma, diabetes, heart disease and stroke than people who did not experience serious mental illnesses.Adults experiencing major depressive episodes (periods of depression lasting two weeks or more in which there were significant problems with everyday aspects of life such as sleep, eating, feelings of self-worth, etc.) had higher rates of the following physical illnesses than those without past-year major depressive episodes: high blood pressure (24.1 percent vs. 19.8 percent), asthma (17.0 percent vs. 11.4 percent), diabetes (8.9 percent vs. 7.1 percent), heart disease (6.5 percent vs. 4.6 percent), and stroke (2.5 percent vs. 1.1 percent).
+ Full Report (PDF)
More Than 70 Medicines in Development for Asthma
More Than 70 Medicines in Development for Asthma
Source: Pharmaceutical Research and Manufacturers of America (PhRMA)
America’s biopharmaceutical research companies are developing 74 medicines to treat or prevent asthma, according to a report released today by the Pharmaceutical Research and Manufacturers of America (PhRMA). All of the medicines are either in clinical trials or awaiting review by the Food and Drug Administration.
…
Asthma is a narrowing of the airways to the lungs caused by inflammation in the air passages, resulting from both genetic and environmental influences. Today, more than 24 million American adults and children suffer from asthma, with the prevalence increasing 12 percent in the last decade, according to the Centers for Disease Control and Prevention. Each day, 40,000 Americans miss school or work due to asthma, costing the U.S. economy an estimated $56 billion each year in direct and indirect costs.
+ Full Document (PDF)
Consumers Rely on OTC Cough Medicines to Stay Productive at Work, School
The Consumer Healthcare Products Association (CHPA) today released the following statement regarding a new survey from the Center for Medicine in the Public Interest (CMPI) finding that the majority of adult consumers and parents in the United States rely on accessible, affordable over-the-counter (OTC) cough medicines to treat themselves and their families’ cough symptoms. CMPI’s Cough Medicine Consumer Insights national survey found that 68 percent of adult consumers agreed that OTC cough medicines allow them to stay productive at work and school, and 60 percent of parents reported that these medicines allowed their children to stay productive at school.
Non-communicable Diseases will Cost Global Economy $47 Trillion by 2030
Non-communicable Diseases will Cost Global Economy $47 Trillion by 2030
Source: Chatham House
Non-communicable diseases (NCDs) are the greatest cause of deaths and disability for humans and have a serious economic impact, says a new Chatham House paper, Silent Killer, Economic Opportunity: Rethinking Non-Communicable Disease. The cumulative losses in global economic output due to NCDs will total $47 trillion, or 5% of GDP, by 2030. The author, Sudeep Chand, says modest investments to prevent and treat NCDs could bring major economic returns and save tens of millions of lives.
NCDs, such as heart disease, cancer, asthma and depression, have their place alongside economic risks such as infectious diseases, illicit trade, migration, terrorism and food security. They have global scope, cross-industry relevance and a high economic and social impact. Economic policy-makers and businesses concerned with capital and labour costs have good reasons to consider the burdens from NCDs. Sustainable, balanced economic policy can consider low rates of NCDs as a measure of success. Where the economic benefits outweigh the costs, civil society has a major role to play in harnessing an effective response to NCDs.
Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan
Long-Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan
Source: Institute of Medicine
From press release:
Insufficient data on service members’ exposures to emissions from open-air burn pits for trash on military bases in Iraq and Afghanistan is one of the reasons why it is not possible to say whether these emissions could cause long-term health effects, says a new report from the Institute of Medicine. High background levels of ambient pollution from other sources and lack of information on the quantities and composition of wastes burned in the pits also complicate interpretation of the data.
During deployment to a war zone, military personnel can be exposed to a variety of environmental hazards, many of which have been associated with long-term adverse health outcomes such as cancer and respiratory disease. Many veterans returning from Iraq and Afghanistan have health problems that they worry are related to their exposure to burn pits on military bases. Special attention has been focused on the burn pit at Joint Base Balad (JBB), one of the largest U.S. military bases in Iraq and a central logistics hub.
Based on its analysis of raw data from air monitoring efforts at JBB conducted by the U.S. Department of Defense, the committee that wrote the report concluded that levels of most pollutants of concern at the base were not higher than levels measured at other polluted sites worldwide. Moreover, research on other populations exposed to complex mixtures of pollutants, primarily firefighters and workers at municipal waste incineration plants, has not indicated increased risk for long-term health consequences such as cancer, heart disease, and most respiratory illnesses among these groups.
Even so, the committee pointed out shortcomings in research and gaps in evidence that prevented them from drawing firm conclusions, and it recommended a path to overcome some of these limitations. Lack of information on the specific quantities and types of wastes burned and on other sources of background pollution when air samples were being collected meant it was difficult to correlate pit emissions, including smoke events, with potential health outcomes. Different types of wastes produce different combinations of chemical emissions with the possibility of different health outcomes in those exposed. Moreover, it is hard to determine whether surrogate populations such as firefighters experience exposures to pollutants and durations of exposures similar to those of service members stationed at JBB.
Associations between pre-pregnancy obesity and asthma symptoms in adolescents
Associations between pre-pregnancy obesity and asthma symptoms in adolescents
Source: Journal of Epidemiology & Community Health
What is already known on this subject
- The increased and high prevalence of children’s asthma symptoms, worldwide, is unexplained.
- Rapidly changing environmental factors that go beyond genetic predisposition are likely to explain the increase in asthma prevalence.
What this study adds
- Prenatal exposure to maternal overweight and obesity is an important risk of asthma symptoms later in life through to adolescence, after controlling for numerous relevant confounders.
- Our results suggest that maternal overweight and obesity prior to pregnancy may programme the risk of asthma symptoms in their adolescent offspring and be a new target for prevention of adolescents’ asthma and wheeze if the associations are causal.
See: Overweight Mothers Increase Asthma Risk for Their Children (Science Daily)
FDA: Over-the-counter asthma inhalers containing chloroflouorocarbons (CFCs) will no longer be made or sold after Dec. 31, 2011
FDA: Over-the-counter asthma inhalers containing chloroflouorocarbons (CFCs) will no longer be made or sold after Dec. 31, 2011
Source: U.S. Food and Drug Administration
The U.S. Food and Drug Administration says users of epinephrine inhalers containing chlorofluorocarbons (CFCs) should plan now to get a prescription for a replacement product because these inhalers will not be made or sold after Dec. 31, 2011.
Epinephrine inhalers, marketed by Armstrong Pharmaceutical Inc. as Primatene Mist, are the only FDA-approved inhalers for the temporary relief of occasional symptoms of mild asthma that are sold over-the-counter in retail stores without a prescription. The product uses CFCs to propel the medicine out of the inhaler so that consumers can breathe it into their lungs.
However, Primatene Mist will no longer be available by year’s end because no CFC-containing epinephrine inhalers can be made or sold after Dec. 31, 2011, to comply with obligations made under the Montreal Protocol on Substances that Deplete the Ozone Layer. This is an international agreement signed by the United States, in which countries agreed to phase-out substances that deplete the ozone layer, including CFCs, after certain dates.
“If you rely on an over-the-counter inhaler to relieve your asthma symptoms, it is important that you contact a health care professional to talk about switching to a different medicine to treat your asthma,” said Badrul Chowdhury, M.D., director of the Division of Pulmonary, Allergy and Rheumatology Products in the FDA’s Center for Drug Evaluation and Research.
+ Phase-Out of Epinephrine CFC Metered-Dose Inhalers
+ Epinephrine CFC Metered-dose Inhalers – Questions and Answers
+ Consumer Update: Primatene Mist With Chlorofluorocarbons No Longer Available After Dec. 31, 2011
Early Releases of Selected Estimates From the National Health Interview Survey
Early Releases of Selected Estimates From the National Health Interview Survey
Source: National Center for Health Statistics
From press release (PDF):
In this release, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) updates estimates for 15 selected health measures based on data from the January–March 2011 National Health Interview Survey (NHIS) and presents estimates from 1997 through 2010 for comparison. The 15 Early Release measures are being published prior to final data editing and final weighting, to provide access to the most recent information from NHIS. The estimates will be updated as each new quarter of NHIS data becomes available.
…
The 15 measures included in the present report are lack of health insurance coverage and type of coverage, having a usual place to go for medical care, obtaining needed medical care, receipt of influenza vaccination, receipt of pneumococcal vaccination, obesity, leisure-time physical activity, current smoking, alcohol consumption, human immunodeficiency virus (HIV) testing, general health status, personal care needs, serious psychological distress, diagnosed diabetes, and asthma episodes and current asthma.
+ Full Release (PDF)
Hospital Readmissions for COPD Highest Among Black Patients
Hospital Readmissions for COPD Highest Among Black Patients
Source: Agency for Healthcare Research and Quality
For patients age 40 and over with chronic obstructive pulmonary disease (COPD), hospital readmissions within 30 days of initial treatment were 30 percent higher among Blacks than Hispanics or Asians and Pacific Islanders and about 9 percent higher than Whites in 2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).
Based on data for patients who were hospitalized with COPD in 15 States during 2008:
- About 7 percent of patients were readmitted within 30 days principally for COPD, but 21 percent were readmitted for any health condition (all-cause readmission). There were 190,700 initial hospital admissions specifically to treat COPD at an average cost of $7,100. The average readmission cost principally for COPD was 18 percent higher—$8,400 per stay—but all-cause readmissions were 50 percent more expensive than the initial stay—$11,100.
- Readmissions were 22 percent higher among patients from the poorest communities than among those from the highest income areas.
- Readmissions were about 13 percent higher among male patients compared to females.
+ Statistical Brief #121: Readmissions for Chronic Obstructive Pulmonary Disease, 2008 (PDF)
Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial
Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial
Source: British Medical Journal
In children selected for adenoidectomy for recurrent upper respiratory tract infections, a strategy of immediate surgery confers no clinical benefits over a strategy of initial watchful waiting.
Global status report on noncommunicable diseases 2010
Global status report on noncommunicable diseases 2010
Source: World Health Organization
Of the 57 million global deaths in 2008, 36 million, or 63%, were due to NCDs, principally cardiovascular diseases, diabetes, cancers and chronic respiratory diseases. As the impact of NCDs increases, and as populations age, annual NCD deaths are projected to continue to rise worldwide, and the greatest increase is expected to be seen in low- and middle-income regions.
While popular belief presumes that NCDs afflict mostly high-income populations, the evidence tells a very different story. Nearly 80% of NCD deaths occur in low-and middle-income countries and NCDs are the most frequent causes of death in most countries, except in Africa. Even in African nations, NCDs are rising rapidly and are projected to exceed communicable, maternal, perinatal, and nutritional diseases as the most common causes of death by 2030.
Associations between pre-pregnancy obesity and asthma symptoms in adolescents
Associations between pre-pregnancy obesity and asthma symptoms in adolescents
Source: Journal of Epidemiology and Community Health
Background The high prevalence of children’s asthma symptoms, worldwide, is unexplained. We examined the relation between maternal pre-pregnancy weight and body mass index (BMI), and asthma symptoms in adolescents.
Methods Data from 6945 adolescents born within the Northern Finland Birth Cohort 1986 were used. Prospective antenatal and birth outcome data, including maternal pre-pregnancy weight and BMI, and asthma symptoms in adolescent offspring at age 15–16 years, were employed. Logistic regression analyses were performed to examine the associations between relevant prenatal factors and asthma symptoms during adolescence.
Results Current wheeze (within the past year) was reported by 10.6% of adolescents, and physician-diagnosed asthma by 6.0%. High maternal pre-pregnancy BMI was a significant predictor of wheeze in the adolescents (increase per kilogram per square metre unit; 2.7%, 95% CI 0.9 to 4.4 for ever wheeze; 3.5%, 95% CI 1.3 to 5.8 for current wheeze), and adjusting for potential confounders further increased the risk (2.8%, 95% CI 0.5 to 5.1; 4.7%, 95% CI 1.9 to 7.7, respectively). High maternal pre-pregnancy weight, in the top tertile, also significantly increased the odds of current wheeze in the adolescent by 20% (95% CI 4 to 39), and adjusting for potential confounders further increased the risk (OR=1.52, 95% CI 1.19 to 1.95). Results were similar for current asthma. Furthermore, these significant associations were observed only among adolescents without parental history of atopy but not among those with parental history of atopy.
Conclusions The association demonstrated here between maternal pre-pregnancy overweight and obesity, and asthma symptoms in adolescents suggests that increase in asthma may be partly related to the rapid rise in obesity in recent years.
NRDC: It’s Not Just the Heat, It’s the Smog Pollution
NRDC: It’s Not Just the Heat, It’s the Smog Pollution
Source: Natural Resources Defense Council
Most of the nation – from seaside suburbs to our national parks – has experienced health-threatening “bad air” days this year due to smog pollution, according to a new analysis of government air pollution data by the Natural Resources Defense Council.
Led by California, about 250 communities and parks in nearly 40 states have experienced one or more “code orange” dangerous air days this year, making it unsafe for children, older adults and people with breathing problems to go outside.
In all, more than 2,000 “code orange” air quality alerts occurred nationwide in just the first seven months of this year, with many areas having long stretches of days with bad air due to elevated smog levels.
NRDC’s analysis comes amid ongoing EPA delays for approving updated air pollution standards that could save thousands of American lives and stop tens of thousands of asthma attacks each year.
