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No Escape 

Scientists' concerns mount over the health impact of tiny toxic airborne particles.

Beginning in 1922, various incarnations of the local "Sunshine Climate Club" have sold Tucson as a health haven for people suffering from respiratory diseases. Thousands of people have come here from around the country seeking a "cure." One of these is long-time Tucsonan Judy Gray.

Raised in Fargo, North Dakota, Judy was a healthy toddler. But by age six she had developed a severe case of asthma. Her widowed mother tried numerous doctors, treatments and even quacks without success. When one physician predicted Judy wouldn't survive another northern winter, the family in 1940 headed for Tucson.

Judy continued to have problems throughout grade school, sometimes spending weeks in bed propped over pillows in order to breathe, but by junior high Judy's life had returned to normal. Since then, she's had asthma ups and downs. Right now the disease is pretty much under control.

Judy worked on the fourth floor of downtown's Valley National Bank building in the early 1950s. She remembers the first time she saw a little line of brown haze across the bottom of the Catalina Mountains in 1958. She watched it increase over the years. One traffic-congested Rodeo Day in the early '70s when the parade was still downtown, she recalls not being able to see the nearby Tucson Mountains because of the haze.

The cause of that haze, and the many that have followed, are trillions of tiny particles, each the size of a human hair divided up one thousand times. Scientists say evidence is mounting that these tiny toxic particles might be causing health problems for many people in Tucson like Gray, and especially for children. Despite that, our state and local governments are doing almost nothing to even monitor them, let alone control them.

Regulators call these particulates, and the smallest and most deadly are referred to as PM-2.5. They can penetrate all respiratory defenses and enter the lung's air-sacs, causing irreparable damage. Dr. Mary Kay O'Rourke of the University of Arizona's College of Public Health states there is a preponderance of evidence that, "in children, a presence of PM-2.5 particulates raises the risk of lung disease."

Microscopic PM-2.5 particulates, along with larger PM-10 particles, come primarily from automobiles and diesel vehicles. A 1991 study conducted for the Arizona Department of Environmental Quality found that diesel vehicles contribute roughly one-half of exhaust pollution, though they comprise only 5 percent of the vehicles on our roads.

An apparent link between these diesel emissions and poor health is now subject to intense scientific scrutiny. O'Rourke believes research soon could show that "combustion products in diesel may be a major environmental pollutant damaging to public health."

"Right now there are hundreds of studies underway and reports being issued about the hazards of PM-2.5 and its relationship to diesel emissions," said David Feuerherd, a vice president of the American Lung Association of Arizona.

"And with every report the news keeps getting worse," adds Feuerherd. "For the past four years we have been working to get the Arizona Legislature to pass a bill bringing safer diesel to Arizona. Special interest groups, including the trucking and oil industries, construction and farming, have spent nearly $3 million to successfully block this important public health legislation. But we'll keep trying."

In Tucson, both PM-2.5 and PM-10 particulates have been a problem for decades. With a huge explosion of suburban sprawl starting in the 1960s and the increasing use of cars and trucks to drive farther and farther each day, the problem is worsening.

In 1999, according to Environmental Protection Agency particulate records, Tucson had only 181 "good days." There were also four "unhealthy days," meaning if you were already vulnerable, your next breath could be painful, or even your last.

Local air quality officials believe 1999 was an especially bad year because of the weather. In 2000, Tucson had 250 "good days" for particulates. But Beth Gorman, program manager for Pima County's Department of Environmental Quality, says particulate pollution "is something we're always going to be struggling with."

More research is underway because of growing concern in the medical community about PM-2.5. For example, Dr. Uwe Manthei, an adult and pediatric specialist at the Alvernon Allergy and Asthma Clinic, is worried that children who live near freeways are exposed to increased levels of diesel and other fine particulates. These children, he believes, are at a much higher risk of severe asthma attacks.

Manthei worked with Dr. Wayne Bryant and Dr. Paul Enright on a Tucson Inner City Asthma Study, the results of which should be published soon. Manthei tracked emergency room visits for pediatric (childhood) asthma from 1993 to 1999 and found the majority of cases occurred in children living along the Interstate 10 corridor between Marana and Ajo Way.

That research adds to other recent conclusions about PM-2.5. Last December, the highly respected New England Journal of Medicine published an article by Dr. Jonathan Samet and others, "Fine Particulate Air Pollution and Mortality in 20 U.S. Cities 1987-1994." This study found an undeniable link between fine particulate pollution, PM-2.5, and the death rate. It's a linear relationship: as fine particulate pollution goes up, no matter where the city, deaths from cardiovascular and respiratory illnesses go up--and in direct proportion.

James Ware of the Harvard School of Public Health wrote in an editorial in the same Journal issue, "The epidemiological evidence suggests that the association between the fine-particle concentrations and mortality (death rate) is linear across the entire range of current concentrations."

Ware called for "an aggressive research program" to learn more about the harmful components of PM-2.5, their sources, and how governments best can reduce them to protect public health. "In the meantime, these results present a challenge to policy makers who are required to protect the public's health with an adequate margin of safety," he added.

There are only two PM-2.5 monitors in all of Tucson and local public health experts believe they might be poorly sited. "It is unfortunate that none of the monitors have been placed close to the interstate, given what we know about the negative effects of diesel-exhaust particulates on the lungs, and in particular on the lungs of children who have asthma," Enright said. "PM-2.5 monitors are the best measures for diesel. Maybe doctors who see kids with asthma and those who place the monitors are not talking enough."

O'Rourke agrees. "It is a real concern that we do not have more monitors for PM-2.5, especially along I-10 with so much diesel exhaust," she said. "These are the particles in our air that research has shown have the greatest impact on public health. (But) I'm a professor of aerobiology and I can't tell you the state of PM-2.5 in Pima County. I don't believe anyone really knows. We don't have enough data."

It's not only a lack of PM-2.5 monitors that worries public health experts. The legitimacy of federal EPA standards for it, and for PM-10, are suspect. The EPA itself concedes that with the current standards, too many Americans are suffering as a result of air pollution. EPA experts wrote in 1996 of particulates, "staff cannot conclude that the current standards protect public health with an adequate margin of safety."

The American Lung Association has been in agreement for years. It developed standards for particulates more protective than the EPA's.

"We have not been satisfied with the EPA standards for some years now," said Jennifer Jones, regional executive director of the American Lung Association of Arizona. "Politics have prevented the EPA from adopting standards that truly protect public health ... there is growing evidence that asthma and other lung diseases are aggravated by currently 'acceptable' levels of particulate pollution."

More than eight years ago, Tucson attorney David Baron petitioned the state of Arizona to lower the PM-10 standard by two-thirds in order to protect human health. The request was rejected.

Dr. Fernando Martinez is a world-renowned expert on pediatric asthma at the University of Arizona's Respiratory Sciences Center, where he is director. He now is engaged in a study of the chemicals within fine particulates, trying to isolate the deadliest killers in our air.

"It's not the dust which is the major problem," Martinez said. "It is the manmade chemicals which are carried in the dust itself. As human beings we have evolved to deal with dust. But the human body cannot evolve to disarm the barrage of chemicals we breathe in every day. These chemicals we will never adapt to."

Martinez added, "Unfortunately, diseases made worse by air pollution always have a constituency and a market. Industry favors this environment because it smells a product to be made. I work to determine factors that increase the risk of disease. But in our economy, prevention is not given a lot of attention."

Medical experts agree there is a need for more monitors to identify what is happening with our air, especially with PM-2.5, but local governments have allocated no public money for them. These monitors are inexpensive compared to other government expenditures. The cost of a monitor is only $9,000 to $12,000 plus installation; and annual operating expenses are about $5,000 per unit.

Local air-quality agencies could at least seek grants for programs that would give people immediate access, via the Internet, to the environmental monitoring now underway.

"This gives us a website that provides asthmatics with air quality data to help them make decisions about their activities outdoors," according to Dr. Jeff Burgess, a professor with the University of Arizona's College of Public Health. "It is a public service."

But what about the thousands of families that don't have easy access to the Internet?

Manthei's work has shown that while the far northwest side has the highest rate of cases in Tucson, two-thirds of children with asthma admitted to either University Medical Center or Tucson Medical Center came from poor neighborhoods. Manthei's records study found no childhood asthma admissions from the Catalina Foothills.

With any discussion of air quality, the same nagging question keeps coming up: Do all U.S. residents, regardless of where they live, have the right to breathe clean air? The natural response is yes, but the reality is too often quite different.

UA's Martinez says, "In America, everyone has a right to breathe clean air." But he adds, "Pollution, especially the mostly invisible kind we have in Tucson, is less important to people than whether they have a job or not."

Because of growth, increased driving, emissions from the Arizona Portland Cement plant in Rillito, and other reasons, Tucsonans face an uncertain air-quality future. Meanwhile, there is no political incentive to take more aggressive action on improving Tucson's or the nation's air quality. "In today's political climate, the best we can hope for is not to backslide," Martinez said.

"City and county officials are not ready to address the air quality issues because, at current EPA standards, the pollution is not bad enough yet," said Jones of the Lung Association. "But by our standard we have two or four ozone exceedences a year, and in summer the ozone levels are frequently at the high end of what is acceptable to the EPA. And even this is not totally accurate because there are very few monitors out there."

While politicians mostly ignore air-quality issues, the rest of us help to exacerbate the situation. Driving the automobile is the obvious number-one cause of local air pollution problems. But Pima County residents, instead of reducing their driving, now drive more miles than ever.

The Sun Tran bus system is an alternative, but it is losing market share because the Tucson City Council has increased Sun Tran fares and cut its service. Pima Association of Governments data shows that over the last decade, people riding the bus has fallen from 7 to 3 percent of area residents. Yet the council is considering a further reduction in Sun Tran service.

At the same time, the urban area continues to sprawl in all directions. As a recent memorandum from County Administrator Chuck Huckelberry to the Board of Supervisors noted, "As population continues to grow, Pima County is experiencing a geometric increase in daily vehicle miles traveled (VMT). For example, in 1990 the population was 667,000 and the VMT was 12,500,000 miles per day. In 2001, the population has increased 29 percent to 861,000, however the VMT has increased 60 percent to nearly 20,000,000 miles per day."

Without effective action, that figure is projected to increase by one-third, to more than 27,000,000 miles daily over the next decade.

More and more driving, in addition to worsening the particulate situation, also increases the amount of carbon monoxide and ground-level ozone in our air. The public-health ramifications of these air pollution problems seem clear. Already Tucson has one of the fastest-growing asthma rates in the country. Over the last decade, the asthma death rate in Arizona also has outstripped the national average.

Jones, of the Lung Association, said asthma is the number one reason children miss school and that one-fourth of Arizona's 320,000 asthmatics are children. Pima County is number three in the state for illness and death due to asthma, trailing only Yuma and Maricopa counties, she said. "It's just not about death, but about quality of life issues and premature death," Jones said. "It's hard for us to measure those sorts of issues."

In addition, according to a survey done last year, at least one family member in 52 percent of Pima County households suffered from breathing or vision problems because of air pollution. The American Lung Association also reports that as many as 40 percent of Tucsonans have increased vulnerability to illnesses associated with air pollution.

Lung disease is the third-leading cause of death in Arizona. Medical researchers are finding indications there might be a connection between air pollution and both immune-system disorders and allergies. But instead of prevention efforts, pharmaceutical companies sell inhalers like hotcakes, and research money pours into products to help us cope with our respiratory illnesses.

Despite the mounting evidence from around the world about the hazards of air pollution, especially airborne particulates, politicians in Pima County give the problem very little attention. The entire $2.4 million budget for the Pima County Department of Environmental Quality's air quality division comes from grants or license fees. Not a cent of local general fund tax money is invested in the effort.

At the same time, Tucson is following the same old urban automobile model used in Los Angeles and other sprawling Western cities. We say we don't want to be another Phoenix, but we are driving ourselves to that destiny.

Twenty-first century Tucson appears to be stuck in a recurring cycle of population growth, decreasing air quality, and increasing disease caused by the pollution. The assessment of the Lung Association's Jones: "I think our air quality is going to get worse, and consequently the asthma, if we don't change our approach to roads, infrastructure, and mass transit, and don't control sprawl."

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