1. CHOOSE CLEAN AIR FOR CALIFORNIA RALPH JOHN DI LIBERO, MD 135 TH LACMA PRESIDENT

3. DISCLOSURE NO CONFLICTS OF INTEREST

4. SMALL LUNGS

6. What is diesel exhaust? Since 1990, diesel exhaust has been listed as a known carcinogen under California’s Prop 65. In 1998, the California Air Resources Board formally listed diesel particulate as a toxic air contaminant. A cocktail of thousands of gases and fine particles (referred to as soot) that contains more than 40 toxic air contaminants. 94% of diesel emissions are estimated to be ultrafine particles which can bypass respiratory systems and lodge deep in the lungs. Contains Nitrogen Oxides (NOx) a major component of smog.

7. Long Term Health Effects of Diesel Exposure Increased respiratory illnesses – Decreased lung function growth in children – Asthma exacerbations – Increased doctors’ visits and school absences Exposure linked to increased risk of developing lung and other types of cancer. Premature Birth Premature Birth Cardiovascular Disease

8. FINANCIAL STRAIN HEALTHCARE SYSTEM DOCTOR VISITS EMERGENCY ROOM HOSPITAL ADMISSIONS MEDICATION USE LEADING TO EDUCATIONAL LOSS JOB TIME LOSS LIFETIME PERSONAL AND SOCIETAL COST OF PREMATURE BIRTHS

9. CA FREEWAY CANCER ALLEY

10. SULPHUR DIOXIDE SO 2 Non-ferrous metal smelting, thermal electricity generating stations, oil refineries, pulp and paper plants, incinerators SHIPS TRUCKS TRAINS

12. Major Air Pollutants Ground-level ozone (O3) Nitrogen Oxides (NOx) Volatile Organic Compounds (VOCs) Sulphur Dioxide (SO2) Carbon Monoxide (CO) Airborne particles (PM) Other contaminants

13. Ozone (O 3 ) (Smog) (Photochemical reaction) Ozone - good up high, bad nearby += EmissionsSunlightOzone (smog)

16. WE MUST FORCE OURSELVES TO SEE WHAT CAN BE FORESEEN

18. Victim of PUTRID AIR: Pre Term