1. Improving Life, One Breath at a Time 1-800-LUNG-USA www.lunginfo.org

2. The American Lung Association’s State of the Air Report Kevin M. Stewart Director of Environmental Health American Lung Association of the Mid-Atlantic

3. Philadelphia Diesel Difference Working Group American College of Physicians Building 190 North Independence Mall West Philadelphia, Pennsylvania Monday, May 19, 2008

4. Outline History of Report Ozone Fine Particle Pollution Note on Pittsburgh Populations at Risk Questions

5. History Evolution of Ozone Standard –1979 Standard 0.12 ppm 1-hr daily maximum, up to 3 exceedance days over three years –1997 Standard 0.08 ppm 8-hr daily maximum, 4 th highest annual value averaged over three years How to Communicate to Public?

6. History ALA Issues first State of the Air (SOTA) Report in 2000, assigns grades and ranks Covered Ozone Data 1996-1998 Evolution of Particle Pollution Standard –1987 PM 10 150 μg/m 3 daily standard –1997 PM 2.5 65 μg/m 3 daily standard Implementation delayed by lawsuit until U.S. Supreme Court decision 2001

7. History 1997 PM 2.5 Daily Standard with Unhealthy for Sensitive Groups level at 40 μg/m 3 SOTA Report 2004 includes PM 2.5 for the first time, using same day-counting method 2006 PM 2.5 Daily Standard set at 35 μg/m 3 (annual unchanged) SOTA Report 2007 uses new PM 2.5 Std.

8. History 2008 Ozone 8-hour daily maximum Standard set at 75 ppb SOTA Report 2009 to use new Ozone Standard

9. Ozone Health Impacts –Pulmonary inflammation –Shortness of breath –Chest pain when inhaling –Wheezing, coughing –Asthma attacks

10. Ozone Health Impacts –Increased susceptibility to respiratory infections and to allergens –Increased need for people with chronic lung diseases to require medical treatment –Permanent decrement in lung function from long-term exposure –Cardiac arrhythmia+ link –Premature death (~3700/10 ppb /yr)

11. Ozone Populations at Risk –Infants, children, teens –Seniors –People with existing lung diseases (asthma, chronic bronchitis, emphysema) –Outdoor workers and exercisers –“Responders”

12. Ozone Trend in Phila - C - V CSA

13. Ozone Trend in Philadelphia County

14. Ozone Trend in Philadelphia County

15. Ozone Grades in Pennsylvania SOTA 2000 Report –22 F’s, 1 D, and 1 C..... SOTA 2006 Report –29 F’s and 2 D’s. SOTA 2008 Report –8 F’s, 8 D’s, 5 C’s, 8 B’s and 2 A’s

16. Fine Particle Pollution Health Impacts of Short-term Exposure –Pulmonary inflammation –Exacerbation of asthma Symptom days / Attacks / ER visits / Hospitalization –Increased respiratory ER visits –Increased numbers of heart attacks –Increased hospitalization for cardiovascular disease, including strokes –Increased mortality in infants and young –Premature respiratory and CV deaths

17. Fine Particle Pollution Health Impacts of Long-term Exposure –Increased hospitalization for pediatric asthma –Significant damage to bronchioles –Slowed lung function growth in children and teens –Increased risk of lung cancer death –Increased risk of death from cardiovascular disease –Premature births

18. Fine Particle Pollution Populations at Risk –Infants, children, teens –Seniors –People with existing lung diseases (asthma, chronic bronchitis, emphysema) –People with sensitive airways –People with heart disease –People with diabetes –Women over 50

19. Trend for Long-term PM in Phila - C - V CSA

20. Rankings for Long-term PM in Phila - C - V CSA

21. Rankings for Long-term PM in Philadelphia County

22. Grades for Long-term PM in Pennsylvania SOTA Counties Report Year FailingPassing 2004 11 6 2005 11 9 2006 10 10 2007 13 11 2008 7 11

23. Trend for Short-term PM in Philadelphia County

24. Rankings for Short-term PM in Philadelphia County

25. Grades for Short-term PM in Pennsylvania SOTA Counties with Grades Report Year F D C 2004 16 3 4 2005 17 5 1 2006 12 4 8 begin use of more stringent standard… 2007 21 1 2 2008 18 1 2

26. Note on Pittsburgh Comparison of Trends in Annual Average Fine-Particle Pollution for the Pittsburgh and Los Angeles Metropolitan Areas

27. Pittsburgh-New Castle CSA

28. Los Angeles – Long Beach - Riverside

29. Rankings for Long-term PM in Pittsburgh-New Castle CSA

30. Metro Area Component County Long-term PM Rankings

31. Populations-at-Risk CategoryPhila. Co. Phila.-C-V CSA Under 18 370,676 1,547,208 65 and Above 188,773830,364 Ped. Asthma 34,399143,581 Adult Asthma 94,765413,222 Chr. Bronchitis 46,140210,028 Emphysema 20,183 92,485 CV Disease 367,502 1,679,649 Diabetes 84,098385,159

32. A Final Thought Approximately one in ten Americans has a chronic lung disease and is at greater risk from air pollution. Infants, children, the elderly, and those with other chronic diseases are at increased risk, too. These are not faceless statistics, but people close to you: Your friends, your coworkers. Your parents, your children. Your neighbor with emphysema struggling to breathe. Your coworker who can't make it in for that important task. Your child taking that frightening trip to the emergency room. Maybe even yourself.

33. Remember: When You Can’t Breathe, Nothing Else Matters. 

34. Improving Life, One Breath at a Time www.lunginfo.org For 100 years, the American Lung Association has been the lead organization working to prevent lung disease and promote lung health. Lung disease death rates continue to increase while other leading causes of death have declined. The American Lung Association funds vital research on the causes of and treatments for lung disease. With the generous support of the public, the American Lung Association is “Improving life, one breath at a time.” For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or log on to www.lunginfo.org. The official registration and financial information of the American Lung Association of Pennsylvania may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, (800) 732-0999. Registration does not imply endorsement.