Air: What’s in a grade?

Although Maricopa County was assigned a grade of “F” for ozone pollution and a grade of “C” for 24-hour particulate pollution in the American Lung Association’s recently released 2012 State of the Air Report, air quality professionals contend that the simple letter grade doesn’t tell the entire story of the Valley’s air, and that progress has been made during recent years in reducing air pollution.

The report says that people in Maricopa County spent 34 days breathing unhealthy air because of ozone and four days of unhealthy air because of particulates during the past three years.

Even though that equals three-tenths of one percent of days during that period, that number warrants concern because of the county’s population density, says Stacey Mortenson, executive director of the American Lung Association in Phoenix.

She has a slightly more positive take on the grade. “On the surface you might get discouraged on the grade that we have been given. But when you compare it to reports and data in the past it’s more like an F+,” she says.

Ozone is created when the sun heats up volatile organic compounds such as gasoline, car emissions, and pollution from factories, which release their vapors into the air. High above the earth, the ozone layer acts like a shield to protect life from the ultraviolet rays of the sun that can cause cancer. But when it is formed artificially near ground level and breathed, it can cause health problems.

Dr. Rajeev Saggar, director of Pulmonary Hypertension and Pulmonary Fibrosis Programs at St. Joseph Hospital and Medical Center, says as air quality in Maricopa County gets worse during the summer months, more and more people come into his clinics.

“There is no doubt on certain days our clinics and urgent care units start to full up with non-specific complaints,” he says.

Saggar, who also spent time on staff at UCLA Medical Center in Los Angeles, says the situation can also exacerbate breathing issues for people with existing respiratory issues.

It is difficult to put a direct cost of patient care due to air pollution.

But a Rand Corporation study conducted from 2005 to 2007 in California shows health care costs due to air pollution can be significant.

The study estimated that Californians spent $193 million on treatments for respiratory illnesses tied to air quality during that time period.

Eric Massey, deputy director of air quality at the Arizona Department of Environmental Quality (ADEQ), says that Maricopa County’s air quality has actually improved since the 1990s, but that the American Lung Association keeps raising the bar on standards, which means that government, industry and the general population lag behind in reducing ozone concentrations and particulate matter.

“What’s disappointing is that they give this arbitrary grade and don’t really take into account what has already progressed.” Massey says.

Mortenson, of the Lung Association, says that the report does not grade on progress. “We are grading purely on the number of days people are breathing healthy air,” she says.

She does acknowledge that air quality has gotten better, just not quite enough to move the needle on the report. “We are seeing a decrease in the number of days. It just hasn’t been enough of number of days to move into a different grade point based on our methodology,” she adds.

Judy Harris, a pediatric nurse practitioner and director of the Breath Mobile at Phoenix Children’s Hospital, says her workload always increases during days designated by local authorities as high in ozone, particulates, or both.

“It’s (poor air quality) a common trigger for many of the kids we see,” she said.

Since 2000, Harris has traveled to schools in a vehicle similar to an RV with a team of health professionals who test and treat school children for asthma for free.

“We advise them not to go outdoors on high pollution days,” she says. She also advises them to have medication such as inhalers close by in case of an immediate need.

Saggar agrees. “While it’s important as a system we are moving to a prevention modality, they (patients) should be taking precautions during those days where they are telling us that air quality is going to be poor.”

For example, older patients with known respiratory disorders should have their medicines at hand as well as their respirators and dilators, Saggar says.

A 2009 Arizona State University Study determined that high levels particulate matter in the air did correlate with the need for increased medical attention relating to asthma. The study was done in conjunction with ADEQ and the Arizona Department of Health Services. One of those researches was George Runger, a professor of engineering at Arizona State University.

“We determined a significant increase in asthma events in children 5-18, “

Runger says. “These were events serious enough to go the emergency room,” he adds.

The report, “The Children’s Health Project,” said that increased levels of particulate matter, which includes dust, contributed to a 13 percent increase in the probability of asthma incidents among children ages 5-17.

ADEQ issues high ozone warnings when monitoring stations around the state detect higher than normal levels in the air.

Those warnings should tell people who suffer from any respiratory illness to limit their time outdoors. In severe cases, some people can actually get a burning sensation in the lungs, Massey says.

Massey detailed some solutions that have led to cleaner air such as industrial scrubbers, two-stage fume recovery systems at gas pumps and better technology for limiting the release of pollutants from petroleum tank farms.

Harris also says the air quality is better. During the construction boom leading up the real estate market crash, she noticed a lot more cases of asthma probably due to the dust being kicked up by construction.

“There were many years in the Phoenix area that we could not see enough patients in a day,” Harris says.