August 4, 2011
Health Care Without Harm Press Release
Contact: Eileen Secrest  540-376-4495
 
Nurse Leaders Advocate for a Health Protective Ozone Standard

Washington, DC — This week nurse leaders representing Health Care Without Harm and several nursing organizations and practice areas met with officials of the White House Office of Management and Budget (OMB) to share their concerns about poor air quality and its impacts on public health.

Cleaning up ozone can save thousands of lives each year. EPA estimates that between 4,000 and 12,000 lives could be saved each year by cleaning up ozone pollution to 60 ppb. In addition, a 60 ppb standard will prevent 58,000 asthma attacks and 21,000 hospital and emergency room visits annually and 2.5 million missed work and school days.

— U.S. EPA (2009)

Forty years ago, Congress directed the U.S. Environmental Protection Agency to set official limits, called National Ambient Air Quality Standards (NAAQS), on the amount of ozone and five other pollutants that could be in the air. Congress explicitly directed the EPA to base those standards on what is needed to protect human health. In 2001, the Supreme Court unanimously ruled that the EPA has the authority and responsibility to set standards based solely on protecting public health.

Nancy Hughes, MS, RN, Director and José V. Cárdenas MD, MPH, Senior Policy Fellow from the American Nurses Association’s Center for Occupational and Environmental Health, were present at the meeting. Dr. Cárdenas offered a review of the public health implications of the current ozone standard. “The relationship between mortality and ozone exposure has been proven by many epidemiological studies. Nurses care for many patients with health effects due to ozone exposure every day. A stronger ozone standard is critical to preventing the human health impact.”

Ground level ozone is one of the nation’s most widespread air pollutants; it threatens the health of millions. Ozone burns the lungs and airways, causing them to become inflamed, reddened, and swollen. Children and teens, senior citizens, and people with lung diseases like asthma, chronic bronchitis, emphysema, and others are particularly vulnerable to the health effects of ozone.

Nurse Leaders Advocate for a Health Protective Ozone Standard

Sally Schoessler, MEd, BSN, RN, Interim Executive Director, National Association of School Nurses, participated in the OMB meeting and shared her thoughts about the special vulnerabilities of children. “Asthma is one of the most prevalent chronic conditions of childhood. Approximately 10% of school-aged children have asthma, one in every three in a classroom. It is responsible for 13 million missed school days each year.” Children rely on adults to create the environment they live in. They cannot identify threats and remove themselves from them. They rely on adults to create a healthy environment for them.

Outdoor workers and exercisers are also at higher risk. When inhaled even at low levels, ozone can cause chest pain and cough, aggravate asthma, reduce lung function, and increase emergency room visits and hospital admissions for respiratory problems. And, research shows that breathing ozone can shorten human life—can kill—at levels currently considered safe!

Air quality standards must be strong enough to protect sensitive groups, not just average healthy individuals. Under the Clean Air Act, EPA must set national air quality standards for ozone that protect public health, including the health of children, older adults and people with lung diseases like asthma, with an adequate margin of safety. Laura Anderko RN PhD, who holds the Scanlon Endowed Chair in Values Based Health Care at the School of Nursing & Health Studies at Georgetown University, expressed her concern about the effects of poor air quality on the health of older Americans. Dr Anderko noted that in 2009 approximately 39.5 million Americans were age 65 or older, this is expected to double of the next 20 years, and that a decline in respiratory function frequently accompanies aging.

Adelita G. Cantu, PhD, RN, Assistant Professor at the University of Texas Health Science Center of San Antonio School of Nursing and a member of the Board of Directors, National Association of Hispanic Nurses discussed the special vulnerabilities of Hispanic adults and children. Dr. Cantu also stressed the link between multiple asthma exacerbations and their link to poor performance academically and the long term impact of this for Hispanics.

In January of 2010, U.S. Environmental Protection Agency (EPA) Administrator Lisa Jackson announced the EPA would reconsider a 2008 decision to set the National Ambient Air Quality Standards for ozone air pollution at 75 parts per billion, a level significantly above the level recommended by their own Science Advisory Panel.

The science is clear that the current ozone standard fails to protect public health. The Clean Air Scientific Advisory Committee, EPA’s independent science advisors, reviewed the evidence from over 1,700 studies of the health impacts of ozone. They concluded unanimously that the ozone standard should be set between 60‐70 parts per billion, 8‐hour average, to protect human health.

The American Academy of Pediatrics, American Lung Association, American Medical Association, American Public Health Association, American Thoracic Society, Asthma and Allergy Foundation of America, EPA’s Children’s Health Protection Advisory Committee, Health Care Without Harm and many others have called on the current administration to set a primary National Ambient Air Quality Standard for ozone at the most protective end of the range recommended by the Clean Air Scientific Advisory Committee.

The ozone health standard must protect those who are most vulnerable from the negative health impacts of ozone, including children, older adults, and those with chronic diseases. Nurses who participated in the meeting in DC advocated for the most protective standard under consideration: 60 parts per billion (ppb) averaged over eight hours.

At the OMB meeting, Rosemary Chaudry, PhD, RN, Past President of the Ohio Public Health Association stated, “Clean air is a public health issue. Adverse air conditions threaten everyone's health and quality of life, but create an extreme hardship for our most vulnerable residents including children, older adults, people who live in poverty, and people with chronic illnesses.”

Katie Huffling, CNM, RN, a Nurse Midwife and Coordinator of Health Programs at the Environmental Health Education Center of the University of Maryland School of Nursing expressed her concern for her most vulnerable patients, pregnant women with asthma, “Ozone and other air pollutants make it harder for pregnant women to keep their asthma well controlled during pregnancy which can lead to complications for both the woman and her growing fetus. Clean air is vital for healthy moms and babies.”

To protect the health of children, the elderly and other sensitive groups, EPA should set the ozone standard at the low end of the range – 60 ppb. A standard at the lower end of the range will provide the strongest protection for public health. Groups that have called for a 60 ppb ozone standard include: American Academy of Pediatrics, American Lung Association, American Medical Association, American Public Health Association, American Thoracic Society, Asthma and Allergy Foundation of America, EPA’s Children’s Health Protection Advisory Committee, Physicians for Social Responsibility and many others.

All Americans deserve to breathe clean air and are counting on the Clean Air Act to protect the air in their communities! Nurses call on the EPA to set a health standard for Ozone that will protect the most vulnerable amongst us.

Heath Care without Harm, an international coalition of more than 500 organizations in 53 countries, is working to transform the health care sector, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment. To learn more about HCWH's work, visit our website at www.noharm.org, our YouTube channel at HCwithoutharm, and our twitter feed at hcwithoutharm.