non: [00:00:00] You are listening to the ATS Breathe Easy podcast brought to you by the American Thoracic Society.
Patti: Hello, and welcome to another episode of ATS Breathe Easy. I'm your host Patty Tripathi. President Trump's administrator of the Environmental Protection Agency has announced a barrage of deregulatory actions designed to roll back current EPA regulations to reduce air pollution, emitted from major sources of pollution, including power plants, industrial facilities, and from cars and trucks.
EPA also announced plans to target dozens of environmental protections with an intent of easing regulations on businesses. But what will these policies mean for the health of the [00:01:00] American public and for the environment we live in? To discuss what the EPA announcements mean are the chair and vice chair.
The American Thoracic Society's Environmental Health Policy Committee, Dr. Allison Lee and Dr. Jillian Goby. Dr. Lee is a pulmonologist at Mount Sinai in New York, and Dr. Goby is a respiratory medicine physician at St. Paul's Hospital in Vancouver, Canada. Welcome to both of you. Thank you for joining me, Lisa.
Thank you for having us. We recently announced his intention to reconsider. 31 historic actions undertaken by the agency, including regulations on air pollution, emission, and greenhouse gases. Can you tell us what this means for public health? Dr. Lee and Dr.
Alison: Yes, of course. And, and Patty, thank you so much for having us here today to speak to the [00:02:00] broader ATS community and our patients about the importance of these rollbacks.
So, as you mentioned, the US EPA administrator recently announced rolling back several major EPA policies. And these policies are really critical to protect us. Our families and the communities that we serve from harmful air pollution, water pollution, and other environmental toxic exposures. To put it simply, Patty, the EPA rollback of these policies will increase unhealthy pollution that big businesses can emit.
And I think to sort of shine some light on the policies, you know, 31 policies are, are too many to, to go into detail. But I just wanna sort of discuss briefly a few key proposed rollbacks. I. So the first is around mercury. And Mercury is a toxic and deadly [00:03:00] substance that is released from power generation facilities and currently is regulated by the EPA.
And we know from strong scientific evidence that even small amounts of mercury exposure can cause, for example, neurological damage in young children resulting in disease and permanent brain damage. Despite the strong scientific evidence and the evidence that the current regulations through the Mercury Air toxic standard has protected our children, the EPA has put forth its intent to roll back this important regulation.
That's just one. Another for example is ozone. We know that ozone is a powerful air pollutant. It triggers asthma attacks, COPD exacerbations and contributes to many days of missed work of missed school [00:04:00] for adults and for children across the country. And I just wanna say, as a parent, I know how difficult it is when our kids are sick and when they're missing school.
And so if the EPA were to successfully roll back ozone regulations we believe that ozone pollution will increase across the United States, and this means that our kids and our patients with asthma, COPD will have more exacerbations, more emergency room visits, more hospitalizations. And then the final rollback that I wanted to just briefly mention here is the rollback for limiting particulate matter pollution.
And the science here is really strong. In fact, the Lancet publication recently listed. Particulate matter pollution as the number one risk factor for disease burden across the world. [00:05:00] And so by rolling back protections for particulate matter we know then that cases of respiratory disease, cardiovascular disease, and even premature death will rise.
And so this is only just three of the proposed 31 rollbacks. So I think, you know, just to take a step back and look at the larger picture, it's really important for all people listening for our ATS community and for all Americans really to understand that rolling back these policies means poor health for our communities, for our patients, and for our own families.
That rolling back of these policies really means a less healthy America. Thank you,
Patti: Dr. Goby. If you can just jump in here. The moves toward deregulation of air pollution and greenhouse gas emissions regulations fly in the face of the historical mission of the EPA.
Gillian: Yeah, that's exactly right Patty.
And thank you so much for [00:06:00] having us here to talk about this today. So the EPA was established in 1970, actually under the Nixon administration, and this was in the setting of increasing concern about air and water quality throughout the us. Primarily in the 1960s. Sixties, and it was really Rachel Carson who shone a light on this issue of air and water quality, particularly water quality implications from pesticide use that was harming human and animal health across the us.
And this was published in her book. Silent Spring. And that really brought to the attention of many Americans throughout the country how air and water pollution could impact human health. And that led to the development of the EPA that was established with the primary purpose of ensuring that Americans have clean air, land, and water, and that national efforts to reduce environmental risks were based on the best available scientific evidence.
So these remain the [00:07:00] primary legislated mission of the EPA. And if these regulatory rollbacks succeed, the EPA we think will fail to achieve that mission.
Patti: The policy change appears to underpin many of the EPAs climate regulations. What are some of the consequences of good air and bad air? What studies conclusively show reducing air pollution improves our lives.
Alison: I think this is a really critical point that there is strong and convincing science that supports the relationship between air pollution and health. And further that shows that policy led reductions in air pollution improve health. And so scientific evidence including, um. A lot of scientific evidence produced by, by ATS members finds time and time again, that long-term or [00:08:00] short-term air pollution, air pollution that is above at and even below current standards or regulations harms human health.
And so. You know, I think that the science is so clear that even just last year, the EPA lowered the fine particulate matter standard to a more health protective standard, and that science has not changed. So I just wanna highlight, you know, take the time to highlight just a few studies that I think have really demonstrated that policy led reductions in air pollution.
Do improve health. And so the first, for example, is a large body of evidence that has come out of California through the Southern California children's health study. And this study showed that not only did policy lead to reductions in air pollution, but that children who were growing up in times of lower air pollution, [00:09:00] again, that policy led reduction in air pollution have better health, they had less asthma.
They have better lung function amongst many different health outcomes. There's also the Harvard Six City study that was published way back in 1993, which demonstrated differences in mortality amongst people living in a higher polluted city versus a less polluted city. And then also, you know, just to bring attention to real life examples that you know, that, that you may remember, for example, thinking about the Olympics and how Olympic policy has led to a really acute reduction in air pollution.
So this happened in Atlanta during the Summer Olympics in 1996 and more recently during the Beijing Olympics, where due to Olympic. Committee requirements of a reduction in air pollution exposure. We saw in real time [00:10:00] improvements in health outcomes amongst the population living in the vicinity. So, for example, in asthma, we, or in Atlanta, I.
We saw a reduction in asthma attacks for kids who were living in that area during the Olympics. We saw the same thing in Beijing, and of course these effects reversed after the Olympics was over and air pollution went back up. So there's so much evidence out there pointing to the harms of air pollution and also really strong evidence saying that these.
Policy led reductions in air pollution do improve the health of our communities.
Patti: And you have personal experience from this in your family.
Alison: Yeah. Patty, as you know I'm also a mother of a young child who has asthma. And I'm fortunate to, to understand the relationships between air pollution and health.
And my son is now five. [00:11:00] When he was very young his asthma was quite severe. And we were living in New York City living near a busy roadway and he was having frequent asthma exacerbations. And I'm sure for all the parents out there listening, it is so difficult when you have your child sick in front of you telling you that they can't breathe.
And so, you know, just because of, of how severe his asthma was, we made the decision over a year to go to leave New York City and actually move to the suburbs where the air quality was better. And it has been night and day since we moved. And, you know, just to point out that this is not just my personal story.
I also wanna highlight the story of Ella Kissy, Debra who, I don't know if, if our listeners are aware, but. She is a 9-year-old girl who lived in the uk [00:12:00] and actually died from an asthma attack resulting from air pollution exposure. And I, I recently had the honor of hearing her mother speak.
Her mother is now a major advocate for clean air and the fact that that clean air is a human right. And she spoke about the fact that she did not know at the time that the trucks and cars that were driving by her apartment were what was making her daughter sick. And she said that she has to live with the fact every day that if she had just known it, that she, you know, if she had been able to move that her daughter might be alive today.
And it's, you know, it is such a heartbreaking story. And I think really speaks to our responsibility as, you know, as healthcare providers to educate the community. But also the responsibility of our [00:13:00] governments and the EPA to leverage its regulatory authority to reduce air pollution. So that all kids and, and all, all people across the globe really can breathe clean air.
Patti: Not, not everyone has a luxury of just moving to the suburbs. Exactly, exactly.
This,
Patti: Sounds like a consequential policy shift. If these potential actions are harmful to public health, as both of you say, and we all know, why do it, who benefits and what cost, who would be hurt?
Gillian: Yeah, that's, it's a very important question, Patty, and I think it's important for all of us to consider this.
So if current EPA policy is changed, it's likely that big businesses, like power companies, car manufacturers, and other large scale industrial emitters will benefit from this deregulation. Scaling back on air and water quality regulations will enable [00:14:00] industries to skimp on installing pollution, controlling equipment in their factories.
And in all likelihood, this will contribute to increases in air pollution in the air that we breathe. And this will force the public and our healthcare sea. Systems to deal with the real cost of these harmful exposures. So for example, current EPA regulations have encouraged a power industry to retire its oldest and dirtiest power plants such as coal-fired power plants and replace them with newer plants that emit far less pollution.
And the great thing was that industry was cooperating with these nudges from the EPA. Rollback of these critical regulations will provide industries now with every incentive to keep those dirt dirty, old power plants in operation, and that will continue to pump out tons of toxic pollution into the air that we breathe.
What's really unfortunate in this scenario is that technologies exist today that these industries have already been adopting to meet current EPA policies. And in fact, the majority of power plants [00:15:00] already meet EPA Mercury and air toxic standard policies. So rollback of these regulations will, in all likelihood lead to these industries, taking step back steps backwards in their commitments to preserving the health and environment of the communities in within which they operate.
And the losers in this scenario are everyone who breeds, but especially vulnerable populations like the very young, the elderly, and people with underlying health conditions, particularly respiratory conditions like asthma, COPD, interstitial lung disease, and individuals with cardiac cardiac diseases as well.
And that's a lot of vulnerable people. Literally millions of people that EPA right now seems willing to put in danger through air and water quality, deregulation, and as well as the elimination of the endangerment finding, which recognizes how greenhouse gas emissions and climate change present a threat to human health.
What's more is the cost of additional disease, onset [00:16:00] hospitalizations and deaths related to these increases in pollution in the face of deregulation will disproportionately fall on the most vulnerable communities as well as our already struggling healthcare systems. It's, it's a lot to swallow.
We'll be right back.
non: The ATS 2025 International Conference returns to San Francisco, May 16th to the 21st. Members get a discount on conference registration, so become an ATS member or renew your membership to take advantage of these savings at ATS 2024. You can network with colleagues. Find your next research collaborator.
Listen to patient stories and get inspired and be among the first to learn about breaking news in pulmonary medicine. Register now to attend. Go to conference.thoracic.org today.
Patti: We know clean air is good for you and dirty air is [00:17:00] bad for you. Science tells us so. So are you aware the EPA is also considering eliminating its science arm that is the Office of Research and Development as an EPA National Program Office, a proposed plan reportedly calls for the elimination of 50% to 75% of the office is 1500 plus staffers.
That's frightening.
Alison: It is, and I think I'm really glad that you brought it up, Patty, because I think it's important that we all, you know, take a step back and understand really the broad scope of what is being proposed at the EPA. And so, you know, the EPA administrators. Proposal to either significantly cut back or completely eliminate the Office of Research and Development, or ORD is a critical step [00:18:00] to deregulating the environment.
And this is because the ORD conducts. Critical scientific research and also synthesizes all available scientific research so that we can better understand how air pollution impacts health. So, for example the ORD produces a document that's called the Integrated Science Assessment, or ISA.
For different pollutants. And this helps not only policy makers, but also us as healthcare providers, as patients, as patient advocates to understand the broad reaching implications of air pollution. These documents also have global impact are leveraged by researchers and governments across the world and really support the foundational principle that clean air saves [00:19:00] lives and is good economic policy.
And so this work by the ORD is really critical for translating science into policy. And without the ORD or even with a severely scaled back version of the ORD it's gonna severely limit the ability of the EPA to enact these health protective policies. And so as we've been discussing, we really need the EPA, you know, at its current strength and its Health protective policies.
Patti: Anything to add Dr. Kuby.
Gillian: I mean, I think I want to just reiterate that the scientific investigation is core to the legislative mission of the EPA. So this move to get rid of the ORD at EPA is reflective of a broader attack on science that's occurring throughout US federal agencies right now. And that also includes other agencies like the NIH, the [00:20:00] CDC, niosh and and other agencies across the government.
Science is meant to be nonpartisan or nonpolitical. This is a search for truth and the scientific basis is essential to the mission of improving the health and wellbeing of all Americans, and really people across the globe to continue researching the impacts of the environment on human health.
Patti: A friend of mine who's a national correspondent in Washington DC said us covering all of this has been like drinking water through a fire hose.
So much going on. So most of our discussion has focused on how these EPA changes will impact air pollution emissions in the us. Does this policy change have international implications?
Gillian: Yeah, I can address that as the, the Canadian on the call. But but also thinking about broader, broader global implications.
There's a huge potential for major global [00:21:00] implications of the rollback of EPA regulations and functions for decades that EPA has stood out as a shining example, providing international leadership in developing policies to control air pollution. Water pollution, toxic chemical emissions, and more recently dangerous greenhouse gas emissions that contribute to climate change.
The tech technical expertise, scientific advancement, and international collaborations that the U-S-E-P-A has established, has provided assistance to other nations across the globe to address environmental pollution and climate change. So without US leadership in this space and without the availability of this.

Critical environmental information and resources that are supplied by the EPA. I truly believe that the scientific and public health missions of global agencies will suffer, and this will in all likelihood, hamper global progress to address some of the greatest public health rests of our time, which are air pollution and climate change.
Dr.
Patti: Lee would you like to [00:22:00] highlight
Alison: some of these
Patti: rollbacks?
Alison: Yeah. I just wanna really emphasize a critical point that Dr. Goby. Just made about the need for an importance of the incredibly high level science that's produced by researchers in the United States, often funded by government agencies such as the NIH, NASA Department of Defense, among others on the health impacts of air pollution not only for Americans, but also others globally.

I think it's important for us to remember that science doesn't have any boundaries, and so if high quality evidence shows that air pollution is harming the health of our children here. In America then air pollution is harming the health of children in Europe, in Asia, in Africa and beyond. And I think it's also important for us to remember that air pollution doesn't respect geographical boundaries.

And we've all seen this [00:23:00] firsthand with wildfire smoke, where people in New York, for example, are affected by what's happening in Canada or on the West coast. Um. And the EPA works really closely with global partners across a number of different topics. Vehicle emissions, transboundary pollution, methane emissions.

And so weakening, the EPA and its regulatory positions are really gonna hurt these global partnerships. And I also wanna highlight, you know, just another example of the importance of having a strong federal government stance on air pollution. And that is that the US government for decades now has been collecting and publicly sharing high quality air pollution data using monitors that are placed at US embassies around the globe.

And these data are critical not only for the health of the approximately 5 million Americans who are stationed abroad, for example, our military families or state department [00:24:00] families, but also for global health and scientific research. In many countries, these high quality air pollution monitors are sometimes the only or one of a few high quality air pollution monitors and experience has shown that when the United States is able to produce and share this high quality air pollution data, the host countries take action.

And they reduce air pollution exposure. And that is good and beneficial for the health, not only of the Americans that are living there, but for their entire communities and countries. And as I just mentioned, air pollution doesn't respect geographic boundaries. And what that means as well, particularly for states and the Western United States, is that international, you know, global communities through US air quality monitoring.

Have enacted policies that have actually improved air quality here in the United States [00:25:00] as well. And this is all really important because just a few weeks ago, the US government announced that it was no longer going to share these critical data. And this has real implications not only for Americans.
Living abroad, but also for Americans here and all of our global partners and community around the world.

Patti: So what is the American THO Elastic Society going to do about it? Can the concerned public dealing with a child with asthma like yours or COPD, do anything? And what is ATS doing?
Alison: Well, first I just wanna say that, that the ATS.
Has a long history of participating in the public comment and legal process with the EPA. And so the EPA. By law is required to uphold these regulations [00:26:00] until they are legally changed. And so the EPA needs to work through a federal notice and comments process. And as we have done in the past, the ATS intends to fully engage in these processes, and we will be submitting documents about the adverse health effects.

We will provide science that shows that policy led reductions in air pollution improve health. And we will do all that we can to protect the health of our patients. But I also, you know, and hopefully through this podcast, want to encourage the broader ATS community to act. I think that, you know, we, as air pollution experts and leaders in our community, we really need to encourage all ATS members and anyone in the public.

Who's concerned about these issues to contact their elected representatives regarding not only the attacks on public health [00:27:00] but also the attacks on science. And we need our ATS colleagues who you know, are, are. On an everyday basis, speaking with patients, with families, with community members to educate your patients on the importance of, of air pollution and other pollutants on health.
I think that this is really a, a central. Obligation for us as trusted members of the community, as trusted voices within the community. We need to make sure that our patients have the knowledge and the tools to advocate for their health. And so, again, just to sort of go back to the story that I told and to amplify Ella's very powerful story and her mom's, you know, continued grief over not knowing that air pollution.

You know, that was produced by, by vehicles, by trucks and [00:28:00] cars that passed by their apartment every day where, what was killing her daughter. You know, it's been over 10 years since Ella died and we still have so many people. Who are unaware of the health harms of air pollution. And we are in a really unique position to change that.

So I think, you know, I think ATS we're gonna do our part. We're going to, you know, play as key a role as we can in the process. But I just wanna encourage anyone out there listening. If. You know, if this impacts you, if, if, if you're bothered by what we've talked about here, please reach out to your, your your congress people, to your senators, to your attorneys general.

I. It's critically important that we have a voice. And also please, you know, educate your patients. Talk to your patients and community members because I think if we can let people know what's going on and let people know how important it is to their [00:29:00] health I'm convinced that my fellow Americans will act.

Patti: Thank you both. Dr. Lee is a pulmonologist at Mount Sinai, New York. Dr. Goby is a respiratory medicine physician at St. Paul's Hospital in Vancouver, Canada. Both are the chair and vice chair of the American Thoracic Societies Environmental Health Policy Committee. And I thank you for joining us.
Very, very insightful. Thank you. Thank you, Patty.

non: Thank you for joining us today. To learn more, visit our website@thoracic.org. Find more ats, breathe Easy podcasts on transistor, YouTube, apple podcasts, and Spotify. Don't forget to like, comment, and subscribe, so you never miss a show.