Dr. Robert Wahl

Air pollutant exposures are associated with adverse birth outcomes and worsening symptoms of asthma, heart disease, and other chronic diseases. How can Michiganders track local forecasted air quality? Robert Wahl, DVM, MS, assistant professor in the College of Human Medicine’s Master of Public Health program, explains how.

Smoke from the recent Canadian wildfires will likely have greater health effects on people who already experience poor air quality on a daily basis. Air pollutants have additive effects, so vulnerable people, including children, pregnant women, the elderly and those with chronic health conditions such as asthma, COPD (chronic obstructive pulmonary disease) and heart disease, living in low-income areas with higher levels of air pollution, add wildfire smoke on top of their day-to-day exposures. As total exposures to air pollutants and smoke increase, the risk for severe health effects increases, and asthma attacks and heart attacks are more likely in those with asthma and heart disease. In addition to increasing numbers of wildfires due to climate change, ozone levels are likely to continue to increase in the summer months. Ozone is an airway irritant, and it is added on top of a person’s air pollution and wildfire smoke burden, increasing the number of asthma attacks among people with asthma and COPD.
Detroit air quality improved steadily over the last 20 years. However, American Lung Association ranked Detroit in the top five percent of all the cities they measured in annual particle matter (PM) pollution, so there is more work to do. Southwest Detroit suffers from higher levels of air pollution, and this pollution affects the entire city. Sources include a heavy concentration of vehicles, an oil refinery, a steel mill, a wastewater treatment plant, two power plants (one coal-fired, one gas-fired), three heavily-trafficked highways, and a six-lane bridge to Canada.

The Environmental Protection Agency (EPA) and the Michigan Department of Environment, Great Lakes and Energy (EGLE) Air Quality Division (AQD) are constantly monitoring our air quality throughout the state, but, for good reason, a lop-sided number of their air monitors are in these industrial areas of Detroit.

EPA and EGLE AQD share these air monitoring and air quality data with citizens in the form of the Air Quality Index (AQI) and Enviroflash. The AQI index for reporting daily air quality indicates how healthy or unhealthy the ambient air is. The index is calculated for four major air pollutants regulated by the Clean Air Act: ground‐level ozone, PM, carbon monoxide, and sulfur dioxide. For each of these pollutants, EPA has established national air quality standards (NAAQS) to protect public health. EPA and EGLE AQD offer Enviroflash, and it provides local forecasted air quality reports through email to citizens. AQI and Enviroflash allow people to avoid high air pollution exposure days by changing plans to a different part of the day or another day altogether.

Lastly, the Michigan Department of Health and Human Services (MDHHS), Division of Environmental Health, provides near real-time air monitoring levels of ozone, PM, and other air pollutants using the Michigan Environmental Public Health Tracking (MiTracking) Program portal.  The MiTracking Program gathers existing Michigan-specific environmental and health data and provides them in one online location. These data can be easily queried on the portal, with results provided in tables, charts, and maps that can be downloaded, saved, and printed. The MiTracking Program is part of the Centers for Disease Control and Prevention's National Tracking Network.

The availability of tools that allow people to know and understand the air quality in their area will enable people to make informed decisions to protect their health. However, air pollution is still a significant public health issue. Improvements in air quality since the Clean Air Act of 1970 have reduced air pollutants to levels below the NAAQS, in which air pollution can no longer be seen. Even at these low levels, air pollutant exposures are associated with worsening asthma and heart disease symptoms, adverse birth outcomes (pre-term birth, small for gestational age, low birth weight), etc. Many people with chronic illness must always be careful.

Not surprisingly, the asthma burden in Detroit is greater than the overall asthma burden in Michigan. According to the Asthma Prevention and Control Program at MDHHS, in 2016, the prevalence of current asthma among Detroit adults was 29% higher than in Michigan as a whole, and the rate of hospitalizations for asthma was more than three times greater for Detroit residents than for Michigan residents as a whole. Furthermore, the rate of asthma hospitalizations for white persons in Detroit was about 35% lower than the rate among black persons in Detroit.

Important research at MSU continues to measure the connections between air pollutants and harmful health effects. I have worked on a couple of sides of this air pollution/chronic disease equation. As an Environmental Epidemiologist at the MDHHS for 15 years, I researched the effects of air pollution on health in collaboration with researchers at Michigan State University and the University of Michigan School of Public Health. The next five years were spent practicing chronic disease epidemiology at MDHHS, where I learned to deeply understand the struggles of living with chronic illness and the effects of exposure to air pollutants on their daily lives.

I am interested in how living near high-traffic areas, railways, and industry (auto body painting facilities, coal-burning power plants, steel plants, etc.) affects health. My previous research in this area found an increased risk for severe asthma attacks in children living close to highways in Detroit. Earlier research found associations between exposure to pregnant women of certain air pollutants and increased risk for adverse birth outcomes.

It is important to note that communities with low income and minority residents are more likely to live in or near high-pollution areas. These communities are also more likely to have higher rates of asthma, heart disease, and other chronic illness due to low or no access to care, lack of insurance, difficulty with transportation to health care, etc. To compound bad situations, these same folks living in high pollution areas and experiencing more chronic disease are seeing their symptoms get worse DUE TO air pollution exposures.   

We must teach our MSU Master of Public Health (MPH) students the importance of air quality and how it relates to public health. It is vital to understand the inequity in exposure to air pollution among high-risk, low-income, and minority people and the health disparities caused by environmental and social factors. Every student that leaves MSU with an MPH should be encouraged to argue for improved air quality and fair and equitable placement of facilities that release air pollutants. If we generate a few environmental public health practitioners, that would be fantastic too.

 

Updated June 28, 2023

Originally published May 24, 2021