Hi, I'm Alex Smith from Radio Ecoshock. In my last broadcast, "The Polluted Womb," we followed the science given to top government advisors, proving vehicle exhaust is poisoning a new generation. Smog causes an increase in diseases, and descreased mental capacity, starting in the womb.

Now, we investigate the other end: how people die from smog.

Unseen particles in the air shepherd us to the end, killing us by the millions. Whenever smog levels rise, victims die suddenly, slumped over in homes or offices. They die in ambulances and hospitals, despite the best medical help. For most, their heart breaks down.

It's counter-intuitive to think of air pollution as a killer of hearts, not lungs. We're going to learn how it works from one of the world's true experts, Doctor Joel Schwartz, from the Harvard School of Public Health. We'll use a briefing he gave to Congressional Staff on March 31st, 2005. I will be quoting and paraphrasing from Dr. Schwartz throughout this broadcast.

Why do people die? Of those who die from internal causes - not car accidents or hunting with the Vice President - the largest single cause of death is heart failure. Could smog be involved? Doctor Schwartz went on a 30 year odessy to uncover the role of air pollution.

The basis of the study seems simple enough. Take a polluted city, find the record of bad air days - which are often published in the daily paper - and compare the number of deaths on smoggy or clear days.

We know smog kills. The indisputable case: in 1952, London England, 3,000 thousand people died within 5 days, due to a nasty combination of fog, coal smoke, and chemicals. It was pea soup. People couldn't see more than a couple of feet. A wave of bodies arrived at the morgue. They did not die of lung disease, or the flu.

That was the real, orginal "smog" - a wet fog with hostile particles. Later, Los Angeles became famous for a differerent kind of pollution, caused by ozone hugging the ground, during air inversions. It was called "photo-chemical pollution," but people just called that "smog" as well. Both types share a key component: tiny particles incompatible with our biology.

We now know it's the particles, not sulfur dioxide gas. Studying different smog events, and through other research done in various countries, Dr. Schwartz and his team have ruled out sulfur dioxide GAS as the direct trigger for a wave of smog deaths. But, the gas combines with other chemicals to form other particles that irritate the body, adding to the chain of events resulting in sudden death.

In Europe, particles are measured by the number of micrograms per cubic meter. The authorities have decided that the 24 hour average should not exceed 65 micrograms per cubic meter. By comparison, when people smoked at the back of airplanes, they inhaled two or three hundred micrograms per cubic meter.

In North America, we only count particles 2.5 microns in diameter or less, the size that penetrates deeply into the respiratory system. These are the so-called "fine" particulates. You'll hear scientists discuss the air quality as Particulate Matter 2.5, or PM 2.5. Almost half the PM 2.5 particles come from burning carbon, and 30 to 40% come from sulfates, depending where you live. Larger particles, up to 10 microns, are called "coarse particulates."

If you lined up microns, it would take more than 25,000 of them to make an inch. The period at the end of this sentence contains at least 600 microns, maybe more. Human eyes can't see them.

But is there any safe level? Is there a threshold where the human body tolerates particles in the lungs, beyond which we die? The Harvard team selected 6 cities in the United States, ranging from the former steel town of Steubenville Ohio, to the less polluted Madison, Wisconcin. When all air quality and death rates were calculated, the scientists did NOT find any safe threshhold. There is no really safe level of exhaust particles for humans. And not just humans. When Boston street air was given to lab rats, they died too.

After 15 years of the study, statistics clearly showed: the worse the air pollution, the sooner people died. Dr. Schwartz tell us "the difference in life expectancy between the cleanest town and the dirtiest town, it's two years."

Some humans are more susceptible than others. Those with medical conditions, like diabetes, are threatened by smog. People already sick with a respiratory infection have a lower threshhold. And, it turns out, 50% of the population has a gene that helps them detoxify, which others lack. A 50-50 genetic chance.

In one study in Philadelphia, there was a 7 per cent increase in total deaths on smoggy days, compared with clear air days. But these are not just feeble people who would have died within a few days anyway. The California Air Resources Board concludes smog-related premature deaths take away 14 years of expected living, on average.

Most victims would never have guessed that smog would suddenly kill them. Yet, our method of collecting death statistics lists the cause of death as heart attack, or arrhythmia, not air pollution. Arrhythmia is "when the beating of the heart becomes incoherent." The electrical signal to beat goes haywire.

[clip hearbeat, then dis-rhythm]
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Doctor Schwartz told the Congressional staffers that based on his extensive studies, smog is killing 250,000 Americans a year. Quote, "That's more than AIDS, plus breast cancer, plus prostate cancer, plus colon cancer, put together."

Some scientists, and more vested interests, questioned his results. So Schwartz collected all his original data, going back to 1975, and sent it to an independent team for verification, plus another outside group for analysis. Results confirmed. Still, not all scientists agree with the findings, and many family doctors have not heard about the link from smog to heart failure.

How do we know fewer people die, and live longer, if we clean up air pollution? The world has a classic example in old East Germany, which was a Stalinesque smokestack state. Just a few years after re-unification, when the worst polluters were closed down, or retro-fitted to meet West German standards, the smog levels went down, and so did the health problems and deaths. Bronchitis, endemic in the former Communist state, dropped to low Western levels. The lung function of school children improve markedly, in just three years. We know that cleaning up works.


[SUPRISING THINGS]

Some people die several times - those like Vice President Cheney who have defribrilators implanted in their chests. These devices start the heart back up, and record when heart failure occured. The Harvard team checked those records, to see if hearts stopped on smoggy days or clear, and once again, smoggy days stop hearts.
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It's important to realize that most of the harmful particles that reach our lungs are not exactly what left the power plant, or the exhaust pipe. They are "secondary" particles, new chemical and metal combinations that grow from sulfur and carbon waste. Yet these secondary particles contain the fingerprints of their original source, whether trucks, chemical companies, or power plants. Scientists know, and can prove, where they come from.

[Clip4: "There was an increase in mortality associated with the particles from the coal burning power plants. There was a somewhat larger increase associated with motor vehicle particles."]

And, no, common dust particles are not killing us. Human-made ones are.

[THE PATHWAYS]

Combustion of coal or gasoline produces carbon particles, soot, but it also makes particles of various metals like nickel, iron, and more. Although not necessarily poisonous in themselves, studies show these metals act as catalysts to generate toxic chemicals that inflame and damage our circulation system. They create "oxidative stress."

Most people have heard that a oxidation can damage cells. Health conscious people look for food and supplements that contain "anti-oxidants." Now we know that a major source of this oxidation, which may limit or end our lives, comes from burning carbon fuels, especially in metal engines. Exhaust particles lead to chemical reactions in our bodies.

In addition, the disease fighting agents of the body, the macrophages, mistake industrial products for living agents. Our germ fighters try to get rid of metals and other toxic compounds - by creating inflammatory chemicals. The lung becomes inflamed, and this is the first step toward death.

All branches of medicine are now realizing the the impact of oxidative stress on most of our organs. Tests show that oxidatant compounds from pollution show up not just in our lungs, but in our hearts, within hours of exposure.

[Clip 2: Dr. Schwartz: "So particles do produce oxidative stress, oxidative stress is well established as a risk factor for cardiovascular disease, in particular, inflammatory processes associated with oxidative stress increase the risk that plaques in your arteries rupture, and that's what triggers a heart attack."]

Humans do have a series of natural anti-oxidants that combat this stress on the heart and other organs. But half the population lacks the gene that makes one of the most powerful anti-oxidant enzymes. The rest of us have some protection, but less.

Tests also show that pollution, from coal plants and vehicle exhaust, interfere with the ability of blood vessels to relax, to let blood flow where it is needed.

The first pathway to pollution heart failure is thought to be plaques from hardened arteries breaking free, to create a heart attack, or a stroke. The plaques break off due to oxidative stress, passed on from the inflammation of lungs, caused by tiny toxic particles from the air.

The second pathway involves a chain of events. The heart depends upon the nervous system for its signals. The sympathetic nervous system, linked to consciousness, is one factor regulating the heart. For example, when we are afraid, the heart might beat faster. But the heart is also regulated by a second, unconscious, called the parasympathetic nervous system. This unfelt body system can act faster to regulate the heart beat. That regulation can be disrupted by chemical changes caused by inhaling smog. Why? Because the parasympathetic nervous system is connected to all the neural receptors in the lungs. We are aware of our rib cage moving, but do not feel the lungs themselves. Improper signals from the lungs impact the most important control of the heart.

For those without the strongest antioxidant gene, a mere 10 microgram change in PM 2.5, in the Boston study, reduced the high frequency parasympathetic control of the heart rate by 37 percent. That's a big change, for a small change in smog level, imperceptible to all of us. Hearts begin to react long before the threshold triggering official smog alerts is reached. Yet, in this test, those with the magic anti-smog gene did not register any effect, with a 10 microgram change.

A Swiss study showed that asthma symptoms in kids dropped dramatically, and bronchitis rates dropped 40%, with just a 10 microgram reduction in particles. Small changes can have big benefits for the whole population.

Because particle smog affects us so quickly, a cleanup can have dramatic results.

[Clip5Dublin] "There was a ban on the use of domestic coal in Dublin, in 1990. And there was a 13 percent reduction in cardio-vascular mortality, from one winter to the next."]

A miracle story.

Meanwhile, our industrial particle clouds are all too visible from space.

[Clip3: "This is a NASA photograph of the North East [United States], and I want to point out that this white stuff here, is clouds. But this stuff, underneath, is not a cloud. That's a fine particle aerosol haze. Those are particles. The East coast of North America is blanketed with particles, in the summer. And, in the summer, almost half of those particles are sulphates, the long range transport particles, from the power plants in the mid-West. And, you don't need an air pollution monitor. You can see can see it from space."

It's much worse for China. In some areas, the satellite photos can't penetrate the thick particle smog. China is disappearing under a heavy layer of coal smoke and vehicle exhaust. Millions are dying from it.

We already learned that while sulfur dioxide is not a killer, sulfur combines into particles that are. "Sulphate particles are one of the major sources of particles in our air." And we could clean up those power plant stacks with proven technology, for a lot less than the cost of treating and burying their victims.

According to more conservative figures from the California government, about 16,000 Americans a year die due to drunk drivers. 17,000 deaths are homicides. But the still unfiltered coal burning power plants can top both, with an estimated 18,000 people dying too soon, due to their particulates going out the stacks. Get more info from the group "Clear the Air" at cta.policy.net.

America, for all its riches, still has unfiltered coal-fired power plants belching out deadly pollution. Still has millions of diesel trucks and buses pumping out heart-stopping smog. The doctor has the last word:

[Clip6 "So we're talking about something whose mortality rate is on the order of half of cancer, right? Now, if I told you that I had a pill that cure half the cases of cancer in the United States, and we were going to phase it in over a 15 to 18 year period.... you would lynch me.

Now, every coal-fired power plant built since 1979 has had a scrubber on it, to remove the SO2 gas that turns into the sulphates. We know how to do this.

With the 1990 acid rain bill, a bunch of power plants, that had been built earlier, retro-fitted scrubbers. We know how to do that. And it takes 18 months to build a scrubber, not 18 years.

So you want to talk to me about Clean Air Interstate rules, versus "Clear Skies," but I want to know... how... unlike cancer, we know how to cure this! it's an existing technology. [Cough] Why are we giving people so much time to put it on.

And we know how to make particle filters, for diesel engines. The other half of the equation. And in London, at the end of this year, they will have retro-fitted every single existing bus, - and they have 7,000 diesel powered buses in London, - with a particle filter."]

Londoners, who still remember the 1952 killer smog, may now breathe easier. But the rest of the world, men, women, children, and animals, continues to be exhausted, even though the technology to solve it is known and quite affordable.

But Americans won't get it. The Bush administration has been caught, again, doctoring the advice of its own appointed scientific review board on air pollution standards - and refusing to improve particulate regulations by even a single microgram, though it could cut the health impacts in half.

A group of regulators from the North East states took the federal government to court to demand the EPA act to save lives. They wanted the acceptable annual average for Americans to be lowered from 15 cubic meters of particulates, to 14. As you've already heard, top American scientists, and the EPA's own review board, recommended this small change. In fact, the review board wanted to cut emissions to 12 cubic meters.

Nope. The Bush appointee, Stephen Johnson, turned it down, and, according to the group Environmental Defense, doctored reports to make them sound better. According to CASAC Committee Chair Dr. Rogene Henderson, this is the first time the EPA has refused their scientific recommendations for human health. You can hear more about this, from the February 10th edition of the NPR radio program "Living on Earth," at loe.org.

[The exact program is here: www.loe.org/shows/toc.htm?year=2006]

For Americans, this is literally a life and death issue. The EPA is holding public hearings on the new standards on March 8th in Chicago, Philadelphia, and San Francisco. You or your group can voice your opinion, to the EPA, until April 17th.

Wherever you live in the world, you are inhaling the exhaust of this new carbonated world.

Demand better. Your life depends on it.

The one hour lecture by Doctor Schwartz is available, free, from the downloads page of Radio Ecoshock, at www.ecoshock.org. The tip for this feature came from Calvin Jones from climatechangeaction.blogspot.com. Environmental problems described in this podcast may be closer than they appear.