Map of coal power by state. Note: about of third of the air pollution can go thousands of miles from the plant. There is more impact on air quality and health of those near the plants. Air pollution has been improved in the USA since the 1950s and 1960s. There is still a negative effect. 24,000 coal impacted deaths and a total of 60,000 air pollution impacted deaths out of 2.5 million deaths from any cause. Cigarette smoking and obesity have larger negative effects, which is seen in West Virginia’s health statistics. The bad air pollution states are ending up at or near the bottom of state health rankings.
Rank State # of Plants Total Capacity 2005 Power Prod.
1 Texas 20 21,238 MW 148,759 GWh
2 Ohio 35 23,823 MW 137,457 GWh
3 Indiana 31 21,551 MW 123,985 GWh
4 Pennsylvania 40 20,475 MW 122,093 GWh
5 Illinois 32 17,565 MW 92,772 GWh
6 Kentucky 21 16,510 MW 92,613 GWh
7 West Virginia 19 15,372 MW 91,601 GWh
8 Georgia 16 14,594 MW 87,624 GWh
9 North Carolina 25 13,279 MW 78,854 GWh
10 Missouri 24 11,810 MW 77,714 GWh
11 Michigan 33 12,891 MW 71,871 GWh
12 Alabama 11 12,684 MW 70,144 GWh
13 Florida 15 11,382 MW 66,378 GWh
14 Tennessee 13 10,290 MW 59,264 GWh
15 Wyoming 10 6,168 MW 43,421 GWh
16 Wisconsin 28 7,116 MW 41,675 GWh
In 1997, Minnesota had the fewest deaths due to heart disease of any state.
American health rankings allows comparisons of the healths of different states. The thousands of in depths studies separate out the impacts of different levels of smoking from the air pollution effects.
Air pollution ranking by state
Ranking States by Cancer Deaths
Pennsylvania air quality and Health Impacts
• Soot pollution causes about 5,000 premature deaths in Pennsylvania annually.
• At this rate, air pollution ranks as the third highest risk factor for premature death, behind smoking and poor diet/ physical inactivity.
• Smog pollution leads to an estimated 7,000 hospital admissions for respiratory disease and soot pollution contributes to roughly 4,000 admissions for cardiovascular disease annually.
• In addition, air pollution causes approximately 4,000 new cases of chronic bronchitis in adults every year.
• Among asthmatics, soot pollution causes an estimated 500,000 asthma attacks annually, with an additional 300,000 asthma attacks caused by smog.
An air pollution disaster over the two southwestern Pennsylvania towns of Donora and Webster in October 1948 took dozens of lives, left thousands literally gasping for breath, and motivated the United States Public Health Service (PHS) to enter the arena of air pollution policy.
American Cancer Society Cohort Study: This study of half a million people in 100 American cities over 16 years has been audited, replicated, re-analyzed, extended and ultimately reconfirmed. The latest results show that long-term exposure to fine particulate matter is associated with premature death from cardio-respiratory causes and lung cancer. Increased risk of premature death is evident at concentrations below current standards.
Harvard Six Cities Study: This long-term cohort study has also been subject to an independent audit, review, and re-analysis and the original findings have been confirmed: long term exposure to fine particle pollution shortens lives and contributes to an increased risk of early death from heart and lung disease, even at air pollution levels far below the current standards. Extended follow up of the Harvard six city study
Children’s Health Study: A study of school-age children in 12 southern California communities reported increased cough, bronchitis, and decreased lung function in children living in more polluted areas. The long-term mean fine particle concentration was at the level of the current standard.
Air pollution in Cairo
Researchers comparing air quality in six cities across the United States were stunned when their data showed that people living in cities with the dirtiest air died on average two years earlier than residents of cities with the cleanest air. The difference in death rates was linked to elevated levels of fine-particle pollution.
In public-health terms, a two-year shift in life expectancy is enormous—comparable to the protective effects of proper diet and exercise—so that the researchers themselves had doubts at first about their findings. But the association held up.
Lung diseases like cancer, emphysema, fibrosis, and asthma are almost all initiated or aggravated by the inhalation of particles and gases, says center director Joseph Brain, Drinker professor of environmental physiology.
“97 to 98 percent of lung cancer would be eliminated if people didn’t smoke cigarettes and avoided environmental and workplace exposures to air pollution.
Sometimes the structure of the lungs leads to different levels of particle exposure. Says Rogers, “We know if you have a mom and her seven-year-old standing at a bus stop and they get a blast of diesel exhaust, the child is going to get relatively much greater particle deposition.” Because of differences in surface to lung volume, metabolic rate, and activity, the seven-year-old’s lungs will get two and a half times the dose of particles as the mother’s lungs. “We first predicted this theoretically,” says Rogers, “and the experimental evidence supports it. The seven-year-old has a fully alveolated lung with an enormous surface area, but a small chest volume, so there is a greater particle deposition relative to the adult, who has a much larger chest volume and a slower metabolism.”
But what they found in 1990, a full 15 years into the Six Cities study, was something entirely unexpected. People were losing lung function, but what was killing them were cardiovascular events such as heart attacks and dysrhythmias. And it was fine particles from power plants and other combustion sources such as automobiles and home heating that showed the strongest associations with these deaths
In 1993, the group published their Six Cities findings in the New England Journal of Medicine. It is the most cited air-pollution paper in existence.
Dockery and his colleagues had the integrity of their science questioned; all their data were later independently examined—and ultimately validated.* “We are in an interesting quandary,” he says. “Congress wrote the law to protect even the most sensitive individuals, at a time when we thought we could define a level at which nobody would be adversely affected. But as we have become more sophisticated in our epidemiologic studies, it has become clear that…this concept—that there is a safe level at which you can protect everybody in the public against health effects—is not holding up. There are detectable health effects at even the lowest levels.”
But how do fine particles cause heart attacks? “One hypothesis,” says Godleski, “since some of the effects are almost immediate, is that they must be neurally mediated.” Particles may stimulate nerve fibers in the lung. Signals relayed to the central nervous system may change the autonomic balance of the heart in ways that “make it more prone to arrhythmia and other effects, which in turn create the potential for a fatality.”
Another hypothesis suggests that, because particles cause inflammation of the lungs, inflammatory agents produced there may affect the heart in a negative way. Vasoconstrictors such as endothelin, for example, are secreted by the lungs when inflamed. The fact that mortality peaks 18 to 20 hours after the peak in a particle-pollution event (such as a smoggy day in summer) lends some support to this possibility; think of the way a sunburn can develop over time, after you leave the beach.
Even after laboratory studies validated the epidemiology of the Six Cities study, questions were raised about the nature of susceptible individuals. So began what Dockery calls “a horrible discussion” that asked, “If people are dying from air pollution, are they people who were going to die soon anyway? Are we just advancing their date of death by a day, and if so [getting back to economic considerations], is that really worth a million dollars [to change]?’” After much investigation, it now appears that air pollution is in fact shortening lives by many years.
“If you get sick with influenza or pneumonia,” Dockery explains, “you might be in trouble for a few days, but if you recover, you can go on and live for another 20 or 30 years. But if, during the period when you are sick, air pollution pushes you over the edge, then you are talking about substantial decreases in life expectancy.”