By Rene Ebersole
Out of Breath
If nothing is done to break the planet�s mounting fever, scientists offer a cloudy forecast for the millions of Americans who suffer from asthma
NIGHTLY TRIPS to Chicago�s Mount Sinai Hospital emergency room with a newborn son gasping for air were routine for Alma Clark, a 21-year-old single mom. Clark would stand nearby as doctors worked to help baby Michael inhale through a nebulizer. Like many other children, Michael suffered from chronic asthma. �He couldn�t breathe,� says Clark. �Many a day I just cried and prayed.�
Michael Clark is one of at least 17 million Americans (including 5 million children) today who have coughed, wheezed and fought for breath because of asthma�nearly double the number of reported asthma cases two decades ago. As researchers across the country race to find out what is causing asthma rates to rise so rapidly, some are focusing on the influence of global warming. And their forecasts are anything but sunny.
�Climate change represents possibly the most challenging public health issue we�ve ever faced,� says Jonathan Patz, an expert on climate-related health issues at the University of Wisconsin�Madison. �It involves population growth, energy consumption, emissions, even land use issues because forests absorb carbon dioxide. Air pollution is expected to increase due to warming, and that will affect a lot of people, especially asthmatics.�
Asthma is considered a complex illness with strong genetic and socioeconomic influences, but the burning of fossil fuels and global warming present �multiple assaults� for people who suffer from the disease, according to Paul Epstein, associate director of the Center for Health and the Global Environment at Harvard Medical School. First, carbon dioxide�a by-product from burning fossil fuels that is considered one of the key greenhouse gases causing climate change�increases the formation of ground-level ozone, or smog, by accelerating the reactions between other by-products of fossil fuel production. Further, global warming is associated with more weather extremes, says Epstein, including floods, which bolster fungal growth indoors, and droughts that spur wildfires, adding particulates to the air.
According to a report published by Epstein and his colleagues, the effects of global warming will be felt particularly by American preschoolers. Children ages three to five have experienced the largest rise in asthma incidence�160 percent during a recent 14-year period�hence increasing the population that could be sensitive to the predicted boost in pollen production as carbon dioxide rises. �This is a real wake-up call for people who think global warming is only going to be a problem way off in the future or that it has no impact on their lives in a meaningful way,� says Harvard researcher Christine Rogers.
Rogers� research has revealed that earlier spring warming and elevated carbon dioxide affect plant biomass and the production and timing of pollen release in plants such as ragweed, a common asthma trigger. She and others have discovered that ragweed plants exposed in a controlled laboratory environment to double today�s carbon dioxide levels produce 40 to 60 percent more pollen. If these findings hold true in a real-world environment, children living in inner cities could be in for a double whammy. �These children are exposed to the worst air pollution,� says Rogers. �And they are at risk for increased exposure to allergenic pollen as a result of global warming.�
Inner city children may already be disproportionately affected by asthma. A recent survey released by the Sinai Urban Health Institute (SUHI) in Chicago found that 34 percent of Puerto Rican children and 25 percent of African-American children in that city have asthma. A similar study conducted in New York in 2003 showed that one in four children living within a 24-block area of Harlem likewise suffer from the disease. Frustrated by such statistics and the number of asthmatic children flooding Chicago emergency rooms, SUHI Director Steven Whitman says, �No one should ever die or have to go to the emergency room from this disease. We may not know what causes asthma, but we do know what exacerbates it and how to treat it.�
Improving access to proper healthcare could go a long way toward winning the battle against asthma. But doing that alone without a concerted effort to halt the factors causing global warming could be the equivalent of plugging the holes in a dam as the dam floods, say environmental health experts. If global warming continues at its present pace, scientific models show Americans will face an onslaught of global warming-related health problems, from large numbers of heat-related mortalities and increased outbreaks of mosquito and waterborne illnesses such as West Nile, malaria and cryptosporidia to a nationwide epidemic of respiratory illnesses such as asthma.
Higher temperatures and more frequent and intense heat waves will cause summer air quality in many U.S. cities to plummet in the coming years, according to a recent report authored by Patz and some of the nation�s leading medical experts. Their studies show that people living in such cities as Atlanta, Baltimore, Cincinnati and Pittsburgh could see by mid-century a 60 percent increase in the number of days when levels of smog exceed the U.S. Environmental Protection Agency�s current air-quality standard.
�The air in many of our nation�s cities is already unhealthy,� says Patz. �Reducing greenhouse gas emissions should be long-term public health policy.�
Rene Ebersole is a senior editor for this magazine.
Factor in Food
Acting from Your Gut
When most people think about curbing global warming emissions, cars and power plants usually come to mind. But did you know that the production and transportation of the food consumed by the typical American generates nearly as much carbon dioxide as the average car? That�s because the standard kilogram of food consumed today in the United States travels 1,500 miles from farm to plate. Peter Hoffman, national chair of the Chefs Collaborative, a nationwide network of food producers with a mission to advance a more sustainable food supply, and the owner and chef of New York City�s Savoy restaurant, says, �If you want to reduce your environmental impact, in particular your carbon dioxide emissions, then the less fossil fuels that are used to get food to you, the better. You can start simply by going to a farmer�s market, buying something locally produced and incorporating it into your regular shopping.�