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Relationship between Clean Air and Asthma Examined

A new report, analyzing detailed asthma incidence and cost data, concludes that the already staggering human and financial toll of asthma in the United States likely will increase if Congress acts to stop updates to the Clean Air Act (CAA).

More than 24 million Americans – including 7 million children – suffer from asthma, with direct and indirect costs of treating the nation’s worsening asthma epidemic already exceeding $53 billion, according to the report, which was released by Health Care Without Harm (HCWH), the Alliance of Nurses for Healthy Environments (ANHE) and the National Association of School Nurses (NASN).

The U.S. House is scheduled to vote on Energy and Commerce Chairman Fred Upton’s bill to block EPA from reducing carbon pollution and the Senate may vote on one or more amendments that would block or delay EPA’s efforts. At the same time, Congress is negotiating with the White House to continue funding the federal government with a new spending measure, onto which some members of Congress hope to attach EPA-related “riders” that also would prevent the agency from updating the CAA.

“Congress is literally talking here about taking the breath away from millions of American children and adults,” said Brenda Afzal, MS, RN, U.S. climate policy coordinator, Health Care Without Harm. “Because they have a disease that is very susceptible to pollution, Americans with asthma provide members of Congress with 24 million compelling reasons for the EPA to be allowed to proceed with needed updates to federal Clean Air Act standards. By siding with polluters and against their constituents with asthma, Congress is ignoring the public health and financial implications of pollution-related illness.”

Air pollution from cars, factories and power plants is among the major causes of asthma episodes. Air pollutants that can contribute to asthma include ground-level ozone smog, sulfur dioxide, particle pollution, and nitrogen oxides. Carbon dioxide pollution also can worsen asthma in several ways, such as by driving climate change (rising temperatures increase ozone smog concentrations) and by increasing production of airborne allergens like ragweed pollen (which is another trigger for asthma episodes).

According to the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality, almost 15 percent of the costs of asthma are paid out-of-pocket by the patient. That is equivalent to just under $8 billion a year. Private insurance covers more than 38 percent of the costs, equivalent to more than $20 billion a year. That leaves almost half of the cost of the asthma epidemic to be paid by taxpayer-funded federal programs such as Medicare and Medicaid.

According to a recent EPA analysis, the CAA amendments of 1990 currently prevent 1.7 million cases of asthma exacerbation and by 2020 will prevent 2.4 million cases.

The HCWH/ANHE/NASN report states: “Legislation that would greatly reduce the authority of EPA to reduce these air pollutants under the Clean Air Act would prevent improvements in air quality – stopping reductions in emissions of carbon dioxide, fine particles, soot, and other pollutants – and would make it harder for children and adults with respiratory problems such as asthma to breathe.”

The report is based on asthma prevalence and cost data from the American Lung Association and the Centers for Disease Control and Prevention and relevant peer-reviewed literature. Compiled by the consulting firm David Gardiner & Associates, the new report, titled “The Economic Affliction of Asthma and Risks of Blocking Air Pollution Safeguards,” outlines the cost of asthma for all 50 states, with detailed findings broken out for Illinois, Maine, Massachusetts, Michigan, Minnesota, Montana, New Hampshire, Ohio, Pennsylvania and Wisconsin. The report and related state facts sheets are available online at

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