A Physician, Scientist and Mother Clears the Air

Editor's Note: This blog introduces readers to Kari Nadeau, MD, PhD, an Associate Professor at the Stanford University School of Medicine and a pediatrician who specializes in asthma and allergy.

Recently, both the Clean Air Act and the EPA have been attacked by some who claim that the restrictions on air polluters are too intrusive, too expensive and too burdensome. They go on to question the validity of the EPA's studies. As a physician, scientist and mother of five young children, I believe that it is time to "clear the air". 

In the United States and particularly in California, we are experiencing an epidemic in asthma and other pulmonary diseases that has reached unprecedented numbers. In the United States, asthma affects approximately 24 million people, of which an estimated 7 million are children. In the United States, asthma is the most common chronic disease in childhood, is one of the most common causes of hospitalization for children, and its incidence has increased dramatically (http://www.aafa.org/display.cfm?id=9&sub=42). According to CDC data, in 1980, 3.6% of U.S. children had asthma. By 1995, that number more than doubled to 7.5% (http://www.cdc.gov/nchs/data/ad/ad381.pdf). Clearly, something needs to be done, and done quickly.

As a physician, I see and treat patients with allergies and asthma each day I am in clinic. As research scientists, my colleagues and I follow the evidence to find a possible cause. And increasingly, evidence is pointing to air pollution as the culprit. 

Our research led us to investigate the effects of air pollution on children in Fresno. According to the American Lung Association's State of the Air 2011, of the top 10 most polluted cities, 6 of them are in California, and one of them is Fresno, the center of our study. Our results were published last fall in the Journal of Allergy and Clinical Immunology: Ambient Air Pollution Impairs Regulatory T-Cell Function in Asthma(http://www.ncbi.nlm.nih.gov/pubmed/20920773). Much like the scientific evidence finally proved the link between smoking and lung cancer, our study exposed the critical evidence linking air pollution directly to asthma. Our research showed that the effects of air pollution in Fresno are associated with genetic changes in the immune cells of children. In other words, inhaling polluted air could affect the immune system's ability to do its job. The increasing numbers and severity of asthma are directly related to these genetic changes. These genetic changes are permanent.

Yet, despite all the evidence implicating air pollution's deleterious impact on public health, some people continue to ignore or attack the evidence. Worse yet, some in Congress are trying to stop the Environmental Protection Agency for taking reasonable steps to clean up our polluted environment. What's so frustrating is we have the technology to clean up the dirtiest sources of air pollution, and still industry and their supporters in Congress refuse to clean up their act. We cannot afford to debate and wait a half century before we clear the air; we must act now. As parents, as citizens, and as a nation, we have a responsibility to provide for the common good and the common health. As long as we have the will to defend our right to clean air, we can ensure that our children's future will be a brighter and healthier one.

Kari Nadeau, MD, PhD, is an Associate Professor at the Stanford University School of Medicine and a pediatrician who specializes in asthma and allergy. She is a member of the American Thoracic Society Environmental Health Policy Committee and a volunteer physician with the American Lung Association in California.

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Improving the Health of our Children and Communities: the Clean Air Act   

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