CLEANING THE AIR: CONTRASTING VIEWS \ STRINGENT RULES NEEDED

As a pediatrician, I've never had a parent complain that the air was too clean for their child to breathe. Instead, they ask me how to prevent or relieve their child's asthma, bronchitis or cough.

And I get such questions all the time, especially with millions of children suffering from asthma today. Rates of other respiratory problems are skyrocketing as well. According to the Centers for Disease Control and Prevention, asthma is now the most chronic childhood illness in the United States, affecting 4.8 million children under 18.

I prescribe all the best ways to protect children that I can - medications, treatments and behaviors - except for one: less air pollution.

Yet cleaner air may be on the horizon - if Congress allows it.

The U.S. Environmental Protection Agency recently proposed strengthening air pollution standards for ozone (smog) and fine particulate matter (soot). Exposure to these pollutants has been linked to aggravation of respiratory diseases like asthma, as well as to increased visits to emergency rooms and increased hospitalizations due to respiratory problems. Exposure to fine particulates has been linked to shortened lives.

A major battle, however, is brewing in Congress over EPA's proposals. Opponents of the stronger standards contend improving our air quality will be too expensive. These special interests want Congress to halt the new safeguards. If that direct assault fails, they will pressure Congress to adopt legislation leading to extensive court review and many years of litigation before these standards can be fully implemented.

Every parent should be watching this battle closely. Kids are especially susceptible to harm from air pollution. Their respiratory defenses are not fully developed and their airways are smaller than those of adults. Pound for pound, children need more oxygen and inhale more pollutants than adults.

Dozens of studies have proved that our current air quality goals are not strong enough.

A recent study by the American Lung Association and the Harvard School of Public Health found that emergency department visits and hospitalizations for respiratory problems doubled on days where the ozone level was high - even when the ozone registered below the current standard. At ozone levels 33 percent below the current standard, children at summer camp and healthy exercising adults suffer from shortness of breath, coughing, painful breathing and loss of lung function.

The current particulate standards fail to control the smallest, most harmful particles that lodge deep in the lungs. Studies have shown that as particulate levels mount, bronchitis and chronic cough increase in school children, acute respiratory symptoms and illness rise among adults, while emergency room visits and hospital admissions increase.

And one seven-year study of more than half a million people from all 50 states found that those living in the most polluted city had a significantly greater risk of premature mortality than the people living in the least polluted city due to exposure to particulates.

Decisions made this year will determine how much pollution youngsters will breathe for decades to come. We need to protect our children and set lower air pollution levels now. Congress should not force EPA to take a pass on cleaner air while pediatricians and parents are forced to deal with soaring numbers of respiratory problems and escalating rates of childhood asthma-related hospitalizations.

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