PROVO — The enemy isn't acid rain anymore. It's the tiny particles of pollution that find their way from tail pipes to windpipes and end up inflaming lungs and damaging hearts.
"The science has developed far enough ... that as a matter of public policy, we need to deal with the air pollution issue," said BYU professor C. Arden Pope, who spoke recently at an EPA seminar in Washington, D.C., for the 40th anniversary of the Clean Air Act.
"We need to address it, take it seriously and not overstate its impact or understate it, just understand it in a clear scientific way such that we can effectively deal with the problem and improve human health," he said.
An environmental economist and epidemiologist, Pope was thrust to the forefront of the pollution discussion after his "landmark study in Utah Valley that alerted the world to the dangers of particle pollution," according to the EPA.
Pope found that when Geneva Steel closed for 13 months in late 1980s, the number of pediatric respiratory hospital admissions in Utah Valley fell, then nearly doubled when the plant started up again, a phenomenon not seen in Salt Lake or Cache valleys.
"When I first saw those early reports, not that I didn't think air pollution had some effects, but I thought that the effects were probably so small we wouldn't be able to (measure) them in observational data," he said.
Yet the striking results changed the direction of his research for the next 20 years and paved the way for future studies.
"Dr. Pope's work is among the seminal in the field," said Dan Costa, National Program Director for Air Research at the EPA. "His research was the first to show links between respiratory health and risk of mortality to contemporary air pollution."
Since then, researchers have identified even greater dangers from pollution, even at low levels.
"Air pollution is not just a lung issue," Costa said. "It has a significant, if not more important, cardiac component. There is mounting evidence that chronic exposure causes changes in blood vessels, namely atherosclerosis."
He said the World Health Organization estimates that nearly 2 million people die each year from air pollution, with 25,000 to 40,000 deaths in the U.S.
The culprit is fine particulate matter, or PM2.5, that comes from burning fossil fuels in cars or industry, or biomass burning from cooking, heating and forest fires, according to the American Heart Association Web site.
The microscopic particles are inhaled and trigger inflammation in the lungs, which eventually causes increased blood clotting and thrombosis, impaired vascular function and blood flow, elevated blood pressure and disrupted proper cardiac electrical activity, thus leading to heart attacks, stroke or even death, according to Dr. Robert Brook, a cardiovascular medicine specialist and associate professor in the Department of Internal Medicine at the University of Michigan in Ann Arbor.
University of Utah Pediatrician Michelle Hofmann agrees with and applauds this research, but she doesn't need a report to know there's a problem with Utah's air.
"I'm pretty convinced that our air pollution is impacting the severity of diseases that we're seeing," Hofmann said. "Children are not just getting bronchiolitis, but they're getting it bad enough to need to be in the hospital and be cared for."
Pneumonias in children are also becoming more complicated, with children developing large puss collections that must be drained with chest tubes and require lengthy and intense antibiotic follow-ups, she said.
Utah is particularly plagued by particulates because the many valleys act like bowls to hold in dirty air.
"It's not uncommon on a night shift (at Primary Children's Medical Center) for me to admit 90 percent respiratory illness in the winter time," she said.
Although the pollution is worse for children who already have asthma or other infections, even high summertime ozone levels can cause healthy individuals to feel chest tightness.
"I worry about what we're actually seeing in our valley clinically that hasn't been studied," said Hofmann, former president of Utah Moms for Clean Air. She now is involved with a new group, Breathe Utah.
Yet as hazy as the future may appear, there are signs of progress, Pope says.
"Last year, we had this research ... that demonstrates that the improvements in air quality have actually had impacts on life expectancy," Pope said. "It's fun to start seeing real evidence of substantial improvements."
Individuals can help by supporting responsible, reasonable public policy efforts to reduce pollution and by making smart choices.
Drive clean cars, don't exercise in the middle of the day along a busy, pollution-filled street. Stay indoors on red air or high PM2.5 days, install a good filtration system in your home and above all, don't smoke.
"We're going to continue to do this research until we get it figured out," Pope said.