WPSR is working with nurses and physicians in 350 Tacoma to build a team of health professionals in Pierce County who support climate action and a fossil fuel-free future for Tacoma.   For World Asthma Day, we teamed up to write the  blog post   below. Are you a health professional in Tacoma interested in joining us? Email Sarah ( sarah@wpsr.org ).

WPSR is working with nurses and physicians in 350 Tacoma to build a team of health professionals in Pierce County who support climate action and a fossil fuel-free future for Tacoma. 

For World Asthma Day, we teamed up to write the blog post  below. Are you a health professional in Tacoma interested in joining us? Email Sarah (sarah@wpsr.org).

With May 1, 2018 being World Asthma Day, our first topic has been the link between asthma management and climate change. We acknowledge that:

  1. Asthma is an important health problem in our local area, and is linked to environmental triggers. Asthma disproportionally affects Black, Brown, and poor people, making it an environmental justice issue.
  2. Climate change increases prevalence of asthma symptoms and attacks in various ways. Here we focus on how wood smoke and diesel use, both linked to climate change, make asthma worse.
  3. We must stop climate change in order to promote lung health for future generations. This includes halting new fossil fuel projects, divesting money from existing fossil fuel infrastructure, and promoting renewable energy sources.

Asthma is an important problem in Pierce County

Asthma is a syndrome of diseases affecting the upper airways characterized by reversible inflammation, airway constriction and mucus production. Asthma is one of the most prevalent chronic disease of childhood occurring in one in seven families (15,000 children) in Pierce County. Asthma exacerbations account for more missed school days than any other childhood chronic disease. Poor asthma control also contributes to missed work days, overuse of emergency medical response systems, and economic losses for our communities.

Medical breakthroughs in reversing airway inflammation mean that today while asthma cannot be cured, it can be controlled, provided the right steps are taken to eliminate or mitigate environmental threats. The four national guidelines for asthma management as described by the American Thoracic Society and the American Lung Association include medication management, two or more provider visits a year, patient education, and reducing exposure to environmental triggers. Environmental triggers for asthma are wide ranging and numerous, including social stress, violence, discrimination, economic instability, and indoor and outdoor air pollution.

Given that poor air quality increases asthma symptoms, asthma management is concerned with environmental justice. Low income and people of color in the Tacoma area are already burdened by increased air pollution. Indeed, disparities in asthma prevalence exist: Native American/American Indian, Native Hawaiian and Other Pacific Islanders, African Americans, and families living in poverty have sometimes twice the prevalence and more than twice the incidence of hospitalizations for asthma exacerbations. Exposing non-white and low-income people disproportionately to environmental hazards is environmental racism, and must be recognized and ended.

Climate change makes asthma worse

The root causes of asthma are complicated. However, it is clear that a changing environment and our living conditions are important contributors to the rise in asthma prevalence witnessed over the last 4 decades. Hotter, longer summers create increased hotspots of pollution and smog which can worsen respiratory allergies, asthma, and trigger asthma attacks. Increasing levels of ground-level ozone (a gas formed in the climate change process), coupled with these hot temperatures also make asthma worse. Due to climate change, flowering plants start earlier in the year, leading to longer pollen seasons and more asthma exacerbations. Ozone pollution peaks with pollen seasons in late summer and early fall, with a cumulative effect on asthma exacerbations.

There is much research which shows how the effects of climate change worsen lung health around the nation and even the world. Our Climate and Health group wanted to investigate how climate change is affecting our local asthma management. As such, we researched a few locally relevant issues – last year’s regional wildfires, our county’s particulate matter levels, local transportation emissions, and industrial pollution in the Port of Tacoma – to identify how climate change is a real health problem for our community.

Wildfires make Pierce County asthma management more challenging

Last summer and early fall was a particularly bad season for local asthma management, because of the enormous forest fires raging in Eastern Washington, the Cascades, Eastern Oregon and British Columbia. Remember those eerie, overcast days when the sun didn’t come out? And when ash gathered outdoors on bushes and windshields as if Mount St Helens had erupted again? The smoke made our eyes burn, our throats scratch, and, for those with asthma, our symptoms worse. Research shows wood smoke exposure is a common cause of asthma attacks for people with asthma in our area. The Department of Ecology’s air quality monitors in Pierce County documented record-breaking numbers of “unhealthy” days this summer. In August, officials said that our air quality was “twice as bad as the air in Beijing.” This led the Tacoma Pierce County Health Department to encourage both healthy and vulnerable people to limit outdoor time, and for organizations to cancel outdoor youth events. Experts agree that climate change is increasing the incidence and intensity of forest fires, and this will continue unless climate change is stopped. By fighting the causes of climate change, we reduce the likelihood of forest fires, which reduces exposures to wood-burning smoke and will improve quality of life for people with asthma in our area.

Pierce County struggles with high levels of particulate matter, a common asthma trigger

Tacoma and surrounding communities in Pierce County were designated as “out of attainment” by the EPA when the 24 hour average limit of exposure to particulate matter (PM2.5) was reduced to 35 micrograms/m3. This designation threatened any future funding for expansion of the transportation corridors through the county. The Puget Sound Clean Air Agency and partners in the Tacoma Pierce County health Department and the Washington State Department of Ecology worked on funding a plan to reduce burning from uncertified woodstoves but stopped short of banning woodstoves entirely. Their efforts to replace uncertified woodstoves with certified ones, and new predictions by the Department of Ecology, succeeded in the EPA converting the “Out of Attainment” designation to a 10 year “Maintenance” designation intended to monitor the outcomes of their efforts to reduce particulate matter exposure.

While this achievement was significant, what is less understood by the public is that this plan is based on a ten year prediction on the increase of the number of electric and low emission vehicles on our roadways. This prediction is troubling because as of May 31 2018 the state tax incentive for purchasing such vehicles will disappear and the EPA under Scott Pruitt have been dismantling several provisions for reducing emissions from vehicles. Further, the increase in population in the South Sound area and the increase in commuters using the I5 corridor, especially due to the recent expansion of I5 through Tacoma might have prompted the DOE to have underestimated the relative increase in particulate matter from increased traffic in the I5 corridor. Further, by replacing one woodstove for a certified one gives the public the impression that wood burning can be safe for people with asthma: it simply is not. Emissions from certified woodstoves still contribute 97 pounds of annual pollution per household compared to natural gas (⅙ lb annually) and electricity (zero pollution per household).

People might not realize that individual actions in regards to driving combustion engine cars and burning wood recreationally and for heating are key contributors to the fuel-related pollution in our area. Just as we seek to transition the fossil fuel infrastructure into renewable energy we also need to consider our own direct actions that accelerate the release of carbon dioxide into the atmosphere.  Wood burning advocates erroneously regard the practice as “carbon neutral” considering the balance of carbon dioxide absorbed by the tree over its lifetime matches the release of carbon dioxide in the act of burning. It would be carbon neutral if climate change were not increasing so rapidly: a rotting tree acts as a carbon sink, slowly releasing carbon dioxide back to the atmosphere over decades. Unfortunately new industries in Oregon and elsewhere are now marketing wood pellets to sources in Europe as “renewable energy.”

Tacoma residents living near the freeway are exposed to more asthma triggers

Asthma exacerbations are triggered by air pollution from combustion. Key sources of outdoor pollution are diesel, particulate matter, nitrous and sulfur oxides from car exhaust from vehicles, wood smoke, and industrial machinery. Tacoma and other urban areas of Pierce County are particularly hard hit owing to natural geographic and meteorological features that trap air pollution. Research shows that diesel exhaust goes beyond exacerbating existing cases of asthma – it may even cause it.

Data from the Washington State Department of Health shows that nearly half of Tacoma is the highest possible risk category for diesel pollution and disproportionate health impacts. Neighborhoods most at risk include those in closest proximity to Tacoma’s Tideflats and the heavy industries in the Port, which include shipping, fossil fuel terminals, and the US Oil Refinery. The same areas also run parallel to the I-5 corridor. With the recent I-5 expansion along asthma hotspots, it’s essential to recognize that driving vehicles directly correlates with worsened air quality and higher rates of asthma.

Fossil fuel burning industrial plants contribute to local asthma triggers

Proximity to fossil fuel infrastructure has also been shown to directly correlate with asthma exacerbation and threats to air quality. Communities in close proximity to oil and gas infrastructure face higher than average rates of asthma and poorer air quality, as a result of ozone and particulate pollution.

Tacoma is home two multiple fossil fuel projects, including the Targa Sound Terminal and the US Oil Refinery. Air quality in closest proximity to these projects is worse than in other parts of the City and County.

Those living near fossil fuel plants, including facilities that store, refine, and ship oil, coal, and natural gas are prone to significant threats to air quality. Pollution generated by these facilities, including ozone pollution, small particulate matter, sulfur dioxide, and nitrogen oxide have all been shown to exacerbate asthma.

The health benefits to transitioning to clean, renewable energy sources have been shown to equate to thousands of reduced asthma attacks (in one example, studies of the health benefits of the Obama Administration’s Clean Power Plan showed that it could reduce up to 150,000 of asthma attacks per year).

We must stop climate change in order to protect human health

There is plenty of evidence to show that climate change is making asthma worse. This is a real problem in our local communities, and unjustly affects our most vulnerable residents. If we truly value our health, and that of future generations, we must act now to stop climate change. Stopping climate change means concurrently opposing new fossil fuel projects and ending funding of existing fossil fuel industries, while also promoting renewable energy sources and infrastructure upgrades.

We must be savvy to recognize the greenwashing of energy projects in our area, such as the Puget Sound Energy liquified natural gas (LNG) plant being built in our Port of Tacoma. For example, it’s true that LNG burns cleaner than wood, making LNG a safer home heating choice for people with asthma. Eliminating the use of woodstoves has great potential for improving health for low-income people with asthma. However, until gas heat is truly accessible to and affordable for low-income people in Tacoma, the plant poses little hope for improved asthma management. Also, we must recognize that even if we were able to supply low-income homes with cleaner-burning gas heat, LNG is not a pathway to a renewable energy future. LNG is a fossil fuel, comprised of at least 80% methane, one of the strongest greenhouse gases. Burning LNG also releases particulate matter 2.5 and volatile organic compounds into the air, both which trigger asthma symptoms. Burning LNG continues climate change and its negative health effects.

It’s also true that LNG burns cleaner than diesel, potentially offering a cleaner fuel source for ships while docked in the port. We support ending the practice of burning diesel in the port, as it would improve air quality for port workers and nearby residents. However, the LNG project proposed in the Port of Tacoma has only been approved to serve one shipping company, Tote Shipping. All other ships would continue to burn diesel while on our shores. Furthermore, Tote Shipping is the only company that currently does not burn diesel in our port; its ships plug into electric shore power, creating zero local emissions. Instead of building a new fossil fuel plant in the Port of Tacoma, we should be developing our existing electrical infrastructure and require all ships plug in while docked here. There is no clear pathway identified from the construction of the LNG plant to a renewable energy infrastructure for our port, our homes, and for our shipping.

A healthy future is one that relies on renewable energy sources, such as solar and wind projects, which do not impact air quality. As such, we need to be actively involved in planning what industries we support in our port. In May 2017, responding to the demands of many concerned residents like us, the city council approved temporary regulations on Port of Tacoma activities, to limit the expansion of fossil fuel industry there until health and safety concerns could be addressed. The city council also allowed for a “Port of Tacoma/Tideflats Subarea Planning process” that would take into consideration the concerns of local people in planning future industrial use. We need to push for this subarea planning process to begin, and to genuinely reflect the needs of our most vulnerable community members. We encourage everyone to write to her or his city council person and insist that the Port of Tacoma Subarea Planning process get underway, meaningfully include resource-poor groups, prioritize health, and focus on a renewable energy future. Check out @protecttacomastideflats to find others working on the planning process and to get involved.

Our Climate and Health group encourages everyone to keep learning about how climate change impacts human health. We are planning a training on this topic and invite you to help organize it, and attend. Please contact us if you are interested. Everyone is welcome and valued!


References and Further Reading

Environmental triggers for asthma

United States Environmental Protection Agency “Clearing the air: Asthma and indoor air exposure (highlights).” https://www.epa.gov/asthma/clearing-air-asthma-and-indoor-air-exposure-highlights

Washington Department of Health “Health of Washington State report – Outdoor (ambient) air quality.” https://www.doh.wa.gov/Portals/1/Documents/1500/EH-AQ2014.pdf

Local wildfire references

Past and present air quality monitor information is available from Puget Sound Clean Air Agency at https://secure.pscleanair.org/airgraphing

“Smoke from regional wildfires returns to the area: Tacoma Pierce County Health Department.” CourierHerald (August 29, 2017) http://www.courierherald.com/news/smoke-from-regional-wildfires-returns-to-the-area-tacoma-pierce-county-health-department/

“South sound officials warning of air quality say people should stay inside.” KIRO7 News (August 4, 2017) https://www.kiro7.com/news/south-sound-news/south-sound-officials-warning-of-air-quality-says-people-should-stay-inside/581459238

“Pierce County air quality may be unhealthy for sensitive groups due to wildfires, officials say.” Q13 FOX News (August 29, 2017) http://q13fox.com/2017/08/29/pierce-county-air-quality-unhealthy-for-sensitive-groups-due-to-wildfires-officials-say/

“Wildfire smoke means air quality can change quickly: Tacoma Pierce County Health Department.” Courier-Herald (Sept 7, 2017) http://www.courierherald.com/news/wildfire-smoke-means-air-quality-can-change-quickly-tacoma-pierce-county-health-department/

“Has climate change intensified 2017’s western wildfires?” The Atlantic (Sept 7, 2017) https://www.theatlantic.com/science/archive/2017/09/why-is-2017-so-bad-for-wildfires-climate-change/539130/

Woodsmoke and woodstove references

Puget Sound Clean Air Agency “Relative Emissions of Fine Particles” https://www.pscleanair.org/DocumentCenter/View/2433/Heating-Choice-Comparison-Chart—Annual-Emissions-PDF

Schlesinger, Bill (March 28, 2018) “Are wood pellets a green fuel?” http://blogs.nicholas.duke.edu/citizenscientist/are-wood-pellets-a-green-fuel/

Diesel and car exhaust references

“Traffic-related pollution linked to risk of asthma in children.” Journal of Allergy and Clinical Immunology. ScienceDaily (May 1, 2017)

“Diesel Exhaust May Cause Asthma, Not Just Aggravate It” NRDC. (February 13, 2002) https://www.nrdc.org/media/2002/020213-1

Fossil fuel plant references

Concerned Health Professionals of New York and Physicians for Social Responsibility. “Compendium of scientific, medical, and media findings demonstrating risks and harms of fracking (unconventional oil and gas extraction)” 5ed, (March 2018) http://www.psr.org/assets/pdfs/fracking-compendium-5.pdf

Fischetti, Mark (August 11, 2011) “The health care burden of fossil fuels” https://www.scientificamerican.com/article/graphic-science-health-care-burden-of-fossil-fuels/

Perera, Frederica (August 2008) “Children are likely to suffer most from our fossil fuel addiction” https://ehp.niehs.nih.gov/11173/

United States Environmental Protection Agency. “Fact sheet: Clean power plan benefits.” https://archive.epa.gov/epa/cleanpowerplan/fact-sheet-clean-power-plan-benefits.html#benefits

“The Health Co-Benefits of Climate Action in Washington State,” Washington Physicians for Social Responsibility (February, 2018). https://www.wpsr.org/co-benefits

“Climate Change & Health in Washington” Washington Physicians for Social Responsibility


 Port of Tacoma/Tideflats subarea planning resources

“Tideflats Subarea Plan.” City of Tacoma http://www.cityoftacoma.org/cms/one.aspx?portalId=169&pageId=132602

“Tideflats Interim Regulations.” City of Tacoma

A coalition of people and organizations working with the City on the Tideflats Subarea Plan are reachable at https://www.facebook.com/protecttacomastideflats/