Ayana Currington is only eight years old but she knows all about air quality alerts because they tell her whether she has to take her asthma medication and stay inside all day.
- Naya Thompson and Ayana Currington.
Ayana and her mother Naya Thompson watch The Weather Channel every day for “red” or “orange” alerts about the quality of air that day because ignoring the warnings could result in an asthma attack that will land the little girl in the hospital.
That’s happened at least seven times in the three years since Ayana, who was born prematurely, was diagnosed with asthma, and each time has involved a stay of three or four days, Naya said. Even if she can avoid going to the hospital, asthma means Ayana has trouble catching her breath, gets tired easily, and has to stay inside.
“She really wants to play outside with her friends,” said her mother.
The girl’s condition prompted Naya Thompson and her two older children to move in 2009 from a house next to an interstate highway to a suburban location in Newark. That has helped Ayana, who has not been hospitalized for asthma in the last year, but must still plan her life according to the condition of the air she breathes.
A big part of her life is constant visits to doctors including her pediatrician, a pulmonologist, and an allergist. “It’s almost a full-time job,” Naya said.
In the first ten days of June, New Castle County exceeded the federal ozone standard of 0.075 parts per million (ppm) averaged over an eight hour period on five days, according to data from the state’s Department of Natural Resources and Environmental Control (DNREC). Kent and Sussex counties each topped the limit on two days.
The highest reading for the period was obtained at a Bellefonte monitoring station where the ozone level was 0.100 ppm – above the EPA’s “red” level of 0.096 ppm — on June 7 when temperatures in the 90s and bright sunlight combined with nitrous oxide from car exhaust to form ozone.
New Castle County, as part of the Philadelphia metropolitan area, is among the nation’s 25 most polluted cities, according to the American Lung Association’s 2011 State of the Air Report.
David Fees, an engineer in DNREC’s Air Quality Management Section, said the state often fails EPA ozone standards with levels of the gas that can be unhealthy to sensitive groups such as young children and the elderly, or for the population as a whole.
Children like Ayana are increasingly visiting emergency rooms or being admitted to local hospitals for treatment of asthma.
The Christiana Care Health System reported the number of admissions for asthma jumped 11 percent to 441 in fiscal 2010, resulting in an average length of stay of 3.78 days. The number of emergency room visits for the illness rose 5 percent in the same period to 2,064 patients, 23 percent of whom were under 18.
At the Alfred I. duPont Hospital for Children, there has been an increase over time in complaints of asthma and other respiratory illnesses, although it has not drawn a direct causal link to air quality.
There is, however, general evidence that bad air has an impact on respiratory illnesses in all age groups, said Dr. John Loiselle, the hospital’s chief of emergency medicine.
“If air quality in Delaware is declining, it will definitely be to the detriment of kids with asthma and other chronic respiratory illnesses,” Dr. Loiselle said in a written statement.
Asthma affects 28,000 children in Delaware, accounts for a third of pediatric emergency room visits, and is a leading cause of school absenteeism due to a chronic illness, according to Delaware Sen. Tom Carper, who recently co-chaired a Senate subcommittee hearing on air pollution and children’s health.
As summer heat and sunlight boost ozone levels, Carper urged lawmakers to back new proposed EPA rules that update air pollution standards for ozone, mercury and other pollutants.
“Millions of our kids ride a bus to school, play on a playground or live in a community that exposes them to high levels of ozone, particle pollution or air toxics – all of which can severely impact children’s health,” the Democratic senator said. The EPA rules will help improve health care and cut medical bills, he said.
But the EPA’s plans came under fire from a study by the National Economic Research Associates, paid for by a coal-industry group. According to the report by the consulting group released June 8, planned restrictions on power plant emissions would cost the industry nearly $18 billion a year to implement; raise retail electricity prices by an average 11.5 percent in 2016, and lead to thousands of job losses.
Still people like Patty Resnik, Corporate Director of Performance Improvement/ Utilization Management at Christiana Health Care System, Delaware’s largest, have backed calls for tighter standards on pollutants.
“It is imperative that we act now since children are one of the most vulnerable populations affected by poor air quality,” Resnik told the Senate panel.
She argued that children are more severely affected by poor air quality because they take in more air per unit of body weight than do adults, leaving them more exposed to polluted air.
Poor air quality can also exacerbate the national obesity epidemic by forcing children to stay indoors where they won’t be taking exercise, Resnik said.
In a June 15 speech to the Ozone Transport Commission, a multi-state organization that advises the EPA on transportation and ozone in the northeastern states, Carper, a former Delaware governor, called for a region-wide approach to ozone reduction, noting that 90 percent of Delaware’s air pollution comes from out of state, undermining its own efforts to clean up the air.
“As governor, I could have shut down every source of pollution in the state and Delaware would still have been in nonattainment,” he said. “That’s when I realized we had to have a national solution to address our air quality problems.”
Improving air quality is the only real solution to the increasing number of hospital patients with respiratory problems, according to Sarah Bucic, a Delaware nurse representing the American Nurses Association who testified before the U.S. Senate Committee on Environment and Public Works on June 15.
“We are fixed in a state of keeping patients with chronic conditions like asthma and other pulmonary and cardiovascular conditions stabilized, when we all know that prevention is the only real, effective and long-term treatment,” she told the panel.
For now, the heat wave of early June suggests there will be many more days this summer when Delawareans will experience unhealthy ozone levels. “Those levels are as high as anything we saw last year,” DNREC’s Fees said.
- Ayana keeps inhalers and other medications close by on days air quality alerts are issued.
To reduce ozone emissions, DNREC urges people to avoid driving their cars whenever possible; to postpone using gasoline-powered lawn mowers until the evening; avoid lighting barbecues with lighter fluid, and to use latex rather than oil-based paints.
Meanwhile, unless state and federal authorities find a way of bringing ozone back to healthy levels, Ayana Currington and her mother will have to be vigilant about when and where she goes outside, especially during summer months.
Naya Thompson says she has been able to keep her daughter out of the hospital in the last year because they have gotten better at managing her condition, but not because the air is getting any cleaner.
“I don’t see any improvement in the air quality,” Naya said.
