Junk Medicine: A Senator’s Appalling Statement on Asthma and Air Pollution

By Dr. Larry Chiaramonte and Dr. Paul Ehrlich

As Senator Daniel Patrick Moynihan famously said, “Everyone is entitled to his own opinion, but not his own facts.” Thus we read, “Air pollution has no connection to asthma, Kentucky GOP Sen. Rand Paul said on the Senate floor.”

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Relying on a 2006 paper by someone named Joel Schwartz, which “contends that most information on air pollution from environmentalists, regulators, scientists and journalists is exaggerated or wrong. Paul, an ophthalmologist and eye surgeon said in his remarks: ‘We have decreased pollution and rising incidence of asthma. Either they are inversely proportional or they are not related at all.’”

The two of us don’t agree on much politically. One of us is a bleeding heart liberal and the other emphatically is not. However, we both practice in a big city where asthma has been an epidemic for generations, and we know that air pollution is a terrible problem for people with asthma. As far back as 1966, one of us (Dr. Chiaramonte), while running the training program for allergists at Long Island College Hospital in Brooklyn, measured the highest two-day levels of sulfur dioxide levels on record, and they happened to coincide with the highest emergency asthma admissions at the hospital ever. You remember 1966—that was when the Tobacco Institute was arguing that smoking wasn’t bad for us. Today SO2 is not at big a problem as it was because of a 1990 cap-and-trade program, but there are other things out there to replace it as a contributing factor to asthma.

What’s wrong with Sen. Paul’s assertion? Start with the use of the terms asthma and air pollution as if they were each one thing. They’re not. As we write in our book, asthma is now commonly acknowledged not to be a disease anymore, but a syndrome. That is, a collection of symptoms with a multiplicity of triggers, some of which are allergic and some of which are not. Some air pollution is natural—say pollen, if you happen to be allergic, or the smoke from an active volcano–and some of it is manmade, such as diesel particulates, like those discharged from the trucks at the Hunts Point Terminal Market, which make the neighborhood highest asthma zip code in the country (and where Dr. Chiaramonte now practices). Some pollution is a combination of natural and manmade things, like the interaction of sunlight, topography, and vehicle emissions that make Los Angeles the Disneyland for ozone that it is. Air pollution might not be the sole cause of asthma in a population, but it contributes to the underlying inflammation and sensitivity of asthmatic lungs and in fact can trigger asthma even in those who have no genetic predisposition, as happened to many 9/11 first responders in New York.

What would Doctor Rand Paul say if we dealt with blindness this simplistically? He knows that glaucoma is different from macular degeneration. He also knows that although children are taught not to stare directly at the sun, some of them do lose their sight from other causes. Unfortunately, children can’t be taught not to breathe on bad air days.

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