According to a new report by the American Thoracic Society and the Marron Institute of Urban Management at NYU, thousands of lives would be saved each year, and many more serious illnesses avoided, if US counties met clean air standards set by the ATS for the two most important air pollutants.

The ATS’s standards for ozone (O3) and fine particulate matter (PM2.5) are more protective than those adopted by the US Environmental Protection Agency. If the ATS’s clean air standards were met, each year in the US approximately:

  • 6,270 lives would be saved,
  • 15,300 instances of serious illness would be avoided and
  • 12.7 million missed school and work days would be eliminated.

The new report, published online in the Annals of the American Thoracic Society, builds on the two organizations’ 2016 “Health of the Air Report” by using the latest air quality data available. The latest report includes two new measures — short-term PM2.5 and lung cancer incidence — to give a clearer picture of how air pollution impacts health in the US.

The ATS-recommended standards for O3 and PM2.5 are based on scores of national and international epidemiological, animal and human-exposure studies. These standards are more rigorous than National Ambient Air Quality Standards (NAAQS) for both O3 and PM2.5 that the EPA relies upon.

The ATS recommends:

  • A 0.060 parts per million (ppm) 8-hour standard for O3, rather than the EPA’s 0.070 ppm standard. Eighty-two percent of monitored counties failed to meet this ATS standard.
  • An 11 micrograms per cubic meter (µg/m3) annual standard for PM2.5, rather than the EPA’s 12 µg/m3. Eight percent of monitored counties failed to meet this ATS standard.
  • A 25 µg/m3 short-term (24 hours) standard for PM2.5 rather than the EPA’s 35 µg/m3. Twenty-one percent of monitored counties failed to meet this ATS standard.

“In addition to highlighting the benefits of strengthening the NAAQS, this report can help guide local and regional air quality management decisions,” said report co-author Gary Ewart, MHS, chief of the ATS advocacy and government relations program. “The report’s local health estimates can help public officials make difficult decisions regarding how aggressively to adopt new technologies or, alternatively, how aggressively to restrict high-polluting sources.”

The 10 metropolitan areas that would benefit the most from meeting the ATS O3 and PM2.5 standards are:

  1. Los Angeles (Long Beach-Glendale), CA: 941 lives saved, 2,670 fewer morbidities, and 2,250,000 fewer impacted days
  2. Riverside (San Bernardino-Ontario), CA: 609 lives saved, 1,250 fewer morbidities, and 1,100,000 fewer impacted days
  3. Bakersfield, CA: 369 lives saved, 513 fewer morbidities, and 247,000 fewer impacted days
  4. Fresno, CA: 244 lives saved, 458 fewer morbidities, and 359,000 fewer impacted days
  5. Pittsburgh, PA: 205 lives saved, 382 fewer morbidities and 197,000 fewer impacted days
  6. Phoenix (Mesa-Scottsdale), AZ: 178 lives saved, 432 fewer morbidities, and 453,000 fewer impacted days
  7. New York (Jersey City-White Plains), NY-NJ: 166 lives saved, 626 fewer morbidities, and 492,000 fewer impacted days
  8. Houston (The Woodlands-Sugar Land), TX: 163 lives saved, 508 fewer morbidities and 476,000 fewer impacted days
  9. Visalia (Porterville), CA: 144 lives saved, 199 fewer morbidities and 109,000 fewer impacted days
  10. Philadelphia, PA: 132 lives saved, 218 fewer morbidities and 136,000 fewer impacted days

On a state-wide basis, California alone is responsible for half the total estimated deaths, while the next highest impacted states—Pennsylvania, Texas, Arizona, Michigan, Ohio, New York and New Jersey—contribute nearly 30% of the total mortality impact.

A searchable online tool for city- and county-specific health estimates to aid in quality management decisions at the local level can be found at