EPA must consider COVID-19 when setting air pollutant standards

EPA must consider COVID-19 when setting air pollutant standards
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The Clean Air Act requirements for setting major air pollution standards contain a superb example of how to write a law to protect public health. Congress nailed it. Their language, affirmed by federal courts, requires EPA to adopt science-based numerical standards for allowable levels of major air pollutants, which, importantly, contain an adequate margin of safety.

The rationale given for the margin of safety is to “ address uncertainties associated with inconclusive scientific and technical information” and “to provide a reasonable degree of protection against hazards that research has not yet identified” (these and subsequent quotes can be found in EPA’s Federal Register notice), This rationale seems prescient in anticipating the likely harmful interaction between COVID-19 and air pollutants. Yet COVID-19 is not considered by EPA in their recent proposal for the particulate air standards, despite obvious grounds to do so. 

COVID-19 primarily targets the lung and the heart. These two organs are also the major targets of particulate air pollutants. The particulate air pollution standards of greatest health relevance are for fine particles — those small enough to cause harm by penetrating deeply into the lung. They cause death, increased hospitalization, and other acute and longer-term health consequences, and the elderly and those with pre-existing heart and lung disease are disproportionately at risk. We already know that the same is true for COVID-19. 

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Many affected by COVID-19 teeter at the brink between life and death before either succumbing or surviving. It makes eminent sense to a physician that those with reduced reserve lung function from any cause, including air pollution, are less likely to survive COVID-19.

Conversely, preliminary evidence indicates that even less seriously affected COVID-19 survivors have lung scarring suggesting potential long term loss of lung function. These survivors would be at increased risk from the acute effects caused by fine particles — a vicious cycle.

Precise information is not available. But again, Congress showed its understanding of public health by specifying that the EPA administrator should set the margin of safety even if “the risk is not precisely identified as to nature or degree” - which certainly fits the impact of COVID-19. Congress also gave the EPA Administrator very specific common-sense directions about the factors to be considered when addressing the margin of safety. First listed is the “nature and severity of the effect,” which in this case includes death.

Next is “the size of the sensitive populations(s),” which, including the aged and those with pre-existing lung and heart disease, is about 50 million Americans, with baby boomers swelling the elderly population before the particulates standard is next reconsidered. Also specified by Congress is that the Administrator should consider the “kind and degree of uncertainties.” Many uncertainties will need to be evaluated as we learn more about COVID-19, including whether it is the new normal. But a virus which viciously attacks the lungs and heart is more likely to be fatal to those whose lungs and heart are already compromised because of air pollution - and vice versa. Preliminary studies have already have associated past air pollution with COVID-19 mortality, although such findings are problematic early in the pandemic. 

Wheeler might claim a lack of time to consider COVID-19. He has already used the Clean Air Act’s five-year requirement for reconsidering air pollutant standards to peremptorily dismiss the expert subcommittees for particulates and the forthcoming ozone standard. But this five year time obligation for revisiting air pollution standards rarely has been met, and half of the other air pollutants that are similarly regulated are even longer out of date. It is unlikely to be coincidental that Wheeler has chosen particulates and ozone to jump to the head of the line before the next election. These are the air pollutants for which tougher standards justified by recent scientific studies are of greatest concern to the fossil fuel industry.

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EPA has had time to consider COVID-19. It made its proposal for ignoring the direct scientific evidence by not strengthening the particulate standards a month after President TrumpDonald John Trump Trump responds to calls to tear down monuments with creation of 'National Garden' of statues Trump: Children are taught in school to 'hate their own country' Trump accuses those tearing down statues of wanting to 'overthrow the American Revolution' MORE declared a national emergency for COVID-19. During this period, EPA used the pandemic as a rationale for reducing pollution oversight rules.

The formal proposal for the particulate standard, available for comment until June 29, does not even provide specific reasoning for justifying the adequacy of the margin of safety. However, such thinking has been customary for prior EPA administrators, Republican or Democrat. It does mention COVID-19 once — as the rationale for closing the EPA public docket library.

The pandemic has caused many delays in governmental functions. With so many Americans at risk, EPA needs to withdraw its proposed particulate standards and seriously consider the impact of COVID-19 on the adequacy of the margin of safety required for air pollutant standards. Otherwise, we will be condemned to wait until the next review at least five years from now, which will be too late for too many.

 Bernard D. Goldstein, M.D., is a professor emeritus and dean emeritus at the University of Pittsburgh Graduate School of Public Health. He was chair of the EPA Clean Air Scientific Advisory Committee and the Environmental Protection Agency assistant administrator for research and development under President Reagan.