Elsevier

The Journal of Pediatrics

Volume 161, Issue 5, November 2012, Pages 781-786
The Journal of Pediatrics

Commentary
The Impact of the Clean Air Act

https://doi.org/10.1016/j.jpeds.2012.06.064Get rights and content

Section snippets

A History of the Clean Air Act and the Environmental Protection Agency

Key federal legislation related to clean air is summarized in Table I. The first legislation involving air pollution was enacted in 1955, and it authorized funds for air pollution research.2, 3 It was followed 8 years later by legislation to control air pollution. The Clean Air Act of 1970 represented a major shift in the responsibility of the federal government for limiting the exposure of US citizens to air pollution by authorizing regulations limiting harmful emissions from stationary and

Adverse Effects of Air Pollution on Children

There are several lines of evidence suggesting that the health consequences of air pollution are not distributed equally among the population. Children are more susceptible and at greater risk.5 Compared to adults, children have unique developmental and physiologic differences that impact health and disease, differences that increase their vulnerability to air pollution.6 The health effects of air pollution on children are summarized in Table III. Lung development begins in utero but continues

Prenatal Exposure to Air Pollution and Birth Weight

Multiple studies have demonstrated a relationship between air pollution and lower birth weight31, 32, 33, 34 with subsequent increased risk for the development of respiratory diseases and diminished lung function. Reduced lung function in infancy predicts low lung function later in life,35 suggesting that early influences on respiratory health have lasting impact. In a community-based prospective study of pregnant women living in 4 residential areas of Beijing, China, which included >74 000

Air Pollution and Infant Mortality

Air pollution is associated with increased postneonatal infant mortality, including sudden infant death syndrome (SIDS).38, 39, 40, 41 Using time-series analyses, the relationship between daily air pollution levels and daily SIDS rates was studied in 12 Canadian cities over a 16-year period.40 Average levels of all pollutants were well within current EPA standards for criteria pollutants (Table II). Higher levels of carbon monoxide, sulfur dioxide, and nitrogen dioxide were associated with

Air Pollution Negatively Impacts Lung Growth

Numerous studies using animal models have demonstrated interrupted lung development due to exposure to pollutants, as reviewed elsewhere.7 These findings are reflected in several clinical studies that showed exposure to air pollution was associated with impaired lung growth in children that may be permanent.

Two decades ago, the Second National Health and Nutrition Examination Survey established an association between chronic exposure to air pollution and reduced pulmonary function.5, 44 In a

Air Pollution and Respiratory Illnesses in Children

Children of all ages are at risk for suffering respiratory symptoms related to air pollution exposure, but children with chronic respiratory diseases, including asthma, may be particularly at risk. Although asthma is a multifactorial disease, evidence that exposure to airborne pollutants is associated with asthma inception, asthma exacerbations, and severity of asthma symptoms will be reviewed later. This is an important public health concern, because asthma is one of the most common chronic

The Economic Costs of Air Pollution

The Clean Air Act Amendments of 1990 included requirements that the EPA perform periodic benefit-cost analyses of the impact of the regulations. To date, 3 in-depth analyses have been performed. The first was a retrospective analysis that estimated the benefits and costs of the initial Clean Air Act regulations before 1990 by comparing the differences between historical environmental and economic conditions observed with the Clean Air Act in place and hypothetical scenarios that projected

Discussion

We have come a long way since the catastrophic Donora smog. We know that levels of air pollution below current standards are unhealthy, particularly for vulnerable populations, such as children with respiratory diseases.59, 62, 63 In 2004, the American Academy of Pediatrics issued a statement that argued current standards for several critical pollutants were inadequate and should be reevaluated.70 The recent EPA recommendation to strengthen ozone standards was based on these and other valid

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    The authors declare no conflicts of interest.

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