Moderated by Rick Badie

It’s summertime and, in Georgia, that means stifling heat and occasional poor air quality. Ground-level ozone, a main ingredient of smog, has harmful effects, notably on the young, older adults and those with respiratory illnesses. It’s the focus of today’s discussion, led by a pediatric pulmonologist who calls for stronger ozone standards based on scientific evidence. The other column is written by an Atlanta teen who suffers with asthma.

Reduce ozone levels for kids’ sake

By Dr. LeRoy Graham Jr.

Caution: “Code Orange Smog Alert.”

We have already seen and expect to see more code orange days this summer, especially when the temperatures soar into the 90s. A code orange day means that metro Atlanta’s air quality is unhealthy for sensitive groups, including all children and those with heart and lung disease. When ozone levels reach code orange, we are suppose to limit prolonged outdoor exertion, especially during the late afternoon or early evening. Code orange days also meanI see more young patients coming into my practice coughing and wheezing with exacerbated asthma.

Ozone triggers asthma attacks and has the potential to send children to the hospital. Asthma is still the No. 1 reason for admission to the inpatient services and emergency rooms at Children’s Healthcare of Atlanta. And the direct cost for asthma-related hospitalizations among these children in Georgia amounts to more than $27.8 million.Metro Atlanta has a longstanding problem with ground-level ozone pollution. Luckily, levels have improved somewhat over the last few years thanks to the Clean Air Act. However, currently inadequate ozone limits still allow our children to be exposed to levels which current research show to be clearly harmful to their lungs.

Ozone, also known as smog, causes millions of asthma attacks every year in the United States. According to this year’s recently released American Lung Association “State of the Air 2015” report, Atlantans are among the nearly half of all Americans – more than 138 million – who live in counties where ozone or particle pollution levels make the air unhealthy to breathe. The report, which is like a report card for America’s air, gave Fulton, Gwinnett, DeKalb and Cobb counties, an “F” for having too many days where levels of ozone made the air unhealthy to breathe.

Breathing ozone pollution can shorten life as demonstrated by increased daily death rates when ozone levels are markedly elevated. Ozone also causes shortness of breath, wheezing and coughing; asthma attacks; increased risk of respiratory infections; and increased need for children with asthma to receive medical treatment resulting in increased utilization of the already busy emergency room and inpatient services. Most recently, breathing high levels of ozone has been linked to cardiovascular harm and risks to the central nervous system.

Even low levels of ozone pollution can be deadly, with researchers finding that ozone at these levels are still associated with deaths from strokes, respiratory causes and cardiovascular disease. The lungs of our children are uniquely at risk as their airways are smaller with still-developing defense systems that are too often easily overwhelmed. Also, let’s face it: Children want to play outdoors, as well they should.

Based on the review of thousands of studies, experts agree ozone harms health at levels well below what is currently considered “safe.” Stronger ozone standards that reflect the latest science will help reduce the devastating impacts from ozone pollution on children. The Environmental Protection Agency standards for ozone are set higher than levels recognized to be dangerous to health and, as a result, Atlantans continue to breathe harmful levels of ozone.

I typically urge parents to protect their children by checking air quality levels daily. Sources include local radio and TV weather reports, newspapers and online at http://www.airnow.gov. Since air quality alerts are based on the outdated ozone standard, the warnings may not accurately reflect the risk to children who simply want to play outside on a warm sunny day.

In my opinion, the EPA needs to heed the scientific consensus and set stronger ozone standards based on the scientific evidence available. Every child deserves the opportunity to play outside and breathe clean air. Our children should not continue as canaries in the cold mine serving as our early warning system as our air quality deteriorates.

As doctors, parents and adults, we have to put the health of our children first and strengthen standards to reduce ozone pollution.

Dr. LeRoy M. Graham Jr., a pediatric pulmonologist, is associate clinic professor of pediatrics at Morehouse School of Medicine and a staff physician at Scottish Rite Children’s Medical Center, Hughes Spalding Children’s Hospital and Egleston Children’s Hospital.

Clean up our air to ease asthma

By NNaserri Carew-Johnson

I am 16 years old. I was diagnosed with asthma when I was four years old. Since then, my life hasn’t been the same. Asthma causes my airways to become inflamed, narrow and produce extra mucus. My airways are different from other individuals because the inflammation makes the air that passes through my airways scarce. Because of this, my chest often tightens when I’m active and I have to take multiple breaks. I am always aware that I have asthma and need to monitor my activities.

My favorite sports are track and tennis and I love spending time outdoors. The adrenaline and family vibe from running and hitting that yellow ball and my everlasting curiosity to travel and explore our beautiful world, make me work harder regardless of my asthma, because it’s no excuse. Striving for excellence doesn’t afford me to sit out and whine.

Initially, it really bothered me when my coaches felt I was dragging and I was scared that I might not make the track team. I have learned how to pace myself and let my coaches know how asthma affects me. They cut me some slack when I’m in distress, but I never take it for granted. I know I’m capable and that they’re counting on me.With the help of my mom, I’ve learned what triggers my asthma attacks. Many of them, like drinking milk, I can control by avoiding them. However, for a few of the causes like air pollution, I can’t. My mom checks air quality levels daily and on days that are really hot, there is usually more ozone. I’ve learned that when there is more ozone in the air, my asthma is much worse and I have to be extremely careful. When we travel, mom always plans our activities based on the air quality in those states and countries so that I can be safe and have a great experience.

To protect myself, I carry two inhalers at all times in case I have an attack. My inhalers are an extension of me. If it wasn’t for my self-control and my inhalers, my body would be pretty messed up and I’d be in danger. I am still a teenager who wants to be as normal as possible so, at times, I have taken my inhalers late and had to temporarily sit things out. When my asthma affects me, I become extremely lightheaded, my chest feels tight and, in extreme cases, I gasp for air.

I’m confident of what I can do and know my limits. That wasn’t always the case. When I was younger, I felt different because of my asthma. Five years ago, I attended Camp Breathe Easy, a weeklong overnight camp for kids with asthma, and my perspective changed completely. We learned we can do anything other kids can. That inspired me.

Last summer and this summer, I returned as a leader-in-training, assisting counselors to make the camp experience safe, healthy and fun for younger children. Because the camp truly changed my life, it is important for me to share my knowledge and help raise awareness about air pollution and how it affects me and other kids with asthma.

Having asthma has made me determined and motivated to help others to not have to deal with what I’ve had to. I want to fight for myself and other kids with asthma so that we can play outdoors on a summer day. I want to be able to run track and play tennis. I don’t want our moms to risk jail time, like my mom did, because we miss a lot of days from school. I want kids to realize their capabilities like I have. To do so, we need to be able to breathe clean air every day. Adults have to be willing to do what’s right and tell our nation’s leaders that we need to clean up our air.

NNaserri Carew-Johnson and her mother, Vicki, live in Atlanta.