Reduce ozone levels for kids’ sake

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.

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 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.