TAKING OUR BREATH AWAYHealth Risks from Florida’s Electric

Power Plants

The Florida Clean Power Coalition (FCPC)

November 1998

The Florida Clean Power Coalition (FCPC) gratefully acknowledges and thanks the Educational Foundation of America, the Energy Foundation, the Pew Charitable Trusts and the Turner Foundation for their generous support in making this report possible.

The FCPC includes the following organizations which are responsible for publication of this report:

Florida Consumer Action Network (FCAN)

Legal Environmental Assistance Foundation (LEAF)

Contact: Steve Murchie Contact: Gail KamarasMercede Executive Plaza 1114 Thomasville Road, Suite E1804-C North University Drive Tallahassee, Florida 32303-6290Ft. Lauderdale, FL 33322 (850) 681-2591(954) 423-3226 e-mail:

leafeap@igc.apc.org or leaf@lewisweb.nete-mail: a037782t@bc.seflin.org

Project for an Energy Efficient Florida (PEEF)Florida Public Interest Research Group (FPIRG) Contact: Bill JonesContact: Lynn Tyrrell 707 East Park Avenue704 West Madison Avenue Tallahassee, Florida 32301Tallahassee, FL 32304 (850) 222-0808(850) 224-3321 e-mail: creative@lewisweb.nete-mail: floridapirg@pirg.org

This report is available on the following websites: FCAN - www.fcan.orgPEEF - www.lewisweb.net/creative FPIRG - www.pirg.org/floridapirg

Hard copies are available from the above FCPC member organizations for $5.

Taking Our Breath Away (November 1998)

The FLORIDA CLEAN POWER COALITION works to improve human health and the environment through reducing air pollution from electric power plants and increasing energy efficiency and clean renewable resources.

_Printed on recycled paper

TAKING OUR BREATH AWAYHealth Risks from Florida’s Electric Power

Plants[We] impose the cost of pollution on people who breathe, so the people who pollute can avoid the cost of control. I think this is backwards.

-- The late Edmund S. Muskie, U.S. Senator

Overview

Air pollution kills more than 50,000

people a year in the U.S. -- more than traffic

accidents, breast cancer or AIDS. Though our

air has gotten cleaner, even with current

pollution standards in place, it is not clean

enough to avoid making millions of people sick.

Electric power production is a major contributor

to air pollution and its health impacts.

Florida’s electric power plants are

significant sources of air pollution, releasing

hundreds of thousands of tons of dangerous

pollutants each year into the air we all breathe.

Breathing high levels of ozone smog, fine

particles, acid aerosols, and hazardous air

pollutants puts the health of millions of Florida

residents at risk. Still other poisons, like

mercury, affect human health through the

aquatic food chain. Millions of tons of carbon

dioxide emissions contribute to global warming

which could have severe health effects. All

these pollutants come from power plants.

In 1997, Florida’s largest power plants

emitted nearly 320,000 tons of ozone smog-

causing nitrogen oxides (NOx ), almost

700,000 tons of fine particle- and acid rain-

forming sulfur dioxide (SO2) and more than

120 million tons of global warming-carbon

dioxide (CO2) into our air. Surprisingly,

mercury pollution is neither measured nor

restricted by state or federal environmental

agencies; however, the U.S. Environmental

Protection Agency (EPA) estimates that one-

third of mercury pollution comes from coal-fired

power plants.

Ironically, nearly 30 years after passage

of the federal Clean Air Act in 1970, we still

have health-threatening air pollution problems.

A loophole in the Act exempted power plants

built before the early 1980's from having to

meet the same clean air standards as new plants.

In fact, exempt plants pollute at four to ten times

the rate of new plants. Many of Florida’s coal

and oil-fueled power plants take advantage of

that loophole, creating excess emissions over

new standards. This means Florida has a

significant number of dirty older power plants

(primarily coal-fueled) that disproportionately

pollute and threaten our right to breathe safe air.

Florida’s dirtiest dozen power plants for 1997

were:

1. BIG BEND (TECO)* Excess tons: NOx 31,764, SO2 84,4912. CRYSTAL RIVER (FPC) Excess tons: NOx 32,345, SO2 86,2263. GANNON (TECO)* Excess tons: NOx 27,648, SO2 56,6744. SMITH (GULF) Excess tons: NOx 4802, SO2 52,8355. CRIST (GULF) Excess tons: NOx 7023, SO2 30,062*6. SEMINOLE (SMNL)* Excess tons: NOx 13,256, SO2 23,2207. FT. MYERS (FPL) Excess tons: NOx 7178, SO2 19,8298. SANFORD (FPL) Excess tons: NOx 7479, SO2 21,2589. ST. JOHNS RIVER (JEA) Excess tons: NOx 17,264, SO2 10,25510. BARTOW (FPC) Excess tons: NOx 2676, SO2 21,26511. RIVIERA (FPL) Excess tons: NOx 4256, SO2 19,31012. ANCLOTE (FPC) Excess tons: NOx 4083, SO2 19,157

[Based on excess emissions in 1997 over new plant equivalents. * incomplete reporting]

The problem could worsen with retail

competition in the electric power industry if

citizens and government do not call on all

electric power producers to take responsibility

for the environmental health problems they

cause. Competition could allow consumers to

choose their power suppliers similar to how we

choose a long distance phone company.

Companies that can make the cheapest

electricity will beat the competition. This will

create an incentive to electric companies to

operate the cheapest (and dirtiest) plants more

often and for a longer time. New power plants

meeting today’s stricter Clean Air Act standards

have pollution control equipment that greatly

reduces pollution and the damage it causes. But

because the cost of pollution control is part of

the cost of new plants, they cannot compete with

older coal plants having minimum or no

controls.

The health and environmental

consequences of air pollution are not included

in what customers pay for electricity from

exempt power plants. As a result, the health

costs from power plant pollution are imposed

on taxpayers and health care recipients. Every

taxpayer bears the cost of Medicaid payments to

treat illnesses caused by air pollution. Florida

spent more than $326 million from July 1996 to

July 1997 to treat 69,000 Medicaid patients with

asthma, an illness associated with air pollution

(see discussion below). In addition, as health

care patients and health insurance customers,

everyone pays for air pollution-related health

care costs in higher insurance premiums.

Healthy People 2000, a report prepared by the

Centers for Disease Control and others,

estimated the costs of outdoor air pollution in

1994 at $40 - 50 billion (On a per person basis,

Florida’s share would be about $2.5 billion).

More importantly, the report attributes between

50,000 and 120,000 pre-mature deaths per year

to air pollution. People with respiratory

diseases die, on average, three years earlier than

the average life expectancy.

Regulated Power Plant Pollutants and Their Health Effects

OzoneWhat Is It? It is a highly corrosive, invisible

gas.1 It is the main ingredient in smog

(particulates, discussed below, often make smog

visible). Ozone is our nation’s most widespread

air pollution problem.

1 It is easy to be confused about ozone. In the upper atmosphere, it acts as a sunscreen, protecting Earth. At ground level, where we all breathe, it is dangerous.

How Is it Produced? It is created when

nitrogen oxides (NOx) and other air pollutants

combine in sunlight and high temperatures to

form ozone smog. In most places, ozone is

worse in summer. In Florida, the air circulation

from the seas and frequent summer rains often

“wash” ozone out of the air. But in late spring

and early fall, re-circulation of land-sea breezes

play an important role in the build-up of smog

that does not go away quickly. In 1998, Florida

environmental and health officials issued the

state’s first statewide smog alert a few days

before Memorial Day weekend. [See box (next

page) on ozone alerts.]

What Are its Health Effects? Generally, small

airways in people’s lungs can become damaged

somewhat like a smoker’s lungs. Also, the

lung’s defenses are weakened and people

become vulnerable to increased infection.

Ozone burns (oxidizes) people’s lungs and is a

powerful respiratory irritant. It causes airways

to become swollen and inflamed, resulting in

scarring and decreased breathing ability.

Exposure to ozone, even for healthy

individuals, may cause:

Ø temporary reduction in lung function;

Ø cough, throat irritation, chest pains on

deep breathing, nausea and

shortness of breath;

Ø increased airway sensitivity, leading to

increased respiratory

inflammation and infection;

Ø worsened symptoms from outdoor

exercise.

The most vulnerable are children,

people with respiratory illness (e.g., asthma,

bronchitis, emphysema) and those who exercise

outdoors. Children are at increased risk

because:

OZONE ALERTS -- 1998

The U.S. Environmental Protection Agency (EPA) adopted tighter ozone smog standards in July 1997 that will become effective sometime after 2000. State environmental and health agencies issue public alerts when standards are violated for longer than a minimum period. In late May to early June 1998, Florida had 22 ozone days that exceeded the current (old) standard of .12 parts per million for one hour and 28 days that exceeded the proposed (new) standard of .08 parts per million over 8 hours.

Reporting of ozone alerts by the media, especially weather forecasters, would help to educate and warn the public about this dangerous condition. During ozone alerts, people are recommended to stay indoors if possible and not to exercise outdoors.

Ø their airways are narrower, making

inflammation effects worse;

Ø they breathe more air per pound of body

weight than adults; and

Ø they spend more time outdoors,

especially in seasons when

ozone is worst.

Many medical studies show a link

between higher ozone levels and increased

hospital admissions and emergency room visits

for respiratory distress. Most effects of ozone

are short-term and associated with higher

exposure, but long-term exposure appears to be

a serious concern that is being studied by the

medical community.

Particulate Matter (PM)

What Is It? A potentially deadly pollutant,

PM is a “grab-bag” of pollutants that includes

small, solid particles (soot), gas and liquid

chemicals, and aerosols. Larger soot particles

that we can see are not as dangerous as the very

small ones we can’t see.

How Is it Formed? Larger particles typically

include substances like wind-blown dust from

vehicles or agricultural activity. Particles formed

by burning coal, gasoline, oil and diesel fuels are

much smaller. Currently regulated larger PM is

referred to as PM-10. Sulfur dioxide (SO2)

emissions from power plants are a primary

ingredient in PM-10 and in soon-to-be-regulated

finer particles -- PM-2.5.

Asthma - A Special Concern: Asthma is a chronic condition in which airways are constricted, resulting in labored breathing, wheezing, coughing and inflamed and swollen airways. Asthma affects about 15 million Americans. It is now the number one chronic childhood illness in the U.S. The prevalence of asthma rose 61% from 1982-1994, with a dramatic 69% rise in childhood asthma. Physician office visits for asthma rose 50% from 1980-1994 and asthma accounted for one of six emergency room visits by children in 1996. The Centers for Disease Control reports that Americans suffer more than 100 million days of restricted activity each year from asthma. Medical and lost work costs are expected to rise from $6 billion in 1990 to more than $14 billion in 2000. As noted above, Florida Medicaid spent more than $326 million in the last fiscal year to treat asthma patients in this state.

Children - five million have asthma; every two minutes a child 15 years or younger is taken to a hospital emergency room for an asthma attack. The death rate for persons under 19 years has increased 78% from 1980-1993. 10 million school days are lost each year. Air pollution is recognized as an important factor in triggering asthma episodes.

African Americans - are 26% more likely to suffer childhood asthma than whites.

Puerto Ricans - one in five children have asthma, the highest rate of any ethnic group.

While air pollution is not the underlying cause of asthma, it does worsen its frequency and intensity. EPA has estimated that 250,000 asthma cases could be eliminated by its new PM-2.5 and ozone standards.

Asthma disproportionately affects children, women, African Americans, Puerto Ricans and people living in urban areas:

What Are its Health Effects? Fine particle

pollution can kill. Thousands of deaths each

year are associated with PM pollution, even at

levels below current federal standards. The

EPA estimated that about 15,000 deaths per year

could be prevented by its new PM standards.

Fine particles are breathed deep into the

lungs and may not be expelled. Typical heath

effects include: runny or stuffy nose, sinusitis,

sore throat, wet cough, burning or red eyes,

wheezing, dry cough, phlegm, shortness of

breath, chest pain, and increased symptoms from

asthma, bronchitis and emphysema.

Sulfur Dioxide (SO2)What Is It? SO2 is an invisible gas created

when the sulfur contained in coal, oil or diesel

fuel is burned.

How Is it Produced? Roughly 70% of total

U.S. SO2 emissions are from coal-fired power

plants. In Florida, over 95% of SO2 is from

power plants. SO2 reacts chemically in the air

to form acid particles (PM), sulfuric acid, and

other sulfates -- all of which are dangerous.

What Are its Health Effects? When inhaled,

SO2 and its by-products (e.g., acid aerosols)

may cause a range of health effects. At high

levels, it can reduce lung function in healthy

people. Asthmatics, particularly children, are

very vulnerable. SO2 triggers swelling in

airways that chokes off breathing. SO2

combines to form ammonium sulfate aerosols, a

major component in fine PM pollution discussed

above.

Nitrogen Oxides (NOx)What Is It? NOx is a family of chemical

compounds; two principal chemicals are nitric

oxide (NO) and nitrogen dioxide (NO2).

How Is it Produced? Nitric oxide is emitted

from cars and power plants and changed in the

air to nitrogen dioxide, which is then changed to

fine particle (PM) nitrates or gaseous nitric acid.

When exposed to sunlight, NOx reacts with

other chemicals to form ozone smog.

What Are its Health Effects? NOx is a

potent pollutant by itself, and it also is an

essential component in the formation of other

dangerous pollutants. Like ozone, NOx

corrodes lung tissue. Studies show that animals

exposed to NOx are less able to fight bacterial

A SNAPSHOT OF FOUR MAJOR POLLUTANTS

EPA regulates the following four"criteria" air pollutants:

Particulate Matter, commonly known as soot, is linked to about 50,000 American deaths each year.

Sulfur dioxide, an invisible gas that poses a severe threat to asthmatics, is also the main cause of acid rain.

Ozone, or smog, literally burns holes through the cells of the lung, leaving children and adults unable to breathe normally.

Nitrogen oxides are gases formed by smokestacks and other sources that lead to formation of particulate matter and ozone and may themselves be linked to lung disease.

infections and their risk of viral infection increases.

The Electric Power ConnectionElectric utilities are required to report emissions of SO2 and NOx to EPA. The graphs below

[Figures 1-4] show the total tons and the rate at which Florida’s dirtiest dozen power plants emitted those

pollutants in 1997. While many people think only of cars as contributors to ozone, Table 1 shows that

electric utility NOx pollution is significant compared to cars. Generally, power plants exempt from the

Clean Air Act produce these pollutants at 4 to 10 times the rate of new facilities (see Figures 1-4):

The following shows how much NOx was generated by Florida’s largest electric utilities in 1997 and how many cars would produce the same NOx emissions:

Utility NOx tons/yr As much as*

FLP 56,300 2,252,000 carsFPC 59,000 2,368,000 carsGULF 18,000 720,000 carsJEA 27,800 1,112,000 carsSMNL 20,900 836,000 carsTECO 74,200 2,968,000 carsTOTAL 256,200 10,256,000 cars

*Calculation based on U.S. EPA National Vehicle and Fuel Emissions Lab figures for cars, minivans and light trucks.

Hazardous Air Pollutants

Congress, in 1990, classified more than

160 substances as hazardous air pollutants

(HAPs or air toxins) that are known to cause

irreversible and serious illness. Health effects

that may result from long-term exposure to

HAPs include birth defects, cancer, reproductive

problems, nerve disease and poisoning. Coal-

fired power plants emit many air toxins,

including arsenic, chromium, and mercury.

Oil-fired plants are also sources of nickel.

MERCURYMercury is a pollutant of great concern

because it is highly toxic and accumulates in the

body. One main way mercury gets in the human

body is through fish that people eat from lakes,

rivers and coastal

waters where mercury

has contaminated the

fish. Mercury builds

up in the food chain, from microscopic animals

to the fish we eat. Mercury is so powerful that a

20-acre lake can be contaminated by as little as

1/70th of a teaspoon of mercury. While many

foreign governments have made the phase-out of

mercury a priority, power plant emissions of

mercury are not currently monitored or regulated

in the U.S.

At high levels, mercury can disrupt

nervous, immune, hormone and enzyme

functions of human cells. Mercury can harm the

central nervous system and can result in mental

retardation and blindness in fetuses and small

children. (See Table 2 for a list of health

effects). Studies consistently find that fetuses

and children are more at risk because their

bodies and brains are still developing. Mercury

particularly affects language, attention and

memory abilities in children. People who rely

on self-caught fish for food (subsistence fishers),

recreational anglers and Native Americans are

also at high risk.

Health advisories for many waterbodies

in Florida warn pregnant women and children

from eating fish; other waterbodies also have

advisories against eating certain types of fish

from those waters or eating it more frequently

that once a week. More than 2000 miles of

rivers and 183,000 acres of lakes are under

mercury health warnings in Florida.

Human Health Effects from Mercury * Kidney damage Brain damage in unborn children Coordination problems (spasms) Stomach cramps, nausea, diarrhea Fluid in the lungs High blood pressure Low grade/intermittent fevers Redness of palms and soles Numbness or tingling Irregular heart beats Genetic abnormalities Skin irritation

* Effects not listed in any particular order

Unfortunately, most of those waterbodies have

no warning signs posted. Regional DEP offices,

state Health Department offices and the Florida

Freshwater Fish and Game Commission can

provide specific information. (See also:

http://www.state.fl.us/gfc/fishing/health.) See

Table 3 for mercury levels in commonly

consumed fish.

EPA issued a 1997 report to Congress

showing that coal-fired power plants are the

largest source of mercury air pollution in the

U.S. -- about 32% of mercury in the

environment comes from coal plants. Older coal

power plants, exempt from modern clean air

standards, generally pollute the most. EPA has

proposed to issue an information request to

electric utilities to monitor mercury in coal and

in some emissions and to report that information

publicly to EPA. Utilities strongly oppose

EPA’s request to gather that information or to

make it public.

Mercury Levels in Commonly

Consumed FishThe top 10 types of fish consumed by Americans and their average mercurycontents in micrograms per gram weight(parts per million):

Catfish 0.088 & 0.16*Clam 0.023Cod 0.121Crab 0.117Flounder 0.092Pollack 0.15Salmon 0.035

Scallop 0.042

Shrimp 0.047Tuna 0.206

The daily level considered safe by EPA is0.1 micrograms per gram weight (ppm).

Source: U.S. EPA, Mercury Report to Congress, 12/97.

*Two studies surveyed different types of catfish.

Global Warming, Power Plants and Our Health

The Earth’s climate is changing in

significant part because human activities, such

as burning coal, oil and natural gas in power

plants, are altering the chemical make-up of our

atmosphere through the build-up of “greenhouse

gases” -- carbon dioxide (CO2), methane,

nitrous oxide and chlorofluorocarbons (CFCs).

Although there is uncertainty about exactly how

and over what time period this will happen,

climate experts are sure it is happening and

observations indicate that detectable changes are

underway. Even some major CO2 polluters like

3M, Lockheed and British Petroleum recognize

the problem and are urging action. However,

the vast majority of electric utilities still deny

global warming is real.

In the last century, average temperatures

in Florida have increased by two degrees and are

projected to increase by three to four degrees by

2100. Such seemingly small changes can make

a big difference. The frequency of extremely

hot days in summer is expected to increase; it is

likely that severe storms and huricanes may

intensify. The intense drought, fires and flood

experienced in 1998 may be examples of global

warming’s effects.

Global climate change poses serious

risks to human health. Higher temperatures may

increase heat-related deaths and illness.

Scientists recently suggested that 28 people die

in Tampa each year from heat-related causes; as

many as 68 additional deaths could occur with a

three degree temperature increase. People at

risk include the very old, the very young, and

those with pre-existing heart and lung disease.

State and federal programs will be strained to

provide assistance, including social and health

services, Medicare and Medicaid and health

insurance.

Global warming is likely to increase

incidents of infectious diseases carried by

insects and rodents (vectors). Potential diseases

include encephalitis, hantavirus, malaria and

dengue fever. Populations at risk for

encephalitis include rural residents, outdoor

recreationists, and outdoor workers.

Government programs involved include vector

control programs, social and health services,

Medicare and Medicaid and health insurance.

Sea water warming and sea level rise are

already occurring and increased cases of marine-

borne disease, such as from algal blooms, are

also probable. Populations at risk include

coastal residents, marine sport fishermen and

commercial fishermen. Government programs

strained will include food inspection programs,

social and health services, Medicare and

Medicaid and health insurance.

Finally, increases in extreme weather

events like drought, flood and intense

hurricanes, can be expected. Populations at risk

include coastal residents, the elderly, the very

young, the poor and those without access to

health care. Government programs involved

will include disaster relief funds, social and

health services, Medicare and Medicaid and

health insurance.

Florida’s electric utilities produced

more than 120 million tons of carbon dioxide

in 1997 alone. Old coal-fired power plants

cause the lion’s share of the problem. The graph

below shows total tons released into the air by

Florida’s worst CO2 emitters. (See Fig.5.)

Florida’s rapidly growing population

and a trend toward increased consumer use of

electricity are increasing CO2 emissions.

However, Florida could decrease CO2 emissions

significantly by reducing reliance on old,

inefficient coal power plants. Even better,

Florida has an

abundance of

solar energy

from the sun

that remains

untapped.

Florida cities and counties participating

in a federally-sponsored Cities for Climate

Change program include: Broward ,

Hillsborough, Miami-Dade, Orange, and

Sarasota Counties and Miami Beach, Riviera

Beach, and Tampa. This program is aimed at

acting locally to slow the Earth’s warming and

to improve local air quality and livability. If

you live in one of the participating cities or

counties, contact their environmental office to

find out what they are doing.

SolutionsFortunately, Florida is in a unique

position to benefit from energy efficiency and

from the use of clean energy technologies such

as solar energy. Floridians spend more than $20

billion a year on fuels. 2 None of that fuel is

produced in-state, which means our fuel dollars

spent to run power plants have few, if any, local

economic benefits.

State policies supporting solar energy

resources and energy efficiency are on the

books, but are not being seriously pursued.

Electric companies and government decision

makers do not consider the substantial health

costs of our current energy choices. Some states

put an actual dollar value on pollution damage

and consideration is being given in other states

to pollution taxes in place of real property or

sales taxes.

Meanwhile, Florida residents have some

of the highest average monthly electricity bills

in the nation because of our almost exclusive

dependence on electricity to run our homes and

businesses. Aggressive use of energy efficiency

measures could significantly reduce the amount

of electric energy Floridians use. Bringing clean

energy technology manufacturers and energy

2This includes gasoline for vehicles, natural gas, oil, coal and nuclear materials for power plants. Slightly less than half goes for generation of electricity.

efficiency services to Florida could create 2-5

times the number of jobs as power plants for

each unit of energy produced or saved and could

move Florida into the 21st century using clean

renewable energy sources. We could not only

grow our domestic market for solar

technologies, but are well suited to serve as the

export center to growing world markets in the

Caribbean, Latin America and Africa.

Renewable energy technologies could

help Florida meet state air quality goals. In

addition, Florida could reduce its health care

costs and the damage that pollution causes to all

its citizens - particularly those most vulnerable.

Public health, medical and other health-related

professions need to be more aware of the full

implications of air pollution to good health and,

in turn, help to educate others. All citizens need

to demand more healthful air and energy

choices.

Conclusions

Recommendations

« Clean up old, dirty power plants. By the year 2000, all plants must meet modern emission standards for nitrogen oxides and sulfur dioxide currently met by newer power plants (1.5 lbs per megawatt hour for NOx and 3.0 lbs per megawatt hour for SO2).

« Set strict limits on emissions of mercury for all power plants. Currently, there are no limits on power plant emissions of mercury. Power plants should be required to reduce mercury emissions significantly.

« Set strict limits on emissions of carbon dioxide for all power plants. Currently, there are currently no limits on power plant emissions of CO2. Standards are needed to require power plants to reduce CO2 emissions to a level consistent with a cautious approach to global warming.

« Ensure that any electric industry restructuring encourages "green power." Any move towards retail competition at the federal level must include mechanisms to ensure deployment of clean, renewable resources and energy efficiency technologies.

«

We must eliminate the loophole

exploited by Florida’s old fossil plants for too

many years and encourage cost-effective

solutions to meet new clean air standards.

Utilities can take steps at each old dirty plant to

come into compliance with modern standards.

Pollution control equipment, fuel-switching to

relatively cleaner natural gas and retiring

obsolete units are options. If all old plants,

nationwide, are held to the same standard, none

will have the "dirty is cheap" advantage and all

Floridians will have a healthier future.

In order to reduce harmful power plant

pollution and remove unfair subsidies that keep

cleaner energy resources from being used,

federal policy makers must resolve to end the

clean air loophole subsidy given to older power

plants. New power plants must meet

performance standards that are four to ten times

stricter than old plants. It's time to put "term

limits" on the loopholes and phase them out

quickly.

The health damage and health care costs

associated with air pollution from old power

plants are unacceptable. Citizens armed with

information can demand that changes be made

to ensure our air is safe to breathe. Citizens and

government must continue to expand efforts to

encourage clean energy technologies like solar

energy and energy efficiency alternatives to

dirty “dinosaur” power supplies. We need to

make sure these dinosaurs become extinct so

that we won’t!

Information SourcesAsthma and the Role of Air Pollution: What the Primary Care Physician Should Know, Physicians for Social Responsibility, 1997.

Burt, Catharine & Knapp, Donna, “Ambulatory Care Visits for Asthma: U.S. 1993-94,” 277, Centers for Disease Control, 9/27/96.

Dickey, Jefferson, MD, Health Effects of Ozone and NOx, unpublished draft, July 1998.

Dickey, Jefferson, MD, “No Room to Breathe: Particulate Air Pollution and Excess Mortality,” nd.

Dockery, Douglas, et al., “An Association between Air Pollution and Mortality in Six U.S. Cities,” New England Journal of Medicine, v. 329, pp. 1753-9, 1993.

Health Effects of Ground-Level Ozone, Acid Aerosols and Particulate Matter, Ontario Medical Assn. May 1998.

“Health Effects of Outdoor Air Pollution,” Committee of the Environmental & Occupational Health Assembly of the American Thoracic Society, American Jl. of Respiratory & Critical Care Medicine, v. 153, pp. 3-50, 1996.

Health Effects of Outdoor Air Pollution, American Lung Assn. 1996.

Korrick, Susan, et al., “Effects of Ozone and Other Pollutants on the Pulmonary Function of Adult Hikers,” 106 Environmental Health Perspectives 2, 2/98.

Moore, Curtis, Dying Needlessly: Sickness & Death Due to Energy-Related Air Pollution, Univ. Of Maryland, REPP Issue Brief, 2/97.

Pope, C. Arden, et al., “Particulate Air Pollution as a Predictor of Mortality in a Prospective Study of U.S. Adults,” American Jl. of Respiratory & Critical Care Medicine, v. 151, pp. 669-74, 1995.

Statistical Abstract of the U.S., U.S. GPO, 1997.

U.S. EPA Acid Rain ETS/CEM Database 1997. (www.epa.gov/acidrain/edata.htm)

U.S. EPA. Mercury Study Report to Congress, 12/97. (www.epa.gov/ttnuatw1/112nmerc/mercury.html)