A Breath of Not So Fresh Air

"Asthma Capital" Knoxville in midst of ongoing air quality alerts, still in EPA non-attainment

The warnings from morning newscasters and interstate signs seem to be increasingly common: “Members of sensitive groups may experience difficulty breathing and should limit outdoor activities.” Aug. 15 marked the fourth day of seven last week considered an air quality alert day, and on Aug. 18, Knoxville reached the “orange” level for ozone, considered “unhealthy for sensitive groups” by government agency AIRnow that collects air quality data.

The daily air quality index (AQI) used to administer the alerts measures ground ozone levels and the amount of fine particles, carbon monoxide, sulfur dioxide and nitrogen dioxide in the air. This thick, murky haze that often obstructs views of the Smoky Mountains can also obstruct the health of local residents.

Coal-burning factories, chemical releases from factories and corporations and vehicle traffic are just a few factors in East Tennessee’s poor air quality, but there’s another factor no one can control: Knoxville and surrounding areas are geographically unfortunate, located in a topographical bowl where pollution gathers and has no way of escaping, says Steve Drevik, president of Agilaire, a Knoxville-based company that provides software and equipment for stations that analyze data to determine AQI levels.

“If you look all around the world, the places with the worst air pollution — L.A., Mexico City, for example — they all have a common geographical feature. They're in a bowl where all the pollutants gather, as opposed to Kansas where it’s nice and flat and pollution can blow away,” he says. 

Regardless of its source, accompanying ongoing pollution in the area are a series of dubious “awards” for the area’s air quality.

In January, Knoxville was named the “Asthma Capital” of the United States by the Allergy and Asthma Foundation of America, the third such honor bestowed upon the city. According to the report, 27,196 adults and 8,465 children in Knoxville suffer from asthma. Knoxville was ranked first because of its poor air quality, a high annual pollen score and lack of “100 percent public smoke-free laws,” the report states.

Also this year, the Brookings Institute labeled Knoxville 10th in the country for carbon dioxide pollution and in 2007, the American Lung Association gave Knoxville a failing grade on its  “State of the Air” report card. The Tennessee Department of Transportation continues to hold Knox County and Anderson, Blount, part of Cocke, Jefferson, Loudon and Sevier counties in EPA ozone non-attainment — meaning the counties do not meet Environmental Protection Agency standards for air quality — and Anderson, Blount, Knox, Loudon and Roane counties in particulate matter non-attainment.

Environmental factors are some of the most influential on asthma patients, says Dr. Bob Overholt, an allergist at a Knoxville office of the Allergy, Asthma and Sinus Center and a national expert on the condition, although asthma is caused by numerous factors and some, like a genetic predisposition to the condition and interior air pollutants like cigarette smoke and pet dander, are unrelated to outdoor air pollution and air quality.
Overholt has practiced medicine in East Tennessee since 1970 and says he has seen the number of patients afflicted with allergies and asthma increase greatly during that time.

“Pollution affects asthma in two different ways,” he says. “It’s a trigger in itself — cold air or any irritating substance like pollution will trigger an asthmatic event in many people — and it reduces mucus production and causes blockage in the airway and clogging of the lungs. It’s really a huge, huge problem.”

There are other repercussions of poor air quality — studies have linked air pollution to upper respiratory infections, allergies, headaches, nausea, lung cancer, heart disease, chronic respiratory disease and blood clots.
Knoxville dipped further into non-attainment this year because ozone standards were lowered after EPA findings that the new level would be more beneficial to public health. Knox County’s director of air quality management, Lynne Liddington, says the new standards are difficult to meet, especially considering the possibility of crossover contamination from pollutants in neighboring counties.

“Knox County entered the 2008 ozone season with a three-year design value [that  was] very close to meeting the then-existing standard," Liddington says. “Remember, the law does not say that you can’t pollute. Rather, the law sets limits on how much you can pollute. Our staff ensures that these regulations are followed.”

Liddington says the 15 employees of  Air Quality Management are working to meet the new standards by monitoring both air quality and local businesses’ level of pollution, trying to improve local conditions through alternative fuels, working with TDOT to lower interstate speeds, enacting an anti-idling policy for fleet vehicles and banning construction-related open burning.

But if their efforts don’t move Knox County into attainment by 2009, Knox County can request two one-year extensions. If attainment standards aren't met by 2013, the EPA will enact more stringent measures, including the possible introduction of yearly vehicle emissions inspections or a reduction in the county’s TDOT interstate funds.

Liddington says some prior legislation inhibits work to avoid these outcomes: “If Congress and EPA do not rewrite and re-introduce certain EPA regulations overturned by the federal courts, such as the Clean Air Interstate Rule, Knox County and many other counties will be left with too few tools to use to make substantial reductions required by the … new standards.”

Though the current air condition is somewhat grim, local residents can still help. Drevik recommends driving less, carpooling and switching out regular light bulbs with fluorescent ones to reduce the amount of electricity used, thus reducing the amount of electricity power plants must produce. “But we can’t do much about the level of through traffic,” he admits, “We just have to set attainable goals.”