For a long period of time in the last century, Pittsburgh was known for its dirty and dangerous air quality.  But over the last 40 years, the city has really cleaned up its act.  Today, your eyes would see a very clean city.  Your lungs would have a different opinion.

In 2012, the Pittsburgh region had an unhealthy air quality index (AQI) for 35 days (almost 10% of the year), in violation of federal clean air standards for ground level ozone and particulate matter.  It had “satisfactory” air quality (which is not equivalent to “good” air quality) for 245 days.  Put another way, we breathed air that was not “good” 280 days out of 365 days in 2012.  Lexi Belculfine reveals where Pittsburgh ranks:

While the air in Pittsburgh is the cleanest it’s ever been, the American Lung Association still ranks the city among the United States’ most-polluted metropolises.

Pittsburgh is one of two metro areas outside of California to rank among the top 25 most polluted by ozone smog and by soot, formally called long- and short-term particle pollution, according to the American Lung Association’s State of the Air 2013 report released today.

Pittsburgh was ranked 7th in short-term particle pollution, 8th in year-round particle pollution and 24th among the ozone-polluted, the lung association said.


Pediatricians Deborah Gentile, Keith Somers, and Jonathan Spahr report what we’ve all been seeing:

Not just last century’s smoke-choked skies were a problem. The report found that modern-day levels of air pollution lead to a broad range of very serious — and potentially fatal — health effects, from cradle to grave. These include heart and lung disease, asthma, poor birth outcomes (fetal development problems, premature birth and infant mortality), stroke, lung cancer and early death.

Since we all have to breathe, no one is safe from these kinds of health effects. And some of our most vulnerable citizens — children, the elderly, the sick and those living in poverty — are at even higher risk, the report found.

These are the terrified children we treat in the ER gasping for every breath, their caregivers unable to afford pricey asthma meds. These are the premature infants who spend months in the neonatal intensive care unit until they are strong enough to leave the hospital. These are the families struggling financially when a parent can no longer work after a stroke or a diagnosis of chronic obstructive pulmonary disease. These are the beloved grandparents who die well before their time.

All of these heartbreaking scenarios are part of our daily reality as physicians.


Most air pollution comes from two activities:  electricity generation and transportation.  Coal burning — still the primary source of electricity in this area — has left a legacy of pollution in southwestern Pennsylvania.  While the burning of natural gas is about 50% “cleaner” than coal, obtaining it through fracking is an energy-intensive and dirty business.  Air pollution emanating from diesel trucks and buses are also a big part of the problem.

Make no mistake — air quality has been improving for almost half a century in the Pittsburgh region.  But pollution is still present in the air we breathe, and it is still negatively affecting health in profound ways and measurable ways.  Kirsty Oswald has one example:

European research shows that exposure to elevated levels of air pollutants is associated with an increased risk for pneumonia before the age of 3 years, and particularly in the first year of life.


Health is the ultimate judge of how well we, as a society, balance the promotion of progress and the protection of our environment. As long as we truthfully acknowledge that it’s our own health (as well as the health of our loved ones) that hangs in the balance, we should continue to work hard to stay aware and be part of the solution to better living and cleaner air.