As a pulmonologist and a critical care physician at the the Johns Hopkins Bayview Medical Center, I spend my days caring for children and adults who are living with chronic diseases such as asthma and chronic obstructive pulmonary disease. But often, I’m fighting a losing battle. When I prescribe an inhaler to a child, I know it’s only going to be undermined by the air pollution they’re forced to breathe when they leave my office. Air pollution harms our children’s lungs, causes a host of other health problems for all ages, and can even cause early death. The federal government must do more to address it.

This isn’t a niche problem; currently, more than 34 million people in the U.S. suffer from chronic lung diseases, including asthma and COPD. I understand firsthand the benefits of breathing clean air and the impact it can have on children and adults living with lung diseases. I grew up in a largely immigrant community in Baltimore surrounded by large-scale factories and several major highways. Breathing in toxic pollution and diesel emissions was part of growing up in my neighborhood. In fact, we knew the smell of pollution more than we knew the scent of fresh, clean air. I want a different reality for the next generation of Baltimoreans.

The air pollution to which I’m referring is particle pollution — widespread and dangerous emissions produced by power plants, vehicle tailpipes and industrial sources. Thanks to the Clean Air Act, the U.S. has made major strides in reducing particle pollution, but climate change is making it harder to clean up. Many of my patients continue to experience worsened asthma and COPD symptoms because of air pollution. Beyond worsening chronic lung diseases, air pollution can cause heart attacks, strokes and premature death. It is also linked to dementia, low birth weight, greater risk of preterm birth and higher rates of infant mortality.

Recently, the U.S. Environmental Protection Agency unveiled a new proposal to cut deadly particle pollution in our air. While I appreciate this action, the proposal simply doesn’t go far enough. In fact, it leaves thousands of people unprotected. A majority of the Clean Air Scientific Advisory Committee — the EPA’s expert advisers — recommended levels as low as 8 µg/m3 for the annual standard and 25 µg/m3 for the 24-hour standard. 1 µg/m3 means that one cubic meter of air contains one microgram — 10 to the power of -6 grams — of pollutant.

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The EPA didn’t heed the panel’s advice. Instead, the agency proposed to update the national annual standard from 12 micrograms per cubic meter (µg/m3) to between 9 and 10 µg/m3, and didn’t propose updating the 24-hour standards at all.

Developing strong particle pollution standards is especially critical for neighborhoods of color. In fact, the American Lung Association’s 2022 “State of the Air” report found that people of color were more than three times as likely to live in a county with a failing grade for all three categories of pollution the organization measures — ozone and long-term and short-term particle pollution. Systemic injustices have forced communities of color to live near interstate highways and polluting industries, exposing them to increased air pollution. Communities of color and overburdened communities are paying the price for the EPA’s inaction.

Here at the Baltimore Breathe Center — which studies lung health and the environmental effects on it — we’ve created a Lung Health Ambassador Program in which youths discuss the urgent need to address air pollution, particularly in communities of color. Our lung health ambassadors educate students and parents on the health effects of particle pollution, and teach them how to advocate for equitable policies that will result in cleaner air in their communities.

It’s exciting to see young people leading the way on this, but it’s on all of us to make our voices heard on this critical topic. I don’t want to see the EPA miss an important opportunity to strengthen and finalize these life-saving standards. That’s why I’m joining the American Lung Association and other health and medical organizations in calling for the EPA to choose the most protective levels — 8 µg/m3 for the annual standard and 25 µg/m3 for the 24-hour standard — and to finalize them as quickly as possible. I encourage all Baltimore residents and members of the medical community to support our efforts at lung.org/stronger-standards.

Dr. Panagis Galiatsatos is a physician with the Johns Hopkins Bayview Medical Center, an assistant professor at the Johns Hopkins School of Medicine and community engagement co-director of the Baltimore Breathe Center.

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