5 questions: Obama's clean power plan and lung health

The battle over President Obama's clean power plan - in Congress and the courts, in the realms of commerce and common conversation - will rage for some time.

But few are debating the value of the potential health benefits, which are expected to be significant.

In the final rule announced Aug. 3, the U.S. Environmental Protection Agency has set a goal of reducing carbon pollution from the power-generating sector by 32 percent below 2005 levels by 2030.

This major climate-change initiative focuses on power plants because they are a major contributor to carbon pollution, accounting for one-third of all carbon emissions in the U.S.

The EPA has predicted that once the reductions are met, Americans will avoid up to 90,000 asthma attacks a year. Because of reduced absenteeism, they'll spend 300,000 more days in the office or classroom. About 3,500 premature deaths will be avoided.

The American Lung Association supports the plan. Here to give more perspective on the health benefits is pulmonologist Albert A. Rizzo, senior medical adviser to the association. He also is chief of pulmonary and critical-care medicine at the Christiana Care Health System in Newark, Del., and clinical assistant professor of medicine at Thomas Jefferson University Medical School in Philadelphia.

It may be a plan aimed at power plants, but how important is the public-health component? What's at stake?

At its simplest, the quality of our air. This is a major public-health initiative. From the standpoint of the American Lung Association, we feel that climate change is going to mean more extreme temperatures, and more extreme weather, all of which can affect people with lung disease, as well as those who don't have lung disease. Certainly, climate change is going to mean more problems with poor air quality related to ozone and particulate matter, longer extremes of bad allergy seasons, more wildfires.

Can you connect the dots for us? How does climate change affect air quality and lung health?

The main thing is that the reduction of carbon dioxide lessens the greenhouse-gas effect, which causes the warmth. The warmer the environments are over the course of a year, the more likely we are to have bad air quality with regard to ozone and particulate matter.

Ozone - it's called ground-level ozone, or smog - results from the baking of chemicals in the air in the sunlight. It is a chemical reaction that the sunlight causes when pollutants are present. That is more likely to occur on hotter days.

Ozone acts as an irritant in the airways, as if the airways are getting a sunburn. Symptoms can include coughing, chest pain, wheezing, and shortness of breath.

That certainly is more likely to occur and cause problems in a person who already has a lung disease, such as asthma. But on high-ozone days, even someone with normal lungs can feel those symptoms.

Particulates, which can travel deep into the lungs, often with toxins attached, have to do with the fact that climate change would lead to more uncontrolled forest fires, longer forest-fire seasons, and fires occurring in areas where they may not be as common now. There are more immediate effects right there where the fire is, but these particulates can travel outside the area.

There's plenty of debate about the plan itself. Is there doubt about the health benefits?

The science and the health benefits are sound. Even in all the commentaries of people who are against the plan, it's never couched in terms of "we don't think there's going to be a health benefit." It's always whether that benefit is worth the increased economic costs. I have not seen anyone refute the fact that this is good for health.

The plan aims for compliance by 2030. Can we expect any more immediate health benefits?

Yes. The changes needed to reduce carbon emissions from power plants also will affect the emission of other industrial toxins, including sulfur oxides and nitrogen oxides. These are irritating to the airways as well, and they are some of the chemicals that go into making ozone. These are already in some way addressed by the EPA regulations in place. But this rule goes further because it makes the power plants more efficient, so they're likely to have even less of these emissions overall.

How significant is the new rule, historically?

The Clean Air Act, in 1970, was a major initiative. Other EPA regulations built on that. But this is probably the biggest initiative since then with regard to immediate and long-term health, as well as regional, national, and potentially global impacts. This is a global issue. We can't control all of it. But we can certainly be leaders.