• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    The Air Is Not Apparent: An Update on Just What Air Pollution Does

    By Dr. Arthur Lavin

    This fall I was honored to once again attend an important meeting devoted to acting on the harms done to our babies’ brain development by certain chemicals in our air, water, and food.  The nature of harm was brought home to us as the meeting was held a county or so away from the mammoth Kincaid fire in Northern California.  We could see, and smell, the smoke from our conference hotel in Berkeley.  During the conference we were also advised that the air was dangerous enough that we should not breathe it, and so should stay indoors.

    When I say the air is not apparent, this day truly brought that fact home to me.  Because I did go outside, very briefly, and the most striking aspect of the air is that it seemed fine.  Yes, a touch hazy, yes a touch of smell of burning leaves, but just a touch.  It felt perfectly fine to breathe, the sun was shining, it was a nice day.  Had a warning not been issued, I would have no idea any danger was present.

    So, what harm can such air cause?  Why was a warning issued?

    The meeting I was at was of the group called Project TENDR (Targeting Environmental NeuroDevelopmental Risks).  TENDR has brought together 50 or so of the nation’s top researchers in the field of neurotoxicology and epidemiology to share with the public what we now know harms the development of our children’s brains, causing a substantial percentage of the cases of learning disorders, autism, and ADHD.

    This year Project TENDR published a paper stating what we know about air pollution damaging brain development and what can be done to protect the most precious minds of our children.  Here is that paper: https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304902  (2019).  And what follows are some highlights from this work.

    What is Air Pollution?

    Everyone knows what is air pollution and yet, not many not what is in air pollution.

    Everyone knows dirt and chemicals in the air is polluting, but not everyone knows what is in the dirt and chemicals.

    Most elements of air pollution are created by the burning of some material, it’s the smoke from fire pumps particles and chemicals into the air.  Many of the chemicals form tiny particles as well.  This is what is meant by air pollution.

    The fires that create air pollution come in all sorts of sources, including, but not limited to:

    • Wildfires, like the Kincaid fire our meeting was near
    • The internal combustion engine of cars and trucks
    • Coal burning and other power plants
    • Burning agricultural waste

    These sources of smoke lead the creation of particles and chemicals.

    The particles come in various sizes, but those particles in the size of fine or ultrafine are of particular interest.  This group of particles is called Fine Particulate Matter, or PM2.5 for short.

    PM2.5 is the group of particles TENDR finds the most compelling evidence for causing harm to brain development.

    Smoke from fires creates a host of chemicals, too, and TENDR has found the following two classes of chemicals have the most solid evidence for causing harm to brain development:

    • Nitrogen dioxide
    • Polycyclic aromatic hydrocarbons

    What Harm do these Air Pollutants Cause?

    When we say the air is not apparent, we really mean it.  The harm caused by air pollution is deadly, can be seen quickly and over the long-term.

    Stats on impact are hard to really grasp, so I like to use a yardstick of impact that is very familiar, and use that to compare impacts.

    My favorite yard stick for an impact from a common, poisonous practice is smoking tobacco.  People who smoke live an average of 10 years less life.

    So if some practice takes 5 years off an average life of exposure, I know it is 50% as deadly as tobacco, which I know is one of history’s great killers.

    Air pollution shortens life an average of 3 years, but the impact varies by how much air pollution one breathes.  But overall, dirty air is about 1/3 as deadly as smoking cigarettes daily.

    That is an overall picture, here are some of the details:

    Air pollution spikes cause death and illness almost immediately:

    • rapid increases in heart attacks and strokes
    • rapid increases in the death rate of infants and children
    • and, as expected spikes in hospital visits for asthma

    Air pollution, if sustained, has a profound impact on overall health:

    • Increases the chance of heart attack and strokes
    • Increases the chance of lung cancer
    • Increases the chance of developing diabetes
    • Damages developing lungs, leading to decreased lung capacity and of asthma
    • Increases the chance of developing dementia later in life
    • Increases the chance of developing mental health dysfunctions

    The experts at Project TENDR have also documented that air pollution causes measurable and serious harm to brain development, specifically exposure to air pollution can impair a child’s functions across a critically important range of brain functions, including:

    • Behavior abnormal
    • Memory impaired
    • Intelligence impaired
    • Anxiety and depression increased
    • Pre-term birth rates increased exposing babies to damage to the brain

    The impact on brain development has been confirmed in laboratory studies where exposure to air pollution causes a directly observed alteration in the growth of animal brains, with observed impacts including:

    • Inflammation of the brain
    • Reduced size of brain tissue
    • Abnormalities of myelination, a process vital to the ability of the mind to communicate information across different parts of the brain and body
    • Alterations in information flow as measured by neurotransmitter function in specific functional units of the mind

    The Issue of Air Pollution and Money

    Money turns out to be a central reality of air pollution in two ways.

    First, it is one of the economy’s great money-makers.  Industry is one of history’s great engines of wealth creation, which is a very good thing.  But it costs money to clean up the dirt industry has to create.  One of the great forces in modern politics is the eagerness of industry to avoid the cost of clean manufacture.  A case in point is the story of the Olin family, who ran large chlorine producing industries that produced mercury waste as part of their manufacturing process.  The Olin plant in Saltville, VA would dump the mercury from their chlorine plant directly into the Saltville drinking water sources.  It was the efforts of people drinking that water that led to imposition of costly steps to protect their water from mercury contamination.  The Olin family responded with a decades long effort through its foundation, and collaboration with other like-minded industrialists, to stymie the rules that forced their industries to limit pollution.  We see the fruits of these efforts today with the steps taken by the current US government to battle limits on pollution of air, water and food across a wide variety of poisons, including mercury in the air.  For the first time since Americans banded together to demand cleaner air, our air pollution problem is now getting worse year to year!

    The second connection between air pollution and money is the lack of money.  People with less money tend to breathe dirtier air, because their homes are closer to sources of air pollution such as coal-burning power plants and highways.  This simple fact translates into shorter lives, more premature births, more brain damage, more heart attacks and strokes, more diabetes, in communities of color and poverty.

    What Can Be Done?

    The main thing that can be done is to stop polluting the air.

    As the above amply demonstrates, dumping particles and chemicals in the air kills people, damages brains, and makes many illnesses worse.  It is very hard to come up with a good reason to pollute, in fact impossible.

    Adults can perhaps choose to shorten their lives by ignoring the dangers of air pollution, but can we in good conscience knowingly force our children to be exposed to possible brain damage with all the lifelong harms that come along with such damage?

    Very dramatically, all the health effects outlined above get worse when regions let go of rules to keep air clean, and get healthier when their air gets cleaner.  The rules save lives and minds.

    So the answer to the damage done to us by air pollution is for our national, state, and local governments to set rules that limit our exposure, and enforce them.  This approach has worked when followed.  We now know from data from 1974 to 2009 that for every drop of 1 microgram of particle pollution per cubic meter of air, 34,000 fewer deaths a year happen.   That’s about how many people die from gun injuries a year in the US!


    1. It is hard to see, smell, but air pollution kills, and it damages our children’s developing brains.
    2. Air pollution is a choice, we either choose to have it increase, or decrease.  Currently we are choosing to increase it, and the harms are evident.
    3. If only to protect the development of our children’s minds, we should agree to make our air clean.  
    4. The only path to clean air, and to end the very real harm from air pollution, is by setting rules that those who create the pollution must follow, and by moving industry and transportation to processes that do not pollute, such as using solar and wind to manufacture electricity that in turn will power homes, cars, and trucks.
    5. Special attention needs to be paid to members of our community suffering the greatest levels of harm from air pollution.

    It shouldn’t be that challenging to make the harm from dirty air apparent.  Here is to once and for all making our air clean, and ending the harm air pollution does to us all.

    To your health,
    Dr. Arthur Lavin 




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