35 Worst Cities (and the Worst State) for Asthma and Allergy Sufferers
One of the hidden costs of climate change is its health costs. As more pollutants are pumped into the air we breathe, the health impacts mount. They include asthma, which has been increasing steadily especially in poorer neighborhoods, and allergies. Now the Natural Resources Defense Council (NRDC) has released a report, Sneezing and Wheezing: How Climate Change Could Increase Ragweed Allergies, Air Pollution and Asthma, which identifies the most vulnerable regions and cities, including the 35 "Sneeziest and Wheeziest" cities, which have the largest concentration of factors that can affect asthma.
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The report explains that climate change is impacting ozone level and pollen pollution, key irritants that trigger asthma and allergic reactions.
"Scientific studies have shown that our changing climate could favor the formation of more ozone smog in some areas and increase the production of allergenic pollen such as that released by the ragweed plant, the principal source of pollen associated with allergic rhinitis," the study says.
"This is bad news for allergy sufferers and asthmatics because both ragweed pollen and high levels of ozone smog can trigger asthma attacks and worsen allergic symptoms in adults and children. Moreover, studies show that people exposed to both ragweed allergens and ozone are likely to become more ill than people exposed to just one of the two. These negative health effects are expected to worsen if carbon dioxide (Co2) concentrations keep rising and climate change continues unchecked."
“Americans deserve to breathe clean air, but today millions of us are sneezing and wheezing from allergies and asthma linked to climate-fueled ragweed and ozone pollution," said the report's lead author Juan Declet-Barreto. "This double-whammy health threat will only intensify, and affect more people, if we don't take steps to reduce climate change now.
Richmond, Virginia leads the list of the worst cities for asthma and allergy sufferers, followed by Memphis, Oklahoma City, Philadelphia, Chattanooga, Chicago, Detroit, New Haven, Allentown and Atlanta. It was also named the U.S. Asthma Capital by the Asthma and Allergy Foundation of America (AAFA) for 2014, a dubious distinction it also claimed in 2010 and 2011. It also identified the country's most vulnerable regions: Los Angeles Basin, St Louis area, Great Lakes regions, Mid- Atlantic States and New England.
And while it doesn't have any cities in the top 10, Ohio has the most cities listed, which is bad news for those with allergies and asthma, with seven in the top 35: Dayton (15), Cleveland (16), Toledo (17), Akron (20), Cincinnati (23), Youngstown (33) and Columbus (34).
"We think of the state of Ohio as the #1 wheeziest, sneeziest state because it has seven cities," said Declet-Baretto. "These cities are home to five million Ohioans, a sizable amount of population exposed to ozone health risk."
He suggests that Ohio increase its investment in clean energy sources, the opposite of what the state has been doing. Last year, the state became the first in the U.S. to freeze its Renewable Energy Standards and it is now considering repealing them entirely.
The number of people impacted is huge. According to the report, 50 million people in the U.S. have some type of nasal allergy, with about 26 million children and adults dealing with asthma.
The report points out that warmer temperatures and hot, clear summer days tend to increase ozone concentrations, and that ragweed, the main cause of respiratory allergies, has a longer growing season and produces more pollen when CO2 concentrations are higher. Other pollen-producing plants also thrive in warmer temperatures with higher CO2 concentrations.
"Climate change is already causing shifts in basic natural systems," said Alexandria, Virginia pediatrician Dr. Samantha Ahdoot. "The life cycle and growing patterns of plants are being impacted by climate conditions."
That's particularly pronounced in northern regions such as Ohio and Chicago, she said.
"Changes in climate are impacting allergies with later fall frost and earlier spring thaw," Ahdoot said. "Most people feel allergies have gotten worse, and they have. Total pollen counts have increased by 40 percent in part due to changes in atmosphere. In northern regions, the [allergy] season increased by nearly 20 days. In my practice in past month, I was flooded with parents and children experiencing intractable allergies. Most require multiple medications and often that is not enough. We have had two admissions this year—toddlers experiencing severe asthma attacks requiring hospitable admissions."
The NRDC report also made some suggestions about what we can do to address the problem, both on a personal and policy level. Policywise, it advocates for limiting carbon emissions from power plants, lowering the allowable standard for ozone, improving data collection on ozone and ragweed pollution, and making that information more accessible to the public and the scientific community. It urges individuals to keep track of pollen levels, avoid strenuous outdoor activities on high pollen count and ozone days, and washing bedding and showering frequently, among other things.
"Child health is inextricably linked to climate change," said Dr. Ahdoot, pointing out that public health initiatives on issues such as tobacco and lead paint have been essential in making children healthier. "The Clean Power Plan is the next essential legislation needed to protect the health of children in the U.S."
“Climate change is the central challenge of our time," said Declet-Baretto. "We need to take steps to reduce its strength."
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By Bob Jacobs
Hanako, a female Asian elephant, lived in a tiny concrete enclosure at Japan's Inokashira Park Zoo for more than 60 years, often in chains, with no stimulation. In the wild, elephants live in herds, with close family ties. Hanako was solitary for the last decade of her life.
Hanako, an Asian elephant kept at Japan's Inokashira Park Zoo; and Kiska, an orca that lives at Marineland Canada. One image depicts Kiska's damaged teeth. Elephants in Japan (left image), Ontario Captive Animal Watch (right image), CC BY-ND
Affecting Health and Altering Behavior<p>It is easy to observe the overall health and psychological consequences of life in captivity for these animals. Many captive elephants suffer from arthritis, obesity or skin problems. Both <a href="https://doi.org/10.11609/JoTT.o2620.1826-36" target="_blank">elephants</a> and orcas often have severe dental problems. Captive orcas are plagued by <a href="https://doi.org/10.1016/j.jveb.2019.05.005" target="_blank">pneumonia, kidney disease, gastrointestinal illnesses and infections</a>.</p><p>Many animals <a href="https://doi.org/10.1016/j.neubiorev.2017.09.010" target="_blank">try to cope</a> with captivity by adopting abnormal behaviors. Some develop "<a href="https://doi.org/10.1016/j.applanim.2017.05.003" target="_blank" rel="noopener noreferrer">stereotypies</a>," which are repetitive, purposeless habits such as constantly bobbing their heads, swaying incessantly or chewing on the bars of their cages. Others, especially big cats, pace their enclosures. Elephants rub or break their tusks.</p>
Changing Brain Structure<p>Neuroscientific research indicates that living in an impoverished, stressful captive environment <a href="https://doi.org/10.1016/j.jveb.2019.05.005" target="_blank" rel="noopener noreferrer">physically damages the brain</a>. These changes have been documented in many <a href="https://doi.org/10.1002/cne.903270108" target="_blank" rel="noopener noreferrer">species</a>, including rodents, rabbits, cats and <a href="https://doi.org/10.1006/nimg.2001.0917" target="_blank" rel="noopener noreferrer">humans</a>.</p><p>Although researchers have directly studied some animal brains, most of what we know comes from observing animal behavior, analyzing stress hormone levels in the blood and applying knowledge gained from a half-century of neuroscience research. Laboratory research also suggests that mammals in a zoo or aquarium have compromised brain function.</p>
This illustration shows differences in the brain's cerebral cortex in animals held in impoverished (captive) and enriched (natural) environments. Impoverishment results in thinning of the cortex, a decreased blood supply, less support for neurons and decreased connectivity among neurons. Arnold B. Scheibel, CC BY-ND<p>Subsisting in confined, barren quarters that lack intellectual stimulation or appropriate social contact seems to <a href="https://doi.org/10.1590/S0001-37652001000200006" target="_blank" rel="noopener noreferrer">thin the cerebral cortex</a> – the part of the brain involved in voluntary movement and higher cognitive function, including memory, planning and decision-making.</p><p>There are other consequences. Capillaries shrink, depriving the brain of the oxygen-rich blood it needs to survive. Neurons become smaller, and their dendrites – the branches that form connections with other neurons – become less complex, impairing communication within the brain. As a result, the cortical neurons in captive animals <a href="https://doi.org/10.1002/cne.901230110" target="_blank">process information less efficiently</a> than those living in <a href="https://doi.org/10.1002/dev.420020208" target="_blank">enriched, more natural environments</a>.</p>
An actual cortical neuron in a wild African elephant living in its natural habitat compared with a hypothesized cortical neuron from a captive elephant. Bob Jacobs, CC BY-ND<p>Brain health is also affected by living in small quarters that <a href="https://doi.org/10.3233/BPL-160040" target="_blank">don't allow for needed exercise</a>. Physical activity increases the flow of blood to the brain, which requires large amounts of oxygen. Exercise increases the production of new connections and <a href="http://dx.doi.org/10.1126/science.aaw2622" target="_blank">enhances cognitive abilities</a>.</p><p>In their native habits these animals must move to survive, covering great distances to forage or find a mate. Elephants typically travel anywhere from <a href="https://www.elephantsforafrica.org/elephant-facts/#:%7E:text=How%20far%20do%20elephants%20walk,km%20on%20a%20daily%20basis." target="_blank">15 to 120 miles per day</a>. In a zoo, they average <a href="https://doi.org/10.1371/journal.pone.0150331" target="_blank" rel="noopener noreferrer">three miles daily</a>, often walking back and forth in small enclosures. One free orca studied in Canada swam <a href="https://doi.org/10.1007/s00300-010-0958-x" target="_blank" rel="noopener noreferrer">up to 156 miles a day</a>; meanwhile, an average orca tank is about 10,000 times smaller than its <a href="https://www.cascadiaresearch.org/projects/killer-whales/using-dtags-study-acoustics-and-behavior-southern" target="_blank" rel="noopener noreferrer">natural home range</a>.</p>
Disrupting Brain Chemistry and Killing Cells<p>Living in enclosures that restrict or prevent normal behavior creates chronic frustration and boredom. In the wild, an animal's stress-response system helps it escape from danger. But captivity traps animals with <a href="https://doi.org/10.1073/pnas.1215502109" target="_blank">almost no control</a> over their environment.</p><p>These situations foster <a href="https://doi.org/10.1037/rev0000033" target="_blank">learned helplessness</a>, negatively impacting the <a href="https://doi.org/10.1155/2016/6391686" target="_blank" rel="noopener noreferrer">hippocampus</a>, which handles memory functions, and the <a href="https://doi.org/10.1016/j.neuropharm.2011.02.024" target="_blank" rel="noopener noreferrer">amygdala</a>, which processes emotions. Prolonged stress <a href="https://doi.org/10.3109/10253899609001092" target="_blank" rel="noopener noreferrer">elevates stress hormones</a> and <a href="https://doi.org/10.1523/JNEUROSCI.10-09-02897.1990" target="_blank" rel="noopener noreferrer">damages or even kills neurons</a> in both brain regions. It also disrupts the <a href="https://doi.org/10.1016/j.neubiorev.2005.03.021" target="_blank" rel="noopener noreferrer">delicate balance of serotonin</a>, a neurotransmitter that stabilizes mood, among other functions.</p><p>In humans, <a href="https://doi.org/10.1006/nimg.2001.0917" target="_blank" rel="noopener noreferrer">deprivation</a> can trigger <a href="https://doi.org/10.3389/fnins.2018.00367" target="_blank" rel="noopener noreferrer">psychiatric issues</a>, including depression, anxiety, <a href="https://doi.org/10.3389/fnins.2018.00367" target="_blank" rel="noopener noreferrer">mood disorders</a> or <a href="https://doi.org/10.1177/1073858409333072" target="_blank" rel="noopener noreferrer">post-traumatic stress disorder</a>. <a href="https://doi.org/10.1007/s00429-010-0288-3" target="_blank" rel="noopener noreferrer">Elephants</a>, <a href="https://doi.org/10.1371/journal.pbio.0050139" target="_blank" rel="noopener noreferrer">orcas</a> and other animals with large brains are likely to react in similar ways to life in a severely stressful environment.</p>
Damaged Wiring<p>Captivity can damage the brain's complex circuitry, including the basal ganglia. This group of neurons communicates with the cerebral cortex along two networks: a direct pathway that enhances movement and behavior, and an indirect pathway that inhibits them.</p><p>The repetitive, <a href="http://dx.doi.org/10.1016/j.bbr.2014.05.057" target="_blank">stereotypic behaviors</a> that many animals adopt in captivity are caused by an imbalance of two neurotransmitters, dopamine and <a href="https://doi.org/10.1016/j.neubiorev.2010.02.004" target="_blank" rel="noopener noreferrer">serotonin</a>. This impairs the indirect pathway's ability to modulate movement, a condition documented in species from chickens, cows, sheep and horses to primates and big cats.</p>
The cerebral cortex, hippocampus and amygdala are physically altered by captivity, along with brain circuitry that involves the basal ganglia. Bob Jacobs, CC BY-ND<p>Evolution has constructed animal brains to be exquisitely responsive to their environment. Those reactions can affect neural function by <a href="https://www.penguinrandomhouse.com/books/311787/behave-by-robert-m-sapolsky/" target="_blank">turning different genes on or off</a>. Living in inappropriate or abusive circumstance alters biochemical processes: It disrupts the synthesis of proteins that build connections between brain cells and the neurotransmitters that facilitate communication among them.</p><p>There is strong evidence that <a href="https://doi.org/10.1523/JNEUROSCI.0577-11.2011" target="_blank">enrichment</a>, social contact and appropriate space in more natural habitats are <a href="https://doi.org/10.1111/j.1748-1090.2003.tb02071.x" target="_blank" rel="noopener noreferrer">necessary</a> for long-lived animals with large brains such as <a href="https://doi.org/10.1371/journal.pone.0152490" target="_blank" rel="noopener noreferrer">elephants</a> and <a href="https://doi.org/10.1080/13880292.2017.1309858" target="_blank" rel="noopener noreferrer">cetaceans</a>. Better conditions <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543669/" target="_blank" rel="noopener noreferrer">reduce disturbing sterotypical behaviors</a>, improve connections in the brain, and <a href="https://doi.org/10.1038/cdd.2009.193" target="_blank" rel="noopener noreferrer">trigger neurochemical changes</a> that enhance learning and memory.</p>