Doctors Speak at EPA Hearing

Testimony of Leslie Fields, MD
President of Greater Kansas City Medical Society
Testimony at Kansas City EPA Listening Session
Against Repeal of Clean Power Plan
February 21, 2018

Good Morning members of the EPA Listening Session Panel.  My name is Dr. Leslie Fields.  I am a hospitalist physician at St. Luke’s Health System.  I am also President of the Greater Kansas City Medical Society, which is the local and Kansas City affiliate of the National Medical Association.  As African American physicians, we are particularly concerned about the proposed repeal of the Clean Power Plan, as it will create adverse health outcomes in low-income communities and communities of color.

In Kansas City, we see significant amounts lung disease, COPD chronic obstructive lung disease most commonly in adults, and asthma in children.  Both of these disease processes are largely affected by air quality and environmental pollution.

The literature reveals that air pollution stunts the lung capacity of growing children, making them more vulnerable to respiratory problems later in their lives, and that there is a negative effect on pregnancy as well leading to higher rates of prematurity and low birthweight. [1],[2]  For older adults, poor air quality exacerbates heart and lung problems.[3]  When air pollution intensifies, people with these conditions are more likely to end up in emergency rooms or a hospital.[4]  This is costly, time-consuming, and sometimes life-threatening for the affected individual and their family; but it is also a strain on the larger community.  Due to all these heart and lung health problems, there are missed days from school and work, lower productivity, and a high price paid by the patient and society  of emergency room visits and hospitalizations.  These health problems add significantly to the nation’s health costs.  These problems do not necessarily stop at hospitalization.  Deaths do occur; this is the ultimate tragedy for many families and for the health system.  In 2015, almost 150,00 people died from chronic resp illnesses.  It is the 3rd leading cause of death.  The annual economic cost of asthma is more than $56 billion including medical costs and school and work loss days.

In addition to the immediate air pollution effects, climate change is directly harming our health through severe heat waves, extreme storms and rainfall, the spread of disease carried by mosquitoes and ticks, flooding due to rising sea levels, and reduced air quality.

National Medical Association stands with the Medical Society Consortium on Climate and Health, which represents over 550,000 physicians (more than half the nation’s doctors), who have come together to inform the public that combating climate change will improve the health of Americans now and in the future.  The Clean Power Plan is a vital tool in reducing these health threats by cutting the heat-trapping pollution that drives climate change.

For the sake of the public’s health, the nation and its Environmental Protection Agency must address climate change and repealing the Clean Power Plan is taking a step in the wrong direction.

Thank you for this opportunity to testify.

[1]  Gauderman The Effect of Air Pollution on Lung Development from 10 to 18 Years of Age. N Engl J Med 2004; 351:1057-1067.
[2] Stieb, et. al.  Ambient air pollution, birth weight and preterm birth: A systematic review and meta-analysis. Environmental Research. Volume 117, August 2012, Pages 100-111
[3] Qian Di, Air Pollution and Mortality in the Medicare Population. N Engl J Med 2017; 376:2513-2522
[4] Cromar, et. al. American Thoracic Society and Marron Institute Report. Estimated Excess Morbidity and Mortality Caused by Air Pollution above American Thoracic Society–Recommended Standards, 2011–2013. Annals ATS Aug 2016; 13(8): 1195-1201.