Hold your breath; Acute episodes
The following tape recorded program is distributed through the facilities of the National Association of educational broadcasters. Just hold your breath. Hold your breath as long as you can and you'll soon discover how vital this natural resource is. Yes air is the most precious substance we have when it's clean. It's healthy and usable when it's polluted. It's costly and it kills. Air pollution is a threat to our way of life and you should know more about it in these radio programs produced by Michigan State University under a grant from the United States Public Health Service. Every aspect of this national problem from health impacts to economic considerations will be discussed. Air pollution will be viewed by legislators scientists and public health officials representatives of industry. That's why we challenge you to draw some logical and responsible conclusions.
In this initial program we'll look at three acute air pollution incidents in which death to numerous persons was attributed to the contaminated state of the air. The earliest instance which achieved notoriety in this country occurred and NRO Pennsylvania in one thousand forty eight. Dr. Albert he has this Michigan health commissioner talks with Dr. Harry Hyman who supervised the original study of the dinar episode. Dr. Hyman could we ask you to look back into your memory just a little bit. As I recall it you were in charge of the medical study that was made in connection with the Dinora episode. Could you tell us a little bit about it what you remember from it and what implications it may have. While the dinar episode. Was an episode in which air pollution accumulated to a high degree in this small community of about 12 to 15000
population and this air pollution resulted in serious and mild illness amongst half of the people. In addition there were some 20 persons who died during the few days after the episode. The episode incidentally lasted from what I Thursday through the following Saturday. It ended on the Sunday morning. With rain. That the Highland sometimes when we had episodes of acute to air pollution. That folks have said there was a major logic phenomenon that was known as an inversion condition. Can you tell us what is an inversion. This generally is a a something which would leave to the engineers and the meteorologists to describe but I shall try to describe it to you
briefly. Under ordinary circumstances the air at ground level is warmer than the air above and therefore the convection currents which occur under such conditions cause the air to rise carrying with it any air pollutants any pollutants which might be present. This rising of the air. Will carries the pollutants up out and away from people to be dissipated in the upper and the upper atmosphere. When we have what is termed an inversion the air at the at the ground level is actually cooler than the air above it. As a result the air does not dries and any pollutants which are present stay there in the air and more pollutants that are being contributed by from various smoke stacks of various chimneys our automobiles all remain No. Low in the
atmosphere at levels which people will breathe. This is the tram integration and in an inversion you actually have a ceiling with Ekta which could be 500 feet up or a thousand feet up and that ceiling is almost a barrier. The gases will not rise above that level. This is this is what occurred in the NARA. This occurred in London in 1952 and is occurring and what occurred there only a few only a short while ago. And this is what occurred in the Merced Valley incident as well. That happened many times when folks talk about air pollution and the tragedies that can occur and they were kind of look a little Ascot said to Norah and say well that happened 14 years ago. Why do we keep bringing this up. What can we learn about the NRA that's important today. The NRA was important and still is important
because it showed us that air pollution can cause serious illness and death. It can be a serious public health problem. And it can occur here in the United States as it did occur. This episode was important because it was the first time that in the United States there was such an incident which was studied rather completely in fact. Looking back at the that study we found that when we carefully reviewed the data. Available for the previous years of sickness and other weather conditions in the community. We found that such episodes had occurred previously possibly not as severe but
they had occurred but they had never been recorded and they had never been studied. This means that had we been looking we might have seen this is correct. If one looks for this type of thing one can find it a lot more frequently. As again reminding you of what happened only just a few years ago in 1953. There was a peculiar weather situation in New York City. Tell us about that. Dr Greenberg who was in charge of the unit of air pollution from New York City at that time subsequently made a study of the data for that year and he has just reported in 1962. He has reported that there was an unusual occurrence in weather. In New York City that the air was rather stale and allowed accumulation of air pollutants and in addition to the hiss there was an unusual occurrence of
numbers of people who died during that episode. I believe he showed that there were two hundred more deaths in a period of about a week in that community than normally occurs in that time of the year in such a community. These figures on mortality mentioned by Dr. Hyman impressed us. We decided to learn more about this New York episode and equally tragic but less known incident. And so we paid Dr. Greenberg a call. Dr. Leonard Greenberg is now chairman of the department of preventive and Environmental Medicine in the Albert Einstein College of Medicine and yes UVA University in New York. Here is his account of the study. An office study published in the public health reports in January of this year was a study of an air pollution incident New York City in November 1953. Now we picked this period because at this particular time in New York City and it was a month of November 1953
there were certain media logic conditions in New York which tended to decrease the dispersion of air pollutants. As a result of this we found that the amount of pollution in the head during this period was greater by far than it usually is in New York City. And we wondered whether due this excessive pollution in New York during this period of approximately 10 days or whether there were we could measure any effect on deaths and we did it. But what you find out what we did was as we went to the New York City Department of Health and we got the daily number of deaths for each day during this period and then we compared it with previous years during the same months and the subsequent years during the same months
and the same day. For example we made up the table showing the dust by day in New York City on a seven year period November 1950 to fifty six seven years. And we found out that during this period in 1953 this period of increased air pollution that the number of deaths were excessive over the other six years used as a control. This was a statistically significant increase this winter a statistically significant increase. Yes and we did an analysis of clinic visits for upper respiratory illness and cardiac illness and asthma three causes during this same critical period in 1953.
Now interestingly enough in this study which again was a retrospective study we found that there was an increase statistically significant in upper respiratory illness in three of the four hospitals the study and there was a statistical interesting and statistically significant increase in cardiac illness. Then two of the four hospitals based on what we're doing now we're beginning to make prospect of studies in other words we're collecting air pollution data day by day. At the present time and at the same time we're collecting morbidity records from hospitals and old age homes to see what it shows as the days go on from now on.
In view of these things do you see do you believe that we we ought to wait until the studies are completed before we start in programs to prevent air pollution. No. Well I said we do not. I said we do not and I want to emphasize it. I think that municipalities and other areas and other industry and other people who produce air pollution. Should move on the problem right away because this problem is not going to get better by itself. We have got to take constructive efforts and steps to control this problem to bring it under control and this should be done without any further proof of any kind. Each and every one of us should be interested in our own establishment and put our house in order. And if we do this we keep out of trouble. If we wait if we wait until we have
acute episodes then we have a situation such as developed in Los Angeles where automobile smog became serious enough so they just caught an awful lot of money into the problem. They spent many years and did a tremendous amount of work. But still they had the problem with us. Now interestingly enough a friend of mine was in Los Angeles at a meeting. Within the last two weeks he came back and he said to me I never realized that this snog was so bad and that its effects on the I was so obnoxious. He said Yeah I smile and here he said I almost felt like leaving me at the end of a day and coming back. He's I don't think we ought to wait for this. I think we all ought to try and do something constructive and I think that this is a real public health problem from the point of view of comfort
in the point of view of illness from the point of view of death. We have to recognize it as such. We should move on just the way we move on any other public health problem is a problem in preventive medicine. This means that we do something constructive to prevent trouble. We don't often act on our social problems soon enough. Air pollution is no exception. A short time after we talked with Dr. Leonard Greenberg newspapers around the world carried the story of a fresh air pollution tragedy. London December 1962. As usual the United States Public Health Service was alert and was soon in the middle of things and Observer was immediately dispatched to the scene. He was Dr. Richard a Prindle chief of the medical services of the division of air pollution in the Public Health Service. What did you find out Brenda when you arrived in London I had a chance to get your bearings and get a little rest after the trip so well I think the first thing was actually getting off the airplane in the immediate impact of the odor. Of the
pollution. I was very much in evidence from the standpoint of visibility although it was sufficient for a plane to land it was quite obscured. And the odor of sulfur dioxide a kind of acid taste that one has in his mouth when he breathes this material a pungent. Odor it is in a rather irritating. We had to take a train and to London because the roads were pretty well closed by the fog and smog and the time one got in there oh. He realized how great the visibility was affected. You could say about 15 20 feet. Maximum. It was almost impossible to get a cab to get to the hotel for example because traffic was almost at a complete standstill. And you had this tremendous irritant effect upon your nose and throat so that outside it was most unpleasant to smoke a cigarette indoors it was tolerable.
How how far away from London is this airport that you had to land at approximately approximate 25 30 miles this is outside I'd say definitely outside of the area and as we came in on the train we began to get into thicker and thicker air as a matter of fact I would say shortly outside of London that an area called East Croydon it was already thicker than it was in downtown London there and a train riding through the station you could not see the station signs know where you were. And even though they were lighted and so forth that night now we have you at your hotel and right in the middle of London the what what happened after this. Well I did wander around that night a bit gave an area that I know pretty well and I have to admit I didn't wander very far because you can see the street signs you couldn't figure out where you were if you didn't know the north quite well. Rather dramatic in saying the large number of people. Who were wearing either masks or handkerchiefs or scarves over their face in the attempt to cut down a little bit of.
The gunk they are inhaling. A compression of almost isolation lost in this fog is quite a dramatic thing and I'm sure adds a lot to the terror and concern of people in this kind of a situation. They mention the fact that cigarettes are most uncomfortable and even in a buildings such as the hotel which was a very large hotel. All of the fog had been entered. They smoke was so thick. Inside the building even that looking down a long corridor the lights at the end of the corridor were somewhat obscured and had brownish yellow rings around them. And even in your own hotel room with the window closed you still felt they heard Taisha and your cough was frequent and. Your hands and clothes were quickly soil from the material that that seeped in. Now in the ensuing days I made appointments to see the various people the embassy had arranged some of this and. The rest of a trip. Actually
the fog cleared up on Friday I arrived on Thursday evening so I just saw the tail end of this. And. On Friday then I was able to get around and make my first visit to the Medical Research Council to get as quickly as possible as much of the data and the impressions of those who were working there as to what the problem was. Dr Patrick law through who is in charge of this Medical Research Council program has been carrying on a long term studies on people who have chronic bronchitis and chest illnesses so common in England. And these people are the ones who usually are the most severely affected by the smogs cough on chest such severe chest condition as I go into a type of lung failure and usually require hospitalization and these are the ones who often died during these episodes. So the first day was spent. Partly on the chemical or getting some of the chemical analysis of the material and visiting in the hospital some of these patients and talking with them. It was very dramatic because these people are so
short of breath. Most of them are on oxygen tans severely affected by this smog. Quite a few of them mentioned that they had had the same they had. In 152 10 years ago when that episode occurred they had been affected and this one had affected them similarly. Is any one case history stand out in your mind in particular at all or not. No but I think one could sort of average it by being what might be a typical case many of these people are. Or when their 50s or 60s they've had coughs severe chronic cough for many years. Winters have always affected them particularly wet damp foggy winters. He's a full time on the line disease and they have an underlying disease in general this picture of chronic bronchitis which is an inflammation of the air tubes leading into the lungs. They produce quite a bit of material when they cough. And they gradually get worse and worse with
increasing shortness of breath. Many of them have to cease work and so forth. And then when one of these episodes come along they really go downhill very rapidly. If they survive the episode generally they are not quite as well from then on as they had been. But. Generally they can live. However if the episode really had some they may die as a result of it in the matter of the few days they. Thing that has been a real concern to us under the British workers we recognise that people who have this preexisting disease get worse during these episodes. I want to things though that really concerns us is how much this existing disease is caused by air pollution from the right beginning. That is assuming that they were healthy to begin last night assuming that they were healthy to begin with. Concern here is in a sense a twofold one were concern over episodes such as this one which are acute and dramatic and cause these deaths.
But we're also concerned with the long term aspects of air pollution day in and day out. Problem which London has whether or not it has a fog and we have the impression that many of these people's busy is has started as a result of their pollution. There is much to back this up. For example in England there were workers that I discussed this with and made studies of where in England people have chronic bronchitis where they live in these air polluted areas. Their oppression is a living in these areas results over a long period of time continued irritation of the long and its parts are resulting in these diseases the deaths from chronic bronchitis are higher in those cities with higher pollution. People who come from these areas and one study they shone and joined the army are more prone to have other aspiring Tory infections and things even though they are not assigned now to the same place it was observed for example in the island of Cyprus and the
soldiers who had the most horrid disease were those who had come from air pollutant areas of England give you some thought that there was some underlying damage that had result underlying damage as a result from years of exposure even more dramatic perhaps is the work that's been done in New Zealand on Britishers who have moved to New Zealand and here those who've resided in England for less than 30 years before they moved to New Zealand are compared with those who resided for 30 years or more in England before they moved to New Zealand. Those who resided there a longer period of time and hence presumably had a longer exposure to the problem here is affecting when I was smoking habits had more lung cancer and more chronic bronchitis and those who had resided a shorter period of time at their the same Britishers in other respects and had similar occupational summer smoking habits and so forth. So there's good reason to believe that this continuous exposure to relatively low levels of pollution the daily average type. Help so to speak. So the seed of the disease that ultimately then when the air pollution
is very high may be the killer. I personally do you happen to have any. They gaze at your fingertips that would be some way you show the magnitude of this air pollution episode in London. We don't have the final figures as yet it will take several months before the Ministry of Health can collect them from all the outlying parts and classify them appropriately but in all likelihood in the London Greater London area there were about 500 who died in these four or five days. As a result of the pollution that is four or five hundred more than would normally be expected to die in this same period of time. And a large majority of these died of these respire Tauriel this is all that I have described chronic bronchitis and related diseases such as emphysema perhaps asthma. Now and one thousand fifty two. And the week that that occurred. Similarly there were about 4000 deaths so that was by far a much more dramatic and much more severe
episode where a little puzzled by this but perhaps wait. So an explanation that auger is good for the control of air pollution in the sense that in 1952 the episode lasted a little bit longer. Another day and a half. In 1962 the episode seemed to be just as severe from the meteorological point of view the same amount of fog the same amount of temperature inversion affecting the general mixing of the pollutants a sulfur dioxide level was equally high in both years 1950 to 1962 but the smoke was much less in 1962. And we believe that this may have been a very important factor in helping reduce the number of deaths that occurred. That smoke per se may not be too important as a toxic agent. But as a mixture add it in with the software dioxide it may have. Been a very important factor and increasing the number of deaths in 1952. We have laboratory evidence that would back this up
for example and work at Harvard where animals are exposed to small amounts of sulphur dioxide has certain respond to effects. But if we add particles into this mixture then they have much more severe effects. The particles seem to help carry they self are dockside down into the lungs. This is probably what happens with smoke in this case. We and the British both feel that a reduction in smoke has been a real help and that this episode demonstrates that. This reduction is partly the result. It's hard to evaluate how important which factor has been and what is partly the result of the Clean Air Act. A national act for air pollution control which is helped reduce smoking by cutting down the use of smoky fuels and providing better burning facilities for both homes and buildings using coke and other smoking so-called smokeless fuels and also. Probably has resulted from the natural technological growth in the
area. Instead of row upon row of small houses each with this old fireplace spewing out smoke there are more large buildings now with central heating. This is more efficient and again would cut down the smoke so both of these factors I'm sure of operate in reducing the amount of smoke and. I feel has as really been a major contribution in the number of deaths. The same is true of the deaths incidentally also backed up by the amount of morbidity that is the number of people who had to be hospitalized during that period was also much reduced. So in learning. From London although it may not be gretly transferred to all of our problems here one thing seems to be outstanding. That through the Clean Air Act the reduction of smoke has accomplished a reduction in the health effects of air health effects on the people. This action was taken as somewhat empirical way there was very little evidence as smoke as such is a health hazard. But even when taking this control action seems to have been of real
assistance to the people in that community. Therefore if there are lessons to be learned it's a lesson that taking action to reduce air pollution can be of assistance even though we may not have all the scientific answers as to why this is going to work. There is evidence that it will work in reducing illness and death as a result of the pollution itself. All of us in mainland and we here in the United States they work in this field feel that this is this kind of an episode as a distinct possibility any time in almost any place certainly in London this will occur again in all likelihood unless. More drastic action is taken in cleaning up the pollution that has occurred in the United States and it can occur again. It may be different pollutants it may be a slightly different set of circumstances but these kinds of episodes can occur. Theyre the result of all the problems of domestic automobile industrial pollution coupled with whether we can effect. A emission of these pollutants. We can
affect the weather. So we have to act on the air pollution end of this problem. Thing for air pollution tragedies recounted on today's program represent only those acute episodes severe enough to attract national or international attention. Actually it is not these episodes which cause air pollution officials the most concern. The next programme in the series will explore the day to day health of facts of contaminated air. Hold your breath was produced by Patrick Ford of Michigan State University under a grant from the division of air pollution Bureau of state services U.S. Public Health Service. Our interviewer was Dr. Albert E. used as commissioner of health for the state of Michigan. These programs are distributed through the facilities of the National Association of educational broadcasters. This is the end E.B. Radio Network.
- Hold your breath
- Acute episodes
- Producing Organization
- Michigan State University
- WKAR (Radio/television station : East Lansing, Mich.)
- Contributing Organization
- University of Maryland (College Park, Maryland)
- AAPB ID
Interviewee: Greenberg, Leonard
Interviewee: Hyman, Harry
Interviewee: Prindle, Richard A.
Interviewer: Eustis, Albert
Producer: Ford, Patrick
Producing Organization: Michigan State University
Producing Organization: WKAR (Radio/television station : East Lansing, Mich.)
- AAPB Contributor Holdings
University of Maryland
Identifier: 63-36-1 (National Association of Educational Broadcasters)
Format: 1/4 inch audio tape
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- Chicago: “Hold your breath; Acute episodes,” 1963-08-23, University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC, accessed September 23, 2023, http://americanarchive.org/catalog/cpb-aacip-500-j09w4z21.
- MLA: “Hold your breath; Acute episodes.” 1963-08-23. University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Web. September 23, 2023. <http://americanarchive.org/catalog/cpb-aacip-500-j09w4z21>.
- APA: Hold your breath; Acute episodes. Boston, MA: University of Maryland, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from http://americanarchive.org/catalog/cpb-aacip-500-j09w4z21