THE VICIOUS CIRCLE

Craig S. Marxsen University of Nebraska at Kearney My grandfather died in 1980, near the end of winter. I partly blame the EPA. My father was an only child and my grandparents had followed my parents through several geographic relocations. They all finally settled on Jekyll Island when Dad retired -- where the famous millionaires liked to winter a few decades ago. My father seemed to take Grampa's death pretty hard, so I phoned him from Texas every evening for several weeks afterwards. Grama had Alzheimer's disease. When Mom read her grampa's obituary, grama asked: "Is it someone we know?" My grandmother never perceived the deadly significance of what the EPA had done. Grampa had given up driving years earlier when his eyes had gone bad. My grandparents had been getting occasionally stranded at the Jekyll Island shopping center because grama would forget how to shift the automatic transmission into reverse. The owner of a restaurant there told me that grampa had sometimes come in and ask him to go out and show them how to put their car in reverse. Grampa had subsequently deteriorated rapidly after my grandparents had moved into my parents' house in the fall of 1979. I do not think my parents fully appreciated the health benefits my grandfather derived from his, by then, feeble efforts at home maintenance and yard care. My parents were more concerned with risk control. My parents had scaled down my grandparents' activity after my parents began delivering regular meals to my grandparents home like hotel room service. My grandparents finally and reluctantly moved in with my parents after my grandmother started flushing her underpants down the toilet. It was not like the fire problem that turning off the circuit breakers to their stove had solved. Disconnecting my grandparents' toilets would have been too dirty a trick! My Dad gave me a very detailed account of my grandfather's death. Dad had sat with many dying individuals during the course of his career as an Episcopal priest. My Dad sat up, unable to sleep, listening to Grampa's labored breathing. He breathed with greater and greater difficulty until, shortly before sunrise, his breathing ceased. Grampa, suffering congestive heart failure for quite a while, had been very explicit about his desire to avoid heroic medical intervention under such circumstances. Pneumonia shortens the final agony of a dying person. "Pneumonia is called the old man's friend, Dad said. Subsequently, I read that pneumonia is not so much the cause of death as a typical mode of dying for a terminally ill person, dying of heart failure or some other disease. A day or so earlier, Grampa had complained of feeling very uncomfortable in his bed and had refused his meals. He was offered medication for pain and took percodan, as I recall. He just stayed in bed and never got up. He seemed to become less uncomfortable and slept more continuously, I was told. I remember thinking that Grampa's death might have been easily postponed. If I had been there, I would have gotten Grampa up more and walked him out on the porch. It had previously done wonders for him back during the Christmas holidays when I had last visited from Texas. I still believe it would have worked -- it might have helped his waterlogged lungs by shifting fluid to his legs. One of the principal reasons that hospitals try so hard to get patients up from bed periodically is to fight pneumonia. Nurses and orderlies seem so obnoxious and pushy, insisting that the patient get

out of bed the day after an operation. Years earlier, our old dog, Tallulah, was dying of heartworms. She expired and urinated immediately after I lifted her onto my own bed to make her more comfortable. It was too late when I realized that staying on her feet seems to have been all that was keeping Tallu alive. Letting Grampa stay in bed continuously for days seemed to me a deadly error, subsequently. By 1980, the EPA and the environmental movement had ruined peoples' appreciation for the value of a "breath of fresh air." Outdoor air was, by then, regarded as polluted and a little poisonous by nearly everyone in the United States. You could sometimes smell air pollution on Jekyll Island, even in the winter. It smelled a little worse than cabbage cooking but not as bad as a Nebraska feedlot. I guess factories cooking wood pulp in nearby Brunswick tried to confine the smoke making activities to evenings when the wind would blow the smoke out to sea. The stink would sometimes blow right over Jekyll Island, unfortunately. I have concluded that my grandfather's death was typical. I think many families have played out the same scenario, and, by the grace of God, receive the same somewhat merciful, howbeit, unwelcome blessing. My parents were reluctant to walk my grandfather out for a "breath of fresh air," just as many other families have similarly over-sheltered their elderly. By the late 1970s, no one even used the expression "breath of fresh air" any more. This phenomenon helps explain recent statistical findings associated with numerous deaths and reported illnesses. The EPA, in its 1997 report to Congress, The Benefits and Costs of the Clean Air Act, 1970 to 1990, claims that a large number of statistical studies find that air pollution consisting of fine particulate matter (PM10 or PM2.5; particles 10 microns or 2.5 microns or smaller) is causing many deaths. The largest study, as Kenneth Chilton of the Center for Study of American Business reported to the Senate Subcommittee on Clean Air, Wetlands, etc., (April 24, 1997), finds an association between particulate pollution and death due to cardiovascular and pulmonary causes together. Chilton observed: "It is curious, to say the least, that the statistical link that has been demonstrated is between fine particles and cardiopulmonary deaths, and not deaths due to respiratory disease or lung cancer alone." My grandfather's death sheds considerable light on this statistical association. People have learned to be afraid of air pollution. The EPA has been partly responsible for persuading the public that air pollution in American cities is a serious threat to human health. Consequently, people engage in a substantial amount of averting behavior. For many people (though a small percentage), the fear of air pollution probably results in an occasional unnecessary visit to a doctor or hospital as an over-reaction to symptoms of asthma or bronchitis. This behavior gives rise to a statistical impression of causality in studies, which focus on hospital admissions or doctor's visits. Retreating from outdoor pollution ironically increases the proportion of time these people spend indoors where, according to a recent article in Scientific American, pollution levels are much higher than outdoors. Indoor sources of pollution are surprisingly more potent than those regulated outdoors by the EPA. The indoor pollution exacerbates their problems. But, in cases like that of my Grandfather, pollution avoiding behavior is actually very deadly. Families, trying to protect their terminally ill beloved, tend to cloister them in their bedrooms. They therefore reduce the lifesaving activity of getting the dying elders up from their beds for a walk (or a ride in a wheel chair) and a "breath of fresh air." The averting reaction reveals itself statistically: more deaths occur on high pollution days and people tend to die sooner in high pollution cities. Mortality associates with particulate matter pollution especially because PM is the visible kind of air pollution. Similar results would probably be discovered if statisticians focused on stinky kinds of

pollution rather than visible kinds. The deaths result from the behavioral reaction people make when they detect pollution in the air, not from any actual toxicity of the pollution. I hope that the EPA is acting in ignorance, spreading this deadly error throughout our land! According to Robert W. Crandall of the Brookings Institution, particulate matter proves harmless at even 20 times ambient levels in clinical trials which expose people with obstructive pulmonary disease. The EPA knows clinical studies fail to demonstrate toxicity. However, the EPA has demanded ever-tighter restrictions on particulate pollution on the grounds that it has been proved deadly by epidemiological studies (statistical correlations). The EPA has campaigned to persuade the public that fine particulate pollution kills. The EPA is causing many families to unwittingly "smother" their dying loved ones by trying to protect them. Knowledge that its propaganda about particulate matter is killing people, if the EPA has possessed such knowledge, seems more morally reprehensible than the cigarette companies' alleged knowledge that nicotine is addictive. An examination of internal EPA memos seems warranted to see if it secretly knew that it was causing people to die prematurely by unnecessarily avoiding air pollution. The EPA has created a vicious circle. Old people retreat to their deathbeds in fear of air pollution. They die for their failure to get up for a "breath of fresh air." The EPA funds research and gathers statistics. It finds that the premature deaths the EPA is causing (by spreading terror and lies) are statistically associated with fine particulate pollution. It finds the results in both time series and cross sectional statistical studies. The EPA then, using its statistics persuades the public that the smog they see is deadly. More elderly hide under their covers and die. REFERENCES
Chilton, Kenneth W. "Has the Case Been Made for New Air Quality Standards?" (St. Louis, Mo.: Center for the Study of American Business, Policy Brief 181, April 1997). http://csab.wustl.edu/papers/environment/pb181.htm (July 7, 1998) Crandall, Robert W., Rueter, Frederick H., and Steger, Wilbur A. "Clearing the Air: EPA's Self-Assessment of CleanAir Policy." Regulation (1996 Number 4): 35 - 46. Marxsen, Craig S. "The Environmental Propaganda Agency." The Independent Review 5:1 (Summer 2000): 65 - 80. Ott, Wayne R. and Roberts, John W. "Everyday Exposure to Toxic Pollutants." Scientific American 278:2 (February, 1998): 86-91. U.S. Environmental Protection Agency. The Benefits and Costs of the Clean Air Act, 1970 to 1990. Prepared for U.S. Congress by U.S. Environmental Protection Agency, October 1997. http://www.epa.gov/airprogm/oar/sect812/index.html (July 7, 1998)