Neurosurgeon has embraced activism in fight against Salt Lake Valley air pollution for personal and professional reasons

(Trent Nelson | The Salt Lake Tribune) John Macfarlane is a neurosurgeon who has become an activist against air pollution based on his personal and professional experience. Personally, two of his four children suffer health problems he blames on air pollution. Professionally, his research and a growing number of studies indicate that bad air is dangerous not only to lungs and respiratory systems, but to human brains. Tuesday, Oct. 9, 2018.

John Macfarlane, a neurosurgeon and longtime Utah resident, has reared four children on the Wasatch Front.

His first two kids grew up in Emigration Canyon, a Salt Lake City enclave out of the thick of the valley’s air pollution. His younger two grew up breathing the valley air, with its wintertime inversions, and emissions from cars, oil refineries and gravel mines straddling Salt Lake and Davis counties.

Macfarlane’s two older children, now in their upper 20s, are healthy. His younger offspring, in their early 20s, both grew up with asthma, and had other challenges.

“As a medical professional,” Macfarlane said, “that got my attention.”

In addition to his work as a neurosurgeon for Intermountain Healthcare and working closely with those affected by air pollution, he belongs to Utah Physicians for a Healthy Environment. This advocacy group made up of health care professionals uses lobbying and education in its quest to help create a healthy living environment in the state.

“The transition from seeing information [about air quality concerns] to doing something about it occurred as I watched my children struggle and have medical problems. It was really hard as a parent to see children in the hospital,” Macfarlane said. “As time went on I started to figure out the difference between my older and younger kids.”

Macfarlane has two sons and two daughters.

“My [younger] daughter had croup all the time in the winter,” he said. “Both [younger children] were in the hospital a lot with asthma. [My younger son] still has to take medication for it.”

“As a neurosurgeon … I have enough understanding of the brain and its physiology that I wanted to learn more about it. I wanted to try and understand better what was happening.”

One of Macfarlane’s responsibilities for Utah Physicians for a Healthy Environment (UPHE) is to monitor air quality issues, including the current battle over the proposed expansion of Geneva Rock’s gravel mine at the Point of the Mountain in Draper. The group has three major concerns about the project:

  • The narrowing valley acts as a funnel for high winds and swirling air flow that kicks up dust and soil and distributes it over a large area.

  • Mine operators continuously run diesel-burning machines that produce harmful exhaust.

  • Mining breaks up and releases silica. This tiny particle, a subset of PM 2.5 (Salt Lake City’s main pollutant), is crystalline in appearance, and when inhaled can act like microscopic barbed wire in the lungs.

Air pollution

“One study was done evaluating a large patient population of over 100,000 right here on Utah’s Wasatch Front,” Macfarlane said. “It showed that serious lower respiratory infections in every age group were increased with more air pollution, even short-term exposure lasting only several days.”

Macfarlane says his research came up with a lot of information on how air pollution may be harming developing brains, in addition to lungs.

The brain is the primary fat reserve of a developing fetus. Many of the most toxic components of particulate air pollution — such as dioxins, PAHs and heavy metals — dissolve in lipids (fats), according to UPHE.

“During the first three months of gestation, a human embryo adds 250,000 brain cells per minute, reaching 200 billion by the fifth month,” Macfarlane said. “But more than just rapid cellular [reproduction], this is an extremely complicated process that involves … the establishment of specific connections between neurons and target tissues.”

This exquisitely delicate process can be negatively affected by environmental conditions at any age, but particularly in the brains of fetuses as a result of rapid cellular division.

“The well-established disturbances of developmental processes in the brain by these toxic substances can lead to permanent cognitive and behavioral abnormalities,” Macfarlane said.

Clinical studies have shown a strong correlation between these factors and childhood anxiety, attention deficit, motor and behavioral disorders, he added.

Can air pollution cause autism, dementia?

Some studies have shown that autistic children and their mothers have a high rate of a genetic deficiency in an antioxidant called glutathione, which is the body’s primary means of making heavy metals not toxic. While indicating a correlation with autism, these studies did not prove causation.

The link between dementia and Alzheimer’s disease and air pollution is still controversial and the field of study remains very young; however, a growing number of studies have built some support for the claim.

“The latest research examined the brains of 203 people, ranging in age from less than 1 year old to 40 years old," Macfarlane said. "At autopsy [causes of death were usually trauma], every single brain but one showed the abnormal proteins that are the microbiologic hallmarks of Alzheimer’s, even in an 11-month-old. And the amount of these abnormal proteins was proportional to the amount of air pollution where the subjects lived.”

Science Magazine in a 2017 article analyzed PM 2.5 research said that while scientists acknowledge this is a relatively new area, a growing number of epidemiological studies are raising alarms about the correlation between air pollution and cases of dementia and Alzheimer’s.

Point of the Mountain

The gravel extraction pits at the Point of the Mountain at the south end of Salt Lake Valley present a variety of health concerns, in the view of UPHE. In fact, the group has made the particulate matter pollution there its top priority, with the premise that the first step in solving the problem is not making it worse.

It has also become a concern for Draper residents as Geneva Rock, one of the mine operators, has proposed expanding its mining zone. More than 100 people showed up at a public hearing on the issue last month.

Trent Nelson | The Salt Lake Tribune Geneva Rock's operations at Point of the Mountain, straddling Utah and Salt Lake counties, Tuesday, Sept. 22, 2015.

Company spokesman David Kallas told the Tribune recently, “After listening to and considering feedback from the public, cities and other stakeholders, Geneva Rock chose to reduce the size of its rezone request from 73 acres to 18.5 acres. The company intends to submit a revised application to the city in the near future.”

Geneva Rock declined to comment for this story on air quality concerns.

The state’s Division of Air Quality monitors the mining operations and says they generally fall within regulations.

“Under our air quality regulations we regulate the dust and air pollution that comes from Geneva’s mining activities. Those regulations require that they manage the mining, truck speeds, etc., to minimize the impacts from the activities that create dust," said Bryce Bird, division director.

The state uses the National Ambient Air Quality Standard and "We don’t violate those standards here unless a wind storm becomes a regional event,” Bird said.

Silica, a subset of PM 2.5, remains the biggest concern for Utah physicians as well as for many residents. But Bird said that because the Environmental Protection Agency doesn’t have standards for silica, the state does not regulate this mineral.

“There’s no national standard for silica. We have a federal program where the EPA identifies pollutants and then requires monitoring for those where a standard has been developed. The company is responsible for managing workplace exposure to silica, but not for managing silica [outputs into the general environment],” Bird said.

The Utah Department of Health said it has only a minor role in community health concerns surrounding Point of the Mountain mining, and the agency is not aware of the specifics of any expansion plan.