Two years ago, Utah Physicians for a Healthy Environment called on the Utah Legislature to invest in individual room air purifiers for all the state’s school classrooms. In pre-pandemic America our request was born of hundreds of studies that revealed air pollution is toxic to the brain, directly impairing students’ ability to learn. Now there is even more urgency to embrace the idea.
A resurgence of the pandemic, courtesy of the more transmissible delta variant, is now colliding with the opening of schools throughout the state, and a persistent stretch of the worst air pollution of the year. Air pollution is a “force multiplier” for the risk of COVID, and victims of serious COVID infections are now more common in school age children, especially the unvaccinated, which includes children younger than 12 who are not eligible for the vaccine. Pediatric ICUs in Utah and across the country are beyond capacity.
That Utah’s political leaders have inexplicably dug in their heels, refusing to mandate either masks or vaccines, elevates the need for all other mitigation measures such as classroom air purifiers.
Air pollution, both acute and chronic exposure, increases the risk of a serious COVID infection. Last year’s Western wildfire smoke is estimated to have caused an extra 19,000 cases of COVID, and 700 subsequent deaths. Viruses can hitch a ride on pollution particles and, by reducing ultraviolet radiation, pollution can extend their life and distribution in the atmosphere. Pollution reduces the synthesis of vitamin D, an important contributor to the immune system.
Acutely, air pollution increases the permeability of cells that line the respiratory tract, allowing easier penetration by the virus. Air pollution allows greater viral replication by decreasing the immune response, the scavenging of viruses by white blood cells, and the activity of antioxidants.
Air purifiers in classrooms would help decrease the transmissibility of COVID without the burden of inconvenience, discomfort, or ideological trespass. The Brookings Institute determined that air purifiers “can even reduce virus-containing aerosol particles, with obvious implications for classroom safety in our current pandemic.”
Chronically, air pollution’s multi-faceted adverse effects on human health also increase the risk for serious COVID infections, including the risk of hospitalization and death. This is no surprise because air pollution and COVID affect the same organ systems. Pollution risk is similar in magnitude to the well-known comorbidities that also increase a patient’s COVID vulnerability, like smoking, asthma, COPD, diabetes, cardiovascular disease, immunodeficiency and obesity.
If the pandemic miraculously disappeared tomorrow, classroom air purifiers are still badly needed. Within 30 minutes of inhaling diesel exhaust, like from freeway traffic or riding in school buses, the brains of healthy volunteers show inflammation and a cortical stress response documented by EEGs. The impact lingers long after exposure ends. In a similar real-life situation young students would arrive at school already with a significant learning disadvantage.
Other studies confirm that is indeed the clinical outcome. The air pollution that children breathe on the way to school impairs their working memory in learning exercising on that very same day. Other research showed the flip side; that removing pollution in classrooms through air purifiers, even when the pollution levels were well below the EPA’s standards, resulted in improved performance, even more than standard interventions such as reducing class size by 30%, or “high dose” tutoring.
Air pollution impairs brain development and function throughout the age spectrum, from the earliest stages of life to the elderly. Gaining entrance through the nose, lungs and blood stream, the particles actually penetrate the brain in large numbers, millions per gram of brain tissue. This is undoubtedly one reason why air pollution is associated with almost the full range of neurologic disorders, from autism in children to Alzheimer’s in seniors.
Utah’s dominant religion celebrates a tenet that “the glory of God is intelligence.” Lately “glory,” Godlike attributes, “intelligence,” and even common sense, have given way to tribalism and the domination of fringe politics in Utah.
For $30 million to $40 million, we could purchase air purifiers for every classroom in the state, and with it achieve a rare win/win/win/win: cleaner air for those most in need, improved public education, a more intelligent next generation, and better control of the pandemic. For such little money a public policy that protects our children and helps them achieve their maximum potential should be a “no brainer.”
John Macfarlane, M.D., is a Salt Lake City neurosurgeon and a member of the board of Utah Physicians for a Healthy Environment.