Public Policy Position - Healthy Air

DATE APPROVED: October 22, 2022

Policy Principle on Healthy Air

All people are entitled to breathe healthy air and to be free of the adverse health effects of indoor and outdoor air pollution.   The American Lung Association strongly supports safe, healthful air for all. Environmental policies must protect the public against acute and chronic adverse health effects.  The American Lung Association is especially concerned about the effects of air pollution on the health of populations who are at greater risk, including people with lung diseases such as asthma, lung cancer, and chronic obstructive pulmonary disease (COPD); children and the elderly, low-income communities, communities of color, and people living near power plants, major roads and other transportation hubs, oil and gas operations and other sources of pollution. All available strategies, including public education and outreach, research, legislation, regulation and litigation, should be employed as necessary to protect the public health.  The development of these strategies must include early inclusion and meaningful involvement of those living in communities impacted by pollution; must prioritize the most impacted communities for cleanup; and must foster health equity by ensuring that no community bears a disproportionate burden of health impacts from air pollution. 

Clean Air Act

The Clean Air Act has proven to be one of the nation’s premier public health measures, enabling the nation to protect the health of millions of people from dangerous air pollutants, including greenhouse gases that drive climate change.  Through the Act, Congress clearly established enforceable deadlines and processes for setting and attaining national air quality standards.   The Act has shown its effectiveness by significantly reducing ambient air pollution from 1970 levels. The documented benefits from the lower pollution levels have greatly exceeded the implementation costs.   The American Lung Association supports strengthening the Clean Air Act and opposes any measures that weaken the important public health protections it provides. 

Environmental Justice

The American Lung Association supports the protection of all people from the harm of air pollution, especially those who suffer disproportionate exposure from local sources of emissions.   The American Lung Association recognizes that major sources of air pollution are often located near where many people, especially communities of color or lower income, live and work, which means their exposure to pollutants emitted can be more immediate and disproportionately harmful.   The American Lung Association recognizes that, for many reasons, people in those communities also face a greater burden of lung disease, making them even more vulnerable to these pollutants.

The American Lung Association recognizes that many factors have contributed to the disproportionate levels of exposure in these communities, including missing or weak limits on emissions, poor enforcement of existing regulations, inadequate monitoring of pollutants and limited scientific research. The American Lung Association also recognizes that systemic racism drives these ongoing inequities. The American Lung Association supports the formulation, execution and enforcement of health and environmental laws and policies to address these factors, clean up contributing sources and reduce such exposures. The American Lung Association supports an integrated approach across our issue areas to address the underlying roots of disparities in exposures and negative health outcomes. As the nation transitions to cleaner sources of electricity, disproportionately burdened communities should be prioritized for investment and community-informed clean-up programs. The American Lung Association supports measures to ensure that communities have an active voice in decision-making about local polluting sources and climate change mitigation and adaptation measures. Federal and state policies to address air pollution and climate change must also include robust, meaningful engagement of affected community members. 

The American Lung Association supports regular, thorough assessments of the impacts to nearby communities of sources of dangerous air pollutants, including highways, ports, industrial boilers, power plants, and other sources of air pollution as vital to reduction and elimination of harmful exposures.  The American Lung Association supports the aggressive targeting of these sources for cleanup, with priority investment in the most highly impacted communities. The American Lung Association will work in partnership with communities to reduce the disproportionate health burdens borne by economically disadvantaged and politically disenfranchised communities.

Climate Change

The American Lung Association recognizes that human activity drives climate change, one of the most urgent threats to human health of the 21st century. Major health impacts of climate change include warmer average temperatures that exacerbate ozone and particulate air pollution that cause asthma attacks and premature death. Extreme weather patterns, such as longer and hotter heat events and severe storms, contribute to droughts, increased allergens, pollens and molds, wildfires and flooding that destabilize communities and harm health.  Vector-borne diseases are expanding seasons and geographic ranges as ticks, mosquitoes and other disease-carrying insects spread.  The American Lung Association supports measures to maximize health protections for those who are most at risk, including children, seniors, low-income communities, pregnant people, communities of color, outdoor workers and those with chronic lung diseases.

Climate Change Mitigation

The American Lung Association supports science-based emission reductions requirements to keep global temperature increase to no more than 1.5 degrees Celsius. The American Lung Association supports legislative and regulatory measures to reduce all emissions that contribute to climate change. Such measures should include but are not limited to transitioning away from fossil fuels to increased use of clean, non-combustion, renewable energy sources and zero-emission transportation technologies; expanding energy conservation and efficiency measures; and establishing enforceable and science-based limits on emissions for all sectors including industrial, energy, agricultural, commercial, residential and transportation. The American Lung Association supports measures to reduce other outdoor air pollutants while reducing emissions that cause climate change.

Pollution control strategies, including market-based approaches, must directly reduce local adverse air quality impacts from all sectors, including power plants and refineries, cars, trucks and other mobile sources, as well as other industrial and agricultural sources, in addition to addressing any global impacts. Any legislative approach must not block, weaken, or delay the authority of the U.S. Environmental Protection Agency and states to curb climate change pollution under the Clean Air Act. The American Lung Association supports strategies and approaches targeting emissions from sources that also contribute to ambient air pollution that can directly and immediately harm health. 

Market-based Mechanisms to Mitigate Climate Change

Market-based greenhouse gas pollution reduction mechanisms, including taxes, fees, emissions trading or caps, have the potential to promote efficient and immediate pollution reductions. Any market-based mechanism must include strategies to protect communities that bear a disproportionate burden from the emission sources nearby as well as the impacts of climate change. The development of these strategies must include early inclusion and meaningful involvement of those living in communities impacted by pollution and must foster equity by ensuring that no community bears a disproportionate burden of health impacts from air pollution, and that market-based strategies do not perpetuate existing disparities in pollution burdens.  Any legislative approach must not block, weaken, or delay the authority of the U.S. Environmental Protection Agency to curb climate change pollution under the Clean Air Act.

Health Protection in Climate Adaptation 

The American Lung Association recognizes that, even with aggressive mitigation, climate change will continue to create widespread threats to lung health, placing the nation at risk. Some populations face greater risk, including children, seniors, low-income communities, pregnant people, communities of color, outdoor workers and those with chronic diseases such as lung or heart disease. Further, essential medical and public health services as well as supplies of food, water and housing face grave risks, especially to meet the needs of people with lung disease. The American Lung Association supports efforts to provide communities and people with the funding, tools and resources necessary to identify community-specific current and projected health impacts of climate change, and to develop and to implement localized adaptation action plans to build resiliency and protect communities and people. The American Lung Association supports the development and implementation of adaptation action plans that identify the heath threats faced and outline evidence-based actions that will protect health. The plan development process should incorporate early input from key stakeholders, including at-risk populations, health and medical leaders, and healthcare institutions. The American Lung Association supports the evaluation and updating of plans to ensure that they meet ongoing needs of the community.

Hazardous Air Pollution

The American Lung Association supports the use of the least hazardous materials, chemicals and processes to reduce the potential exposure to hazardous air pollutants whenever possible. The American Lung Association supports policies that emphasize preventing hazardous chemical accidents and fully protecting workers and communities when such accidents occur.   The American Lung Association supports continued and expanded reporting to the public of hazardous air pollutants released by public or private sources. The American Lung Association supports maintaining and updating a scientifically-reviewed listing of pollutants and the strengthening of controls for hazardous air pollutants through use of maximum achievable control technologies.  The American Lung Association also supports increased research on the acute and chronic health effects of hazardous air pollutants and for establishing better models for predicting and monitoring the impact of these releases. 

Healthy Air Infrastructure

The American Lung Association supports the state and local agencies responsible for specific strategies to reduce air pollution and protect the health of their communities, including the responsibility to monitor emissions; issue permits; inspect sources of pollution; and oversee and enforce codes and laws. The American Lung Association supports adequate funding for these agencies to protect the health of everyone in their communities.  The American Lung Association supports the strengthening and expansion of the nation’s network of air pollution monitors. The American Lung Association supports increasing air pollution monitoring near roadways, freight hubs, ports and other high emission areas.

The American Lung Association supports strengthening the fundamental, historical public health tools to reduce indoor and outdoor air pollution, including building and housing codes, as well as nuisance laws. The American Lung Association opposes the federal pre-emption of states’ ability to require stronger protections for clean, healthy air.

Air Quality—Public Spaces and Workplaces

Everyone is entitled to a safe and healthy indoor and outdoor public space and workplace environment. The American Lung Association supports measures to improve air quality in public spaces and workplaces through the use of regulations, standards, guidelines and management practices to protect the public health. The American Lung Association supports measures to require totally smokefree environments.   Effective air quality measures protect primarily through the control and elimination of sources of pollution and the provision and maintenance of adequate, state-of-the-art ventilation to reduce the spread of airborne infectious organisms, allergens and particulates. The American Lung Association urges specific planning for the prevention and cleanup of indoor and workplace air problems, including planning for emergency response. 

Indoor Air Quality—Residential and Institutional

Everyone is entitled to a safe and healthy indoor environment. Effective indoor air quality measures protect primarily through the control and elimination of sources of pollution and the provision and maintenance of adequate, healthy ventilation.   The American Lung Association supports construction standards, building and housing codes, disclosure and mitigation requirements, and enforcement measures that will protect public health in all residential spaces, including single and multi-family, publicly and privately owned. The American Lung Association supports measures to require totally smokefree environments in multi-unit housing and to encourage smokefree single family housing, recognizing that no ventilation system or other alternative provides adequate protection. The American Lung Association supports measures to ensure that radon levels in residences are protective of occupant health. The American Lung Association supports efforts to decrease the risk to lung health from household products and materials in the home, including building materials. The American Lung Association supports measures to prevent and mitigate the health harms of combustion-based home appliances, including woodstoves and fireplaces.  The American Lung Association supports measures to safeguard the health of residents in institutional settings including prisons, jails, detention centers and other locations. 

Indoor Air Quality – Schools and Childcare Facilities

Everyone is entitled to a safe and healthy indoor environment, especially children.  The American Lung Association recognizes that childcare facilities and schools, attendance at which is mandated by statute, merit special concern. Children’s growing lungs are highly vulnerable to harm from unhealthy air and the typical classroom has many more occupants than the same floor space in an office building. The American Lung Association supports measures to improve indoor air quality through the use of regulations, standards, guidelines and management practices to protect the health of children and workers in schools and childcare facilities, such as the U.S. EPA’s Indoor Air Quality Tools for Schools. Effective indoor air quality measures protect primarily through the control and elimination of sources of pollution and the provision and maintenance of adequate, state-of-the-art ventilation to reduce the spread of airborne infectious organisms, allergens and particulates. The American Lung Association supports measures to require totally smokefree environments as well as ensuring schools are not a source of exposure to harmful levels of radon, cleaning chemicals or pesticides. The American Lung Association urges specific planning for the prevention and cleanup of indoor air problems, including planning for emergency response. 

International Environments

The American Lung Association strongly supports a healthful environment worldwide.  Pollution sources should be required to maintain state-of-the-art pollution controls to protect public health. International goods movement, including ocean-going vessels, marine vessels, trucks, and locomotives, should reduce emissions by first prioritizing zero emission technology, and second, incorporating clean fuels including ultra-low-sulfur diesel fuel and the best available pollution control technology. International air travel should use systems, fuels and pollution control technology that will reduce emissions worldwide.  People worldwide should have access to cleaner cookstoves that reduce exposure to household air pollution. The American Lung Association supports efforts to improve both indoor and outdoor air quality worldwide.

National Air Quality Standards

The primary National Ambient Air Quality Standards (NAAQS) must be set solely on the basis of the protection of public health, as required by the Clean Air Act.    The American Lung Association supports the NAAQS development and revision process as delineated in the Clean Air Act of 1970 and amended through the 1990 Amendments and opposes the use of cost-benefit analysis or technological feasibility in the standard-setting process.   The American Lung Association recognizes and supports the Clean Air Act delegation of the nation’s standard-setting responsibility to the U.S. Environmental Protection Agency.  

Pesticides and Herbicides

The American Lung Association supports the use of integrated pest management as a primary approach to reducing exposure to pests, including animals, insects and plants, in residences, public spaces and workplaces. Integrated pest management is a recognized and tested comprehensive approach that prevents and eliminates pests by reducing their habitats and food sources.  The Lung Association urges the adoption of policies that require schools and childcare facilities to practice integrated pest management and strategies to minimize or eliminate the exposure to pesticides and herbicides.

Radon

The American Lung Association supports measures to reduce exposure to indoor radon to protect public health. The American Lung Association supports setting the action level or standard for radon solely based on the protection of public health with an adequate margin of safety, and a regular review of the scientific research recurring no more than every five years to determine that level.  The American Lung Association strongly supports public education programs regarding the health risks of elevated indoor radon levels and the need for radon testing and mitigation.  The American Lung Association supports the adoption of building codes that require new construction to meet guidelines for radon resistance. The American Lung Association supports requirements in real estate transactions that require disclosure of radon testing results to purchasers. The American Lung Association recommends that all federally-funded housing, including public housing, and all schools be tested for radon and mitigated. 

Research:  Healthy Air

The American Lung Association strongly supports research to discover, understand, and reduce the impact of indoor and outdoor air pollutants, including greenhouse gases that cause climate change, on lung health and lung disease. Research should investigate measures to identify and eliminate disparities in exposure to indoor and outdoor pollutants, particularly for low socioeconomic populations and communities of color. Research should be conducted in a legal, ethical and humane manner.  The American Lung Association supports increased federal funding levels for environmental and intervention research and research training programs. The American Lung Association supports improved surveillance and tracking of risk factors and exposure to environmental health risks, especially indoor and outdoor air pollutants.

Right-To-Know

The American Lung Association supports the public’s right-to-know about air quality, pollution emissions and environmental hazards in their community, school, childcare facility, housing and workplace.  The American Lung Association supports right-to-know laws, public education and awareness efforts and other measures to accomplish this objective. 

Stationary and Area Sources

The American Lung Association supports measures to ensure the reduction or elimination of air pollution emissions from the manufacture, assembly, installation or other processes at major and area stationary sources, including from use of industrial and architectural coatings and solvents.   The U.S. Environmental Protection Agency should adopt and enforce stringent emissions control regulations for these sources. 

Small Equipment

The American Lung Association supports measures to reduce the air pollution impacts of combustion-based, fossil fuel-powered lawn mowers, leaf blowers and other small equipment, which contribute a significant share of the air pollution burden in parts of the U.S. The American Lung Association supports the transition to electric small equipment.  

Victims' Rights

The American Lung Association supports preserving all available avenues for citizens, governments and others to bring actions to seek compensation for and protection from injury and/or disease attributable to environmental exposure, especially injuries related to lung health.   The civil justice system's ability to address misconduct and protect public health must not be preempted.  The American Lung Association supports alternative systems, using sound scientific and medical criteria to determine injury, which allow full and fair compensation for victims, so long as those systems are completely voluntary and do not diminish legal rights.

Waste and Agricultural Burning

The American Lung Association opposes agricultural burning or the burning of waste and debris, including through pile burns, and supports policy efforts to limit and phase out this practice. Agricultural burning involves the intentional burning of croplands or agricultural waste and is conducted for reasons other than wildfire management purposes. If such burning does occur, fires should only be implemented under planned, predictable circumstances. To reduce harmful exposure from smoke, fires should be conducted only under the following conditions: meteorological conditions are favorable, available fuel sources are at a minimum, atmospheric conditions support adequate smoke dispersion, and wind patterns allow smoke to move away from sensitive areas (e.g., populated areas, hospitals, schools, roadways).  

Measures must be implemented to reduce public health impacts associated with burn activities. The American Lung Association supports air quality monitoring and surveillance coupled with public outreach and public notification systems; the provision of indoor air filtration and clean air spaces, especially for high-risk individuals; the provision and use of respiratory protective equipment; and additional emergency planning and response; including protections for vulnerable populations. The American Lung Association supports funding for public health protections during smoke events.

Wildfires

The American Lung Association recognizes that wildfire smoke is a current and growing threat to lung health. Climate change is increasing the likelihood of catastrophic wildfires, putting lung health in danger of wildfire smoke. The American Lung Association supports action to curb greenhouse gases to mitigate climate change, but much of the nation is already suffering from more frequent and intense wildfires and longer wildfire seasons. Research shows that historical fire suppression policies are insufficient for longer-term fire management. Fire suppression has been shown to defer, rather than mitigate, the air quality and health burdens associated with smoke. 

The American Lung Association supports prescribed fires under certain conditions as a tool to mitigate wildfire risk. Prescribed fires should only be implemented in appropriate ecosystems under planned, predictable circumstances to limit harmful smoke exposure. By “prescribed fire,” the Lung Association is not referring to forest thinning, pile burns, the use of thinned biomass for energy production, and other forms of prescribed fire used for purposes other than fire management (e.g., agricultural burning). Prescribed fires should only be implemented under planned, predictable circumstances where additional measures can be taken to minimize exposures, including but not limited to the following conditions: meteorological conditions are favorable, there is reduced fuel available to burn, atmospheric conditions support adequate smoke dispersion, and wind patterns allow smoke to move away from sensitive areas (e.g., populated areas, hospitals, schools, roadways). 

Measures must be implemented to reduce negative public health impacts associated with wildfire smoke and prescribed burn activities. The American Lung Association supports increased air quality monitoring and surveillance coupled with public outreach and public notification systems; the provision of indoor air filtration and clean air spaces, especially for high-risk individuals; the provision and use of respiratory protective equipment; and additional emergency planning and response, including protections for vulnerable populations.

The American Lung Association supports local, state and federal funding for the use of prescribed fires under conditions that mitigate the potential harm. The American Lung Association supports funding for public health protections during prescribed fire or wildfire smoke events. The American Lung Association supports additional research on the health impacts of wildfires and prescribed fire.