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By John Doxey He's only midway through a four-hour shift, but Dr. David Pepper is already consulting with his third asthma patient of the day, a former field worker whose chronic breathing difficulties prevent her from doing housework or playing with her three children. "On a typical day during the summer months, when the air quality outside tends to be at its worst, we'll see 40 to 50 asthma patients," says Pepper, a wiry, 42-year-old respiratory specialist who oversees a team of residents at his hospital. "Numbers like this were once unheard-of around here."
Los Angeles? Nope. Houston, maybe? Guess again. This is Fresno, Calif., hub of the San Joaquin Valley, one of the richest agricultural areas in the nation--and now, one of the smoggiest. On many days, the air in this sprawling city of 430,000 hangs so thick that it's impossible to see the picturesque Sierra Nevada Mountains just 20 miles east of town. Concentrations of ground-level ozone (better known as smog) and airborne particles such as soot and dust regularly exceed federal health standards. Last October, the Environmental Protection Agency (EPA) classified the San Joaquin Valley as a "severe" ozone region, a ranking shared by a few major metropolitan areas. Earlier last year, the American Lung Assn. reported that three of the four smoggiest cities in the country--Bakersfield, Fresno, and Visalia-Tulare-Porterville--were in the same valley. And now, the worsening pollution has set off a fierce debate about how to fix it.
Why should a valley mostly known as a cornucopia of vegetables and fruit now be struggling to breathe? Partly it's a matter of geography: The 270-mile long valley is shaped like a bowl, and the surrounding mountains trap pollutants that drift southward from cities around San Francisco Bay. But mostly it's that old environmental villain: cars and trucks. Boosted by rapid growth--during the 1990s, the valley's population jumped 18%, to 3.3 million--"the amount of vehicular traffic on our roads and highways has grown significantly," explains David L. Crow, executive director of the San Joaquin Valley Unified Air Pollution Control District. Crow figures "mobile sources" account for some 60% of the smog in the valley.
Besides cars, other sources of pollution include emissions from agribusiness equipment and the oil-and-gas extraction operations that dot the valley's southern end. As a result of all this gunk pouring into the air, the San Joaquin Valley Air Basin exceeded the federal 8-hour ozone standard 103 times in 2000 and 101 in 2001, the first years in which the valley recorded more violations than the Los Angeles area's South Coast Air Basin.
As pollution has worsened, the per capita incidence of asthma in the valley has risen to nearly twice the 5% national average, and Fresno now has the country's third-highest rate of asthma-related mortality. Only New York City and Chicago top it, according to Community Asthma Education & Management, a program run by Community Medical Centers of Fresno. "To some extent, the increases we're seeing reflect better diagnosis and population growth. But it's clear that respiratory diseases are rising faster here than in most parts of the country," says Kevin Hamilton, the program's coordinator.
Adds asthma specialist Pepper, who works at Fresno's University Medical Center: "What's most alarming to me is the toll this illness is taking on our children." Reported asthma cases among students attending Fresno's public schools surged 156% between 1990 and 1999, far exceeding an 18% growth in student enrollment, according to Fresno Unified School District statistics.
The smog also exacts an increasing cost from the valley's mainstay, agriculture--ironically, since farm equipment spews out a goodly share of pollutants. Ozone interferes with photosynthesis and other plant functions, limiting plants' ability to grow and reproduce. Studies show that ozone concentrations commonly found in the San Joaquin Valley can cut harvest of some crops by 25%. The air district estimates conservatively that crop damage resulting from smog costs valley farmers more than $150 million per year. "And we may only be seeing the tip of the iceberg. We still don't know, for example, what the long-term effects of ozone exposure will be for soil or orchard trees," says David A. Grantz, director of the University of California's Kearney Agricultural Center, about 15 miles south of Fresno. Grantz worries that worsening air pollution could have "serious long-term ramifications" for the valley, which produces about a third of America's fruits, vegetables, and nuts, and whose agriculture annually pumps about $14.5 billion into California's economy.
Given these worries, activists say that government isn't being aggressive enough in cleaning up the air. "One of the main reasons our air remains so polluted is that the EPA and other agencies have neglected the valley," says Kevin Hall, an outspoken member of Fresno's Sierra Club chapter. The Sierra Club belongs to a coalition of medical, environmental, and community groups that filed a lawsuit last November against the EPA for, among other things, failing to act on a plan, submitted by the San Joaquin Valley air district in 1997, to reduce dust, soot, and other tiny airborne pollutants. The suit was settled on Jan. 15, giving the EPA until August to either approve or reject the plan submitted by the district.
For its part, the EPA is quick to admit that it has focused more on cities such as Los Angeles and Phoenix, which have managed steady air-quality improvements in recent years. "We haven't paid as much attention to the San Joaquin Valley as we should have," acknowledges Jack Broadbent, the EPA's director of air programs for the region that includes California. But that's changing, he says, pointing to the EPA's recent classification of the valley as a "severe" ozone region, a move that compels the air district to produce a plan for reducing smog-forming emissions by 30% over the next five years.
The air district itself argues that it's too dependent on other agencies to mount a campaign on its own. "We haven't made as much progress as we would have liked, but [the air district] can only do so much," says Crow. "We'll be fighting a battle of attrition against air pollution until the valley comes up with better land use and transportation planning, and finds a way to reduce the vehicle-miles people are traveling."
Regulatory efforts have also been hampered by local industries, claim environmentalists. "Agencies like the air district and the California Air Resources Board have repeatedly bowed to pressure from agribusiness, oil companies, and developers," says Bruce Nilles, a lawyer at Earthjustice, a San Francisco law firm that handled the lawsuit against the EPA.
As an example, Nilles points to the air district's approval last November of a dust-control plan that exempts dust kicked up by tractors and other farm equipment traveling on unpaved roads. Farmers insist the exemption was justified: "We got involved in the [dust-control] plan's development because we were concerned about the accuracy of the data the air district was using," says Manuel Cunha, president of the Nisei Farmers League, a Fresno lobbying group. Early drafts of the plan "were full of factual errors that could have ended up costing farmers millions."
The question is whether savings by industry will end up costing more in health problems. Pepper frets over the millions of new residents who will either move to or be born in the valley in coming years. "Population growth is inevitable because homes are so much more affordable here than in the coastal metro areas, and because birth rates are high in the valley. But if things go on as they are, we're going to have the worst air in the country," says the doctor, sipping a beer after work at a bustling caf? in Fresno's artsy Tower District. Indeed, the San Joaquin Valley is projected to remain one of California's fastest-growing regions: Its population will more than double, to 7.3 million, over the next 40 years, according to estimates by the state's Finance Dept. Muses Pepper: "I often wonder if these new arrivals know what they're getting into." Doxey lives in San Francisco and often writes about environmental and health issues. EDITED BY Edited by Harry Maurer