In the past few years, especially during the summer months, Dr. Wallace has seen a growing number of children and elderly patients rushed to the emergency room with asthma and other respiratory ailments. And he's convinced that air pollution is the culprit.
"The Triangle and Charlotte are now on the top-10 lists of places with the [nation's] dirtiest air," says Wallace, a lanky, dark-haired man who's been practicing medicine since 1975. "We may not see the trees dying because of it, but where we do see serious damage is in the health of our children and seniors."
Studies by university scientists and government agencies bear him out. A report by the state's Clean Air Task Force found that high-ozone days in North Carolina three summers ago resulted in 1,900 respiratory hospital admissions, 630 emergency room visits for asthma and 240,000 asthma attacks. While atmospheric ozone plays a positive role, protecting the earth from harmful ultraviolet rays, ozone that's trapped at ground level becomes a reactive chemical that can irritate the lungs and exacerbate breathing problems such as asthma.
And those problems can be severe. "Some of these children [with asthma] would die if they didn't get to the emergency room," Wallace says.
The incidence of childhood asthma is strikingly high across North Carolina. A recent survey commissioned by the state Division of Public Health's Asthma Task Force found nearly 30 percent of children in public middle schools in North Carolina had asthma or asthma-like symptoms. Casey Herget, state asthma coordinator, says her office is now seeking funding for additional studies to determine why asthma is so widespread. "We do believe it's an environmental issue as well as a medical disease," she says.
Air pollution is also causing early deaths from other ailments such as chronic lung and heart disease in the Tar Heel state. Data from the federal Centers for Disease Control and Prevention shows dirty air is responsible for more than 1,800 premature deaths in North Carolina each year--the fourth worst in the nation. Asheville has the sixth-highest premature death rate in the country. At 46.9 premature deaths per 100,000 adults, the western North Carolina city topped such industrial centers as Birmingham, Ala.--which was ninth on the list--and major metropolitan areas such as New York, which came in 138th.
None of these findings are a surprise to Wallace. "There are two ways you can try to deal with such [health] problems," he says. "You can try to treat them as they occur or you can try to prevent them from happening."
Clean-air advocates hope this will be the year that North Carolina lawmakers take major steps toward prevention. Wallace was one of dozens of environmentalists from around the state who rallied in Raleigh April 4 to support a new "Clean Smokestacks" bill that would cut emissions of toxic chemicals in the air by as much as 75 percent over the next dozen years.
The proposed measure, which was introduced by two western North Carolina legislators, already has the support of 53 co-signers, and is expected to be debated sometime this week. Sen. Charles Metcalf is the sponsor of Senate Bill 1078, and Rep. Martin Nesbitt is sponsoring the companion Bill 1015 in the House. Both are Democrats from Buncombe County.
The proposed legislation focuses on pollution from 14 coal-fired power plants operated by Duke Power Company and Carolina Power & Light--by far the largest source of soot and smog in North Carolina. Statistics from the N.C. Division of Air Quality show those 14 plants generate 82 percent of sulfur dioxide (SO2) emissions, 45 percent of nitrogen oxide (NOx) emissions and 65 percent of mercury emissions in the state.
Because they were built before 1975, the plants are exempt from federal Clean Air standards for ozone and soot, which "grandfathered" many older facilities. The new bill would require power companies to reduce the amounts of NOx and SO2 they send into the air by 70 to 75 percent over the next 12 years. The bill also directs the state Environmental Management Commission to study setting standards for carbon dioxide (CO2) and mercury emissions by power plants.
Companies would be allowed to recoup the costs of compliance through higher electric rates. Officials for Duke and CP&L estimate that monthly household electric bills in North Carolina would need to rise by between $3 and $5 to allow the power companies to meet the proposed new standards.
The bill was a compromise between environmentalists, who had hoped for smokestack reductions of 80 percent, and power company leaders, who had argued at different times for reductions of between 35 and 65 percent. Efforts to get statewide air pollution legislation received a boost last summer when citizens flocked to a series of public hearings on rules to reduce smog from power plants. Following those hearings, the state's Environmental Management Commission voted to require power plants to reduce summertime emissions of NOx by 65 percent. Now it's up to the General Assembly to decide whether the state should enforce even tougher rules contained in the new bill.
Michael Shore, southeast air quality manager for Environmental Defense, says he's pleased that utility companies "who didn't agree to these numbers six months ago are now not only agreeing, but are also willing to make those reductions year-round."
Power company officials cite the cost-recovery provisions--which were not part of the Environmental Management Commission's rules--as key to their lack of opposition to the proposed new smokestacks bill.
"What we've said is we can support this as long as we have a reasonable time to get it done and adequate cost recovery to help pay for it," says Keith Poston, a spokesman for CP&L.
Duke Power spokesman Joe Maher is a bit more qualified in describing his company's reactions to the new smokestacks bill. "It's not our role to be convinced that we need to take those steps," he says. "But if the state feels it must move in this direction as a matter of public policy, then this bill appears to be a reasonable vehicle."
Nationally, industry groups have been fighting efforts by the federal Environmental Protection Agency to enforce air quality standards based on public health needs without consideration of costs. The U.S. Supreme Court recently upheld the agency's right to determine standards based solely on health, but the court also said that it was "appropriate" for states to consider costs in implementing those standards.
Clean-air advocates have a clear yardstick for measuring the cost of air pollution regulations. A "Clean Smokestacks Plan" released in March by a coalition of 12 statewide environmental groups put the price tag for reducing power plant emissions by 80 to 90 percent at $449 million. That's compared to the $3.5 billion the report estimates the state is now spending on lost work days, hospital admissions, fewer tourists and long-term environmental damage caused by dirty air.
For Raleigh resident Ena Foster, air pollution in the Triangle adds up to 10 years without a vacation. Her 11-year-old daughter, Megan, has asthma, and Foster has to save up vacation time from her job as a computer operator for the many days when outdoor ozone levels require her to keep her daughter inside.
"Megan's heavily medicated but I still feel restricted to the times she can go out," says Foster, who testified at last summer's public hearings on smog reduction. "She stays in on both Code Red and Code Orange days [the highest stages of alert]."
Last year, the state Division of Air Quality reported there were 35 such days statewide when ozone levels exceeded the EPA's safety standards, and 13 Code Red or Code Orange alert days in the Triangle.
Foster smiles when she remembers how she felt about moving to Raleigh from San Diego almost a decade ago
"I thought, it's so smoggy in California, let's move to somewhere else," she says. "Now, the Triangle is worse than San Diego. I really love it here. But I think we need to focus on this air pollution problem."
For information on the proposed smokestacks bill, go to the General Assembly's Web site, www.ncga.state.nc.us. Ozone air quality forecasts begin in May and can be reviewed online at www.epa.gov/airnow.