Medicine: The Deadly Air

It made little difference whether the experts at the American Medical Association symposium in Los Angeles were reporting on Britain, Japan or the U.S.

They all agreed that wherever the landscape is cluttered with factories and the roads are jammed with automobiles, the very air man breathes is killing him.

> Southern California’s much-touted sunshine is, ironically, an essential accomplice in making smog so irritating to the eyes and so dangerous to health. The assorted hydrocarbons and nitrogen oxides spewed out by chimney stacks and tail pipes are bad enough in the raw. But sunlight sets up photochemical reactions involving such chemicals as ozone (a deadly poison) and nitrogen dioxide (an insidious and lethal gas when it hits the lungs). U.S. Public Health Service Toxicologist Sheldon Murphy neatly proved the perils of sunlight by exposing guinea pigs to city-street concentrations of exhausts. Unirradiated, the gases did little harm; after exposure to artificial sunlight, they made the animals sick, several of them fatally. In Los Angeles, automobiles spew out almost 80% of the smog-producing hydrocarbons and nitrogen oxides, and the afterburners now being compulsorily installed on California cars cannot do the whole job of cleaning up the city’s air, said Dr. Arie Jan Haagen-Smit. If Angelenos want real relief, he said, they must have better, and preferably electric, public transportation, fewer commuters, smoother-flowing traffic, and cars that burn less fuel.

> Japan’s Kanto Plain, on which Tokyo and Yokohama nestle, makes smog differently but just as deadly. Countless industrial plants burn soft coal or oil, said Lieut. Colonel Harvey W. Phelps, but few have proper smokestacks. Acrid smoke can be seen billowing out of doors, windows and ventilators near ground level.

And the region has produced a crippling kind of lung disease, “T-Y asthma.” Hitherto healthy G.I.s are seized late at night with uncontrollable coughing and wheezing, leaving them exhausted and panicked by fears of suffocation. Treatments for ordinary asthma do no good; between nightly bouts, the victims suffer continuously from shortness of breath. Japanese doctors do not recognize this as a unique form of asthma, but this does not mean the Japanese are immune: five native Japanese have come down with it, and the only victim who died was a Nisei from Hawaii. Army medics once thought that evacuation from the Kanto smog zone effected a geographic cure, but now they find many victims with continuing symptoms long after return to the U.S.

Even more ominous, last week’s meetings heard the first report of two T-Y asthma cases originating in Los Angeles.

> Britain’s soft-coal-burning open fireplaces had already poisoned the air sufficiently to help kill Samuel Johnson in 1784. Now, combined with auto exhausts, oil and other chemical fumes, they are killing Britons in droves. London’s Epidemiologist Donald D. Reid noted that although British physicians call the resulting lung disease chronic bronchitis, it appears to be essentially the same as American doctors’ “pulmonary emphysema,” now being reported with increasing frequency. Wherever it occurs, this kind of lung damage might as well be called “the English disease,” said Dr. Reid.

Though smoke and smog the world over inevitably damage the airways leading to the lungs and the oxygen-exchange cells in the walls of the lungs themselves, the effects usually appear slowly. There is an imperceptibly progressive shortness of breath. After years of decreased breathing volume and oxygen exchange, the heart has to work harder to pump more blood, and may fail in the process. The damage shows up dramatically when the lungs are subjected to added stress—from infection or vigorous exertion. This sort of weakness, said Colonel Phelps, is an increasing cause of medical retirement among officers aged 45 to 55. All the A.M.A.’s experts agreed that cigarette smoke is chemically similar to polluted air and inhalers add the effects of individual air pollution to those of public pollution.