Louisville KY, June 28, 2017- Today marks the close of AIR Louisville, the first-of-its-kind data-driven collaboration among public, private and philanthropic organizations to use digital health technology to improve asthma. The program leveraged Propeller Health’s medication inhaler sensors which tracked when, where and how often residents of Louisville experienced asthma symptoms. These data helped patients to better manage their asthma symptoms, and aided city leaders in making smarter decisions about how to keep the air clean.
The project’s findings identify potential gaps between federal limits on air pollution and the air quality needed to protect human health. In 2015, the ozone standard was lowered to 70 parts per billion (ppb). Analysis of the AIR Louisville data suggests that a limit of 65 ppb would be appropriate, based on the impact this pollutant has as a trigger for asthma. AIR Louisville has created a unique dataset that includes both medication use and environmental conditions at the time of use. Analysis of these data shows that asthma attacks and healthcare costs both increase when pollution levels reach even moderately unhealthy levels.
“The health of our residents is critical to the overall health of our community, and Louisville’s location within the Ohio River Valley provides particular challenges for residents with asthma,” Mayor Greg Fischer said. “Data and research show that asthma can become more severe on days of extreme heat and poor air quality. As the city and our many partners, including AIR Louisville, work to plant trees, improve air quality and #cool502, I look forward to seeing asthma sufferers enjoy cleaner air and easier breathing.”
The program was a collaboration between Propeller Health, Louisville Metro’s Office of Civic Innovation and the Institute for Healthy Air Water and Soil. This unique combination helped the project reach enrollment goals and form new partnerships, said Veronica Combs, executive director of the Institute for Healthy Air Water and Soil.
“AIR Louisville is a perfect example of how communities have to work together to change our definition of healthcare,” said Combs. “We need an urban environment that supports our health just as much as we need access to medical care.”
Participants saw a 82% reduction in asthma rescue inhaler use, a significant increase in the number of symptom-free days, and 14% increase in nights without symptoms.
“Propeller’s mission is to better understand patterns of respiratory disease through individual and community data,” said David Van Sickle, CEO Propeller Health. “The collaboration with AIR Louisville has been a profound opportunity to put the data that we’re collecting to work to help improve people’s lives with asthma and COPD, improve public health for the community of Louisville and to move the conversation towards prevention of respiratory disease. We’re excited to expand this work in other cities globally.”
The AIR Louisville team created a report card that highlights the project’s accomplishments, policy recommendations and next steps.
Participating in AIR Louisville were the Louisville Metro Department of Public Health and Wellness, Air Pollution Control District, local employer partners such as Brown-Forman, Humana, Papa Johns, WHAS-11, Seven Counties Services, Kindred Healthcare, JenCare Neighborhood Medical Centers, local health plans such as Passport Health Plan, and local asthma specialty clinics like Family Allergy & Asthma and the University of Louisville.
AIR Louisville funded by a grant from the Robert Wood Johnson Foundation, and additional financial support from the Midland States chapter of the American Lung Association.
Everyone in the standing-room-only audience laughed.
Guillaume Coiraton, the plant manager of the American Synthetic Rubber Company, had just explained an illustration that showed the range of 1,3 butadiene emissions from the plant. He said the reach of this cancer-causing pollution is very small, barely reaching beyond the fence around the plant. He said that the emissions were not a problem for most people in West Louisville.
Coiraton started his presentation with pictures of smiling employees, green lawns and even a family of geese with the goslings in the foreground and the plant’s big tanks in the background. No one believed him when he said the exposure to butadiene emissions was minimal.
This was the second public hearing that the Air Pollution Control District has held on this topic. ASRC wants permission to increase emissions of 1,3 butadiene. The company claims that this is necessary despite their use of toxics best available technology to control emissions. Butadiene is linked with cancer and many other health problems. The Air Pollution Control District uses exposure modeling techniques to understand the risk of exposure. The exposure limits in the STAR program are expected to cause one cancer per million people over the course of 70 years. At the last public hearing on the ASRC request, a resident of Rubbertown testified about living near the plant, sharing that she had recently had surgery for thyroid cancer.
I attended both hearings and noticed a disconnect between two realities described in the meetings.
ASRC is a company operating in Louisville and emitting toxic chemicals, sometimes within legal limits and sometimes above those limits. The company, and the Air Pollution Control District, say that the risk of exposure is small and within legal limits.
Then, there are the people living and working in Rubbertown. They describe a day-to-day life that is not reflected in the official rules or in any exposure model. Resident and air activist Eboni Cochran spelled out the impact on daily life at the hearing. She called out the educational impact of kids missing school due to an asthma attack, the financial impact of a parent missing work to care for the child and the health impact of not being able to play and exercise outside due to air pollution.
Modeling the risk of exposure is a good way to write regulations to limit emissions. Modeling does not reflect the day-to-day experience of living in the neighborhood. The best models can estimate risk but they do not reflect the daily reality of smells and health issues.
We are asking these residents to take on a higher risk due to the operations of the American Synthetic Rubber plant. How can ASRC and the city recognize this additional risk? What about creating a community benefit fund to recognize this additional risk and balance these two realities?
Creating a community benefit fund would recognize the risk of exposure to butadiene. Providing these funds and giving control of this fund to residents would recognize this risk and give some measure of control to the people living in the neighborhood.
This approach also could make the dialogue between the Air Pollution Control District and Rubbertown residents more productive. Right now the decision is us or them, increased risk or current level of risk, corporation vs. citizens.
The ideal solution would be no risk at all – meaning the residents or ASRC would relocate. That option is not on the table.
A small step forward would be a community benefit fund that residents could use to find solutions to reduce the exposure risk. This specific action would recognize the increased risk of living next to a chemical plant, the increased risk that city leaders and ASRC are asking residents to accept.
You can see pictures and short biographies of each Ambassador here. We are planning several lunches for the Ambassadors over the summer to share ideas and get to know each other. We plan to induct a second class this fall. Nominations are open now for the second 2017 class. We’ll start reviewing nominees in August and announce a second class in September. In October, we’ll have a day-long event to discuss ideas, share strategies and plan new collaborations.
Congratulations to all 32 Ambassadors. We are honored to work with all of you.