THE AIR YOU BREATHE IS MAKING YOU SICK

YOU THINK THAT DRUGS IS THE ANSWER? A DOCTOR RESPONDS

Asthma - Accolate, Oral Steroids and Flovent [posted 8/13/98]
Question: My 16 year old son was recently hospitalized for an acute asthma attack. He was given Accolate, Prednisone, Flovent to continue taking at home. He completed the Prednisone and continued the with the other two medications, but when his behavior became uncharacteristically aggressive with bouts of crying and anger, all medications were immediately stopped. I am aware that these symptoms can result from steroids, but can these symptoms also be attributed to either Accolate or Flovent? Can side effects occur from abruptly stopping these medications? Within two days of discontinuing all medications, the aggressive symptoms disappeared, but he was very anxious and nervous. Within the next two days all symptoms seemed to disappear and he seems to be back to normal. What other options do we now have to treat his asthma?

Answer: I'd restart his Accolate first. I doubt that this would cause the mental disturbance that you are seeing. Steroids are notorious for this (mainly high dose systemic steroids - not inhaled). Consequently, secondly start an inhaled steroid after you ensure that Accolate isn't doing it, but start with a low dose steroid first and work up slowly.

Asthma Medication [posted 8/11/98]
Question: My 4 year old grandson has just started taking Vanceril (Beclomethasone Dipropionate) 84 mcg double strength inhalation aerosol, 2 times daily for treatment of coughing and wheezing diagnosed as asthma. Please give us any comments or advice as to the effects of this drug on him (especially since he is so young). Does it have any effect on the personality (irritability) or growth or any other effects that we should be aware of.

Answer: Inhaled steroids are generally not absorbed into the body and as a consequence the systemic side effects are few. However, about 1% of patients will experience the systemic side effects of inhaled steroids - worsening as the dosage or frequency is increased. Steroids can definitely have effects in children, changing their growth patterns, etc. On rarer occasions they would affect the personality of an individual, but theoretically possible. It should be well tolerated if not used excessively, however, it is a great asthma drug and one needs to balance the risk of the steroid against the problems of not being able to breath. Patients still die from asthma, it is not a benign disease.

Asthma
Question: Why isn’t there a cure for asthma? Is there hope that a cure will ever come about?

Answer: Asthma is a disease of the airways to the lung. It is due to spasm or narrowing of the airways after stimulation by one of many factors. It is usually reversible so that the airway returns to normal after a period of time. It is one of the more common medical problems and is a leading cause of loss of work and school time. In severe cases, it can lead to death and often limits an individual's activities. Asthma is classified in several ways, but generally falls into allergic and non-allergic types. Allergic is generally seen in young children and teen-agers. Non-allergic is typically seen in older individuals, although there is a wide spectrum of distribution. However, both are due to the hyper-irritability of the airways. Different common triggers include allergens, exercise, cold, chemicals, aspirin, beta- blockers, infections, emotional triggers, and work exposures. Treatment centers on reversing the spasm of the airways. This can be accomplished by one of several drugs. Preventive medications prevent the cold, exercise or whatever from triggering the asthma. These are drugs like cromolyn sodium, occasionally steroid, and occasionally drugs like Valium. Other drugs are used during a spell while the spasm is present. These fall into beta-agonists (inhalers or pills like metaproterenol, etc.), adrenergic drugs like epinephrine etc., methyxanthines like theophylline (caffeine is a weak methyxanthine), and lastly steroids. Steroids have been used in increasing amounts over the last few years as the element of inflammation has been more clearly recognized as a component in asthma. Steroids are usually given as an inhaler, but can be used as system pills in severe disease. These have long term side effects when given as pills. Unfortunately, I doubt that there will ever be a cure for this disease, but there may be better treatments in the future.

Asthma
Question: My 2 1/2 year old son has been diagnosed with asthma and we have been told it is critical that we have air conditioning available to him for the summer. We live in Southeast Michigan and occasionally the temperature reaches the mid 90's. Is central air actually required? I have had many friends (who have asthma) tell me otherwise.

Answer: The earlier that asthma arrives usually the more severe it will be. I have not seen your son, but I suspect that you will see a large difference with air conditioning. There is no absolute way anyone can say with absolute certainty that it will help.

Acute Asthma Complications
Question: I am a 26 year old white male suffering from acute asthma and its' complications. I was born 11 weeks premature and weighed in at a mere 1 lb. 8 oz. I have had asthma problems since day one. I didn't use my first inhaler until the age of 13 (the age I was told I'd "outgrow it"). I have tried many different asthma therapies to no avail, limited only by my pocketbook. I really started suffering from asthma around the age of 19. I tried Maxair, Alupent, Ventolin & Proventil, Primatine Mist (like inhaling sand), Azmacort, and Serevent. At 19, I had 2 episodes where Maxair didn't work and I had to go to the ER I started on Ventolin and Azmacort simultaneously with moderate success...but I was inhaling 24 puffs of Azmacort daily. The doctor suggested I take even more! (no thanks). I then got off Ventolin and Azmacort, and went to Proventil. Not much better and still had to take the maximum dosage to stay alive. When I heard of a drug study for Zileuton, I volunteered for the study. After several days, I broke out into a very itchy rash from my abdomen to my scalp. I was done with Zileuton. I read about this marvelous drug Serevent, and when it was FDA approved, I started on it with great success. The max. dosage is 2 puffs twice daily. I use it only 1 puff once daily...it works so well! The only major problem is severe migraines...ouch! Mainly, if I have to take more than one puff in a 24 hour period. Anyway, now Accolate is out in the world, but it's hard to find trusting info...and that's why I'm here. I would like to know if I should try the new Accolate, and use it along-side Serevent. Or stick with the very potent (but working) Serevent, or use Accolate alone. If Accolate works well, should I use Ventolin in acute cases too? Lastly, I was taking Hisminal and Ventolin at the same time with quite a bit of relief from my allergies, but I was told not to take Hisminal with Serevent. Is it safe to take Hisminal with Accolate?

Answer: Accolate is chemically much different from Zileuton. I'd certainly try it, knowing that you might have the same itching. However, I'd had much better luck with Accolate vis a vis side effects. It can be used with Serevent. I'm not sure why you stopped Azmacort(or equivalent) since the side effects here are usually fairly minimal. This also can be used with Serevent and or Accolate.

General Information
Question: My 10 month old son has been diagnosed with asthma. He's been breathing with great difficulties for 3 days. Please is there any advice you can give me?

Answer: Asthma in one so young is very ununusal;but, occurs occasionally. More commonly it is due to a bronchial infection that needs to be addressed. Aspiration of gastric fluid is also seen as a trigger. Ensure that you and your wife stop smoking if you are since any inhalant will exacerbate the problem. If it was my child I would see a Pediatric Pulmonary specialist to ensure that the diagnosis is correct.

Air Pollution:

Every year millions of people die or suffer serious health effects from air pollution: mainly respiratory diseases, asthma, chronic obstructive pulmonary disease, cardiovascular disease and cancer of the lung. An estimated 3 million people die each year because of air pollution ( see Figures for breakdown); this figure represents about 5% of the total 55 million deaths that occur annually in the world. It is possible, because of uncertainty in the estimates, that the actual death toll is anywhere between 1.4 and 6 million annually. Many studies consistently show the direct link between mortality rates and daily ambient concentrations of suspended particulate matter that have diameters below 10 m m.

Air pollution also affects the workforce, and indoor air pollution is the primary cause in as many as 50 million cases of occupational chronic respiratory disease each year a third of all occupational illnesses. These are widespread, debilitating and affect people in their social and economic prime of life.

Many studies consistently show the direct link between mortality rates and daily ambient concentrations of suspended particulate matter that have diameters below 10 m m. Life expectancy can be significantly reduced in communities with high levels of particulate matter.
Indoor air exposure to suspended particulate matter increases the risk of acute respiratory infections, one of the leading causes of infant and child mortality in developing countries. In Asia, such exposure accounts for between half and one million excess deaths every year. In sub-Saharan Africa the estimate is 300,000-500,000 excess deaths.

Around 30-40% of cases of asthma and 20-30% of all respiratory diseases may be linked to air pollution in some populations.
Studies in São Paulo, Brazil, have shown that a 75 µg/m³ increase in concentrations of nitrogen dioxide (NO2) was related to a 30% increase in deaths from respiratory illness in children under five years of age.

In adult non-smokers chronic exposure to environmental tobacco smoke increases mortality from lung cancer by between 20% and 30%.
Air pollution also damages plant and animal life and contaminates water sources, threatening economic and social welfare as well as health.
Indoor air pollution
Even today, homes of the poor in developing counties are dangerous, unhealthy places – a rule of thumb states that a pollutant released indoors is 1000 times more likely to reach people's lungs than a pollutant released outdoors.
Some 2000 million people throughout the world use wood or other biomass fuels (cow dung, crop residues and grass) for cooking and heating. The domestic burning of these fuels is an inefficient process that produces many pollutants, some of which may be carcinogenic. The problems are worsened in areas where people spend most of their time indoors.
- A 20% reduction in indoor air pollution could reduce mortality from acute respiratory infection by at least 4-8% in some populations.
Coal burning for heating and cooking in developing countries results in indoor particle concentrations of up to 10,000 µg/m³, a level that is much higher even than ambient concentrations in polluted cities in Asia.
August 27, 1999 ENN Air Pollution Kills, but Deaths Can Be Prevented From a report by Australia's ommonwealth Science Council. 8,000 people a day die from air pollution. Of the 3 million annual deaths, 2.8 million are from indoor air and .2 million are from outdoor pollution. 90% of the deaths occur in developing countries. China has 500,000 deaths a year die due to air pollution. In the developed world and in some of the developing countries, the greatest source of particulate matter is from diesel engines. "Transport and industrial emissions generate smog that destroys sensitive tissues (in people and animals), as well as producing fine carcinogenic particles that reduce lung function, and are ultimately responsible for many untimely deaths each year," the report said. The indoor use of coal and biomass fuels for cooking and heating is a killer in Asian and African countries. Ventilation of the smoke to the outside can greatly reduce the problem, while replacing biomass fuels with kerosene or natural gas, or building cities so that cars aren't need are suggested solutions. Monitoring the air is also important.
May 2 1999 CNN Clinton: New Rules Can Help Clean Air at Modest Cost Automobiles,SUVs and light trucks, account from 1/3 to 1/2 of nitrogen oxide pollution in urban areas and about 22 percent nationwide. They also are major sources of toxic chemicals and microscopic soot in the air.
Apr 16 1999 Reuters SE Asia Vows to Fight Dry Season Smog The 1997 smog, mostly from fires in Indonesia, plagued SE Asia for months, pushing air pollution levels to unhealthy levels and affecting tourism.
Apr 16 1999 Reuters 16 ,000 Airplanes Daily Polluting Planet. At a meteorologist conference in Costa Rica, the secretary of the UN Intergovernmental Panel on Climate Change said that airplanes have become one of the main sources of atmospheric pollution and emitters greenhouse gases.
Mar 11 1999 Reuters Children Suffer most in World's most Polluted City - Mexico City. Students banned from playing outside. Common in Mexico City were sulphur dioxide, nitrogen dioxide and total suspended particulates (TSPs), small particals of dust and heavy metals which cause damage to lung tissue. Beijing, Shanghai, Tehran and Calcutta not far behind. Respiratory disease is now the leading cause of death for children worldwide. 80 % of all air pollution caused lung infection deaths occur in children under five in Third World countries. Coal-fired power plants and leaded gas are the top culprits.
Mar 8 1999 Reuters Bangladeshi Capital Dhaka Pollution Blamed for 15,000 Deaths per Year Traffic congestion and poor infrastructure services impacts economic growth and the quality of life. 70% of the population lives in poverty. High content of lead in the air leads to ban on lead fuel and halt to imports of two-stroke motor vehicle engines.
Mar 4 1999 Reuters Pollution Fight Begun at U.S. "Cancer Alley", a 85-mile long petrochemical corridor from Baton Rouge to New Orleans. POPs - Persistent organic pollutants, migrate by air and water, plus waterways are contaminated with dioxins and mercury. According to Greenpeace: "Toxins are showing up in indigenous peoples around the world who depend on their environment for life."
Mar 4 1999 AP Asian Air Pollution Reaching West Coast. Carbon monoxide, radon, aerosols, hydrocarbons, as well as Plus dust particles containing arsenic, copper, nickel, zinc and sulfur, all from East Asia, have been measured in the state of Washington. Dust from northern Africa, coming across the Atlantic Ocean, has been found in Texas.
Mar 1 1999 AP Enormously High Toxic Pollution Levels in Los Angeles, up to hundreds of times higher. Could cause up to 426 more cancer cases per million.
Feb 25 1999 Reuters Bad Air Threat to Central Americans. High levels of nitrogen dioxide, poisonous ozone and hazardous particles endangers health of impoverished people: respiratory illness caused deaths of 11,000 people El Salvador last year. Cost of related health care in the capital, San Salvador, up to $41.2 million for 1.5 million inhabitants.
Feb 1 1999 Xinhua UNEP Report Stresses Environmental Impact of Fire. Most of the fires set by locals for land clearing or were caused by extreme drought conditions. Dangers are carbon dioxide and methane gases, greenhouse gases leading to global warming, photo-chemical production of ground-level ozone which is a pollutant with a adverse impact on all living systems, and large amounts of particulate matter, which absorbs and scatters incoming solar radiation and impact climate systems, and also causes health problems upon entering the human respiratory system.

DISCLAIMER: I am not a doctor, so my personal opinions are not on this page. All you will see are links to other pages where the people are experts on this topic.

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Human Health Benefits from Sulfate Reductions Under Title IV of the 1990 Clean Air Act The result of a two-year study on health benefits of reducing atmospheric sulfate aerosol concentrations, this study finds that annual US health benefits will be between $3 billion and $11 billion in 1997, and between $12 billion and $40 billion when the program is fully implemented in 2010.

Air Toxics World Wide Web site - http://www.epa.gov/ttnamti1/airtox.html This site provides a wide range of information on EPA's air toxics program, including health effects information and plain-English fact sheets on air toxics regulations.

Evaluating Exposures to Toxic Air Pollutants: A Citizen's Guide Exposure assessment is part of the risk assessment process. This short booklet describes in plain English how exposure assessment is used to determine to what extent and/or how many people are exposed to toxic air pollutants. [Contact: Kelly Rimer, 919-541-2962]

Hazardous Air Pollutants (1995) Provides general information on how to comply with the regulation to reduce air toxics emissions from halogenated solvent cleaning operations (degreasers). Document # EPA 453/R-04-081. [Contact: Deborah Elmore, 919-541-5437, or EPA's Control Technology Center Hotline, 919-541-0800] New Regulation Controlling Emissions From Dry Cleaners (1994) This brochure provides general information on how to comply with the air toxics regulation for dry cleaners. Document # EPA 453/F-94-025. [Contact: Deborah Elmore, 919-541-5437, or EPA's Control Technology Center Hotline, 919-541-0800]

Chemical Accident Prevention and Clean Air Act Amendments of 1990 General information concerning the provisions of the Clean Air Act relating to prevention and management of accidental chemical releases. [Contact: Emergency Planning and Community Right-to-Know Hotline, 800-535-0202]

Atmospheric Pollution Prevention Division (APPD) World Wide Web Site - http://www.epa.gov/appd.html Access to information about energy efficiency, methane reduction, atmospheric pollution prevention, and other climate protection programs conducted by APPD.

PFC Emission Reduction Partnership for the Semiconductor Industry This partnership promotes reduction of perfluorocarbon (PFC) emissions from the manufacture of semiconductors. PFCs include the most potent greenhouse gases known. The program distributes a fact sheet describing partnership goals and methods for accomplishing reductions. [Contact: Scott Bartos, 202-233-9167] Voluntary Aluminum Industrial Partnership The Voluntary Aluminum Industrial Partnership promotes the reduction of PFC emissions from primary aluminum production. PFCs are emitted as byproducts of the production process. The program distributes an information packet detailing the program goals and accomplishments. [Contact: Methane Hotline, 1-888-STAR-YES (888-792-7937)]

ENERGY STAR World Wide Web Site - http://www.epa.gov/energystar.html Energy generation is the most important source of carbon dioxide in the US. Carbon dioxide is a major greenhouse gas, and the ENERGY STAR and Green Lights Programs are designed to find profitable opportunities to reduce carbon dioxide emissions. The web site provides publications for all of the ENERGY STAR Programs for homes, office equipment, buildings, residential heating and cooling equipment, transformers, and exit signs, as well as the Green Lights Program. Specific types of information include: reference material on energy efficiency, business partner and participant lists, qualifying technologies, information about how to become a partner or ally, software tools and reference materials, and program updates.

ENERGY STAR Hotline (also serves as hotline for all APPD programs) - 888-STAR-YES (888-782-7937) This hotline answers questions and distributes materials for the ENERGY STAR Labeling Program, the Green Lights/ENERGY STAR Buildings Program, the Methane Program and the other climate protection programs. In addition to answering general inquiries, the hotline provides guidance on joining and participating in energy efficiency voluntary programs. Types of materials available at the hotline are described below.

Saving with ENERGY STAR (1997) Brochure for the general public describing the ENERGY STAR Labeling Program with list of products currently labeled. Other brochures on specific labeled equipment will become available during 1997. [Contact: ENERGY STAR Hotline, 888-STAR-YES (888-792-7937)] Information About ENERGY STAR Labeling Programs (1996-1997) Fact sheets on each of the technologies, lists of manufacturer partners, and lists of qualifying equipment in each of the following sectors: Office Equipment: computers, monitors, faxes, printers, and copiers

Indoor Air Quality World Wide Web Site - http://www.epa.gov/iaq/ Contains information on indoor air pollutants including radon, carbon monoxide, and environmental tobacco smoke (secondhand smoke); how to solve indoor air quality problems; and air quality in large buildings, schools, and residences. Indoor Air Quality Information Clearinghouse - World Wide Web Site (http://www.epa.gov/iaq/iaqinfo.html), Hotline (800-438-4318 [direct 202-484-1307]), and email (iaqinfo@aol.com) Operator-assisted hotline provides information pertaining to indoor air pollutants and their sources, health effects; how to control pollutants; and maintaining air quality in homes, office buildings, and schools. The email address can be used to request documents or ask questions. Please include a telephone number and address in your message.

The Inside Story: A Guide to Indoor Air Quality (1993) Published in cooperation with the Consumer Product Safety Commission. Provides an overview of common household pollution sources, health effects of indoor air pollutants from these sources, and what can be done to mitigate, prevent, or reduce levels of these pollutants. Document #402-K-93-007. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198]

Secondhand Smoke: What You Can Do About Secondhand Smoke as Parents, Decision Makers, and Building Occupants (1993) This leaflet describes health risks from exposure to secondhand smoke. It provides steps to take to reduce the health risks of passive smoke in the home, workplace, restaurants and bars, and other indoor places. Document #402-F-93-004. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198]

How Healthy is the Air in Your Home (1994) Developed in cooperation with the Consumer Federation of America, this pamphlet is a companion piece to The Inside Story: A Guide to Indoor Air Quality. It provides a room-by-room checklist for your home's indoor air. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 (direct 202-484-1307)] Indoor Air Fact Sheets (1990-1996) Nine general information fact sheets explain subjects such as:
environmental tobacco smoke
asthma
carbon monoxide poisoning
carpets
air quality sick building syndrome
air cleaners
humidifiers
flood cleanup.
[Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198]

Combustion Appliances and Indoor Air Pollution (1991) Published in conjunction with the Consumer Product Safety Commission and the American Lung Association. This brochure contains information on the nature of combustion pollutants, common household sources of combustion pollutants, and how exposure to these pollutants can be minimized. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198]

Asbestos in Your Home (1990) Published in conjunction with the Consumer Product Safety Commission and the American Lung Association. Introduction to how to identify asbestos-containing materials in the home, how to manage those materials, and how to hire a professional inspector and corrective-action contractor. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198]

Current Federal Indoor Air Quality Activities (1995) This booklet described activities of federal agencies that are part of the Interagency Committee on Indoor Air Quality (CIAQ). Each agency describes the status and contacts for ongoing research, policy, and program development activities as well as a list of publications available to the public. Document #402-K-95-005. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198]

Targeting Indoor Air Pollution: EPA's Approach and Progress (1992) This brochure describes the health and economic impacts of indoor air pollution and the EPA's program and approaches to reducing pollutant levels indoors. Also discussed are the carpet policy dialogue and outreach efforts to improve access to indoor air information. Document #400-R-92-012. [Contact: Indoor Air Quality Information Clearinghouse, 800-438-4318 or EPA's National Center for Environmental Publications and Information, 800-490-9198] Building Air Quality: A Guide for Building Owners and Managers (1991) Three ring binder containing detailed information designed to increase the effectiveness of building owners and managers in preventing and resolving indoor air quality problems. Available for $24.00 from the Government Printing Office. GPO Document #055-000- 00390-4. EPA Document #400-1-91-033. [Contact: Government Printing Office/Superintendent of Documents, 202-512-1800]

Methane Programs World Wide Web Site - http://www.epa.gov/methane.html Methane is an important greenhouse gas. EPA's methane programs are designed to promote profitable opportunities for reducing methane emissions in the U.S. Information available includes: fact sheets and manuals, information about how to become a partner or ally in some of the energy efficiency programs, and program updates. [Contact: Nabilah Haque, 202-233-9758]

Coalbed Methane Outreach Program The Coalbed Methane Outreach Program works on a mine-by-mine basis to identify the technologies, markets and finance sources for projects that profitably use the methane that mines currently vent to the atmosphere. The Program also develops reports, guidebooks, and analytical tools that provide unbiased information on different project options, addressing the economics, technologies, markets, and financing strategies. [Contact: Methane Hotline, 888-STAR-YES (888-792-7937), ask for Mary DePasquale]

Landfill Methane Outreach Program The goal of the Landfill Methane Outreach Program (LMOP) is to reduce emissions of methane from landfills. The LMOP develops targeted technical tools, such as a Project Development Handbook, E-PLUS project evaluation software, and several state handbooks that profile the energy recovery potential of candidate landfills. In addition, the program sponsors state and local workshops, facilitates meetings between key stakeholders, and works with financiers to develop specialized financing packages for landfill gas-to-energy projects. [Contact: Methane Hotline, 888-STAR YES (888-792- 7937)].

Natural Gas STAR Program The Natural Gas STAR Program is a cooperative effort between the natural gas industry and the EPA to reduce emissions of methane (the primary component of natural gas), using cost-effective techniques. The Program distributes a number of informational materials including: a brochure, frequently-asked questions, a partner list, MOU summary and reproduced articles from various publications. In addition, EPA provides partners with a number of implementation tools, including the implementation guide, media kit, newsletters, and lessons learned study. [Contact: Methane Hotline, 888-STAR YES (888- 792-7937)].

Ruminant Livestock Methane Program The Ruminant Livestock Methane Program is a collaborative program between EPA and USDA to promote improved US beef and dairy industries production efficiency in order to reduce methane emissions from cattle. The program has produced tools to help improve livestock management, including: manuals documenting improving grazing management techniques; brochures, posters and other written materials that convey a number of key technical topics for improving management of cattle; and a web site which conveys program information to the public. [Contact: Methane Hotline, 888-STAR-YES (888- 792-7937)]

World Wide Web Site - http://www.epa.gov/OMSWWW/ This web site features fact sheets, regulations, and information about how to reduce pollution from mobile sources, including cars and trucks, buses, planes, trains, and lawn care equipment. This site also includes information on the effects of different fuels on pollution from these engines. Environmentally Beneficial Landscaping World Wide Web Site - http://www.epa.gov/glnpo/greenacres.html EPA has formed an Agency-wide task group to look at all EPA programs (e.g. air, water, pesticides, etc.), evaluate the interrelationships of each program, and determine how landscaping concepts can be applied to improve pollution problems. This site provides information on "green" landscaping, including how-to's and case studies.

Fact Sheets and Brochures on Pollution from Motor Vehicles Several fact sheets and brochures provide information on pollutants produced by motor vehicles, the effects of those pollutants on health and the environment, and actions consumers can take to reduce pollution from motor vehicles, including:
Automobile Emissions: An Overview Air Toxics from Motor Vehicles
Automobiles and Carbon Monoxide
Automobiles and Ozone
Automotive Imports
Car Owners: Protect the Environment and Your Health: Don't Tamper With Emissions Controls
Mechanics: An Important Law That Affects You; Don't Tamper With Emissions Controls
Milestones in Auto Emissions Control
Motor Vehicles and the 1990 Clean Air Act
Your Car and Clean Air: What You Can Do To Reduce Pollution
[Contact: Russ Banush, 313-668-4333]

Inspection/Maintenance Brochures The Drive to Cleaner Air: An Introduction to Vehicle Emissions Testing Provides the general public with a basic knowledge of the I/M programs, as well as basic background on air pollution. This brochure also focuses on an individual's responsibility to maintain their vehicle, and how the I/M program can assist by assuring proper maintenance and thereby reduce air pollution.
Auto Repair's Green Future: Building Your Business Through Enhanced Emission Testing
Provides technical information to the automotive repair technicians who will perform I/M related repairs. This brochure explains basic repair issues and discusses training needs.
The Next Steps: Correcting Your Vehicle's Emission Problems This brochure is designed to educate and provide information to consumers whose vehicles fail the emissions test. It includes the types of failures leading to emission increases, basic information on air pollution control equipment, and how to select a repair shop.
[Contact: Russ Banush, 313-668-4333]

Lawn Care Equipment A series of fact sheets and brochures providing tips to consumers on how they can help clean the air and reduce air pollution from small nonroad engines such as lawn and garden equipment.
Tips for Reducing Emissions From Lawn Care Equipment
Your Yard and Clean Air: What You Can Do to Prevent Pollution
EPA Task Group on Environmentally & Economically Beneficial Landscaping
EPA Resources on Environmentally Beneficial Landscaping Be a Grower, Not a Mower
[Contact: Russ Banush, 313-668-4333]

Radiation Protection Programs World Wide Web Site - http://www.epa.gov/radiation/ This site provides general information about EPA's radiation protection programs and provides links to projects supporting standards, guidelines, emergency response, and various initiatives for protecting public health and safety from hazardous radiation exposure.

Radiation Site Cleanup World Wide Web Site - http://www.epa.gov/radiation/cleanup/ This site provides documents relating to EPA's development of standards for clean up of radioactive contaminated sites. The site also includes information on the Multi-Agency radiation survey and multi-agency survey and compliance demonstration document.

Radiation Dose and Risk World Wide Web Site - http://www.epa.gov/radiation/modeling/ This site provides risk assessors, the scientific community, and the general public information about EPA's radionuclide risk assessment models.

Remediation Technology and Tools World Wide Web Site - http://www.epa.gov/radiation/technology/ This site provides information on remedial technologies for radioactive wastes, radiation protection for EPA's Health and Safety program and inter-governmental projects dealing with treatment technologies.

Radiation: Risks and Realities (1993) This booklet describes radiation, relative doses from radiation sources, risks from exposure to radiation and methods for controlling those risks. The booklet also discusses the differences between natural and man-made radiation and the various roles that States and various Federal Agencies have in protecting the public and the environment from radiation. Document #402-K-92-004. [Contact: EPA's National Center for Environmental Publications and Information, 800-490-9198]

WIPP World Wide Web Site - http://www.epa.gov/radiation/wipp/ This site provides comprehensive information on the EPA's regulatory activities for the Waste Isolation Pilot Plan (WIPP). The WIPP (under development by the Department of Energy) is a potential geologic disposal facility for transuranic radioactive waste near Carlsbad, New Mexico.

Yucca Mountain World Wide Web Site - http://www.epa.gov/radiation/yucca/ This site provides information on EPA's role in setting radiation protection standards for a potential geologic repository at the Department of Energy facility at Yucca Mountain, Nevada. The repository would permanently store spent nuclear fuel and high level radioactive waste.

Mixed Waste World Wide Web Site - http://www.epa.gov/mixed-waste/ This site provides information and links on mixed waste. Mixed waste is waste that has hazardous and radioactive constituents.

EPA's WIPP Information Line - 800-331-WIPP (800-331-9477) Recorded information in English and Spanish about hearings, meetings, publications, and other important EPA activities that involve the Waste Isolation Pilot Plant.

EPA's Yucca Mountain Information Line - 800-331-9477 Recorded information about hearings, meetings, publications, and other important EPA Yucca Mountain activities.

Radioactive Waste Disposal -- An Environmental Perspective (1994) This booklet discusses the different types of radioactive waste, the site selection for storage and disposal practices for each type, and applicable environmental protection standards. Document #402-K-94-001. [Contact: EPA's National Center for Environmental Publications and Information, 800-490-9198]

EPA and the WIPP (1994) This booklet describes EPA's role, activities, regulatory milestones, and outreach program for the Waste Isolation Pilot Plant (WIPP). The WIPP is a potential geologic disposal facility for transuranic radioactive waste generated from the production of nuclear weapons. The WIPP, under development by the Department of Energy, is located near Carlsbad, New Mexico. The document also describes the key oversight responsibilities of other Federal and State agencies involved with the WIPP. Document #402-K-93-009. Spanish Translation, Document #402-K-94-010. [Contact: EPA's National Center for Environmental Publications and Information, 800-490-9198 or Cheryl Malina, 202-233- 9677]

EPA's Communications Plan for the Waste Isolation Pilot Plant (1995) This booklet describes EPA's plan for communicating with the public and other interested parties concerning its WIPP Oversight Program. It also includes a listing of public information resources and recent EPA WIPP Publications. Document #402-K-95-006. Spanish Translation, Document #402-K-95-007. [Contact: EPA's National Center for Environmental Publications and Information, 800-490-9198]

Public Participation -- EPA and the Waste Isolation Pilot Plant (WIPP)(1995) This pamphlet describes how the public can stay informed of opportunities for involvement in EPA's WIPP Oversight Program. Document #402-K-95-002. Spanish translation, Document #402-K-95-003. [Contact: Cheryl Malina, 202-233-9677]

Fact Sheets on EPA's WIPP Program (Available in English and Spanish)
EPA's Revised Activities Regarding the WIPP National Advisory Council for Environmental Policy and Technology (NACEPT),
Advising the EPA on WIPP Activities
EPA's Radiation Disposal Standards EPA's
Final Compliance Criteria for the WIPP
[Contact: Cheryl Malina, 202-233-9677]

Fact Sheet: EPA Setting Environmental Standards for Yucca Mountain (1995) This fact sheet describes EPA's role in setting environmental standards for Yucca Mountain -- a potential site for a geologic repository for spent nuclear fuel and high-level radioactive waste. Document #402-95-002. [Contact: Paula Selzer, 202-233-9677]

Big Apple - Hot Apple A 30-minute video about the radioactive material emergency removal action at the Radium Chemical Company Superfund site in New York City. [Contact: Miles Kahn, 202-233- 9384]

Radiological Emergency Response World Wide Web Site - http://www.epa.gov/radiation/rert/ This site provides information on EPA's radiological emergency response program. It includes the on-line version of Ready to Respond: EPA's Radiological Emergency Preparedness and Response Program (1992).

Ready to Respond: EPA's Radiological Emergency Preparedness and Response Program (1992) This informative booklet describes how EPA responds to a variety of radiological incidents from accidents at superfund sites to Chernobyl and Three Mile Island. The document also includes a listing of Federal agencies with key roles in responding to radiological emergencies. Document #520-1-91-027. [Contact: EPA's National Center for Environmental Publications and Information, 800-490-9198]

EPA & Ozone Depletion World Wide Web Site - http://www.epa.gov/ozone/ This web site features information and fact sheets about: the science of ozone depletion regulations to protect the ozone layer, organized by subject matter substitutes for ozone-depleting substances, organized by industrial sector the UV Index and how to protect yourself from the sun Nearly all of the fact sheets, Federal Register Notices, and brochures described below are available on the web site.

Methyl Bromide World Wide Web Site - http://www.epa.gov/ozone/mbr/ This web site focuses solely on methyl bromide, a widely used agricultural and structural pesticide. The site includes information about the product itself, the production phaseout, alternatives, and case studies about the use of certain substitutes.

Stratospheric Ozone Protection Hotline - 800-296-1996 (direct 301-614-3396) Operator-assisted hotline provides up-to-date information and fact sheets on rulemaking developments, Federal Register notices, regulatory requirements, the UV Index, and other topics related to ozone depletion. The hotline also serves as a distribution and referral point for non-EPA information on the issue of ozone depletion, including NASA studies and United Nations Environment Programme assessments. The hotline operates Monday- Friday, from 10:00 am to 4:00 pm Eastern Time.

Alternatives to Ozone Depleting Substances (ODS) Lists are available for products reviewed under the Significant New Alternatives Policy (SNAP) Program in the following industrial sectors: refrigeration and air conditioning; solvent cleaning; foam blowing; fire extinguishing; adhesives, coatings, and inks; sterilants; aerosols; and tobacco expansion. In addition, a fact sheet titled Choosing and Using Alternative Refrigerants for Motor Vehicle Air Conditioning lists alternatives for motor vehicle air conditioners and conditions on their use. [Contact: Stratospheric Ozone Protection Hotline, 800-296-1996 (direct 301-614-3396)]

Fact Sheets and Summaries of Regulations Several fact sheets explain regulatory requirements to protect the ozone layer, including: the phaseout of the production of ozone-depleting substances (ODS) the recycling and emissions reduction program under section 608 of the Clean Air Act (CAA) the servicing of automotive air conditioners under section 609 of the CAA the ban on nonessential products that are made with or use ODS the labeling of products made with or containing ODS [Contact: Stratospheric Ozone Protection Hotline, 800-296-1996 (direct 301-614-3396)]

Refrigerant Retrofit and Replacement Fact Sheets Several fact sheets targeted to air conditioning and refrigeration technicians explain issues related to converting existing equipment to new refrigerants and list alternatives found acceptable under the Significant New Alternatives Policy (SNAP) Program. Titles include Choosing and Using Alternative Refrigerants for Motor Vehicle Air Conditioning, Questions to Ask Before You Purchase an Alternative Refrigerant, and Keeping Your Customers Cool (information for automobile service technicians). [Contact: Stratospheric Ozone Protection Hotline, 800-296-1996 (direct 301-614-3396)]

Brochures A series of brochures explain issues related to the end of use of ozone-depleting substances in common products.
Recharging Your Car's AC System with Refrigerant
Converting Your Car's AC System from Using CFC-12 to R-134a Refrigerant
Qs and As About Motor Vehicle Air Conditioning: What Consumers and Service Technicians Want to Know
Cool Tips for Consumers
Underhood Tips to Help You Keep You Cool
Disposing of Appliances with Refrigerants: What You Should Know
Halon: Recycling and Banking to Help Protect the Ozone Layer
Benefits of the CFC Phaseout
[Contact: Stratospheric Ozone Protection Hotline, 800-296-1996 (direct 301-614-3396)]

UV Index A series of brochures, fact sheets, and posters that inform the public about the Ultraviolet (UV) Index and sun protection measures. Titles include The UV Index: What You Need to Know, What is the UV Index? (poster), UV Radiation, and Sun Protection for Children. [Contact: Stratospheric Ozone Protection Hotline, 800-296-1996 (direct 301-614-3396)]

Ozone Depletion Science The science of ozone depletion is described in an EPA fact sheet titled The Facts Behind the Phaseout and in the Executive Summary to Scientific Assessment of Ozone Depletion: 1994, published by the World Meteorological Organization and the United Nations Environment Programme. [Contact: Stratospheric Ozone Protection Hotline, 800-296- 1996 (direct 301-614-3396)]

Documents on Alternative Solvent Cleaning Agents Developed by the International Cooperative for Environmental Leadership (originally the Industry Cooperative for Ozone Layer Protection), this series of documents reviews the conservations of ozone depleting solvents and their substitutes. They are titled Eliminating CFC-113 and Methyl Chloroform in Precision Cleaning Operations, Alternatives for CFC-113 and Methyl Chloroform in Metal Cleaning, Aqueous and Semi- Aqueous Alternatives for CFC-113 and Methyl Chloroform for Cleaning of Printed Board Assemblies, and Conservation and Recycling Practices for CFC-113 and Methyl Chloroform. [Contact: Stratospheric Ozone Protection Hotline, 800-296-1996 (direct 301-614-3396)]

Urban Air Quality World Wide Web site - http://www.epa.gov/oar/oaqps/cleanair.html This site provides a wide range of information, including fact sheets on urban air quality and the six common air pollutants (lead, ozone, carbon monoxide, sulfur dioxide, nitrogen dioxide, and particulate matter) for which EPA has set national ambient air quality standards (NAAQS).

Office of Air Quality Planning and Standards (OAQPS) World Wide Web Site - http://www.epa.gov/oar/oaqps/ This site provides information about air pollution programs conducted by OAQPS, including programs related to urban air quality, air toxics, air pollution trends, and visibility.

National Ambient Air Quality and Emissions Trends Report , 1995 Twenty-third annual report documenting air pollution trends in the United States for those pollutants for which the U.S. Environmental Protection Agency has established National Ambient Air Quality Standards (lead, ozone, carbon monoxide, sulfur dioxide, nitrogen dioxide, and particulate matter). In addition, short-term trends for selected air toxics measured at PAMS (photochemical assessment monitoring stations) sites are highlighted in this year's report. Document # 454/R-96-005. [Contact: Linda Ferrell 919-541-5558]

Brochure on National Air Quality: Status and Trends, 1995 This brochure summarizes the air pollution trends documented in the National Ambient Air Quality and Emissions Trends Report. This brochure also highlights trends in Acid Rain, Visibility, Air Toxics, Stratospheric Ozone, and Global Warming/Climate Change. Document # 454-F-96-008. [Contact: Linda Ferrell, 919-541-5558]

Brochure on Measuring Air Quality: The Pollutant Standards Index (1994) The Pollutant Standards Index (PSI) provides accurate, timely, and easily understandable information about daily levels of air pollution. This brochure provides general information on how to interpret PSI figures and recommends cautionary measures people should take if pollution levels are high. Document # 451/K-94-001. [Contact: Linda Ferrell, 919-541- 5558]

Good Up High, Bad Nearby - Ozone (1994) This brochure provides a plain-English explanation about the differences between ground- level ozone (smog) and stratospheric or high-altitude ozone, including information on health and environmental effects and the programs to address the problems associated with too much ground-level and too little high-altitude ozone. Document # EPA-451/F- 93-011. [Contact: Debbie Stackhouse, 919-541-5354]

Residential Leaf Burning - An Unhealthy Solution to Leaf Disposal (1992) A pamphlet that describes the adverse health effects caused by pollutants produced by burning leaves: particulate matter, hydrocarbons, and carbon monoxide; provides information on composting as an alternative. Document # EPA-452/R-92-007. [Contact: Ken Woodard, 919-541-5697]

Leaf and Yard Trimming Management: Composting Versus Residential Burning (1993) This fact sheet describes how composting is a safer and more environmentally responsible method for managing leaves and other yard trimmings than residential burning. Document # EPA-452/F-93-010; Addendum: EPA-452/F-93-012. [Contact: Ken Woodard, 919-541- 5697]

CTC News A quarterly newsletter issued by EPA's Control Technology Center (CTC) for state and local air pollution control staff involved in evaluating air pollutants. [Contact: Bob Blaszczak, 919-541-5432]

AMTIC News EPA's Ambient Monitoring Technology Information Center (AMTIC) issues this yearly newsletter that focuses on events, regulations, and technology developments related to ambient air quality monitoring. [Contact: Ed Hanks, 919-541-5475]

The CHIEF A quarterly newsletter issued by EPA's Clearinghouse of Information on Emission Factors (CHIEF) providing guidance and other information on the development of emission inventories for air pollution control. [Contact: Ron Meyers, 919-541-5407]

AIRSLetter A quarterly newsletter for states, local governments, universities, industry, consultants, and others on air quality data base systems such as EPA's Aerometric Information Retrieval System (AIRS). [Contact: Jonathan Miller, 919-541-3330]

Stacknotes A yearly newsletter discussing new or ongoing method developments, field testing projects, and other issues related to emissions testing. [Contact: Mike Ciolek, 919-541- 4921]

If any of these phone numbers don't work or have contact names have changed, go to the epa home page to get the current number and contact name.