No Cardinal Rule: Asthma & Air Quality in St. Louis

airpollution updated

Image by Andrew Kay

On good days, St. Louis’s Air Quality Index sits on the high end of green—polluted, but not dangerously so. During these days, the city’s air is often just about to slip from the green “good,” to the yellow “moderate.” As summer intensifies, the year-round pollution caused by the coal industry, tobacco use, and radon gas starts to take its toll. The index slips from green to yellow, orange, even red as the seasons change, ranging from “unhealthy for sensitive groups” to “unhealthy” for all St. Louis citizens. High levels of pollutants emitted from the combustion of fossil fuels—as well as the city’s lax environmental regulations—denote St. Louis as having the 12th unhealthiest air in the United States, according to American Lung Association’s 2013 report.

Modern pollution has negative, insidious ramifications for health. The illness spread by air pollution, unlike many other forms of pollution, builds slowly. Effects often only appear after decades, and even then, there are so many pollutive forces that the origins of disease can be hard to track. What we do know: particulates from air pollution—from places as prevalent as exhaust pipes of cars and coal power plants—build up in the lungs, causing inflammation, long-term lung problems, and, eventually, fatal heart problems. Ozone pollution shortens life span and is associated with cardiovascular disease, stroke, and other respiratory problems. Cancer has also been linked to air pollution. Further, this relationship between air pollution and respiratory processes means that any source of air pollution also worsens asthma, particularly in children and senior citizens.

The effects of air pollution run rampant in the communities around St. Louis’s metropolitan area. According to Professor Krummenacher of Washington University in St. Louis, “We’re a city that has a lot of industrial pollution. We’re an old industrial city, we’re a river city. We’re also a city that has big traffic problems. Those things come together here in the region to give us a pretty nasty mess.”

That mess?

Asthma causes the highest frequencies of admissions to St. Louis Children’s Hospital. One quarter of the state’s childhood asthma deaths occur in St. Louis City. Lung-related health problems disproportionately affect the racial and ethnic communities that live near St. Louis highways and coal power plants. St. Louis Children’s Hospital reports that zip codes in East St. Louis have significantly higher admission than the rest of the city, showing direct correlation between health disparity and socioeconomic situation. More than that, East St. Louis has been determined to have the worst asthma rates in the nation. Further parallel is evident between health disparity and race: African-American children account for over 90 percent of childhood asthma emergency department visits in St. Louis City.

Susannah Fuchs, director of the local branch of the American Lung Association, works to improve air quality. “In my community work, we’ve seen no matter how much public education you provide, no matter how many ads you buy, people still don’t immediately see how air pollution relates to health,” she said. She described the education process as difficult, but entirely necessary and worth the good it can do. “If you look at the last couple of decades, the levels of air pollution have definitely gone down. However, it’s still being fought for—because as it’s reducing, we’re seeing studies coming out that show the health ramifications of air pollution are much worse than we thought they were.”

In St. Louis, these ramifications might surprise. In a lawsuit recently filed, a local advocacy group, the Sierra Club, cites almost 8,000 violations of the Clean Air Act committed by Ameren. The Clean Air Task Force is a non-profit organization that studies the effects of air pollution. They have determined that Ameren’s Labadie coal plant, Meramec coal plant, and Rush Island coal plant (all located in proximity to St. Louis) contribute to 3,870 asthma attacks, 360 heart attacks, and 226 premature deaths every year. Much of this illness and death relates to the violations cited by the Sierra Club, and could be mitigated if legal action were taken.

Due to the efforts of organizations like the American Lung Association, over the past fourteen years of air monitoring, air quality has improved. Legislation that limits the emissions of coal-fired power plants and restricts tobacco use in public areas was passed in the form of the Environmental Protection Agency’s 1970 Clean Air Act and 2011 Indoor Clean Air Code. St. Louisans now breathe cleaner air. However, work still remains. Despite the overall positive trend, air quality worsened last year. Through groups like the Sierra Club, the fight continues to actually make industry powers adhere to these legislations.

Fuchs said, “These health effects of air pollution have a huge community cost that everyone shoulders—including industry, who’s fighting the reductions. So even if people fight these changes, in the long run it turns out to benefit everybody.” Meanwhile, American Lung Association continues to educate the community through programs that teach students how to manage their health and understand environment-to-health relationships.

Despite all this, Fuchs said, “Ideally we can continue to reduce air pollution, continue to push the edge of the envelope to make stronger restrictions and reduce pollution from all the different sources.”

Some Washington University students are currently involved in action related to this issue as part of the Students Against Peabody sit-in. Peabody Energy threatens to worsen current air quality conditions. Although Peabody does not have power plants around St. Louis, they are headquartered in Missouri, and Peabody representatives a seat on boards at large institutions like Washington University and Barnes Jewish Hospital. In this case, air pollution enabled by a Missouri company has consequences all across the nation. Because of Peabody’s association with Washington University’s board of trustees, the school currently endorses Peabody’s actions, even though they wreak havoc on public health.

There is no hard-and-fast way or cardinal rule to solve these problems for St. Louis. Community support, political action, public health campaigns, education—each of these plays a role in the fight for cleaner air. All we can do is raise awareness, help where we can, and push for change where it is needed. And indeed, here, change is needed. So what will you do?

Another version of this article is published through Material Monsters’  “The 2014 Missouri Exhibit: A Look at Agency Here at Home.” For more information about the project and to read this article and more like it, please visit



'No Cardinal Rule: Asthma & Air Quality in St. Louis' has 1 comment

  1. April 20, 2014 @ 5:44 PM Dear Reader | Frontiers Magazine

    […] effects on health and medicine. For a look into asthma in St. Louis, take a look at “No Cardinal Rule: Asthma & Air Quality in St. Louis,” which explores the link between coal plants and East St. Louis’ stance as the worst […]


Would you like to share your thoughts?

Your email address will not be published.

Old Paper by