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Breathless

How healthy is Chicago's air?

By MELISSA MARES
On the surface, office environments often appear tidy to the point of being sterile. Use a can of compressed air to clean your office keyboard, though, and you will get a glimpse of exactly how misleading that appearance can be. Crumbs, dust, dirt, hair and even more unpleasant bits will surface, and that's only what's visible to the naked eye.

The view through a microscope would be even more unsettling. In fact, a University of Arizona study found that the average desk has 400 times more bacteria than an office toilet seat.

Living in an urban area often entails working in an office environment every day, as well as facing a host of other health threats, including respiratory problems and illness spread through close contact with others. At the same time, city dwellers often have access to health care services, specialists, education and options that those living in more rural areas do not.

Are people who live in the city as healthy as people in rural areas? The answer to that is not simple.

"Broad brushstrokes can't be used to say people's health in urban areas is better or worse than in rural areas," says Dr. Joseph Gibes, an instructor in the Department of Family Medicine with Evanston Northwestern Healthcare. "There are so many different things affecting our health."

In the United States, there are 50 million people with allergies of all types, according to the Asthma and Allergy Foundation of America (AAFA). Twenty million additional people have asthma. There is no direct connection between asthma and allergies, but there is a correlation. More than half of the 20 million with asthma also have allergies, according to Angel Waldron of the AAFA.

Waldron confirms that allergies tend to have a higher prevalence in rural areas and says that this is one reason why it is so important to be educated about health issues. An asthma sufferer might be more comfortable living in a rural area, while one who suffers from allergies might actually be better off in a city, she says.

Dr. Gibes agrees. Though it can seem like a clear-cut case where city dwellers suffer more respiratory problems from environmental pollutants than those in suburban or rural areas, it's not always this simple. Gibes says that he has observed many lung problems in his work in rural areas of southwest Wisconsin, where many people are engaged in agricultural work.

Every year AAFA ranks the top asthma and allergy "capitals," U.S. cities deemed most difficult for asthma or allergy sufferers based on several criteria.

"We see larger metropolitan areas dominate the [asthma] list," Waldron says.

Although larger urban areas lead the asthma list, the allergy list ranks southern, often smaller cities, as the worst for allergy sufferers. For 2007, the worst city for

environmental allergies is Tulsa, Oklahoma.      In the rankings, the allergy list is primarily based on pollen counts, but the asthma ranking analyzes 12 different factors, including smoking laws and socioeconomic factors that affect how asthmatics in each city can manage their asthma.

"Asthma is definitely affected by urban living," says Dr. Laura Rogers, an asthma, allergy and immunology specialist in private medical practice in Chicago. "Ozone and pollution definitely trigger it."

Experts cite many different causes for the rise in these two widespread respiratory problems for people in both urban and rural areas.

One theory about why urban areas in developed countries have high numbers of asthma sufferers while rural areas and even Third World countries have lower incidences is known as the "hygiene hypothesis." It states that developed countries have become so "clean" with the use of antibiotics and antibacterial products that people's immune systems "go haywire," according to Rogers.

It is important to note that the hygiene hypothesis is not proven, but is a theory that has been discussed widely.

"Sick building syndrome" is another term that encompasses building-related illness, Waldron says. This can include cough, fever, muscle aches, headaches, throat irritation and itchy skin among others.

Not all agree that sick building syndrome even exists, however.

Dr. Rogers says that the medical community often views sick building syndrome with skepticism. She says there are some fears that charlatans use sick building syndrome as a way to make money from people's fears and sell them things that will not improve their health, are unnecessary and not approved of by the medical community.

"Indoor air quality is never as good as outdoor air quality, no matter what you do," Rogers says.

Though indoor air tends to be dirtier than outdoor air, the US Green Building Council (USGBC) says that our buildings can be better for our health by being more environmentally sustainable. New technologies may be able to improve indoor air quality and other urban health hazards.

"We spend 90 percent of our time indoors," says Ashley Katz of the USGBC.  "Pollutants inside are 25 to 100 times higher than outdoors....Green buildings are beneficial to those in the building."

People who spend time in green buildings enjoy some respiratory benefits due to increased ventilation and use of products picked because they emit fewer chemicals than conventional carpets, paints and upholsteries. The USGBC uses the Leadership in Energy and Environmental Design (LEED) rating system to evaluate a green building's level of sustainability.

"When you go into a LEED certified space, it doesn't smell 'new,'" Katz says. She says this is because LEED certified buildings make use of materials that do not give off toxins.

Smoking is not allowed in any LEED certified building, which also contributes to better air quality. Temperatures can also feel more comfortable in a green building because those inside can open and close windows and adjust thermostats. Feeling connected to the outdoors has also been shown to be beneficial to people's feelings of satisfaction.

This idea played out at one company that renovated its facilities with sustainability in mind. When VeriFone, a division of Hewlett-Packard, renovated its headquarters, energy consumption was reduced by 59 percent, decreased employee absenteeism by 47 percent and increased employee productivity by 5 percent, according to what the company reported to the USGBC.

Those in the health industry say that green building seems to have the potential not only to impact the natural environment in a positive way, but also could be good for the people who inhabit those buildings.

"There is no downside to [the increase in green building] in our eyes," says Waldron.  "The positives are going to take a few years to track."

In both rural and urban areas, lack of access to care can be most detrimental to the population's health. Poor people in cities and outside of urban areas face problems getting health care both on a preventative basis and in response to existing problems.

"In my personal experience, many patients [who] have limited means in the city still have more services to call on than those in rural areas," Gibes says. o

How does Chicago stack up?

Chicago is ranked number 13 out of 100 on the Asthma and Allergy Foundation of America's (AAFA) 2007 Asthma Capitals List, which means that it can be a challenging place to live for asthmatics. The air quality is low, and the public smoking ban has not been put in place yet.

"Chicago isn't necessarily doing the best job taking care of [its] asthmatics," says Dr. Laura Rogers, a physician in private practice in Chicago. South Side power plants and lack of access to care in inner city areas contribute to this, she says.

In April of this year, Crain's Chicago Business reported that a paper released by Environment Illinois found that the state's coal-fired power plants produced 64 percent more carbon dioxide in 2004 than in 1990. This figure makes Illinois the top-ranked state in terms of increases in carbon dioxide emissions from coal-fired power plants.

The AAFA stresses the importance of educating people about their own health and the problems from which they suffer.

"Chicago could be a great or really bad place depending on your symptoms," says Angel Waldron of the AAFA. "What are your triggers? If it's pollen, a metropolitan area is a good bet."

Though Chicago is weak in some areas, the city's use of green building practices and the establishment of top notch health facilities could help boost its profile overall.

"Chicago is a leader in green building," Ashley Katz of the US Green Building Council said. "Mayor Daley has been doing this for a very long time."

Dr. Joseph Gibes, instructor in the Department of Family Medicine with Evanston Northwestern Healthcare, agrees that Chicago can be a mixed bag in terms of the health care access for its people.

"Chicago is a great place to be for people with [respiratory] problems" because of the world-class medical centers here, Gibes says. "How much of that trickles down to a poor 4-year-old on the South Side, though?"

Published: May 28, 2007
Issue: Summer 2007 Urban Living