California logged fewer unhealthy air days in 2011 than a decade ago, giving hope that air quality is improving. (Getty Images)

California air pollution reached unhealthy levels less often in 2011 than a decade ago, according to a report released this week by a state association of regional air district officers.

Compared with 2000, there were about 74 percent fewer days of “unhealthy air” statewide last year, data from the report [PDF] showed. Air quality can range from “good” to “very unhealthy,” and it is calculated based on local monitoring of four air pollutants regulated by the federal Clean Air Act.

The report found that ozone pollution has decreased statewide between 1980 and 2011; there have been smaller and more limited reductions in particulate matter emissions during the same time frame.

Dr. John Balmes, a professor of medicine at UC San Francisco, said California is “ahead of the pack with regard to air quality and greenhouse gas control.” He said any reductions in ozone and particulate emissions could have positive effects on public health because these pollutants have been associated with cardiovascular or respiratory disease health risks.

The new report acknowledged that “despite significant improvements, air quality remains a major source of public health concern in large metropolitan areas throughout California,” especially in the San Joaquin Valley and the southern coast area surrounding Los Angeles. California has 35 regional air districts, which regulate businesses and industrial facilities.

“We recognize that we have a long way to go in some of these air districts, but we have made a lot of progress,” said Kenneth Koyama, executive director of the California Air Pollution Control Officers Association, which published the report. “Some districts have gone down to one unhealthy day in the past year for air-quality purposes, and others have actually had zero unhealthy days.”

The report also outlines the local conditions that create air-quality problems and some ongoing efforts to address them. In the Great Basin Unified Air Pollution Control District, for example, water diversion to Los Angeles from tributaries of the Owens and Mono lakes have resulted in exposed lake beds that contribute to particulate matter pollution in the region. The district is spending $6.5 million on clean air projects.

Koyama said the air district association’s report was issued in part as a counterpoint to the American Lung Association’s State of the Air analysis, which has been published since 2000. In 2011, the American Lung Association gave 36 California counties an F grade for ozone exposure based on the number of unhealthy ozone days, and 19 California counties received an F for particulate pollution.

“Giving a grade of F suggests to me that whatever the air district has done has failed, and that’s certainly not the case,” Koyama said. “We’ve introduced programs that we believe have been very innovative to reduce emissions and improve air quality in the state. We believe we’ve done a lot to protect public health.”

Bonnie Holmes-Gen, executive director for air quality and public health for the American Lung Association in California, said her organization’s report offers a complex picture of the state’s air quality.

“We think the grades provide a good snapshot as to what people are breathing, and the report also tracks trends over time for each region,” she said. “California has shown tremendous progress in healthy air, which we attribute to California’s groundbreaking regulations” related to vehicle emissions and clean fuels.

The 2012 State of the Air findings will be released Wednesday.

“After next week’s report, we will have 13 years of data on unhealthy air days in California, and just as we’ve shown tremendous progress in most areas of the state over the past 12 years,” Holmes-Gen said, the latest analysis will “show continued progress despite the serious challenges we still have.”

Wood-burning stoves are a major source of air pollution in Butte County. (Photo: Marley Zalay)

Editor’s Note: KQED produces ouRXperience, a blog from community correspondents, to enrich coverage of health issues across California.

Recently, ouRXperience featured posts from four California communities:

• ouRXperience welcomes Marley Zalay as our new Greater Oroville community correspondent. For her first blog post, Marley writes about how Butte County received a whopping “F“ on its air quality report card this year.

• Changvang Her, of Merced, interviews a Hmong shaman and a western doctor about a program that helps create understanding between the Hmong and medical staff at a local hospital.
• From South Sacramento, Sharon Chandler introduces us to a non-profit with a mission of creating a cleaner environment and access to healthy foods in the community.
• Finally, San Bernardino correspondent Bobbi Albano writes about a program that raises awareness about child abuse.

Farming in the Central Valley contributes to the poor air quality there. (Photo: Getty Images)

As if there wasn’t already enough to worry about, now doctors are predicting that climate change will harm people’s respiratory health. The American Thoracic Society is so concerned it filed a report with two goals. The Society not only wants to raise awareness with doctors so they can take preventive measures with their patients but also is enticing researchers to take on the question for further study. They found that climate change has a direct impact on air quality. A hotter climate, wildfires, more pollen in the air and rates of airborne diseases are worsening respiratory health worldwide.

Climate change will likely affect different places in different ways, but in California it could mean hotter summers and more wildfires. The itchy eyes and sneeze-inducing allergies that plague many people during pollen season could also hang around longer if weather patterns continue to change. All of that is bad for asthmatics, children and the elderly, but also for poor people – as it turns out.

“It was really an eye opener for us,” said Kent Pinkerton, a professor of pediatrics at UC Davis and the lead author on the report. “We were really not aware of the implications of change in temperature on respiratory health. But it really is a global issue. It’s not just a concern for here in our country,” he added. In some parts of Africa and Turkey desertification and increased particulates in the air have already forced people to relocate, often into cramped conditions, which further heightens their risk for respiratory diseases.

In California, wildfires are a blazing example of how increasing dryness and changing weather patterns harm people’s lungs. Pinkerton pointed to the summer of 2008. “We had over 1000 wildfires burning at the same time. And that really had a significant impact on air quality and particle concentration within the atmosphere,” he explained to me. Another big change — doctors are seeing infections from molds–molds not seen before in California. “I think a good example of this has been a fungal type of infection that was only found in Central America, that is now found as far north as British Columbia, in Canada,” said Pinkerton. So far the people most at risk are those with preexisting lung conditions, the very old and the very young. But in California’s Central Valley some of these affects have gotten so bad that doctors are seeing them in all age groups.

“I’m seeing an increase in the last 19-20 years in the number of patients I’m seeing who are experiencing chronic lung disease,” Kevin Hamilton, deputy chief of programs at Clinica Sierra Vista in Fresno told me. ”If we see continued changes in the climate you will see resulting problems in people’s health,” he continued. Hamilton is a respiratory therapist who treats mostly low-income patients, often Latino farmworkers making their living in the Central Valley. He says in his experience if air pollution is high, people pass a threshold where they keep getting sick. He says the San Joaquin Valley often has more than 150 days a year that break the health statutes for particulate matter–fine particles in the air that can affect people’s lungs. Consistent poor air quality exacerbates–and can cause–illnesses like asthma and chronic obstructive pulmonary disease (COPD). In Hamilton’s 34 years of treating lung diseases he says he thinks it’s getting worse.  Something else different — he’s seeing problems in all age groups among his low-income patients, something he doesn’t see with wealthier patients.

John Capitman, the Executive Director of the Central Valley Health Policy Institute and a professor of public health at CSU Fresno, says not all lung problems are created equally in the Central Valley. In fact, he’s also done research that links the poorest air quality and the poorest health to communities that are low-income and often segregated. “In some of our more affluent communities we have health status outcomes that are similar to anywhere else in the country,” Capitman explained. “But in other communities, particularly low-income communities, places that are racially segregated basically, there is evidence that life expectancy is much lower.” Life expectancy is not linked solely to air quality, but exposure to high levels of particulate matter, ozone and pesticides are a contributing factor to the overall poor health that these communities experience.

That disparity is true around the world. Pinkerton’s report makes clear that many respiratory illnesses linked to a changing climate have a socio-economic component. The people in Africa being forced to relocate are often the poorest, just as the farmworkers in the Central Valley bear the brunt of poor air conditions and increased ozone.