Curbing air pollution control devices would cost thousands of lives and billions of dollars

Air pollution control devices (APCDs) prevented up to 9,000 deaths and saved up to $100 billion in health costs in 2023, according to new estimates published in an American Journal of Public Health editorial.

But these public health benefits will be sharply reduced in future years if a future presidential administration implements the environmental policies outlined in Project 2025 and the America First Agenda, write researchers from Boston University School of Public Health (BUSPH), the Sierra Club, the Institute for the Environment at the University of North Carolina at Chapel Hill, and Columbia University Mailman School of Public Health.

Both far-right policy platforms are gunning to dismantle environmental regulations, including by weakening the Clean Air Act, the bedrock 1970 federal law that gives the Environmental Protection Agency (EPA) the authority to regulate emissions of major air pollutants at power plants. Thanks to EPA policies that require or encourage power plants to use APCDs, SO₂ emissions decreased by 93 percent and NO_x emissions dropped by 87 percent between 1995 and 2022, translating into a massive decline in coal-related excess deaths, from 40,000 in 2000 to 1,600 in 2020, the commentary states.

If Project 2025 and/or the America First Agenda federal policy platforms are adopted by the next administration, APCD use could plummet and severely jeopardize the health of the public, the authors argue.

“Air pollution control devices and other provisions of the Clean Air Act are a bedrock part of the public health infrastructure in the United States,” says Dr. Jonathan Buonocore, assistant professor of environmental health at BUSPH, and lead author of the commentary. “This work serves to remind us how important the Clean Air Act is, and that there are big public health benefits to protecting or strengthening it.”

To capture the environmental and health ramifications from a potential reduction in APCD use if Project 2025 or the America First Agenda is enacted, the team calculated changes in SO₂ and NO_x emission levels based on a hypothetical “worst-case” scenario in which power plants ceased use of existing APCDs.

The researchers estimated that SO₂ reductions would be 2.9 times higher and NO_x reductions would be 1.8 times higher if power plants — many of which are coal-fired — stopped operating APCDs. The team used a reduced complexity model to estimate the health benefits from emissions reductions if APCD use continued at these plants. They found that, in 2023, APCDs at power plants captured about 1.2 million tons of SO₂ and 1 million tons of NO_x emissions, which would prevent between 3,100 and 9,000 premature deaths in 2023 and save between $35 billion and almost $100 billion in health costs.

“Power plants are not the highest contributors to air pollution-related public health risk anymore in the US, thanks to federal policies that drastically reduced the emissions of SO₂ and NOx from this sector over this time period,” says Saravanan Arunachalam, Deputy Director, Institute for the Environment at the University of North Carolina at Chapel Hill. “Any future efforts to weaken the Clean Air Act may elevate this sector back to the top again, and further increase the overall disease burden for Americans.”

Even with these substantial health benefits, these models underestimate the additional health benefits of a reduction in emissions from APCD use, including lower risks of stroke, heart attacks, and asthma in adults, as well as low birth weight, preterm births, asthma onset, and other respiratory or developmental issues in children, the authors point out.

Although these health benefits are nationwide, the highest benefits occurred from emissions reductions at power plants in Appalachia, the Midwest, and the Mountain West. More than 85 percent of these reductions were attributed to a sharp decline in SO₂, mostly from coal-fired plants. While the researchers note it is unlikely that future policy changes would eliminate all APCD use, these new estimates quantify the health consequences that are at stake — as well as the future health benefits that could remain — depending on changes to the EPA’s authority under a potentially weakened Clean Air Act.

“Health benefits from APCDs may be concentrated in specific locations, but these results show that strong environmental regulations benefit everyone,” says Dr. Mary Willis, assistant professor of epidemiology at BUSPH.

Importantly, any future policies that strip the EPA of its current regulatory authority would also exacerbate racial inequities in health and likely curtail other climate policies at all levels of government, the authors write. Policies that reduce APCD use would heavily burden environmental justice communities, a majority of which are people of color or low-income populations who already experience the harms of other environmental hazards at disproportionate rates. Increases in power plant air pollution emissions would also offset gains in cities with climate action plans driving reductions in greenhouse gas emissions through the electrification of buildings and transportation.

The authors point out that federal policies that strip regulatory authority for harmful practices can lead to near-term health consequences.

“These misguided plans to unravel pollution protections and undermine the Clean Air Act would jeopardize the health and safety of millions,” says Jeremy Fisher, principal advisor on climate and energy for the Sierra Club. “Lives are on the line and the American people deserve more thorough accountability and oversight of polluting power plants, not less.”

Air pollution policy and climate policy are ultimately health policy, says Dr. Jonathan Levy, chair and professor of the Department of Environmental Health at BUSPH and senior author of the commentary. “These policy platforms targeting the EPA threaten to take us backward and make Americans less healthy.”

The commentary was also coauthored by Dr. Frederica Perera, professor emerita of environmental health sciences and special research scientist in the Department of Environmental Health Sciences at Columbia Mailman School of Public Health; Dr. Daniel Prull, deputy director of research, strategy and analysis for the Sierra Club; Dr. Patrick Kinney, Beverly Brown Professor of Urban Health at BUSPH; and Brian Sousa, research data analyst in the Department of Environmental Health at BUSPH.