Public Health

Supreme Court case on Clean Air Act could have major health implications

Depending on how it reads the Clean Air Act, the Supreme Court of the United States could limit the authority of the Environmental Protection Agency (EPA) to restrict carbon emissions that cause climate change and have been proven to inflict major health problems on the people of the world. Find out how this case could affect your patients.

A case for clean air

At stake in West Virginia, et al. v. EPA, is whether that federal agency has the authority to enforce recent regulations known as the Clean Power Plan. The final rule of the plan was released in October. On the same day, 12 state governments, led by West Virginia, sued the EPA in the U.S. Court of Appeals for the District of Columbia Circuit, claiming that the regulations exceeded the EPA’s authority under the Clean Air Act.

The states involved moved to prevent the regulations from being enforced until the appeals are resolved. The Court of Appeals denied the stay motions, and the states appealed this denial to the U.S. Supreme Court. By a 5:4 vote, the U.S. Supreme Court stayed these regulations until complete resolution of the case.

How this case affects public health

The Clean Air Act empowers the EPA to establish standards for the regulation of pollution from existing stationary sources of emissions. In response to this directive of the Clean Air Act, the EPA adopted the Clean Power Plan, which establishes carbon pollution standards for power plants that will help slow the harmful impacts of carbon pollution on public health. The plan was designed to achieve a 32 percent reduction of the 2005 levels of carbon emissions by 2030.

“These regulations are well within [the] EPA’s statutory authority,” the Litigation Center of the AMA and State Medical Societies said in an amicus brief submitted to the U.S. Supreme Court. “Failure to uphold the Clean Power Plan would undermine [the] EPA’s ability to carry out its legal obligation to regulate carbon emissions that endanger human health and would negatively impact the health of current and future generations.”

Carbon emissions are a significant driver of the anthropogenic greenhouse gas emissions that cause climate change and consequently harm human health. Direct impacts from the changing climate include health-related illness, declining air quality and increased respiratory and cardiovascular illness. Changes in climate also facilitate the migration of mosquito-borne diseases, such as dengue fever, malaria and most recently the Zika virus.

“In surveys conducted by three separate U.S. medical professional societies,” the brief said, “a significant majority of surveyed physicians concurred that climate change is occurring … is having a direct impact on the health of their patients, and that physicians anticipate even greater climate-driven adverse human health impacts in the future.”

The brief highlights three ways that carbon emissions affect climate change and consequently human health:

  • Heat: Increasing concentrations of greenhouse gases trap a higher portion of the sun’s solar energy, leading to an overall rise in global land and ocean temperatures. Excess heat has a major impact on human health. The 2003 European heat wave is estimated to have led to approximately 50,000 deaths in August alone. A 2006 heat wave in California resulted in more than 16,000 extra visits to the emergency room and 1,182 extra hospitalizations.
  • Ozone and particulate matter: Climate change has a number of effects on air quality that are harmful to human health, including higher concentrations of ground level ozone and particulate matter. Air pollution from these sources has been linked to cardiovascular disease and respiratory illness. 
  • Pollen and microbial hazards: Climate change promotes increased exposure to pollen, fungi and other microbial growth. Rising global temperatures are increasing both the duration and intensity of pollen seasons. Higher pollen counts impair the quality of life of at least 16.9 million Americans and impose substantial costs on the health care system. Higher pollen levels also are associated with lung inflammations, which can cause upper and lower respiratory tract symptoms, even among those who do not suffer from allergic asthma, allergic rhinitis or hay fever.

“By addressing both carbon emissions responsible for climate change and conventional air pollutants,” the brief said, “[the] EPA’s Clean Power Plan carries out the Clean Air Act’s mandate to protect the public health.”

Other recent cases in which the AMA Litigation Center is involved