In the ’80s it was seatbelts, now doctors are pushing for electric cars

Secretary Buttigieg’s recent testimony in front of Congress describes a different future for America’s transportation, one that improves the air we breathe. This testimony comes weeks after pledges by the giants of the auto industry to vastly increase their production of electric vehicles (EV) over the next five years. Carrying out these pledges sets the stage for a breakthrough in public health.  

Phasing out gasoline-powered cars will be a slow process and, honestly, much more aggressive policy is needed to reap the health benefits of electrification. It is highly likely, however, that in 30 years we will look back at gasoline-powered cars the same way we now look at cars with no seatbelts and wonder why there was such a debate about making the change to EVs.  

As an ear, nose and throat doctor, I see patients whose breathing is worsened by air pollution. While politics may not belong in the exam room, policy that impacts health does. I, along with thousands of other health care professionals, advocate for cleaner air because we know that every person, but especially our patients with asthma and heart disease, will be better protected if the air they breathe is cleaner, safer and healthier.  

The transportation sector in the U.S. is responsible for over 55 percent of nitrogen oxides in the air, which can form ground level ozone and particulate matter, and up to 10 percent of direct particulate matter. There is no “safe level” of air pollution. The direct health burden of burning fossil fuels is why 17 medical and health organizations recently wrote an open letter to Congress urging it to support transportation policies, such as zero-emission vehicles, and expanded access to healthier mobility options, such as public transit.  

One of the health concerns associated with tailpipe emissions from cars and trucks is the release of fine particulate matter into the air. Fine particulate matter particles are about 20 to 30 times smaller than a typical human hair. As we breathe, these particles are small enough to bypass the filtration barriers of the nose, travel down the airway and enter into our lungs.  Here these foreign particles cause irritation and inflammation of the tissue where oxygen exchange takes place.  This inflammation leads to an increased risk of asthma attacks, increased susceptibility to developing pneumonia and, with chronic exposure, increased risk of lung cancer.   

The damage does not stop there. Some of the ultrafine particles are small enough to go from the lungs to the bloodstream, leading to high blood pressure, heart attacks and strokes. It can also travel to the brain and affect cognitive function, which is especially problematic for young children whose brains are still developing and for older adults, for whom cognitive decline is a risk factor for the development of dementia.

Another public health benefit of electrification is the decrease in net global warming emissions.  In 95 percent of the world that relies on modern transportation options, when considering the full life-cycle emissions tradeoffs, electric cars produce fewer overall global warming emissions than gasoline-powered cars.

Of course, transportation initiatives do not start and end with emissions and electrification- systemic changes must go beyond the tailpipe to include infrastructure upgrades that make our cities and towns less dependent on cars and trucks by improving public transportation options, expanding public access to transit and investing in safer walk and bike lanes. 

No conversation about air pollution is complete without talking about environmental justice. While I have spent years learning how to keep the airway safe, protecting it with breathing treatments, intubations and surgical interventions, I have become aware that my medical training has limits to helping people when the very air they breathe is affected by systemic racism. Historically, highways were more often built near communities with a majority Black population so it is not surprising that they are disproportionately exposed to air pollution from transportation. Clean transportation initiatives benefit everyone’s health, but communities of color stand to gain the most as one of the demographics most often deprived of the basic human right to breathe clean air. 

The time is now. Legislation around wearing seatbelts was not easy. It took years to get a national mandate through and then years after that for it to become common practice. Policy changes that decrease our dependence on fossil fuels are essential to restoring clean air for children, for families, and for the planet.  

Neelu Tummala, MD, is an ENT doctor at The George Washington Medical Faculty Associates, a clinical assistant professor of Surgery at George Washington University School of Medicine and Health Sciences, the vice chair of Public Relations of Virginia Clinicians for Climate Action and a Public Voices fellow.