Traffic on the I-580 spews exhaust onto nearby neighborhoods in Oakland. Credit: Amir Aziz

Seniors who live near high-traffic roadways, including Oakland’s I-580 and I-880, experience more health problems and pay more in health-care costs due to diseases, according to a new study. 

Scientists from the Environmental Defense Fund and Kaiser Permanente looked at Northern California seniors who live in areas with high concentrations of pollutants like nitrogen oxide, black carbon, and especially nitrogen dioxide, and found that they end up in emergency rooms more often with heart disease, asthma, and other illnesses. They published their findings this month in the journal Atmospheric Environment.

The primary source of those pollutants is vehicle exhaust. Up to 80% of the nitrogen dioxide in our air, for example, comes from vehicles. The gas is one of the main indicators used to determine overall air quality.

The study also found that vehicle pollution costs individuals hundreds of dollars more per year in health care due to emergency room visits and outpatient fees. Oakland’s most polluted areas are in West Oakland, near the port and freeways, and in East Oakland along I-880.

“Even if you live a few blocks from someone else, you know, not every street in Oakland has the same air pollution. We found different hotspots, different traffic patterns on different streets,” said Stacey E. Alexeeff, one of the study’s authors. 

The study is the first of its kind in the U.S., although the U.K developed a similar tool to estimate health care costs from air pollution. Researchers of that study also found that overexposure to pollutants caused by vehicles raised health care expenditures.

While traffic pollution levels in Oakland have gone down from their peak 30-40 years ago, they remain high. Several agencies have graded the city and Alameda County as being among the worst in the state, including for carbon dioxide and fine particulate matter levels. 

In a statement provided to The Oaklandside, the Alameda County Public Health Department said the study was another reminder of the racial inequities in the region. Low-income residents, many Black and brown, tend to live in industrial neighborhoods close to highways because of the lower-cost housing there and the history of racial segregation that forced these communities into more polluted areas. “It is a reminder that neighborhood pollution is one of the many ways that inequitable, racist policies over generations have shaped the way people live, individual and community health, and health-care costs,” the statement said.

Dr. Dhruv Kazi, a Harvard health economist specializing in cardiovascular disease, said the study was important and made the case to reduce dependence on fossil-fuel vehicles. But even the best data, said Kazi, has limitations. In this case, he said, there could be “residual confounding,” or other health-care issues involved. “Individuals with households most exposed to traffic pollution may have other barriers to health and healthcare, including insufficient availability of healthy food, opportunities for exercise, or access to health care,” Kazi told The Oaklandside.

How pollution affects the whole body 

Part of the importance of the study, Alexeeff and co-researcher Dr. Stephen Van Den Eeden said in an interview, is that looking at overall health care costs is a good way to incorporate all of the effects that pollution can have on the body. In the past, research used to focus primarily on respiratory conditions. 

“We realized there are a lot of cardiovascular effects from air pollution. There’s new research that it affects cognitive function, diabetes, and more,” Alexeeff said. 

The study used 25,000 records of Kaiser Permanente patients in Northern California and data from previous air pollution sensor readings that Kaiser and the University of Texas at Austin analyzed with The West Oakland Environmental Indicators Project. Researchers at WOEIP used this same data to find that air pollution levels near the Port of Oakland were abnormally high because, in part, hundreds of huge diesel trucks come in and out of the area and idle near residential neighborhoods. According to the federal Environmental Protection Agency, one idling truck produces about 21 tons of carbon dioxide a year. 

The new study found that even small changes in pollution levels from city to city or neighborhood to neighborhood appear to have a strong correlation to higher instances of hospital room visits and their associated costs. And the recent adusting of standards for pollutants like nitrogen dioxide by the EPA suggests that pollutant levels we consider “safe” today in many parts of Oakland and elsewhere may actually not be.

“We need to keep doing more research for state regulators to be able to review that and look at whether these levels are considered to be safe or not,” Alexeeff said. 

Concentrations of nitrogen dioxide, commonly known as NO2, can be 30 to 100% higher in neighborhoods within 50 meters of heavily trafficked streets or freeways. All over Oakland, hundreds, perhaps thousands of households live near these kinds of roads. 

Doctors Chris ​​Wendt and Jesse Berman at the University of Minnesota, who study pulmonary effects from pollution, said they think these vulnerable populations are impacted by lower levels than what has been previously believed, and that day-to-day conditions might be even more toxic than previously thought. 

“A more plausible scenario is these areas being exposed have generally lower levels, but also more frequent or elevated spikes than in other areas,” Berman said. “And those types of acute doses can have very different health responses than those without high peaks.” 

Similar to a heat wave that can cause strokes and kill people, pollution peaks may also lead to immediate and long-term health complications.

“And we know from older studies that when you have these acute increases in air pollution, you’ll have excess death in the next 48 hours and it’s usually cardiopulmonary, “ ​​Wendt said.

According to Berman, areas with higher carbon dioxide because of car traffic are also likely to have higher levels of dangerous particulate matter, known as PM 2.5, in the air. Diesel trucks spew solid and liquid particles, including metal, that can get into people’s lungs.

“Most of particles can be harmful, but they’re also tiny, so they can sneak between the cells, through the lungs, you can find them circulating, and they can have reactions in the lung that generate a systemic whole body effect,” Wendt said.

This map shows long-term air pollution levels between 2020 and 2021, measuring near 4258 International Boulevard in Oakland. Aclima sensor tech and components used in the Kaiser/EDF study are used to create these maps from sensors on top of Google Maps cars and Aclima cars. Source: Aclima

The pollution data used in the new study was collected over two years from block-by-block readings taken by sensors placed on top of cars used by Google Maps in Oakland, and combined them with the home addresses of Kaiser patients. The researchers said that individual patient home data was anonymized to protect their privacy.

Using the study to reduce pollution and improve people’s health

Researchers said the new study’s findings can be used across the board by government agencies, industry, and community groups to address the societal problem of air pollution.

“They allow us to really see what the effect is on the population and understand how making changes to regulatory policy will improve the health of the overall community,” said Berman. “And this might be as simple as making regulatory standards stricter, making air pollution levels a little bit lower across the board for everyone.” 

Wendt, the medical section chief of pulmonary allergy critical care at the University of Minnesota, told The Oaklandside that cardiopulmonary or cardiac issues are expensive conditions that usually affect patients with a history of pollution. But she stresses they also affect everyone else using the same health care system. The more people that get sick from pollution, the more health-care costs goe up, and the more crowded emergencry rooms and acute care facilities become—similar to when COVID-19 spikes filled up hospitals.

“These increase in pollution events have downstream effects on other people seeking health care unrelated to that,” Wendt said. 

Hannah Boogaard, an air pollution epidemiologist at the Health Effects Institute, a nonprofit healthcare think tank, says it’s important to keep in mind that beyond the availability of sensors, other technologies are being used in a positive way to help us understand and improve air conditions. For example, the Medicare database of 68 million people is being used by her organization for pollution studies that will provide a more detailed understanding of the air than ever before. 

“This is really an advantage that we have [that we didn’t] in the past. Techniques have evolved. Computation power has improved. If you want to get to learn how pollution actually affect us, we are in a better place to do that,” she said.

Kaiser’s Van Den Eeden says doctors can also convince patients to choose better transportation options, especially in low-income communities, through message alerts. But it’s important to know that those most affected often suffer from poor technology access. 

“Anybody can subscribe to the Bay Area Air Quality Management District app and get their warnings delivered right to their phone,” he said. “[But there could be more notifications] coming into communities that are more difficult to access those kinds of systems.”

How Oakland, Alameda County, and the state can do more

In recent years, the city has tried to reduce pollution in some parts of Oakland where most industrial and residential mixing happens through street redesign and parking laws. Since 2017, the ​​West Oakland Truck Management Plan has tried to create a plan to reduce pollution from trucks by forcing them off residential streets. Recent congressional amendments to the Clean Air Act may allow the city and state more leeway over the next few years to regulate greenhouse gasses.  

Conversations in Oakland about environmental disparities and their effects on low-income communities have also advanced in recent years. Students at Life Academy, a small public high school in Oakland, last year advocated for the city to open up the I-580 from San Leandro to Grand Avenue to diesel big-rig traffic to reduce the impact that residents living near I-880 have felt for decades.

The state legislature recently passed legislation that mandated the California Air Resources Board to work with local jurisdictions to lower air pollution in communities historically suffering from it. The West Oakland AB 617 Community Action Plan, a partnership between the Bay Area Air Quality Management District and WOEIP, came about because of this law, and an East Oakland plan will be developed in the next few years. 

The state has also changed some laws pertaining to ports to prevent transport diesel and other heavy fuel-powered ships from idling at the port, which has led to fewer pollution emissions.

​If you’re a Bay Area or Oakland resident or business owner looking to reduce your pollution imprint, the air authority recommends you look into the EV charging installation program, its vehicle buyback program, its clean cars for all program for low-income residents, and the individual EV charging rebate. Low-income Bay Area residents may also be eligible to receive free home air filtration and ventilation hardware units. 

Jose Fermoso is a 2021 Knight-Wallace Fellow reporting on traffic and road safety for The Oaklandside. His work covering tech and culture has appeared in publications including The Guardian, The New York Times, and One Zero. Born and raised in Oakland, Jose has also worked on the bestselling unauthorized biography of Apple's Jony Ive and led all content initiatives at App Academy, the top U.S. coding boot camp. He is the host and creator of the El Progreso podcast, a new show featuring in-depth narrative stories and interviews about and from the perspective of the Latinx community.