January 1, Dear North Carolina Elected Officials:

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1 January 1, 2011 Dear North Carolina Elected Officials: As leaders in public health, we urge you to take action to reduce diesel pollution in our state by supporting the adoption of clean construction policies. North Carolina is one of the fastest growing states and older, more polluting construction equipment is used on many local and state projects. The construction sector represents the largest source of land-based non-road diesel pollution and often operates in neighborhoods and other urban areas with large numbers of pedestrians. Nationally there are over two million pieces of construction equipment in use, most of which lack pollution controls. The Problem Diesel exhaust contains over 40 toxic air contaminants. 1 Fine particles in the exhaust are linked to a wide variety of serious health effects from upper and lower respiratory ailments such as asthma attacks and possible asthma onset, to heart attacks, stroke and premature death. 2 In North Carolina, it s estimated that diesel fine particles cause 279 premature deaths, 343 heart attacks, 178 cases of chronic bronchitis, and over 9,000 asthma attacks annually. Diesel pollution also contributes to over 38,000 missed workdays every year in North Carolina. The estimated monetized cost of health impacts to our state from diesel fine particles is $2.3 billion. 3 The Solution Cleaner diesel fuel and effective pollution control technologies are available today that can virtually eliminate all toxic fine particles from diesel engines. Commercial emission controls known as diesel particulate filters (DPFs), when combined with the use of widely available ultra-low sulfur diesel fuel, can eliminate over 90% of fine particles from construction equipment. In addition to reducing particle pollution, clean construction policies can include diesel engine repowers and replacements to reduce the amount of nitrogen oxide (NO x ) emissions which contribute to North Carolina s ozone problems another public health risk. Ozone pollution continues to be a serious problem in an increasing number of counties, especially in our urban areas. Leadership is needed now from our elected officials to adopt policies that reduce harmful pollution and protect public health. On behalf of the public health leaders signed below, we strongly urge you to adopt clean construction policies to improve air quality and protect the health of North Carolinians. Sincerely, Lawrence Raymond, MD ScM Professor of Family Medicine, UNC Chapel Hill Director, Occupational and Environmental Medicine Carolinas HealthCare System, 1 Cal\EPA s OEHHA and the ALA of CA. Health Effects of Diesel Exhaust. Page Clean Air Task Force. Diesel Engines: Health and Environmental Impacts. V.2 Revised Page Clean Air Task Force. Diesel & Health in America: Diesel Soot Health Impacts. Select North Carolina State.

2 Dael Waxman, MD Medical Director of Behavioral Medicine Karl B. Fields, MD, FAAFP Professor, Department of Family Medicine, UNC-Chapel Hill School of Medicine Director, Sports Medicine Fellowship, Moses Cone Health System Ronald J. Pudlo, MD, FAAP Greensboro Pediatrics Chief of Pediatrics, Moses Cone Health System Teresa Sue Bratton, MD, FAAAAI Pediatric Allergist Sarah T. Jordan, MD, MSPH Family Rita Heath-Singer, RCP, RRT Director of Cardiopulmonary Maeve O'Connor, MD, FAAAAI Carolinas Asthma and Allergy Meg Houlihan, PhD Medical Psychologist Jackie Butch RN, BSN, MSN Clinical Care Coordinator Community Care Partners of Greater Charlotte Mecklenburg

3 Marian Earls, MD, FAAP Immediate Past President, North Carolina Pediatric Society Deborah Leiner, MD Piedmont Pediatrics Chair, NC Pediatric Society s Children s Environmental Health Working Group Kathleen E. Lucas, MD, FAAP Lucas Pediatrics Lori Van Horn, RN, MSN, CNOR Operating Room Clinical Educator Camina Davis, MS, CHES Public Health Sciences, Lecturer University of North Carolina-Charlotte Jessica Schorr Saxe, MD Stephen R. Keener, MD, MPH Medical Director Mecklenburg County Health Department Cheryl Walker-McGill, MD, MBA President, Researcher American Health Strategies

4 David T. Tayloe, Jr., MD, FAAP Goldsboro Pediatrics Goldsboro, NC Shannon McQueen, MD Melinda Paul, MD Andrew Harver, PhD Chair and Professor Department of Health Behavior and Administration University of North Carolina-Charlotte Debbie Credle, RN, BSN WakeMed Children's Asthma Program Raleigh, NC Daniel Murrey, MD, CEO OrthoCarolina Dana Hershey, MD Southeast Anesthesiology Consultants Jenni Mullendore, MD, MSPH Asheville, NC Claudia C. Prose, MD, MPH Chapel Hill, NC Sharon Caudle, RN, AE-C, BSN, BSW Educational Specialist, Clinical WakeMed Children s Asthma Program Raleigh, NC

5 Richard Fireman, MD Retired Mars Hill, NC Lew Patrie, MD Chair, Western NC s for Social Responsibility Asheville, NC Katherine Combs Rehabilitation Technician Carolinas Rehabilitation Emily Diznoff, MD Asheville Family Medicine Asheville, NC Andrew Dews, MD Arboretum Pediatrics Don Richardson, MD Pathologist Brevard, NC Arthur Kelley, MD Dale Gertz MD Ahmed A. Arif, PhD, CPH Associate Professor of Epidemiology, Department of Public Health Sciences University of North Carolina-Charlotte Rosalena Conroy, MD

6 Pam Ellwood, FNP-C, AE-C Cleveland County Health Department Cleveland County Asthma Coalition Shelby, NC Emily McCormick, MD Moses Cone Health System Julie Henry, MD UNC Dept of Pediatrics Chapel Hill, NC Richard Winters Built Environment, SRTS Coordinator Mecklenburg County Health Department Denise Fiery Perez MD Donald R. Freund, MD Retired Marylou C. Freund, RN Retired Kathi J. Kemper, MD, MPH, FAAP Wake Forest University Baptist Medical Center Winston-Salem, NC Lisa Springer, MD T. Hayes Woollen, MD Cotswold Medical Clinic

7 Joe Coyle, MD Southeast Anesthesiology Consultants Lecturer, UNC Charlotte Stanley, NC Nicole Gomez-Fleming Social Worker and Parent Advocate Steve Bruggeling, RRT Certified Pulmonary Function Technologist Veteran s Administration Hospital Salisbury, NC Amy Whaley Respiratory Therapist Salisbury, NC Thomas A. Lee, PhD Administrative Director, Dept of Family Practice (Retired) Shruti Simha, MD Peter Coccaro, MD Minda Kramer, NP Kaye Gable, MD Hilary McCormick, MD