June 14, Dear North Carolina Elected Officials:

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1 June 14, 2010 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 Rita Heath-Singer, RCP, RRT Director of Cardiopulmonary Maeve O'Connor, MD, FACAAI Carolinas Asthma and Allergy Meg Houlihan, Ph.D. Medical Psychologist Jackie Butch RN, BSN, MSN Clinical Care Coordinator, Nurse, Medicaid Community Care Partners of Greater Charlotte Mecklenburg Lori Van Horn, RN, MSN, CNOR OR Clinical Educator Camina Davis, MS, CHES Public Health Sciences, Lecturer Jessica Schorr Saxe, MD Andrew Harver, Ph.D. Professor Debbie Credle, RN, BSN WakeMed Children's Asthma Program Raleigh, NC

3 Daniel Murrey, MD, CEO OrthoCarolina Dana Hershey, MD Southeast Anesthesiology Consultants Jenni Mullendore, MD, MSPH 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 Richard Fireman, MD Mars Hill, NC Lew Patrie,MD Chair Western NC s for Social Responsibility Katherine Combs Rehabilitation Technician Carolians Rehabilitation Emily Diznoff, MD Asheville Family Medicine Andrew Dews, MD Arboretum Pediatrics Don Richardson, MD Pathologist Brevard, NC

4 Ahmed A. Arif, Ph.D., C.P.H. Associate Professor of Epidemiology, Department of Public Health Sciences Richard Winters Built Environment, SRTS Coordinator Mecklenburg County Health Department Pam Ellwood, FNP-C, AE-C Cleveland County Health Department Cleveland County Asthma Coalition Shelby, NC Stephen R. Keener, MD MPH Medical Director Mecklenburg County Health Department Cheryl Walker-McGill, MD, MBA President, Researcher American Health Strategies David T. Tayloe, Jr., MD, F.A.A.P. Goldsboro Pediatrics Goldsboro, NC Deborah Leiner, MD Greensboro, NC Kathleen E. Lucas, MD, FAAP Lucas Pediatrics Greensboro, NC Donald R. Freund, MD Marylou C. Freund, RN

5 Kathi J. Kemper, MD, MPH, FAAP Wake Forest University Baptist Medical Center Winston-Salem, NC Lisa Springer, MD Hayes Woollen, MD Cotswold Medical Clinic Joe Coyle, MD Southeast Anesthesiology Consultants Lecturer, UNC Charlotte Stanley, NC