Mon Valley residents with asthma had trouble catching a breath as a direct result of the massive 2018 Christmas Eve fire that knocked out pollution controls at U.S. Steel Corp.’s Clairton Coke Works, according to a new study.
The study found that the rate of outpatient and hospital emergency department visits by asthma sufferers in the Clairton area nearly doubled in the months following the fire. The study determined that the higher rates of visits to clinics, doctor offices and hospitals occurred on days when pollution emissions from the nation’s largest coking facility were exceeding federal air quality standards.
The study, accepted Monday by Toxics, a peer-reviewed journal, also determined that the increase in medical facility visits was not related to either weather inversions that trap ground level pollution or seasonal flu activity.
The new findings support those of several previous studies, and more directly and strongly tie the increases in asthma morbidity in the Mon Valley to the Pittsburgh-based steelmaker’s coking facility, which continued to operate at the same level after the fire as it did before the fire.
“I was not surprised,” Dr. Deborah Gentile, director of allergy and asthma services at East Suburban Pediatrics and study author, said about the study results. “It is well documented that acute pollution leveIs like this lead to increased visits for asthma attacks; these results were expected.”
Dr. Gentile, who is also medical director of the newly formed nonprofit Community Partners in Asthma Care, said her study’s findings were similar to those reported by researchers at the University of Pittsburgh Graduate School of Health in April. That study showed that asthma sufferers living within 10 miles of the coke works had an 80% greater risk of worse symptoms following the fire. It also showed increased use of asthma “rescue medication” or inhalers.
And in September 2017, prior to the fire, Dr. Gentile reported the findings of a three-year study that found significantly higher asthma rates in a group of 1,200 children at 15 elementary schools located near big sources of industrial pollution, many of those in the Mon Valley.
That study, which appears in the Journal of Asthma, found that the students had an asthma rate of 22.5%, almost three times the national average of 8.5 % reported by the Centers for Disease Control and Prevention. And Black children had an even higher asthma rate — 26.8%.
“The previous work showed a high incidence of asthma prevalence and poorly controlled disease in children residing near point sources of air pollution and showed that these rates were linked to long-term (one year) high exposure to air pollution,” Dr. Gentile said. “This new study shows the direct impact of short-term exposure on visits for asthma attacks.”
Before the fire, from Dec. 24, 2017, through Feb. 28, 2018, there were 54 adult acute outpatient visits. After the fire, from Dec. 24, 2018, through February 2019, there were 98, the study found, which translates to an increase in the visit rate from 5.6 to 10.2 per 1,000 residents. The study also charted adult emergency department visits for asthma during those same periods, which increased from 19 pre-fire to 35 post-fire.
Overall, the study counted 73 medical facility visits before the fire and 133 after the fire 31 — an 82% increase, which the study noted as “significant.”
During the more than three months it took U.S. Steel to repair and replace the pollution control equipment, the company continued to burn unfiltered coke oven gas as fuel at the Clairton facility and its two Mon Valley steel mills in Braddock and West Mifflin. Nearby monitors measured multiple violations of federal air emissions standards for small airborne particles or soot, hydrogen sulfide and sulfur dioxide.
The steelmaker did extend coking times and increase use of natural gas in its fuel mix in an effort to mitigate emissions from combusted coke oven gases and stop exceedances of pollution limits.
But the Pitt study found that the coke works emitted sulfur dioxide at levels 25 times higher than it typically does. And according to estimates by the Allegheny County Health Department, which regulates air pollutants, sulfur dioxide emissions during the three-plus months the pollution control system was inoperable totaled 4,685 tons — almost as much as is emitted annually by all industrial sources in the county.
A pending federal citizens lawsuit, filed in April 2019 by the Clean Air Council and PennEnvironment, charges that by continuing to operate its coke works and mills U.S. Steel violated the Clean Air Act and jeopardized the health of Mon Valley residents.
Sulfur dioxide is one of six primary or “criteria” pollutants regulated by the Clean Air Act. At high concentrations, the chemical compound can affect breathing and aggravate respiratory and cardiovascular diseases, including asthma, bronchitis and emphysema.
U.S. Steel was provided a copy of the new study and days to review it but declined to comment on its findings, citing the “ongoing litigation.”
The company’s response did note that the county health department’s chief epidemiologist, Dr. Luann Brink, testified at a public hearing that “there was no connection between the fire and any increase in hospital visits.” The company’s statement concluded, “We agree with the ACHD’s findings.”
But Dr. Brink didn’t say there was “no connection” between the fire and hospital visits. According to the 70-page record of the state Joint Senate and House Democratic Committee hearing held in Clairton on Feb. 7, 2019, just six weeks after the fire, Dr. Brink said her analysis determined that an “equal number of emergency department visits” occurred before and after the fire, that her analysis did not include primary care or doctors office visits, and therefore “there is always more to discover.”
Dr. Gentile said the health department’s statistical review had a number of “limitations.” It looked at a shorter time frame and could have missed cases; tallied hospital emergency department complaints but not asthma diagnosis; wasn’t peer reviewed; and didn’t look at visits to doctor’s offices or urgent care facilities for asthma.
“This is very important because asthma is an outpatient disease; most patients that have attacks will call their doctor and be seen at their office for worsening asthma,” Dr. Gentile said. “Only more severe patients or those without a primary care doc will go to the emergency department. Dr. Brink was not able to look at outpatient data.”
The health department declined to make Dr. Brink available for an interview, saying she won't comment on the new study by Dr. Gentile or the apparent discrepancy between the new study and one she conducted following the fire due to the pending court case.
In filings on that April 2019 case, U.S. Steel repeatedly maintained that its emissions following the December 2018 fire did not harm the health of Mon Valley residents.
According to a response document filed with the court in July 2019, the company denies that exposure to airborne particles, volatile organic compounds, or VOCs, and benzene “in any amount” causes harmful health impacts.
The U.S. Environmental Protection Agency classifies benzene as a “Group A, known human carcinogen.”
Joshua Kratka — an attorney with the National Environmental Law Center, a Boston-based nonprofit environmental litigation firm representing the two environmental organizations, PennEnvironment and the Clean Air Council, in the case — said the new study could be useful as the case proceeds.
“We’re wrapping up discovery, did a site inspection and depositions have been taken,” Mr. Kratka said in a phone interview June 17. “Right now we are focused on liability: Did the company violate the Clean Air Act and violate its [emissions] permits for 100 consecutive days? The impacts of those emissions can be incorporated in the case later.”
The findings of the new study will be disseminated to Mon Valley residents, local and county government leaders and officials with the goal of developing new and more protective public health policies.
Dr. Gentile said the study recommends the adoption of regulations requiring Mon Valley industries to curtail emissions and operations during weather inversions, and the creation of a rapid response system to assess immediate health impacts and provide notification, alerts and assistance — if needed — to residents already suffering from asthma.
According to the study, the first public health alert about the fire to the 130,000 people who live within five miles of the coke works was sent 16 days after the industrial accident occurred.
Also recommended is the development of a health registry in vulnerable communities that would enable public health officials to track short- and long-term health outcomes related to chronic air pollution and short-term air pollution events.
Two of those recommendations are already in the works. In response to air pollution concerns raised by Mon Valley residents, the Allegheny County Board of Health at its May meeting approved for public comment the Mon Valley Air Pollution Episode Rule. The legislation would require existing big industrial facilities to file air pollution mitigation plans with the county health department within 90 days and take steps to cut back on emissions when temperature inversions occur.
New major or synthetic minor pollution sources must have a mitigation plan in place when they submit initial operating permits. Major sources emit more than 100 tons of pollutants annually, while synthetic minor sources could emit more than that threshold but don’t due to operational controls.
In addition, the health department has instituted a new electronic “dashboard” to provide more transparent, “easily digestible” information about specific air pollutants, including airborne particles or soot and sulfur dioxide. The department has also beefed up its public notification network through expanded use of Allegheny Alerts, social media and web-based information to alert residents about the occurrence of high pollution levels.
The 120-year-old coking operation in Clairton bakes coal into coke, a necessary component of the steel-making process. Clairton's number 15 coke battery is now on hot idle, but the other nine batteries containing 647 coke ovens are operating and can produce approximately 4 million tons of coke a year.
The facility has a long history of air pollution violations and has been fined millions of dollars.
In December 2019, U.S. Steel agreed to an $8.5 million settlement of a 2017 class-action lawsuit that alleged the company was negligent in allowing air pollution and odors from its Clairton Coke Works to impact residents of the surrounding community. That lawsuit involved high emissions from the coke works prior to the December 2018 fire.
The facility’s latest fines for air pollution violations during the first three months of this year, announced earlier this month, totaled $201,500.
At the end of April, U.S. Steel announced that it was abandoning plans to spend $1.5 billion upgrading its Mon Valley Works.
The study headed by Dr. Gentile was funded by The Heinz Endowments. A study disclaimer states Heinz had no role in the study design, the collection, analysis and interpretation of data, the writing of the study manuscript or the decision to publish the results.
Don Hopey: dhopey@post-gazette.com.
First Published: June 28, 2021, 9:36 a.m.
Updated: June 28, 2021, 3:17 p.m.
