Clearing the Air A U interdisciplinary program aims to become a national resource on improving air quality.

Every day, Ron Fessenden clicks open the in-box for his email account and looks for the daily air quality indicator messages distributed by the Utah Division of Air Quality. Depending on the reading—red, yellow, or green—the retired local television sales executive and onetime University of Utah sports information director decides how he’ll spend his day. “When the air quality starts to get bad, I just don’t go outside,” the Midvale, Utah, resident says.

Fessenden suffers from idiopathic pulmonary fibrosis (IPF), a little-known, progressive disease that is slowly scarring and hardening his lungs. His disease has progressed more rapidly over the last year, and eventually, IPF will kill him, just as it does roughly 40,000 people annually in the United States. Diagnosed seven years ago after seeking a doctor’s care for a persistent dry cough, Fessenden uses supplemental oxygen round the clock and has had to give up many of the things he loves. That includes his beloved golf game, just when he “was finally getting good,” he jokes. “I can’t take a deep breath,” he says, and he also must pause at the halfway mark when coming up the stairs from his basement. “It really limits the things you would like to be able to do and hampers your quality of life.”

Fessenden has been a willing participant in five different University of Utah-based drug trials that sought to cure his disease. None provided any relief, but Fessenden says he’s encouraged by news that U researchers across a wide range of fields—from biology and bioinformatics to engineering, epidemiology, medicine, meteorology, and more—are now working together on projects aimed at understanding the connections between pollution and health. The research is part of the University’s Program for Air Quality, Health, and Society, a two-year-old initiative designed to foster cross-disciplinary, collaborative study of all facets of air quality in hopes of identifying pathways for reducing pollution and improving quality of life for those in Utah and beyond. University leaders hope the program will establish the U as the national leader in research and information on air pollution and health, as well as innovative ways to help solve the problems.

Dr. Robert Paine, professor and chief of pulmonary medicine in the U School of Medicine, co-founded the U’s Program for Air Quality, Health, and Society and serves as its director. The program brings together researchers from diverse disciplines to study the various impacts of air pollution. (Photo by August Miller)

“As a major research institution, we at the University of Utah are uniquely positioned to bring together the expertise from health and epidemiology to engineering, atmospheric science, urban planning, and more to tackle the challenge of improving our air quality,” says Vivian S. Lee, senior vice president of University of Utah Health Sciences, dean of the U Medical School, and chief executive officer of U Health Care. “We view this as both an opportunity and an obligation.”

Winter weather inversions are common along Utah’s Wasatch Front and occur when a layer of warm air traps cold air, and pollution, in the valleys. (Photo by Erik Crosman)

Ruth Watkins, senior vice president of academic affairs, shares Lee’s view on the importance of interdisciplinary collaboration in the endeavor. “Air quality is a significant issue for the people of this region, the state of Utah, and beyond,” Watkins says. “As a public research university, it is imperative that we lead in efforts to address societal challenges. The quality of our air and environment is closely linked to quality of life, and this is core business for the University of Utah.”

Utah has attracted national attention in recent years for its air quality problems. Winter inversions trap pollutants in the Cache and Salt Lake valleys, and ozone levels leave a haze over much of the Wasatch Front, primarily in the summer but also across the Uintah Basin in winter months. At times, pollution levels have been so high during a single 24-hour period that the U.S. Environmental Protection Agency has placed some Utah communities at the top of its list for cities with the nation’s worst air. In 2013, daily EPA monitoring in 10 Utah counties found air pollution levels exceeded national healthy air standards a combined 99 times.

The problem has raised the ire of Utahns worried about the impact of breathing bad air, which has been linked to a range of health problems, including increased incidence of asthma, cardiovascular disease, and dementia, as well as adverse outcomes for babies in utero, including low birth weight and high infant mortality. In January 2014, more than 4,000 concerned Utah residents, many wearing gas or surgical masks, rallied at the Utah Capitol, demanding more aggressive state action on the issue. State lawmakers responded by proposing a record number of legislative solutions, although only a handful passed and none include regulatory standards that are tougher than those already imposed by the EPA.

Beyond its impact on health, the pollution has economic costs, including lost work days due to illness and increased health care costs. The air pollution also has an impact on employee recruiting for Utah businesses. And it can present costly regulatory challenges for industries large and small.

It’s a problem Lee knows about firsthand. When she was hired at the University of Utah in 2011, she had planned to bring three New York University faculty members with her as members of her research team. To her dismay, however, one declined, citing significant concerns about air quality. “I know I’m not alone: Many other Utah business leaders frequently report about the challenges they face in convincing companies to relocate to our wonderful state,” Lee says. “And as a health care institution, we are particularly concerned about the impact of air pollution on the health of our patients and on the broader community, including our employees.”

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Kerry Kelly, a University of Utah chemical engineering researcher who helped co-found the University’s Program for Air Quality, Health, and Society, works with U student Timothy Carter on some sensor equipment in a campus laboratory. (Photo by August Miller)

The U’s Program for Air Quality, Health, and Society is the brainchild of Dr. Robert Paine, chief of pulmonary medicine at University Hospital, and Kerry Kelly, a College of Engineering researcher. The pair met by chance in 2009, when both were appointed to the state’s Air Quality Board and were assigned to sit next to each other at a meeting. The appointments launched a friendship and a conversation about the need for University collaboration between academic disciplines, many of which were already, albeit separately, engaged in cutting-edge air quality science. “We needed an umbrella, and we needed a catalyst to greatly enhance what we do,” says Paine. “One of the key things about air pollution is that it’s easy to do pieces of research. It’s much harder to come up with opportunities where we bring all these pieces together and say, ‘How do we go from what’s emitted to what the health consequences are?’ ”

The pair believed that the U’s academic experts and researchers were well suited to the challenge. So after six years of conversation, Paine and Kelly in 2011 crafted a proposal for the Program for Air Quality, Health, and Society and began a conversation with University leaders.

“The idea was that we’re much stronger together,” says Kelly. “It’s not just a health problem and also an engineering problem, it’s an atmospheric science problem, and we’re going to come up with better solutions if we all get together and take advantage of everyone’s expertise.”

Robert Adler, dean of the University of Utah’s College of Law, says scientific advances from the U air quality research may help lead to better environmental law and policy. (Photo by August Miller)

University leaders agreed. By 2012, Paine and Kelly had secured enthusiastic support, as well as some funding, from Lee, Watkins, the office of the vice president for research, and the College of Engineering. Paine now serves as the program director, and Kelly is the associate director. The program’s steering committee also includes representatives from atmospheric sciences, biology, chemical engineering, internal medicine, law, and pediatrics.

The program’s first event, a spring 2013 retreat designed to stir up interest in cross-disciplinary projects, drew nearly 100 curious U investigators and spurred a number of grant requests. Research began in earnest in January 2014, when the program distributed $165,000 in grants from the University’s Funding Incentive Seed Grant Program, which is administered by the office of the vice president for research. Kelly says the six projects were selected based on their potential to advance science and draw additional large grants from organizations such as the National Institutes of Health or the EPA.

The seed grants have supported both first-time research and ongoing work. One grant, to obstetrician and gynecologist Jeanette Carpenter-Chin, is allowing her to study a suspected link between in utero exposure to air pollution and children’s health. The study focuses on children whose pregnant mothers were exposed to air pollution from Utah County’s Geneva Steel Mill in the 1980s.

Another study, led by Russ Richardson PhD’92, a U professor with joint appointments in internal medicine and exercise and sport science, examines the effects of particulate air pollution on vascular function in chronic pulmonary disease. And Hanseup Kim, a USTAR professor of electrical and computer engineering, is using his grant to develop a wireless system for detecting volatile organic compounds that are part of air pollution.

Dr. Cheryl Pirozzi, a University of Utah pulmonologist, is leading a cross-disciplinary study of the effects of air pollution on patients with idiopathic pulmonary fibrosis. (Photo by August Miller)

The U program’s grant funding has also furthered study of correlations between air quality data and the number of patients suffering from diseases with known connections to pollution exposure, such as some cancers and respiratory illnesses. Led by U bioinformatics professor Ramkiran Gouripeddi, a team that includes experts in meteorology, atmospheric science, chemical engineering, medicine, and informatics is working with combined data sets to analyze any possible links between disease occurrence and air pollution concentrations.

Amanda Bakian, a U research assistant professor of psychiatry, has used her grant to study links between air pollution and suicide. The project, believed to be the first study of its kind nationwide, combines the expertise of a diverse group of psychiatrists, suicidologists, environmental and genetic epidemiologists, psychologists, and biostatisticians. “Assembling a team composed of individuals with diverse expertise helps guarantee that the problem or question is approached from the best angles possible and ensures that the study design is maximized appropriately,” says Bakian. “This is how science is moving forward in this day and age and how gains in scientific understanding are being made.”

Dr. Cheryl Pirozzi, a U pulmonologist, is another grantee, and she shares Bakian’s enthusiasm for cross-disciplinary work. Pirozzi is studying the effects of air pollution on individuals with idiopathic pulmonary fibrosis, the disease from which Fessenden suffers. This winter, the pilot study will place 20 air quality sensors in patient homes across the Salt Lake Valley to gather data about indoor air pollution exposure, daily respiratory symptoms, and lung function during an eight-week period. To meet Pirozzi’s data-gathering needs, Kelly is working with Tony Butterfield BS’96 PhD’07, an assistant professor of chemical engineering with an expertise in prototyping and data analysis. He and a team of students are retooling a commercially available sensor for Pirozzi’s study. “There are people in all aspects of the University who are interested in air pollution and have expertise in areas I know nothing about, so I think getting people together to work on projects like this is a huge opportunity,” Pirozzi says.

Butterfield also is working on a separate community outreach effort that would place the sensors in K-12 schools across the Salt Lake Valley, increasing the number of locations where air quality measurements are gathered for the state’s monitoring. About 30 teachers have already expressed interest in using the sensors as curriculum tools in a wide range of subjects, from mathematics to biology. “People are really interested in doing citizen scientist work,” says Butterfield. “They like being a part of the process that helps us in discovering how we can make the world a better a place.”

Watkins says the University has also begun a hiring initiative to recruit faculty members—four over the next two academic years—for the colleges of Social and Behavioral Science, Mines and Earth Science, and Engineering to enhance the work of the U’s air quality program while also advancing scholarship and understanding of broader environmental issues. “That will accelerate our potential to address challenging problems, including water and air quality, and relationships with climate and weather,” she says.

The increased environmental focus the faculty members will bring, along with the work of the air quality program, will enhance the academic experiences and opportunities for students who work with those professors, says Robert Adler, dean of the U’s S.J. Quinney College of Law and a member of the Program for Air Quality, Health, and Society’s steering committee. “The program reflects the best of what universities can be,” he says. “Rather than working in isolated disciplinary silos, the effort reflects shared commitment to advancing knowledge and helping the community through collaboration within the U and beyond.” The law college’s Wallace Stegner Center for Land, Resources, and the Environment recently has hosted events examining regulatory changes regarding air pollution, and the annual Stegner Symposium this coming March will examine air quality as it relates to health, energy, and economics.

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Winter air pollution cloaks the U’s Rice-Eccles Stadium and the rest of the Salt Lake Valley, while the mountains above the inversion remain clear and sunny. The U currently has six cross-disciplinary research projects that include installing more sensors across the valley to help the state’s air monitoring. (Photo by Erik Crosman)

Adler and Watkins also say the scientific advances expected from the U air quality research may ultimately help lead to innovations in industry practices and environmental regulation and law, as well as better public policy. “Good decisions about complex issues are always informed by better science and related policy analysis,” Adler says.

For now, Paine and Kelly hope the program’s initial research projects will result in promising findings to draw in large grant awards from national institutions and organizations. The Program for Air Quality, Health, and Society currently has no ongoing funding and needs those grants and private funding to further its goals. Years down the road, Paine says, “success would be a robust research enterprise here so that people around the nation and around the world think about Utah as the place that produces high-quality air pollution research.”

Fessenden says he’ll be happy if researchers are finally able to answer the question that so many Utahns find themselves asking each time they wake up to another day of gray, mucky winter air or summer haze: What is breathing this stuff doing to my body? “I have thought about moving, but my life is here, my family and my doctors,” says Fessenden. “When the pollution is bad, my breathing is just more labored, and if I do go outside, I find myself constantly coughing.” In life, you “play the cards you are dealt,” he says, but he welcomes any advances in science and medicine that will help cure or even ease the struggles of patients like him. “Anything that would buy some time would obviously be great.”

—Jennifer Dobner is a Salt Lake City-based writer and a frequent contributor to Continuum.


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