Diesel trucks are disastrous for children’s health

A driver walks past a row of trucks preparing to leave their shipping containers at the Port of Los Angeles on Nov. 2, 2017. The nation’s largest port complex will move to slash health-damaging and planet-warming air pollution with a plan to phase out diesel trucks and equipment in favor of natural gas, then zero-emissions technology. The ports are Los Angeles’ No. 1 source of air pollution. Genaro Molina/Los Angeles Times

In my career as a pediatric lung specialist, I have witnessed the terrible impact that poor air quality has on children’s lungs. Every day, I work with young patients whose asthma and other respiratory illnesses are caused or worsened by poor air quality where they live, play and go to school. I routinely advise children and their parents about the importance of reducing exposure during poor air quality days, which could mean forgoing important outdoor playtime or skipping a soccer match.

Last year, the Maryland legislature passed a law that will greatly reduce trucking pollution in Maryland. The timely implementation of this program is critical for my patients. State lawmakers and regulators should not let regulatory barriers delay this program. Improved air quality for our children is at stake.

Maryland, including Baltimore, suffers from significant air pollution. Multiple counties in the state received failing or low grades for air pollution in the American Lung Association’s “State of the Air” report for 2024.

Trucks are a leading contributor to air pollution because they emit diesel exhaust. Emissions from medium- and heavy-duty trucks make up more than half of all particle pollution in the air. Soot and smog-forming pollution produced by these trucks and buses are profoundly harmful to the body. Short-term exposure to air pollution is associated with intensified symptoms of existing lung disease, such as asthma attacks and emergency room visits. Long-term exposures can interfere with lung development for babies and young children and can contribute to the development of new diseases, including asthma, cancer, chronic inflammatory lung disease (COPD) and diabetes, and can lead to cognitive impairments later in life.

Children are uniquely vulnerable to diesel pollution. Proportionate to the size of their bodies, children breathe in larger amounts of air than adults, which means air pollution exposes them to higher concentrations of toxic chemicals. Unfortunately, this also means children are at increased risk of worse long-term health outcomes and school performance from exposure to diesel pollution. Other populations who stand to experience greater harms from diesel pollution include older adults, people with disabilities and people who work outdoors.

Exposure to diesel pollution magnifies existing health disparities. Research from the U.S. Environmental Protection Agency shows that communities of color or those from low-income households are more likely to be exposed to greater concentrations of diesel trucking pollution.

The consequences of these health inequalities are also present in Maryland: Black children in the state experienced asthma-related emergency room visits at almost five times the rate of white children in 2020.

As a physician working with patients in the clinic and the hospital, I see the effects social inequities have on lung health every day. Low-income families are often the ones dealing with some of the most severe and complex lung health problems and experiencing the worst health outcomes while also struggling to afford basic care and medications. Even with insurance, it is expensive and time-consuming to manage chronic respiratory conditions (like asthma and COPD) and address acute illnesses (like asthma attacks, bronchitis and pneumonia) that can cause permanent damage if not adequately treated. Poor air quality increases the chances that acute health issues will arise, adding further to the burden for people with lung conditions and their families.

To save lives and improve children’s health, we must cut diesel pollution at the source.

Last year, our state legislature took a historic step toward cutting diesel pollution by passing the Clean Trucks Act.

This lifesaving legislation will increase the supply of pollution-free heavy-duty vehicles available to fleet operators and provide crucial health benefits. The American Lung Association’s “Delivering Clean Air” report has found that Maryland could see $19.8 billion in public health benefits from the legislation and avoid 1,800 premature deaths, 46,875 asthma attacks and 231,260 lost workdays by 2050.

That’s why many health professionals — pediatricians, pediatric pulmonary specialists like myself, and our colleagues who care for adult patients — are united on the importance of, and urgency for, clean trucks.

However, the clean truck standards — and the associated health benefits — still face a risk of being delayed due to regulatory obstacles. We urge state lawmakers and regulators to do everything in their power to ensure that Maryland’s clean truck standards are implemented without delay.

The health consequences of air pollution are serious but preventable. Maryland can significantly improve air quality and lung health — ushering in a healthier future for all — if these standards are implemented urgently and decisively.

Dr. S. Christy Sadreameli is a pediatric pulmonologist at Johns Hopkins Hospital.