WHAT ARE THE HEALTH IMPACTS OF AIR … ARE THE HEALTH IMPACTS OF AIR POLLUTION? ... INTRODUCTION OF...

High School and Middle School Air Quality Education Program

7

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WHAT ARE THE HEALTHIMPACTS OF AIR POLLUTION?

OVERVIEW OF THE LESSON

Scope and Purpose of the Lesson:

This lesson contains a variety of activities that provide a conclusion to the AirQuality Lessons. Students will examine the health symptoms caused byspecific pollutants.

Topics Addressed:

Health impacts of air pollutionSegments of the population that are most at riskParticulate matterCarbon monoxideOzoneHealth symptomsLeadNitrogen OxideSulfur Dioxide

Synopsis of the Lesson:

This lesson contains three activities that are focused on the health symp-toms caused by specific pollutants. In the heart of this lesson students en-gage in a Questioning Game activity of analyzing a series of case studies.

LEARNING OBJECTIVES

Students will be able to:Identify what segments of the population are most at risk from air pol-lutionUnderstand that healthy teenagers and adults can be affected by se-vere air pollutionSummarize the health effects of exposure to high concentrations ofparticulate matter (PM

10)

Summarize the health effects of exposure to high concentrations ofcarbon monoxide (CO)Summarize the health effects of exposure to high concentrations ofOzone (O

3)

Apply this knowledge in analyzing a series of case studies to determine the specific pollutant(s) likely to have caused a given set of symp-toms

GRADES: 7-11SUBJECTS: Social Science, Biology,

Science, Geography, Health,Environmental Studies, Civics andGovernment

TIME: 4 Hours; 2 2/3 Blocks or 5Periods.

STATE STANDARDS:Civics Standard 3 - Citizenship,

P.I. C.416 - Grades 9-11Geography Standard 1 - Maps, G.402

- Grades 9-11Geography Standard 2 - Environ-

ment, G.406, G.408 - Grades 9-11;7.422, 8.422 - Grades 7-8

History Standard 1 - Chronology, P.I.H.401, H.402 - Grades 9-11; 7.427,8.428 - Grades 7-8.

History Standard 1 - Interpretation, P.I.H.408 - Grades 9-11

Science Standard 1 - Nature andApplication of Science andTechnology (Science as Inquiry)1.11

Science Standard 6 - Life Processes(Health and Technology Applica-tions) 6.41

Science Standard 8 - Ecology(Interaction of Humans within Ecosystems) P.I. 9.75 - Grades 9-11

WHY STUDY AIR POLLUTION?

BACKGROUND

The heart of this activity is a questioning game in whichthe class interviews a “patient” who is experiencing a healthproblem that may be related to air pollution. The classgoal is to ask questions that clarify the patient’s symptomsand deduce the probable cause. Seven such cases areincluded on the “Symptom Scenario” cards.

The Symptom Scenarios, although based on fictionalcharacters, are realistic examples of well-documentedhealth effects of exposure to specific pollutants.

LESSON PROCEDURE

INTRODUCTION OF LESSON Start the lesson with a Warm-up, Mind Set, or Anticipatory Set on the overhead or chalkboard. The WARM UP and the DISCUSSION should takeabout 10 minutes.

1. WARM UP, MIND SET OR ANTICIPATORY SET - Do youthink that air pollution levels in Delaware could be highenough to affect people’s health? Explain why or why not.Give students 3 to 4 minutes to respond in writing.

2. LARGE GROUP DISCUSSION - Conduct a class discus-sion about the health effects of pollution from the WarmUp. Should take about 5-6 minutes.

3. LESSON OBJECTIVES - The lesson objectives should bepresented on an overhead or on the chalk board. Theseshould be read and explained to the class. (2-3 minutes)

OPTION: You may want the students to copy the lessonobjectives in their notebooks.

ACTIVITY 1: Reading

1. Description/Overview of Activity:Students will work individually to complete Reading #1 andStudent Worksheet #1 to develop a background and un-derstanding of the health impacts of air pollution.

2. Materials Needed:Reading #1Student Worksheet #1

3. Performance Indicators of the Activity:Geography P.I G.406, G.408; 7.422, 8.422History P.I. H.401, H. 402; 7.427, 8.428

4. Preparation for Activity:Make copies of Reading #1 and Student Worksheet #1.

5. Activity Outline and Directions to the Teacher:

STEP 1: Students will now complete Reading #1 to developa better background and understanding of the health im-pacts of air pollution. Give the students Reading #1 andStudent Worksheet #1 and ask them to complete boththe reading and the worksheet individually. (10 minutes)

STEP 2: CLASS DISCUSSION - Have the class brieflydiscuss Reading #1 and their answers to Student Worksheet#1—see answer sheet in Teacher Materials (10 minutes).

ACTIVITY 2: Questioning Game

1. Description/Overview of Activity:Students will be engaged in a Questioning Game activityof analyzing a series of case studies to determine the spe-cific pollutants likely to have caused a given set of healthsymptoms.

2. Materials Needed:Photocopies of Criteria Pollutants chart - 1 per studentPhotocopies of Group Task Cards - 7 copies, or 1 per groupPhotocopies of Student Worksheet #2 - 1 per studentPhotocopies of Symptom Scenarios 1, 2, 3, 4, 5, 6, 7 - 1 setonlyReading #1 (from Lesson 1)Student Worksheet #1 (from Lesson 1)

3. Performance Indicators of the Activity:Geography P.I G.406, G.408; 7.422, 8.422Science P.I. 9.75History P.I. H.401, H. 402; 7.427, 8.428

4. Preparation for Activity:Make copies of Criteria Pollutants Chart, Group Task Cards,Student Worksheet #2, and Symptom Scenarios. Studentsshould also have their copy of Reading #1 and StudentWorksheet #1. Divide the class into Cooperative LearningGroups of four students each arranged heterogeneouslyby gender, race, and ability.


STEP 1: Divide the class into groups of four students each.Give each student a copy of the Criteria Pollutants chart.Ask the students to also get out their copy of StudentWorksheet #1 and Reading #1. Ask students to take a fewminutes to review this material (3 minutes).

STEP 2: Give each group one copy of the Symptom Sce-nario Cards (different card to each group) and a copy ofStudent Worksheet #2. Using Reading #1, StudentWorksheet #1, and the Criteria Pollutants Chart, discuss and

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come to agreement on the probable cause of your patient’ssymptoms. Then answer the one set of questions on Stu-dent Worksheet #2 that pertain to your group’s scenario.Students will need to apply information from Reading #1,Student Worksheet #1, and the Criteria Pollutants Chart. En-courage students to refer freely to these throughout theactivity (10 minutes).

STEP 3: Give each group a copy of the Group Task Cards.Explain that each member of the group will choose andassume a specific responsibility, as defined on the GroupTask Cards. Explain that each group will do an oral pre-sentation of their Symptom Scenario. The group membersthat chose to be the patient and second patient or familymember will introduce themselves based on the informa-tion on the Symptom Scenario. The information at the bot-tom of the Symptom Scenario will be used to answer classquestions only. Give groups a few minutes to prepare (5minutes).

STEP 4: The groups will take turns presenting their Symp-tom Scenario to the class. The class will begin asking ques-tions of the patients similar to a doctor. The presentinggroup will answer questions based on the information atthe bottom of their Symptom Scenario. Each group willattempt to arrive at a conclusion as to the cause of theillness and a prevention. It is important that students notbe allowed to arrive too quickly and confidently at the con-clusion that a given pollutant is “the” cause of a patient’ssymptoms. First, encourage thorough questioning; be surethat students have asked questions about other aspectsof the patient’s life that could also be an influence. Sec-ond, be sure students recognize that even when air pollu-tion is a primary factor, many other factors still influenceour health. Finally, when a causative pollutant is initiallyproposed, you may wish to ask the class to vote on whetherthey are sure of the cause or whether they need to affirm itwith further questioning (Would a physician or scientistannounce a diagnosis based on a first guess or seek ad-ditional information to confirm that diagnosis?). (1 1/2hours)

ACTIVITY 3: Culminating Activity -Essay

1. Description/Overview of Activity:Students will write an essay explaining whether we as in-dividuals can accept full responsibility for the extent to whichour health is impacted by air quality, or whether govern-ment and industry must also assume some responsibility.

2. Materials Needed:Handout #1Scoring Rubric

3. Performance Indicators of the Activity:Geography P.I G.402Science P.I. 9.75History P.I. H.408Civics P.I.C.416

4. Preparation for Activity:Make copies of Handout #1.


STEP 1: Explain to the students that they will write an es-say as a culminating activity for this lesson. Their instruc-tions and paper for their rough draft is on Handout #1. Giveeach student a copy of Handout #1 and the Scoring Rubric.Tell students that this essay will be graded based on thescoring rubric that you gave them. Students will first writea rough draft in class and then complete their final essayfor homework or in a computer lab. Essays are to be twopages in length, typed, and double spaced (3 minutes).

STEP 2: Explain to students to be sure to support theirviews with evidence from their research and readings.Now students will begin to work on their rough draft (45minutes).

STEP 3: Students could be taken to a computer lab to typetheir essays—two typed pages that are to be doublespaced. (45 minutes).

CONCLUSION:

1. Review the lesson objectives to see if the students havemastered the lesson expectations.

EXTENDED ACTIVITIES

1. PROJECT - Students would write a “History of Air Pollu-tion Events” as a useful supplement to this lesson. (SeeAppendix A)

OPTION: Students could focus on the “History of Air Pollu-tion Events” in Delaware (See Annual Air Quality Report forthe state of Delaware at (http://www.dnrec.state.de.us/air/aqm_page/reports.htm)

2. RESEARCH PAPER - Students could research and write apaper on the “History of Air Pollution Legislation” as the foun-dation for a government lesson on how the public experi-ence of the health and environmental effects of air pollutioninfluenced government action. (See Appendix A)

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OVERHEADTRANSPARENCIES

Introduction of Lesson 7

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OVERHEAD TRANSPARENCY: WARM-UP

Do you think that air pollutionlevels in Delaware could behigh enough to affect people’shealth? Explain why or why not!

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OVERHEAD TRANSPARENCY:LESSON 7 OBJECTIVES

Identify what segments of the population are most at riskfrom air pollution

Understand that healthy teenagers and adults can beaffected by severe air pollution

Summarize the health effects of exposure to high concen-trations of particulate matter (PM

10)

Summarize the health effects of exposure to high concen-trations of carbon monoxide (CO)

Summarize the health effects of exposure to high concen-trations of Ozone (O

3)

Apply this knowledge in analyzing a series of case studies todetermine the specific pollutant(s) likely to have caused a given

set of symptoms

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STUDENTMATERIALS

Lesson 7 Activity 1

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Lesson 7 - Symptom Scenarios

Air Pollution and Everyone

Air pollution is something we can’t escape. We breatheit every day. In fact, every minute of everyday, we breathe sixto ten liters of air. If the air around us carries pollutants, thosepollutants enter our bodies and can affect us in many ways.The Environmental Protection Agency estimates that four outof ten Americans live where the air is often unhealthy tobreathe. Enough people are affected, and affected badlyenough, that just in Delaware, the health impacts of air pol-lution costs us millions of dollars every year.

Air pollution is especially harmful to the very young andold. Infants and young children are at risk because theirlungs are not fully developed and because they breathefaster. The elderly are at risk because their bodies are nolonger as effective at dealing with environmental stress.

Of course, since the respiratory system comes in di-rect contact with the air we breathe, it is the body systemmost likely to be affected by air pollutants. So people whoalready have asthma, emphysema, or other respiratoryconditions, people with heart or circulatory problems, andcigarette smokers are especially susceptible to the effectsof air pollution.

People who are young and healthy can be affectedby pollution too. Air pollution can affect anyone. Evenhealthy teenagers, young adults, and strong athletes cansuffer negative effects from high pollution levels, especiallywhen exercising outdoors.

A Tricky Question

It’s a real challenge for scientists to study the healtheffects of different air pollutants. It wouldn’t be ethicalfor researchers to just put people in a lab and expose themto high levels of a pollutant. Outside the lab, people wholive in heavily polluted areas are exposed to not just one

Reading 1pollutant but to many pollutants. Also, the concentration ofeach pollutant is changing all the time, in some cases in-dependently of other pollutants. All of this makes it difficultto separate out the effects of each pollutant.

In addition, how susceptible people are to the effectsof air pollutants can vary widely. Think about a roomful ofhealthy people who are all exposed to the same cold vi-rus. Some will develop a bad cold, others a mild cold, andothers no cold at all. In a similar way, susceptibility to pol-lutants can vary greatly even among a group of healthyindividuals.

Finally, there are always many influences on ourhealth. If you develop symptoms that might be caused byair pollution, it’s often difficult to be sure that pollution was“the” cause. Just as with other health problems, there arelikely to be several factors affecting your health.

How Much Do We Know?

One way to study the relationship between air pollu-tion and health is to compare hospital records and deathrecords to pollutant levels. Researchers have found thatduring extreme air pollution events, hospital admittancesfor respiratory problems increase. Death rates also in-crease, especially among the elderly and those who al-ready have respiratory problems.

Another type of research involves evaluating the ef-fects of long-term exposure to pollutant levels that are highbut not extreme. In one study, scientists analyzed medicalrecords of several thousand people who lived in an areawhere pollutant levels went above the National AmbientAir Quality Standards for 42 days or more. These peoplewere 33 percent more likely to have bronchitis, 74 percentmore likely to have asthma, and 37 percent more likely tohave lung cancer than people who lived in an area withclean air. Other studies have found these kinds of resultsas well.

Finally, being affected by air pollutants is not just an“either/or” question. People can suffer from pollution tovarying degrees. Although they may not be diagnosed

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with a specific disease, their health may be affected on along-term basis in a way that reduces their quality of life.

In general, we know that long-term exposure to irritantsin the air can cause swelling and constriction of the airways,increased production of mucous, and paralysis of bacteria-destroying cells. Normally, the cilia of the epithelial cells thatline the airways make sweeping movements to keep the air-ways clean. The cilia move mucous, along with germs anddirt caught in the mucous, out of the respiratory tract. Airpollutants can irritate the cilia, so that their protective actionslows down or even stops. This leaves sensitive tissues un-protected. Then microorganisms and bits of foreign matterin the air are more likely to remain in the lungs. Here theycan cause infections, lead to the development of lung dis-eases like chronic bronchitis and emphysema, and increasethe chances of lung cancer.

Although the part of our bodies most affected by airpollutants is the respiratory system, the circulatory systemworks in close relationship with the respiratory system, soit can be affected too. If the respiratory system is dam-aged or diseased, then it will not be as effective at ex-changing gases with the blood. With less oxygen in theblood, the heart must work harder, pumping more bloodto deliver the same amount of oxygen to the body. In thisway, the heart and arteries can be stressed.

The Criteria Pollutants chart (see Handout 1) summa-rizes the health effects of the criteria pollutants. Each ofthem has different effects. For example, when we inhale

particulate matter (PM10

), these tiny bits of foreign mattertravel deep into the lungs where they become lodged inthe alveoli. These small, balloon-like sacs are the point inour bodies at which oxygen exchange occurs. This is wherethe lung removes carbon dioxide from the blood and re-places it with oxygen from the air. Very tiny particulates,those less than one micron, can stay trapped here for years.They can irritate the alveoli, reducing their ability to workproperly, and cause long-term chemical and structuraldamage to the lungs.

In contrast, carbon monoxide is unusual in that it hasno direct effect on the lungs but is absorbed by the blood.Carbon monoxide readily combines with hemoglobin inred blood cells, taking the place of some of the oxygenthat should be entering the bloodstream.

Every moment, we are interacting with the air aroundus. Our bodies are constantly exchanging molecules withthe atmosphere. Just as breath is essential to life, so too isthe quality of the air we breathe essential to good healthand the quality of our lives.

Source: Students For Clean Air. Clean Air Program. PimaCounty Department of Environmental Quality. Tucson, Arizona

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Lesson 7 Activity 1 - Symptom Scenarios

STUDENT WORKSHEET 1

1. Explain how much air we breathe every minute:__________________________________________________________

2. What fraction of the American people live where the air is often unhealthy to breathe?_________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Which body system is most likely to be affected by air pollutants?_______________________________________________________________________________________________________________________________________________

4. Who is affected by air pollution? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. Why is it difficult to determine the health effects of different air pollutants? _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6. Briefly explain how researchers study the health impacts of air pollution:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7. Which system, besides the respiratory system, can be affected by air pollution?_________________________________

8. Describe the health effects of particulate matter:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

9. Describe the health effects of carbon monoxide: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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TEACHERMATERIALS

Lesson 7 Activity 1


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Answer Key to Student Worksheet 1

1. Explain how much air we breathe every minute: Every minute of everyday, we breathe six to ten liters of air.

2. What fraction of the American people live where the air is often unhealthy to breathe? The Environmental ProtectionAgency estimates that four out of ten Americans live where the air is often unhealthy to breathe.

3. Which body system is most likely to be affected by air pollutants? Since the respiratory system comes in direct contactwith the air we breathe, it is the body system most likely to be affected by air pollutants.

4. Who is affected by air pollution? People who are young and healthy can be affected by pollution too. Air pollution canaffect anyone. Even healthy teenagers, young adults, and strong athletes can suffer negative effects from highpollution levels, especially when exercising outdoors.

5. Why is it difficult to determine the health effects of different air pollutants? It wouldn’t be ethical for researchers to just putpeople in a lab and expose them to high levels of a pollutant. People who live in heavily polluted areas are exposedto not just one pollutant but to many pollutants. Also, the concentration of each pollutant is changing all the time, insome cases independently of other pollutants. All of this makes it difficult to separate out the effects of each pollutant.In addition, how susceptible people are to the effects of air pollutants can vary widely.

6. Briefly explain how researchers study the health impacts of air pollution: One way to study the relationship between airpollution and health is to compare hospital records and death records to pollutant levels. Researchers have found thatduring extreme air pollution events, hospital admittance for respiratory problems increase. Death rates also increase,especially among the elderly and those who already have respiratory problems. In one study, scientists analyzedmedical records of several thousand people who lived in an area where pollutant levels went above the NationalAmbient Air Quality Standards for 42 days or more. These people were 33 percent more likely to have bronchitis, 74percent more likely to have asthma, and 37 percent more likely to have lung cancer than people who lived in an areawith clean air.

7. Which system, besides the respiratory system, can be affected by air pollution? Circulatory system

8. Describe the health effects of particulate matter: When we inhale particulate matter (PM10

), these tiny bits of foreignmatter travel deep into the lungs where they become lodged in the alveoli. These small, balloon-like sacs are thepoint in our bodies at which oxygen exchange occurs. This is where the lung removes carbon dioxide from the bloodand replaces it with oxygen from the air. Very tiny particulates, those less than one micron, can stay trapped here foryears. They can irritate the alveoli, reducing their ability to work properly, and cause long-term chemical and struc-tural damage to the lungs.

9. Describe the health effects of carbon monoxide: Carbon monoxide is unusual in that it has no direct effect on the lungsbut is absorbed by the blood. Carbon monoxide readily combines with hemoglobin in red blood cells, taking the placeof some of the oxygen that should be entering the bloodstream.

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STUDENTMATERIALS

Lesson 7 Activity 2


7-13


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7-15




Lesson 7 Activity 2 - Group Task Cards

GROUP TASK CARDPATIENT

You will play the role of the primary character describedon the Symptom Scenario card. Using information onthe card, you will introduce yourself to the class andthen answer questions from the class. A second pa-tient or a member of your family will be helping youanswer questions. After some time, if you feel thatthere is important information on your Scenario cardthat has not been covered by the questions you may

decide to volunteer that information.

GROUP TASK CARDCLASS MONITOR

It is your responsibility to maintain order and desig-nate whose turn it is to ask a question. Call on thosewith their hand raised so that they can ask questionsone at a time and everyone can hear the answers.You will want to pace the questions so that the Scribehas time to write the answers on the board.

GROUP TASK CARDFAMILY MEMBER OR SECOND PATIENT

Depending on the Symptom Scenario assigned to yourgroup, you will play the role of a second patient orsomeone in the patient’s family. Using informationon the Scenario card, you will introduce yourself tothe class and then help answer questions from theclass. If questions are asked which are not answeredon the Scenario card, you will consult with the patientabout how to best answer the questions (in a waythat would not alter the conclusion reached by theclass).

GROUP TASK CARD SCRIBE

You are responsible for writing information on theboard as the patient and his or her family memberanswer questions from the class. Making a list of thisinformation will make it easier for the class to focuson what they know so far, choose pertinent questionsto ask next, and determine the cause of the patient’ssymptoms.

7-16




SYMPTOM SCENARIO 1

First Patient: MARY MILLERSecond Patient: MARTIN MILLER

Use this information to introduce yourselves:My name is Mary Miller, and this is my husband Martin. When we woke up this morning, we both felt really terrible. Martinjust called the doctor and made an appointment for us to see her, but now our car won’t start. It seems to be out of gas.

Use this information to answer questions:

Mary is 68, Martin is 64Both have always been very healthy for their ageNeither has ever smoked cigarettesRetired from working as secretary (Martin) and bookkeeper (Mary)Neither has a history of respiratory, circulatory, or other major health problemsHobbies include seeing lots of movies and volunteering at the Dover Botanical GardensLive in Wilmington, on the east side of townHad planned to go to a movie last night, but went to bed early insteadWhat happened last night: It was cold, so Martin went out to start the car. He was going to start it and thenopened the garage door. But as soon as he started the car, Mary called him back inside to help her find herglasses. Then the phone rang. It was a friend calling, who really needed to talk about something that had upsethim. After that, they would have been late for the movie, but they both felt tired anyway, and so decided not togo.Slept longer than usual but both woke up still feeling tiredBoth felt really bad upon waking up in the morningMartin felt so awful that it seemed like he couldn’t think clearly; deciding to call the doctor, looking up the number,and makeing the call seemed hard to do

Source: Students For Clean Air. Clean Air Program. Pima County Department of Environmental Quality. Tucson, Arizona


7-17


SYMPTOM SCENARIO 2

Patient: F. GRIJALVAFamily Member: JORGE GRIJALVA (cousin)

Use this information to introduce yourselves:

My name is Francisco (or Francesca) Grijalva. I used to be a runner years ago. I stopped for a few years, but took it up againlast year. Lately I’ve been feeling short of breath in the middle of my run. This is my cousin Jorge, who is also my roommate.He’ll tell you that I’m a pretty serious runner.


34 years oldLives and works in central DoverWorks as a computer programmerWorks with a small, independent companyThe office building he works in is well-ventilatedRunning is an important personal interestOther hobbies include hiking, bird-watching, and surfing the NetSmoked from age 14 to 16, but “I quit when I got smart enough to know better”Roommate smokes, but only outside, so Francisco is not breathing Jorge’s smokeRan pretty regularly from age 20 to around age 30Started running again last year, in DecemberRan in the early morning, about 6:00 to 6:30 a.m., all winterIn April, started working an early schedule and running after work, around 2:00 p.m.Last winter, felt refreshed and really “up” after running, just like years agoHas been running very regularly and is confident he’s in good shapeLately has been feeling short of breath only halfway through a runBy the end of the run, often gets a tight, uncomfortable feeling in the chest areaHe also notices that he seems to cough and need to spit while running, which didn’t happen beforeHas never had any lung or respiratory problems in the pastCousin Jorge will vouch that Francisco has been running as regularly as he says—five or six times a week, for overa year—so this can’t be happening because he’s in poor shape





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SYMPTOM SCENARIO 3

Patient: RANDY CHUFamily Member: ELIZABETH SMITH (mother)


My name is Elizabeth Smith. This is my son Randy. I’m very worried about Randy’s eyes. Our optometrist is worried too. Everyfew months, Randy needs new glasses—stronger and stronger glasses.


Randy is 6 years oldThe optometrist can’t figure out why Randy’s eyes keep getting worseHe started kindergarten this yearThe teacher tells his mom that he’s a very active childShe also says he seems to be a little behind the rest of the classHe never went to preschoolHe’s gone to work with his mother for yearsNow she picks him up at her lunch break and takes him to workHis eyes don’t itch or hurt or bother him in any wayHe has no apparent physical or medical eye problems, other than declining visionHe’s just learning how to read, so he doesn’t spend a lot of time readingHe watches TV less than an hour a day, and always sits across the roomSometimes he plays outside in the evening, after he and his mom get home from workDuring the day, he brings his favorite toys and plays while his mom worksElizabeth works as a carpenterHer specialty is restoring the woodwork in old housesShe sands the old paint off the walls and door frames, repairs them, and refinishes the old wood


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SYMPTOM SCENARIO 4

Patient: J. JACKSONFamily Member: PAUL PETERS (stepfather)


My name is Jay Jackson. I’ve had asthma since I was little, although not all that bad compared to some people. Lately itseems to be getting worse. This is my stepdad Paul here with me today.


16 years oldBorn in Milford, Delaware and grew up in Laurel, DelawareMain personal interest is rollerbladingOther interests include following Blue Hen basketball, reading, and writing stories—especially stories abouthorses and about basketballRollerblading is his main form of exerciseFamily just moved from Laurel to Middletown, DelawareThey live in an apartment complex in Middletown (on a paved road, with paved parking)He can’t think of any particular way his life has changed since moving to Middletown; still spends about the sameamount of time skating, reading, and so onHe has been feeling pretty nervous about being in a new schoolHe thinks cigarettes stink and says he would never smoke one even if he didn’t have asthmaStepfather smokes, but because of Jay’s asthma, for many years he’s smoked only outside the houseAsthmatic reactions seem to be happening more often than they used to, and the reactions seem to be stronger alot of the time


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SYMPTOM SCENARIO 5

First Patient: KERRY KOLSCHOWSKISecond Patient: JOE SANCHEZ


My name is Kerry Kolschowski and this is my friend Joe Sanchez. All of a sudden tonight, in the middle of the game, it seemed

like we both just started dragging. We have no idea why we’ve suddenly lost our touch.


Playing a game of ice hockeyKerry is 20 years oldJoe is 21 years oldBoth in excellent healthBoth work out regularlyPlay hockey with Ice CatsKerry’s other interests include anthropology (his major), rollerblading, and surfing the internetJoe’s other interests are mathematics (his major), music, and his girlfriendDon’t smoke cigarettesThis all started just after the first intermissionThe game is at an indoor arenaUntil a few minutes ago, they both felt great and felt like they were playing wellSo after a break at the end of the first period, they expected to come back even strongerBoth are suddenly playing poorly and have missed the puck on what should have been easy shotsKerry is having trouble concentrating on the game, and is moving so slow that he’s not much good to the rest of theteamJoe says he feels really out-of-it, says he’s suddenly tired instead of energetic and alert like he was a little while ago;and says that trying to explain any more about how he feels would be hard to doBetween periods, the ice was resurfaced by the Zamboni (a gas-powered ice resurfacing machine)The temperatures in the rink and arena are about what they usually are; the spectators are wearing sweaters, butthe players still get hot while playing the game


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SYMPTOM SCENARIO 6

Patient: CHRIS CHAPMANFamily Member: ROSE CHAPMAN (his wife)


My name is Chris Chapman. My doctor just told me that I have a pre-cancerous growth in my lungs. This is a very seriousdiagnosis. My wife Rose and I are both stunned and upset by what the doctor said. My health has always been pretty good,so I feel upset and confused.


Chris is 62 years oldHe retired early, at age 50Never smoked cigarettes or anythingUsed to work for the city as a technician installing and repairing traffic lightsThey live in the city of Wilmington because they like living near their children and grandchildrenLove kidsEvery Monday through Friday, ever since retiring, Chris volunteers as a school crossing guard at a busy intersection,helping kids get across the streetHe does this for an elementary school and a middle school, that start at two different times, so he’s out there almosttwo hours each morning and two hours each afternoonLikes to wear white shirts, even though they always look really dirty after doing the crossing guard workThey live in an apartment near the same intersectionHis hobbies include bowling, going to grandchildren’s soccer and softball games, babysitting for the youngestgranddaughter, and staying in close touch with world newsNot really into exercise or working outRose and Chris take a walk around the neighborhood a couple of times each week, usually right after he finishescrossing guard duty


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SYMPTOM SCENARIO 7

Patient: JERRY WOLAKSecond Patient: DOT WOLAK


My name is Jerry Wolak and this is my partner Dot. We live together in Lewes, Delaware. We came back from our afternoonwalk feeling just awful.


She’s 48 years oldHe’s 58 years oldThey take a brisk walk together almost every day, in mid-afternoonUsually walk two miles, along a local canal, where it’s quiet and there’s no trafficJerry’s interests include cooking, woodworking, and fishingDot’s interests include painting and playing drums with a jazz bandToday was a beautiful sunny day and the first really hot day of springToday they took a different route than usualThe traffic was backed up for several blocks on Kings Highway, and they were curious why, so they decided to turnup that road and see for themselvesEnded up sitting by the road for an hour in the middle of the walk, talking with a friend who was stuck in the gianttraffic jamNear the end of the walk, both Jerry and Dot started wheezing and coughingDot was feeling some nauseaJerry felt like his asthma was acting up for the first time in years, and he even had chest pains


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Lesson 7 Activity 2 - Student Worksheet 2

Name:______________________________________________________________Date: ___________________________

Class:_______________________________________________________Period or Block:___________________________

Problem:How is human health affected by specific air pollutants?

Materials (per group):Symptom Scenario card - 1 onlyGroup Task Cards - 1 set of four cards

Procedure:1. Review Student Worksheet #1 and the Criteria Pollutants chart.

2. As a group, analyze the information on your Symptom Scenario card. Using Reading #1 and the Criteria Pollutantschart, discuss and come to agreement on the probable cause of your patient’s symptoms. Then answer the one setof questions below that are specific to your group’s scenario.

3. In preparation for presenting your Symptom Scenario to the class, choose roles from the Group Task Cards, witheach member of the group assuming a different task.

4. As each group presents their scenario to the class, the remainder of the class will complete the appropriate set ofquestions below. You may refer freely to the background reading and the Criteria Pollutants chart throughout theactivity.

Symptoms - note key symptoms or behaviors in the patient.Probable cause - Note the pollutant that is most likely to cause these symptomsPrevention - Note precautions that could have been taken to prevent or decrease the likelihood of thisproblem arising.

Observation and Conclusions:

1. Mary and Martin Miller (retired movie buffs)

Symptoms: ___________________________________________________________________________________

Probable Cause:_______________________________________________________________________________

Prevention: ___________________________________________________________________________________

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2. F. Grijalva (young adult runner)

Symptoms: ___________________________________________________________________________________

Probable Cause:_______________________________________________________________________________

Prevention:___________________________________________________________________________________

3. Randy Chu (kindergarten student)

Symptoms: ___________________________________________________________________________________

Probable Cause: ______________________________________________________________________________

Prevention:___________________________________________________________________________________

4. J. Jackson (teenager with asthma)

Symptoms: ___________________________________________________________________________________

Probable Cause:_______________________________________________________________________________

Prevention: ___________________________________________________________________________________

5. Kerry Kolschowski and Joe Sanchez (ice hockey players)

Symptoms: ___________________________________________________________________________________

Probable Cause:_______________________________________________________________________________

Prevention: ___________________________________________________________________________________

6. Chris Chapman (crossing guard)

Symptoms:___________________________________________________________________________________

Probable Cause:_______________________________________________________________________________

Prevention:___________________________________________________________________________________

7. Jerry and Dot Wolak (middle-aged walkers)

Symptoms: ___________________________________________________________________________________

Probable Cause:_______________________________________________________________________________

Prevention: ___________________________________________________________________________________

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Critical Thinking and Applications:

1. Imagine that you and a friend started working out and running together a few weeks ago, meeting each day at 5:00p.m. Today your friend proposes trying a new jogging route. One possibility is the Brandywine River, and another isthe Delaware Freeway (I-95). Explain which route you prefer and why.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Imagine that your family has just moved into a house built in the 1940s. The exterior of the house needs to be painted,and this weekend you will be helping sand and scrape the old, peeling paint to prep for repainting. Explain whatpollutant(s) may be of concern and any precautions you would take.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Imagine that you have been training for a bicycle race, and the day of the race is here. Ozone levels in Wilmington,where you have come for the race, are at .125 ppm. One group of cyclists is asking the race committee to reschedulethe race. Another group of cyclists, many of whom have driven some distance, are upset that the race may berescheduled. Explain which group you agree with and why.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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TEACHERMATERIALS

Lesson 7 Activity 2


7-27





ANSWER KEY TO STUDENT WORKSHEET 2

Problem:How is human health affected by specific air pollutants?

Materials (per group):Symptom Scenario card - 1 onlyGroup Task Cards - 1 set of four cards

Procedure:1. Read the background information and review the Criteria Pollutants chart.

2. As a group, analyze the information on your Symptom Scenario card. Using the background reading and the CriteriaPollutants chart, discuss and come to agreement on the probable cause of your patient’s symptoms. Then answerthe one set of questions below that are specific to your group’s scenario.

3. In preparation for presenting your Symptom Scenario to the class, choose roles from the Group Task Cards, witheach member of the group assuming a different task.

4. As each group presents their scenario to the class, complete the appropriate set of questions below. You may referfreely to the background reading and the Criteria Pollutants chart throughout the activity.

Symptoms - note key symptoms or behaviors in the patient.Probable cause - Note the pollutant that is most likely to cause these symptomsPrevention - Note precautions that could have been taken to prevent or decrease the likelihood of this prob-lem arising.

Observation and Conclusions:

1. Mary and Martin Miller (retired movie buffs)

Symptoms: tired/drowsy; reduced alertness and reduced ability to think clearly; also decreased ability to per-form basic tasks such as calling to schedule an appointment

Probable Cause: carbon monoxide poisoning

Prevention: never run a car or any internal combustion engine in a closed space; even outdoors, avoid breath-

ing exhaust from any engine

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TEACHER NOTES FOR DISCUSSION: Carbon monoxide poisoning is obviously the problem here, accounting for

both the couple’s physical symptoms and the impaired mental clarity reflected in the difficulty of scheduling a doctorappointment.

2. F. Grijalva (young adult runner)

Symptoms: feeling short of breath, experiencing tightness in chest, coughing and spitting while running,symptoms occurring during outdoor exercise on summer afternoon

Probable Cause: ozone exposure

Prevention: exercise indoors, or exercise outdoors in the early morning, before ozone levels begin to rise

TEACHER NOTES FOR DISCUSSION: Exposure to high ozone concentrations can affect even healthy teens andadults. In this scenario, the time of day and time of year at which the problem occurs provide clues that ozone, ratherthan another pollutant, is likely to be responsible.

3. Randy Chu (kindergarten student)

Symptoms: not doing well in school, vision is deteriorating on an ongoing basis

Probable Cause: lead poisoning, from breathing lead paint dust

Prevention: Young children should not be present when old paint is being sanded. Anyone present shouldwear a protective mask or respirator

TEACHER NOTES FOR DISCUSSION: Randy has probably been exposed to high levels of lead by breathing dustfrom old paint as it is sanded. This could be linked not only with his vision problem but with his behavior andperformance at school. Since leaded gasoline has been phased out, lead poisoning from auto exhaust is no longera problem in the U.S. However, lead poisoning can also occur in young children from breathing lead paint dust,ingesting soil contaminated with lead paint flakes, chewing on woodwork or toys with leaded paint, etc. Althoughyoung children are most susceptible, everyone should wear a dust mask or respirator when preparing old paintedsurfaces for repainting.

4. J. Jackson (teenager with asthma)

Symptoms: asthma problem has increased in frequency and severity, since moving from a small town to the city

Probable Cause: exposure to higher levels of pollutants in general, rather than to a single particular pollutant

Prevention: track pollutant levels given with the weather forecast and avoid outdoor activities on days withunusually high levels, or engage in outdoor activities at times of day when pollutant levels are lowest

TEACHER NOTES FOR DISCUSSION: Particulate matter, ozone, nitrogen dioxide, and sulfur dioxide can all aggra-

vate the condition of those who already have asthma or other lung problems. In this case, it is not possible to singleout a particular pollutant as a primary influence. This would be a common situation in real life. Also, although it isvery likely that the poorer air quality in Wilmington would aggravate the asthma, emotional stress is also known toinfluence asthma. It seems likely that both of these would be contributing factors in this case.

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5. Kerry Kolschowski and Joe Sanchez (ice hockey players)

Symptoms: feeling tired, having trouble concentrating, being less alert, having slower reflexes, decreased ability toperform familiar tasks, all as evidenced by the players’ comments and that they’re missing “easy shots”

Probable Cause: carbon monoxide poisoning

Prevention: internal combustion engines should not be used in enclosed spaces; the arena should be using anelectric resurfacing machine

TEACHER NOTES FOR DISCUSSION: The players’ symptoms began just after the ice was resurfaced by a gas-powered Zamboni. The U.S. Center for Disease Control has documented several instances of ice hockey playerssuffering carbonmonoxide poisoning from gas-powered resurfacing machines used in indoor arenas. Carbonmonoxide poisoning has also been documented in individuals employed in ice hockey arenas.

6. Chris Chapman (crossing guard)

Symptoms: long history of exposure to many pollutants through work as a traffic lights technician and acrossing guard at a busy intersection; the white shirt getting dirty hints that particulates rather than justgaseous pollutants are involved

Probable Cause: exposure to high levels of air pollutants in general, especially but not exclusively particulates

Prevention: avoid ongoing exposure to high levels of pollutants

TEACHER NOTES FOR DISCUSSION: Increased likelihood of lung cancer is one of several respiratory conditions thathave been linked to ongoing exposure to high PM

10 concentrations. However, much of the research on this topic has

involved populations exposed to particulates with high levels of certain metals, such as those released at smelters.Compared to some of the other scenarios presented here, this case is less clearly the result of pollution. Also, it isinteresting to note that ambient levels of primary pollutants from motor vehicle exhaust are significantly higher atbusy intersections than they are only one city block away.

7. Jerry and Dot Wolak (middle-aged walkers)

Symptoms: wheezing and coughing, feeling queasy, chest pain, asthma acting up; and this occurred duringmid-afternoon on a warm day, along a busy road with a traffic jam

Probable Cause: ozone exposure

Prevention: avoid exercising along busy roads, and avoid exercising during the times of day that ozone levelsare highest

TEACHER NOTES FOR DISCUSSION: The time of day and that it’s a warm, sunny day are clues that ozone is theproblem, in addition to the actual physical symptoms. The situation does not reflect only the patients’ ages. Re-search has shown that even trained endurance athletes can suffer similar symptoms at high ozone concentrations.Effects of ozone exposure documented in athletes include being unable to complete a regular routine, postingslower times in a race, and other performance problems.

7-30


Critical Thinking and Applications:

1. Imagine that you and a friend started working out and running together a few weeks ago, meeting each day at 5:00p.m. Today your friend proposes trying a new jogging route. One possibility is an indoor track at a health club, andanother is a major highway. Explain which route you prefer and why.

The health club would be preferable. This would avoid unnecessary exposure to high levels of various airpollutants, primarily from motor vehicles.

TEACHER NOTES FOR DISCUSSION: The notes for scenario 2 apply here as well.

2. Imagine that your family has just moved into a house built in the 1940s. The exterior of the house needs to be painted,and this weekend you will be helping sand and scrape the old, peeling paint to prep for repainting. Explain whatpollutant(s) may be of concern and any precautions you would take.

Lead and particulates would be the pollutants of concern. All involved in the work should wear a dust mask ora respirator, depending on the amount of dust generated.

TEACHER NOTES FOR DISCUSSION: Lead-based paints were the norm until 1977, so this house is likely to havemultiple coats of leaded paint. If only scraping is involved, dust masks would suffice. If much sanding is being done,so that finer particulates are being created, respirators should be used. Also, drop cloths should be used to collectthe bulk of the old paint flakes and dust rather than letting them fall to the soil.

3. Imagine that you have been training for a bicycle race, and the day of the race is here. Ozone levels in Wilmington,where you have come for the race, are at .125. One group of cyclists is asking the race committee to reschedule therace. Another group of cyclists, many of whom have driven some distance, are upset that the race may be resched-uled. Explain which group you agree with and why.

Many athletes would want the race to be rescheduled so that they could avoid exercising at this concentrationof ozone.

TEACHER NOTES FOR DISCUSSION: There is no single correct answer to this question. EPA guidelines suggest thatthe general population avoid outdoor activity at ozone levels above .125 parts per million, as this is the level at whicha majority of healthy individuals will experience decreased exercise tolerance. However, irritation symptoms canoccur in the normal population at levels over .80. Some people would consider it prudent to avoid exercising at lowerlevels as well.


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STUDENTMATERIALS

Lesson 7 Activity 3


7-32





HANDOUT 1 - ESSAY

Name _________________________________________________________ Date _____________

Subject________________________________________________________ Block or Period ________

DIRECTIONS: You will write an essay explaining whether we as individuals can accept full responsibility for the extent to

which our health is impacted by air quality, or whether government and industry must also assume some responsibility. Be

sure to give supporting details for your explanations. Your essay should reflect evidence of research and a course of action

that you propose to ease the health impacts of air pollution. Be sure to give reasons for your course of action.

_____________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________________________________

______________________________________________________________________________________________________

__________________________________________________________________________________________________________

_________________________________________________________________________________________________________

__________________________________________________________________________________________________________

_____________________________________________________________________________________________________

____________________________________________________________________________________________________

_____________________________________________________________________________________________________

____________________________________________________________________________________________________

________________________________________________________________________________________________________

______________________________________________________________________________________________________

_______________________________________________________________________________________________________

________________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_________________________________________________________________________________________________________________

________________________________________________________________________________________________________

_______________________________________________________________________________________________________

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SCORING RUBRIC FOR ESSAY

4 - The essay is clear and well developed3 - The essay is somewhat clear and well developed2 - The essay is vague and somewhat developed1 - The essay is vague and not well developed0 - The essay was not attempted and not developed

0 1 2 3 4

1. Explanation of responsibility _____ _____ _____ _____ _____ x 5 = _____P.I. C.416

2. Supporting details _____ _____ _____ _____ _____ x 5 = _____P.I. 9.75 (Science)

3. Evidence of research _____ _____ _____ _____ _____ x 5 = _____P.I. H.405; 9.75

4. Course of action needed _____ _____ _____ _____ _____ x 5 = _____P.I. G.404; 9.75; H.408

5. Reasons for action proposed _____ _____ _____ _____ _____ x 5 = _____P.I. H.408

GRADE _________

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WHAT ARE THE HEALTH IMPACTS OF AIR … ARE THE HEALTH IMPACTS OF AIR POLLUTION? ... INTRODUCTION OF...

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