Table 4 Examples of recommendations to reduce air pollution and prevent pollution-related disease

Community-level Recommendations:

•.Convert all municipal vehicle fleets – cars, trucks, buses - to hybrid and fully electric vehicles

•.Place solar panels on the roofs of municipal buildings

•.Preferentially purchase electricity produced by renewable energy

•.Block construction of gas pipelines, compressor stations and other components of the natural gas network

•.Prohibit gas hook-ups in new construction

•.Revise building codes to increase energy efficiency

State- and National-Level Recommendations:

•.State authorities must urge the US Environmental Protection to tighten federal air quality standards for PM_2.5 pollution to better protect health. The occurrence of disease, premature death and cognitive impairment at PM_2.5 pollution levels below current federal standards is clear evidence that these standards are not sufficiently protective of health. Current federal air pollution standards fail especially to protect the health of children. A critical next step will be lowering of the federal air quality standard for PM_2.5 pollution to at least 5 μg/M³.

•.State Departments of Environmental Protection must add more air monitoring stations and increase the density of the statewide Ambient Air Quality Monitoring Network. There is particular need to prioritize placement of air monitoring stations in economically disadvantaged and socially vulnerable communities. The current sparse network of air monitoring stations makes it impossible to quantify air pollution’s health effects at the neighborhood level and thus impedes assessment of localized differences in air pollution’s health impacts.

•.State Departments of Environmental Protection must publish an annually updated, open-source air pollution emissions inventory in an easily accessible, interactive dashboard-style format.

•.State Departments of Public Health must create an open-access dashboard that annually tracks and publicizes information on pollution-related disease and death in each county, city and town

•.State and national governments must require operators of electric power grids to favor renewable energy over electricity produced by fossil fuel combustion

•.State and national governments must reduce pollutant emissions and air pollution levels by accelerating progress away from fossil fuels toward net zero carbon. Fossil fuel combustion is the major source of both air pollution and greenhouse gas emissions and is the predominant source of the air pollution produced in Massachusetts. The most effective strategy for reducing air pollution, preventing air-pollution-related disease, and achieving net zero carbon is through a rapid, wide-scale, government-supported transition from away all fossil fuels — coal, gas, and oil – to clean, renewable energy. Two powerful tools for accelerating this transition are to phase out all governmental subsidies and tax breaks for the fossil fuel industry, while at the same time increasing incentives at both the individual and system levels for wind and solar power.

•.State and national governments must recognize the significant health and environmental impacts of methane gas and resist the temptation to continue to rely on gas for power generation and heating. Methane gas has been marketed as a “transition” fuel – a “bridge” from coal and oil to the clean energy sources of the future. However while methane provides some reductions in pollution compared to coal and oil, it is a polluting fuel, a potent driver of global warming and is associated with health and environmental hazards at every stage of its life cycle. Gas extraction by hydraulic fracturing, “fracking”, releases vast quantities of methane to the atmosphere and contaminates air and groundwater. Pipelines and compressor stations experience leaks and explosions. Gas combustion generates greenhouse gases and air pollution by oxides of nitrogen (NO_X).

•.State and national governments must end all subsidies and tax breaks for the fossil fuel industry

•.State and national governments must resist any temptation to move to nuclear power