Clean Air Carolina provided Novant Health with signs encouraging people to not let diesel-powered vehicles to idle unnecessarily. This one was posted at its Mint Hill Hospital construction site.
Clean Air Carolina provided Novant Health with signs encouraging people to not let diesel-powered vehicles to idle unnecessarily. This one was posted at its Mint Hill Hospital construction site. Photo credit: Novant Health

In Charlotte, a collaboration blooms that reduces air pollution at two medical construction sites.

By Catherine Clabby

What happens when a big-league health system, clean-air advocates and construction companies sit down at the same table?

Medical values influence building projects, averting some pollution at two health system construction sites.

Clean Air Carolina provided Novant Health with signs encouraging people to not let diesel-powered vehicles idle unnecessarily. This one was posted at its Mint Hill Hospital construction site. Photos courtesy Vannoy Construction

And clean-air advocates dream of the same thing happening across the state.

The nonprofit Clean Air Carolina recently gave Novant Health, along with two construction companies, one of its Air Keeper’s awards. At Novant’s urging, Rodgers Leeper and Vannoy Construction limited use of older (and therefore more polluting) diesel-powered equipment during construction at Novant’s Matthews and Mint Hill properties.

They also curbed idling by trucks at the work sites and moved some tasks, such as mixing cement, to locations where fewer people would be exposed to diesel emissions, said Joe Fiorenza, Novant’s director of corporate construction operations.

Fine and ultrafine

Fiorenza was unaware of the risks from diesel exhaust until he saw Thomas Zweng, Novant’s medical director and an ally of Clean Air Carolina, give a presentation describing those problems, he said.

Burning diesel releases nitrogen oxides, which contribute to the formation of ground-level ozone, a respiratory irritant that causes coughing and choking and impairs lung capacity. Diesel combustion also produces soot containing damaging fine and ultrafine particles.

Ultrafines are insidious. Produced during the combustion of diesel, the particles are often attached to heavy metals and toxic compounds. They’re small enough to squeeze between the cells deep in the lungs and enter our bloodstreams.

Larger soot particles can irritate eyes, nose, throat and lungs. They have also been linked to lung cancer.

Both kinds of particles can worsen asthma and heart and lung disease, especially among children and older people.

At any construction site, workers are at risk of harmful diesel-emissions exposure. At medical construction sites already hosting patients, the toxic brew can seep inside and reach vulnerable people.

“Doing something made sense,” Fiorneza said. “When we talked to contractors, they wanted to protect patients, the environment and their employees too.”

June Blotnick, executive director of Clean Air Carolina, has wanted hospitals in and near Mecklenburg County to take steps to reduce diesel emissions at construction sites for years.

“With the research showing how toxic and how dangerous diesel emissions are, it’s important to take steps,” she said.

Replacing older diesel engines or retrofitting them with diesel particulate filters, required on new diesel-powered vehicles, is an extremely effective way to reduce harmful emissions, she said.

Stalled by the recession

About five years ago, Blotnick asked the Mecklenburg County Medical Society’s public health committee to pass a resolution requesting hospitals to reduce emissions. The committee, led by Zweng, met with local contractors to start a discussion. At the time, Zweng was Novant’s vice president of medical affairs in the Charlotte market.

The proposal started a needed conversation. But the timing – at the height of the recent recession – stalled the push.

Zweng briefed a local chapter of the Association of General Contractors about the dangers of diesel pollution from construction equipment, but the contractors could not commit to reducing their emissions quickly, “There was no money for upgrading equipment,” Blotnick said.

A few years later, when Blotnick learned that Novant had two construction projects planned in Mecklenburg County – a new hospital in Mint Hill and a Women’s Center in Matthews – she reached out to Zweng.

The presentation Fiorenza saw was one result. So was a meeting with Rodgers Leeper, Vannoy Construction, the medical director of the Mecklenburg County Health Department and Medical Advocates for Healthy Air, among others.

The construction companies agreed to track all the diesel-powered equipment to be used in the projects and to use as much diesel-powered equipment as possible that met the strictest EPA diesel emission controls. Equipment meeting EPA’s Tier 4 standards use pollution-control technologies that eliminate most off-road diesel engine emissions.

More change to come

Fiorenza wants to try to integrate the approach into more Novant construction projects, he said. Blotnick has goals for the future too.

Something as simple as a spreadsheet, where construction companies can keep track of the diesel-powered equipment they use on a building site, offers insight into potential emissions. Clear Air Carolina gave this one to Novant Health and its construction firms.

She hopes to create a hospital clean-air certification program that could help all North Carolina hospitals voluntarily reduce unhealthy air emissions on their grounds, from their constructor sites to the curbs outside their emergency departments, where sick people are very likely to be exposed to exhaust.

Such moves, Blotnick said, are in step with a national and international do-no-harm movement advanced in health care by groups such as Health Care Without Harm.

The movement opposes polluting management of hospital waste, including the careless burning of trash, such as plastics, that can produce PCBs and dioxins; the use and release of toxic chemicals, including mercury, in any context; and much more.

The Diesel Clean-Up Campaign is more specialized. It works nationally with hospitals and other institutions to urge them to improve air quality on their properties by reducing diesel emissions.

Having watched the spread of no-smoking-anywhere policies at North Carolina hospitals in recent years, Blotnick said she is optimistic that the movement to rid health care properties of toxic diesel emissions can spread too.

In time.

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Catherine Clabby

Catherine Clabby (senior environmental reporter) is a writer and editor. A former senior editor at American Scientist magazine, Clabby won multiple awards reporting on science, medicine and higher education...

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