Why do we ignore ‘smoke’ and health risks from idling cars?

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I had occasion recently to go to United Hospital in Saint Paul for a minor medical procedure. Entering the “tobacco-free campus,” I passed three cars and one truck parked right by the entry doors with their engines idling.
Why do we worry about the health effects of smoke from a burning cigarette but ignore “smoke” from other sources?
The harmful health and environmental effects of the substances emitted by a vehicle’s tailpipe have been very well documented. But just as an example, let us briefly consider one notorious culprit: nitrogen dioxide. This gas occurs in both cigarette smoke and car exhaust, but defenders of “tobacco-free” environments might be interested to learn that cars and trucks, rather than burning cigarettes, account for 35% of the total amount of this pollutant in our regional air (Minnesota Pollution Control Agency website).
Short-term exposure to nitrogen dioxide can trigger asthma attacks but might also be associated with more systemic effects like reduced cardiovascular function.
However, researchers are more certain when it comes to long-term exposure, which is associated with a variety of pathological conditions: cardiovascular disease, diabetes, cancer and overall increases in premature mortality. (U.S. Environmental Protection Agency website) All of the research carried out by government, academic and environmental defense institutions re-enforces the same point: vehicle exhaust is harmful to human health.
While it is true that innovations over the years have led to great reductions in the quantities of toxins released into the air by individual vehicles, the size of the vehicle fleet nationwide, and, indeed, in the world, has continued to grow, and the improvements simply can’t keep pace with the huge increase in the number of offending sources. (Special Report 17 of the Health Effects Institute) And we haven’t even considered the problem of carbon dioxide, which is released, unfiltered, by even the most advanced smog-control devices.
This takes us back to our four vehicles parked with their engines running at the entrance to United Hospital. I believe it is time to initiate a public information campaign regarding the great waste and harm that is caused by the widespread habit of idling engines unnecessarily.
The U.S. Department of Energy has a report on its website that summarizes the situation without much room for objection or contradiction. In the U.S., “personal vehicle idling wastes about 3 billion gallons of fuel and generates around 30 million tons of CO2 annually.” The site also reminds us that when its engine is idling, a vehicle’s smog equipment is working in its least efficient state, and higher-than-normal levels of all pollutants are released into the air.
An Environmental Defense Fund study for New York City attempted to quantify the specific amounts of pollutants produced by idling. For example, they determined that, annually, public and private vehicles parked with their engines idling within the city limits produce 940 tons of nitrogen oxides.
They report that this is equivalent to the amount that would be produced by 9 million trucks driving across the city from one end of the Bronx to the other end of Staten Island.
The report gives these same sorts of alarming details for all of the various harmful substances produced annually by idling vehicles within the city limits. When you look at the various government websites on this issue around the world, the “anti-idling” message is remarkably consistent, and the amount of CO2 and other harmful emissions that could potentially be kept out of the air is monumentally high.
This campaign needs to be extended to all vehicles: private and public, whether stopped by the side of the road or even waiting in line at a “drive-thru” window. Recommendations for public and commercial vehicles need to be worked out, and there obviously could be exceptions, but the fact of the matter is that drivers of these sorts of vehicles park with their engines idling in a great number of situations where they have absolutely no reason to do so.
Although some metropolitan regions across the country and around the world actively enforce ordinances against this practice with fines to drivers, I believe a public information campaign would be much more effective than punishment and alienate fewer drivers. After all, this is not a malicious act, and it most likely results from the great amount of time that people spend in their vehicles.
Driving in general is such a given part of our daily lives here that most of us don’t give it a second thought except when there’s heavy traffic, bad weather or road construction. But our transportation system based almost exclusively on private automobiles causes many problems that aren’t always fully acknowledged or addressed.
Engine idling is not just the innocent, absent-minded habit of a few drivers stopped momentarily to pick up passengers or check their phones.
It is a very widespread practice with very measurable and harmful impacts on our health and the environment.

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