The following is an excerpt from Beth Gardiner’s Choked: The Age of Air Pollution and the Fight for a Cleaner Future, in which the author travels the world to meet the scientists who have transformed our understanding of pollution’s effects on the human body, and to trace the economic forces and political decisions that have allowed it to remain at life-threatening levels. But she also focuses on real-world solutions, and on inspiring stories of people fighting for a healthier future. Choked: The Age of Air Pollution and the Fight for a Cleaner Future is now available from Granta Books.


What Comes Next

Crisscrossing the world on an itinerary built around pollution, I’ve listened, in a half-dozen time zones, to stories of dirty air’s effects spilling forth in nearly as many languages: Mandarin and Hindi, Polish and Spanish and English. I’ve seen the depredations of terrible pollution, the confluence of political and economic power that too often allows it to persist, and the despair it can bring — the despondent shrugs of people who no longer believe those in charge care what happens to them. Stewing in London’s diesel mess, I’ve sometimes felt that hopelessness myself.

But I’ve also found cause for optimism. Leading utterly different lives on opposite sides of the globe, people fighting the same fight have invited me in to watch it unfold. Doing what they can to ensure their families and their neighbors and perfect strangers can fulfill that most basic human need — the need to breathe, and to breathe air that isn’t poisoned.

Of course, individuals can’t solve this problem alone. Only our governments have the power to stop polluters who’ve shown, again and again through the years, that they’ll put profit over human lives unless we force them to change.

In a sunny office in upstate New York, Tom Jorling handed me a copy of a law that did just that, the one he helped draft with his old friend Leon Billings in the months just before I was born. A law that, for all its technical language, is, at bottom, a statement of values, a declaration of what we are prepared to accept and what we will not. The Clean Air Act of 1970 was voted into the statute books by a generation of public servants all but passed now, a generation that included, among others, a Republican senator named Howard Baker, so proud of the part he played in its passage that he later said he’d be honored to have it etched on his tombstone.

That generation’s gift to us, their children and grandchildren, is air far cleaner than it once was, far cleaner, because of their work, than the stuff I breathe in London. It’s a living inheritance, though, a legacy that must be defended and extended if we are to bequeath it to our own children. Instead, many Americans have come to take it for granted, forgetting the long, hard battles that brought us where we are. And the ever- present truth that what’s been won can also be lost, that the gains of the past offer no guarantees for the future. While clean air feels like a birthright, it can disappear in a puff of smoke if the rules created to protect it, and the enforcement that gives those rules teeth, are unraveled.

As we absorb that painful reality, a rising power on the other side of the globe is searching for a way to replicate the achievements of an American agency that was, not so long ago, the envy of the world, but has more recently suffered an onslaught of presidential hostility, emerging weakened and undermined: the EPA. Through the choking filth they still endure, China’s leaders and its people can see what we, with our clearer skies, now struggle to keep in focus: the value of a public guardian, guided by science and empowered by the law, to protect human health and draw lines polluters may not cross. India lags further behind, but perhaps someday its people, and their neighbors across South Asia, and others far beyond, will have such a protector, too, and be able to breathe air that’s not horrendous.

There’s another lesson in our history, one that offers a valuable signpost for today: The benefits of cleaner air almost always dwarf its costs. When we’re contemplating change, the price tag tends to loom larger, and those who will have to pay often exaggerate it, hoping we’ll shy away from action. But when polluters are forced to clean up, they buckle down and find the cheapest way to do it. That determination often brings innovations that make change quicker and easier than predicted. And while the cost is less than we’d feared, the benefits are often much larger, multiplying in a cascade of well-being and rising productivity. Spread among millions of people, they can be hard to see, but that doesn’t make them any less real.

After all my travels, I can see now what I couldn’t when I started. In the suffering pollution brings, there is also the glimmer of a different future, its outlines visible through the haze. Because as we come to grasp dirty air’s dangers, there is something else we should understand: This is not an insoluble puzzle, a problem to which we must resign ourselves. We know how to fix it. If we do, we’ll reap the rewards, in lives saved and health improved, almost immediately. That’s what scientists like Ed Avol and Jim Gauderman have shown us, with help from the thousands of children whose breath they measured, year after year, in school gyms and lunchrooms. With every new study, they and others like them remind us why we must move forward, not back.

Yes, there are small-scale fixes, simple and necessary. Like the filters ready to snap onto smokestacks of ships moored in a Californian harbor, or the dockside electricity that lets them still idling engines. Like New York City’s push to rid itself of the dirtiest heating oil when it saw that outdated furnaces in just 1 percent of buildings were creating more soot than all its traffic. And bigger solutions, too, like the rejection Britain, and all of Europe, must finally deal to diesel.

Such changes will bring meaningful improvement: fewer heart attacks, less cancer and asthma and dementia. But the real answer, the one with the power to bring truly healthy air— along with another, even greater prize – lies in a more fundamental change. A shift, at long last, away from fuels that, while they poison our bodies, are also wrecking our planet.

Looming over the air pollution crisis, of course, the frightening backdrop to the stories of this book, is the existential threat of cli-mate change. We’re already feeling its effects, in weird, unseasonable weather, vicious storms, and temperatures that seem to be always shattering records. The warning lights are flashing, more urgently than ever. But for most of us, this is a danger that still feels abstract, distant. Not as pressing as one that hits us where we live, threatening our very bodies and those of our children and parents.

That, it turns out, is where the good news multiplies. Because the changes that will lengthen, and improve, lives in the here and now are the same ones with the potential to save us from the most catastrophic dangers of runaway warming. For these two crises are deeply intertwined, both symptoms of the unhealthy foundation on which we have built our world: fossil fuels. Both will abate only when we replace those fuels with something better. When we finally end the reign of coal, which has brought industrialization and prosperity in so many places, but whose dark side has blighted lives for far too long now, and on which we no longer need to rely. And wean ourselves as well from gasoline and diesel, and the oil from which they come. A revolution, too, in the way we get around: cleaner cars, and fewer. The building blocks of a different kind of world, healthier and more resilient.

The change we need now is more dramatic, more radical, than the steps we’ve taken in the past. The price of not making the leap is greater than before, but the rewards will be too. Ending millions of lives every year and blighting many more, air pollution is cause enough for action. But the imperative of confronting climate change means something even bigger is at stake: our very survival, on a planet capable of supporting us, one where floods don’t drown our biggest cities and drought doesn’t parch the fields that feed us.

While it can be difficult to imagine a world different from the one we know, it is within our reach. The unconscious mind controls breathing and so many of the body’s other vital functions, but the decisions that determine the parameters of all our lives ought to be made consciously. We have a choice: We don’t have to give our cities over to the cars crowding their roads, don’t have to let the ships that underpin our global economy poison the bodies of those who live along coasts, don’t have to accept that simply stepping outside can sap our strength.

I believe we have it in us to rise to the challenge, to create something better than what we were given. In the end, it’s up to us. We hold the power to build a cleaner, healthier future. One in which breathing, life’s most basic function, no longer carries a hidden danger.




Deep inside the body, the oxygen delivered by the breath is on its way to the muscles, the organs, the brain. The carbon dioxide they must be rid of is filling the lungs, ready to make its escape. As the muscles of the chest wall relax, the ribs fall inward, and down, and the diaphragm springs into a dome. The chest is too small to hold all that stale air now, and the tightening confines push it back out. The breath retraces the path it took seconds earlier, whooshing upward through the bronchi, over the voice box, then out. Borrowed only for a moment, now returned. Released, again, into the world.

There’s just an instant’s pause before the cycle begins once more. No rest, as the body demands the thing it cannot do without. In and out, again and again, hour after hour, day after day. From the moment of birth until our time reaches its end.

Life. Breath. Air.

Two Poems