In the middle of the night, Casandra Cabrera stopped breathing. She doubled over in bed, gasping for air. In the panic that followed, her lungs constricted. Her eyes filled with tears. The asthma attack continued for 10 long minutes.
"I keep an inhaler with me everywhere. I have one in my purse, in my sports bag, and in my truck and by my bedside," the San Joaquin Valley, Calif., teenager said. "I've never really imagined life without it. It's kind of normal for me."
It's normal for many children, especially those in California, home to the country's worst air pollution. More than 5 million people in the state have been diagnosed with asthma, which is caused, in part, by contamination from nitrogen compounds, pollutants that stem from the farming and transportation industries.
Climate change is expected to compound the issue, according to a new body of work published in the journal Issues in Ecology. Higher temperatures and an increased risk of drought on the West Coast essentially "cook" the nitrogen, resulting in nitrous oxide and ozone. These nitrogen byproducts cause cardiovascular and respiratory diseases, especially among the region's rural and urban poor who don't have the money to move away and reduce their exposure.
"We have a lot of poverty. This is one of the poorest regions in the country. We have a fairly high fraction of vulnerable people in the population," said David Lighthall, a health science adviser for the San Joaquin Valley Air Pollution Control District. "Kids with asthma aren't getting access to care, and, of course, we have the high levels of exposure. That's a bad combination."
In 2007, about 25 million Americans had asthma, according to the Centers for Disease Control and Prevention. Costs for the chronic disease increased from an estimated $53 billion in 2002 to about $56 billion in 2007. The condition is distinctly prevalent in California's Central Valley, where one out of every six children have asthmatic symptoms -- a contemporary warning of how dire this issue could become in the near future.
Nitrous oxide leads to more ozone
It's not nitrogen gas by itself that's the problem. Eighty percent of the world's atmosphere is made up of the gaseous form. Nitrous oxide is a different story. The combination of nitrogen and oxygen molecules creates a powerful gas. In small quantities, nitrous oxide is used as "laughing gas" in dentist offices. On a larger scale, the vapor traps heat and contributes to global warming.