Karen Gryzwinski is one of many residents living with respiratory conditions in Allegheny County for whom the struggle to breathe is exacerbated by the region’s smoggy air.
To treat her asthma, which started in her 40s, Gryzwinski began a biologic medicine — in addition to daily medications and inhalers — at the recommendation of her pulmonologist. She says she sometimes experiences worsening symptoms as her environment changes, suggesting a clear connection between air quality and her health.
“If I’m stopped in traffic and there’s a bus or a truck that’s really putting out a lot of exhaust, that’ll bring on an asthma problem,” she said. “So I definitely know that there’s a link to it for me.”
Last year, there were 2,083 asthma-related emergency department visits recorded in Allegheny County hospitals. That’s down from 3,019 in 2019, though experts say this doesn’t necessarily reflect a decrease in asthma’s prevalence locally.
“I suspect maybe [emergency department visits] have declined, but I also suspect something’s missing,” said Dr. Deborah Gentile, a physician with the University of Pittsburgh Asthma & Environmental Lung Health Institute at UPMC.
It is possible that since the pandemic some emergency department visits involving asthmatic symptoms or flare ups have been classified as something else, said Gentile, who is also a clinical associate professor of physician assistant science at Saint Francis University. Dr. Sally Wenzel, director of the University of Pittsburgh Asthma & Environmental Lung Health Institute at UPMC, said the visit counts seem surprisingly low — and “certainly would not be in line with my experience,” which includes nearly 18 years as a pulmonologist with UPMC.
‘I have to live in a bubble’
Pittsburgh has long been identified as one of the worst metro areas in the country for air pollution, which experts connect to above-average rates of asthma and related conditions.
When, at age 14, Qiyam Ansari moved to Braddock from New Haven, Connecticut in 2010, he already knew he had asthma, though it had been well controlled until his move to the Mon Valley.
“My asthma went from regular, normal, mild asthma to life threatening, where the amount of flare ups became more and more prevalent,” said Ansari, adding that he began taking a rescue inhaler on a daily basis.
At age 16, after a move to McKeesport, Ansari’s lungs collapsed and he was kept in a medically induced coma for two weeks.
Now 28 and board president of Valley Clean Air Now, Ansari has taken steps to avoid the pollutants that cause his airways to tighten and trigger his asthma. He has an air purifier in his car, a special mask that blocks out particulate matter, air purifiers in his home and medical-grade air filters, all to help reduce the symptoms of his asthma.
“I have to live in a bubble, you know, in order to not succumb to an attack,” Ansari said. “And I think that’s just a new reality that I’ve come to accept so long as I’m living here in Pittsburgh, or really near any major pollution source.”
Like Ansari, Gryzwinski has taken up the air quality cause in response to its impact on her health and daily life. In 2014, she helped establish Allegheny County Clean Air Now [ACCAN] to pressure the former Shenango Coke Plant on Neville Island to comply with local and federal regulations.
“I remember the odors from Shenango. I went out to water plants, it was in the early fall in the evening, and I had to immediately go back in the house. That’s how bad the pollution was,” Gryzwinski recalled.
Following the plant’s closure in 2016, area local emergency departments experienced an immediate 42% decline in cardiovascular visits, according to a 2023 study, linking the plant’s chemical emissions to negative health impacts on nearby residents.
Slow improvement
In the American Lung Association’s 2024 State of the Air report, Pittsburgh was ranked the most polluted metro area in the Middle Atlantic region for both daily and year-round particulate matter. Nationwide, Pittsburgh came in 26th, the first time in a quarter century it fell outside the top 25.
“Pittsburgh has certainly shown improvement,” said Kevin Stewart, director of environmental health, advocacy and public policy at the American Lung Association. “When you take a look at past reports, there were times when Pittsburgh was among the top one, two or three metro areas in the country for certain measures of fine particle pollution.”
But another reason for improved rankings, Stewart said, is a drastic increase in wildfire particle pollution which has worsened air quality in other regions.
Pittsburgh still received an “F” grade from the association for both daily and annual PM in 2024. Stewart said this grading means an area has accrued at least 10 orange air days, meaning the air is unhealthy for sensitive groups to inhale. Last year, Pittsburgh had 18 orange particle days.
“That one day can be enough to cause them to need more medication, go to the emergency department, be hospitalized or even die,” Stewart said.
Locally, the Allegheny County Health Department is responsible for monitoring the air quality and ensuring companies and facilities comply with the federal Clean Air Act. The department’s Air Quality Program has about 45 employees.
The health department’s annual air quality report, released Monday, showed the county met federal air quality standards for 2023 while noting the county “still has important work to do.”
Ana Hoffman, air quality program director for Carnegie Mellon University’s CREATE Lab, said the Health Department’s role of monitoring and tracking data is vital to understanding rates of asthma and other respiratory conditions. The department operates six monitors around the county — mostly near large pollution sources. While some monitors effectively capture PM2.5 (potentially harmful particle pollution), they are ineffective at capturing other carcinogenic pollutants and tracking their dispersion from pollution sources, according to Hoffman.
“CREATE Lab, and many other organizations, including EIP [Environmental Integrity Project], have submitted comments saying, ‘We think your monitoring network plan is insufficient to capture the extent of the pollution from these facilities in these very specific ways. This is what we want,’” Hoffman said. CREATE Lab and other advocates have pushed for more monitoring of benzene and other highly carcinogenic particles, but so far, nothing has come of their efforts, Hoffman said.
“There has, to date, not been enough interaction with the county Health Department to be able to have just a common sense conversation about our comments and their responses,” she explained, “like that would be a thing that we would hope for in the future with the new leadership that’s there.”
The Allegheny County Health Department hired a new director in August, Dr. Iulia Vann, who has already spent time speaking to residents living in air-polluted communities in Allegheny County, including the Mon Valley.
Ronnie Das, public information officer for the Health Department, said both Dr. Vann and Allegheny County Executive Sara Innamorato have made resident outreach a priority since taking office.
“Both have a proven track record of working with air quality advocates and community members,” Das wrote in response to written questions from PublicSource. “These public servants have worked tirelessly in the short time they have been with the county to be more inclusive with the public by providing a seat at the proverbial table through public information sessions, workshops, outreach efforts, conversations, community gatherings, events, etc. They are listening, reflecting and working on behalf of concerned community members to ensure we are actively addressing public health issues.”
Lisa Graves-Marucci, the EIP’s Pennsylvania coordinator for community outreach and a lifelong Mon Valley resident, said she’s familiar with the smells that come from Clairton Coke Works and Edgar Thomson Steel Works.
“People are getting sick and dying while we’re prolonging the inevitable, that we need more monitoring, we need more facts so that we can have more oversight and accountability, which is all we’re ever asking for,” Graves-Marucci said.
Since CREATE Lab launched its Smell Pittsburgh app in 2015 to enable residents to report bad smells to the Health Department, more than 103,300 reports have been sent, said Hoffman.
The most frequently reported smell is “rotten eggs,” pointing to sulfur as the likely source. Though sulfur is a colorless gas, it can be unhealthy to inhale at a certain threshold for people with respiratory conditions like asthma, according to the U.S. Centers for Disease Control.
Hoffman said the app was designed as a more accessible alternative to the county’s formal complaint form.
“A resident of Allegheny County should not have to be an expert in the health thresholds associated with sulfur smell to get a response from their Health Department that has a common sense and holistic approach to air pollution problems,” Hoffman said.
In response to written questions from PublicSource, Health Department officials wrote that they receive a “summary of some reports from Smell Pittsburgh but [the department] does not directly utilize this information for regulatory enforcement purposes.”
‘A bold cultural and political shift’
Kathleen Krebs, 75, a lifelong Pittsburgh resident and a retired nurse, lives in Brighton Heights, just downstream of the former Shenango Coke Plant. After experiencing a strange set of symptoms over several years, Krebs was diagnosed with bronchiectasis in both lungs in 2016. Bronchiectasis is a chronic condition that causes airways to widen or develop pouches, making it difficult to clear out mucus, and presents similar symptoms to bronchitis.
An avid gardener, Krebs said she was told by one of her pulmonologists that she should wear a mask outdoors regardless of the air quality, even when she’s harvesting and planting on the ground on her knees. While she and her doctors aren’t able to identify whether the air pollution was the cause of the late development of her condition, they are confident it was a contributor.
“The thing is, with bronchiectasis, the disorder continues to get worse every time you have an infection and there’s no treatment, so it’s symptom management,” Krebs explained. “It isn’t like there’s some cure-all. The damage is done. And my job, my commitment, is to try to minimize exposures.”
Krebs, along with other residents, physicians and those working in advocacy groups said the Health Department does not adequately hold U.S. Steel and other facilities accountable for their toxic emissions.
“I absolutely believe there is an opportunity for us to do better,” Krebs said. “And I think we really need to be holding people in elected, appointed positions, we need to hold them to the highest accountability.”
Each year from 2018 to 2024, the Health Department issued penalties and fines to U.S. Steel for air pollution emissions, uncontrolled pushes in coke ovens, equipment failures and leaks at Clairton Coke Works.
“We need all of these heavy industries. However, if they’re going to make money and have to operate in our neighborhoods, then they should have to be responsible for the toxins that they are releasing.”
In an email, Health Department staff said they have “continued to implement the federally authorized local air quality permitting program and for the years of 2020 to 2023 is in attainment with the federal criteria pollutant standards.”
Das declined to comment further on specific cases citing pending litigation, and referred to the Health Department’s enforcement actions webpage to view enforcement actions dating back to 2020.
Since Shenango’s closure, ACCAN’s attention has turned to a cluster of other plants and factories tucked within the Ohio River valley. The group has installed cameras outside two facilities and streams the footage live on their website.
“I really don’t want to spend my time doing this. There are so many things I’d rather be doing, but it’s that important that we’re taking our time to try to get this situation to a better point,” Gryzwinski said.
In the Mon Valley, Ansari is also pushing for more monitoring and oversight.
Ansari said he respects the role of the industrial sector in providing jobs and needed resources, but he also believes industry should shoulder the costs of operating cleanly and safely.
“We need steel. We need all of these heavy industries,” Ansari said. “However, if they’re going to make money and have to operate in our neighborhoods, then they should have to be responsible for the toxins that they are releasing.”
U.S. Steel invests “approximately $100 million per year in environmental compliance at the Mon Valley Works alone,” according to a U.S. Steel spokesperson.
“More than 3,000 Mon Valley Works employees strive each day to ensure their role in the steelmaking process is done in the safest and most environmentally responsible manner. Because of their work, U.S. Steel has a compliance rate exceeding 99%,” wrote a spokesperson in response to written questions from PublicSource.
Last February, the Health Department fined U.S. Steel nearly $2 million for hundreds of working violations at Clairton Coke Works.
But critics argue this is a smaller cost to absorb than taking permanent steps to reduce pollution.
“The other thing that really disgusts me is these companies make billions of dollars, and they could put controls in place, but they don’t,” Gentile said. “They would rather pay the fine.”
U.S. Steel and Japan-based Nippon Steel have contended that a proposed merger would put $1 billion into modernizing the Mon Valley Works, potentially affecting emissions. Former President Joe Biden blocked the deal on Jan. 3 shortly before leaving office after the bid received criticism from United Steelworkers union leadership.
Following Biden’s blocking of the deal, Innamorato released a public statement, stating that new ownership should “be a good community partner with the residents of the Mon Valley, and work with county and local government to build a future where everyone can thrive.”
“Ultimately this is a federal decision, but regardless of if operations are owned by U.S. Steel or another entity, we are committed to working collaboratively with all partners to make sure the Mon Valley is invested in and has the resources it needs,” the statement read.
President Donald Trump on Friday introduced a new twist in the meandering acquisition saga, suggesting Nippon would invest in, rather than buy, U.S. Steel. The two companies did not immediately comment.
Air quality advocates were critical of Rich Fitzgerald’s tenure as county executive, which spanned 2012 through 2023. But they’ve expressed cautious optimism about his progressive-branded successor, Innamorato, and Dr. Vann.
“Culturally, there’s the Steelers, [the steel industry is] culturally embedded here,” said Hoffman. “And it takes a bold cultural and political shift, and one that’s brave, to uproot it, and that is our hope for our new county executive.”
According to Innamorato’s comprehensive fiscal plan and proposed budget for this year, the county will receive $200,945 in federal funding for clean air grants for air pollution control agencies. These, the plan states, “will support operational goals of the ACHD Air Quality division” by funding technical support to pollutant monitoring and analysis, lab training support and more.
Gryzwinski said Vann has already been receptive to demands for change, and hopes as an advocate to partner with the agency.
“We’re not like the enemy of the Health Department,” Gryzwinski said. “We want to work with them. We want to share the technology that CMU has given us. We want to share what we know about the history of our areas so they know what people are dealing with. That’s what we want. And I hope that the door is opening now to that kind of conversation.”
Allie Miller is a freelance journalist covering health, food and the LGBTQIA+ community in the Pittsburgh region, and lives in New Stanton. Allie can be reached at allie.l.mill@gmail.com or on Instagram, @alliemiller6.
This story was fact-checked by Jake Vasilias.
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