Moms on Fire

Irene Smith, JD, PhD
20 min readMar 26, 2022

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No matter where you live, everyone should have clean water and clean air, especially children. Living in downtown San Jose has made this difficult because my neighborhood lives in between two creek bed homeless encampments and fires are used for warmth, cooking, entertainment, and for both offense and defense of territory. The numerous studies and citations below outline the tremendous danger we put our children in by permitting toxic air. Also find the resource list we used to contact various departments and agencies to report pollution.

When I talk to other residents of San Jose, they have no idea of the number of fires we often have daily. They have no idea of how many of my neighbors own Purple Air sensors to alert them of the air quality immediately surrounding their home. And my neighbors, regularly use the PulsePoint app on to see how close the fire is to their home.

Several years ago, a neighborhood mom reached out, and asked me to help. We had had several fires close to our downtown neighborhood, the smoke had made the air uncomfortable to breathe, and she was looking for somewhere to turn.

We walked down to Coyote Creek and took a stroll around the public park area. Tents, tires, a swath of five feet wide and four feet high pile of sneakers, bicycle parts, discarded clothing, and disassembled computers lay around the banks. I remember us both being taken back by the sheer volume of refuse and the utter lack of response to pleas for cleaning the environment. We couldn’t reach the water itself for all the debris in our way however we saw mallards swimming around food packaging and a stark white crane standing on a sofa which was halfway submerged.

We saw burnt and hollowed out trees, fire soot moving along in the creek water and the air stank of melted plastic. The fires which impacted the air, were also having an impact on the water which runs to the Bay.

On our walk back to our homes our voices were raised in outrage and frustration. We talked about “somebody’s got to do something.” Turns out that somebody was going to be us.

We formed a small group of moms and we named ourselves The Defenders of Clean Air E-Quality and gave each other superhero names. I was Elastagirl.

We first tried to reach out to get help from the city. But help was not immediately forthcoming and often we were directed to contact other organizations within the city or other organizations outside the city. It became a game of pointing fingers and unprecedented delays. Here is a quote from this city this month on clean ups.

“Valley Water and CSJ conduct joint cleanup efforts up to 10 days per month. Valley Water funds labor and equipment, while CSJ funds outreach, SJPD support and disposal. The City of San Jose has not declined any assistance but does select which cleanup sites on its land to prioritize for any particular joint cleanup effort.”

It should be noted, when we went to the large fire site adjacent to San Jose Muni Golf course, South Bay Creeks pointed out that we could hear gas powered generators active in most of the camps along Coyote Creek.

San Jose Water

I started calling Valley Water. Since voters had agreed to measure S, a permanent property tax to support the cleaning of waterways I thought they would be a good place to start.

At first, our Defenders conversations focused on cleanup and Valley Water responses were focused on homelessness. I stated quite emphatically that we were not asking them to solve the homelessness crisis, that in fact that room was very full of experts working diligently. I was asking specifically for the debris and any incendiary type of device to be removed from the Creek bed areas so that we could stop the pollution in the waterway going out to the bay and stop the air pollution created by setting objects on fire.

After refocusing their attention solely on pollution, I hoped we could get help through Measure S. Unfortunately Valley Water states that they are only responsible for “segments“ of the waterways. When asked if the voters were given a color-coded map of the waterways outlining where the segments were and where they weren’t, there was no answer. It does seem that if the voters of Santa Clara County voted to pay an organization to clean the waterways, that the waterways would be clean. Regardless of segments.

The other interesting conversation that I had with Valley Water included the concept of physics. That water is in a constant state of motion and even though segments were defined by non-moving pieces of land, the waterways themselves moved and were not beholden to segments. Our small group of moms wondered if we could push the refuse along the waterway to the appropriate segments in the hopes the cleanup could then proceed.

And finally, Valley Water pointed to homeowners who refused permission and access their creek side property to allow clean-ups. The obstacles were endless.

American Lung Association

We continued to work and there continued to be more fires. We went to the American Lung Association and discovered that Santa Clara County had been given an F for air quality. We went to Breathe California and discovered the grassroots effort fighting for clean air in San Jose.

And while this was happening, we discovered the Stanford study demonstrating that children exposed to these types of fires suffer permanent irreversible IQ damage. And we became more determined to live up to our superhero status.

Army Corps of Engineers

In further work with the water district, I discovered the Army Corps of Engineers contract which requires the water district to clear the channel. In addition, finding a lawsuit which the City of San Jose lost which required the city to clean up the waterways by 2022. Unfortunately, it is currently 2022 and the cleanup is far from over.

We were unable to get the water district to focus on cleaning so next we went to the county. We were able to get a meeting with the fire captains, police captains, district attorney, county staff, city staff, bay area management quality, and other interested folks who wanted to protect the environment.

Felony Fire Laws

We involved the district attorney because we have felony fire laws 451 and 452 which are options to prosecute folks who start arson fires. And in our education process we wanted to understand how these laws were used to protect the public from danger.

Fire Department

In talking with the fire department, we discovered that there were many more fires than we had considered. I did a public records request of all the fires that were attributed to encampments. And then talking to the public records person he asked me if I was trying to understand the cost of fighting all these fires. I replied that I was looking for how many fires were at each encampment and of course the cost would be interesting. He explained that it was about $2,000 for an engine to leave the station but those costs were nothing in comparison to the workers compensation costs. Because firefighters, in their attempts to put fires out in encampments, were tripping over debris, falling and having other physical issues as they tried to put out cumbersome fires.

Police Department

In speaking with the police, they asked me not to go down to the creeks or the encampment to clean because the areas were not safe. They felt that there were too many needles, potential explosive devices, and discarded guns in the area. And that a coordinated cleanup with an organization would work but I should not go by myself. This came as a shock to our moms group as we had been going down and doing some pick up cleanup.

Bay Area Air Quality Management

We engaged with the bay area quality management board. And they asked us to report into their system, every time one of our neighbors had a smell or an odor. It was difficult to organize numerous neighbors, but many neighbors were complaining about the air quality and the toxic smells from plastic. We reported odor after odor after odor.

California Water Board

We also engaged with a California water board. They asked us to document and send numerous pictures. We sent a picture after picture after picture.

EPA

After discovering the lawsuit against San Jose and the required cleanup of 2022 we went to the EPA and started filing complaints.

Places to Volunteer

We also started working with South Bay Creeks and Keep Coyote Creek Beautiful and helping with regular cleanups.

https://sbcleancreeks.com

https://www.keepcoyotecreekbeautiful.org

https://www.sanjoseca.gov/your-government/departments-offices/city-council/mayor-s-office/our-work/beautifysj

All this to say that our small little group made a substantial difference. But I can tell you it’s not enough. Our oceans are suffering because of the waste and fire soot we are putting in our waterways in San Jose. Our children in downtown are having impacts to their IQ because of regular exposure to these fires of plastics, rubbers, and computer parts. I encourage you to take it upon yourself and help clean the creeks and rivers in the local areas with organizations with the links above. We cannot wait for government agencies to work together to protect the health of our children.

Downtown San Jose encampment fire
Downtown San Jose encampment fire

RESEARCH CITATIONS

https://www.opportunitynowsv.org/blog/san-joses-homeless-and-sensitive-creek-environment-can-they-both-be-saved

Neurological and Delayed IQ Development due to Particulate Air Pollution

Studies at the school level have associated air pollution exposure with group-level differences in academic proficiency. In the Los Angeles Unified School District of California, closer proximity to point-source industrial facilities and higher concentrations of ambient air toxics known to harm the respiratory system in each schools’ host census tract were significantly associated with schools having lower academic performance index (API) scores [23]. The same pattern was found statewide [16]. Higher PM2.5 concentration (measured as a three-year average, 2009–2011) has also been associated with lower 2010 API scores at schools in the Sacramento area located near roadways [14]. Michigan public schools exposed to industrial toxics in 2006 had the highest proportion of students who failed to meet state testing standards in ELA and math in 2007, adjusting for other factors [24]. A more recent study in Michigan also found a similar pattern [6]. In addition to this school-level literature, a handful of studies have examined individual children’s academic performance in relation to air pollution exposures. Annual air pollution exposures among primary school children have been linked to lower grade point averages [25], and lower reading [7,9], science [7] and math standardized test scores [7,8].

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559489/

February 22, 2021 Stanford University — “Air pollution puts children at higher risk of disease in adulthood.”

Summary:

A new study reveals evidence that early exposure to dirty air alters genes in a way that could lead to adult heart disease, among other ailments. The findings could change the way medical experts and parents think about the air children breathe and inform clinical interventions.

Children exposed to air pollution, such as wildfire smoke and car exhaust, for as little as one day may be doomed to higher rates of heart disease and other ailments in adulthood, according to a new Stanford-led study. The analysis, published in Nature Scientific Reports, is the first of its kind to investigate air pollution’s effects at the single cell level and to simultaneously focus on both the cardiovascular and immune systems in children. It confirms previous research that bad air can alter gene regulation in a way that may impact long-term health — a finding that could change the way medical experts and parents think about the air children breathe, and inform clinical interventions for those exposed to chronic elevated air pollution.

“I think this is compelling enough for a pediatrician to say that we have evidence air pollution causes changes in the immune and cardiovascular system associated not only with asthma and respiratory diseases, as has been shown before,” said study lead author Mary Prunicki, director of air pollution and health research at Stanford’s Sean N. Parker Center for Allergy & Asthma Research. “It looks like even brief air pollution exposure can actually change the regulation and expression of children’s genes and perhaps alter blood pressure, potentially laying the foundation for increased risk of disease later in life.”

The researchers studied a predominantly Hispanic group of children ages 6–8 in Fresno, California, a city beset with some of the country’s highest air pollution levels due to industrial agriculture and wildfires, among other sources. Using a combination of continuous daily pollutant concentrations measured at central air monitoring stations in Fresno, daily concentrations from periodic spatial sampling and meteorological and geophysical data, the study team estimated average air pollution exposures for 1 day, 1 week and 1, 3, 6 and 12 months prior to each participant visit. When combined with health and demographics questionnaires, blood pressure readings and blood samples, the data began to paint a troubling picture.

The researchers used a form of mass spectrometry to analyze immune system cells for the first time in a pollution study. The approach allowed for more sensitive measurements of up to 40 cell markers simultaneously, providing a more in-depth analysis of pollution exposure impacts than previously possible.

Among their findings: Exposure to fine particulate known as PM2.5, carbon monoxide and ozone over time is linked to increased methylation, an alteration of DNA molecules that can change their activity without changing their sequence. This change in gene expression may be passed down to future generations. The researchers also found that air pollution exposure correlates with an increase in monocytes, white blood cells that play a key role in the buildup of plaques in arteries, and could possibly predispose children to heart disease in adulthood. Future studies are needed to verify the long-term implications.

Hispanic children bear an unequal burden of health ailments, especially in California, where they are exposed to higher traffic-related pollution levels than non-Hispanic children. Among Hispanic adults, prevalence for uncontrolled hypertension is greater compared with other races and ethnicities in the U.S., making it all the more important to determine how air pollution will affect long-term health risks for Hispanic children.

Overall, respiratory diseases are killing more Americans each year, and rank as the second most common cause of deaths globally.

“This is everyone’s problem,” said study senior author Kari Nadeau, director of the Parker Center. “Nearly half of Americans and the vast majority of people around the world live in places with unhealthy air. Understanding and mitigating the impacts could save a lot of lives.”

Nadeau is also the Naddisy Foundation Professor in Pediatric Food Allergy, Immunology, and Asthma, professor of medicine and of pediatrics and, by courtesy, of otolaryngology at the Stanford School of Medicine, and a senior fellow at the Stanford Woods Institute for the Environment. Co-authors of the study include Justin Lee, a graduate student in epidemiology and population health; Xiaoying Zhou, a research scientist at the Parker Center; Hesam Movassagh, a postdoctoral research fellow at the Parker Center during the research; Manisha Desai, a professor of biomedical informatics research and biomedical data science; and Joseph Wu, director of the Stanford Cardiovascular Institute and the Simon H. Stertzer, MD, Professor of Medicine and Radiology; and researchers from the University of Leuven; the University of California, Berkeley; the University of California, San Francisco; and Sonoma Technology.

Story Source:

Materials provided by Stanford University. Original written by Rob Jordan. Note: Content may be edited for style and length.

Journal Reference:

1. Mary Prunicki, Nicholas Cauwenberghs, Justin Lee, Xiaoying Zhou, Hesam Movassagh, Elizabeth Noth, Fred Lurmann, S. Katharine Hammond, John R. Balmes, Manisha Desai, Joseph C. Wu, Kari C. Nadeau. Air pollution exposure is linked with methylation of immunoregulatory genes, altered immune cell profiles, and increased blood pressure in children. Scientific Reports, 2021; 11 (1) DOI: 10.1038/s41598–021–83577–3

Stanford University. “Air pollution puts children at higher risk of disease in adulthood.” ScienceDaily. ScienceDaily, 22 February 2021. <www.sciencedaily.com/releases/2021/02/210222124613.htm>.

https://www.sciencedaily.com/releases/2021/02/210222124613.htm

Brain Pollution — Podcast

It’s well-established that air pollution has significant negative effects on the human body. And many places do require a public announcement when pollution levels are high. But is it possible that on a given day, high pollution can affect your brain, your cognitive abilities?

“Longer-lasting effects that might affect cognitive capacities” — that is, effects that outlast the original, 19th-century pollution. The idea is that children who grow up in those polluted areas suffer negative effects that lead to worse outcomes in education, health, and income, even if they were to move away later. The U.K., like the U.S., began cracking down on air pollution in the mid-20th century. But here’s the thing: Heblich found that the effects of neighborhood sorting didn’t go away.

Okay, lower test scores and higher crime in the areas that have historically had high pollution. But again, how can you untangle cause from effect? Does pollution itself lower people’s cognitive abilities, or do people with lower cognitive abilities sort into polluted areas? Lower cognitive abilities may mean lower incomes, which may mean fewer options when it comes to where you live. And how can you untangle this question in the face of snowball effects like school funding? This brings us back to Andrea La Nauze.

https://freakonomics.com/podcast/pollution-brain/?mc_cid=f0d926a835&mc_eid=18fa7c40e4

Harvard Air-Quality impacts cognitive productivity

For immediate release: Thursday, September 9, 2021

Boston, MA — The air quality within an office can have significant impacts on employees’ cognitive function, including response times and ability to focus, and it may also affect their productivity, according to new research led by Harvard T.H. Chan School of Public Health.

The one-year study, which included participants in offices across six countries working in a variety of fields, including engineering, real estate investment, architecture, and technology, found that increased concentrations of fine particulate matter (PM2.5) and lower ventilation rates (measured using carbon dioxide (CO2) levels as a proxy) were associated with slower response times and reduced accuracy on a series of cognitive tests. The researchers noted that they observed impaired cognitive function at concentrations of PM2.5 and CO2 that are common within indoor environments.

“Our study adds to the emerging evidence that air pollution has an impact on our brain. The findings show that increases in PM2.5 levels were associated with acute reductions in cognitive function. It’s the first time we’ve seen these short-term effects among younger adults,” said Jose Guillermo Cedeño Laurent, a research fellow in the Department of Environmental Health and lead author of the study. “The study also confirmed how low ventilation rates negatively impact cognitive function. Overall, the study suggests that poor indoor air quality affects health and productivity significantly more than we previously understood.”

The study was published online in Environmental Research Letters on September 9, 2021.

A growing body of research has shown that indoor and outdoor air pollution diminishes cognitive function. While it is well known that air pollutants such as PM2.5 can penetrate indoor environments, few studies have focused on how indoor exposures to PM2.5 and outdoor air ventilation rates affect cognition. Cedeño-Laurent noted that this is a particularly important area of research given the high percentage of time people spend indoors, especially office workers.

To better understand the issue, the research team enrolled more than 300 office workers in cities across China, India, Mexico, Thailand, the United Kingdom, and the United States. All participants were between the ages of 18 and 65, worked at least three days a week in an office building, and had a permanent workstation within the office. Each participant’s workspace was outfitted with an environmental sensor that monitored in real-time concentrations of PM2.5 and CO2, as well as temperature and relative humidity. Additionally, each participant had a custom-designed app on their phones through which cognitive tests and surveys could be administered.

Study participants were prompted to participate in tests and surveys at prescheduled times or when the environmental sensors detected levels of PM2.5 and CO2 that fell below or exceeded certain thresholds. Two types of tests were administered: One test required employees to correctly identify the color of displayed words and was used to evaluate cognitive speed and inhibitory control — the ability to focus on relevant stimuli when irrelevant stimuli are also present. The second test consisted of basic arithmetic questions and was used to assess cognitive speed and working memory.

The study found that response times on the color-based test were slower as PM2.5 and CO2 levels increased. They also found that accuracy on the color-based test was affected by PM2.5 and CO2 levels. For the arithmetic-based test, the study found that increases in CO2 but not PM2.5 were associated with slower response times. As concentrations of both pollutants increased, however, participants completed fewer questions correctly in the allotted test time.

“The world is rightly focused on COVID-19, and strategies like better ventilation and filtration are key to slowing infectious disease transmission indoors,” said Joseph Allen, associate professor of exposure assessment of science and senior author on the study. “Our research consistently finds that the value proposition of these strategies extends to cognitive function and productivity of workers, making healthy buildings foundational to public health and business strategy moving forward.”

Other Harvard co-authors included Jose Vallarino, Skye Flanigan, Anna Young, as well as Piers MacNaughton, Emily Jones, and Maya Bliss, who were previously affiliated with Harvard Chan School.

Funding for the study came from National Institutes of Health Grant T32-ES007069, the National Institute of Environmental Health Sciences Grant P30-ES000002, the National Institute for Occupational Safety and Health Grant T42-OH008416, and a gift from Carrier Global Corporation. Additional support was provided by Jones Lang LaSalle, Inc.

“Associations between acute exposures to PM2.5 and carbon dioxide indoors and cognitive function in office workers: a multicountry longitudinal prospective observational study,” Jose Guillermo Cedeño Laurent, Piers MacNaughton, Emily Jones, Anna S Young, Maya Bliss, Skye Flanigan, Jose Vallarino, Ling Jyh Chen, Xiaodong Cao, and Joseph G Allen, Environmental Research Letters, online September 9, 2021, doi: 10.1088/1748–9326/ac1bd8

For more information:

Chris Sweeney
617.432.8416
csweeney@hsph.harvard.edu

https://www.hsph.harvard.edu/news/press-releases/office-air-quality-may-affect-employees-cognition-productivity/?utm_source=newsletter&utm_medium=email&utm_content=Office%20air%20quality%20may%20affect%20employees%E2%80%99%20cognition%2C%20productivity&utm_campaign=091021_WeeklyUpdate

Air Pollution Associate with Increased Risk of COVID

New York Times August 2021

Exposure to wildfire smoke during last summer’s wildfire season could be associated with thousands of additional coronavirus infections as well as hundreds of deaths, potentially causing an even greater challenge to public health officials in Washington, Oregon and California, a new study has found.

Wildfire smoke contains high levels of the smallest, most dangerous type of soot known as PM 2.5.

Researchers at Harvard University estimated that there were nearly 20,000 extra coronavirus infections and 750 Covid-19 deaths associated with exposure to wildfire smoke between March and December 2020 in the American West. The paper was published Friday in the journal Science Advances.

Exposure to smoke, whether from air pollution or cigarette smoke, is believed to impair the function of white blood cells in the lungs, blunting the body’s immune response. The chemicals in particulate matter can also inflame cells lining the airways and lungs. In both cases, if the body is exposed to a virus in addition to air pollution, the immune response may be slowed and the person may develop a more severe illness than they would have otherwise, researchers say.

The findings build on the well-established connection between air pollution and respiratory-tract infections and conditions such as asthma. But the study is the first to show a statistical link between wildfire smoke and Covid-19 caseloads and deaths.

“These results provide strong evidence that, in many counties, the high levels of PM 2.5 that occurred during the 2020 wildfires substantially exacerbated the health burden of Covid-19,” the authors wrote.

Some places experienced levels of air pollution that were dangerously high. In September 2020, Mono County, Calif., had four days where PM 2.5 levels exceeded 500 micrograms per cubic meter, a “hazardous” level, according to the Environmental Protection Agency. By comparison, on days when wildfires were not burning, the average daily level in the three states was 6 micrograms per cubic meter.

To arrive at their conclusion, the researchers used satellite data of smoke plumes from the National Oceanic and Atmospheric Administration to identify the locations and days affected by wildfires. They paired those readings with PM 2.5 data from ground-level air quality monitors in each of the counties and Covid-19 cases and death rates from data compiled by the Centers for Disease Control and Prevention.

Their statistical model accounted for other factors such as weather and the amount of time people were at home, and included a four-week lag to capture the virus’s incubation period as well as the additional time it can take for infected people’s health to deteriorate.

The same team of Harvard researchers also published the first study to find a clear connection between long-term exposure to air pollution and Covid-19 death rates last year.

The new study included reported infections, not just deaths, which makes it especially interesting, said John Balmes, a professor of medicine at the University of California, San Francisco, and an expert on the health effects of pollution who was not involved in the research. “It’s one thing for air pollution to be increasing the severity of the coronavirus infection, it’s another for it to be increasing reported cases,” he said.

After decades of tightening air quality regulations, the air in many American cities is cleaner now than it’s been in 50 years. But in the West, increased wildfire smoke threatens to undo those advances, said Loretta Mickley, an atmospheric chemist at Harvard’s John A. Paulson School of Engineering and Applied Sciences and one of the paper’s authors.

As the planet warms, droughts intensify and the West becomes drier, wildfires are starting earlier, growing larger, spreading faster and reaching higher elevations. In California alone, a record 2.5 million acres burned during the 2020 wildfire season, 20 times what had burned the previous year.

“We are really talking about climate change,” said Francesca Dominici, a biostatistician at Harvard’s T.H. Chan School of Public Health and senior author of the paper. “I hope that this is providing an additional piece of evidence for why it’s important to get our act together to combat climate change.”

Wildfire smoke may contribute up to half of the PM 2.5 in some parts of the western United States. It is so far unclear whether wildfire smoke is more or less toxic than smoke from diesel combustion or power plants.

Dr. Dominici noted that the analysis did not include individual patient data or consider other factors such as mask mandates.

Researchers are currently investigating whether fine particulate matter can spread the coronavirus.

The research does not bode well for this year, Dr. Dominici said, as wildfires started early and the pandemic is still raging in the United States, with a Delta variant that tends to be more contagious. She added: “I think the wildfires will have the same, if not worse impact on Covid-19 cases and deaths among the unvaccinated.”

https://www.nytimes.com/2021/08/13/climate/wildfires-smoke-covid.html

OCT 2020 SJ planning document with the Bay Area Air Quality

“Hazardous Air Pollutants (or Pollution)” “Toxic Air Contaminants”

3.1 Air Quality This section describes existing air quality in the project vicinity and the region and analyzes the proposed project’s potential air pollutant emissions and resulting impacts. For more information regarding the analysis methods and assumptions, refer to Appendix C1. CEQA requires the analysis of potential adverse effects of a project on the surrounding environment. A CEQA evaluation is generally not required to consider potential effects of the environment on a project’s future users or residents, except when the project may exacerbate existing hazards or existing conditions.1 The Bay Area Air Quality Management District (BAAQMD) California Environmental Quality Act Air Quality Guidelines recommend evaluating the potential effects of existing air quality conditions on the project to provide information to decision-makers and the public.2 As such, this section analyzes both the proposed project’s impacts on air quality and the potential adverse effects of existing air pollution on the proposed project and the surrounding community. 3.1.1 Environmental Setting Topography and Climate Climate and meteorological conditions such as wind speed, wind direction, and air temperature gradients interact with the physical features of the landscape to determine the movement and dispersal of air pollutants. The project site is located in the city of San José and is within the boundaries of the San Francisco Bay Area Air Basin (SFBAAB). The SFBAAB encompasses the nine-county region including all of Alameda, Contra Costa, Santa Clara, San Francisco, San Mateo, Marin, and Napa Counties, and the southern portions of Solano and Sonoma Counties. The climate of the Bay Area is determined largely by a high-pressure system that is often present over the eastern Pacific Ocean off the west coast of North America. During winter, the Pacific high-pressure system shifts southward, allowing an increased number of storms systems to pass through the region. During summer and early fall, when fewer storms pass through the region, emissions generated in the Bay Area accumulate as a result of the more stable conditions. The combination of abundant sunshine and the restraining influences of topography and subsidence inversions creates conditions conducive to the formation of photochemical pollutants, such as ground-level ozone and secondary particulates, including nitrates and sulfates

Note that after applying this highly complex and very subjective algorithm to the situations in the creek, it all boils down to a point-priority system, which ultimately is left TO THE DISCRETION OF THE CEO whether or not to take action.

Downtown San Jose encampment fire

https://www.hsph.harvard.edu/news/press-releases/air-pollution-may-increase-risk-for-dementia/

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