“Choked: Life and Breath in the Age of Air Pollution”

May 20, 2020

BookShelf: “Choked: Life and Breath in the Age of Air Pollution”

By Beth Gardiner
The University of Chicago Press, $27.50

Reviewed by Tom Henry

The Trump administration’s decision to roll back more air pollution laws as the world is distracted by the COVID-19 pandemic should draw you back to an excellent book published last year on the topic. 

It’s not that COVID-19 makes it into “Choked: Life and Breath in the Age of Air Pollution,” by Beth Gardiner, an American who has lived and worked in what she describes as “badly polluted London” since 2000. COVID-19 didn’t exist when she wrote the book — it was not identified in Wuhan, China, until December of 2019. 

No, what is fascinating about this book isn’t some new policy position, such as the Trump administration announcing in April that it was softening Obama-era restrictions on mercury and other toxins produced by oil- and coal-fired power plants; its decision in March to soften rules on vehicle fuel efficiency; or its decision this spring to leave alone a regulation on fine-particle industrial soot emissions that government scientists themselves say contribute to tens of thousands of premature deaths.

What makes the book resonate is Gardiner’s descriptive writing and her mastery of an arcane, often difficult-to-understand subject.

Right off the bat, Gardiner shows readers more than any policy debate reveals. She shows you why you should care.

“A human breath begins in the deepest reaches of the brain, where — far beneath consciousness — the body’s most basic and essential functions are regulated. Just above the point where the spine meets the skull, tiny receptors detect rising levels of carbon dioxide, then stimulate nearby clumps of neurons. Between 12 and 20 times a minute, perhaps 20,000 times a day, millions of times a year, over and over and over again from the first cry of birth until the very last moment of life, those neurons fire signals ordering the muscles of the diaphragm and rib cage to contract.”

And that’s just the first paragraph of the introduction. In subsequent graphs, she describes how the dome-shaped diaphragm flattens, the ribs move upward and out, the chest cavity expands, and air is drawn deep into the body through the nose and mouth. 

Then she describes the beauty of lungs themselves. Far from “unremarkable hunks of spongy pink tissue,” she writes, the lungs fill sacs that “cluster at the airways’ ends like miniature bunches of grapes.”

“There are some 300 million of these alveoli in a pair of lungs, and their surface area is often likened, in total, to the size of a tennis court. Separated from them by membranes one one-hundredth as thick as a hair, tiny capillaries carry blood low in oxygen and laden with carbon dioxide. The gases rush across the barrier, and oxygen molecules bind to hemoglobin, then whoosh toward the heart, ready to be delivered wherever they are needed.

“Like so much about the body, a breath is at once astonishingly simple and magnificently complex, delicately balanced yet highly resilient. Unlike other essential functions, the beating of the heart or the peristalsis of digestion, breath can also be controlled by the conscious mind, when we laugh or speak or hold it in to dive underwater.”


Panoramic view of polluted hotspots

The power of her descriptive writing is not so much that it serves as a metaphor-filled biology lesson but because of how it sets up the rest of the book. 

In it, Gardiner provides a panoramic view of global air pollution hotspots that is at many times distressing and confounding, but also with some inspiring moments which remind the reader that healthier air — while difficult — is not impossible. 


Even today, with all of our modern 

pollution controls, air pollution kills 

seven million people a year globally.


We also learn why certain groups of people are more vulnerable.

Even today, with all of our modern pollution controls, air pollution kills seven million people a year globally, including 100,000 Americans. It is strongly linked to heart attacks, stroke, cancer, dementia and premature birth.

Gardiner writes about her family life, and how she ended up in still-sooty London, which has so much diesel pollution that an estimated 9,416 Londoners die of air pollution annually. 

Some efforts have been made to clean London’s smog in the 20 years she’s lived there, but she says not enough. Gardiner noticed how much better air quality was just one weekend, when roads were closed for a festival. She says she loves London for many reasons, but adds: “The air bothers me, worries me, just about every day.”

In other chapters, Gardiner writes about Poland and the “air you can chew” because of its heavy reliance on coal, and also about rapidly developing economies such as India and China — and their impact on global emissions, good and bad.

She lauds the United States’ Clean Air Act for keeping U.S. air cleaner than other parts of the world and cites accomplishments of the U.S. Environmental Protection Agency until the Trump administration rollbacks began long before the COVID-19 pandemic kicked in.

“Those who care about the planet’s future are right to despair at Trump’s rejection of science, his administration’s refusal to acknowledge reality,” Gardiner writes. “Such intransigence makes the path to a stable climate steeper, if not impossible, to climb. But the United States is not the world’s only actor. China is moving on without us.”

And just as eloquently as she described inhalation in the beginning of this book, Gardiner ends it by describing the involuntary brain impulses and muscle contractions that go into every act of exhalation.

“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.”

[Editor’s Note: For more on what prompted Gardiner to pursue the global air pollution story, read her 2019 SEJournal feature, “Soiled Skies Incite ‘Choked’ Author To Pursue Air Pollution Story”].

Tom Henry is SEJournal’s BookShelf editor and created The (Toledo) Blade’s environment-energy beat when he joined the newspaper in March of 1993. He has been a member of the Society of Environmental Journalists since 1994.

* From the weekly news magazine SEJournal Online, Vol. 5, No. 20. Content from each new issue of SEJournal Online is available to the public via the SEJournal Online main page. Subscribe to the e-newsletter here. And see past issues of the SEJournal archived here.

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