Leaving San Antonio was the only remedy that helped Krystal Henagan's son, Tanner.
Her family moved to San Antonio in 2012, when Tanner was 4 years old. He developed severe asthma, which soon became "uncontrollable." Doctors thought the child had cedar or oak allergies, and put him on seven different medications. But fleeing the polluted Alamo City air was the only reliable treatment.
"There were some nights and afternoons that it would get so bad that we would leave the area just to get some relief," said Henagan, who is now a field organizer with the advocacy group Moms Clean Air Force. "We shuttled him between Lubbock and Houston for about six months so his health could get back on track, and it did."
As the temperature rises and San Antonio's brief winter gives way to spring and summer, many take going outside for granted. But not everyone gets to enjoy the outdoors. The changing seasons signal an approach of the high point for air pollution, pushing children, the elderly and those who suffer from asthma and other illnesses indoors.
San Antonio's air is cleaner than it was a decade ago, but pollution is on the rise. Now local officials are desperate to improve the air as soon as possible, both for the health of residents and the fiscal well-being of the region.
"We're trying to create that sense of urgency. People interested in the fiscal health of our city and the public health of our community have every reason to be concerned," said Councilman Ron Nirenberg, who chairs a committee on air quality at the Alamo Area Council of Governments. "The time for action is certainly now. But it has been now for the past 10 years."
San Antonio is outside acceptable measures for air quality set by the Environmental Protection Agency. If that's still true next year – which almost certainly will be the case – the city's collective health will decline, and the federal government will impose strict, expensive regulations to return the city to compliance.
The main pollutant that plagues San Antonio is ground-level ozone, a mix of emissions from cars, oil and gas production, power plants, organic material and other sources that react in sunlight to pollute the air. Breathing in ozone can exacerbate asthma and other respiratory illnesses, and cause cardiovascular problems.
It's unclear whether rates of asthma have increased over the past few years, since no local study has looked at the issue, according to Brenda Williams, the natural resources director for AACOG.
Ozone levels have dropped steadily since the 1980s, but that trend is reversing in San Antonio. The city's ground-level ozone levels have increased every year since 2010. Although part of that is attributable to population growth, ozone levels in Austin, which has experienced similar growth, have dropped over the same period.
"What Could Have Been?"
As part of the Clean Air Act, the EPA sets standards for air quality. On October 1, 2015, the EPA set new, tighter rules for ground-level ozone, narrowing the acceptable level from 75 parts per billion to 70 parts per billion.
Some argued that the new standards didn't go far enough. But cities such as San Antonio will still find it difficult to comply with the new regulations. The city's official ozone level for 2015 was 78 parts per billion. In order to meet the standard, that will have to drop to 60 parts per billion in 2016. Williams said that's extremely unlikely.
"It's pretty clear that we could not meet the 70 parts per billion," said Williams.
Which means there will be repercussions. For example, it's more difficult for cities that fail to meet the standard to secure federal funds for transit projects. And any new business that's a source of air pollution must pay a fee to offset its emissions.
In more extreme cases, automobile inspections must also include emission standards, and cities must pay millions of dollars in penalty fees to the EPA. The conditions remain in place until 2020 on less-severe cases and 2025 for more extreme ones. AACOG is currently carrying out a study on the financial ramifications of failing to meet the EPA's standard.
"Ultimately, our goal is to have a healthy community, a clean-air community," Williams said. "We certainly want to see a dynamic economy. But I think we can try to promote both as much as possible."
Public entities have lately tried to combat the degradation of air quality. CPS Energy has plans to decommission its coal-fired power plants, and it has increased its wind and solar energy portfolio. The City of San Antonio approved an ordinance in November requiring all business "with sources of air pollution" to register with the San Antonio Metropolitan Health District and pay an annual $200 fee. The idea is to paint a more accurate picture of where pollution comes from to better mitigate emissions. And both the city and AACOG are upping their efforts to get more folks walking, biking and using public transit.
Even if all those efforts are effective though, San Antonio still faces an uphill climb. Some projections show the city's population growing by a million people over the next 25 years, which would mean significantly more vehicles on the road and more emissions related to heavy industry and power generation.
Other factors are outside the reach of local government. There are now 14 applications with the Texas Commission on Environmental Quality to build pollution-emitting facilities in Bexar County, including three concrete and cement plants and an aluminum smelter – some of the most prolific emission sources.
The challenges are significant. But officials such as Nirenberg and Williams say that for the sake of San Antonians' health, they can't just give in. Federal penalties or not, they feel compelled to chip away at the problem for children like Tanner – and for those who may develop similar problems down the road.
"We almost certainly will be out of attainment within the next few years. Does that mean we throw our hands up and say, 'What could have been?' No, because we still have the public health to be concerned about," Nirenberg said. "And as much as we can do to get back into attainment more quickly, both in terms of the regulatory and health costs ... the better."