that rose in the new study following ozone inhalation “can trigger inappropriate artery constriction and cause spasms.”

Cardiologist Wayne Cascio,
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, who heads a division on environmental public health at EPA’s National Health and Environmental Effects Laboratory,
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, noted that his scientists’ new study also identified provocative signs of an elevated risk of clotting after the volunteers had breathed in ozone-enriched air.

The pollutant altered levels of several clot-related proteins, including plasminogen,
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, tissue plasminogen activator and plasminogen activator inhibitor. Concentrations of some went up, others down. Based on the pattern of changes, notes Cascio, “one might predict that [high ozone] would slow the dissolving of clots.” That suggests clots might propagate or enlarge,
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, he says — “or potentially block up a vessel, causing a heart attack or stroke.”

Keep in mind,
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, Devlin notes,
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, many different conditions spawn clots. But once they form,
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, he says,?his group's data are now “suggesting that exposure to ozone might inhibit the body’s ability to dissolve them.”

When EPA is charged with imposing or revising health-related pollution standards, it’s not enough to have good epidemiology — observations and survey data suggesting associations between events (like disease) and possible predisposing factors, explains air pollution epidemiologist Douglas Dockery of the Harvard School of Public Health. Although epidemiology can point to associations, he explains, it can’t establish causes. Yet to set federal health-protecting pollutant limits,
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, “you

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