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KAI RYSSDAL: After our container ship, the Rotterdam, ties up in Long Beach, the choreography of the American economy kicks in. Giant cranes over there lower containers down from the deck onto the beds of these waiting trucks.
Nationwide, this happens more than 80,000 times a day. Globalization is what that's called. The scale of it is breathtaking -- and as Marketplace's Sarah Gardner reports, so are the side effects.
George Rodriguez: My name is George and I'm 8 years old.
Julianna Rodriguez: Hi, my name is Julianna Rodriguez and I'm 14 years old.
Carla Rodriguez: My name is Carla and I'm 15 years old.
Sarah Gardner: Little Angela is too shy to speak around microphones, but she's 4. All these children and their mother, Laura, suffer from asthma. Earlier this year, Angela started wheezing in the back seat of the car. Laura sprang into action:
Laura Rodriguez: I was driving, so I had to pull over. I gave her the quick relief medication -- first puff, then second puff and her coughing wasn't stopping.
The Rodriguez family has plenty of company.
Doctor at children's clinic: Good job Kevin. Tiene los pulmones funcionando muy bien.
Nineteen percent of the children in Long Beach have been diagnosed with asthma -- that's nearly double the national rate. This port city is an air pollution hot spot, one of the worst in the country.
The culprit is "fine particulate matter." This and other diesel pollutants have increased so much in recent years they now merit their own category: it's called "Goods Movement Pollution." And it pours out of all the diesel trains, trucks and ships that bring us consumer products.
Sam Atwood: Ocean-going ships burn some of the dirtiest fuel in the world.
Sam Atwood is with the South Coast Air Quality Management District.
Atwood: It's known as bunker fuel. And it's relatively cheap, which is why it's used.
But it also has 2,000 times more noxious sulfur than the diesel used by trucks.
Elisa Nicholas: This is really much more serious than we had thought before.
Elisa Nicholas is CEO of Long Beach Children's Clinic. She says lung function isn't only at risk, but the actual formation of this vital organ, as well.
Nicholas: We now have studies that actually have shown decreased lung growth that is associated with air pollution.
And that's not all: Particulate pollution is now linked to cancer and heart disease. Frank O'Donnell, president of Clean Air Watch, says transport emissions may be most severe in Southern California, but they're actually a national problem.
Frank O'Donnell: The U.S. EPA has noted that particulate pollution from diesel engines has shortened the lives of more than 20,000 Americans each year.
That's 20,000 Americans essentially dying from consumption and its infrastructure. Officials at the ports of L.A. and Long Beach are now aggressively trying to reduce diesel emissions. Many of the shipping companies, for example, have already agreed to modest changes. Long Beach port spokesman Art Wong:
Art Wong: We've gotten a couple of our companies to sign leases where they agree to plug in their ships to electricity at the docks so that they don't use their dirty diesel engines while they're docked at our berths.
And at least one shipper has switched to low-sulfur fuel on its own. But air quality regulators say voluntary measures aren't enough. Again, Sam Atwood:
Atwood: Southern Californians are paying a portion of the price of our relatively cheap consumer goods with their health, with their own lungs. This has to change.
Problem is, it's unclear who's in charge. Shippers say they're governed by international law, not local regulations. Interstate rail companies say only federal laws apply to them. Short-haul truckers plead poverty in the face of costly fees and upgrades. And if clean-up mandates become too onerous, says Art Wong, it puts the port at risk.
Wong: There's always the threat that if we scare this business away, we will have cost this region many thousands of jobs. We're in competition with ports up and down the West Coast that would love to take this business away from us.
And that's why nobody realistically expects the air here to clear overnight. Locals -- and in fact, the nation as a whole -- are now dependent on the jobs and the abundance of cheap consumer goods now flooding the country. In Long Beach, Calif., I'm Sarah Gardner for Marketplace.