FAIRFAX, Va. (WDVM) — In 2018, 6 million people in Washington, D.C., Maryland, and Virginia breathed dangerously polluted air for 86 days, according to the Environmental Virginia Research and Policy Center.

“Continuing to keep up with this data is crucial so that we know that if we’re doing alright, and at this point we found that we are not doing nearly as much as we can,” said Ellie Reynolds, an Environmental Virginia Research and Policy Center advocate.

The nonprofit has released a report, entitled Trouble in the Air: Millions of Americans Breathed Polluted Air in 2018, which compiles the Environmental Protection Agency’s 2018 air quality data. At a press conference Tuesday, the organization presented its findings that were specific to the Washington, D.C.-metro-area.

Krupal Shah takes care of lung transplant patients as an internal medicine doctor. When they’re discharged after surgery, he advises them not to go outside on days with poor air quality. “When I discharge these sick patients I tell myself they’re going home to heal. But every lung disease in my patients is made worse by air pollution, both indoors and outdoors.”

“But if that’s what it takes,” Shah continued, “if that’s what this data allows me to do, to say that, ‘I would like you to stay indoors from Wednesday to Friday in order for your transplant to last longer,’ that is a very smart thing for me to do.” Shah hopes advising patients to stay indoors on low air quality days will reduce hospital admissions as with extreme heat days.

While there isn’t research that correlates low air quality to increased trips to the doctor or to the hospital, poor air quality has been connected to premature births, low birth rates, asthma, and chronic obstructive pulmonary disease. “I don’t think most people who have not been in a hospital or who have seen somebody with severe lung disease can imagine the torture of not being able to get enough air with each breath,” Shah said.

Shah says these health issues are worse for minorities and disadvantaged populations. “Because of where they live and because of the way land use has developed in the United States over time, the most vulnerable populations from a socioeconomic standpoint are also going to be the most vulnerable populations from a clean air and climate and health standpoint.”

Fairfax County is home to the second largest school bus fleet in the country. Fairfax County mom and PTSA Executive Committee President Sofia Burki dropped her kids off and picked them up from school and says she watched school buses idle for 10 to 15 minutes at a time. “In those five minutes, what is the air quality like? What are those kindergartners and preschoolers breathing in in that moment?”

The county recently partnered with Dominion Energy to purchase eight electric school busses to cut down on its carbon output. “Frankly, there have been some changes in Fairfax County as of late and new school board members and new supervisors are enthusiastic about this issue and I think it’s really coming up off the ground,” Reynolds said.

One of those new school board members is member at-large Abrar Omeish, who attended Tuesday’s press conference. “[On Monday] at our budget hearing we had a lineup of students advocating for solar and whatnot, and we know that this is the direction of the future and we have to start by setting that example in our buildings, in our school system, and in what we teach our kids,” Omeish said.

The Environmental Virginia Research and Policy Center is calling for more electric vehicles and increased multimodal transportation options in the county. On the national level, it’s calling on President Donald Trump to support federal environmental protections, instead of rolling them back.

According to The New York Times, President Trump has rolled back 16 regulations on air pollution and emissions since he took office.