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Clean Air Act

Please note that this page refers to federal requirements.  State and local regulations may differ.

The Clean Air Act (CAA) is the comprehensive Federal law that regulates air emissions from area, stationary, and mobile sources.  This page provides some background information on what the law covers, and indicates how it affects healthcare facilities.  Refer also to the HERC Air Permitting page for additional information.


Background information on the CAA

The federal Clean Air Act (CAA) and its amendments are designed to “protect and enhance the nation's air resources so as to promote the public health and welfare and the productive capacity of the population.”

The CAA consists of six sections, known as Titles, which direct EPA to establish National Ambient Air Quality Standards (NAAQS), and for EPA, states, and tribes to implement, maintain, and enforce these standards through a variety of mechanisms.  It includes programs to address smog, acid rain, stratospheric ozone protection, and air toxics.  Most of the sections applicable to healthcare facilities are found in Title I.  A few very large facilities may come under the permit requirements for major sources spelled out in Title V.  As for the other titles:

  • Title II covers moving sources (motor vehicles, aircraft, etc.)
  • Title III covers some general legal and monitoring issues
  • Title IV covers acid rain issues
  • Title VI covers stratospheric ozone protection

Note that while the federal law establishes the basic standards, it is generally up to state, tribal, and local governments to manage and enforce many of its requirements.

You can access the CAA regulations through the Electronic Code of Federal Regulations ("e-CFR") provided by the Government Printing Office.  CAA Regulations can be found in 40 CFR Parts 50-99

CAA regulations cover certain types of equipment that are operated by many healthcare facilities, such as boilers, generators, and refrigeration units.  Please refer to the HERC Air Permitting page for more information on requirements that may apply to your facility.

Title I

Criteria pollutants

Pursuant to Title I of the CAA, EPA has established national ambient air quality standards (NAAQSs) to limit levels of “criteria pollutants,” including:

  • carbon monoxide
  • lead
  • nitrogen dioxide
  • particulate matter
  • ozone
  • sulfur dioxide

Geographic areas that meet NAAQSs for a given pollutant are designated as "attainment areas"; those that do not meet NAAQSs are designated as "nonattainment areas".  EPA provides an on-line resource called the Green Book that will allow you to determine the status of your area for each pollutant.

Under Section 110 and other provisions of the CAA, each state must develop a State Implementation Plan (SIP) to:

  • identify sources of air pollution, and
  • determine what reductions are required to meet federal air quality standards

Tribes may, but are not required to, develop Tribal Implementation Plans (TIP), which play the same role as SIPs, but apply within Indian country.

Revised NAAQSs for particulates and ozone became effective in 2004.  This may significantly affect facilities that are large sources of particulates (soot) and of volatile organic compounds or nitrogen oxides (which contribute to ozone formation), particularly those in nonattainment areas.

New sources

Title I also authorizes EPA to establish New Source Performance Standards (NSPS).  These are nationally uniform emission standards for new and modified stationary sources that fall within particular industrial categories. The standards are based on the pollution control technology available to that category of industrial source (see 40 CFR Part 60).

Additional information on NSPS requirements for certain specific pieces of equipment can be found on HERC pages dealing with

Hazardous Air Pollutants

Also under Title I, EPA establishes and enforces National Emission Standards for Hazardous Air Pollutants (NESHAPs).  These are nationally uniform standards oriented toward controlling materials that appear on a specific list.  Such materials are collectively known as hazardous air pollutants (HAPs).

Section 112(c) of the CAA directs EPA to develop a list of source categories that emit any of 188 HAPs, and to develop regulations for these categories of sources. To date, EPA has listed 185 source categories, and has developed a schedule for establishing emission standards. The emission standards are being developed for both new and existing sources.

NESHAPs are based on so-called “maximum achievable control technology” (MACT). The MACT for a particular source category is defined as the control technology achieving the "maximum degree of reduction" in the emission of the HAPs when cost and other factors are taken into account.  Other designations (such as "BACT", or best available control technology, and "LAER" or lowest achievable emissions reduction) are used to specify technologies satisfying other criteria, like the maximum reduction without regard to cost.  The distinctions can get complicated.  The important point here is that cost is factored into MACT determinations.  The regulations don't specify which technology to use, but they do require that whatever technology is used must achieve at least as much of an emissions reduction as the MACT can provide.

Additional information on NESHAPs for certain specific pieces of equipment can be found on HERC pages dealing with


How does the CAA apply to healthcare facility inspections?

For the most part, an air inspector will primarily be interested in five areas of a hospital:

The inspector will also check compliance with any air permits that were issued to your hospital by EPA or by your state.

Sixteen percent of all the violations disclosed to EPA from self-audits of healthcare facilities relate to the Clean Air Act, second only to RCRA. Of these violations, almost half (47%) are of State Implementation Plan requirements. The other half involve the repair and disposal of air conditioning and refrigeration units. Common air violations being found at hospitals either through inspections or self-audits include:

  • Failure to use properly trained and accredited asbestos personnel.
  • Failure to notify EPA of asbestos removal projects and keep required documentation/recordkeeping.
  • Failure to properly dispose of asbestos debris.
  • Failure to close lids on parts washers when not in use.
  • Failure to use certified CFC technicians.
  • Failure to maintain CFC leak rate repair records for large air conditioning and refrigeration units.
  • Failure to include ETO sterilizer, spray paint booth, and parts degreaser in air permit.

More resources

None.

©2015 Healthcare Environmental Resource Center
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