Understanding the Health Risks of Air Quality Warnings

Wildfires in North America scorch thousands of miles of forest every year. The smoke from these more and more common events rises into the atmosphere – and can end up around your home. Hazy mornings, fiery sunsets and a scent of wood smoke are among the effects, and so too are air quality warnings.

Anthony Hericks, DO, a pulmonology and sleep medicine specialist physician with Avera Medical Group Pulmonary & Sleep Medicine in Sioux Falls, explains the facts on these warnings and how they affect you.

What is Air Quality?

The Environmental Protection Agency (EPA) offers air quality guidelines and these reports are often shared by the National Weather Service.

Particulate matter in the smog or the smoke of a wildfires is what we’ve faced recently. EPA levels can help us decide whether it’s a healthy environment to be in. They rate air quality as mild, moderate or severe:

• Mild is the normal air quality index of less than 50. It’s healthy for everyone.
• Moderate is once the index reaches 100. That’s where people with lung diseases or at-risk disease processes may have trouble.
• Severe is when we get into the 300 range, and then people without any lung disease can have problems. There have been places on the coasts that have had 400 levels of air quality.

The levels can affect you, depending on your sensitivities, such as allergies.

Who Is Most at Risk When Air Quality is Moderate or Severe?

Most patients that have trouble during times of air quality warnings have COPD, or what we call smokers’ lung disease. Others have pulmonary fibrosis. If you’re an asthmatic, moderate or severe levels may cause more chest tightness or more shortness of breath or wheezing, and we certainly get more calls from asthmatics who have a more of an allergic-type lung problem. For people with just nasal and sinus allergies, the particulate debris in the air can cause a lot of irritation, and if they don’t get that under control, it can spiral into a significant asthma exacerbation.

Air quality is serious, and for certain groups, hospitalization due to excessive exposure is possible.

Are There Low-Risk Groups that Should Pay More Attention?

Non-asthmatic, or people with no lung problems, might get more airway irritation as well as dry, watery, scratchy eyes, or a sore throat when the level is moderate or higher.

You might get a stuffy nose or develop some shortness of breath or coughing. You can try some over-the-counter antihistamines, eye drops, nasal steroids or decongestants may provide temporary relief.

Yet avoiding irritants in the air is the best option. If you stay out of the polluted air, symptoms may improve on their own.

When Levels Are High, is it OK to Be Outside?

The EPA says once a level exceeds 200 or 300, you should not be outside no matter who you are. The potential health risks, for example, of exercising outside during those higher levels may cause you to inhale more of that particulate matter. It would make it more difficult to breathe and lead to those symptoms in the eyes, nose and throat.

If the Levels are Elevated, Should We Take Precautions While Indoors?

When air quality is poor, make sure your windows are closed and sealed and make sure you avoid extended periods of time outside. You can also try to avoid more strenuous activities that would cause you to breathe deeper, heavier or longer. Make sure your air conditioner is working appropriately and that your air filters are in place and changed regularly. Filters range in price and quality; it can be a good idea to have better ones if you’re more sensitive to things in the air. Those steps can make air quality in your home OK when outside it is poor.

What Are Long-Term Effects of Poor Air Quality?

We’re pretty sheltered here in the Midwest, with clean, quality air for the most part, but long-term exposure to particulate debris adds up.

Some workers, like firefighters or coal miners, can end up with black lung where a lung dissection shows the lymph nodes and lung tissue filled with what we call acanthotic or black pigment. When this stuff reaches your lung tissues, it creates inflammation and potentially scarring. Over time, it could contribute to potential lung disease.

As a general rule, less exposure to poor air quality and certain environments that may have a lot of air pollution or airway irritants will result in better lung health overall. If you can avoid being outside or in a structure that has poor air quality, or if you can decrease the time you’re exposed in that environment, it will hopefully result in less severe symptoms.

What’s Your Advice for All Who See These Reports?

The path of the jet stream varies and might give us one clear day or one with more smoke, clouds, haze or smog. I recommend using Air Now or EPA.gov to actually check the air quality during the day. Those sites show how they measure it and what that means to you.

They also offer pointers on avoiding poor air, especially if you’re at high risk of having symptoms related to it. Perhaps today is a good day for a run or long walk. Another day, it might be best to sit in the air conditioning and relax. You can also find pollen and allergen counts on apps or online, or on many weather sites.

Overall, for most people without lung illnesses, it’s a short-term thing to not be too nervous about. It’s something to monitor, and if you’re symptomatic, if you can avoid going out when air quality is poor, you should.

If you have symptoms or one of these conditions, get in touch with your Avera primary care provider for guidance to keep good lung health.

Learn more about Avera’s respiratory and pulmonary care services.