Today is a special newsletter on air quality…
(You can expect my usual Friday Q&A on Monday!)
It’s deja vu all over again. Except this time it’s “Stay INSIDE, mask OUTSIDE.”
What gives?
I live in Washington, D.C. As Canadian wildfire smoke swirls through the Northeast and mid-Atlantic states, I am getting a lot of questions about how to protect ourselves from the debris. I’m seeing as many patients with asthma flare-ups as I am with climate-related anxiety.
If COVID taught us one thing, it’s that being human is a risky business.
According to experts, increased wildfire activity is one of the expected effects of climate change. Which means that even healthy people should learn how to avoid inhaling toxic particulate pollution—specifically knowing when to wear a mask, stay indoors, and understand their air filtration systems.
While everyone is affected by increased particulate matter from wildfires, people with chronic conditions like asthma, COPD, chronic lung disease, and heart disease are at particularly high risk. Children, pregnant women, and the elderly are also particularly vulnerable.
Wildfire smoke contains very small particulate matter—aka “PM2.5”s—that are fine enough to travel beyond the barriers in the nose and enter the respiratory system and bloodstream. These smaller air particles pose the greatest risk to health. In contrast, the stuff we’ve become accustomed to inhaling—such as dust, pollen, and mold—is called “PM10.” They are larger particles and generally less harmful to our health. (For a nice summary of particulate matter, check out the EPA’s website here.)
We don’t know a lot about the long term effects of wildfire smoke and PM2.5s. We do know, however, that the short term risks are mostly respiratory and can trigger coughing, wheezing, asthma flares; sinus, throat and eye irritation; and an increased risk of viral upper respiratory infections as a result of inflammation along the respiratory tract.
There is no amount of particulate matter that is “safe” to inhale. At the same time, we cannot separate ourselves from the air we breathe. So what can you do?
Here are some suggestions to help you and your family minimize the impact of the smoke on your health:
Expect to experience a heightened sense of anxiety during times like this. Not only does inhaling small PM2.5 particles quicken our pulse rate and mimic anxiety symptoms, the mere thought of our planet in distress can be uniquely terrifying.
Monitor your local air quality index (AQI). Every day the AQI tells you how clean or polluted your outdoor air is, along with potential associated health issues. You can find AQI readings on most weather apps or on the EPA’s AirNow site here.
Do your best to keep your windows and doors closed when the AQI is over 150.
Use an air purifier, upgrade your ventilation to use HEPA filters, or use a box fan and a filter. The New York Times published a list of recommended air purifiers here. (I’ve had my Winix humming in my medical exam room all through the pandemic!)
See your doctor to make sure your asthma and/or chronic lung, heart or other medical issues are under good control.
For asthmatics, make sure you carry your inhalers with you, and consider stepping up your medication regime if your symptoms flare. (For example, some of my patients have increased their Flovent steroid inhaler from once a day to twice a day in this smoggy moment.)
Consider wearing a well-fitted KN95 or N95 mask outside if you are at particularly high risk. PM2.5s are so tiny that regular masks won’t block them out.
Avoid outdoor exercise while the air is still hazy and/or you can smell smoke.
Choose exercises that focus on strength work over “cardio” until the air is clear. Cardiovascular exercise requires more air exchanges therefore invites more inhaled debris.
Take a shower after you’ve been outside, and rinse out your nasal passages with saline nasal spray to reduce the particulate matter on your body and in your upper respiratory tract, respectively.
Use this as an opportunity to quit smoking cigarettes or other smoke products. Sometimes it takes evidence of a climate crisis to jumpstart a new habit!
The pandemic laid bare our vast vulnerabilities. It reminded us that risk is everywhere—and that health is about balancing risk, not trying to eliminate it.
The best we can do right now is to limit our exposure to polluted air and balance the risk of being outside with the downsides of not enjoying the outdoors. It’s a good time to remind ourselves why we love nature—and to protect our planet like our life depends on it. Because it does!
What are you doing to protect yourself and your family? What is the air quality like where you live? Drop me a line! 👇
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Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.
Once again it was swimming pool to the rescue. Went to the pool knowing it would be difficult with the foul air First two 100 yard splits were difficult. But after that lungs seemed to clear and the next 1600 yards were quite normal. There’s something different in the air near the water. Incidentally, the Ohio Valley in Ohio where I live has extended the Air Quality Alert until midnight when it’s expired every where else in the area.