2020 has been a difficult year for people all over the world. From learning how to deal with the health-related and economic impact of the novel coronavirus to planning for natural disasters, it’s easy to feel like everything is crashing down around us. The latest concern in this lineup of unexpected events is the wildfires that are spreading across much of the country.
While June through August is known as “wildfire season” in the U.S., 2020 has proven to be particularly dangerous. Currently, California is experiencing both its second and third largest wildfires in history (the SCU Lightning Complex and the LNU Lightning Complex respectively). Colorado is also experiencing some of its worst wildfires in years with both the Pine Gulch Fire and the Grizzly Creek Fire.
Unfortunately, the threat of large uncontained wildfires extends beyond property damage. These fires leave behind an enormous amount of smoke that can lead to air pollution all across the country. If you suffer from a respiratory illness such as chronic obstructive pulmonary disease (COPD), asthma, or pulmonary fibrosis, this smoke could seriously disrupt your way of life.
In this post, we’re going to take a look at some actionable tips for dealing with outdoor air pollution as a respiratory patient, especially as it pertains to the wildfires that are affecting much of the country. If you’re planning on making changes to your respiratory treatment plan, be sure to consult with your doctor first.
How to Recognize Poor Outdoor Air Quality
Many people don’t pay any mind to the quality of air they breathe on a day-to-day basis. Whether it’s indoor air or outdoor air, people simply expect the air to be clean and healthy. However, even if you don’t experience any immediate symptoms, this does not mean that there are no symptoms at all.
Like we’ve discussed in previous posts, indoor air pollution is a major culprit of poor air quality. Despite feeling more secure in your own home, contaminants like cleaning products, mold, and dust can damage your lungs and exacerbate chronic pulmonary illnesses like asthma and COPD. As such, it’s important to take time each day to clean your home and keep it safe for you and your family.
While it’s pretty simple to eliminate air pollution in your home, it’s not so easy to do so outdoors. What’s more, how can you even recognize that there’s poor air quality in the first place?
Air quality is measured using the Air Quality Index (AQI) which runs between 0 (great air quality) and 500 (very poor air quality). Below is a chart showing exactly how this AQI works.
While 51-100 AQI is considered “moderate,” you can assume that this air is not safe to breathe if you have a chronic respiratory ailment. It’s also important to take into consideration the level of activity you will be doing outdoors. Higher levels of activity such as walking, biking, or running will cause you to breathe more heavily and thus result in air pollution entering lower parts of your respiratory system. This means you’ll be more likely to experience exacerbations that could lead to hospitalization.
One of the best ways to check AQI in your area is through AirNow.gov. This organization receives data from a variety of sources in order to help people all across the country plan healthier lives. Simply click on the link above and you will be asked to enter the name of the location you want to check. You’ll be provided with the current AQI in your area as well as the AQI forecast for future dates. You should make it a habit to check this daily and plan your activities accordingly.
What Types of Pollutants are there?
According to the Environmental Protection Agency (EPA), there are six major types of air pollution. These include particulate matter (particle pollution), lead, nitrogen dioxide, sulfur dioxide, carbon monoxide, and ground-level ozone. Let’s take a look at each one of these so that you understand what they are and how they affect your lungs.
Particulate Matter (PM)
Particulate matter is the sum of all liquid and solid particles that are suspended in the air. This includes both organic and inorganic particles like pollen, smoke, dust, and soot. When you check the air quality in your area, particulate matter will be labeled as either “PM10” or “PM2.5.” The former indicates particulate matter that has a diameter of 10 micrometers or less and the latter indicates particles that have a diameter of 2.5 micrometers or less. To put this into perspective, the average human hair is 70 micrometers in diameter, so a PM2.5 particle is about 30 times smaller than this.
PM has a variety of different sources and can be composed of hundreds of different chemicals. PM that is less than 2.5 micrometers in diameter tends to be the most dangerous because it’s small enough to bypass the body’s innate immune system, reaching the lower parts of the lungs and even the bloodstream. Wildfires contain PM of all sizes so it’s imperative that you avoid it in order to keep your lungs safe.
Ground-level ozone is a gas that’s found just above the surface of the earth. This type of pollution is created when volatile organic compounds (VOCs) and nitrogen oxide (NOx) — two primary pollutants — react in stagnant air and sunlight. Ozone is known not only for being a major health hazard to humans, but to animals, the environment, and even property. According to the British Lung Foundation, high levels of ozone are associated with more frequent hospitalization due to asthma attacks and COPD exacerbations.
Sulfur Dioxide (SO2)
Sulfur dioxide typically enters the atmosphere through the burning of fossil fuels by industrial facilities and power plants. Other sources of this gas are locomotives, heavy equipment, ships, vehicles that burn fuel that’s high in sulfur. SO2 is harmful to everyone, but it’s especially bad for people with chronic respiratory illnesses. It can irritate the respiratory tract and can greatly increase your risk of experiencing tract infections.
Despite being significantly regulated by the Environmental Protection Agency (EPA) in the 1980s, lead is still a common type of air pollution. You’re most likely to be exposed to lead when you’re next to metal processing plants, lead-acid battery manufacturers, or piston-engine aircraft that run on leaded aviation fuel. While lead can damage the lungs, it can also enter the bloodstream leading to poor immune or nervous system function, kidney damage, or cardiovascular damage.
Nitrogen Dioxide (NO2)
Nitrogen oxides (NOx) such as nitrogen dioxide, nitrous acid, and nitric acid are known for being highly reactive. This means that they are much more chemically active than other gases which often leads tot hem being more dangerous. Not only is NO2 harmful when inhaled, leading to symptoms like coughing, wheezing, or shortness of breath, but it can also react with other chemicals in the air to form ozone and particulate matter. NO2 usually enters the atmosphere due to the burning of fuel.
Carbon Monoxide (CO)
Carbon monoxide is a by-product of the combustion process. In other words, anything that burns fuel such as a car, machinery, gas heaters, and gas stoves release CO when they are used. CO is harmful to breathe because it displaces oxygen in the blood and deprives organs like the brain and heart of oxygen. Inhaling a large amount of CO can lead to carbon monoxide poisoning, asphyxia, and death.
How to Stay Safe and Avoid COPD Exacerbations
While we can get involved in our communities to help improve air quality, very little can be done to prevent natural disasters like wildfires. It’s normal for there to be thousands of wildfires each year in the United States and it’s difficult to predict exactly where they will be or how bad they will get. As a result, COPD and asthma patients need to pay attention to the news and plan their lives around these devastating events.
Make it a Habit to Check the AQI Daily
Like we mentioned earlier, Air Quality Index (AQI) is the measurement used to determine how safe the air is to breathe. AirNow.gov updates its site regularly so you should make a habit of checking it at least once a day. Another great feature of this site is that it breaks down what pollutants are in the air. For example, it will notify you if there are more PM2.5 than PM10 in the air, indicating that the air is less safe to breathe.
One thing to note about AQI forecasts is that they are not 100% accurate. Similar to weather forecasts, there is room for error and the information is updated as more information becomes available. As a result, it’s important to also use your best judgment. If the report shows 50 AQI in your area but it looks hazy out, it’s best not to go out until it clears up. Another mistake people make is that they assume that rain will clear the pollution. While heavy rain can reduce pollution slightly, it’s nearly inconsequential when it comes to PM2.5 which is most harmful to your lungs.
Recognize the Signs of an Exacerbation
Secondly, you need to be aware of COPD exacerbation symptoms. An exacerbation is a period of time where coughing, wheezing, and chest pain get worse and it becomes increasingly difficult to breathe normally. The majority of COPD exacerbations are caused by respiratory infection, but the second most common cause of exacerbations is air pollution. If left untreated, exacerbations can lead to hospitalization and even permanent lung damage.
Generally speaking, you will want to seek medical attention for your COPD exacerbations. Even if you just experience a flare-up in your symptoms, your doctor should be notified so that he/she can take the necessary steps to help you recover quickly and effectively.
Take Your Oxygen Concentrator and Inhaler
As always, it’s important to have all your medications and medical devices with you whenever you leave the house. No matter what the air quality is like, your portable oxygen concentrator and inhaler will ensure that your blood oxygen levels remain stable throughout the day. What’s more, if you experience an exacerbation while you’re out, your portable oxygen concentrator or rescue inhaler will help you to recover more quickly.
According to a study published in the International Journal of Chronic Obstructive Pulmonary Disease, there is clear evidence that using supplemental oxygen as prescribed by your doctor can strongly influence the outcomes of acute exacerbations. While more studies need to be done in order to determine exactly how it should be used, simply having a reliable portable oxygen concentrator on you at all times is a great first step.
There are many portable oxygen concentrators for sale in this day and age, but we recommend either the Caire FreeStyle Comfort or the Inogen One G5. The FreeStyle Comfort released last year and provides COPD patients with up to 5 pulse flow settings and the G5 provides up to 6 pulse flow settings. If that’s not enough, you’ll be happy to know that both of these portable oxygen devices weigh under 5 pounds meaning they’re light enough to carry wherever you go without causing any strain on your back or shoulders.
Avoid Exercising Outdoors
Exercise is an important part of your COPD treatment plan. Pulmonary rehabilitation is designed to strengthen your muscles, increase your endurance, and help you breathe easier. But it’s imperative that you exercise safely and that you follow the guidelines set forth by your doctor or pulmonologist. Over-exercising or exercising outside when there is pollution can lead to flare-ups or exacerbations.
When you exercise, you breathe more heavily meaning air pollution is more likely to reach the lower parts of your lungs. You’re also taking in more air and more pollution as a result. While it is nice to exercise outdoors, you’re not going to have a good time if you’re breathing in polluted, stuffy air. If possible, try to get inside and clear a space in your living room or bedroom to perform pulmonary rehabilitation.
Don’t Track Harmful Pollutants Indoors
Whether you’re exercising indoors or you’re simply spending more time indoors due to poor outdoor air quality, it’s important to avoid tracking outdoor pollutants inside your home. The problem with indoor air quality is that it’s more concentrated and pollutants can be moved around your home through the HVAC system. So even if you think that your home is safe, it could be affected by the quality of air outdoors.
There are several different ways that you can test the air quality in your home. You can either purchase your own air quality monitor or you can call a home inspection company that will come to your house and do it for you. The latter tends to be a better option because then you don’t have to learn how to interpret the data and find a way to improve your home’s air quality.
Quit Smoking Immediately
The last tip for coping with outdoor air pollution when you have COPD is to quit smoking. Not only is smoking the primary causal factor of COPD and other lung conditions like lung cancer, but it also has a number of other effects on the body that make you more susceptible to the risks associated with air pollution. For example, cigarette smoking damages, and in some cases destroys the cilia in your lungs and airways.
Cilia are small, hairlike organelles that are responsible for trapping and removing foreign substances from the airways. By doing so, they prevent these harmful substances from reaching the lower respiratory system where they can lead to infections. Studies also show that the chemicals in cigarette smoke can also suppress the adaptive immune system by making it less active and prepared to fight off disease.
Unfortunately, wildfires are a reality that we all need to face. Depending on where you live in the country, you may have to deal with wildfire smoke as early as June and as late as August. As such, it’s best to be prepared with an effective action plan.
If you have COPD or asthma, you should not be going outside when the AQI is above 100 and if you want to exercise outdoors, you should wait until the AQI in your area is below 50. This will help ensure that your lung condition remains stable and that you don’t experience any flare-ups or worse, an exacerbation.
As with all concerns related to your COPD treatment plan, you should contact your doctor or pulmonologist if you have any questions.