Wildfire smoke has become more common in the summer. Poor-quality air is unhealthy, especially for vulnerable people, including those with asthma or heart conditions, as well as younger kids and older adults.
The poor air quality, often the result of wildfires in Canada, is something you can actually feel. When air quality is poor, experts say you should consider limiting your time outside, especially if you are exercising or doing strenuous tasks; keeping your windows closed at home; and wearing a high-quality N95 or KN95 mask if you need to go out. Those most at risk should stay indoors.
In this Q&A, Linda Rogers, MD, Director of the Adult Asthma Program, and Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) at the Icahn School of Medicine at Mount Sinai, explains how to protect yourself when air quality is poor.
Linda Rogers, MD, Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine)
How can I tell what the air quality is like in my neighborhood right now?
A good way to see what the air quality is like right now, where you live, is the website AirNow.gov or the AirNow app created by the U.S. Environmental Protection Agency and available for download for free, where you get your apps for your of phone. This site offers a composite score for what we call the big five pollutants—ground-level ozone, particulate matter, carbon monoxide, sulfur dioxide, and nitrogen dioxide. A good score is less than 50. On an average day in New York, we are around 30; we have pretty good air quality. Once it starts getting up over 50, there may be risks for sensitive people. If the score reaches 100-150, due to a combination of heat, humidity, and pollution, the risk for sensitive individuals rises. If it rises above 150, sensitive groups may experience more serious health effects, and some members of the general public may also experience health effects. In recent years, the score has risen to over 100 due to the wildfires. Any of the common weather apps people have on their phones are also a good source of this information.
What does it mean when the air quality reaches the unhealthy levels?
That’s the red zone. That’s where even healthy members of the general public are going to feel it. The effects on the general public may be mild; it may just be a matter of feeling irritation in your nose or throat. But for really sensitive groups, this is a level that could trigger an asthma attack or flare-ups of other lung diseases such as COPD, or chronic obstructive pulmonary disease. It can also pose a risk for those already at risk for heart attacks and strokes. During times of high pollution level, there is a well-established pattern of increased risk of emergency room visits for these types of cardiovascular events 48 to 72 hours after exposures to high pollutant levels.
The Effects of Wildfire Smoke Particles Can Persist for Months, Even After a Fire Has Ended
Being exposed to lingering fine particulate matter from wildfire smoke can have health effects up to three months afterwards, well beyond the couple of days that previous studies have identified, and the exposure can occur even after the fires have ended, according to new findings by researchers at the Icahn School of Medicine at Mount Sinai and Harvard T.H. Chan School of Public Health. “Even brief exposures from smaller fires that last only a few days can lead to long-lasting health effects,” says Yaguang Wei, PhD, Assistant Professor of Environmental Medicine. Read more
What safety precautions should I take when air quality is at an unhealthy level?
The best thing to do is stay inside with the windows closed. If you have to go outside, make it as short as possible. I don’t think anybody should exercise outdoors while the air quality is poor. When you’re exercising, you are taking in more of these contaminants. It depends on your personal circumstances, but when levels are between 100 and 150, you may want to consider limiting outdoor exercise, especially for young children.
Should I wear a mask?
You should consider wearing a high-quality mask, such as an N95 or KN95 mask. Surgical-style masks will not be helpful. Those masks offer at least partial protection from viruses transmitted by droplets, but they do not protect you from the extremely small particle pollutants. And even the N95 and KN95 masks cannot protect you from the gases, such as carbon monoxide, that are produced by wildfires.
What about working outside?
I think it depends on your underlying health, your age, your circumstances, what the work involves, and what the air quality is in the area that you’re working. If you have to work outside, a high-quality N95 mask will be a great idea if it’s possible for you.
Does it help to use my air conditioner?
Air conditioners vary tremendously in terms of how old they are, how they’re built, and what kind of filters they have in their use. Closing your windows and using an air conditioner is better than having the windows open. Ideally, your air conditioning system has a high-efficiency filter. Air purifiers can also help.
Who is most at risk?
Young children are more at risk because they tend to breathe at faster rates with higher volumes. When there’s an elevated pollution level, they’re generally getting more exposure. The elderly are at higher risk for heart and lung disease and have other underlying health conditions. Those with lung diseases, notably asthma and chronic obstructive pulmonary disease (or COPD), are often sensitive to environmental triggers like this, or changes in weather, temperatures, and humidity. Many of those with asthma, for example, often reach out to their doctors in advance to make sure they have emergency medication on hand. But it can be different for those with heart conditions.
What should people with heart disease know about this?
People with heart disease may not be aware that they are at increased risk, but these high levels of pollutants have been linked to visits to emergency rooms with cardiovascular conditions. People who are at risk may want to consider staying indoors to the extent possible. It’s also important to note that there may be a lag in the onset of symptoms. It may take a while for the contaminants you are breathing in to have an effect on your blood vessels. That is why we may sometimes see a lag in visits to the emergency department. The health effects can persist and escalate from 24 to 48 hours after the air quality levels are at their worst.
What are the signs that the air quality is affecting a typical, healthy person?
When the air quality index gets above 100, and then over 150, as has happened in recent years, you’re going to feel throat irritation, nasal irritation, nasal congestion, runny nose, sore throat—almost cold-like symptoms except without a fever. Some people may feel chest discomfort and headaches. These aren’t particularly dangerous. But for those with underlying conditions, such as lung disease and allergies, they can cause more severe debilitating symptoms. The air is unhealthy for everyone, but some groups are at risk of significant health effects.
Details of the air quality index from the federal government’s AirNow.gov site.