You have probably noticed the hazy skies throughout the New York City area. Health experts say everyone should pay close attention. That 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, the result of wildfires in Canada, is something you can actually feel. 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.

“Many people may have noticed the hazy conditions, but not realized they should be concerned—especially younger people and the elderly, who are at greater risk,” says Linda Rogers, MD, Professor of Medicine  (Pulmonary, Critical Care and Sleep Medicine) at the Icahn School of Medicine at Mount Sinai. “I think we all should be looking out for the most vulnerable; they are the ones that are at most risk right now. But this has crossed a threshold where the general public will feel this.”

Linda Rogers, MD, Professor of Medicine  (Pulmonary, Critical Care and Sleep Medicine)

In this Q&A, Dr. Rogers, who is also Director of the Adult Asthma Program, offers a number of other tips, including what type of mask to consider wearing, whether to turn on your air conditioner, and who is most at risk.

How bad has the air quality been in New York City because of these wildfires?

Our air quality has been in a zone that’s considered dangerous to sensitive populations and that may be hazardous to people who are either elderly, very young, or have underlying heart or lung disease, or other sort of significant health conditions. It’s not something people are normally aware of, though most people going outside will realize that something is up.

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, due to a combination of heat, humidity, and pollution then the air quality may be risky for the general population rather than just for sensitive individuals. 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 we have seen lately?

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

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.

Prostate cancer is periodically in the news, often when a celebrity or public figure announces they are undergoing treatment. But experts say that for older men, prostate cancer should be something they regularly discuss with their health care providers, and the key for most men is to understand the need for regular prostate cancer screenings.

Prostate cancer is the second most common cancer among men in the United States, after skin cancer, and the number of cases has been rising. It’s also the second-leading cause of cancer death (after lung cancer). About one in eight men will get prostate cancer in their lifetime.

However, in many cases, men can recognize and manage this disease through testing and early detection, according to Ash Tewari, MBBS, MCh, FRCS (Hon.), DSc (Hon.), Professor and Chair, Milton and Carroll Petrie Department of Urology at the Icahn School of Medicine at Mount Sinai.

“The one thing men should know is that they should understand the risk and get tested,” says Dr. Tewari,  a leading expert on prostate health and an advocate for expanding efforts to get men tested for prostate cancer. “That’s one thing that makes all the difference.”

In this Q&A, Dr. Tewari, who is also Director of the Center of Excellence for Prostate Cancer at The Tisch Cancer Institute at Mount Sinai, explains when men should be tested for prostate cancer, how to assess your risk, and how regular testing is critical to identifying cancer earlier when treatment is significantly more successful, especially for those who may be at higher risk.

What are the warning signs of prostate cancer?

Prostate cancer is a silent killer. No symptoms will show up before the cancer has grown and has become incurable. The message here is: Don’t expect cancer to declare itself. You should go out and look for it. You should understand the risk. If you find it early enough, it’s very curable. But if you wait for the signs and symptoms to come and the cancer declares itself, the battle is usually a difficult battle. It’s a silent killer, don’t wait for the symptoms.

What are the symptoms?

Symptoms can happen when the cancer is quite advanced. People may have difficulty in passing urine, they may have some pain, they may have some blood in their urine. That usually is a sign that the cancer is growing into the areas surrounding the prostate. But similar symptoms can happen even if there is no cancer. For example, an enlarged prostate—a condition called benign prostatic hyperplasia, or BPH—can produce these symptoms. It can be confusing. My message remains the same: Look for prostate cancer, and get screened, especially if you have a high risk, and that’s what saves lives.

When should men get tested for prostate cancer?

Men normally should start having a conversation with their primary care doctor or a urologist when they are about 45 to 50 years of age. When we talk about the testing, it’s not just about the test, it’s also what are the implications of the test—what we call shared decision making.

On average, any man 50 to 69 years old should be having a discussion with their doctors about prostate-specific antigen (PSA) screening, and older men should also discuss prostate cancer with their doctor. But we can have this conversation earlier. For example, if someone has a family history of prostate cancer, is BRCA positive, or is African American, we could consider that group to have a high risk of prostate cancer. That discussion can start at about age 40. It is all about the individual’s risk for prostate cancer. Prostate cancer can be checked, and that’s the beauty of it.

About 288,000 men were diagnosed with prostate cancer last year. About 34,700 men died due to prostate cancer last year, and the majority of these deaths were avoidable if we had found the cancer early. PSA screening is a simple blood test. I think of PSA as standing for “Please Stay Alert.” There are other ways of testing, including a digital rectal exam, ultrasound and MRI scans, and other tests of your blood and urine. But the discussion starts with the PSA, and people should talk about what this PSA can do for them.

How can you minimize the risk of prostate cancer?

Those at high risk can do a lot to prevent this cancer and live healthier lives. It’s not rocket science. It starts with diet and nutrition—cutting down on carbs and processed food, balancing your diet, having more lean protein, avoiding red meat, cutting down on smoking and alcohol. And exercising a lot. I mean about 30 minutes a day, three to four times a week. Combining all of these is one of the biggest preventive factors in prostate cancer risk. Obviously, testing early makes all the difference.

How treatable is prostate cancer?

If we find prostate cancer early, we can cure it 98 to 99 percent of the time. But think about it: Despite this high cure rate, we still lost 34,700 men last year. Why did that happen? Because we are finding the cancer a little late. In five percent of patients, when we find cancer, they already have a cancer that has advanced to their bones, to the lymph nodes, to other parts of the body. We call it metastatic cancer.

Finding cancer when it is confined within the prostate makes all the difference. At that time, it’s very curable, and the cure can come in many different forms. We have nerve sparing procedures in which we can remove the prostate using minimally invasive, robotic surgery, and the patient is cured of the cancer in a majority of times. We have new kinds of radiation therapies that can do the same job in a select group of patients. In many cases, prostate cancer doesn’t even need active treatment. Patients can be closely monitored in what we call “active surveillance.” We have many forms of the treatment. An expert can tell exactly what is suitable for each person, based on the type of cancer, how far it has progressed, and personal choices. Hope is there, but we need to fight it early.

What role does family history play in prostate cancer risk?

When I ask people about their cancer, they often say, “I never talked to anyone in the family about medical issues.” That’s not a good answer. Basically, if people have many members in the family who had prostate cancer, or if there is breast cancer, uterine cancer, or pancreatic cancer in the family, that tells us they are from a family with high risk of prostate cancer. For example, the BRCA2 gene that can increase the risk of breast cancer in women is known to be correlated with a higher risk of prostate cancer. Knowing there are members in your family going through the same journey should make you a little more cautious, and that can save your life.