Why Should You Care About the Air?

Linda Brookes, MSc

Disclosures

September 10, 2015

In This Article

Advising Patients at Risk

"Right now we don't have any magic bullets to counteract the effects of air pollution, so we must advise people to reduce their exposure to air pollution as much as possible," Dr Balmes stresses. "I am a pulmonary physician, so I have many such patients with asthma and chronic obstructive pulmonary diseasewho need to pay attention to the air quality alerts," he says. "Many newspapers in California and major cities throughout the United States publish the Air Quality Index, which reports daily levels of the five most common ambient air pollutants regulated under the CAA: ground-level O3, CO, sulfur dioxide (SO2), and nitrogen dioxide (NO2).[40] They should pay attention to that, and when there is advice for sensitive, susceptible people to stay indoors, they should," he urges.

"If people can afford them—unfortunately not everybody can—they should get window air conditioners so that they can keep the window closed during hot smoggy days. Most of the air pollution will not make it into the house because of the air conditioner," Dr Balmes also advises. He also recommends using indoor air cleaners with high-efficiency particulate air (HEPA) filters. These have been shown to reduce indoor levels of PM2.5 and improve microvascular function in healthy individuals.[41,42] The California ARB is currently funding a study being carried out by the University of California at Davis, which is installing HEPA filters in the homes of 200 children with moderate-to-severe asthma to measure indoor exposures to PM and O3 and determine whether there is a concomitant reduction in symptoms, Dr Balmes notes.[43] The study will compare the effects of central system and portable HEPA filters or filtration units. It is anticipated that both the in-duct and stand-alone HEPA filtration units will result in reduced indoor air pollution and a lower prevalence of asthma symptoms. "As a result of this study, ARB should be able to determine whether these interventions will reduce exposures to key air pollutants and be cost effective in reducing health costs associated with asthma care," Dr Balmes says.

Another recommendation Dr Balmes makes is to not barbecue on a smoggy day, or "not on any day if you have a sensitive member of the family, because that is another way of generating combustion particles that add to the problem." Also, "Get smoking out of the house, because air pollution and tobacco smoke are on a continuum of combustion particles in terms of the health effects," he stresses. Advice for patients on how to avoid exposure to air pollution in the United States is issued by several professional medical organizations, including the ATS (in a publication edited by Dr Balmes),[44] the ALA,[45] the AHA,[46] and the American Academy of Family Physicians.[47]

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