Does Extreme Heat Worsen The Health Risks Of Poor Air Quality?
A pulmonary and critical care medicine expert offers tips on how to protect yourself amid extreme heat and unhealthy air caused by Canadian wildfires.
Wildfires burning across Canada have led to air quality alerts in the New York City area. Lingering smoke in the air can spread “fine particulate matter,” an air pollutant that is produced by fires and can cause short-term health effects.
Air Quality Indexes (AQI) span from 0 to 500, and the higher the number, the greater the air pollution and potential health risks. The AQI in New York City and surrounding suburbs is currently between 51 and 100.
Adding to the air quality health risk is extreme heat in the forecast this week. The National Weather Service issued a heat advisory for New York City as temperatures are predicted to be in the upper 90s and lower 100s.
“When there is extreme heat with poor air quality, it is a double stress on people, particularly those with underlying cardiovascular and lung disease,” says Dr. Michael S. Niederman, a physician specializing in pulmonary and critical care medicine at NewYork-Presbyterian/Weill Cornell Medical Center and a professor of clinical medicine at Weill Cornell Medicine. “People should be vigilant about exercising in extreme heat, and it is even more of a risk now because you are breathing in particulates in the air.”
Health Matters spoke with Dr. Niederman about how to protect yourself amid unhealthy air conditions and high temperatures.
Why does extreme heat, combined with poor air quality, pose a greater health risk to people?
The health risks involved with extreme heat are accentuated by poor air quality.
Extreme heat increases cardiovascular demands on the body – when it’s hot, the amount of air you breathe in and out is greater than normal, especially if you are exercising. When you are also breathing poor-quality air, you are exposed to greater amounts of particulates in the air, and that can cause potential injury.
What kind of precautions should be taken when there is poor air quality and extreme heat?
People most at risk are those with underlying conditions, such as heart and lung diseases, the elderly, infants, and very young children. Lung disease patients who are most at risk, for example, are those with asthma, emphysema, and pulmonary fibrosis. They should follow precautions, such as limiting outdoor activities, postponing outdoor events, using air conditioning with filters, and masking.
How is air quality measured and what is a typical healthy average?
Air quality is a measure of the concentration of particulate matter and gases in the ambient air. Good air quality is typically an Air Quality Index below 50. When levels rise above an Air Quality Index number of 100, people are more likely to develop symptoms.
What is fine particulate matter, the pollutant of concern?
Fine particulate matter is the product of combustion that can arise from fires and contains burnt material and sometimes other gases and noxious fumes. Inhaling fine particulate matter is like inhaling cigarette smoke but without the nicotine.
The smaller the particle, the more likely it is to reach deep into the lungs and potentially allow some contaminants to enter the bloodstream.
How can the current air quality affect our health, and what are the symptoms?
Inhaling particulate matter from fires can irritate the bronchial tubes in the lungs and cause symptoms, such as chest tightness, cough, wheezing, and shortness of breath. In general, short-term exposures are bothersome, but do not have long-term effects.
Other health effects of exposure are that people may be prone to developing respiratory infections such as bronchitis or even pneumonia if the particulate matter interferes with the lungs’ ability to remove infectious organisms.
Some experts are concerned that there may be long-term effects to the heart and lungs, but we currently do not know if there will be any long-term effects of this current exposure.
AirNow, a source for air quality data, states that the six categories include:
- Green (good, 0 to 50): Air is satisfactory, and air pollution poses little or no risk.
- Yellow (moderate, 51 to 100): Acceptable, but there may be a risk for some people, such as those who are sensitive to air pollution.
- Orange (unhealthy for vulnerable groups, 101 to 150): Sensitive groups may experience health effects. The general public is less likely to be affected.
- Red (unhealthy, 151 to 200): Some members of the general public may experience health effects. Members of sensitive groups may experience more serious health effects.
- Purple (very unhealthy, 201 to 300): The risk of health effects is increased for everyone.
- Maroon (hazardous, 301 or higher): Health warning of emergency conditions: everyone is more likely to be affected.
What can people do to limit exposure inside their homes and cars?
Keep the windows closed. In cars, people should keep the windows closed and air conditioning on if it gets hot.
Will masks help protect people from poor air quality?
An N95 or particulate respirators can protect you more than surgical masks, and people should consider wearing them. The efficacy depends on wearing them properly. When commuting, people should determine if they should wear masks by analyzing conditions in buses and subways, such as whether the windows are closed or opened.
When should someone consider going to the doctor?
If someone feels persistent symptoms, they should call their physician. There are several treatments that we can consider giving you, such as bronchodilators (which prevent bronchial spasm and open bronchial tubes, which can relieve chest tightness, wheezing, and cough) and inhaled steroids that relieve bronchial inflammation and are often used for patients with asthma.
How long should people expect air alerts to last, and what should they keep in mind during this time?
At this moment, we want to follow state and city public health announcements and air quality measures, such as through AirNow. Even healthy people may develop symptoms. And if you develop symptoms, take similar precautions, such as limiting outdoor activities, air conditioning, and masking. And call your doctor if symptoms are persistent and bothersome.
Michael S. Niederman, M.D., is dedicated to the care of patients with complex lung diseases, with a particular focus on respiratory tract infections including pneumonia, chronic obstructive pulmonary disease, sepsis, and respiratory failure. He is an expert in the management of patients with pneumonia, has written national and international pneumonia guidelines, and done research on new therapies for pneumonia that can optimize treatment of patients infected with antibiotic-resistant pathogens. Dr. Niederman has published over 350 articles and book chapters related to these efforts and is active in national pulmonary and critical care organizations and journal editorial boards.