By Olivia Trani

Wildfire season has returned to North America, with blazes scorching many regions of Canada and the West Coast, sending smoke hundreds of miles across the country. While many people know to avoid wildfire smoke and take precautions on hazy days, there are other forms of air pollution we’re exposed to year-round, often on a daily basis. 

”You can still be exposed to air pollution even if you can’t see it,” said  Stephen Fong, Ph.D., director of the VCU Integrative Life Sciences doctoral program and a professor in the Department of Chemical and Life Science Engineering at the VCU College of Engineering. “The past few years have been some of the hottest on record, and while people have become more aware of the health impacts of extreme heat, we need to be cognizant that it can also worsen our air quality.”

“For someone who has healthy lungs, exposure to one day of poor air quality is unlikely to have a drastic effect on their health. However, when we start adding those days together, it’s possible that long-term exposure to poor air quality can increase the risk of developing chronic respiratory conditions,” said Drew Barber, M.D., a pulmonologist at Children’s Hospital of Richmond at VCU and an assistant professor in the Department of Pediatrics at the VCU School of Medicine.

VCU Health News spoke with Fong and Barber about the ways air pollution infiltrates our neighborhoods, how it impacts our health, and what we can do to limit exposure.  

What are the most common forms of air pollution?

SF: When it comes to air pollution, there are two major types: solid particles or liquid droplets (smoke, soot, dust, and pollen) and gases (sulfur dioxide, nitrogen oxides, carbon monoxide, and ozone).

Air pollution is often the byproducts of combustion, like burning fossil fuels, gasoline, and coal. Because of this, neighborhoods next to major highways and industrial complexes are more likely to experience high levels of air pollution. Oftentimes, these neighborhoods also have more asphalt and less shady green spaces, which can increase the local temperature, further exacerbating air quality issues.

What does poor air quality do to our bodies?

DB: When we are exposed to poor air quality, pollutants can find their way into the small airways of our lungs. This can cause inflammation and sometimes lead to respiratory symptoms like shortness of breath, wheezing, or persistent coughing. 

For people with asthma, chronic obstructive pulmonary disease (COPD), or other respiratory issues, spending time outside during a poor air quality day can worsen or trigger symptoms they otherwise might not have on a day-to-day basis.

For those with healthy lungs, short-term exposure to poor air quality will likely not cause any damage to the lungs or result in any symptoms. However, there is growing evidence that long-term exposure to poor air quality can lead to chronic inflammation in the small airways of the lungs. This in turn can increase the risk of developing chronic respiratory conditions, particularly asthma and COPD. 

How can I protect myself from poor air quality? At what point should I call a health care provider?

DB: If there is a day when the air quality is very poor, the primary recommendation is avoiding exposure as much as possible. It’s best to stay inside or wear a facemask if you have to go outside. If you have a pre-existing lung condition, make sure you are correctly taking the medicines that are prescribed by your physician. For example, if you have an asthma diagnosis, using your controller inhaler can help with managing symptoms. 

If you start experiencing respiratory symptoms, like shortness of breath or feeling like you can’t catch your breath, contact a healthcare provider. Another symptom is wheezing, which is a high-pitched whistling noise that can emanate from the chest while breathing, especially when you breathe out. That’s a sign that the small airways deep in your lungs are a little swollen from inflammation. 

Infants and small children obviously can’t tell you if they are feeling chest tightness or shortness of breath, but there are a few ways to tell if you need to take them to a health care provider. For instance, if you see a child starting to wheeze or breathe faster than normal, that can be an indicator that something is going on in their respiratory system. Alternatively, if you notice that the muscles underneath their ribcage are sinking every time they take a breath or the skin around their neck is pulling in, that means they are working harder to breathe or struggling. 

Is there a particular season when air pollution is at its worst?

SF: There are some correlations between heat and air pollution. During the hottest months of the summer, which are July and August in the U.S., we often see spikes in air pollution. This is partly because, when certain pollutants enter the atmosphere, the sunlight and heat can trigger a reaction that creates ozone as a byproduct. Ozone is the main component of smog and irritates people’s lungs if inhaled.

How can I monitor air quality?

SF: Many weather apps on our smartphones now show forecasts for air quality, called the air quality index (AQI), which is a very accessible guideline and great for raising awareness of air pollution. The index takes into account various kinds of pollutants to create an air quality score that is easy to digest. 

However, there are some limitations. The index is set up to make a prediction about air quality, so it doesn’t represent direct measurements for air pollution. Also, the AQI doesn’t always show how air quality differs between neighborhoods

There are community science initiatives, like Purple Air, that collect hyper-local data in real-time to show how air quality varies across a city. In my research lab, we are mapping the air pollution hotspots in Richmond. NASA also launched a series of satellites that are specifically designed to measure air pollutants hourly across North America, which will significantly enhance our air quality forecasts.

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