Asthma - Ozone and Other Air Pollutants

Air pollutants such as ozone and sulfur dioxide may be found in the home. The levels of these gases are lower indoors than outdoors but still may be irritating to patients with asthma and other lung diseases. Fine particle pollutants may also be found in the home. Patients should be aware of pollution levels and air pollution "alerts" issued by local public health authorities. Air conditioning can be effective in reducing irritating airborne gases. An air filter reduces levels of particulate pollutants.

Outdoor Allergens and Irritants

Avoidance

Avoidance is the best way to reduce your number of asthmatic attacks triggered by exposure to pollens, molds, and other outdoor allergens. Sensitive individuals are best protected in an air conditioned environment that contains an air filter. Pollen and mold spore counts are commonly found in newspapers and TV weather reports.

Pollens and Molds

Pollens are seasonal and patients should be able to prepare ahead for particularly difficult months. Patients with known tree pollen allergy who are symptomatic in the spring, for example, may reduce the frequency of asthma attacks by beginning an anti-inflammatory agent such as inhaled corticosteroid or cromolyn or nedocromil two to three weeks before the start of their "season." Those who are sensitive to grasses and ragweed will want to maintain their medication through to the first frost.

Mold spores are more plentiful in warmer months. Thousands of different species of mold exist. They may be found in high numbers on both dry and rainy days. Alternaria is a mold often found in dry, warm climates and in farming areas. Fusarium mold is often found in plants and is abundant during damp, humid weather. Other molds are found in decaying wood and soil. Be sure you anticipate exposure during outdoor activities (mowing the lawn, raking leaves). A simple filter mask may help you reduce your exposure. Patients may also reduce exposure by staying indoors, using air conditioning and air filtration.

Air pollution

Air pollution has been demonstrated to have significant adverse effects on patients with lung disease and especially those with bronchial asthma.The Environmental Protection Agency (EPA) has set standards for most common pollutants, including sulfur dioxide (S02), nitrogen dioxide (N°2) , carbon monoxide, ozone, particulates, and lead. Sulfur dioxide and particulates are produced by combustion of sulfur containing fuels such as coal and petroleum. Sulfur dioxide is found in high concentrations near steel mills, power plants, and other factories that burn coal or oil. Particulates are the soot and ashes produced by incinerators, smokestacks, and diesel trucks.

Nitrogen dioxide is a product of industry found in high concentrations when fuel is burned and it may be released by power plants and automobiles. This type of industrial pollution affects primarily the central and eastern United States but may also be found in any area with many vehicles. According to the EPA, heavy duty diesel engines produce 25 percent of all vehiclem generated nitrogen oxides, a main component of acid rain and a major source of urban smog. Carbon monoxide is also emitted by automobiles and factories.

Asthmatics are extremely sensitive to sulfur dioxide and may react to exposure with constriction of the bronchial tubes to increased levels of this gas in outdoor air. Increased levels of particulate pollution have also been associated with exacerbations of chronic respiratory disease. The effect of particulate pollution depends on the size and chemical nature of the inhaled particles. The smaller particles have a greater likelihood of reaching the lungs of patients with asthma, bronchitis, and emphysema. A recent study links particulate pollution with a greater likelihood of death from respiratory disease.

Photochemical pollution or "smog" is the product of the action of sun light on vehicle exhaust and chemical fumes. Ozone is a product of this interaction and can be used as an index for this type of pollution. Southern California was the first area affected by photochemical pollution, but it has become common in major cities throughout the United States, especially in the summer. Ozone has been shown to cause a reduction in lung function in normal subjects and individuals with asthma. It has been suggested that prolonged exposure may produce chronic lung disease.

National standards for air pollutants have been set with a "margin of safety" that should protect the health of patients with asthma and other illnesses as well as the general population. Air pollution "alerts" are issued by local public health agencies when increased levels of pollution are noted. Air pollutants will be found in greater amounts when weather conditions produce stagnant air circulation. The warm summer months in the eastern United States are particularly dangerous due to increased ozone levels. Patients are advised to stay indoors in an air-conditioned environment during periods of increased pollution. Exercise outdoors, which increases the likelihood of inhaling pollutants, should especially be avoided during these periods. Remember that pollutants such as ozone may also be damaging to individuals with normal lungs and therefore should be avoided by everyone.

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