Ozone, Air Quality, and Asthma

How Poor Air Quality Affects People With Asthma

Air pollution is a problem for everyone — not just people with asthma. Studies have shown that high levels of air pollution can be associated with decreased lung function and more frequent reports of respiratory symptoms. This is especially true for people who spend a lot of time outdoors.

Kids may be particularly affected by pollution levels because they:

• play outdoors
• have faster breathing rates
• have lungs that are still developing

But although high levels of pollution affect everyone, people with asthma are more sensitive and experience the effects more quickly and severely. Additional studies have shown that ozone, particle pollution, and other forms of air pollution worsen asthma and increase hospital visits for people with asthma. And again, it's kids with asthma who are especially vulnerable to these effects.

Pollutants in the air have the same effect on people with asthma as other triggers. They reduce lung function by inflaming the lining of the lungs. Exposure to pollutants in the air can cause flare-ups and may increase the chance of upper respiratory infections, which can worsen asthma symptoms. If allergens in the air are an asthma trigger, pollutants can make the lungs even more sensitive to them.

What You Can Do

An important aspect of managing your child's asthma is avoiding triggers. That means you should pay attention to pollution levels and plan accordingly when they're going to be high.

The Air Quality Index (AQI) was created by the Environmental Protection Agency (EPA) to monitor outdoor air quality. In over 900 counties across the United States, it measures levels of five major air pollutants regulated by the Clean Air Act:

1. ground-level ozone
2. particle pollution
3. carbon monoxide
4. sulfur dioxide
5. nitrogen dioxide

Using a color-coded system, the Air Quality Index indicates when air quality is dangerous. Green or yellow are acceptable colors, and orange, purple, or maroon mean people with asthma should limit their time outdoors.

The Air Quality Index varies from season to season, from day to day, and even from morning to evening. In cities larger than 350,000 people, state and local agencies are required to report the index to the public daily. But many smaller communities also report the Air Quality Index. In many places, the next day's index is reported, so you can make plans.

You can get Air Quality Index information:

• from weather reports
• in the newspaper
• at www.airnow.gov

On days when air quality is poor, run the air conditioning and limit your child's time outside. Plan any outdoor activities for early in the day — when air quality tends to be better — and avoid spending time in areas where there's a lot of traffic.

If your child participates in a sport that practices outside during hot weather, talk to the coach about alternate arrangements, such as working out in an air-conditioned gym. Also, make sure your child always has rescue medication on hand.

Improving the air quality in your home is also wise. You can do this by using an air cleaner, venting all gas appliances to the outside, and avoiding wood fires in your house.

Talk to your doctor about increasing medication during times when air pollution is high. This can be included as part of your child's asthma action plan.

And although you can't single-handedly solve air pollution, you can take these important steps to help improve it when the air quality is poor:

• Don't drive — share a ride, take public transportation, ride a bike, or walk.
• Don't put gas in your car until after 7 PM.
• Avoid using outboard motors, off-road vehicles, or other gasoline-powered recreational vehicles.
• Avoid mowing your lawn or using other gasoline-powered gardening equipment until the late evening or until the air quality improves.
• Don't use paints, solvents, or varnishes that produce fumes.
• If you're barbecuing, use an electric starter instead of charcoal lighter fluid.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: October 2010