Cigarettes used to be marketed as a trendy and cool, but they’re increasingly being replaced by e-cigarettes. The CDC found that over 263,000 teens who had never smoked a cigarette before tried e-cigarettes in 2013, which is three times the amount of teens trying e-cigarettes in 2011. Since there’s no tar in e-cigarettes, some consumers believe that e-cigarettes are a healthier alternative to regular cigarettes, but this isn’t entirely true.

Most e-cigarettes do contain nicotine, which can cause inflammation in the lungs. Particles in the vapor and flavoring in the e-cigarettes can also irritate the lungs, which is a recipe for trouble for those with asthma. These factors can exacerbate asthma symptoms and potentially bring on an asthma attack.

Air quality is easy to take for granted until we experience first-hand the effects of poor air quality. You can probably relate to driving with the windows down to let in the crisp, fall air, but that enjoyment abruptly ends when the exhaust of another vehicle wafts through your car. Fortunately, North Carolina is ahead of the curve on improving air quality, which is especially important for asthmatics.

Triangle Air Awareness, a public-private partnership between the North Carolina Division of Air Quality and the Research Triangle Regional Partnership, hosted their End of Ozone Forecast Season Luncheon last Friday to give the audience a snapshot of the state of North Carolina’s air quality. Speaker Sushma Masemore, PE, Division of Air Quality at the Department of Natural Resources, explained that the Research Triangle Region is meeting federal air quality standards. Masemore said that the NC legislature was ahead of the curve by enacting the Clean Smokestacks Act in 2002, which was an early action state mandate to control air pollution from coal-fired power plants.

Air quality has an effect on a variety of illness, like acute bronchitis, explained keynote speaker Dr. Kim Lyerly, professor of Surgery, assistant professor in Immunology, associate professor of Pathology, Duke University School of Medicine. Thanks to the Clean Smokestacks Act, Dr. Lyerly and his research team found a reduction in death rates for emphysema, asthma and pneumonia in NC. The research team, which published their findings in the International Journal of COPD, discovered a tight association between a reduction in pollutants and improvement in death rates related to air quality.

“The take home message for us is that we had such a forward thinking state…that they strictly adhered to a policy that reduced emissions in NC,” said Dr. Lyerly.

We will likely see even higher EPA standards in the future, but based on the proactive CSA, NC is up to the challenge.

Sneezing, itchy eyes and nose…these symptoms sound like allergies, but they could be an indicator of sick building syndrome (SBS). If you have a frequent dry cough and often sneeze at work, it might not be a result of your asthma or allergies. Sick building syndrome (SBS) occurs when employees have acute health problems that are linked to the building, and not a specific illness.

The best way to identify if you’re experiencing SBS is to first take a mental or written note of your symptoms. In addition to itchy eyes, nose, or throat irritation; are you experiencing dizziness or nausea? Is there a certain room in the office in which you sneeze more frequently? Do these symptoms only occur or increase when you’re in the office?

If you answered yes to any of these questions, talk to your employer or the property manager about assessing the air quality in the building. Without proper ventilation and air filtration, you could be exposed to high levels of indoor air pollution caused by building materials and furniture that emit volatile organic compounds (VOCs). Mold and bacteria are additional irritants. If you have asthma, SBS can exacerbate your symptoms, so share your concern with your employer if you suspect SBS is a problem in your building.

Photo from Pexels.

Before heading out into the sunshine, we know to lather up with sunscreen and pack plenty of water. But another important step is to check the ozone forecast; this is especially important for children, the elderly, those with respiratory diseases or heart disease, and asthmatics.

Ground-level Ozone

There are two types of ozone, but ground-level ozone is the one you should be concerned about. Ozone occurs naturally in the stratosphere, but ground-level ozone is created when nitrogen oxide (NOx) and volatile organic compounds (VOCs) chemically react in the sunlight. Ground-level ozone comes from sources like cars and smokestacks.

Ozone Forecast

Ground-level ozone can exacerbate asthma symptoms, but asthmatics can monitor the ozone forecast each day to know if it’s OK to participate in outdoor activities. Elaine Loyack is the program coordinator for Triangle Air Awareness, an organization that helps Triangle-area residents and businesses stay informed about and help improve local air quality. Each summer, she reminds folks about the importance of keeping tabs on the local ozone forecast and to plan their outdoor activity level accordingly.

“Ozone forecast season is the time of the year when the risk for unhealthy levels of ground-level ozone formation is highest,” says Elaine. “In North Carolina, ozone forecast season runs from April 1-October 31.”

What the Ozone Forecast Means for Asthmatics

On unhealthy air quality days, asthmatics should limit time outdoors to the morning and early to late evening. Severe asthma sufferers should avoid the outdoors completely. Asthmatics should also reduce their level of activity, so if you normally run outside, choose a walk instead.

• Code Yellow (Moderate)–dangerous for those suffering extreme asthma.
• Code Orange (Unhealthy for Sensitive Groups), Code Red (Unhealthy), and Code Purple (Very Unhealthy)–dangerous for all asthma sufferers.

Ozone Forecast Resources

Asthmatics can monitor ozone levels by email, phone, the Internet, social media, and through a mobile app. Each day at 3pm, the ozone forecast is published for the following day so folks can plan ahead. Click here to sign up to receive the ozone forecast.

Part I: How to Lessen Asthma Symptoms by Addressing Indoor Air Quality, I explained how improving indoor air quality with the right air filters is key to managing asthma symptoms. In Part II of this series, you’ll learn how to manage indoor humidity levels to prevent mold growth.

Checking  Humidity Levels

Air filters are great at capturing particulates that can exacerbate asthma symptoms, but asthmatics can also be sensitive to heat and humidity. Since high humidity can encourage mold growth, it’s best to maintain 30-50 percent (% RH) humidity levels year-round. Humidity levels are higher at night and first thing in the morning during the summer, so leaving the windows open at night can actually raise the humidity levels in your home. It’s best to leave windows closed in the summer unless the outdoor RH is about 50 percent.

Smart Thermostats

Some thermostats, like Sensi from Emerson Climate Technologies, will tell you your home’s humidity level both on the thermostat and through the companion smartphone app. Although use of air conditioning can help with dehumidification, there are times when it may not be sufficient and a whole-home dehumidifier will help close the gap.

Bath and Kitchen Fans

Kitchen and bath fans are also important for keeping humidity in check. Today’s modern fans are equipped with automation and controls to run the fan at the most optimal times. Controls or use methods can also be adapted to older installations. Be sure to run your bath fan for a half hour after taking a shower.

If you’re unsure about the humidity levels in your home, consult with your trusted HVAC technician or an indoor air quality specialist. They can help you determine if your current fans, thermostat and air conditioning unit are working efficiently or if there is a benefit to install new equipment.

Vacuuming with a HEPA vacuum cleaner, dusting, and regularly changing bedding are all important steps to take care of allergens in your home. Asthma sufferers should also frequently change return air filters in their HVAC system to capture particulates; monitoring humidity levels in the home to manage mold is also beneficial.

Selecting the Right Air Filter

There are a few key components to look for in an air filter to make sure you’re getting the most bang for your buck. Peter Kusterer, of Air Comfort for Homes, which specializes in indoor air quality (IAQ), recommends better performing 1″ traditional filters designed with low pressure drop (LPD) for your system. Select a pleated filter with a minimum efficiency reporting value (MERV) of 8, or better. Aprilaire and Honeywell are two brands that manufacture whole-home media air filters with a minimum MERV 11 rating that require less frequent replacement; in some cases, only once a year.

If you’re still experiencing discomfort after cleaning your home and changing your air filters, consider installing a whole-home media air cleaner that attaches to your HVAC system. Unlike a more traditional 1″ filter, a whole-home media air filter  cleans the air across a greater surface area. You can also move up to an electronic media air cleaner for an even higher MERV rating and efficiency. These filters will seem more expensive when compared to the traditional 1″ filter. Consult with your trusted HVAC technician or an indoor air quality specialist to determine if there is a benefit for you to install a whole-home media air cleaner.

Changing the Air Filter

Traditional 1″ filters will capture larger particulates and should be changed every 30 days. Follow the manufacturer’s recommendation of when to change the air filter.  When air filters aren’t changed regularly, your HVAC system has to work harder since particulate matter has built up on the filter and may restrict airflow. Set a reminder on your smartphone or calendar so you can easily remember when it’s time to change the air filter. Another quick tip is to write the “change by” date on the filter itself. Also consider running your system with just the fan on during high pollen count periods or when you have guests over. Using the fan, only, requires only the blower motor to capture particulates and can save energy when compared to running heating or cooling; you also capture airborne particulate that may have otherwise settled and is no longer capable of being trapped by the filter.

 In Part II of this series, I’ll explain how humidity levels can be monitored and managed to lessen asthma symptoms.