How Dangerous Is Poor Air Quality for Your Health?

A Keck Medicine of USC thoracic surgeon explains the health impact of poor air quality, including from wildfire smoke.

The rise in wildfires globally brings into sharp focus how such disasters increasingly threaten our health and security. One question many people ask is how poor air quality could be harming their health.

Brooks Udelsman, MD, MHS, a thoracic surgeon with USC Surgery, part of Keck Medicine of USC, understands this concern. He shares his clinical perspective and advice on how you can protect yourself.

How wildfires affect air quality

There’s no question that wildfires wreak havoc on air quality. Air Quality Index (AQI) spikes may rise to “hazardous” levels of pollution. The nature of the pollutants themselves also raise alarms. Dr. Udelsman notes that levels of asbestos, lead and microplastics can increase in a fire’s immediate aftermath.

Once a fire has peaked, outdoor air quality will start returning to baseline levels within two to three days. But even as air quality returns to normal, some residents may still report a range of associated symptoms, including allergies, coughs, irritated eyes, asthma attacks and headaches.

Acute versus chronic exposure

The good news is that for the majority of those affected, Dr. Udelsman continues, “These symptoms will be self-limited and improve on their own.”

That’s because most people’s exposure to the unhealthy air is acute — occurring for a brief time.

Contrast this with the effect that chronic, or long-term, exposure to unhealthy levels of airborne particulates can have on health. For that, Dr. Udelsman says, the best long-term data come from firefighters themselves.

“They’re out there fighting fires every fire season,” he explains. “They’re chronically exposed. And we do see higher rates of some chronic lung diseases in this group.” That said, he doesn’t think we can extrapolate those outcomes to “the average healthy person who, while certainly affected by wildfires, isn’t chronically exposed.”

People at notable risk

Where acute exposure to unhealthy air can pose a risk is in those with preexisting pulmonary conditions, Dr. Udelsman says.

After all, the pulmonary system has “the greatest interface with the air,” he points out. So, if an individual’s lungs are already compromised by, say, cancer, chronic obstructive pulmonary disease (COPD), emphysema, lung fibrosis, recent pulmonary surgery or even severe asthma, “They’re going to want to be more careful about exposure,” he cautions. “Their ‘reserve’ — the ability to tolerate more injury — is potentially going to be lower.”

What you can do to protect yourself from poor air quality

Nevertheless, Dr. Udelsman has some commonsense tips that we all can follow to limit our exposure to unhealthy air:

• First, if you are in a region experiencing the aftermath of a wildfire, Dr. Udelsman suggests doing some post-fire spring cleaning. “Make sure ash is removed inside and out,” he says. “And make sure your kids aren’t playing in ash piles, which have higher levels of lead and other contaminants.”
• Mind air-quality warnings via the news, apps or reports from reputable sources like state and local air-quality agencies, the National Weather Service or the EPA. “You can also buy an in-home monitor that measures indoor and outdoor air quality,” Dr. Udelsman adds.
• When reports forecast a smoky or smoggy day, Dr. Udelsman counsels limiting outdoor exposure. “If you have to go out,” he says, “it’s not a bad idea to wear some type of protective gear like an N95 mask, especially if you have an underlying chronic pulmonary disease.”
• And trust your own experience. If you get headaches on bad-air days, monitor symptoms and respond accordingly. “You’ve got to be your own judge and personal evaluator of how you feel,” Dr. Udelsman says.

Is it safe to go outside?

Dr. Udelsman also offers reassurance for those exposed to short-term bad air quality. “I don’t think there’s going to be a lot of lasting harm for the average person,” he says. “The data we have doesn’t really show that.”

Is it safe to venture outside once a wildfire has passed? “Overall, I think the answer is yes,” he says. “It’s just finding the balance. Yes, it’s important to be careful, but you’ve got to live, too.”

And if you do have concerns or questions, don’t hesitate to reach out to your health care provider. “We live with this, too,” Dr. Udelsman says. “We’re part of the community, so we understand. We know how to be cautious, we know how to exercise good judgement in this area and we can help patients navigate it.”