The Effects of the Environment on Respiratory Health

In this podcast, Payel Gupta, MD, answers our questions about how the indoor and outdoor environment affects respiratory health, including the impact of climate change on allergies and asthma. 

Additional Resources: 

• Climate change. The American Lung Association. Updated April 6, 2021. Accessed April 23, 2021. https://www.lung.org/clean-air/climate-change

Payel Gupta, MD, is a pediatric and adult allergy, asthma, and immunology specialist and assistant clinical professor with Mount Sinai Medical Center and SUNY Downstate Medical Center, Co-Founder and Chief Medical Officer of getcleared.com, and a volunteer national spokesperson for the American Lung Association (New York, NY). 

TRANSCRIPTION:

Jessica Bard: Hello, everyone, and welcome to another installment of "Podcast360," your go‑to resource for medical news and clinical updates. I'm your moderator, Jessica Bard, with Consultant360 Specialty Network.

According to the American Lung Association, poor indoor and poor outdoor air quality can cause or contribute to the development of infections, lung cancer and chronic lung diseases, such as asthma. Dr. Payel Gupta is here to speak with us about that today.

Dr. Gupta is an allergy, asthma and immunology specialist affiliated with Mount Sinai Hospital and SUNY Downstate Medical Center in New York City. She's also a co‑founder and chief medical officer of getcleared.com and a volunteer national spokesperson for the American Lung Association.

Thank you for joining us today, Dr. Gupta. Talk to us about the impact of air pollution and climate change on our respiratory health.

Dr Payel Gupta: Absolutely. As temperatures increase with climate change, the warmer air helps to form ground‑level ozone. Ground‑level ozone is sometimes called smog, and smog is a powerful air pollutant that makes it harder to breathe, especially for someone with lung disease. Smog can even shorten life.

Some parts of the US have less rainfall because of climate change. As a result, wildfire seasons are longer, and wildfires are more frequent and affect larger areas. Wildfires produce smoke that contains tiny particles called particle pollution that goes deep into the lungs.

Breathing these tiny particles makes asthma and COPD symptoms worse and can shorten life. Wildfire smoke can travel thousands of miles and can cause spikes in air pollution that affect people far beyond the immediate fire path.

Jessica: What is the impact of climate change on people with asthma?

Dr Gupta: I spoke about this a little bit in my first answer. We know that those people with lung disease are more impacted and at more risk when exposed to poor air quality. Studies show that air pollution exposure is linked to greater risk of respiratory infections.

Right now, one thing that this pandemic has illustrated to us is how sensitive our lungs are and how important they are to our system functions. Simply put, we need to breathe, and there's no shortcut and no alternative. Anything, be it a virus, or tobacco smoke, or air pollution, that puts our lungs and our ability to breathe at risk is a danger.

Jessica: We talked about asthma. What is the impact of climate change on people with allergies?

Dr Gupta:  For allergy sufferers, it's very interesting. Climate change can increase allergies. The reason for that is that, as temperatures rise because of climate change, plants produce more pollen. Those rising temperatures is almost like trigger for plants to be nervous that something's happening where their existence is put in danger.

They release more pollen in order to keep their existence alive. More pollen means more allergens. Every year, we're noticing that allergy seasons are getting longer and stronger.

Jessica: What tips can you give your patients for reducing the health risks caused by climate change?

Dr. Gupta: One tangible thing that people can do to reduce the health risks caused by climate change is to pay attention to the daily reports on air quality. You can go to sites like airnow.gov, which gives current air quality information and forecasts for the next day.

When the air quality is poor, you can limit your outside activities. Also, keep your windows and doors closed during those moments where the air quality outside is poor. That will help to mitigate some of the negative effects of poor air quality.

In addition, if you do suffer from allergies, you can also keep track of the pollen counts. Similarly, on days where the pollen counts are higher for the things that you're allergic to, you should try not to exercise or do outdoor activities as much on those days. You should keep your windows and doors shut on those high pollen count days.

I don't want people to become obsessed by this. I want people to be able to enjoy their lives and be able to go outside. Experiencing nature is so important for our health and well‑being, but it is important, especially during wildfire season, for example, in California and other parts of the West, that we do pay attention to things like that.

Now, with COVID, everyone is more acclimated to wearing masks and things like that. Wearing a mask on those poor air quality days or high pollen count days may theoretically help to a certain degree. That's also something that you can do that may help to mitigate some of the effects.

At the end of the day, what we all need to do is fight for better air quality through advocacy. That's something that the American Lung Association does well is advocating for measures that will improve long term air quality for all of us.

If we all do our part in helping to mitigate air pollution and the negative effects of climate change on a larger scale, that's the only way that we're going to fight this problem.

Jessica: That's well said. When we talk about the environment, it's not just the outdoor environment, either. Indoor home environment matters, too. Can you explain some factors and the possible effects of each?

Dr. Gupta: Poor indoor air quality can cause or contribute to the development of infections, lung cancer, chronic lung diseases, like asthma. People who already have lung disease are at greater risk, as I've already mentioned.

There's lots of things that can make indoor air quality poor, things like asbestos, building paint and products, carbon monoxide, allergens, like cockroaches, mice, dust mites. Then, for indoor air quality, for example, in work exposure, lots of people are exposed to harsh cleaning supplies and other chemicals in their workspaces that can also negatively affect their indoor air quality.

Floods, water damage can also affect indoor air quality, which can lead to mold exposure, lead exposure and paint. Then, as I'd mentioned before, residential wood burning can also affect our indoor air quality.

Then secondhand smoke, which, reducing secondhand smoke exposure is so important and also, I understand, so difficult because smoking is such a difficult habit to break. As far as indoor air quality goes, sometimes it's difficult to assess whether all of these factors are present, or even some of these factors are present.

Some of the things that you can do is asking yourself, do your health symptoms improve when you leave the building that you work in, for example? Do they return when you go back to work? If so, then that means that you might have an issue in the indoor air quality in that particular place. That's one way of figuring out if there is an issue.

Then, once you know that, yes, there must be something in my home or in my work environment that's affecting my health, then there's a whole other process that we have to go through to try to figure out what it is in your home or work environment that might be causing that issue. That can be hard to figure out but not impossible.

The first thing is figuring out that there is an issue and then going from there.

Jessica: As a doctor, what can clinicians do to help their patients and get this message across?

Dr Gupta: As clinicians, we have a lot to think about during a visit with our patients. As an allergist, I think about indoor air quality and indoor exposures a lot because that's a part of what an allergist does. All clinicians can do that to a certain extent, especially with things like smoking. That's an obvious one.

Sometimes, we ask our patients if they smoke, but we don't always ask if they have secondhand exposure at home or at work. That's an important thing that clinicians tend to do but can obviously always be reminded of.

Then other things like checking for radon exposure, carbon monoxide detectors and then also checking for leaks and asking about pest control are important things that can lead to poor health outcomes over the long term, so monitoring for things like that.

Jessica: What would you say are the overall take‑home messages from our conversation today?

Dr Gupta: The overall take‑home message is that our lungs are important. They're important to our survival. They're heavily impacted by the air we breathe. The exposures that we have in our indoor and outdoor environment can affect that. There are things that are out of our control. Then there are certain things that are in our control.

As I mentioned, smoking, for example, creating a smoke‑free zone in your home, in your workplace environment, is one of the things that we can do and monitoring the air pollution levels outside and then trying our best not to be outside when we don't need to be outside, but also then making sure that we know that being outside is also healthy.

It's a balancing act that can be hard to achieve sometimes. Overall, the take‑home message is being aware of all of the factors that can influence the air we breathe, whether it's indoor or outdoor, and trying to balance what we can and can't control.

Jessica: That's well said. Thank you so much today, Dr. Gupta, for your time. We learned a lot in the importance of lung health.

Dr Gupta: Thank you for having me. It's such an important topic, and we've realized more and more over the past year how important our lung health is. Thank you for taking the time to cover this important topic.