Your Lungs and the Environment

Posted on May 26, 2021   |   

This article was written by MeiLan Han, MD, MS, COPD Foundation Board Member.


Many of us don’t stop to think about how our environment impacts our lungs. While tobacco smoke contributes to the development of COPD, there are many other environmental factors that contribute both to the development of lung disease and can also make respiratory symptoms worse for those who do have lung disease.

To begin, it is now believed that air pollution not only contributes to the development of COPD but can also make respiratory symptoms worse and trigger exacerbations (also known as flare-ups). Hotter temperatures and drought increase the amount of dust and particle pollution we are exposed to. Wildfires in particular have become a major source of extremely high particle levels, noticeable even hundreds of miles from the fires themselves. Since air pollution can vary significantly on a daily basis, websites such as airnow.gov allow you to look up the Air Quality Index in your area at any given time. On unhealthy air quality days, you may want to stay indoors if possible, while keeping doors, windows, and fireplace dampers shut. Air cleaning devices with high efficiency particulate air (HEPA) filters can provide additional protection. If you must spend time outside, ordinary masks are unfortunately not that helpful for filtering the smaller, more dangerous particles. In these cases, an N-95 type mask is most effective; however, as many now know, these can be uncomfortable to wear and breathe through. When driving on unhealthy air days, another tip is to roll up your windows and operate the recirculate setting for your vehicle’s ventilation system.

We know that air pollution can also come from inside the home. Sources of indoor air pollution include asbestos, paint and cleaning supplies, as well as mold and radon. Strategies to reduce air pollution in the home include trying to use safer products. For instance, “low-VOC” (volatile organic compound) paints are now readily available. Cleaning products unfortunately often contain chemicals harmful to the lungs. Ammonia and bleach can irritate the airways. It is important to never mix bleach or any bleach-containing product with any product containing ammonia. This combination can create a gas which can cause significant breathing problems and even death. The Environmental Protection Agency (EPA) has a list of cleaning products that meet their new "Safer Choice" requirements.

Other tips include having new carpet aired out before installation and making sure the carbon monoxide detectors in your home are working. Radon, the second leading cause of lung cancer, has been found at elevated levels in homes in every state in the U.S., so the only way to know is to test for it. If radon is a problem in your home, mitigation systems can be installed. Also, if you suffer from allergies, keeping the home humidity low and replacing carpets with hard surface flooring can help.

An often overlooked source of indoor air pollution is residential wood-burning stoves. As a child, we used a wood burning stove in the home for winter heating, which was quite commonplace in Idaho where I grew up. In the United States, it is estimated that solid fuel is a primary heating source for more than 2.5 million households. Emissions from wood smoke not only make respiratory symptoms worse, but can also lead to lung function impairments over the long term. If possible, consider upgrading to a clean burning device or consider alternative heating methods. The EPA adopted new, stricter standards so look for devices that meet these new 2020 standards, such as newer wood stove models featuring improved safety and efficiency. However, even gas stoves used for cooking create nitrogen dioxide, which has been associated with increased risk for respiratory symptoms and exacerbations. Using air purifiers with HEPA and carbon filters or replacing gas stoves with electric stoves have been demonstrated to reduce nitrogen dioxide levels in the home.

Finally, another factor to consider is protecting your lungs at work. Roughly 15% of all COPD cases in Western societies have been attributed to occupational exposures. While certain exposures such as asbestos, silica dust, and coal mine dust are notorious for causing lung diseases, a wide variety of occupations are at risk for unclean air. This list includes industries such as farming, woodworking, construction, and taxi driving, as well as hair and nail care services. Hair dressers, for instance, may be exposed to VOC’s found in styling product propellants. Other potentially harmful alcohols are widely used in beauty products. Secondhand tobacco smoke exposure in the work place is another major issue for certain workers which is difficult to control sort of tobacco-free policies within the workplace.

What’s the take home message? If you are doing anything that creates dust or generate aerosols, think about how to reduce your exposure. If the air quality index suggests an unhealthy air day, try to limit outdoor exposure when possible. We all need to become aware of the particles and chemicals in our environment, but this is even more important for individuals with lung disease.


Dr. Han is the author of the book Breathing Lessons, A Doctor’s Guide to Lung Health.

2 Comments



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  • Thank you for this information. The hardest part is the N95 and trying to breath with my air on. Lately it’s just about 24 hours as unless I am home . I do watch every day and take cautions ... I’m not done living yet.
    Thank you again
    Donna
    Reply
  • Thank you very much for this article, it contains heaps of useful information. I recently heard about gas stoves being bad for giving off fumes which can make people ill, but thought it was a political ruse to get people to use alternate forms of energy. Gas stoves are used by restaurants because gas is the best way of stovetop cooking when it comes to instant heat needed for certain recipes. I had an electric stove but hated it, and love my gas stove now. My husband has COPD but I am not going to get rid of my stove! He doesn't spend any time in the kitchen anyway, and it is not near where he spends most of his time.

    But we also have a gas 'log fire' in the lounge, which is serviced every year to make sure the flu is working as it should. Ken is in the lounge room all the time because it is warm in winter, and the heater is on from about 10 am until late evening. I find the thing that has the most effects on his breathing is the weather. Extreme cold or heat (which we experience in Melbourne during winter and summer) makes his breathing difficult. He is one of those people who can't have oxygen supplements due to the severe damage to his lungs, so he relies on his inhalers to get him through the worst days.

    You mentioned secondhand tobacco smoke. Ken was a heavy smoker until 20 years ago, and I lived with that for 20 years, as well as with my last employer's smoke for 15 of those years. I don't have any lung disease fortunately, but I did develop bladder cancer, which my urologist says was most likely due to passive smoking all those years. So those of you here who still smoke, just be aware of the people around you.
    Reply