Pulmonary specialist talks effects of poor air quality

I wish it was about a better topic, but you are already seeing some intense effects from this wildfire smoke. What can you tell us? Absolutely. I'm multitasking today in between our meetings, so I have two patients I just put on a ventilator for unknown reasons. They were found down. Oxygen was low. I suspect it's from inhalation injury, which we know is a thing, you know, and it can cause some severe damage in your lungs, healthy lungs even. So it's a big problem. We all need to be a little bit safer than we normally are out there. So the big question is, you know, we know that this smoke is coming from Canada, but how are we still feeling so much of the effects and getting sick from it here in New York? So these particles are small, 3.2, 2.3, I'm sorry, micrometers. That is smaller than the diameter of your hair. It's very, very small. And these actually linger, which is why we're seeing them day later, days later, and the effects of them can linger for days to weeks in many places, and they settle on the ground. So it takes time. It's a large volume of particles with very finite size, and these float around in the air for a very long time, and as they settle, they actually stay and can get into our system for days to even weeks after. So I'm not surprised we're seeing this effect even despite it being a few days in now. I suspect it's going to go on for many more days. I mean, so what exactly are we breathing in and what makes it so harmful to so many people? So we're breathing in smoke particles. That's exactly what we're breathing in. And these are three to four times for adults, and sometimes even 10 times more inflammatory than already the bad stuff that's in the air. So they're very, very damaging to our lungs. And what happens is because of the diameter, how small they are, how so, so small they are, they bypass our natural means of defense, like the hair in our nose, they're supposed to kind of blow everything out, the mucus in our lungs that normally clears everything out, these bypass those. So what happens, they escape, bypass through those defense mechanisms, they settle in your lungs, and they create inflammatory responses, not just in the lungs, but they move on to the bloodstream and can cause organ damage overall in the entire body. And how much effect, I mean, how much exposure do you need to cause or I mean, is it one day? Is it two days? Or is it prolonged exposure? For some people, it's going outside for two seconds. And, you know, we kind of emphasize that if you are pregnant or unhealthy, or a child stay inside, or if you have lung disease and heart disease, stay inside. No, everyone, if they can, should stay inside, do not go outside because most, more often than not, the first exposure to a harmful inhalation is how they end up in the hospital. They have no idea and it's in healthy lungs. And it's in, you know, diseased lungs as well. And we don't know which one you're going to be. We know inhaling particles causes damage. And if we know those particles are present in the air, avoid them at all costs. Yes, are certain people more prone to getting adverse sensitivity from this? Sure. But I see enough patients who had healthy lungs, healthy heart, no medical problems, go outside and heal the air and end up in the ICU or in the emergency room same day within an hour, a few hours. And what kind of, is it just they can't breathe? Is it dizziness? Is it nausea? You know, what should people watch out for that says, hey, I may need to get some medical attention now? Sure. This is very important because knowing the signs and recognize them, it can prevent further damage. So let's say shortness of breath, chest tightness, cough, wheezing, nasal irritation. We talked about how it goes into the nasal septum. All of that shows that you've been exposed to something that's causing an inflammatory reaction in your body. It is bad. Don't wait to go to the ER or the urgent care or the hospital. Go right away because that's usually the first sign. And then the inflammatory cascade goes on. Now, other uncommon ones people don't realize that we talked about how it's a full body thing. Headache, dizziness, fatigue, blurry vision, just feeling run down. You know, your body's something is happening. It is not all in your head. It's it's better to be safe than sorry. So if anything feels off, if you have any of these symptoms, go to the emergency room. And for my lung patients, usually they're very well versed. Use your inhaler before going outside, before the exposure. And if you've used your inhaler and your breathing is not getting better, do not wait. That is a red flag. Go to the emergency room right away. Is there a way to clear out this from your body? Like, let's say you have to take your dog out. You know, so many people have animals. You have to take your dog out. They walk down the block. You come back inside. You cough a little bit. Is there a way to kind of clear out your system? Well, avoidance is you want to prevent it from getting in your system first. So, you know, the best way is to see if you can't stay inside wearing a ninety five mask as old. Don't know. Don't pull out your old covid mask. It's the regular mask. Actually, the particles are so finite. They travel through that. So an N95 mask, if you can't avoid, you know, at home, if you are inside, make sure the windows and doors are closed. Your HEPA filter, if you have one, is on. Everything is sealed off. And can you actually prevent this from settling long term in the lungs? You know, the lungs are pretty good over time at getting rid of these irritants. But what happens is if they pile up or if for some reason they're unable to clear and they linger in the system, that increases your risk of inflammation and getting infected as well. So it's watchful waiting, which is why I always say preventing them from entering the system is really the key. So if you have to go out mask, if you don't have to go out, that is great. And then it's just watchful waiting. To be honest, I see people get rid of it from their lungs really quick. They feel nothing, just a minor cough. And then I see the opposite, like the two I just put on a ventilator. So you never want to know. I don't know who I'm going to be. You want to try to prevent it and use the tools we have to help your breathing. Now, I saw someone post this on social media. Someone was saying, well, this can have long term effects if you are pregnant. Is that true? Yes, it can have long term effects, pregnant or not even pregnant. There's been multiple studies that show that even one inhalation injury, if the lungs are unable to clear, can actually compound over time and develop lung disease. I think the main thing is for most healthy people, it's repetitive exposure, though. So these wildfires are happening often now. You know, we didn't have this many in frequency many years ago. So that worries me because we know that every time your lungs are exposed to inhalation injury or irritants in the air, which reside not to this degree all the time, that can compound and lead to long term lung problems. So, yes, pregnant patients are always or pregnant people are always the worrisome one because they are immunocompromised. Their immune system is feeding themselves and their babies, you know, so that's not working as it should, as strongly as it is with one person. So they have a weaker immune system. They should not be exposed to things that can further weaken their immune system. And yes, is there a potential for long term harm? Yes. These fires, we don't know when the dust will clear. And like I said before, it lingers for sometimes days to weeks. So it is a little bit dangerous. And what can people do in their homes? Obviously, keep windows closed, keep the air on. Air purifiers, do they help with this? They do help. Air purifiers can help. The particles are very small, so it really depends on the purifier. It has to be one that can filter through this small of a size and HEPA filters are good. Whatever purifying system you're using, though, you want to make sure that it actually is working with the air it has. So you need to make sure all of all out of us live in New York City with the windows, the units are in the windows. They have to be sealed, though, because if they're not completely sealed, you're still getting that external air out. So no matter what filter you have in place, it's filtering outside air. So, you know, it's also I love how things happen together. You have all this smoke in the air and then you have 100 degree weather practically, you know, so trying to keep cool as much as possible, filtering the air to the best of your ability and keeping everything closed. And if you really don't have to go outside, just don't. And make sure you're also cleaning your home regularly. Dust settles, particles settles, and we forget about them for days and then we wonder why we're coughing three days in. And there's a lot of confusion and debate about this. So right now, the air quality index is one twenty four. Obviously, that's in the orange unhealthy for sensitive groups. But let's say tomorrow we wake up. We don't see smoke. We don't see haze. We don't smell anything. Does that mean it's safe or do we have to go by this air quality index? You should always check the air quality index. But like I said, it does settle for a while. It takes a few days to really, really clear out of the air. So what I would say is that if you know your lungs are sensitive or you know your body is sensitive, not just lungs, wait a few more days, wait a few more days before we have more information. And if you have lung problems, heart problems, you are, you know, baby, you are pregnant, whatever it may be. I would wait a few days. I plan on staying and I have asthma myself. One of my kids has asthma and it's just not worth the risk. And I don't know what will happen. So I'm choosing to lock ourselves in for a couple of days before the dust really settles. Literally. And will the rain actually help with literally will the rain actually help kind of clear everything out? You know, we're supposed to get rain tomorrow. Yeah, not not necessarily. The rain can actually kind of swirl it around and the humidity may actually be worse. So we're looking at it sticking around in the air for a long time, which is why I wish rain washed everything away like we think it does. But it really does. And it can make it swirl around. So it's not going to be a good weekend. But the main thing to emphasize here is this is temporary. You know, this is hopefully temporary. That's how we should treat it as such. So, you know, it's summer in the city. We like to be outside, but this will pass. And, you know, I think we just need to keep ourselves safe and try and avoid it at all costs as much as we can if we're able to. OK, well, you know, Sunday, though, big World Cup final. I mean, is it safe for the athletes to be practicing, to be playing? Is it safe for fans to go out to the stadium? Yeah, I'm very biased. You know, I'm a lung doctor. I stand in ICU doctors. I see the worst, the worst. And it's, you know, everything chooses to affect my organ of choice here. This lungs that I love. So be safe. Know your body. I love the World Cup. I love the energy in the city. I love living here. I love being around running around the parks with my kids to know yourself, know the warning signs, because, sure, go out, you know, if you need to go out, go out. If you want to go out, go out. But know the warning signs and get yourself to safety and to help as soon as possible. That's key. But what about for the athletes who kind of have to practice and then compete Sunday? I mean, are they at risk right now? Athletes are, you know, they're in great shape, but I've seen athletes end up on a ventilator too. So, you know, that's a tough one to answer. I don't advise anything being done outside right now. I would advise the World Cup to be postponed a little bit, you know, if I had that authority. But no, it's not safe for anyone to be outside. And, you know, when you're exerting yourself, you're breathing heavily in and that's actually potentially propagating those particles deeper into your lung system. And if you're going to clear it out, we don't know until you do or don't. So it's not advised, which is why I tell everyone this is not the time to get your metrics right in terms of running outside or training for that marathon. This is not the time at all. That deep breathing is worse for particles settling into your lungs. Wow. That's all I got to say is this is not a great situation. Dr. Simon-Thayer, thank you so much for joining us and breaking all that down. It was very helpful and informative. I appreciate it. Thank you so much, Hayley.