RESOURCES:
University of Michigan Health Division of Pulmonary Critical Care
NPR: "Canadian wildfires are impacting air quality in the U.S."
MDHHS: "Your Health and Wildfire Smoke"
TRANSCRIPTION:
Caroline MacGregor: You're listening to 89.1 WEMU. I'm Caroline MacGregor. And today, we are talking about Michigan's air quality, which has nosedived in recent weeks, due to wildfire smoke from Canada. Here in Washtenaw County, like the rest of the state, we've been cloaked in haze, and, as a result, we have had several air quality alerts or advisories. The thick haze of smoke that has blanketed the region and, at one point, even led to Detroit being listed as the third most polluted city in the world, has made it very hard for some people to breathe. And it's affecting our health in ways that are still to be determined. New emerging research suggests that smoke from these wildfires actually goes through chemical changes as it travels long distances, and this could cause it to potentially become even more harmful. Today, I am joined by Dr. Han. She's a Professor of Medicine and Chief of the Division of Pulmonary and Critical Care at the University of Michigan Health. Thank you very much for joining us!
Dr. MeiLan Han: Oh, thank you, Caroline!
Caroline MacGregor: Dr. Han, I know that you also serve on the scientific advisory committees for both the COPD Foundation and American Lung Association. As a pulmonary specialist, can you help us understand how this particulate matter from these wildfires affects not only our lung health, but overall health as we breathe in the smoke?
Dr. MeiLan Han: Yes, this is definitely an area that's received a lot more attention from researchers over the last five to 10 years. And I think we're still learning about some of the effects. But when we think about wildfire smoke, there's actually several components that can be irritating to the lungs, as well as just harmful to our bodies in general. So first, there's what people call PM2.5, which stands for particulate matter under 2.5 microns. And that's harmful because it gets really deep into the lungs and can cause irritation and symptoms like coughing and wheezing. But there's also other gasses that can be irritating, nitric oxides, there's also ozone and a lot of other kind of more dangerous chemicals. So, this sort of soup that we breathe in, not only over short periods, could be highly irritating, particularly to those who are more sensitive and have chronic lung conditions. But also, over longer periods of time, we're finding that chronic exposure to this type of air pollution can actually cause lung disease. One of the other things we're learning is that, surprisingly, the particulate matter actually is taken up into the bloodstream and can actually increase risk for things like heart attacks and strokes and over longer periods of time, have neurocognitive effects. It's really an active area of research, but definitely what we're learning is concerning.
Caroline MacGregor: Yeah, it does sound very alarming. I'm just intrigued how this particulate matter as it enters the bloodstream can lead to an actual cardiovascular or other event in our body. I mean, obviously, we're quite sensitive to this matter in addition to our lungs.
Dr. MeiLan Han: So, I think the thought is that some of these particles are small enough to actually go deep into the lungs and penetrate into the bloodstream, once there are triggers for inflammation. Inflammation can contribute to the development of atherosclerosis over time, but it can also, I think, disrupt the endothelial lining of the blood vessels and also enhance the ability of platelets to clot, and therefore, kind of creates this, what we call, a prothrombotic state that would increase the risk for things like strokes and heart attacks.
Caroline MacGregor: I know a lot of people are becoming more alarmed about this. You know, is this going to become the new norm?
Dr. MeiLan Han: Yeah, it's definitely concerning! So, the way we monitor this, or the general public can learn about how bad the air is, most people have smartphones now, you just open up your weather app, and you'll get a number there called the air quality index. And the general rule of thumb is if it's over 150, then almost everyone will be bothered in some way--if it's worse than 100, then more sensitive individuals. But I have to admit. Many, many people I've talked to, even in that 100 to 150 range in the last week, have had sore throat, coughing, or their eyes have really been bothering them. So, it's definitely, I think, a concern. One of the things that's interesting is, when I was in medical school, this isn't something we talked about at all. And then for me, sort of learning more about this, I think actually, interestingly, came during the pandemic. I kind of started to take a deeper dive into just understanding all the threats in our current environment to lung health. And that includes things like COVID, but also things like climate change and air pollution. And so now, I've actually started teaching some of our medical students more about this, so that they're better equipped and prepared to talk to patients about how to protect themselves. Interestingly, In the American Northwest during the first summer of the pandemic, when there were really bad wildfires in Oregon, they found that there were an increase in the number of COVID cases and deaths during the very high particulate matter days. And the thought is that air pollution can actually increase the risk for respiratory infections by altering or damaging the immune system. So, that's yet another way that our health is threatened with air pollution.
Caroline MacGregor: Fascinating, but it makes sense! There's a lot to be discovered! And also, as this smoke travels, I believe it can become more toxic or at least the initial research is pointing to that.
Dr. MeiLan Han: So, yeah, there's a lot of research on how wildfire smoke can impact health. And we've talked a lot about the PM2.5. There's ozone and nitric oxide, but also a lot other volatile organic compounds that can undergo changes in chemical composition kind of with photochemical reactions that can potentially make it even more harmful.
Caroline MacGregor: Who is at most risk and why? I know we've heard about sensitive groups, but if you could explain why these people are more susceptible to the effects of this particulate matter.
Dr. MeiLan Han: So, there's several groups I worry about--obviously, anyone with an existing health condition, right, so underlying lung disease, underlying cardiovascular disease. But I also worry about pregnant women. There's evidence that exposure to air pollution can be harmful to growing fetuses and be associated with things like preterm birth--you know, the elderly, anyone who's already immunocompromised. But honestly, even relatively healthy individuals, getting frequent enough exposures can even develop problems related to air pollution if the exposure is long and chronic. You know, the other group I worry about is children. People kind of forget that, despite the fact that we become adults in this country at 18, technically, the lungs are still growing, honestly, until your mid-20s. And what we're finding from research is that there's a larger percentage of people than we thought who are reaching adulthood with impaired lung health and probably don't have "healthy lungs" even to begin with. And so, there are a lot of things that go into that, including probably things like frequent respiratory infections as a child, secondhand smoke exposure, but I would also add air pollution exposure to the list of things that can impair the growth of lungs.
Caroline MacGregor: And then, of course, there's outdoor workers: construction workers, farm workers--they're out in this all the time. And with that in mind, I wanted to ask you if you are able to sort of talk a little bit about prevention or what people can do in their homes or outside, obviously, to protect themselves.
Dr. MeiLan Han: So, if people are able, when the air pollution is bad, you're best off staying indoors, keeping your windows and doors shut, and running your HVAC system. I usually recommend to people that they try to get a filter on their system of, like, a MERV-13 or better. The sort of the same discussions we had during COVID, just to try to keep the air in their home as clean as possible. Your central air conditioning that we would run here in Michigan in the summer will run the air through that filter, and it definitely helps. You can also add a separate, portable HEPA filter to the rooms where you spend most of your time. Many people may not know that you actually can make a very cheap air filter with a box fan and then just purchasing one of the furnace filters from, say, Home Depot or Lowe's. There's actually, at the University Michigan, someone actually made a quick video about how to do this. If you can, it's better to avoid doing your heavy outdoor work or going for that long walk or your long run on the really bad days. But if you can't help it, one thing you can do is to wear either an N95 or a KN95 mask. That's not going to protect against the gasses, but it will protect against a PM2.5. Another thing to think about, it sounds kind of silly, but to press the air recirculator on your car. This is not the time to be bringing "fresh air" in from the outside. You'd rather have your car just keeping the same air and letting it continue to filter it. So, those are some things, but obviously for people who are construction workers or we've got a lot of road work going on this summer, there's certain jobs where it's just going to be almost impossible to avoid. You know, many of us have masks left over from COVID. Just go ahead and put it on, or if there's some exposure you can avoid, it's really just best to do so because we really only have one set of lungs, and they have to last a long time. So, I think, if anything, I would hope that with these wildfires and us being at least temporarily a little bit more cognizant about air quality and lung health, that people would remember, even when the air clears, that there are still a lot of threats to lung health and just to be really mindful. Think as a general practice.
Caroline MacGregor: All right, well, thank you so much! I've been talking with Dr. Han. She's Professor of Medicine and Chief of the Division of Pulmonary and Critical Care at the University of Michigan Health. We've been discussing the health effects from the Canadian wildfires, and, as climate change is upon us, there are more health concerns regarding pollution and subsequent particulate matter in the atmosphere. Thank you, Dr. Han, for joining us today!
Dr. MeiLan Han: Well, thank you for having me, Caroline!
Caroline MacGregor: You're listening to 89.1 WEMU-FM Ypsilanti.
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