Graph indicating levels of concern related to the Air Quality Index value.

Summer’s here. That means more time outdoors, playing and exercising. It also means wildfire season. Just last month, smoke from the Western Canada fires caused air quality alerts in Canada, the U.S. and Europe. It was hard to miss footage of thick apocalyptic yellow skies from cities as far south as New York City and Washington DC. New York State alone distributed one million N95 masks to its citizens.

Hazy, smoky air from wildfires is no stranger to our area, and the significant wildfire potential for the Pacific Northwest this year is above normal, according to the National Interagency Fire Center (httsp:// How much of a health risk is poor air quality anyway? And how do we even know if our air is healthy or unhealthy?


The air quality index (AQI) is used to convert pollutant concentrations into understandable health risk language. The U.S. Environmental Protection Agency (EPA) created a color-coded measuring system to do just this. The AQI helps you understand what local daily air quality means to your health. Its measure is on a scale of 0-500, with a higher number meaning greater air pollution and therefore, a higher health risk/concern.

The EPA uses four pollutants to calculate the AQI:

  1. Ground level ozone
  2. Particle pollution
  3. Carbon monoxide
  4. Sulfur dioxide

Concentrations of these pollutants are recorded daily at 1000+ locations around the U.S. Most smart phones include local AQI on their weather apps, but you can also find it at

AQIs can vary seasonally with some pollutants higher in colder months (carbon monoxide) and others higher in warmer months (ozone). Things like rush hour traffic and smoke from wildfires or even wood-burning stoves also affect the AQI.



Health Risks: These can vary depending on which of the four pollutant concentrations exceeds the normal range. The most common risks include:

  • Irritated respiratory system (ozone, sulfur dioxide)
  • Reduced lung function (ozone, particle pollution)
  • Inflamed or damaged cells in lung tissue (ozone)
  • Increased susceptibility to infection (ozone, particle pollution)
  • Aggravated asthma (ozone, particle pollution, sulfur dioxide)
  • Aggravated chronic lung disease (ozone)
  • Permanent lung damage (ozone)
  • Chest pain/heart palpitations for those with cardiovascular disease (particle pollution, sulfur dioxide, carbon monoxide)

Who Is At Risk: In some cases, pollutants can affect even healthy individuals if the AQI is high enough, but for the most part, the following tend to be most at risk:

  • People with lung disease (asthma, chronic lung disease, emphysema, bronchitis)
  • Children, who typically play outside more than other age groups
  • Older adults, who are more likely to have pre-existing lung disease
  • Active people, who exercise outdoors
  • Young infants or fetuses (carbon monoxide)


While these measures will not necessarily make you immune to poor air quality, they can help lower your risk of health problems. Depending on the AQI for specific pollutants, you can take various measures to protect your health. For example, if you have heart disease, avoiding sources of carbon monoxide, such as heavy traffic, is an important step you can take.

Generally, when there are elevated levels of air pollutant, you want to avoid:

  1. Prolonged exertion, which is any outdoor activity that causes slight increased breathing for long periods of time, and
  2. Heavy exertion, which is intense outdoor activity that causes heavy breathing.

Avoiding these by reducing the time spent outside or the intensity of the activity are two important measures.

Pulmonologist Seth Hartung, MD, urges individuals to monitor local AQI and to take the above precautions if the number goes above 101 and moves to the “unhealthy for sensitive groups” level.

“We typically see an increase in our Emergency Department and office visits for respiratory symptoms in the summer months due to air quality issues,” he said.

If you are experiencing increased respiratory symptoms or have concerns about your lung health, contact the Island Pulmonology clinic at 360.299.4273.

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