By Kayla Benjamin
On two or three days this past summer, District residents woke up to find smoke-filled skies and hazy views. Heavy smoke has repeatedly drifted into the DMV from unprecedentedly destructive wildfires in Canada (which, by the way, continue to rage with no real end in sight).
The smoke days brought the problem of outdoor air pollution into sharp focus in a region that has not yet had to deal with intense wildfire smoke events. But difficulties keeping air clean are not new to cities like the District, and pollutants from industrial emissions or vehicle exhaust can lead to health harms even when we can’t see them in the air.
Of the potential health issues linked to air pollution exposure, asthma is one of the most prevalent. The childhood asthma rate in the District is almost 4% higher than the national average, and across the country, it’s one of the top reasons why students miss school.
“There are about 15,000 kids in DC with asthma, and of that number, several hundred of them are cycling in and out of the emergency room and the hospital quite often for their asthma,” said Dr. Janet Phoenix, a public health expert and longtime advocate for childhood asthma solutions in the District.
Few would be surprised to learn that asthma impacts Black children in D.C. far more commonly than white children. And a child with asthma in Wards 7 and 8 is 20 times more likely to end up in the emergency room for asthma than a child living in Ward 3, according to a 2021 report from Children’s Law Center.
If this summer’s wildfire smoke put air pollution on your radar for the first time, here are some basics to catch up quickly on understanding the link between outdoor air and asthma—and what to do about it.
- Air pollution exposure can both cause asthma to develop and trigger attacks
The two main pollutants in D.C.’s air are particle pollution and ground-level ozone. Particle pollution can come from a wide range of sources, from wildfires to construction sites to cars and trucks. Ozone can also stem from a few different places, but in the District it’s most commonly caused by vehicle traffic.
Both of these pollutants can cause short-term problems such as shortness of breath, coughing, wheezing, fatigue, headaches, nausea, chest pain, and eye and throat irritation. For people who already have asthma, it can trigger dangerous asthma attacks. Researchers have also linked particle pollution exposure to kids’ development of asthma in the first place.
- Kids are especially susceptible to air pollution health impacts
Children face particular vulnerabilities when it comes to air pollution. There are two reasons for that: firstly, they breathe faster, so they take in more air than adults. And secondly, their lungs are still developing; some studies have linked air pollution exposure to reduced lung growth for kids growing up in high-pollution areas.
Asthma symptoms also hit kids harder than they hit adults.
“When an asthma attack happens, you get kind of a narrowing of [the] airways, and then you also get mucus forming—the immune system is trying to kind of fight back in the same way that it would if you had an infection,” explained Phoenix. “Children suffer from the effects of asthma more, and the reason is because they’re smaller, and their airways are smaller.”
- Air pollution is worse in the summer
When it’s bad enough to become visible, people commonly refer to ground-level ozone as smog. Long-time Washingtonians will likely remember summers 20 years ago, before many modern pollution regulations, when that haze would coat the city for weeks at a time during the summer.
Ozone comes from an interaction between certain chemicals and sunlight. During hot, sunny days, it’s created much more efficiently. The warm, humid air that hangs over the city without moving also makes it less likely that pollutants will dissipate on their own.
At the same time, children may spend more time running around outdoors during the summer months when they’re out of school, and heat and humidity can increase other asthma triggers in the air, such as pollen and mold spores.
Climate change will continue to intensify summer heat and humidity over the coming years, adding to asthma and air pollution risks.
- Asthma treatment medications are safe and effective
Asthma attacks can be extremely scary, especially for kids and their parents. Luckily, asthma treatments—both long-term daily medications and quick-relief meds like inhalers—can make a big difference. If you suspect your child has asthma, it’s a good idea to take them to a doctor as soon as possible.
Symptoms to look out for include constant or recurring coughing, or coughing linked to physical activity; wheezing or whistling sounds when breathing out; shortness of breath; complaints of chest tightness; and repeated episodes of suspected bronchitis or pneumonia.
- Daily air quality information is easy to track down
For people with asthma or other lung conditions, it’s smart to keep track of local air quality on a daily basis. Dr. Joseph L. Wilkins, a leading wildfire and air pollution expert and Howard University professor, recommends that all people check the air quality online or using a weather app, the same way they might check the temperature in the morning.
Many weather apps will show you a number for your area on the U.S. Air Quality Index, which the Environmental Protection Agency uses to evaluate and report out air quality. The index gives a score from 0 to 500 based on the levels of five major pollutants (ground-level ozone, particulate matter, carbon monoxide, sulfur dioxide and nitrogen dioxide). You can also find this information at airnow.gov.
Code Orange, which indicates that the air is unhealthy for sensitive groups—which includes all kids and anyone with asthma—ranges from 101 to 150. Code Red ranges from 151 to 200, and Code Purple, or “very unhealthy,” begins at 201. The last tier, Code Maroon, refers to anything above 300 and indicates “hazardous” or emergency-level air pollution.
So far this summer, D.C. has already experienced three Code Red days and 17 Code Orange days. Wilkins said that, especially while wildfire smoke remains a threat this season, people should consider changing some behaviors based on air quality readings.
“[It’s] a mindset we want to change—we want people to say ‘okay, maybe you don’t need to go outside for that run [if the air quality is bad].’ You can just move it two days back when the weather changes, same as you would if it was gonna be pouring down rain,” Wilkins said.