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Air quality and asthma: Index a guide for when it's best to stay indoors

asthma inhaler
Rich Cooley/Daily (Buy photo)

asthma
Rich Cooley/Daily (Buy photo)

By Amber Marra - amarra@nvdaily.com

Savoring the sights, sounds and smells of summer in the Shenandoah Valley is not so easy for people who are at risk in the outdoors they love so much.

Almost 14 percent of Virginians say they suffer from lifelong asthma, according to the Centers for Disease Control's 2008 Behavioral Risk Surveillance Survey. The national average is 13.3 percent.

Asthma, a lung disease, causes episodes of chest tightness, wheezing, breathlessness and coughing throughout the night or morning, according to the CDC website.

Though people who have asthma always have it and there is no cure, it takes triggers to set off an attack, triggers that are very common in the Shenandoah Valley, according to Dr. Jeffrey Lessar, a pulmonologist in Winchester.

"There's a ton. We have such lush green trees and grass and we're coming out of a rough spring for people with allergies and asthma because of the heat, dust and dead grass in the air," Lessar said.

Irritants that can trigger an asthma attack can be different among sufferers, but common ones include dust, pollen, mold and mildew, tobacco smoke and outdoor air pollution, according to the CDC.

And the summer heat makes things worse.

"With the heat and humidity, the air is much more dense and harder to breathe," Lessar said.

In order to cope with these issues and be able to spend time outside, Lessar recommends covering the mouth with a mask or rag while doing yard work, participating in outdoor activities in the early morning or late evening and paying attention to the air quality index determined by the Environmental Protection Agency.

The index measures how clean or dirty the air is in a given area, according to www.airnow.gov. Much like a weather forecast, the index has color-coded ratings from green, which stands for good air quality, to maroon, which stands for hazardous air.

In order to avoid attacks, asthma sufferers should stay indoors during an unhealthy Code Red index, Lessar said.

In extreme cases where asthma symptoms are easily triggered, he recommends staying indoors even for a Code Orange index, characterized as "unhealthy for sensitive groups."

Fortunately for area residents, the index is usually between green and yellow, or moderate, for the Winchester area, according to the website.

Lessar also urges asthma and allergy sufferers to use prescribed medications such as nebulizers, an air pump device used to deliver asthma medication into the lungs by inhalation, and rescue inhalers.

Planning ahead for what happens during an asthma attack, which can be frightening and end with a visit to the emergency room, also is essential and has been the focus of the Virginia Asthma Coalition.

"The big thing is to have an action plan for students in school so nurses can know what to do," said Dr. Stuart Tousman, a professor of health psychology at Jefferson College of Health Sciences in Roanoke who is chairman of the coalition.

Through research, Tousman has developed an asthma self-management program by encouraging adults to monitor and record asthma-specific behaviors, like triggers and how often they took their medication.

The coalition also has been instrumental in facilitating air-quality related legislation, including the recently passed ban of cigarette smoking in bars and restaurants without separate ventilation systems.

"We were very happy with the smoking ban, but we're worried about the fine associated with it, it's only $25 and it's not really being enforced, so we're not too happy about that," Tousman said.



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