FEATURE | Posted July 17, 2014

Surviving summer with COPD

Extra precautions are necessary with reduced air quality

Pulmonary rehab specialist with patient © UC Regents
Karina Berge shows pulmonary rehabilitation patient Lloyd McAulay the changes in his oxygen level and heart rate as he exercises in the Pulmonary Services Lab at UC Davis Medical Center. When the air quality index rises over 100, Berge guides COPD patients on how to do some exercise therapies at home.

Summer days of high heat and poor air quality can be extremely challenging for those with reduced breathing capacity due to COPD, or chronic obstructive pulmonary disease. Combined with the drought and likelihood of increased fires, COPD patients need to take extra precautions to protect their lungs during July and August.

UC Davis pulmonary and air-quality specialists encourage COPD patients to check the air-quality index (AQI) each day in their local newspapers or on the Sacramento Metropolitan Air Quality Management District website: www.sparetheair.com.

“The AQI is a prediction of the level of pollutants in the atmosphere we breathe,” said Anthony Wexler, professor of engineering and director of the UC Davis Air Quality Research Center. “It’s based on what is known about the next day’s weather combined with assumptions about activities that increase ozone and particulates.”

While wildfires intermittently increase particulate matter in the air, ozone is a daily concern during summer, Wexler explained. It is created by gases caused by emissions from, for instance, factories, outdoor grills and cars that create a layer of air pollution close to the ground. Increased sunlight and heat put ozone formation into overdrive.

“There’s a lot more chemistry happening near the Earth’s surface during summer that is linked with inflammation, which plays a big role in COPD progression,” said Kent Pinkerton, a pulmonary health researcher and director of the UC Davis Center for Health and the Environment. “It’s not just recommended, it’s essential to be cautious.”

What is the AQI?

The air quality index is used by government agencies to communicate predictions of levels of ozone and particulates in the atmosphere on a scale of 0 to 500. Those with lung diseases like COPD need to take extra precautions when the AQI reaches 101.

AQI value Level of heath concern
0-50 Good
51-100 Moderate
101-150 Unhealthy for sensitive groups
151-200 Unhealthy
200 to 300 Very unhealthy

When the AQI climbs over 100, Karina Berge, a UC Davis Medical Center nurse practitioner and pulmonary rehabilitation program coordinator, gets in touch with COPD patients to reschedule appointments and encourage them to stay indoors.

“If they don’t have air conditioning at home, I suggest they go to a mall or a friend’s house that does,” said Berge.

Because it’s important for COPD patients to maintain their pulmonary rehabilitation programs, including exercise therapy, Berge advises patients to do light exercises at home with resistance bands. She also reminds them to:

  • Stay hydrated
  • Plan essential outdoor activities during mornings or evenings
  • Remember to take medication, including rescue medication in the early stages of exacerbations
  • Call their pulmonologists’ offices if shortness of breath increases, and don’t delay getting to urgent care or an emergency department if it worsens and doesn’t respond to medication

Berge encourages family and friends to check in on those they know with COPD during times of high heat, because interaction can relieve the isolation of being house-bound.

“A little conversation can be the greatest medicine,” said Berge.