Air Quality Awareness Week 2017

Asthma and Air Quality

Interview with a Local Asthma Specialist

To help us talk about the relationship between Asthma and Air Quality we interviewed a local doctor that specializes in Asthma care.

Dr Alvarez


Dr. Alexander Alvarez, MD is a board-certified allergist and immunologist practicing in central Austin at Allergy & Asthma Consultants, LLP (www.austinallergy.com).  An Austin native, Dr. Alvarez holds a bachelor's degree from Rice University and a medical degree from The University of Texas Southwestern at Dallas. He completed both a residency in Internal Medicine and a fellowship in Allergy & Immunology at Virginia Commonwealth University in Richmond, VA prior to joining the practice in 2015. Dr. Alvarez is board certified in Pediatric and Adult Allergy & Immunology as well as Internal Medicine.

What is asthma and how many people does it effect?

Asthma is a chronic lung condition that affects adults and children of all ages. It is characterized by inflammation and narrowing of the airways in the lungs, as well as excess mucus production. Asthma causes repeated episodes of wheezing, coughing, shortness of breath, and chest tightness. Asthma can be brought on or worsened by exposure to environmental factors including air pollutants, tobacco, occupational exposures, and allergens such as pollen, mold, pet dander, and dust mites.

According to the Texas Department of State Health Services, in Texas alone an estimated 7.3% of adult and 9.1% of children have asthma. This means that more than 1.4 million adults and 617,000 children suffer from asthma in our state. The health and economic burden of asthma is significant. Asthma costs the United States an estimated $56 billion each year, and results in 10.5 million missed days of school and 14.2 million missed days of work. Unfortunately, about 9 people die from asthma each day nationwide. In Texas and the US, the burden of asthma disproportionately affects people with certain demographic characteristics, socioeconomic status, and geographic locations.

Why is it important for people with asthma to understand current air quality conditions?

The United States Environmental Protection Agency (EPA) defines air pollution as any visible or invisible particle or gas found in the air that is not part of the natural composition of air. Air pollution comes from many different sources, including gasses, smoke from fires, volcanic ash, and dust particles. Research indicates that higher air pollution levels are associated with an increased risk of severe asthma attacks and medication use. Asthma episodes and emergency department visits increase significantly when air pollution is high.

What air pollutants are of the highest concern to people with asthma?

The pollutants most commonly associated with asthma are gaseous pollutants (ozone, carbon monoxide, nitrogen dioxide, and sulfur dioxide) as well as airborne particles.  Ozone is one of the prevalent air pollutants, and the main component of "smog" or haze in the air. It is most common in cities where there are more cars, and in the summer when there is more sunlight and low winds. Ozone triggers asthma because it is very irritating to the lungs and airways.  Airborne particles include those small particles in the air that can pass through the nose or mouth and get into your lungs. Found in haze, smoke and airborne dust, these particles present serious air quality problems and can make asthma worse. Both long-term and short-term exposure can cause health problems such as reduced lung function and more asthma attacks. Though not strictly pollutants, allergens such as pollen, mold, dust mites, and pet dander are also significantly associated with asthma attacks.

How should people with asthma best control their symptoms when air quality if poor?

The exact cause of asthma is unknown, and there is, unfortunately, no cure for the disease. However, most people with asthma can control their symptoms by avoiding things that trigger asthma attacks and by receiving appropriate medical care. It is best to stay indoors if air quality is very poor. Patients should make sure that they are using their maintenance inhalers and asthma medications as prescribed by their physician. I recommend that all asthmatic patients see an allergy and asthma specialist see how they can better control their symptoms.

Closing Thoughts?

Asthma is a common condition which causes a significant economic and health burden in Texas and beyond. Air quality can have a significant impact on asthma, and patients with asthma should monitor air quality and recognize when it is best to stay indoors. Most importantly, although there is no cure for asthma, with proper treatment most patients can expect to live a full and active life.