Spring time is always a time to hope for better days ahead. Most importantly for my kids, spring is when we have Spring Break! Here in Oregon we have our spring break in March, and this post and the March podcast episode are designed to help you learn more about Air Health Our Health. It serves as an (incomplete) guide of topics from the last 3 years, so you can enjoy listening and learning, perhaps over your own spring breaks.
I started this entire project as the world was shutting down going into a pandemic. I had started to do more advocacy and education around the links between the air we breathe and our health, but suddenly I found myself worried that my professional life would be consumed by the ICU given the waves of illness we were seeing. I worried that I would be able to dedicate little time to my pulmonary patients, with whom I could discuss the links between the air they breathed and their health. I also knew that as a full time working mom, making it to various town halls and to testify to different government bodies was becoming increasingly incompatible with my professional and personal life. I had also come to realize that there was nothing particularly special about my voice, and that these are things that affect everyone. I would rather help spread the knowledge and the science to you, and help you have greater understanding and potentially raise your own voice in your own home, with your own healthcare team, or in your own community about the importance of clean air in our lungs.
I strive as much as possible to keep the podcast episodes evergreen. Obviously, they are always recorded in a particular time and place, but the science or the topic is usually broad enough to be valid for years. Therefore, going back to listen to older episodes helps increase your depth of knowledge on a topic.
Everyone also has different interests and concerns. Maybe you live in wildfire country, and you want to understand better how climate change is driving these fires and how you can ensure clean air refuges for yourselves and your community.
Maybe you have young children, and are very concerned about the candy flavored vapes and e-cigarettes that are flooding our schools.
Maybe you or a member of your family belong to the “Twitchy Airways Club” and want to understand what you can do, besides adding inhalers or other medications, to keep your airways open- learning how that gas stove or air pollution or pollen affects your breathing can help keep you healthy and hopefully help decrease the amount of medication you need.
Regardless of your interests, I’m hoping this month’s post and episode provides an overview to help you scroll through that list of podcasts and find the titles that may be of interest to you and help you spread the word on clean air.
For those of you who are wondering why you may be sneezing more this year and who suffer from allergies, you may find it helpful to listen to “Science over Politics” from Season One with Professor Lewis Ziska about the links between climate change, increasing CO2 and pollen.
Those of you who are planning to engage in spring cleaning may benefit from learning about the impact of various cleaning agents on our lungs from the “Cleaning Agents and Chronic Bronchitis” episode with Professor Alejandro Diaz. If you are planning to gear up and do a lot of yard work or hire someone new to manage your yard, listen to the “Yards on Fire” episode about gas powered lawn equipment and your health. If you are planning any home renovations, you may want to learn more about gas appliances from Dr. Laura Paulin in “The Fire Inside” from last Spring. There are also a host of radon podcasts from the first two seasons to help you learn about the health risks of radon in your home, when to test, and how to decrease that risk.
To get ready for summer and poor air quality from wildfires, there are a host of resources. For general information on the health impact of wildfires, who is at risk, and steps you can take, listen to the “Our Health in Wildfire Season” episode from Season Two. To learn in detail how to make a clean room for your home and ensure healthy indoor air, you can listen to the “Air Inside when Smoke is Outside” episode with Professor Gall from Season One. To learn more about the impact of wildland fire on outdoor workers and wildland firefighters, check out the “Health of Our Heroes” with Professor Khan. If you want to learn more about how people are working to prevent these catastrophic fires and deal with climate change, the “Fighting Fire with Fire” episode with Bodie Shaw from earlier in the fall can provide some insight.
There is a great deal of overlap between concern about wildfires, which generate a great degree of particulate matter, or PM2.5, and concerns about the chronic daily toll of diesel exhaust and air pollution in our communities. This is usually monitored by something called the Air Quality Index- which is made up of two main components, PM2.5 and ozone.
To get up to speed on the basics of PM2.5 and air pollution, you can listen to the “What’s in a Standard” episode with Dan Costa from season two about the basics of particulate matter pollution. For those who want to understand how to use the Air Quality Index (or AQI) for themselves or their children, the “What’s in an Index” episode with pediatric lung doctor Franziska Rosser is very helpful. To learn about ozone, the other component of the AQI, you can listen to the “Money & Lives” episode on ozone and climate change with Dr. Nick Nassikas. If you or someone in your family is a member of the “Twitchy Airways Club” with asthma, chronic bronchitis or other forms of chronic obstructive pulmonary disease, you can learn more about how air pollution affects the airways with the very first podcast episode with asthma expert Dr. Drake or the “Asthma, Obesity and Air Pollution” episode with Dr. Fernando Holguin from Season Two. If you know or care for someone with lung scarring, or pulmonary fibrosis, listen to this season’s “What’s Burning” episode with Dr. Goobie. If you or someone you know is pregnant or lives near an airport, the episode “Pregnancy, Planes & Pollution” with Dr. Ritz may be helpful.To hear a story about how air pollution can affect someone’s life and about how history affects the air we breathe, listen to the episode with my patient, “Ashia, Albina & Asthma- an individual story and a neighborhood history.”
Fortunately, especially in the realm of air pollution, there is a lot of hope! I have tried to provide a host of episodes where we can learn about how sound public policy around vehicle standards, air pollution and land use can improve the health of our communities. There is a dramatic return on investment when we clean up our buses, especially school buses. Learn about the health benefits seen in Seattle kids with cleaner buses in the “Healthy Buses” episode with Sara Adar from Season One. To learn about the money and lives we could save our communities and businesses with a transition to electric transportation, the “Road to Clean Air” episode is for you! If you want to think outside the engines about the benefits and potential impact of trees and ground cover, the episode “Tree-Lined vs Redlined” examines how we ended up with the communities we have now and how much health benefit we could see in terms of where we plant our trees. It can be very helpful to have concrete solutions when advocating for better air in your own community, and it is always vital to emphasize not only how much health and lives can be saved, but also how much less money our businesses will have to pay on missed sick days and lost productivity as well as healthcare expenditures. Cleaning up the air is really a win for air health, our health and our wealth, and it is always a good idea to remind those in power of this!
One of the places the toll of unhealthy air is most clear is in tobacco. A cigarette is basically a PM2.5 firehose that you inhale. The AQI in the home or car of someone smoking, if it were measured, blows into the unhealthy range very quickly, with all the downstream bad health effects on that person and those living or riding with them. All those bad health effects add up to a lot of money wasted. I try to drive this home with the “Smoking and your Wallet- Retirement vs Tobacco” episode in which I talk to someone from Wallet Hub, where they annually calculate the true lifetime cost of cigarette use to someone who smokes. Of course, Big Tobacco is very interested in keeping the cashflow of those addicted to nicotine, and it is vital to understand the history of their activities in different communities. If you are passionate about our veteran community, as I am after training at two different Veterans Affairs hospitals, you should listen to Brandy Carpenter in “Veteran fights back against Big Tobacco” as she shares how she was orphaned by the tobacco industry while on duty in Afghanistan. She now spends her days helping others break free of the nicotine habit and screening them for lung cancer. In addition to preying on veterans, Big Tobacco has long targeted the black community. They continually update their techniques to avoid regulation, so learning that history is very important. The episode “Tobacco & Healthy Black Lives” with Cyreena Boston Ashby from the first episode provides an overview.
One of the biggest techniques that Big Tobacco has used to addict and target communities are flavoring agents such as menthol, another agent also targeted at the black community as well as youth in general. In the Season Two episode “A Hearbreaking Trap- Menthol, Flavors and Our Kids,” youth pastor Ritney Castine from the Center for Black Health & Equity and the Campaign for Tobacco Free Kids reviews the history of flavor targeting, flavor policy, and what we can do about it. He even shares a story of meeting then-Senator Obama, who was struggling with his own nicotine addiction at the time! The flavoring agents themselves are also chemicals that can cause lung damage in an organ never designed to inhale them or filter out toxins – you can learn about how the flavoring chemicals themselves affect the lungs from Professor Ilona Jaspers last month’s episode, “The Route Makes the Poison.”
Knowledge is power, especially when faced with the array of financial resources Big Tobacco will bring to bear to keep their ability to addict new clients. As parents are increasingly aware, the industry continues to target kids, particularly with flavored e-cigs and vapes to addict them. They are also at the same time trying to muddy the waters to prevent regulation of these devices in any way they can to keep the money spigot flowing.
A foundation of sound tobacco policy is making sure we know who is selling tobacco and e-cigarettes and where. To learn about tobacco retail licensing, especially as it relates to keeping tobacco out of the hands of kids, listen to the “Teen Talks Vaping” episode from Season One. Some communities are trying to prevent the sale of flavored nicotine products to help break the generational addiction cycle- for an episode from my own home state, you can hear from two physician legislators and the American Lung Association in “A County vs Big Tobacco” from last spring. It is also vital to talk to the young people in your own life, starting around age 10 or 11 if not earlier, about the way this industry will try to addict them through their own peers. You can find resources on how to have those conversations in the “Do the Vape Talk” episode from the beginning of this season.
Of course, in the background of this entire podcast has been the specter of COVID19, which has dominated a great deal of our lives. Sadly, every element that affects the air we breathe intersects with COVID19, from both tobacco use and air pollution making the virus more deadly to hearts and lungs. You can find all those topics in the episode archives, along with how to talk to family members about vaccines and what we need to know about air quality in schools. I hope it will be a while before we need all this information again, but sadly the next pandemic will likely be on us before we expect it, and there are still many dying from COVID19.
I have built this podcast to be a resource of topics about which I learned little in medical school and during my training, but which I have realized determine so much more of the health of the patients entrusted in my care than I had previously understood. I am now also blessed to be the parent of three extraordinary young children, and I wish them only the cleanest air and most stable climate as they grow up. This project is my small effort at making a better world for my patients, my family and my community. I am sincerely grateful for those of you who have been listening from the beginning and to those of you who have just started- hopefully this spring you can catch up on prior episodes on topics of interest to you and go forth to make cleaner air for us all.
TLDR= Don't Light Things on Fire and Breathe them into your Lungs
To Do-
In terms of steps you can take, look at the “To Do” items on all the above podcasts and prior posts for personal, local and community actions to make the air cleaner. Please also share this website and podcast with others as a resource- sometimes it’s easier to just text someone an episode or a post on a topic rather than trying to explain it all over again. That’s how I ended up doing this! I found myself repeating myself fairly often, so now I can just text a relevant post or podcast episode when someone asks “Are gas stoves really a problem?”
1- Twitchy Airways Clubs Members– learn about how the air you breathe affects your health and what you can do to keep your airways open.
2- Rate and review this podcast in whatever software you use. It helps spread the word.
3- Tell a friend about the podcast and share it to help more people learn about the importance of clean air.
4- Pick an episode and look at the “To Do” items for ideas on making you or your community more healthy.
5- Purchase an Air Health Our Health mug, T-shirt, tote, water bottle or more to spread the word about healthy air- find the items on the website under the “Invest-Stuff” tab. Proceeds go to clean up the air.
6- Consider a donation to the American Lung Association, who continues to fight for clean air.
