Higher temps, reduced air quality and COVID-19 are a triple threat for those with chronic lung disease

Read our tips for surviving summer 2020


Summer days of high heat and poor air quality can be extremely challenging for those with COPD, asthma, pulmonary fibrosis and other lung conditions. Combined with the COVID-19 pandemic and the increased likelihood of fires, extra precautions are necessary.

Respiratory therapists help patients maintain their pulmonary rehab goals during hot summer months. This year, with extra precautions due to COVID-19.
Respiratory therapists help patients maintain their pulmonary rehab goals during hot summer months. This year, with extra precautions due to COVID-19.

"It's more important than ever before to monitor the safety of your outdoor activity," said Aimee Kizziar, a respiratory therapist and pulmonary rehabilitation program supervisor at UC Davis Health.

Kizziar and other UC Davis experts encourage patients with chronic lung disease to check the air-quality index (AQI) each day in their local newspapers or on the Sacramento Metropolitan Air Quality Management District website: www.airquality.org.

“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 exacerbates inflammation, which plays a big role in the progression of COPD and other lung diseases,” 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. Especially this year, because those with chronic pulmonary conditions have higher risk factors for COVID-19.”

Hot-weather tips

In addition to watching the weather and AQI reports, Kizziar shares these tips for surviving summer with a lung condition:

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 health concern
0-50 Good
51-100 Moderate
101-150 Unhealthy for sensitive groups
151-200 Unhealthy
200-300 Very unhealthy
  • If the AQI is 101 or higher, stay indoors. “While it can be frustrating, nothing matters more than breathing,” said Kizziar.
  • Also stay indoors when the thermometer reaches 100. Lung disease and its medications can interfere with the body’s natural ability to cool down and increase sensitivities to heat.
  • Stay cool. If you don’t have air conditioning at home, go to a mall or a friend’s house that does. (Remember to follow social distancing and masking guidelines when you do.) Air conditioning also helps take humidity out of the air, making it easier to breathe.
  • Keep window coverings closed during the day, as it helps air conditioning work more efficiently.
  • Keep in contact with family and friends. Interaction relieves the isolation of being house-bound and, Kizziar believes, “A little conversation is great medicine.”
  • If your pulmonary rehabilitation program includes exercise therapy, do light exercises at home with resistance bands.
  • When exercising, pace yourself. It’s OK on hotter days to avoid exertion.
  • Stay hydrated throughout the day. If you are monitoring your fluid intake for other health-related diseases, talk with your physician about the best hydration options for you.
  • Plan outside activities around the forecasted temperature and heat index. If you have to be out and about, do so early in the day to avoid peak temperatures.
  • Park in shady areas, and never sit or rest in a car parked outdoors or in an enclosure where temperatures can soar.
  • Carry an umbrella or floppy hat for instant shade, and wear loose-fitting clothing made of cotton with sandals or lightweight socks and shoes.
  • Cool off with a fan or mister or by placing cool damp washcloth on your wrist at the pulse site, forehead or neck.
  • Remember to take medication in the early stages of exacerbations.
  • Sign up for daily regional AQI emails or, for current air-quality conditions in specific areas, download the Spare the Air app at www.sparetheair.com.
  • Above all, know your triggers, monitor your symptoms and be aware of how you feel. Call your doctor’s office 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.

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Controling chronic lung disease amid COVID-19 (from the American Lung Association)