Air Quality and Lupus: Take a Deep Breath

Many Lupus Warriors are aware of the link between lupus and lung health, but the air we breathe can also affect lupus.

The air we breathe is linked to many different health issues, and it goes far beyond lung infections and asthma. According to the World Health Organization (WHO), an estimated 4.2 million premature deaths globally are linked to air quality. 

Air quality is measured on a scale of 0-500 called the Air Quality Index. This scale is an average based on how many micrograms of pollutants are in every cubic meter of air. The higher the number, the higher the concentration of pollutants in the air — And the more dangerous it is for people with lupus. 

Air pollution comes in many forms, from human-made pollution, to pollen, to natural disasters and weather conditions. It can change city to city and day to day. You can see an interactive map of air quality in the US here.

According to the CDC, air quality has improved greatly since the 60’s. The improvement is mainly due to laws restricting pollution and technology that reduces emissions from cars, trucks, and factories. However, with increased fires in some regions and new classes of emissions, people with lupus still have to face air pollution and the serious problems it can cause.

What’s in the air?

What is in the air that is causing problems for people with lupus?

Air pollution comes from many different sources including:

• natural sources
  • volcanoes
  • fires
  • plants
  • animals
  • chemical reactions in the soil
• man-made sources
  • factories
  • cars
  • trucks
  • digging (releases gasses and particles trapped in the ground)
  • improper disposal of waste (allows chemical reactions that release gas and chemicals from plastics and other trash into the air)

Air pollution also comes in many forms, both solid particles and liquid droplets. When airborne, these substances are known as aerosols. Anything small enough to be airborne can contribute to air pollution, but there are a few noteworthy (and gross!) culprits.

Common contaminants

• Pollen and dust are naturally-occurring pollutants that clog the air and can cause allergies and other reactions. For people whose immune and respiratory systems have been weakened by lupus, these reactions can be more intense. Pollen levels increase at certain times of year. Depending on where you live, dust can also have annual cycles. More often, an increase in dust is the result of a major disaster (landslide or collapse), human activities (construction), or a major weather condition (drought and wind storms).
• Smoke and ash are the result of burning, either from human-made fires or from natural sources such as volcanoes and wildfires. Smoke and ash are terrible for the lungs. Additionally, they contain other harmful chemicals or particles that can seriously damage the body. Another source of smoke, cigarette smoke, is bad for the smoker and for the people around them. But natural disasters can choke entire cities.
• Smog is a thick gas that heavily affects air quality. This gas is produced through chemical reactions involving other pollutants being broken apart by the sun. Not only does smog reduce visibility but it is also linked to respiratory infections. 
• Carbon monoxide is a poisonous gas found in the exhaust of cars and trucks. Carbon monoxide prevents the body from getting the oxygen it needs by attaching to your red blood cells instead. A lack of oxygen causes fatigue and poor organ function – A small amount of carbon monoxide in an open space may make you feel woozy – a large amount in a closed room can kill you. 
• Chemicals such as sulphate, nitrate, ammonia, sodium chloride (salt), tiny shards of rock or glass, and even water can also act as air pollution and cause problems for people with lupus.

Lupus & the lungs

According to the CDC, air pollution is linked to asthma, heart disease, and stroke risk. This isn’t good for anybody, let alone people with lupus who are more vulnerable to throat, nose, mouth, and sinus problems. You can read more about lupus and the lungs here.

Pollutants are known to cause oxidation damage to the lungs, which the body then has to repair. The repair process involves triggering inflammation. This brings repair proteins and pathogen-fighting proteins (such as cytokines, B cells, and T cells) to the site.

The problem with inflammation is that it makes the symptoms of autoimmune diseases worse and causes flares. Air pollution also can directly affect lupus by changing the activity of autoimmune cells and making them more likely to react to the body.

Between the inflammation and the cell damage, air pollution also puts a strain on the lungs and, by extension, the entire cardiovascular system which includes the heart and affects the entire body, increasing the risks of heart attacks and strokes. 

What to do about poor air quality

Because many air quality problems are caused by a combination of a pollution source and regional weather patterns, one of the best ways to improve your air quality is to change where you live. However just because it’s the best option doesn’t mean that it’s possible.

Family, friends, work, medical facilities, and cost can all make moving nearly impossible. It can also take a lot of energy to move.

So what can you do about air quality? 

First, keep an eye on the weather, natural disasters near your area, and air quality indexes like the one you can find here at the EPA website. Since air quality can fluctuate day by day, you might find that there are days that are particularly bad. If possible, don’t go outside on those days, and leave yourself enough space to schedule outings for clearer days.

Indoor filters can help keep your home’s air clean. There are many different kinds of filters and humidifiers on the market – finding one that is right for you can make all the difference for your respiratory health.  An HVAC filter (such as an air conditioner or a central furnace filter) works to clear the air in your whole home, while small portable air filters (such as air purifiers and air sanitizers) can clear a room or small area. You can find more information about air filters at the EPA website.

If you can’t avoid going out, you can protect yourself with a face mask, which can help filter out some of the air particles.  Respiratory medications and some other lupus medications such as prednisone can also help.