Boise’s air is not just bad — it’s dangerous. How to protect yourself and others

The air in the Boise area has been awful in recent days as wildfire smoke has poured into the Treasure Valley. The air-quality index was in the red zone Thursday and Friday — unhealthy for everybody.

The people at highest risk include pregnant women and those suffering from respiratory illnesses such as asthma or lung or cardiovascular diseases, said Dr. David Pate, former CEO of Idaho’s St. Luke’s Health System.

If your job requires you to be outdoors, you are also at higher risk, because of the longer-term exposure to wildfire smoke you are forced to endure.

But everyone, not just high-risk people, should take precautions to stay healthy and avoid inhaling smoke, Pate told the Idaho Statesman. “The research that we have would suggest that air pollution is harmful to everyone,” Pate said by phone.

Here are seven key things to know about the smoke and what you can do to protect yourself and others, especially if you are part of a vulnerable population.

1. The smoke is worse than ordinary urban air pollution.

Health consequences caused by exposure to polluted air depend on which chemicals are in the air, Pate said.

But wildfire smoke is one the worst kinds of air pollution that people can breathe. Compared with other types of air pollution such as air quality experienced in large cities, wildfire smoke has among the highest risk with short-term exposures, Pate said.

People who have been exposed to wildfire smoke are also likely to have an increased severity of COVID-19, he said.

2. The very young and very old are especially vulnerable.

Dr. Ethan Sims, an emergency room physician at St. Luke’s, said people over 65 and under 12 are among the most vulnerable.

“Kids are especially important to think about, because their population is going to have the longest repeated exposure to this, and we don’t know what that long-term impact to their lung health is going to be,” Sims told the Statesman.

It’s like having your children go to summer camp and smoke cigarettes all summer, he said.

The repeated yearly exposure to heavy smoke as a child could make you more likely to get something like emphysema or COPD as you get older, Sims said, though there have not yet been long-term studies to confirm that.

With most adults spending at least 90% of their time indoors, children are also the ones most likely to be outdoors, especially in the summer, Sims said.

By playing outside and breathing deep and heavily, children get the deepest concentration of the smoke’s small particulate matter into their lungs and the highest volume of exposure to wildfire smoke, Sims said.

Others whom Sims said are at risk are:

• People with allergies, who are much more reactive to things in the air and are therefore more likely to cough, sneeze, have watery eyes and get a scratchy throat.
• Those with skin conditions like eczema, who are more likely to get flares of their eczema when the wildfire smoke is bad.

3. The homeless are especially vulnerable too.

Homeless people are among the most vulnerable, because they don’t have access to clean indoor air or a place to get out of the heat and smoke.

Just by the nature of higher exposure, they are more likely to get sick. Sims said homeless people, or those of lower socioeconomic status who can’t afford an air-filtration system, are the population he sees the most in the emergency room.

Those people also have higher rates of asthma and chronic lung disease caused by longer-term exposure to air pollution, Sims said.

4. Consider these 7 ways to protect yourself.

Here is what Pate and Sims recommend to those who are at higher risk as well as everyone else who wants to take precautionary measures:

Stay indoors as much as you can. Spend as little time as possible outdoors.

Wear an N95 mask. When outside, wear a KN95 or an N95 mask. “A high-quality mask can be very effective for helping decrease the various things in that bad air,” Pate said.

Avoid outdoor exercise. Exercising puts you at increased risk, because your oxygen demands and breathing rate are increasing when working out. This makes you breathe in the smoke a lot more than when breathing normally, which can decrease lung function, affect circulation and lead to higher rates of heart attacks, heart failure and lung problems.

“If you plan on exercising, it should be indoors,” Pate said.

Seal your home. Making your home a “better sealed environment” can help, Sims said. This can be done by having triple-pane windows and by sealing door frames. You can also close the flu in your fireplace so that polluted air doesn’t come through it.

Put a high-quality air filter in your furnace and air-conditioning system. Other measures that can help include changing air conditioning filters, as they quickly get dirty in areas affected by wildfire smoke; or adding air purifiers.

Put a HEPA filter or MERV 13 filter on your AC unit, or have somebody do that, Pate said. While their retail packaging may not say so, most air filters today are sold with MERV ratings printed on them, and a rating of 11 or higher filters smoke.

MERV is short for minimum efficiency rating value. The higher the rating, the costlier the filter is likely to be. A MERV 11 filter costs about $20.

Put a filter behind a box fan. An alternative is to place such a filter on the back of a box fan, so that the air is coming through the filter and then through the fan, Sims said. You should put the box fan in whatever room you’re spending most of your time.

Go to a building with cleaner air. If you start smelling smoke in your house, you can also go to a public place where the air is clean, such as a library or a shopping mall. Some schools, businesses and other building owners have upgraded their indoor air-filtration systems since scientists learned that the 6-foot social distancing of the early COVID-19 pandemic was insufficient, and that indoor air currents can spread the virus much more widely.

5. Working outside? Consider these 6 steps.

People working outdoors are exposed to two threats: bad air quality and heat. Here’s what Sims and Pate advise:

Pay attention to your body. Be sensitive to how your body reacts and, if you’re experiencing a new symptom, take action immediately.

If you have cardiovascular problems or you’re at risk for those, take a break to rest if you’re starting to be short of breath.

If you’re feeling an unusual pain in your arm or the side of your face, stop what you’re doing immediately and seek medical care.

Work earlier, or postpone outdoor work. Ask your employer if you can work earlier in the day. Try to change your schedule to avoid working on days with bad air quality. “You’re more likely to end up missing work and paying an ER bill if you’re out on the roof working when the air quality is bad,” Sims said.

Wear an N95 mask. If you can’t avoid working outside, wear a high-quality mask.

Drink water. As always when outdoors in hot weather, stay hydrated.

Use an inhaler if needed. It’s recommended for people with respiratory illnesses to have a rescue inhaler available to use at first signs of breathing getting worse. If you already have lung problems, make sure to optimize your medical routine, whether that’s through inhalers or other measures.

Don’t overwork. Make sure you don’t get overheated. Minimize the time spent doing things that increase your respiratory rate.

6. Want to know more? Consider these.

Talk to your doctor. Ask your doctor if you’re already experiencing problems or need extra advice, especially if you’re pregnant or have existing medical conditions.

Go to a lecture. St. Luke’s has scheduled a free online lecture on the impacts of wildfires on health and society at noon on Wednesday. You can register to attend at tinyurl.com/yeyrn5f5 .

7. A final word: Don’t get used to it.

“We’ve had bad air quality for awhile. Don’t get lulled by that,” Pate said. “Remember to keep protecting yourself the best you can. Really take this seriously. Be kind to yourself, and pay attention to your symptoms.”

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