Air Quality is “Double Whammy” – Due to Smog and Ragweed

Air Quality is “Double Whammy” – Affects 4 in 10 Americans

The Natural Resources Defense Council (NRDC) released a report on July 11, 2017, that 4 out of 10 Americans live in counties with unhealthy levels of smog and ragweed pollen. The report can be found at: (

Both smog and ragweed pollen contribute to poor air quality is double whammy

Smog obscures view of downtown Los Angeles.

Kim Knowlton, a senior scientist at the NRDC, who oversaw the project,

D.r Kim Knowlton commented on air quality is double whammy

Kim Knowlton, Ph.D., is Senior Scientist and Deputy Director of Science Center of the Natural Resources Defense Council

said that, “Today, 127 million Americans live where ragweed and ozone can threaten their next breath. This health threat will just get worse if we don’t curb climate change soon.”

The report indicated that burning of fossil fuels such as oil, gas, and coal, worsen ozone pollution and extends the ragweed season. Ragweed was selected instead of other pollens, such as tree and grass, because more people are allergic to it than all the others combined. Ragweed comes out toward late summer when temperatures, and thus smog levels, are highest. It means that air quality is a “double whammy.”

air quality is double whammy

Dr. Perry E. Sheffield, Assistant Professor at Icahn School of Medicine at Mount Sinai

Smog forms on warm, sunny days and is made worse from the chemicals that come of vehicle tailpipes and from power plant and industrial smokestacks. According to Dr. Perry Sheffield, a pediatrician at Mount Sinai in New York, “It worsens respiratory illnesses such as asthma and COPD.”

The report listed the 15 worst states where smog and pollen are bad – meaning that air quality is “double whammy.” Those, listed in order with the worst, are: the District of Columbia, Connecticut, Rhode Island, Illinois, Pennsylvania, Utah, Ohio, Arizona, Michigan, Massachusetts, Delaware, Wisconsin, New Hampshire, Indiana, and Kansas.

What Can Be Done?

Ms. Juanita Constible of the NRDC commented that, “The federal government should focus on limiting smog, curbing power plant pollution, and increasing fuel efficiency.”

I encourage you to view my post on April 23, 2017, that describes a report   from the American Lung Association on air pollution. I listed 5 things that each of us can do to help reduce – air quality is a “double whammy” – so that we can all Breathe Easy.


Smog in the Air – What are the Health Risks for Breathing?

Smog in the Air – Is it Safe for Breathing?

Dear Dr. Mahler:

I am travelling to Shanghai and Beijing for business in a few months. and am concerned about the smog in China. I have stable, but moderate COPD and don’t want to have any breathing problems on the trip.  My COPD medications are Spiriva and Advair Diskus. What are your thoughts?  I can’t have someone else go in my place because I work for a small company which is trying to expand business in China.
Thank you.

Bob from Sacramento, CA

Dear Bob:

Do you have any breathing problems with smog or air pollution living in northern California? Is your COPD under good control at the present time? Have you had a COPD “flare up” (exacerbation) in the past 3 months?  If the answers to these questions indicate that you are doing fine, then here are some things to consider on your trip to China.

As you probably know, smog develops in the atmosphere when certain gases are produced when fossil fuels like gasoline, oil, and coal are burned. Nitrogen oxide is emitted from power plants, motor vehicles, and other sources of high-heat combustion.   Volatile organic compounds come from motor vehicles, chemical plants, refineries, and factories. Carbon monoxide is emitted mainly from motor vehicles. When these gases are exposed to sunlight, they react and form ozone smog.

Smog in city.

Smog in city.

Breathing in ozone can cause shortness of breath, wheezing, and coughing and can also increase inflammation (redness and swelling) in the airways of your lungs. The risks are greater if ozone levels are high, if you are breathing faster because of exerting yourself outdoors, and if you spend a lot of time outdoors.

I suggest that you discuss the following with your host in China  before you leave on the trip:

  1. Let the host know that you have well controlled COPD and need to avoid inhaling smog and other airborne irritants (such as cigarette smoke).
  2. Ask to spend as little time as possible outdoors, and request either a taxi or car service to travel from your hotel to the place of business.
  3. Make sure that you will not be expected to participate in any sightseeing that requires spending time outdoors.

I suggest that you discuss the following with your doctor before you leave on the trip:

  1. Ask your doctor if he/she considers it safe for you to travel to China for business.
  2. Ask your doctor to prescribe both an antibiotic and prednisone to have available in case you need either of these medications. Ask you doctor to write down when, if at all, to take these medications.
  3. Ask your doctor whether you are up to date on influenza (depending on the time of year that you are travelling) and pneumococcal vaccines.
  4. Ask your doctor whether it is advisable to wear a mask that covers the nose and mouth when outdoors.

    Mask to reduce inhaling smog in China

    Woman wearing mask to prevent inhaling smog in the air.

In preparation for your trip:

  1. Make sure to hand carry all of your medications with you on the plane, including your rescue albuterol inhaler. Do not pack these medications in checked baggage.

Safe travels,

Donald A. Mahler, M.D.