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How Heat & Humidity Affect Asthma and COPD—And What You Can Do to Stay Safe · Healthy Vitals

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  Scott Webb (Host): The summer months are a time for many of us to get outside
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  and enjoy the hot and humid weather.
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  But for folks who suffer from asthma or COPD, the heat, humidity, and
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  air quality can cause flare-ups.
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  My guest today is here to explain and provide some tips so these
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  patients can enjoy summer too.
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  I'm joined today by Dr.
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  Aliaksandr Ramaniuk.
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  He's a pulmonary and critical care physician with Summa Health.
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  This is Healthy Vitals, a podcast from Summa Health.
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  I'm Scott Webb.
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  Doctor, it's nice to have you here.
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  As we approach the summer months, it's a good time to talk about heat and humidity
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  and how it can make asthma and COPD worse.
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  So when we talk about extreme heat and high humidity, which is coming, of course,
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  what actually is happening inside the lungs of someone who has asthma or COPD?
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  Dr. Aliaksandr Ramaniuk:
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  So at Summa Health here, our pulmonary team sees how asthma and COPD affects
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  real people every day of their lives.
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  When heat and humidity rise, our breathing can become harder very quickly.
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  And for people that already have sensitive and diseased lungs,
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  this can be quite a challenge.
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  Today, our goal is to help understand what is happening inside your lungs,
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  to recognize the early signs and some practical approaches before
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  symptoms become an emergency.
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  We do not want the patients to feel afraid to reach out or to be afraid of
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  the weather that's currently impacting it.
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  During high humidity and high heat, your lungs are already doing a lot of work.
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  They're moving air in and out, they're absorbing oxygen, but they're also
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  providing improved conditioning.
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  In the summer, we're asked to do additional job.
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  We're asked to clear moisture, to clear pollen, ozone smoke all at once, and
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  it puts extra stress on top of your lungs that may or may not already
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  have some sensitivity and reactivity.
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  In addition, heat itself, high heat in the environment
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  doesn't just make people tired.
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  It actually raises your oxygen demand inside your whole body.
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  We usually have to breathe faster to cool off and compensate for all
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  that's happening inside of our bodies while the temperature is going up.
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  Breathing hot and humid air actually increases the ability and the
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  resistance of the air coming in and outside of your lungs by about 112%.
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  And heat increases your hospitalizations and your flare-ups requiring
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  sometimes even acute evaluations and ER visits by over 30%.
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  Host: Sure.
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  Yeah, it's interesting.
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  And as you say, we don't want folks to be afraid of the heat and the humidity.
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  We don't want folks to be afraid of summer.
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  But I'm sure a lot of us, including me, you know, laypeople like me, don't
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  realize that humidity itself is a trigger.
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  Wondering, like, why does the humid air make breathing harder
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  for people, especially those with chronic lung disease?
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  Dr. Aliaksandr Ramaniuk:
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  It's a complex question.
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  A lot of studies are being done about it.
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  But humidity by itself is an additional accomplice to the stress that
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  air and breathing hot air causes.
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  It causes more growth of mold in our environment.
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  It feeds dust mites and traps the ozone and other small particles that we're
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  breathing in, and it really impacts your body's ability to cool it down.
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  Think of the lungs like an air filter or an air conditioner.
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  On a normal day, it's working and it's doing okay.
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  But when those days become hot and humid and polluted, sometimes
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  the system becomes overwhelmed
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  Host: Yeah, you mentioned polluted.
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  You used that word, and I wanted to ask you about that because I'm sure that in
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  addition to the heat and the humidity, air quality probably is a contributing
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  factor, as you said, and an accomplice.
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  I love that.
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  So, they kind of work together, right, to increase flare-ups
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  during the summer months.
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  Dr. Aliaksandr Ramaniuk:
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  Absolutely.
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  And together this causes sometimes a perfect storm and is recognized by
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  the societies in pulmonary medicines.
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  And what I recommend is people check in the summer, in the hot summer month,
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  the heat index, the air quality index.
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  We do know that when that AQI or air quality index goes over 100,
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  and this is something you can look up easily on your phone or on a
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  weather app, it really impacts people with underlying lung disease.
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  So, I recommend people before they're planning outdoor activities,
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  potentially reduce their intensity of activities, to take breaks, to make
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  sure they have their quick relieving and their maintenance asthma or COPD
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  medications, and to really keep an eye on the air quality index around us.
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  We do know that even a 1% increase in the temperature around an environment
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  increases your risk of having an asthma hospitalization by 1%.
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  And the guidelines recommend keeping indoor humidity down as well to less
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  than 50% to prevent mold and fungal spores to also impact our breathing.
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  Host: Yeah.
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  It's really interesting, because I think a lot of us check our
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  phones for the UV index, right?
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  But those with COPD or asthma really should be checking the air
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  quality as well, not only the sun rays and how much sunscreen to use.
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  Wondering, Doctor, like what are some of the maybe early warning
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  signs that heat or humidity is starting to trigger asthma or a COPD
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  flare-up, and when do we take action?
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  What do we do?
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  Dr. Aliaksandr Ramaniuk:
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  That's an excellent question.
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  So, early signs could be variable from person to person.
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  Some people may experience some chest tightness, and that could be a sign
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  of your airways starting to narrow and we're starting to feel more tight.
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  Sometimes people can experience cough, and that could be irritation by the
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  mucus and inhaled substances in there.
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  Some people start wheezing, and that can tell you that the
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  airways are already starting to be narrow and starting to whistle.
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  Some people will say they need their inhaler more often.
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  And that can tell us that the baseline, the maintenance control may be slipping
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  and we need to escalate and come up with an asthma or COPD action plan for you.
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  Some people have more mucus or change in their mucus, and that could be an
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  important trigger for an exacerbation.
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  It's important to keep an eye on your nighttime symptoms as well.
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  If you're waking up multiple times a night gasping for air or your oxygen
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  drops or you're feeling that something is wrong, especially at night, this
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  could be a sign that a flare is coming, and I recommend you reaching out to
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  your Summa Health pulmonary team early on or seek appropriate emergency care
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  Host: Right.
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  If you have to, you know, call 911, get to the ED.
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  But if it can wait till the next morning, obviously get ahold of the team.
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  And just wondering, Doctor, like about practical steps
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  that patients can take, right?
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  Because we can't avoid the high heat and the high humidity if
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  we want to be outside, and some folks have to work outside, right?
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  So, like, what can they do to help themselves and maybe protect their
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  breathing when they still have to be outside and still have to
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  work in those rough conditions?
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  Dr. Aliaksandr Ramaniuk:
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  Oftentimes with our patients here in pulmonary, we come up with
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  kind of a five-part summer plan solution, so you're not afraid of
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  that July heat or that moisture.
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  I recommend a couple things.
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  One, I recommend the patient and the person checks the day
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  before you go out the air quality index, the ozone, the pollen.
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  Some of the apps will tell you is that level—especially if that HQI,
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  the quality index, is over 100, it can give you a red mark to say, "Hey,
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  be careful with this high index."
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  Time the outdoor activities.
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  Point two is time the outdoor activities strategically.
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  Maybe plan for earlier morning activities, especially considering
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  the pollutants and the ozones and other factors in the environment.
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  Avoid the hottest parts of the day.
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  Pre-plan is step three.
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  Pre-plan your inhalers and your oxygen if that's needed.
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  Do not leave your house without your rescue inhaler
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  or that extra tank of oxygen.
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  And if you notice that the oxygen requirements are increasing, try to
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  reach out to your team earlier on.
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  Hydrate before you feel thirsty, especially if you're exerting yourself.
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  Because, again, there's an air conditioner inside your lungs, you're increasing your
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  work of breathing during those hot months.
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  And then, cool the body, not just the room.
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  Loose clothing, shades, breaks, indoor cooling, air-conditioned spaces are
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  very important, especially during the hottest, most humid periods of our time.
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  If you have lung disease and you work outside, the goal is not to avoid work.
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  The goal is to engineer breaks and have a plan with your team so
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  you can go into and avoid crisis.
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  Host: Right.
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  And, Doctor, I would love to believe that we live in a world where everybody
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  has air conditioning, especially in the humid Ohio, you know, nights.
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  But the reality is not everybody does.
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  So, what can folks do at night, especially during heat waves when
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  they don't have air conditioning?
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  Dr. Aliaksandr Ramaniuk:
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  There's certainly a lot of options, and the key goal is to make sure that
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  you're maintaining an indoor temperature optimally, convenient 70 degrees or so.
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  Obviously, fans are available, but some of the evidence shows that fans
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  that are blowing high humidity and high temperature over 90 degrees
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  can actually warm your body up.
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  So, be cognizant about the temperature in your environment.
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  Try to reduce the humidity to less than 50% with a dehumidifier or a fan.
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  When the cool days are there, try to cool the room or air it out and try to
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  put yourself in an environment that if you feel overheated, to put yourself
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  in an environment where you can avoid your whole body becoming overheated.
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  Host: Yeah, just some practical tips there.
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  Obviously, you know, it'd be great to live in a world where everybody has air
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  conditioning, but that's not reality.
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  And some folks do suffer from asthma and COPD, so you gave us some
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  great, you know, suggestions, tips.
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  Always great to have an expert on.
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  Let's just finish up here.
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  What's your biggest piece of advice for patients and caregivers, let's say,
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  when it comes to managing asthma or COPD during the extreme summer weather
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  that we know unfortunately is coming?
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  Dr. Aliaksandr Ramaniuk:
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  As a pulmonologist and an ICU physician, my biggest advice is that heat and
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  humidity are not just minor inconveniences for people living with asthma and COPD.
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  They're true recognized physiological stressors, and
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  they make your body work harder.
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  They inflame the airways, they pollute the environment, and we need to have
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  a caution about approaching the times of day and environments they work in.
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  So, I want the patients to think ahead.
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  I want you to check your environmental air quality indexes, to have an action
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  plan with your family doctor, your nurse practitioner, or your pulmonary
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  team, to have your medications available, to stay cool and hydrated,
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  and to act early when symptoms change.
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  The earlier you respond, the earlier we recognize, they're more likely to stay
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  out of the hospitals and stay healthy.
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  And that is my biggest takeaway for you after this discussion.
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  Host: That's perfect.
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  Yeah, when you're kids, you just open the door and you run out and you be a kid.
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  But us adults with these fancy phones, we can check the air quality, the UV index.
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  We can, you know, be prepared, have a plan, know what we're going to
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  do if our asthma or COPD acts up.
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  So, as always, appreciate your time, your expertise.
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  Thanks so much.
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  Dr. Aliaksandr Ramaniuk:
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  Thank you very much.
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  Host: And for more information, go to summahealth.org/lung.
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  And if you enjoyed this episode of Healthy Vitals, we'd love
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  it if you'd leave us a review.
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  Your review helps others find our educational content.
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  I'm Scott Webb.
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  Thanks for listening, and we'll talk again next time.