Valley Health Magazine

By Kimberly Horg-Webb

You’ve heard it a hundred times before: geography is the primary culprit in the Central Valley’s ongoing air quality problems. We live in the bottom of a basin surrounded by mountains, which severely restricts air ventilation. Without ventilation, air gets locked in, becomes stagnant, and further polluted by factors such as heat and smog, as well as fog that keeps pollution closer to the ground. With more children and adults getting diagnosed with asthma than ever before, the link between air quality, asthma, and allergies in the Valley is also clearer than ever before. Here, local experts weigh in on the worsening problem and how you can protect yourself.

Allergies Vs. Asthma
For the thousands living within a constant cycle of sneezing, wheezing and indoor confinement on hazy summer days in the Central Valley, the difference between allergies and asthma is relatively clear. But for the even greater number who are struggling with first-time or escalating allergy symptoms, a few distinctions are necessary. First, according to Praveen Buddiga, M.D. at Baz Allergy, Asthma & Sinus in Fresno, “Air quality itself is not responsible for allergies. They are two independent factors. If someone breathes a certain allergen, it can trigger an inflammatory response and pollutants irritate it further.”

Allergies may be genetic and are largely pollen-based. They come from exposure in sensitive individuals to dust mites or animals, for example, and are not due to air quality. Bad air quality and ozone only make them worse. The effects of allergies may also not be seen immediately; symptoms or “attacks” may not surface for up to a couple of years. For this reason, moving to another city won’t necessarily help because every area has its own allergens. Allergies, not air quality, are the main cause of asthma, accounting for 80% of sufferers. In terms of air quality, whereas people in other cities may avoid certain foods or their roommate’s cat, here in the Central Valley, the air is the trigger. People who regularly suffer from untreated allergies may eventually develop asthma as a result of prolonged irritation. Asthma occurs when the lining of the bronchial tubes become inflamed and swollen, causing muscle spasms. This constricts airflow to the lungs. Asthma can occur at any age but is more common in children than adults.

“Once you have asthma, you have it,” Buddiga explains. “It is a chronic condition like diabetes or hypertension. Children can develop asthma (more easily) because their lungs are still developing.” He also says the problem isn’t going away anytime soon: “I have seen an increase in asthma and allergy cases since I have been in practice here over the last four years. Bad air quality, ozone levels and particulate matter have been slightly getting worse year by year.”

Likewise, A.M. Aminian, M.D. from the Allergy Institute in Fresno says, “allergic people living in clean air are better off than those living where air quality is poor, although they will continue to remain allergic.” He also believes respiratory problems, allergies and air pollution are the worst he has seen in 23 years of practice. “People who live in the Valley have more respiratory problems than ever before. It has been a gradual increase. There is more land development here now, more crowding, (and) more people and cars on the road, along with a change in climate.”

How Do We Compare?
In November 2008, Cal State Fullerton conducted a study comparing the ozone and particulate matter levels in the San Joaquin Valley, Los Angeles Basin, and San Francisco Bay Area from 2005-2007. While the Bay Area exceeded the federal ozone level standard just 12 days per year, Los Angeles came in at a staggering 120 days, topped only by the San Joaquin Valley at 139 days per year. Regarding particulate matter (dust, dirt, soot and nitrates), and following the same pattern, the Bay Area exceeded federal standards just 5 days per year while Los Angeles and the San Joaquin Valley registered at 48 and 76 days per year, respectively. 
Ozone levels in the San Joaquin Valley increased in four counties the most: Tulare, Stanislaus, Merced and Madera. In Los Angeles, bad air quality results from the general population and smog from cars and diesel trucks. The causes in the Valley are much the same—increasing traffic and diesel exhaust from highway 99. Yet our predominant agricultural businesses, such as dairy and livestock farms, emit a significant amount of gases that add to the ozone and particulate matter, making the problem worse. And unlike Los Angeles, we have no ocean breeze to help sweep and circulate polluted air out.

The Case for California
The recommendation of the Fullerton study is to comply with federal standards warning the San Joaquin Valley to cut ozone and particulate matter in half. Bad air quality is increasing all over the country but California’s case is compounded by several factors such as our shipping industries, agricultural businesses, geography, the lack of efficient public transportation across the state, escalating urban sprawl, community behavior, and more.

Gas emissions from cars are part of the problem, too. Dr. Aminian believes car motors need to be converted so less emissions are released into the environment. He has been lobbying with the San Joaquin Valley Air Control District at the White House in Washington D.C. for the past couple of years to get federal aid to help clean up the problem. “There are some things we cannot change,” Aminian said. “Two things people can do are to contribute less to pollution and take care of themselves so they are not affected.”

Dr. Buddiga also cites the cost of air quality on the state at large, regardless of the epicenter of the problem being right here at home. “There is also a lot of economic loss due to smog and air quality,” he says. “California lost 28 billion in terms of premature deaths, health care, chronic illness, work days lost and hospitalizations.” Indeed, there are 3,800 premature deaths each year in the San Joaquin Valley and South Coast Air Basin due to air quality according to the study by Cal State Fullerton.

Luckily, California has been in the forefront in trying to address the situation of traffic and emission standards. There are policy measures including the recent elections’ bond to build a low-emissions transit system from Los Angles to San Francisco, which could definitely help, however California’s fiscal crisis could delay much needed progress. And, according to Dr. Buddiga, while the relationship between air quality and poor health, asthma and respiratory problems is so clear to those of us living with it, more studies like the one conducted at Cal State Fullerton are needed to pass laws.

How To Stay Safe
If you suffer from allergies, and have not yet developed asthma, preventative measures are key. People who have respiratory problems are more at risk for other illnesses because symptoms can worsen and/or become aggravated by environmental changes. Dr. Buddiga warns that even controlled asthma can act up on a bad air day and end with an emergency room visit or trip to the doctor. Simple things such as always limiting outdoor exposure on bad air days and setting your air conditioner on re-circulate in the car can minimize your risk easily.

Dr. Aminian advises asthma sufferers to take their medications as prescribed, and also to limit their time outdoors. He recommends ride sharing, low-emission vehicles and less use of fireplaces. Using unscented products (including scented candles and air fresheners), sealant on doors, avoiding outdoor activities from 12 to 6p.m. in the summer, as well as staying indoors when the Air Quality Index is high, can all help prevent illnesses.

When planning an outing, check the Air Quality Index (determined by a combination of ozone, particulate matter, carbon monoxide, sulfur dioxide, and nitrogen dioxide levels) in the Fresno Bee, visiting www.bazallergy.com or calling 800.SMOG.INFO to to get daily pollen count information. You can also check out the San Joaquin Valley Air Control District’s Website atwww.valleyair.org for more information on air quality and pollution prevention.