As smoke chokes the Bay Area, some advice from veterans of dirty skies

With thick acrid smoke being swept into the Bay Area from the Camp fire nearly 200 miles to the northeast, residents from Monterey to Napa are getting a taste -literally – of what residents in smog-choked cities like Beijing have been choking on for years now.

And while it feels a bit shameful to complain, as the wildfire's death toll climbs higher each day, the air quality in San Francisco and neighboring towns is threatening to meet or break records set just last year when the Bay Area filled with smoke from the North Bay fires.

Local air-quality officials are warning residents that with possible rain still days away, and with the Camp fire still raging and spewing smoke our way, air-pollution levels will continue to hover at dangerous levels. That Air Quality Index is the federal system that shows pollution levels on a spectrum of zero to 500 and officials say anything between 150 to 200 could potentially and adversely affect even the healthiest of people. Much of the Bay Area has been hovering at levels between 150 and 200 since Friday and officials warn that they could still be as high as 150 through Thursday.

For residents in cities in India like Faridabad and Delhi, and in Beijing, where longtime air pollution has outraged the populace and spawned calls for the government to do something, living with smoky skies is unfortunately a way of life. People try and cope and they come up with ways to make it through each smoke-filled day. Here are some tips from those who have known air pollution in the most intimate of ways: by breathing it.

Know what you're breathing

It's important for those living either temporarily or longterm in a smoggy city to learn exactly what's in the air that's entering their lungs. A guide for newcomers to China called HealthAndSafetyInShanghai says that “smog is made of up of sulphur dioxide (SO2), nitrogen dioxide(NO2), carbon monoxide(CO), particulate matter (PM 2.5 and PM 10) and ground ozone (O3). Though all these substances are harmful, PM2.5 and Ozone (O3) will have the most impact on your health, due to their microscopic size. PM2.5 is emitted during combustion activities such as coal burning, diesel combustion in motor vehicles, wood burning, power plants and industrial processes. The winter months in China see the highest levels of PM2.5 due to increased coal burning and weather patterns.” Ozone, says the guide, is created when Nitrous oxides (NOx) and volatile organic compounds (VOCs)react with sunlight. ”VOCs and NOx are emitted by chemical plants, refineries, car exhaust and vapors from consumer solvents. Shanghai weather in the summer is ideal for creating Ozone.”

Learn about levels

The World Health Organization provides guidelines for safe levels of pollutants like particulates and ground ozone. For example, “for PM2.5, exposure within a 24-hour period should not exceed 25 micrograms per cubic meter (ug/m3), while the average exposure over a year should not exceed 10 micrograms per cubic meter (ug/m3).” But note that Chinese standards are less strict, allowing for a yearly PM2.5 average of 35 micrograms per cubic meter. But here in the US, with the federal Air Quality Index of zero to 500, anything between 150 to 200 is considered unhealthy.

Consider using a mask

The Shanghai guide describes pollution face masks in detail, pointing out that while many residents in polluted Chinese cities do don masks, they're not necessarily the best mask for the job since many of them are either surgical masks or masks created with cloth. The problem is these low-quality masks are permeable and only offer real protection against certain large particles, not the more lethal pollutants in the smoggy air. Another problem with surgical maps, says the guide, is that they are “not designed with carbon filters, nor do they fit tightly against the wearer's face,” so they are not effective against PM2.5, PM10, viruses or bacteria.

But select the right mask

The Beijing Expat Guide says to make sure you buy your mask from a reputable source “because many of the 3M masks sold for cheap are fake. All air should come in through the filter, not through some opening between your skin and the mask.” The site suggest you buy a rather simple make that consists of a washable shell with a filter insert. It recommends routinely replacing the filter insert according to the product's instructions. “Wearing a face mask can be effective in protecting you from air pollution. While you may think of it as unsightly, everyone here is used to it, so no one cares. But it can also be a bit uncomfortable. It can get a little warm and humid under the mask, which my skin doesn't like that much. And wearing sunglasses with the mask can cause the glasses to fog up. But that's a small price to pay for better health.”

Know the unique qualities of wildfire pollution

Writing in the blog My Health Beijing, Dr. Richard Cyr writes about pollution problems unique to smoke from wildfires. “The major danger from wildfire smoke is from short-term health risks caused by the particulate matter from all of the burnt carbon,” writes Cyr, who spent time during medical school in the Bay Area. “You don't have to worry about the larger particles - the soot covering your car - as your nose and mucus in the lungs would trap and expel that. We would call them PM10 (Particulate Matter of 10 microns). It's the smaller particles we worry about, the ones we call PM2.5 (Particulate Matter under 2.5 microns). These micro-soot particles are so small that they can diffuse directly down your lungs and get absorbed into your bloodstream.” Once inside, they act basically as pro-inflammatory reactants, leading to all sorts of flare-ups of chronic disease - especially for the most vulnerable of us, including children with asthma and adults with COPD and emphysema.

Regularly monitor the pollution around you

Cyr says the number one goal is to decrease your exposure to breathing in that bad smoke. For what he calls ”outdoor” tips, Cyr advises keeping an eye on the air-quality index, or AQI. “You need to know just how bad it is before you can make an informed decision,” he writes. “So you would follow the Air Quality Index, which is an hourly update from the EPA. You can find it on their website” here.

The chart offers a quick and easy color-code way to see how clean or how polluted the air is in your town or city as well as what associated health risks you should be aware of. “The AQI focuses on health effects you may experience within a few hours or days after breathing polluted air,” according to the EPA. “EPA calculates the AQI for five major air pollutants regulated by the Clean Air Act: ground-level ozone, particle pollution (also known as particulate matter), carbon monoxide, sulfur dioxide, and nitrogen dioxide. For each of these pollutants, EPA has established national air quality standards to protect public health. Ground-level ozone and airborne particles are the two pollutants that pose the greatest threat to human health in this country.”

Use technology to stay informed

Cyr recommends a smartphone app called AirVisual, “because you can see multiple cities at once (have fun comparing a typical day in Beijing to your town). You can also sign up for alerts via apps, SMS or the website. Users can either choose to share their location or search for a city for current conditions to pop up. A cartoon cloud's expression and the sky behind it changes depending on the quality of the air in that city.”

The Deseret News reviewed handy apps for tracking and dealing with air pollution. AirNow is a free app developed by the EPA, the National Oceanic and Atmospheric Administration, National Park Service and tribal, state and local agencies. “Their goal was to provide the public with easy access to national air quality information,” said the report. ‘They do that, but in the most basic (and boring) way possible.” AirNow serves up the Index numbers without a lot of add-ons. It features real-time maps that update on the hour so you can enter your zip code and see current air quality ratings and a forecast of air quality over the next 24 hours. Finally, the CDC offers practical measures to cut down on risk from wildfire smoke. Tips include closing windows, avoiding using fireplaces and, says the report, “even taking a break from vacuuming, which stirs up particles already in your home contributing to indoor pollution.”