November 18, 2016

Staying In or Venturing Out? – Weekend Air Quality to Reach Unhealthy Conditions

shutterstock-forest-fireBy Calvin Mabry

With the recent outbreak of forest fires in western North Carolina, air quality alerts have been issued to assist residents in determining outdoor activities, leaving many wondering how concerns pertaining to air quality could impact their weekend plans. The following is a comprehensive breakdown of recommendations from Mission Health providers. However, we also suggest that you use your own best judgement in determining your level of exposure.

The Color Air Quality Forecast

The North Carolina Air Quality Forecast Center actively provides live updates to air quality in our region. The purpose of the scale, which ranges in severity from green to purple, is to provide recommendations for outdoor activities based on specific levels of health and sensitivities. Over the weekend, areas of western North Carolina are expected to range between the red, orange and yellow levels, depending on your area.  To determine the air quality level in your community, visit

Primary Care

Kate Rasche, MD, of Mission Community Primary Care – Haywood, A Service of Transylvania Regional Hospital, offers the following tips:

  • Take your cues on activity levels based on air quality.
  • If you do have to go out, consider wearing an N-95 respirator when the air quality is poorer.
  • Consider running your HVAC system and limiting it to air circulating inside.
  • Inside your automobile, limit the air to recirculation.
  • Don’t take outdoor risks that may have adverse consequences.

If you are experiencing a persistent cough or have trouble breathing, contact your primary care physician or request an appointment with one who’s best for you at

Parents – What to Look For

Steven Julius, MD, a pediatric pulmonologist at Mission Children’s Hospital, suggests that when air quality is deemed unhealthy (Code Red), younger children and those at risk should avoid prolonged periods outside whenever possible.

Why are children so vulnerable to air quality issues?

Children are susceptible to respiratory problems from smoke inhalation as:

  • Lungs are still developing in early childhood.
  • Children breathe more air per body weight then adults.
  • Children tend to have more airway reactivity (seen with asthma, not unique to children).
  • Children tend to spend more time outdoors.

What are the signs of respiratory stress?

Symptoms can be obvious or subtle. Look for persistent cough, wheeze and chest congestion. Additional signs of respiratory distress include:

  • Unable to complete a small sentence without catching their breath
  • Retractions
  • Increased respiratory rate
  • Grunting
  • Nasal flaring

When should parents seek medical attention?

  • Any persistent respiratory symptom or any signs of respiratory distress
  • Poor response to asthma rescue therapy in those children with a history of asthma

For more information on how we help children with breathing problems, visit 

Weekend Warriors and Athletes

As many local coaches and athletic directors continue to monitor the air quality for safety, parents and athletes should also be cognizant of what to look for and how to navigate current conditions. According to Mary Helen Letterle, Manager with Mission Sports Medicine, “We are monitoring the air quality throughout the day and working closely with local schools, hospitals and health departments to ensure we provide the safest environment for our athletes and staff.” Letterle  recommends the following tips for navigating the air quality alerts: 

  • If practicing or working outdoors, take frequent breaks and reduce your normal rate of activity. Consider indoor activity where possible.
  • If you or your child have asthma, a heart condition or other underlying conditions, monitor it more closely for exacerbated signs and symptoms.
  • Check indoor spaces to ensure good ventilation, close any open windows and make sure doors close properly.

The Walk-In Orthopedic and Sports Medicine Clinic is available Monday through Friday from 7:30 am to 4:30 pm, and no appointment is required. The Mission Orthopedics/Asheville Orthopaedic Associates – Arden office also sees patients at their Concussion Clinic on Friday afternoons. To schedule an appointment, call (828) 782-9330. 

Individuals Suffering from Heart and Lung Conditions

As air quality levels shift over the weekend, individuals who experience any heart and lung conditions are still considered sensitive and therefore at greater risk. It is recommended to continue reduced exposure to unhealthy air by limiting outdoor exposure and substituting a less intense outdoor activity – for example a walk instead of a jog. If you have any additional concerns, please contact your primary care physician or cardiologist.

For more information about Mission Heart Care services, visit