Respiratory patients must be advised about air pollution says NICE

Healthcare professionals should raise awareness of the dangers of air pollution with patients with chronic respiratory and cardiovascular conditions, says a new Quality Standard on air pollution published by NICE.

It highlights how periods of poor air quality are associated with adverse health effects, including asthma attacks, reduced lung function, and increased mortality and admissions to hospital.

The document recommends providing advice on air pollution to children, young people and adults with chronic respiratory or cardiovascular conditions (and their families or carers, if appropriate) at routine health appointments.  This will support self-management, improve their awareness of how to protect themselves when outdoor air quality is poor and prevent their condition escalating.

Advice should include how to minimise exposure to outdoor air pollution and manage any related symptoms by:

• Avoiding or reducing strenuous activity outside, especially in highly polluted locations such as busy streets, and particularly if experiencing symptoms such as sore eyes, a cough or sore throat.
• Using an asthma reliever inhaler more often, as needed.
• Closing external doors and windows facing a busy street at times when traffic is heavy or congested to help stop highly polluted air getting in.
• Finding out when outdoor air quality is expected to be poor such as from the Department for Environment, Food and Rural Affairs' Daily Air Quality Index.

Dr Steve Holmes, PCRS Education Lead, says: “What this means for the busy clinician is try to encourage patients to use local resources which highlight when air pollution is high, use their asthma reliever inhaler if asthma is worse during these periods - and practically keep windows closed and avoiding exercise (especially around traffic) when pollution levels are high. These are simple measures that I hope will be reinforced by public health campaigns.”