Dust Is Not Only a Breathing Problem

Call 911 for severe difficulty breathing, for chest pain, or for anybody who cannot speak in full sentences. Do not attribute chest pain to the air and wait.

The National Weather Service says airborne particles cause heart attacks.

That is not a paraphrase. Here is the list, quoted exactly, of what the Weather Service says particulate pollution can do:

“This pollution can cause chronic bronchitis, asthma attacks, decreased lung function, coughing, painful breathing, cardiac problems and heart attacks.”

Cardiac problems and heart attacks, on the same list as coughing. And the Weather Service is explicit that dust is part of what it is talking about: “Particulate matter (PM), or airborne particles, includes dust, dirt, soot, and smoke.”

So a bad-air day in the Valley is not only an inconvenience for people with asthma. It is on a list with cardiac events. Almost nobody has been told that.

What this changes, practically

If you have asthma or a lung condition: a dusty or smoky day is a day to have your own prescribed medication where you can reach it rather than where you keep it. That is the whole of the advice this page will give about medication — your plan is the one your prescriber gave you, and this page has no business adjusting it.

If you have a heart condition: the new information is that this is your issue too. Chest symptoms on a bad-air day are not “just the dust”, and that distinction matters more than any precaution.

If you have neither: coughing, a sore throat and painful breathing after heavy dust are on the Weather Service’s list and they are ordinary. Breathlessness is not ordinary.

The trap this page exists to prevent

Do not explain a cardiac symptom with the weather.

It is the same error as blaming chest pain on a spider bite or on a heavy meal: a plausible explanation arrives, the urgency drains out of the situation, and the person waits. A bad-air day makes a cardiac event more likely, not less — so the air is a reason to take chest pain more seriously, not a reason to explain it away.

Chest pain, pressure or tightness is a 911 call, and what to do about it does not change because the sky is brown.

Ozone, which is the other half and gets no attention

Dust is visible and ozone is not, and the Weather Service’s wording on ozone is worth reading carefully:

“Even at low concentrations, ozone can trigger a variety of health problems such as lung irritation and inflammation, asthma attacks, wheezing, coughing, and increased susceptibility to respiratory illnesses.”

“Even at low concentrations.” So a clear, bright, still day with nothing visible in the air can be a worse day for somebody’s chest than a dusty one. There is nothing to see and nothing to warn you, which is exactly why the number is worth looking up rather than guessed at from the window.

Look the number up, because we cannot publish it

The US Air Quality Index is published live at airnow.gov, run by the Environmental Protection Agency and partners, and it gives current conditions for where you actually are.

Its categories:

AQI	Category
0 – 50	Good
51 – 100	Moderate
101 – 150	Unhealthy for Sensitive Groups
151 – 200	Unhealthy
201 – 300	Very Unhealthy
301 +	Hazardous

Note what the 101 to 150 band is called. It is named for a group of people rather than for a level of harm — and if you have asthma, a lung condition or a heart condition, that band is named after you. It is the number to know, and it arrives long before the air looks bad.

We point at AirNow rather than printing a figure because the EPA maintains it and we would not. A number on this page would be wrong within the hour. Theirs will not be.

When to come in

Call 911 for severe breathlessness, for anybody who cannot speak in full sentences, for chest pain or pressure, for blue or grey lips, for confusion, or for a child struggling to breathe.

Come to an emergency room for breathing that is not responding to your usual prescribed medication, for wheezing that keeps returning, for a cough with chest pain or fever, or for anybody with a lung or heart condition who is simply going downhill on a bad-air day.

Our emergency rooms are open every hour of every day and are walk-in, with CT, X-ray and a full laboratory in the building. Go to the nearest one, and if another emergency department is closer to you, that one is the right answer tonight.

If you are unsure, come in — this list is not exhaustive and you are not expected to work out whether your chest is the air or something else.

Questions people actually ask

I coughed for two days after the dust storm. Is that normal? Coughing and painful breathing are on the Weather Service’s list of what particulate pollution does. Breathlessness is a different matter, and so is a cough with chest pain or fever — those are reasons to be seen.

Does a mask help? Reducing how much dust you breathe is sensible. What kind of mask does what is beyond what this page can source, and it is a reasonable question for whoever manages your asthma.

My inhaler is not lasting as long this week. That is a reason to speak to your prescriber, and if it is not controlling your breathing, that is a reason to be seen now rather than to ration it.

Should I stop exercising outdoors? Look up the number at airnow.gov and take your own condition into account. That is a real question for your prescriber rather than something a web page should decide for you.

I have a heart condition and the air is bad. Should I do anything different? Ask your cardiologist that question once, ahead of a season, and you will have the answer for every bad-air day afterwards. And treat chest symptoms as chest symptoms regardless of the air.

It is dusty and I am driving. Different problem, and a serious one — that has its own page, and the instruction is more counterintuitive than you would expect.

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Look up the number at airnow.gov, keep your own prescribed medication within reach on bad-air days, and never explain chest pain with the weather. Both of our emergency rooms are open 24 hours a day, every day of the year — walk in, no appointment and no referral. Find your nearest emergency room →

Related reading: driving into blowing dust · chest pain and when to go

Sources

35. Air Quality Safety — National Weather Service, National Oceanic and Atmospheric Administration. https://www.weather.gov/safety/airquality
38. AirNow — Home of the U.S. Air Quality Index — United States Environmental Protection Agency and partners. https://www.airnow.gov/

This article is general information, not a diagnosis, and it cannot adjust your asthma or cardiac plan. If you are unsure, come in — this list is not exhaustive and you are not expected to assess your own breathing. If it might be an emergency, treat it as one and call 911.