Air Pollution Episodes: A Guide for Health Departments and Physicians

The responsibilities of the health department in air pollution episodes include knowing when an episode is imminent, maintaining effective lines of communication with physicians and laymen, coordinating studies of adverse health effects, and helping to devise and implement plans for pollution abatement. An episode should be diagnosed when pollution levels become dangerously elevated and the weather forecast is for protracted stagnation of air. Episodes are associated with increased mortality and the onset of acute respiratory and cardiac illness. Hospitals should be notified that an unusual number of emergency admissions for respiratory illness is likely. Physicians should be reminded that the elderly and persons with asthma or chronic obstructive pulmonary disease must be followed with special care. Studies of health effects should include analyses of mortality and morbidity; these studies need to be prepared well in advance of episodes. The Air Pollution Control Office of the Environmental Protection Agency is available to assist local health departments in devising monitoring networks and abatement plans and developing health studies to assess the impact of air pollution episodes. The practicing physician should instruct elderly patients and patients with heart or lung disease to minimize their exposure to indoor and outdoor pollution during episodes so that they will not strain their cardiovascular systems. He must also remind these susceptible persons to seek early treatment of acute illness. Physicians should be alert to the possibility of air pollution emergencies, assure early and vigorous treatment of acute illness, and assist the community in studies of the health effects of air pollution.