Asthma Capitals 2018: Poor Air Quality

In the AAFA's Asthma Capitals 2018 ReportDownload PDF, AAFA looked at eight risk factors that can affect asthma rates:  povertylack of health insurancepoor air qualitypollen countslong-term control medicine usequick-relief medicine usesmoking laws and access to specialists

Air pollution is a mix of natural and man-made substances in the air. There is outdoor and indoor pollution. Air pollution includes:

  • Gases (like ozone)
  • Smoke from fires
  • Volcanic ash
  • Dust particles

Research shows that air pollution can worsen asthma symptoms. Air pollution is also connected to the development of asthma.1 Asthma rates are higher in polluted areas. Young children are very vulnerable to living in areas with bad air quality.2

Many sources, including local TV weather forecasts, report the expected air quality for the next day or two. This information can help you know when the air quality may trigger an asthma episode and allow you to plan accordingly.

Poor air quality

The Environmental Protection Agency (EPA) tracks and reports on daily air quality around the country using the Air Quality Index (AQI). The AQI is a measure of air pollution to indicate the safety of the air and possible health effects. Those with asthma can watch air quality on to help them manage their symptoms.

AQI values are color coded by level of health concern. Green (AQI value of 0-50) means air quality is good. When the air quality reaches yellow (AQI value of 51-100) or higher, those who are sensitive to air pollution need to take caution, especially when outside.

poor air quality index

This proves that we need to protect the Clean Air Act. We need to enact policies that fight climate change. As temperatures rise, the risk of wildfires goes up. And high-pressure weather systems trap ozone and other pollutants closer to the ground.

“Last fall we had wildfires in our area, and the smoke got trapped in our valley, and the air quality plummeted,” said Kathy Przywara, AAFA’s Community Director who lives near San Jose, California (overall #97 on Asthma Capitals). “I couldn’t go outside and do any activities that I would normally enjoy because my asthma made it very difficult to breathe the polluted air. I had to keep my windows closed – even though the weather was hot and we have no air conditioning.”

Air quality can limit outdoor activities for those with asthma because asthmatic lungs are more sensitive to poor air quality. April Behounek lives on the northwest side of Milwaukee, Wisconsin (overall #14 on Asthma Capitals), on the bank of Lake Michigan. She loves riding the miles of bike trails around the lake and throughout the city. But outdoor fitness activities are a challenge because of her asthma. 

“When I started to do more fitness activities, like riding bikes, I felt like my asthma was being impacted differently here in the city than when I’d go on a bike ride in my hometown,” shared April. “I’m assuming the pollution in the city contributes to having to use my rescue inhaler when I’m exercising outside.” 

Weather permitting, you can find April on the bike trails almost every day. She rides 8-9 miles a day. Despite her asthma, she loves to be outdoors and loves to ride her bike.

“The biggest impact living in Milwaukee has on my asthma is the air quality,” says April. “I enjoy outdoor activities, and I know that the poor air quality negatively impacts my asthma as I feel better when I visit other communities and engage in the same activities.”



1. Gehring, U., Wijga, A. H., Hoek, G., Bellander, T., Berdel, D., Brüske, I., . . . Brunekreef, B. (2015). Exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence: A population-based birth cohort study. The Lancet Respiratory Medicine,3(12), 933-942. doi:10.1016/s2213-2600(15)00426-9
2. The Effect of Air Pollution on Lung Development from 10 to 18 Years of Age. (2005). New England Journal of Medicine,352(12), 1276-1276. doi:10.1056/nejm200503243521230