Helping Your Patients Improve their Indoor Air Quality

 Published: November 22, 2019

By: Heather Willden


image of man sneeze in dust cloud

The air we breathe makes a difference in our health, and that goes double for people with respiratory conditions. Patients with chronic lung conditions like asthma and COPD know outdoor factors like pollen and cold air can trigger their symptoms, but many may not be as aware of the fact that indoor air quality issues play a role as well.

Mike Hess, MPH, RRT, RPFT, serves as the chronic lung disease coordinator at Western Michigan University Homer Stryker MD School of Medicine in Kalamazoo, and regularly works with patients to ensure they are breathing healthy air indoors and out. He has some good advice RTs can share with their patients to make their indoor environments breathing-friendly.

Mike’s tips

Understanding the Cause: Over the last few decades, there’s been a lot more focus on energy efficiency, which has led to houses (and other buildings) becoming increasingly “buttoned up.” Unfortunately, the same things that prevent energy from escaping also prevent contaminants from escaping, and actually can concentrate them inside. According to the EPA, indoor air can have many times the levels of gaseous, particulate, and/or biological contaminants as the outdoors due to this concentration.

Optimize Ventilation: Considering this buttoning-up effect, the first thing that can be done is to make sure that the environment (homes and offices) is getting enough ventilation. EPA quotes building standards from ASHRAE, the national association of HVAC engineers, that recommend a home exchanges at least 1/3 of its indoor air every hour and/or at least 15 cubic feet of air per person. Of course, that can be hard to measure precisely if you don’t have access to an HVAC engineer, but if you’re feeling stuffy or sick indoors, it’s reasonable to guess it’s not being exchanged enough.

If improving ventilation is not practical, it’s also helpful to make sure what DOES circulate is as clean as possible by using a whole-home filter/purifying system, making sure your ducts are clean, and at the VERY least making sure your furnace filters are in good shape and changed regularly. (See “Clean What Can’t Be Eliminated, But Do It SAFELY” for concerns to keep on mind regarding purifiers.)

Finally, a humidifier (especially a whole-home model) can help keep things at a safe and comfortable level while not encouraging mold/mildew.

Minimizing Sources: It’s also critical to make sure that potential contaminant generators inside the home are addressed. This includes everything from making sure:

    • Combustion sources like furnaces, fireplaces, and gas cooking appliances are adjusted and vented properly.
    • Areas susceptible to mold and mildew are kept clean.
    • Non-irritating cleaning chemicals are in use.

Hobbies can be a hidden cause of fumes and irritants as well, and of course making sure no one is smoking in the house is a must.

Clean What Can’t Be Eliminated, But Do It SAFELY: Sometimes, an air purifier can be an appropriate (or necessary) option. However, there are a lot of products on the market, with a lot of claims. The best move is to avoid any air cleaning device that states it relies on ozone or “ions.”

So-called ion generators can remove certain particles from the air (notably tobacco smoke), but they can’t do fumes or gases, and they struggle with many allergen-size particles. That makes them an incomplete solution at best.

Ozone is a direct irritant of the lungs (that’s why we have “Ozone Action Days”), and there’s no real proof that these machines really do anything at all, so they’re likely to do more harm than good for someone with COPD.

If someone is going to go the purifier route, the absolute best thing they can do is get a “True HEPA” filter, as opposed to a “HEPA-type.” They’re going to be more expensive, but they are much more effective at getting fine particles out of the air and are therefore a better value in the long run.

In addition, keeping surfaces and floor coverings clean can help minimize the accumulation of dust, dander, and other allergens/contaminants

Check for Bugs: Remembering that the presence of insects like roaches, flies, and ants doesn’t necessarily mean a home is “dirty,” it’s still important to minimize exposure to these creatures and their waste products. If you’re having trouble with an infestation, call upon an exterminator as soon as possible. Searching for points of ingress for these pests can also reveal spots where rodents or other uninvited guests may be getting in and leaving waste behind.

Go Outside! This one may sound a bit cheeky, but it’s still important to go outside and get that fresh air whenever possible! Regardless of your indoor air quality, staying active and moving is excellent for your respiratory health and well-being!

Indoor air quality can be tricky to monitor and difficult to ascertain, but ensuring it is healthy for your respiratory patients is worth the effort because most people spend most of their time indoors. Following these tips may help your patients breathe easier and avoid unnecessary health care visits.

Learn more about indoor air quality on the EPA’s Indoor Air Quality page.

Email with questions or comments, we’d love to hear from you.

Heather Willden

Heather Willden is the Director of Governance and Strategic Initiatives for the AARC where she works with state affiliates as the HOD liaison. She also manages DEI efforts and strategic initiatives. Connect with her about these topics by email, AARConnect or LinkedIn. When she's not working, you can find her podcasting with her husband, exploring new hiking trails, photographing, and spending time with her family.

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