How Philadelphians can protect their health on the worst air quality day in a decade

The Philadelphia area is experiencing a serious air quality event as smoke from wildfires in Canada drift down over the Northeast.

Health officials warned Tuesday night that the city's air quality was such that people with conditions that make them more sensitive to pollution might experience health effects. By Wednesday, conditions had worsened to the point that anyone outside might experience adverse health effects.

The Inquirer asked experts and city officials to answer common questions about what this means for residents’ health, and how Philadelphians can protect themselves from smoke and particulate matter.

The air particles affecting people are known as PM 2.5 particles, which are 30 times smaller than the diameter of a human hair. These are by-products of smoke and soot from wildfires in Canada.

Normally, your nose, throat and lungs filter out particles in the air. The bigger those particles are, the earlier the body can catch them and dispel them from your system, said Khalil Savary, a pediatric pulmonologist at Rutgers University Hospital in Newark, N.J.

"But PM 2.5 is that magic number — small enough that particles can get deeper into the lungs," he said. At that point, your lungs could produce more mucus to dispel particles, and your blood vessels could become constricted as your lungs become inflamed.

"The most common symptom is coughing or feeling discomfort," Savary said. "It's your body telling you to get out of this space."

Research has shown that in people with heart disease, PM 2.5 particles can trigger heart palpitations, fatigue, light-headedness, shortness of breath, and tightness or pain in the chest, neck or shoulder, according to the Environmental Protection Agency.

If you have certain types of lung disease, you may experience coughing, wheezing, and chest tightness when you are exposed to particulate matter, Savary said.

Avoid going outside. Philadelphia's health department is recommending that people consider postponing outdoor events and gatherings. The department was recommending schools and day-care centers keep kids inside.

In Delaware County, which is under a "code red" air quality designation, the county health department recommended that people sensitive to air quality avoid long or intense outdoor activities. Everyone should try to spend less time outside, the department says.

Savary, the pediatric pulmonologist in Newark, says people should close windows and try to circulate their air inside. HEPA air purifiers can help improve air quality inside. In a pinch, Savary said, you can make what he calls a "Brick City HEPA filter," after Newark's nickname: "Get an air filter and pop it on the back of a box fan." (How to make your own air filter.)

Savary urged people to avoid other sources of inhaled smoke: cigarettes, incense, and wood and propane fires.

Individuals can also help by not contributing to the existing air pollution by avoiding driving cars or using gas powered lawn mowers, said James Garrow, the city Health Department spokesperson.

Certain places in the city may be more affected than others.

Areas with more traffic congestion or less air circulation — such as Center City, Washington Avenue in South Philadelphia, and Aramingo Avenue in Port Richmond — will likely experience worse air quality, according to Garrow, Places like Fairmount Park, which has better air circulation and less traffic, might have better air quality.

But the way smoke from the wildfire blows also affects the air quality in a given neighborhood in the city. South and Southwest Philadelphia were hit first by smoke and haze Tuesday, Garrow said, before conditions worsened further north. The situation could change from hour to hour in a particular neighborhood, and everyone should be taking precautions," he said.

If you must be outside, wear a high-quality mask — an N95 or KN95 — to help reduce the particulate matter you breathe in. "If you’ve got them tucked away from the pandemic and were saving them for a day when you were worried about what you were breathing in, today is that day," Garrow said.

The city doesn't have a program to hand out N95 masks during an air quality event, but health department resource hubs set up during the pandemic are handing out N95 and KN95 masks. A list of resource hubs and their hours is available here.

Kids with asthma are particularly at risk of health effects. James Reingold, the chief of the emergency department at St. Christopher's Hospital for Children, which treats a number of children with asthma, said families should be alert to symptoms related to the air: coughing and wheezing.

Parents should consider treating their children early, giving them albuterol, a medication that relaxes muscles around the airways, even before the child starts showing signs of distressed breathing, Reingold said. If the child's symptoms aren't controlled by giving them albuterol every four hours, parents should take them to the emergency room, he said.

Kids should continue to take their daily asthma medications as well as allergy medications, said Dan Taylor, a physician and advocacy director at St. Christopher's.

Parents may also weigh whether they want their child to go to school and talk to their doctor and the school nurse to make sure school officials understand their child's condition and needs. He said some kids might want to stay home to limit even brief exposure to the outdoors.