Connections to Air Quality

In a presentation titled “Aging Initiative: Protect Your Heart, Know Your AQI,” Sykes stressed that seniors and individuals in general ought to know their Air Quality Index, also known as AQI, as accessed on the EPA’s Air Now websites at and as well as through weather and climate reports on radio, TV and in newspapers.

“Where you live matters,” she said. “Check your AQI.”

The AQI is a color scale that indicates how clean or polluted the air is and yields a cautionary health message, Sykes said.

The AQI measuring instrument runs from a scale of 0 to 300, with 0 to 50 graded as “good;” 51 to 100 graded as “moderate” for unusually sensitive individuals; 101 to 150 graded as “unhealthy for sensitive groups” with different groups for different types of pollutants; 151 to 200 graded “unhealthy” for a certain risk for the general public and a greater risk for sensitive groups, and; 201 to 300 graded as “very unhealthy” for a greater risk for the general public and the greatest risk for sensitive groups.

Each descriptor or grade is color-coded: “good” is assigned a green color; “moderate” is yellow; “unhealthy for sensitive groups” is orange; “unhealthy” is light and bright cardinal red, and; “very unhealthy” is a deep, rich garnet or ruby red.

For example, the metropolitan area of Houston-Galveston-Brazoria in Texas, as described by the U.S. Census Bureau, has been graded code orange for unhealthy sensitive groups, Sykes said.

In the new millennium, the print and broadcast media widely reported the Houston area as having surpassed Los Angeles as the most ozone-ridden city in the country. Los Angeles, which once held the distinction for being afflicted with the greatest level of smog in the 1980s, has dramatically reduced the level of environmental pollution in its atmosphere over the ensuing decades.

The website features weather forecasts, publications on air quality, updates on air quality in the its free “” e-mail alerts, the AirNow app for iPhone, Android mobile phone apps and research by health providers on the impact of environmental pollution on health and aging.

The forecasts online provide air quality information in over 400 cities throughout the United States. They detail the category of pollutants present in the atmospheres of American cities such as ozone, (also long known as “smog”), particulate matter (PM) sub-exponent 2.5, PM sub-exponent 10, carbon monoxide and nitrogen dioxide. They are distributed to national and local media, including the cable stations CNN and the Weather Channel and such national newspapers as USA Today.

Both the EPA’s Office of Air Quality Planning and Standards and Air Quality System and the U.S. Census Bureau found that the percentage of people aged 65 and older living in counties throughout the country with instances of poor air quality dropped throughout the first decade of the new millennium.

For eight-hour ozone or smog, percentages fluctuated, from 50 percent and plunging in 2004 and 2009 before returning back to their original level of 50 percent. For particulate matter exponent 2.5, the decrease went from 40 percent in 2000 to 0 in 2010.

The EPA defines “poor air quality” as air quality concentrations above the level of the National Ambient Air Quality Standards (NAAQS). “Any standard” means any NAAQS for ozone, particulate matter, nitrogen dioxide, sulfur dioxide, carbon monoxide and lead.

However, seniors and other individuals can be contaminated with toxins in their own home, not just from the outdoors, Sykes pointed out. “Ozone does not penetrate buildings [and pollution] can come from cigarette smoke,” she said.

As a consequence of the influence of both indoor and outdoor environmental pollution on public health, including aging, Sykes said, the EPA developed the Green Heart Campaign, an initiative meant to increase awareness of the cardiovascular effects of air pollution in individuals at risk and decrease the incidence of chronic illness and death related to air pollution among those in jeopardy.

“We have new programs, including Green Heart,” Sykes said. “It has to do with the environment and heart.”

The Green Heart program was meant to complement the Million Hearts campaign launched by the U.S. Department of Health and Human Services, as documented on its website at

Green Heart can be accessed at the EPA’s website at
Similar literature and materials can be found at the website of the National Institutes of Health, the federal government’s biomedical research arm, at and MedlinePlus at

More information on heart disease and stroke can be found at the American Heart Association’s website at and, the EPA’s website at and the Centers for Disease Control and Prevention at and

Visitors to the agency’s Air Now website and apps and participants in its Green Heart program are advised to know when and where particulate matter sub-exponent 2.5 levels may be unhealthy, which can be at any time of the year. However, individuals are warned to stay clear of busy roads during rush hour and smoke in the air as this is the time of the highest incidence of air pollution.

“The [Green] Heart campaign is [mainly] health promotion and education goals,” Sykes said. “You can be at risk just where you live for [your] heart. The [website] identifies examples [of how environmental pollution affects] our hearts. We are trying to educate people with heart disease.”

Besides demonstrating how environmental pollution harms heart health and instructing on how individuals are exposed to atmospheric dangers, the Green Heart campaign educates public policymakers as well.

Sykes explained that, for decades, advocacy and awareness campaigns have educated people about the risks of heart disease. Still, many are not aware of their risk and even fewer know about how environmental hazards can affect individuals with heart disease.

As a result, government agencies and nonprofits should include the link between heart disease and pollution in their public awareness campaigns and literature and stakeholding groups are working to accomplish this, she said.

Part Three: Connections to Environmental Pollution and Aging Health

This article was originally published Feb. 18, 2014 on the website of, one of seven websites that comprise The Pharm Psych Network, a medical communications and education company.