The Health | October, 2019
16
Breathing Easy
FIGHTING CANCER
Haze and
your health
The detrimental airborne pollutant can
cost you your health
BREATHING HARD: It would be difficult to breath easy whenever haze is upon us.
I
n recent years, countries such as Brunei,
Singapore, Malaysia, Southern Thailand,
parts of Vietnam and Cambodia have
been beleaguered with haze resulting
from mass illegal open burning of forest
fires in Sumatra and Kalimantan. This
unfortunately has significant effects on the
economy (e.g. flight cancellations, reduced
numbers of patrons at open restaurants, etc),
closure of schools and universities; and not
forgetting the detrimental health effects.
What is haze?
Haze is a combination of very fine solid or
liquid particles, or both in the atmosphere. It is
made up of smoke particles and air pollutants
such as sulphur dioxide, nitrogen dioxide,
ozone, carbon monoxide and particulate
matter. The particulate matters are the small
particles that can go deep into the lungs,
and in some cases, enter the bloodstream.
The highest health risk is posed by particles
that are smaller than 2.5 microns in diameter
called the PM2.5 which can penetrate right
into the small air sacs in lungs when inhaled.
This can give rise to symptoms such as cough,
wheezing, shortness of breath and a feeling of
tiredness and weakness.
How is the severity of haze
measured?
The ambient air quality measurement in
Malaysia is described by the Air Pollutant
Index (API). It is determined by the level
of air pollutants measured at varying time
according to WHO standard. The index is
categorized into good, moderate, unhealthy,
very unhealthy and hazardous which reflect
the effects on human health.
Who are at risk?
• Children due to faster breathing rates and
as their lungs are still developing
• Elderly with underlying medical illness
• Individuals with respiratory conditions
such as asthma, chronic obstructive lung
diseases, etc.
• Individuals with heart diseases especially
those with coronary artery disease and
heart failure
• Individuals with history of ear, nose and
throat problems such as allergic nasal
conditions or problem with sinusitis
• Individuals with chronic diseases such as
diabetes as they have an increased risk of
heart diseases
By Dr Anza Elias
and
Dr Hilmi Lockman
What are the health
effects of haze?
Short term exposures of hours or days can
result in eye, nose, and throat irritation. It
can also increase susceptibility to respiratory
infections, worsen heart diseases and lung
diseases such as asthma and acute bronchitis.
Increased visits to healthcare facilities and
hospitalisations have been noted during this
period.
Long-term exposures have been associated
with problems such as reduced lung function
and the development of chronic bronchitis.
Several studies have shown increase inci-
dence of lung cancer based on the dose of
exposure. The association is much stronger in
non-smokers. Lung cancer mortality is also
higher in non-smokers. Animal studies
done in traffic related outdoor air pollution
in Brazil observed an increased risk of lung
adenocarcinoma.
General advice
during haze period
Extra care should be taken to prevent expo-
sure to haze both at home and outside. All
windows/ doors and any openings should be
closed whenever possible. It is best to avoid
any exposure and limit outdoor activities
when the API level is above 100. Always try to
keep well hydrated and continue to take own
medications for those with chronic illnesses.
Those with persisting symptoms of illness
such as irritation of the eyes, nose and throat
or any chest symptoms such as difficulty in
breathing or chest pain should seek medical
advice early.
Annual vaccination for influenza is recom-
mended for all and in the elderly pneumococcal
vaccination is also encouraged.
General advice
• Stay healthy with adequate sleep and stay
well hydrated
• Frequent hand washing and face after
outdoor activities
• Avoid smoking
• For those with chronic illnesses, take their
own medications regularly
• Get annual influenza vaccine updated and
pneumococcal vaccination
• Consult doctors if having any symptoms
such as irritation of the eyes, nose and
throat or any chest symptoms such as dif-
ficulty in breathing or chest pain
• Minimize outdoor activities
• Close all windows, doors and any opening
that may allow haze to enter the home or
workplace
• Ensure maintenance of air conditioning
units with regular cleaning and servicing
• Wear N95 mask when outdoors when the
API is at unhealthy level or above (above
100)
What is a N95 face mask?
N95 respirator masks are recommended for
the protection against the haze. They are
designed to achieve a very close facial fit and
very efficient in filtrating airborne particles.
There are different brands and types of N95
masks in the market with the same functional-
ity. It is important to get the mask with the
right size so that it fits properly without any
air leakages. It does not work properly for
people with beards or a lot of facial hair. — The
Health
Dr Anza Elias is the Secretary of the Lung Cancer
Network Malaysia (LCNM) and a Public Health
Physician.
Dr Hilmi Lockman is a council member of Lung
Cancer Network Malaysia and a Respiratory
(Chest) Physician.