#1 Tim

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16 August 2008 - 09:49 AM


Every person with a breathing problem knows that the weather can impact how
they feel on any given day. Why does weather impact our breathing? More
importantly, can we do anything to counteract it? A computer search of
leading medical journals revealed a few articles on weather and asthma, and
one article on COPD. The articles on weather and asthma focused on outbreaks
of asthma flare-ups during periods of thunderstorms, especially in the late
spring and early summer. Researchers speculate the phenomenon may have two
possible causes. The most likely is related to the downdrafts of cold air
that occur with these storms. These strong wind currents stir up more grass
pollen, which can cause problems for those with allergies to the pollen. A
second theory relates to the weather itself. Researchers found a correlation
between the temperature drop that occurs during these storms and asthma
flare-ups. Previous research had noted possible association between asthma
and rainfall, high humidity, high pressure, high and low temperature, and
lightening strikes.

Since there is a shortage of published information on weather and COPD, let’s
take a "common sense" approach to the question based upon our knowledge of
airflow dynamics, physics, and physiology. One thing is certain—perception
of the effects of environment varies greatly from patient to patient. While
one patient feels best in a hot, dry environment, another may feel a humid
environment is preferable.

Changes in temperature seem to affect the level of dyspnea (the sensation of
shortness of breath). How could temperature have an effect? Extreme hot or
cold conditions stress the entire body. In an effort to maintain a constant
body temperature (98.6 degrees Fahrenheit), you expend additional energy to
warm or cool your body. This additional energy requirement also increases
the amount of oxygen your body is using. Breathing hot or cold air can also
have a drying or irritating effect on the airway causing bronchospasm
(contraction of the smooth muscle that surrounds the airway). Bronchospasm
decreases the size of the airway and thus makes it more difficult to get the
air in and out of the lung, increasing shortness of breath.

Many patients notice increased wheezing or shortness of breath when going
out into cold air...One study demonstrated that exposure of the body to cold
air had a more deleterious effect on breathing than just breathing cold air.
Although breathing cold air through a mask while in a warm room did decrease
lung function, placing the patient in a cold environment further reduced

High humidity is also a cause of increased complaints of shortness of
breath. There are a couple of possible explanations for this phenomenon.
First, as humidity increases, the density of the air increases. More dense
air creates more resistance to airflow in the airway resulting in an
increased work of breathing (i.e., more shortness of breath). Another
possible explanation is that as humidity increases, the prevalence of many
known airborne allergens increases. Dust mites and molds both increase in
high humidity.

Barometric Pressure and Elevation ; As barometric pressure drops, less
oxygen is available in the air. This is the same principle that causes a
decrease in oxygen level as you travel to higher elevations. The total
pressure is less and so the oxygen component is less. When barometric
pressure drops, as when a storm front passes, barometric pressure can change
30-40 millimeters of mercury. Although the effect on the partial pressure of
oxygen that reaches the air sacs in the lungs is small (maybe 5-10 mmHg), a
change of just a few points could increase shortness of breath.

Some patients express relief of their shortness of breath by having air
circulating. Many patients will run a fan all of the time. Some patients
feel this does not help and a few have even said it made them worse.

Some suggestions for controlling your environment:
1. Be committed to using all medications and oxygen exactly as ordered by
your doctor.
2. During very hot or cold weather, arrange your schedule to go out during
times with more moderate temperatures.
3. Use an air conditioner to control indoor temperature. A second benefit of
the air conditioner is that it removes a great deal of humidity from the air
as it cools it. Special programs are available in many communities to offset
the cost of fans, air conditioners, and even the cost of electricity for the
elderly or those with health problems. Check with your area agencies for the
elderly for resources in your area.
4. When going outside during the winter, wear a scarf over your nose and
mouth to trap warm air and prevent inhaling cold-air. Breathing through your
nose is more effective than your mouth in warming the air before it reaches
your airways.
5. Many people go as far as to travel to more favorable climates during
periods of difficult weather. If you are considering moving, try going to
the new area for an extended period before making a permanent move. While we
can’t control the weather, there are many things that we can do to better
control symptoms.

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