It can hurt much more than your lungs—and it isn’t just a big-city problem…

You may assume that air pollution problems in the US are a thing of the past, since environmental laws have reduced the haze that once blanketed our big cities. But that’s not true. Air pollution still ranks high on the list of health threats—and not just for city dwellers.

Wake-up call: More than 40% of Americans—nearly 140 million of us—breathe unhealthy air, according to a recent report by the American Lung Association.

Even when the sky appears crystal clear, you’re inhaling exhaust fumes, ground-level ozone and microscopic particles—common pollutants that can increase your risk for health problems ranging from heart disease to asthma. Note that outdoor ozone is less of a problem in winter while air pollutants, in particular nitrogen dioxide, may be more problematic.

Small-town living helps but not completely. In the winter months, the irritant effects of cold dry air may worsen the airway inflammation cause by pollution. Even in the wide-open spaces of the American West, drought and high summer temperatures increase levels of dust and other airborne particles that can worsen conditions such as asthma and chronic obstructive pulmonary disease (COPD).


You would expect bad air to threaten lung health, but there’s increasing evidence showing that the risk is far more pervasive. Examples…

Heart disease. Air pollution is ranked ninth among the most important cardiovascular risk factors—making it more harmful than lack of exercise or elevated cholesterol, according to a report in the European Heart Journal. 

What makes air pollution so hard on the heart? Airborne particles trigger inflammation in the lungs and blood vessels that can increase atherosclerosis and the risk for clots. Even brief exposures to PM2.5—common airborne particles that are about one-fifth the size of a speck of dust—may increase cardiovascular risks. You are likely inhaling these particles if you drive to work with your car windows open, walk past a construction site or light a fire in your fireplace. In areas where particle concentrations are persistently high, such as near busy roads, there’s an 11% average increased risk of dying from heart attack, heart failure or stroke.

Stroke. Even if you live in a rural, “wholesome” area, you will occasionally breathe high levels of carbon monoxide and other gaseous pollutants—when you’re behind a truck, for example. Such limited exposures may seem harmless, but an analysis of more than 100 studies found that intermittent spikes in air pollution caused a corresponding increase in hospitalizations and deaths from stroke.

Heart-rate changes. The varying intervals between heartbeats, known as heart-rate variability, are a sign of cardiovascular health. Bad air—even inside the home—can have a harmful effect. People who frequently use air fresheners are more likely to have reduced heart-rate variability, research has found. Many air fresheners contain terpenes, chemicals that can smell like pine or citrus. They interact with other chemicals in the air and form heart-damaging compounds.


To help protect your health…

Track the Air Quality Index (AQI). The AQI is a rating based on daily levels of major pollutants—carbon monoxide, sulfur dioxide, particle pollution, etc. When the number rises above 100, it’s wise to avoid outdoor activities—particularly if you have already been diagnosed with lung or heart disease or diabetes. For an up-to-date AQI, go to

Exercise away from major roads. Levels of PM2.5 particles tend to be much higher in areas with heavy traffic. If you like to walk, jog or bike, do it as close to nature as possible—and away from busy streets. Pollution is usually highest within 50 feet of roads.

Also helpful: Avoid rush-hour traffic if you can…and drive with the windows closed (see below).

Use the AC. It is nice to conserve power (and save money), but don’t skimp on air-conditioning. It filters incoming air and traps large particles. In fact, a study in Taiwan found that people who used home air conditioners showed none of the “cardiovascular endpoints”—such as inflammation and heart rhythm disturbances—that were apparent when they kept windows open.

In the car: Be sure to use the “recirculate” setting. Research has found that recirculating air will keep out 80% of outside air pollution.

Filter the air. Dust is a major irritant for people with asthma, COPD or other lung diseases, as well as for those with cardiovascular disease. And even if it’s cleaned often, the average home has a lot of dust.

My advice: If you have any of the health issues mentioned above, invest in a HEPA air purifier for any room you spend a lot of time in. Many brands are available—most of which will remove up to 99% of suspended particles in a given room. They work more effectively than electrostatic air purifiers, and they don’t produce the ozone (another lung irritant) that can result from electrostatic units. HEPA filtration is also available in central ventilation systems.

Also: To keep indoor air cleaner, install solid floors (such as wood or tile)—not wall-to-wall carpet…and avoid floor-to-ceiling curtains.

Use natural scents. Commercial air fresheners may smell nice, but they all contain chemical compounds. Why take chances? Natural scents smell better—and cost less.

Examples: Spritz rosewater in the air…or simmer lemon or orange peels on the stove.