A paper in the Journal for Nurse Practitioners advises clinicians on how best to advise their patients with COPD and asthma about exercising.
The National Asthma Education and Prevention Program guidelines for the management of asthma recommend that clinicians advise patients to avoid, to the extent possible, exertion or exercise outside when levels of air pollution are high. The relationship between increased levels of air pollution and asthma risk and impairment are well documented, with increases in asthma exacerbations and emergency care visits.
The relationship between PA, exercise, and air pollution is not as clear. One foundational epidemiologic study found that heavy outdoor exercise in a high ozone concentration was associated with a higher risk of asthma in school-aged children. Air pollution should be taken into consideration when asthma patients engage in PA, especially in outdoor urban environments.
To limit the effects of poor air quality during PA and exercise, patients should be advised to check air pollution levels. On poor air quality days, patients should be instructed to avoid outdoor PA and exercise, engage in indoor PA and exercise, or reduce the intensity and duration of the outdoor activity. Further, patients should be advised to avoid engaging in PA and exercise in high-pollution areas, such as within 50 feet of a road, and when pollution levels tend to be highest, often midday or afternoon.
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