AQI and Cancer Patients: What Each AQI Level Means

Cancer patients should limit time outdoors when the AQI is Poor (201 or above), and stay indoors as much as possible at Very Poor or Severe levels, especially if they have lung or heart problems. The AQI refers to the Air Quality Index, which measures whether the outdoor air is dirty or clean. With the increase in pollution, it might be difficult to breathe the polluted air, and that might cause some difficulties for those individuals who are having respiratory problems or any other medical conditions.

In regard to cancer patients, the sensitivity to air pollution may vary from one individual to another. While some cancer patients may start coughing and feel difficulty in breathing, others may not find any difference.

This does not mean that all cancer patients have to remain indoors every time the AQI rises. Checking the AQI for cancer patients in your area, however, will assist you to make informed decisions regarding outdoor activity, selecting an appropriate mask and scheduling hospital appointments.

In this guide, we will look at how each AQI level applies to cancer patients, when outdoor activity may need to be curtailed, as well as the precautions to observe during chemotherapy days and does air pollution cause cancer. We will also highlight the special cases of lung cancer patients who should take extra care when air pollution levels are high.

What Is AQI and How Is It Measured?

The Air Quality Index (AQI) is a number that shows how clean or polluted the outdoor air is. This metric allows us to understand whether the air quality is good or bad and what actions should be taken before going outside.

In India, the Central Pollution Control Board (CPCB) classifies the AQI into six categories from Good to Severe. The AQI in India takes into account the following air pollutants:

PM2.5: Fine particles which can be transported to deeper parts of the lungs.

PM10: Coarser particles, 10 micrometres or smaller which can be inhaled in the respiratory tract.

Nitrogen Dioxide (NO2): A gas emitted by vehicles and fuel combustion.

Sulphur Dioxide (SO2): A gas emitted during the burning of some fuels and industrial operations.

Carbon Monoxide (CO): A gas emitted due to incomplete combustion of fuels.

Ozone (O3): A gas formed near the ground due to chemical reactions of sunlight with other pollutants.

Ammonia (NH3) and Lead (Pb): Other pollutants which are included in India’s AQI index.

The AQI value is based on measurements of the existing pollutants. This does not imply an addition of all the pollutants but the pollutant with the highest sub-index level.

Why Are PM2.5 and PM10 Important?

PM2.5 and PM10 matter since they are pollutants that can get into the respiratory system of a person through breathing polluted air. PM2.5 is 2.5 micrometres or smaller and can even penetrate deep inside the lungs, while PM10 is capable of irritating the airways.

Cancer patients who suffer from cough, difficulties in breathing, and lung complications can experience more discomfort if they breathe polluted air. One benefit of knowing about the AQI is that it enables people to know when it is safe to conduct outdoor activities.

How Can Air Pollution Affect Cancer Patients?

Air pollutants contain gases and fine particles which might cause irritation in the respiratory system. However, not everyone is affected in the same way. Individual reactions to air pollution may be dependent upon their pre-existing health problems, cancer types and treatments and time spent in an environment with air pollutants. Some possible concerns could be:

Airway Irritation

The pollution in the air can cause irritation of the nasal air passages as well as throats and airways. There may be people who will develop cough, sore throats, wheezing and breathing difficulties due to air pollution. People suffering from respiratory complaints would have more difficulty with such concerns.

Pre-existing Lung or Heart Problems

Cancer patients can also suffer from asthma, COPD and heart problems as well. Air pollution might aggravate the symptoms of some lung diseases and cardiac disorders. Those who suffer from these illnesses need to follow the recommendation of their doctors regarding physical activity outside during bad air pollution.

Treatment-Related Respiratory Concerns

Some forms of cancer therapy can also impact the lungs or result in breathing complications. These could be some medications for chemotherapy, immunotherapy, and radiation that involve the chest and can lead to lung irritation or other breathing issues among some patients.

However, not all patients undergoing such therapies develop this condition. Still, anyone who has noticed any new symptoms relating to breathing should seek consultation from their cancer specialists instead of thinking it’s because of pollution.

Pollution Exposure Is Not the Same as Infection Risk

High AQI means that the outdoor air is polluted but not that the air carries viruses or bacteria. People suffering from cancer, especially those with low numbers of white blood cells, might have a greater risk of developing some infections. However, this is a different issue from the one related to air pollution protection.

Can Cancer Patients Go Outside When AQI Is High?

Not all cancer patients are required to avoid exposure when air quality is poor. The need should be determined based on the AQI value, the purpose of going outside, and the overall condition of the patient.

For instance, an urgent trip that has to be made to get a proper medical consultation may be justified while a long outdoor activity may be scheduled later. Patients and their families can try to do the following:

Be aware of the AQI prior to leaving the house: Use a trusted air quality app or website to know the current situation.

Avoid heavily trafficked roads: Emissions of vehicles may contribute to increased pollution. Take an alternative route that is not filled with traffic.

Restrict outdoor activities: Do not engage in running, cycling, and fast walking during high pollution days. Exercise causes one to breathe in more air.

Keep outdoor trips brief: Make sure to consolidate your errands for one trip rather than multiple trips.

Watch out for symptoms: In case of coughing, wheezing, or shortness of breath, stop your activity and get yourself indoors.

Patients must not abstain from exercise without seeking professional medical help. Exercise might even be an essential component in some patients’ recuperation process. The idea is to regulate outdoor exercise based on the level of pollution and the individual’s health status.

Why Do Lung Cancer Patients Need Extra Attention During High-AQI Days?

Lung cancer impacts the lungs, which are directly impacted by air breathed in by the individual. In some cases, patients might already be suffering from certain symptoms like coughing and chest pain. Air pollution at high levels might irritate the airways and, in turn, cause problems for any respiratory distress the patient may experience.

The level of concern also depends on the medical condition of the individual. For instance, some individuals undergoing chest radiation therapy or even taking certain drugs for cancer may experience lung inflammation. Should this symptom be present, then coping with any respiratory irritation would be difficult indeed.

What Precautions Can Lung Cancer Patients Follow?

Patients with lung cancer can take a few practical steps during high-AQI days:

• Avoid outdoor exercise when air quality is poor.
• Keep necessary outdoor trips short.
• Wear a suitable, well-fitting respirator if recommended by the treating doctor.
• Avoid areas with heavy traffic, construction dust or smoke.
• Report new or worsening breathlessness, chest discomfort or coughing to the oncology team.

It is important not to assume that every breathing problem is caused by air pollution. Lung cancer and its treatment can also cause breathing symptoms. New or worsening symptoms need medical assessment, especially during active treatment.

Which Mask Should Cancer Patients Wear in High Pollution?

Wearing an appropriate mask can reduce the quantity of fine particulate matter a person is exposed to. In case of unavoidable exposure to the outdoors, a properly fitting N95 or a similar particulate respirator can be more effective at protecting one from small particles compared to a poorly fitted mask. However, the effectiveness of a mask is highly dependent on its fit.

Why Does Mask Fitting Matter?

The respirator needs to cover the mouth and nose as well as fit tightly against the face. In case there are openings near the nose, cheeks or chin, the polluted air will seep through these openings rather than the filter of the mask. It is imperative for patients to strictly adhere to the guidelines laid down by the manufacturer regarding usage and disposal of the mask.

Are Cloth Masks Enough?

A cloth mask, scarf, and even a handkerchief cannot give you the same protection as a respirator when it comes to fine particulate pollution. They cannot be viewed as being equal to an N95 mask where fine particulate pollution is concerned.

What If a Patient Has Breathing Difficulties?

Patients suffering from cancer might have problems wearing close-fitting respirators due to their breathlessness. They are supposed to consult their doctors on what kind of mask will be suitable for them and how much time they can wear it. The use of a respirator decreases exposure to particulates; however, it is important to realise that it does not eliminate all pollutants in the air or ensure complete safety when exposed outdoors.

Should Cancer Patients Attend Chemotherapy on High-AQI Days?

A high AQI is not necessarily an indication for a cancer patient to skip their chemotherapy session or another treatment. Treatment programmes for cancers are formulated depending on individual case, types of cancers and the patient’s reaction to cancer treatment. In cases where pollution levels are very high at the time of the scheduled treatment, patients need to talk to their oncology unit or hospital before altering their schedules.

What Should Patients Do Before a Treatment Visit?

• Check the AQI levels locally before going out.
• Enquire from the hospital about any arrangements for transportation.
• Arrange for transport before going out.
• Use a proper mask if advised by the medical team.
• Avoid any unnecessary stops on the way to the hospital.

In case a patient develops any new symptoms such as difficulty breathing, fever, or some other symptoms, they should tell the treatment team first about it. In such a scenario, the medical team will decide about the assessment or appointment change.

Avoid delaying chemotherapy, immunotherapy, or radiation therapy due to air pollution without seeking advice from your physician, who will advise whether the air conditions warrant any alteration in your treatment programme.

How Can Patients Reduce Pollution Exposure During Hospital Visits?

It could be essential for people to visit the hospital even when the air quality outside is bad. They can make some easy efforts to decrease their exposure to pollution.

Plan the Journey in Advance

Consult the AQI before setting out, and take the most direct route to the hospital. Preferably, take a personal vehicle or another transport mode that will allow you to minimise outdoor waits.

Avoid Waiting Outside

Arrive close to your appointment time so you do not have to wait outside. In case outdoor waiting becomes inevitable, inquire at the hospital premises about indoor waiting places.

Wear a Suitable Mask

The patient may wear a suitable N95 mask or other respirator recommended by his or her physician. It needs to fit tightly around the nose and mouth during travel.

Reduce Unnecessary Stops

Make efforts to avoid any unnecessary stops in places that have dense traffic or smoky air. This will aid in minimising the overall time you will spend in the outdoor environment with pollution. This may make your travel more bearable but does not substitute for your doctor’s opinion or eliminate all risks.

What Precautions Can Cancer Patients Follow Indoors During High-AQI Days?

Remaining indoors can assist in reducing exposure when outdoor air quality is poor. However, indoor air pollution is also possible due to various pollutants such as smoke and dust. Patients and their caretakers should take these steps:

• Close windows and doors whenever there is an extremely high outdoor pollution level, but ventilate the house when outdoor air quality improves.
• Never smoke indoors and do not go anywhere there is second-hand smoke around.
• Refrain from burning wood, coal and any other kind of fuel inside a building that is not well ventilated.
• Avoid activities that lead to production of smoke or dust.
• Follow indoor air guidance from local health authorities.

For homes that have an air filtration system, make sure it is used and maintained as recommended by the manufacturer. But it is important for patients to know that remaining indoors does not eliminate all risks related to pollution.

When Should Cancer Patients Contact Their Doctor?

It is important for cancer patients not to overlook newly developed or worsening breathing issues during days with high levels of air pollution. While air pollution may cause irritation of the respiratory system, the same issues can be a result of cancer or treatment. Seek medical attention if you experience:

• Newly acquired coughing.
• Developing breathlessness while engaging in regular activities.
• Whistling while breathing or any other signs of tightness in the chest.
• Signs of respiratory difficulty which persist even when inside.

Get emergency medical help immediately if you have severe difficulty breathing, chest pain, confusion or blue lips. Patients undergoing chemotherapy or any treatment that may cause suppression of the immune system should also pay close attention to fever. Also, a fever above 38°C or 100.4°F may be an emergency situation and require immediate medical care.

Consult Today

Cancer management is not limited to scheduling appointments and taking medicines. There might be some decisions that will need to be made on a day-to-day basis regarding travel and participation in outdoor activities.

At Oncare cancer hospital, patients can get advice on cancer management and treatments, as well as the support they need during their treatment process. If you are having trouble breathing or are worried about going to the treatment on highly polluted days, consult your treating doctor first.

Disclaimer

This article is meant to provide education in general terms only. It should not be considered as a substitute for medical advice, diagnosis or treatment by a qualified health practitioner. Precautions for AQI will depend on the specific type of cancer, ongoing treatments and symptoms of the patient. Consultation with an oncologist is a must before any modifications in outdoor activity and masks.