Extreme weather wreaks havoc on communities in many ways, but it can be even more devastating for people with a chronic illness such as chronic obstructive pulmonary disease (COPD). Different types of weather will carry their unique challenges, so it is crucial to understand what to expect in various weather conditions when you have COPD to ensure your health and safety.
In this blog post, we will discuss some of the most extreme forms of weather and go over how you can prepare for them if you have COPD. Keep in mind that there might be some overlap between various weather conditions, so you might need to prepare for 2 or 3 different weather extremes at the same time. Also, these guidelines are not meant to be exhaustive when it comes to disaster preparation. Instead, the focus here is to provide specific tips if you have COPD.
Whether it is a blizzard, a snow squall, or a sudden cooling of the air, cold waves present many challenges for people with COPD. A 2006 study in the European Respiratory Review concluded that cold weather was correlated with an increase in hospital admissions for COPD. Another 10-year study in 2013 found that cold stress increased COPD exacerbation rates.
The reason cold weather affects people with COPD is that it disrupts a key pulmonary defense mechanism called the mucociliary escalator. Our lungs are lined with mucus and tiny hair-like strands called cilia, which both function to clear the airways of particles and microorganisms. However, the lungs need to stay warm for this process to continue. If your lungs are exposed to cold air, the mucociliary escalator becomes dried out, which shuts down this critical defense mechanism. The result is a lowered ability to fight off infections, which can lead to increased COPD exacerbations.
In addition to the effects of breathing cold air, there are some other things during a cold wave that can affect people with COPD such as hypothermia and frozen water pipes (which can make for an unreliable water supply). Hypothermia can cause rapid breathing and fatigue, which can make managing a COPD exacerbation harder. Also, an unreliable water supply can make staying hydrated difficult, leading to dehydration, which can cause any excess mucus in the lungs to become thicker and more difficult to cough out.
How to Prepare for Cold Waves
There are several steps you can take to prepare for cold waves:
- Plan your activities to avoid being out in the cold
- Wear warm clothing
- Covering your nose and mouth with a scarf
- Breathing in through your nose to warm and humidify the air
- Keeping your oxygen tanks insulated
- Getting your vaccines ahead of time
- Avoid using a wood-burning fireplace (to avoid smoke inhalation)
- Pre-medicate before heading out into the cold
- Eating regularly to keep your body temperature up
When it gets extremely hot outside, many things can affect people with COPD. First, when air pollution is mixed with a heat wave, whether indoors or outdoors, it can cause an increase in COPD exacerbations. The reason this occurs is that there are chemical changes to the existing air pollution when the air is heated. The resulting chemicals can irritate the lungs, especially in people with lung conditions such as asthma and COPD.
Second, heat waves can cause dehydration. As discussed above, the mucociliary escalator needs adequate hydration to function properly. So in a heat wave, dehydration becomes a clear and present danger, which can then lead to impaired defense mechanisms in the lungs and an increased risk of lung infections. Additionally, certain medications can cause increased sweating, so when combined with extreme heat, water loss through perspiration increases dramatically causing rapid dehydration.
Finally, heat waves combined with local dry conditions often lead to large-scale wildfires. For people with COPD, this means more particles and smoke in the air, which can cause COPD exacerbations.
How to Prepare for Heat Waves
Here are some ways to prepare for a heat wave:
- Use your air conditioner and fans indoors (make sure your air filters are replaced regularly)
- Do outside work early in the morning or late in the evening
- Drink adequate amounts of water
- Avoid heavy clothing
- Avoid excess activity when outdoors
There has been a steady increase in tornado activity recently, so preparing for them is a necessity. Tornadoes are columns of wind that extend from a thunderstorm above to the ground below. The reason we can see tornadoes is that they eventually draw up enough dust, water, and debris into the air to make it visible. The dust and tiny bits of debris become airborne and worsen air quality, which can spell trouble for people with COPD.
How to Prepare for Tornadoes
While not meant to be a full list of preparatory steps for a tornado, people with COPD should do the following:
- Access a safe shelter indoors and refrain from going outside until the tornado and the airborne dust has sufficiently dissipated
- Keep your medications in a “go-bag” so you can grab them all at once in case you need to find shelter quickly
- Have a supply of water on hand to stay hydrated
- If you see low-lying clouds and you live in an area prone to tornadoes, make sure to charge the backup batteries for your oxygen concentrator ahead of time in case you lose power
- Consider buying a power generator in case you need to use your nebulizer machine during a power outage
One of the most dangerous effects of hurricanes is flooding. Flash floods can cause direct damage to your home and create unsanitary conditions. The flood water might have sewage and could also attract dangerous insects and animals. Even when the water finally recedes, the water damage can cause mold growth, which will make your home unsafe to live in because of the risk of breathing in spores.
How to Prepare for Hurricanes
People with COPD should keep these things in mind:
- Keep your medications in a waterproof bag so you can keep them dry
- Keep your oxygen concentrator or tank supplies in one place so you can grab them altogether if you need to evacuate quickly
- When the water has receded, have a professional inspect your home for mold and remediate it before reentry
Dust storms can be dangerous for people with chronic respiratory illnesses, especially if you also have chronic allergies. When winds increase, dust on the ground is easily swept up into clouds that sweep across the ground surface. The result is a cloud of airborne particles that can cause illnesses such as dust pneumonia and silicosis. Long-term exposure to dust storms can cause irreversible lung damage and become a constant problem for people with COPD.
How to Prepare for Dust Storms
The best thing you can do to avoid a dust storm is to stay indoors. However, if you must go outside, keep yourself safe by doing the following:
- Wearing an N95 particulate mask to protect your lungs and avoid breathing in dust
- Wear eyeglasses or goggles that are sealed against your skin
- If you don’t have a mask, immediately cover your nose and mouth with your shirt
- Breathe through your nose to use the natural filtration of your nasal cavity
Extreme weather comes in many forms, but if you have COPD, the basic strategy is to protect your lungs, keep your oxygen supply and medications handy, and stay well-fed and hydrated. The specifics of how you prepare will vary slightly depending on the type of weather, but keeping these 3 principles in mind will provide you with a strategy to prepare for any extreme weather.
- European Respiratory Review. How different measures of cold weather affect chronic obstructive pulmonary disease (COPD) hospital admissions in London. https://err.ersjournals.com/content/15/101/185
- Plos One. The Effect of Cold Temperature on Increased Exacerbation of Chronic Obstructive Pulmonary Disease: A Nationwide Study. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057066
- National Institutes of Health. Cilia and Mucociliary Clearance. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378048/
- ATS Journals. Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in Chronic Obstructive Pulmonary Disease. https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201605–329OC
- Teqoya. Air Pollution: The Heat Factor. https://www.teqoya.com/air-pollution-the-heat-factor/
- CNN. Here’s why the US has seen tornadoes, floods and extreme heat in the past few weeks. https://www.cnn.com/2019/05/30/us/tornadoes-flooding-heat-explainer-wxc/index.html
- National Severe Storms Laboratory. Severe Weather 101 - Tornadoes. https://www.nssl.noaa.gov/education/svrwx101/tornadoes/