An important subset of PH is pulmonary arterial hypertension (PAH). People with PAH face a progressive, life-threatening illness caused by high blood pressure in the arteries that carry blood from the heart to the lungs so it can pick up oxygen. PAH forces the heart to pump harder. Eventually, the strain causes the heart to enlarge and become less flexible. Less and less blood is able to flow out of the heart, through the lungs and into the body. Over time, and without treatment, the heart will fail, leading to severe disability and even death. There is no known cure for PAH.

PAH can occur in response to a variety of conditions such as scleroderma (autoimmune disease of the connecting tissues), cirrhosis of the liver, congenital heart defects, HIV infection, taking appetite suppressants (fenfluramine and dexfenfluramine) or chronic use of cocaine or amphetamines. Another possible cause is a family predisposition to the disease. A form with no known cause is called idiopathic PAH or IPAH.

Symptoms include:

extreme shortness of breath
excessive fatigue
dizziness
fainting
weakness
ankle swelling
chest pain
bluish lips, hands or feet

Who has PAH?

PAH affects men and women of all ages and all ethnic and racial backgrounds. While the true incidence is unknown, it is relatively rare, affecting 1 in 100,000 to 1,000,000 people. IPAH most commonly occurs in women in their mid-30s. About twice as many cases are reported in women as in men. PAH can get worse in pregnant women during labor and delivery, resulting in a high maternal death rate.

What happens in PAH?

As their disease progresses, PAH patients get weaker and more easily fatigued, so that their quality of life is affected. Even with treatment, pressure in the lungs will worsen and cause the right ventricle or right side of the heart to get larger. The patient can develop irregular heart rhythms (arrhythmias), which can lead to sudden death. In 2004, 314 people died from IPAH in the United States by IPAH; 241 were female and 73 were male.

Approximately 50 percent of people diagnosed with PAH die within five years. If untreated, the life expectancy is just two to three years from diagnosis. Prognosis is worse for patients who have heart failure, severe PAH or are over the age of 45 when diagnosed.

Even so, PAH patients have more options than ever before. Early diagnosis and treatment can reduce symptoms, improve quality of life, slow the progression of the disease and extend patients’ lives.

How is PAH diagnosed?

PAH is frequently misdiagnosed or diagnosed late because its symptoms can be confused with other conditions such as asthma, pneumonia, chronic obstructive pulmonary disease (emphysema and chronic bronchitis), heart failure and coronary disease. As of now, there is no specific test for PAH. Health care providers looking for possible PAH may conduct tests that include –

chest x-ray (picture of the heart and lungs)
electrocardiogram (electrical measure of the heart beat)
echocardiogram (ultrasound picture of the heart)
stress test (exercise test)
spirometry (breathing test)
right heart catheterization (procedure measuring pressure in the pulmonary arteries)
perfusion lung scan (image showing blood flow through the lungs)

How is PAH treated?

Treatments include anticoagulants, diuretics, calcium channel blockers, digoxin and prostacyclins. For IPAH, the newest and most often used treatments are phosphodiesterase-5 inhibitors (such as Sildenafil) and endothelin receptor antagonists (such as Bosantin). None of the drugs can cure or halt PAH progression, but they may relieve symptoms and slow the disease.

While each drug therapy works somewhat differently, the objective is to reduce the heart’s workload by allowing blood to flow more easily through the pulmonary arteries. The choice of treatment depends on how severe the patient’s disease is and how well the patient responds to therapy. Drugs may be combined to simultaneously target different aspects of the disease.

Some patients may need and be able to receive a heart-lung transplant. As technology advances, these transplants are becoming more successful.

What about PAH research?

The National Heart, Lung and Blood Institute currently supports more than 80 PAH research projects. For example, a recent study looked into different options for diagnosing PAH. A new non invasive tool to measure the pulmonary artery distensibility [stiffness] using MRI may be useful for evaluating PAH patients.

The American Lung Association, too, works with leading researchers to identify new interventions for PAH. The ultimate goals are to better understand PAH, find ways to diagnose PAH more quickly and find successful treatment strategies.

Getting help

Because PAH can be so debilitating and there is no cure, patients may feel frustrated and alone in their struggles. I recommend that PAH patients learn as much about their condition as possible and get to know other patients through support groups and other resources. As one patient says, “The more you learn, the better prepared you are to deal with it.”

For more information on PAH, go to the following websites:

General information – www.lungusa.org

Support groups – www.PHAssociation.org/connect

Treatment options – www.pph-net.org/pph-surgery-treatment.htm

Research – www.nhlbi.nih.gov

For the current 2007-2008 season in the United States, influenza activity during January and into February, according to ongoing reports from the CDC. The CDC recommends annual influenza vaccination throughout the winter and into spring for anyone who wishes to reduce their risk.

Immunization is especially important for high-risk individuals and their close contacts, including: Adults and children with chronic medical conditions, such as asthma, chronic obstructive pulmonary disease (COPD), or diabetes; Children 6 months up to 5 years of age; People aged 50 years and older; Pregnant women; Residents of long-term care facilities and nursing homes; Health-care professionals; and Others in close contact with anyone at risk - parents, grandparents, siblings, babysitters, child care providers

Getting vaccinated against influenza every year is the best way to protect against influenza. Even if the strains that are infecting people are not all included in the vaccine, you will still receive what is called cross-protection. This means antibodies you will get from the vaccine will give some protection against these different strains, and often will make illness milder and will prevent complications.

Although we cannot predict when influenza will hit and how severe each season will be, we do know that vaccination, frequent hand washing and covering your cough will help prevent the spread of this serious virus.

For more information on this year's influenza season, please visit the CDC's Web site - www.cdc.gov/flu.

I also encourage you to visit the American Lung Association's Faces of Influenza Campaign to learn more about who should be immunized against influenza and how to find a clinic near you using our Flu Clinic Locator. The campaign features many famous and not-so-famous "faces" - including actress and mother Jennifer Garner - who are all recommended to receive an annual influenza vaccination and are committed to preventing the disease among their loved ones.

Are you a “face” of influenza? There is a good chance you are among the more than 220 million Americans recommended to receive the influenza vaccine annually.

That’s more than 2 out of every 3 people in the US. Despite this recommendation, influenza vaccination rates are low, especially among those most vulnerable – including individuals with chronic respiratory conditions such as asthma and COPD.

Nationwide, influenza and its complications cause an average of 36,000 deaths and approximately 226,000 hospitalizations each year. These victims and millions more are the “faces” of influenza – people recommended for annual immunization by the Centers for Disease Control and Prevention (CDC).

Jennifer Garner and Dean Cain participate in the Faces of Influenza national launch event in New York

The American Lung Association is pleased to be working with actress Jennifer Garner as the national spokesperson for the 2007-2008 Faces of Influenza campaign. Ms. Garner and I recently joined American Lung Association President and CEO Bernadette Toomey and national, state and local leading medical officials to kick off this year’s program with a media briefing and free public vaccination clinic in New York City. Nearly 800 New Yorkers were vaccinated throughout the day. It was great to see so many people roll up their sleeves to help prevent the spread of the influenza virus this season.

Widespread media coverage has appeared via national morning shows; New York City TV and radio news programming; newspapers; online news, health and entertainment outlets; as well as parenting and women’s lifestyle publications. Faces of Influenza activities are continuing across the country this influenza season, including efforts into January and even later.

Influenza is more than just a common cold; it is a serious respiratory illness. Individuals with asthma, lung disease and COPD need to be vaccinated, as well as anyone who lives with or cares for people with these illnesses.

Influenza immunization can continue through the spring. Influenza virus activity typically peaks in February or March, so vaccination throughout the entire influenza season is beneficial and recommended.

For more information about influenza or to use the Flu Clinic Locator please click here.

The American Lung Association’s Faces of Influenza educational initiative, made possible through a collaboration with sanofi pasteur, is designed to reinforce the seriousness of influenza and highlight the safety and effectiveness of annual vaccination throughout the influenza season.

The American Lung Association’s State of the Air: 2007 finds that America’s air quality picture is clearly split East-West. This is actually the first time we’ve seen a geographic split in the eight years that we have been sending out an annual air quality report card. Particle pollution (soot)—the most dangerous pollutant—increased in the East but decreased in the West. Ozone (smog) levels, on the other hand, dropped across the country from peaks reported in 2002. You can learn more about your own area’s air quality grades by checking out the report.

Why the split? Like most topics related to air quality, the complex answer revolves around sound science and federal policies intended to control pollution.

This year’s State of the Air reinforces our life-and-death need for more protective federal standards so that every community in the United States—East or West—can have truly healthy air to breathe. The report finds that 136 million Americans are breathing air that’s not safe. That’s unacceptable.

Every day, air pollution is affecting people’s health all over the United States. The air you’re breathing is cleaner than it was 30 years ago, but it’s still not healthy air!

Breathing ozone (smog) and particle pollution (soot) can literally shorten life, create life-and-death emergencies, and send our most vulnerable Americans to emergency rooms. We must protect them.

With all the research showing how harmful these pollutants are to the health of so many Americans, you’d think it would be simple to decide to clean up the air. But it’s not. Unfortunately, clear scientific evidence can get tangled up in politics.

Right now, we’re in the midst of a critical debate over how much pollution it too much. We at the the American Lung Association and our colleagues at most other health organizations are at odds with the federal government’s definition of what safe levels of smog and soot truly are.

And it’s that definition of “safe levels” of smog and soot that sets official limits on how much air pollution your community can have.

Understanding outdoor air pollution and how it affects human health is complex and can be overwhelming. The most basic piece of the puzzle to understand is that our lungs simply weren’t made to breathe the levels of air pollution Americans continue to have to inhale.

Here are some specifics about how our bodies can react to smog and soot:

• First and foremost, breathing particle pollution can kill. Someone can die on the very day that particle levels are high, or within one to two months afterward. Breathing particle pollution year-round can shorten life by one to three years. It causes many other health effects, premature births to serious respiratory disorders, even when the particle levels are very low. It makes asthma worse and causes wheezing, coughing and respiratory irritation in anyone with sensitive airways. It also triggers heart attacks, strokes, irregular heartbeat, and premature death.
• Ozone reacts chemically (“oxidizes”) with internal body tissues that it comes in contact with, such as those in the lung. When that irritates the respiratory tract, like getting a sunburn or rubbing sandpaper on a wound.
• Smog can cause health problems the day you breathe in high levels of smog, or after long-term exposure. It’s particularly dangerous for people with asthma and other chronic lung diseases, senior citizens, and children and teens.
• Smog can cause asthma attacks, coughing and wheezing, shortness of breath, chest pain when inhaling deeply, and even premature death. Breathing high levels of smog repeatedly over the long term may also lead to reduced lung function, inflamed lung lining, and increased breathing problems.
• Particle pollution is too small to really see—you can see the haze it creates when the sunlight hits it. Particles can be so microscopic that they’re one-seventh to one-thirtieth the diameter of a single human hair—or smaller.
• The body’s natural defenses help to cough or sneeze larger particles out of our bodies. But those defenses don’t keep out smaller particles, and they get lodged deep in the lungs, where they stay and can cause major damage. Some of the particles are so tiny that they can pass through the lungs into the blood stream and travel throughout your body like oxygen.
• When it comes to air pollution, children and teens are more vulnerable than you might realize. Their lungs are still developing, so they can be easily damaged. Because kids are so active and outdoors more often, they can end up breathing more air pollution per pound than adults.
• Many others are vulnerable as well, including probably someone in your family. Not only children and teens, but adults over 65, adults who work or exercise outdoors, anyone with a chronic lung disease like asthma or COPD, anyone with cardiovascular diseases or diabetes—all these people face much higher risk of harm from air pollution.

The bottom line is that too many people are breathing dirty air. America deserves air pollution standards that protect the health of the public—that’s what the law requires.

Why do air pollution standards matter?
States and the U.S. EPA must enforce the Clean Air Act to reduce air pollution to protect health. To do that, EPA sets standards that every community is required to meet. Local communities and states are legally required to control pollution in their areas so that air is as clean as federal standard says it must be.

Standards drive nearly everything the American Lung Association does to clean up air pollution. The tighter the standards are set, the less people will suffer. Right now, we have the rare chance to get EPA to make them tighter—and we have the evidence we need. The last time EPA looked at ozone standards was 1997. It turns out that what EPA thought was safe then, isn’t. We’re calling on EPA to set new standards for ozone at levels that would protect public health as the Clean Air Act requires.

You can let policymakers know you want them to protect the air you breathe. Sign up to join our e-advocacy team.

COPD, which includes emphysema and chronic bronchitis, most often occurs in people 40 and over and are smokers or former smokers. But environmental exposures (certain chemicals, dust, or fumes in the workplace, secondhand smoke, and other air pollutants) and genetic factors also play a role in COPD.

Symptoms
What should you look for, and when should you be concerned? In short, don’t ignore any change in your health. Talk to your doctor! COPD develops slowly and can worsen over time. Be sure to report any symptoms, no matter how mild they may seem, to your doctor.

If you think someone you love may be experiencing COPD symptoms, urge them to talk to their doctor!

Symptoms include:

The American Lung Association’s COPD Center provides extensive resources for patients and caregivers. For more information about our COPD programs or to speak with a registered nurse or respiratory therapist, please call our Lung Helpline at 1-800-LUNG-USA.

With the goal of earlier diagnosis and treatment for people with COPD, the American Lung Association has joined with the National Heart, Lung and Blood Institute to promote its Learn More Breathe Better campaign (www.learnaboutcopd.org).

Pam’s Story:
We know how COPD can affect individuals’ and families’ lives. The story of Pam, who lives in Idaho, illustrates the “before and after” of diagnosis, appropriate treatment, and education. The American Lung Association is working to prevent this type of story from unfolding again and again.

Pam, 56, endured a long, painful path to her diagnosis of COPD. A former smoker, Pam would get acute bronchitis two or three times each year since her late 40s. Then, as her shortness of breath got worse and she was unable to do the things she used to do, a doctor told her she might have “COPD”. She was told to quit smoking and that was it. Pam searched for more information, but couldn’t get the answers to her questions. In 2003, Pam became dreadfully ill, could not breathe and was rushed to the Emergency Room. The attending physician put her on oxygen and ordered testing of her lung function. At age 53, she was diagnosed with emphysema.

Finally, Pam received proper medical management. But she continued to struggle with the disease, becoming more debilitated and needing to go on full-time oxygen. Pam and her husband were both affected by this disease, living in constant fear and anxiety, Pam became hopeless. Since late 2003, though, Pam has become a regular member of the American Lung Association’s Better Breathers Club, through which she has gotten the information and support she desperately needs. Now Pam tells us that she has learned how to manage her COPD, and is able to accept the disease, no longer ashamed or afraid. Most important, she is able to get out and enjoy life again. Her husband has learned how he can be a supportive caregiver. She has returned to work part-time and has begun horseback-riding.

Now, for every Pam who has been diagnosed, there is likely one other person who has not, there are untold numbers who are not receiving the right care and support, and there are thousands whose activities are severely limited, who are isolated and fearful, who frequently need to go to emergency rooms and hospitals...all at a huge cost in terms of human suffering in addition to the billions of dollars annually that you heard about earlier.

We know and the evidence shows that where chronic disease is concerned, the earlier the diagnosis, the better the chance for reducing serious disability. That means reducing the human suffering, the costs to their families and to society and a much improved quality of life. Early diagnosis and better management can only come about when all Americans are familiar with the term COPD, what causes it, and how to seek help and how to manage it.

Implementing these policies is a proven way to reduce the estimated 438,000 deaths each year from tobacco use:

• A study published in the American Journal of Public Health concluded that if all the states spent just the minimum amount recommended by the Centers for Disease Control and Prevention (CDC), youth smoking nationally would be 3 to 14 percent lower.
• The 2006 Surgeon General’s report on secondhand smoke concluded that there is no safe level of exposure to secondhand smoke, and that eliminating smoking in indoor areas is the only way to fully protect nonsmokers from secondhand smoke.
• Studies have shown that a 10 percent increase in the price of cigarettes reduces consumption by 7 percent for youth and 4 percent for adults.

The report’s grades this year show improvement especially in the area of smokefree air, but the political will is still lacking to implement these policies in many states. States that have done so have seen dramatic results. For the 2nd year in a row, the state of Maine has earned four A’s in the report, and youth smoking in that state has declined by almost 60 percent between 1997 and 2005.

The state of California has sustained its tobacco prevention and cessation program since 1990, and as a result it has some of the lowest adult and youth smoking rates in the country. But the California program is under funded. The Golden State spends about half of what the CDC recommends for a comprehensive program. In fact, only nine states fund these programs at or near the levels recommended by the CDC, 34 others including California fund them at less than 60 percent. Imagine the additional lives that would be saved if California and the other states increased their investments.

Only the strongest tobacco control laws will reduce the death and disease caused by tobacco use. The science behind these policies is proven, and the public overwhelmingly supports them. Yet, like the states, the U.S. Congress has not mustered the political will to make changes at the national level either. Despite tobacco products being one of the only unregulated consumer products, Congress has failed to enact critical legislation giving the U.S. Food and Drug Administration (FDA) the authority to do so. Send a letter today to your Member of Congress and Senators. Tell them to protect kids from tobacco and promote public health by supporting legislation to grant the FDA the authority to regulate tobacco products and advertising claims.

For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or log on to www.lungusa.org.

Lung disease is the number three killer in America, responsible for one in seven deaths. Americans are living with chronic lung disease such as Lung Cancer, Asthma and COPD.

Every year, close to 342,000 Americans die of lung disease. Lung cancer for instance, causes more deaths than the next three most common cancers combined (colon, breast and prostate). An estimated 162,460 deaths from lung cancer will occur in the United States during 2006. As you can see, the numbers are outstanding.

To help address these issues the American Lung Association has launched many campaigns to help Americans fight the battle against Lung Disease:

We have programs geared towards Smoking, COPD, Asthma and Influenza, just to name a few. Such programs as Freedom From Smoking (FFS) is an online smoking cessation program available for anyone who is interested in quitting smoking. The Lung Association understands the challenges faced with cigarette smoking and are here to help you take that next step to improving your health. Remember, millions of people have quit smoking and so can you!

COPD (Chronic obstructive pulmonary disease) is a term referring to two lung diseases, chronic bronchitis and emphysema, that are characterized by obstruction to airflow that interferes with normal breathing. It is the fourth leading cause of death in America, claiming the lives of 122,283 Americans in 2003 and the number of women dying from the disease has surpassed the number seen in men.

To better understand this disease, the Lung Association has created the COPD Center, which provides extensive resources for patients and caregivers.

Another major lung disease that affects an estimated 20.5 million Americans is Asthma. This illness is a chronic disease that affects your airways.

The American Lung Association can give you close to 20 million reasons why we need to "Blow the Whistle on Asthma" and how you can help fight the asthma epidemic. One way of addressing this problem is through our Annual Asthma Walk which is a nation wide effort to bring attention to this devastating chronic illness. We know a lot about asthma, but there is so much we don't know.

And finally, as we end our year and approach the winter season, it’s important that we pay close attention to Influenza and how important it is to receive an annual vaccination. Influenza immunization rates fall short every year, even though health experts recommend more that 200 million people in the U. S. receive an annual influenza vaccination.

The Lung Association recently launched the Faces of Influenza, a multi-year national public awareness initiative to help Americans put a “face” on this serious disease and recognize annual influenza immunization as an important preventative measure to protect themselves and their families each year.

As you know, breathing is important and is the only means to supply our bodies and its various organs with the supply of oxygen which is vital for our survival. Inhale. Exhale. It’s simple and it’s instinctive, but most importantly, it is our life source. We can replace the liver, kidney, even the heart and still live but the act of breathing is our human connection and without that connection we, as humans, cannot survive.

Great things are always happening at the Lung Association and we’re here to show you how to Improve Life One Breath at a Time.

So as we approach the end of the year, wouldn’t it be great to be part of a life saving task force by providing support to the many programs offered by the American Lung Association. You would be part of an ongoing campaign to eliminate lung disease and promote lung health.

To continue these life-saving efforts in the year to come, the American Lung Association is counting on your ongoing commitment to help promote good lung health. Give to the breath of life today and save a life tomorrow.

For more information about the American Lung Association or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or log on to www.lungusa.org.

We all know someone who needs to be vaccinated against the influenza virus this year. In fact, it is likely that you or a family member fall into one of the groups that health officials recommend receive an influenza vaccination. Influenza results in an average of 36,000 deaths and approximately 226,000 hospitalizations in the US each year.¹

Celebrities like Jean Smart, Dean Cain and Kristi Yamaguchi; public health officials and everyday people have joined the Faces of Influenza initiative, sharing their personal stories about their experiences with the disease and encouraging influenza vaccination among target groups. These groups include people 50 years of age and older, young children, everyone in close contact with people who have high-risk conditions, health care providers and anyone else who wants to prevent this serious respiratory illness.

Faces of Influenza Awareness Activities
The initiative also includes educational materials and the Lung Association has developed a new Web site, www.facesofinfluenza.org, where consumers and health care providers can find more information about influenza and the importance of immunization. Visitors to the Web site can also view the photographs and stories featured in the Faces of Influenza Portrait Gallery, view the public service campaign and utilize the Lung Association’s Flu Clinic Locator (the largest online directory of public influenza clinics).

Six local Lung Association chapters are planning regional Faces of Influenza awareness activities in Detroit, Philadelphia, Phoenix, Seattle, Houston and Minneapolis/St. Paul to raise awareness about this serious disease and the importance of annual influenza immunization.

A recent study conducted by the American Lung Association found that 73 percent of parents of children with asthma report they are concerned about how their child’s asthma will affect their ability to participate in school, yet the majority of those parents are not taking steps recommended by the American Lung Association to better manage their child’s asthma.

In addition, studies show that emergency room visits increase in September and October among children with asthma. The back-to-school months herald the cold and virus season, when children return to close classroom quarters after having spent the summer apart from one another. Viruses are a leading asthma trigger, as well as allergens including those that peak in the fall, indoor pollutants, and outdoor air pollution, which can lead to ozone alert days in September and October in some areas of the country.^1,2

There are some simple, basic steps parents can take to make sure their child’s asthma is under control and that their school is involved in managing it:

• See your child’s doctor—If your child is due for a check-up with his or her physician, make sure that happens before school begins!
• Know your child’s triggers—Be aware of what may be triggering asthma attacks, and work to keep him away from those allergens and triggers. Asthma triggers may include: exercise, smoke, pollen, dust, air pollution, animal fur, colds, flu and other respiratory infections.
• Understand your child’s asthma control—Keep track of nighttime coughing and/or waking, which may mean that asthma is not being well controlled, as well as actual asthma attacks. Work with your physician to be sure asthma is under control before school starts, which may decrease the chances of it worsening at the beginning of the year.
• Have a written Asthma Action Plan—Work with your child’s physician to complete a plan, which should include individualized information about your child’s asthma symptoms, daily medications, rescue inhaler or nebulizer treatments, any physical activity limitations or need for inhaler before strenuous activities, and specific instructions about what to do and whom to call if an asthma attack does not improve with medication. Click here to download a free Asthma Action Plan.
• Schedule flu shots—Talk to you child’s physician now about getting immunized against influenza in September or October. Preventing influenza may lessen asthma episodes and trips to the ER. Flu shots for people with asthma have been proven safe through research conducted by the American Lung Association.

Click here for more tips and resources to manage your child’s asthma as they return to school.

Secondhand smoke is a mixture of the smoke given off by the burning end of a cigarette, pipe or cigar and the smoke exhaled from the lungs of smokers. It is involuntarily inhaled by nonsmokers, lingers in the air hours after cigarettes have been extinguished, and causes approximately 3,000 lung cancer deaths and 35,000 to 62,000 heart disease deaths in adult nonsmokers in the United States each year.

The Surgeon General’s report had six major conclusions:

1. Secondhand smoke causes premature death and disease in children and adults that do not smoke.
2. Children exposed to secondhand smoke are at an increased risk for Sudden Infant Death Syndrome (SIDS), acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.
3. Exposure of adults to secondhand smoke has immediate adverse effects on cardiovascular system and causes coronary heart disease and lung cancer.
4. Scientific evidence indicates that there is no risk free level of exposure to SHS.
5. Millions of Americans, both children and adults, are still exposed to SHS in their homes and workplaces despite substantial progress in tobacco control.
6. Eliminating smoking in indoor spaces fully protects nonsmokers from exposure to SHS; separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposures of nonsmokers to SHS.

Secondhand smoke exposure in the workplace

With no safe level of exposure to secondhand smoke it’s imperative that state and local officials take appropriate steps to protect public health in the workplace. An effective way to do that is to pass a comprehensive smokefree air law that covers all workplaces, including restaurants and bars. The popularity of smokefree air laws across the country is increasing as Americans demand safer working environments and elected officials take steps to provide a better quality of life for their constituents. Currently, 14 states including California, Colorado, Connecticut, Delaware, Hawaii, Maine, Massachusetts, Montana, New Jersey, New York, Rhode Island, Utah, Vermont and Washington, as well as the District of Columbia and Puerto Rico, have already passed strong smokefree air laws.¹ This November, voters in Arizona, Ohio and Nevada will have the chance to vote on similar measures.

In January, the American Lung Association released its annual State of Tobacco Control report card grading states and the Federal government in several key tobacco control policy areas, including smokefree air. Click here to see the report and find out how your state ranks.

What you can do to protect yourself and your family

Smokefree Zone: Declare your home a smokefree zone. No level of exposure to secondhand smoke is safe. Children are especially vulnerable to other people’s smoke, suffering acute respiratory infections such as bronchitis and pneumonia, more sever asthma and ear infections as a result. Do not allow smoking in your home, or ask smokers to take it outside.

Travel Healthy: Consider traveling/vacationing in smokefree cities or states. Stay in a hotel that has gone smokefree, like the Westin or Marriott², who are making an effort to provide a healthier environment for their customers.

Get Involved: If your state of city doesn’t have a comprehensive smokefree air law, help to advocate for one. Earlier this year the American Lung Association kicked off its Smokefree Air 2010 Challenge calling on state and local policymakers to pass and strengthen smokefree air laws. Click here to get involved with the challenge.

For more information about secondhand smoke click here.

2 On July 19, 2006 Marriott announced that in September 2007 Marriott, JW Marriott, The Ritz-Carlton, Renaissance, Courtyard, Residence Inn, SpringHill Suites, Fairfield Inn, TownePlace Suites and Marriott ExecuStay brands will 100% smokefree.

Here are a few indoor air menaces:

Dust mites - If you are allergic to dust I don’t have to tell you how irritating it can be and how it can affect your daily routine. If you have asthma and dust is one of your triggers, then that irritable disruption can set off an asthma episode that could potentially land you in the emergency room. Those microscopic critters known as dust mites need to be dealt with, especially if you are susceptible to the aggravation they can cause to your respiratory system.

Dust mites are invisible to the naked eye, but rest assured, they are almost everywhere. Dust mites especially enjoy living in stuffed animals, curtains, carpeting, sofas, old clothing, pillows and bedding. Up to 2 million dust mites can call a double mattress home. The most important step in controlling dust mites is to keep your home’s humidity level below 50 percent. Drier air keeps dust mites and other allergens from growing. Use air conditioning or open the window to exhaust cooking and bathroom moisture. Be sure to wash your bed linens every week in water that is at least 130 degrees Fahrenheit. Many health care professionals recommend pillows made of fabric impermeable to dust mites and pillow and mattress covers that have dust mite barrier protection. Use a damp cloth when dusting and when vacuuming use a vacuum cleaner with a high-efficiency, purifying air-filtration system.

Take our Sweeter Dreams quiz and test your dust mite knowledge by CLICKING HERE.

Pets – Be pet-smart. If anyone in the household is allergic to a pet, the best action is to find a nice new home for it. The next best thing is to keep the pet outside. If you must keep them inside, do not share your sleeping spaces with them. Bathing them weekly may help along with cleaning their bedding each week.

Mold and Mildew – Once again, keeping the indoor level of humidity at no more than 50 percent is one of the best ways to eliminate mold and mildew growth. Also, keep your house well insulated, properly caulked and sealed to prevent leaky basements, windows, roofs and vents. Angle downspouts at a five percent slope away from your house. Properly ventilate and clean bathrooms, kitchen and laundry rooms. Check to be sure your dryer is vented outdoors and not into the garage.

No Smoking!! Don’t let anyone smoke cigarettes, pipes or cigars in your home – secondhand smoke is extremely harmful especially if you suffer from respiratory problems.

Heating and air conditioning systems – It’s very important to perform proper maintenance which includes making sure filters are changed according to manufacturer’s recommendations, in order to make sure the system is regulating the humidity and filtering out irritants. Have anything that burns fuel inspected annually and vented outdoors and make sure to install carbon monoxide detectors.

Paints, cleaning supplies, pesticides and other chemicals – Purchase only what you need to use immediately so you won’t have leftovers in your home. Store those you need regularly in a dry well-ventilated area and away from children. Never mix cleaning products that contain chlorine and those including ammonia…such mixtures produce potentially lethal fumes.

For more information on indoor air quality issues, visit our indoor air section by CLICKING HERE.

How did this happen? While we still don’t know for sure, we do know that family members spent a prolonged period of time in the same room as the initial patient who was in a phase of severe illness and highly symptomatic. Keep in mind, this does not mean that the virus has mutated to an easily transmittable form. It is also very important to note that, according to WHO, lab testing of the viruses showed no evidence of mutations associated with a possible resistance to the anti viral medication Tamiflu.

For additional information on the bird flu, please read the following entry that we posted in response to a recent airing of a movie about a possible bird flu pandemic.

Could this happen? Influenza pandemics have claimed millions of lives in the past, so this is something that is being taken very seriously by governments and health officials around the world. One thing to keep in mind is that the next influenza pandemic could be substantially less severe than what the movie depicts or than what occurred in 1918. Science has come a long way since the early 1900s. Both the influenza pandemics of 1957/58 and 1968/69 caused so much less illness and death than the earlier pandemic, many Americans at that time were unaware that a pandemic was underway.

This is not to say that we are taking the threat lightly. The government is currently stockpiling enough antivirals to treat 25% of the U.S. population should a pandemic occur in the U.S. This figure was based on historical data. While an exact vaccine can be developed only once a strain is identified, a pre-pandemic H5N1 vaccine has been produced that may offer some level of immune protection should the H5N1 virus mutate into a pandemic strain.

Although the federal government through the CDC and other agencies will take a leadership role, much of the responsibility for planning and action is at the state and local levels. Take an interest in whether your state and local health departments have developed plans for a pandemic flu outbreak. Click here to see what’s going on in your local area.

What do you need to know right now?

• There is no avian flu pandemic in humans anywhere in the world at this time.


• The H5N1 avian influenza has not yet appeared in the U.S., and in countries in which it has appeared it is almost exclusively a disease of birds.


• Should the H5N1 virus appear in the U.S., it does not mean the start of a pandemic.


• Congress has approved funding for the Department of Health and Human Services to make significant financial investments to improve the technology for vaccine development and to ensure rapid availability of the vaccine for the population in the event of a pandemic.


• Visit www.pandemicflu.gov for more information on the avian flu and to find out what you can do to protect yourself and what local communities and businesses can do to in the event of a pandemic.

Remember....don’t panic. Be informed and prepared.

The State of the Air report assigns grades to counties throughout the United States with respect to two of the most pervasive air pollutants, ozone (smog) and particles (soot). Take a couple of moments to see how your community fares, by clicking here and typing in your zip code.

How’d you do? If your county scored an F, unfortunately you’re not alone. According to this year’s report, more than 150 million Americans still live in counties where they are exposed to unhealthful levels of soot and/or smog air pollution. The good news is that, believe it or not, we are seeing real improvements in the air quality in much of the nation, but we’re still a long way from winning the battle against dirty air.

This year we are focusing our attention on the millions of people who live in U.S. port and industrial cities because two big contributors to dirty air are marine and locomotive sources. The EPA has promised to issue guidelines for limiting air pollution from these sources, but has not yet acted. You can help right away by sending an online letter to EPA Administrator Stephen Johnson urging him to issue tough regulations that will clean up dirty diesel locomotives and boats.

Does clean air really make a difference to our health? The answer is yes. Mounting scientific evidence shows that cleaning up the source of air pollution results in cleaner air and less illness and death. A recent study out of Harvard’s School of Public Health and Brigham and Women’s Hospital in Boston showed that when particle air pollution declines in a city, the death rate also declines in the city. While air pollution affects everyone, in particular, people with conditions such as asthma, chronic bronchitis, emphysema, cardiovascular disease and diabetes are affected. As if that’s not enough, the nearly 40 million children under 18 and the 17 million adults who are 65 and over are also at risk in areas with unhealthful levels of ozone or particle pollution. I can’t stress enough the fact that cleaner air saves lives.

How can you help? The following are steps you can take to help in our continued quest for cleaner air:

• Drive less, not only will you be saving money due to the soaring gas prices, but you’ll be helping the environment. Vehicle emissions are a major source of air pollution. Combine trips, carpool, use mass transit whenever possible and walk more.
• Care for your car. Regular maintenance and tune-ups, changing the oil and checking tire inflation can improve gas mileage, extend your car's life and increase its resale value. It can also reduce traffic congestion due to preventable breakdowns and it could reduce your car's emissions by more than half.
• Get fuel when it's cool. Refueling during cooler periods of the day or in the evening can prevent gas fumes from heating up and creating ozone. And that can help reduce ozone alert days.
• Don't top off the tank. It releases gas fumes into the air and cancels the benefits of the pump's anti-pollution devices. So stopping short of a full tank is safer and reduces pollution.
• Don’t burn wood or trash. These practices are among the largest sources of air-borne particles in many parts of the country. Convert woodstoves to natural gas, which emits far fewer pollutants. Compost and recycle as much as possible and dispose of other waste properly; don’t burn it. Support local efforts to ban outdoor burning of construction and yard wastes.
• Participate in community reviews of local air pollution plans and support state and local efforts to clean up air pollution.
• Use less electricity. Turn out lights and use energy-efficient appliances.

Also remember to take measures to protect yourself. During the summer months, ozone levels are at their highest, but particle pollution can be a threat year round.

If you exercise outdoors, here are some tips to keep in mind:

• Exercise early in the day or in the evening, avoid midday or afternoon training.
• Avoid strenuous outdoor work,if possible, when ozone smog or other pollution levels are high.
• Avoid congested streets and rush hour traffic; pollution levels can be high up to 50 feet from the roadway.
• Make sure teachers, coaches and recreation officials know about air pollution and act accordingly.

Be aware of the Air Quality Index (AQI) levels on a daily basis and act accordingly. The AQI is the standard system that state and local air pollution control programs use to notify the public about levels of air pollution. The AQI levels are generally reported in the local newspapers, television and radio news reports and online at www.epa.gov/airnow. For more information on AQI, click here.

While there’s no doubt that quitting smoking is a good thing, many people have achieved success by using nicotine replacement products, so we obviously want to encourage people to quit any way they can. However, this preliminary research has brought into question whether or not lung cancer patients, or all cancer patients, should use nicotine replacement products to quit. This is a very important issue and one that requires additional research, including human clinical trials, since there are so many differences between a living, breathing human and a dish full of cells in a laboratory.

This situation is particularly complicated because people who use nicotine patches or gum instead of cigarettes avoid taking in a variety of other poisons. This complicates the picture of just how harmful nicotine is in those forms -- especially since the patches and gums help people quit smoking, in the first place. So, it’s possible that the value of smoking cessation may outweigh the theoretical risk of blunting the effect of chemotherapy. In any case, we will continue to monitor the situation closely should new developments occur.

And, as always, if you’re still smoking, I urge you to quit. Many people are now enjoying smoke-free lives through the help they received from the American Lung Association’s Freedom from Smoking online program or by speaking with one of our stop-smoking experts at our HelpLine at 1-800-LUNGUSA. If you’d like to learn more about chemotherapy, the National Cancer Institute has some valuable information on their website at the National Cancer Institute.