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Air Quality

An unusually active 2015 wildfire season in parts of northern California and the pacific northwest lead to significant air quality challenges for many member institutions located in those regions, especially with the onset of late summer practices and competitions and the start of the 2015-16 sport seasons. As a result, the Sport Science Institute and the Committee on Competitive Safeguards and Medical Aspects of Sport fielded several calls from athletics healthcare professionals at these schools who were inquiring about available information to help guide their decisions about practice or competition modification.

There are three reasons why otherwise healthy athletes, are at special risk for inhaling pollutants. First, as physical activity increases minute ventilation, the number of pollutants that are inhaled relative to when the athlete is at rest are increased. Second, during activity, a larger proportion of air is inhaled through the mouth, which bypasses the body’s built-in nasal filtration system. Third, pollutants are inhaled more deeply and may diffuse into the bloodstream more quickly during physical activity. These concerns are exasperated in those athletes with pre-existing pulmonary or cardiac conditions (Carlisle and Sharp, 2001).

An important and standardized national air quality resource is the National Weather Service’s Air Quality Forecast System. This system “provides the US with ozone, particulate matter and other pollutant forecasts with enough accuracy and advance notice to take action to prevent or reduce adverse effects.” (Accessed 6/14/16; http://www.nws.noaa.gov/ost/air_quality/).

A key component of this forecast system is the NWS Air Quality Index (AQI). The AQI is provides real-time monitoring and alerts in response to changing air quality levels. The AQI accounts for five different pollutants, including 1) ground-level ozone, 2) particle pollution (also known as particulate matter), 3) carbon monoxide, 4) sulfur dioxide, and 5) nitrogen dioxide. Of these, ground-level ozone and particulate matter are the most common and most concerning pollutants for outdoor physical activity. The AQI is a single number, presented on a scale of 0 – 500, where 0 indicated no air quality problems and 500 indicates the most hazardous levels of air pollution.

When threatening or dangerous air quality levels are present the AQI is adjusted upward, and the National Weather Service will issue a corresponding air quality alert. Those alerts and their corresponding behavioral modification recommendations can be found here.

The committee offers the following general guidance to member institutions trying to make decisions about the appropriateness of practice or competition in extreme air quality situations:

  • Attentive monitoring of local AQI and associated air quality alerts, especially during times of extreme environmental conditions, is recommended. This monitoring is best performed by the primary athletics healthcare providers trained to monitor environmental impacts on student-athlete health and safety. However, schools may choose to delegate this responsibility to another staff member with knowledge and training about environmental monitoring.
  • Member schools should consider modifying or canceling outdoor athletic events (practices and competitions) in accordance with AQI guidance. Exposure should be managed more conservatively for student athletes with pre-existing pulmonary or cardiac conditions, which may exacerbate the complications of these conditions and could lead to an acute medical emergency. Specifically, schools should consider removing sensitive athletes from outdoor practice or competition venues at an AQI over 100. At AQIs of over 150, all athletes should be closely monitored. All athletes should be removed from outdoor practice or competition venues at AQIs of 200 or above.

School emergency action plans should guide the emergency care response in these circumstances, and staff should rehearse the plan at a minimum of once a year.