Up in the air

As Shannon Palladino’s feet pounded the rocky terrain of the Steamboat Ditch Trail, she noticed an unusual rhythm in her run. At first, she thought it might have been the song of her favorite bird, the American goldfinch. Or maybe it was the rushing of the Truckee River running alongside her. However, upon closer inspection, she noticed that this change of rhythm was coming from deeper inside her. It was a flare-up of her exercise-induced asthma, a result of the wildfire smoke filtering into Reno from November’s Camp Fire, the most destructive fire in California history.

The National Collegiate Athletic Association (NCAA) recently raised its standards for exercise in poor air quality conditions by 100 points on the Air Quality Index (AQI)—a decision that could affect student-athletes across the country and at the University of Nevada, Reno. The AQI for a region can be found at airnow.gov.

What is AQI?

The Environmental Protection Agency (EPA) oversees the AQI, which is an index for reporting daily air quality, updated hourly at monitoring stations across the country and reported online. The higher the AQI value, the greater the level of air pollution and the greater the health concern.

The index ranges from one to 500 and measures five criteria for air pollutants: particulate matter, sulfur dioxide, carbon monoxide, nitrogen dioxide and ozone. Particulate matter as a result of wildfire smoke is the most detrimental to respiratory health, as well as the most pertinent to the Truckee Meadows, since it is the largest cause of wildfire air pollution.

Generally, AQI levels of 101-150 are unhealthy for sensitive groups—and people may not realize they fall under this category.

“When anyone’s exercising or exerting themselves, they’re considered a sensitive group, whether or not you’re a kid or an adult,” said Brendan Schnieder, an air quality specialist for the Washoe County Health Department.

Therefore, anyone from a rugged Tahoe hiker to a casual dog walker is at risk. The act of getting outside and exercising puts people in the same category as asthmatics and other people affected by lung conditions.

“No matter if you’re running a marathon or doing really hard practice for several hours, you’re a sensitive group—meaning that air quality and pollution will impact you more than someone who is inactive, because of how much more you are breathing in deeply,” said Schnieder.

The National Institutes of Health reports that the average person takes approximately 15 breaths per minute, taking in roughly three gallons of air. As a person exercises, muscles require more oxygen and produce more carbon dioxide. As a result of this increased demand, a person exercising takes in 40 to 60 breaths each minute, roughly 26 gallons of air. This means that a person exercising takes in up to four times as much air, along with any pollutants that may be in it.

But, again, the problem is that many people are not aware they are at risk.

“When air quality is poor, it can not only irritate your eyes, nose and throat, but it can also cause shortness of breath,” said Schnieder. “It can even affect your heart and cardiovascular system. As for long-term effects, we don’t have much of an idea.”

There is a lack of research on the long-term effects of wildfire smoke inhalation—but wildfire smoke continues to negatively affect Northern Nevadans as they are exposed to increasingly poor air quality.

Reno—a hazy situation

This is especially pertinent to the fire season in Reno and the surrounding area. As reported by the National Interagency Fire Center, the season can range from April to November, with December to March only considered minimal risks. The American Lung Association’s “State of the Air 2017” report ranks Reno as 10th in the nation for short-term particulate matter 2.5 (PM 2.5) pollution. PM 2.5 is a product of combustion and is hazardous to health. The “2.5” in PM 2.5 refers to the size of particulate matter suspended in the air—less than 2.5 microns in width. There are about 25,000 microns in an inch.

Not only can PM 2.5 cause eye, ear, nose and throat irritation, but it can get into the lungs and bloodstream. For some individuals, this can result in heart attack and even death.

According to archival EPA data from 2017, many cities experience high AQI numbers. However, for many of these, ozone is the primary pollutant on the majority of days when the AQI exceeds 100. For example, in terms of unhealthy days, there were 107 in Los Angeles, California, and 33 in Phoenix, Arizona. Both these readings are the result of high ozone levels. In Reno, only two days with an AQI over 100 were a result of ozone. Seven days were a result of PM 2.5 pollution, and this can have negative health effects.

Furthermore, the top 10 U.S. cities with the worst air quality are all on the West Coast. This creates a disparity when decisions about air quality measurements are made on a national level, because wildfire smoke disproportionately affects the West Coast. According to the California Department of Forestry and Fire protection, 10 of the top 20 most destructive fires in California history have occurred in the past three years, with the recent Camp Fire topping the list.

According to the National Weather Service, northwest winds funnel wildfire smoke directly into the Truckee Meadows. With the rate of California fires rapidly increasing, and with Reno being the recipient of a significant amount of smoke from these fires, this is an indication that Reno’s air quality could get much worse, not better.

As of Dec. 26, Reno experienced 18 days of unhealthy air quality—landing in the EPA’s “orange” category for AQI. Of these unhealthy days, PM 2.5 was one of the primary pollutants.

Lowering the bar raises the stakes

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports makes decisions regarding air quality policy for collegiate athletics. This is a 23-member committee, with six spots reserved for men and six for women. It also includes a primary-care physician, coach, athletic trainer, sports psychologist, dietician, strength coach, lawyer and representatives from each NCAA division. What the committee fails to represent are members of the West Coast—the part of the country that experiences the worst air quality.

Currently, there are only two members on the committee from Western schools. Kim Terrell of the University of Oregon and Mark Stovak, sports medicine physician for University of Nevada, Reno Athletics, are the only representatives of the smokiest region of the country.

Poor air quality affects the Western states more than any other region. Therefore, in a vote to change the air quality limits, the West was underrepresented.

When the NCAA changes a policy or recommendation, a committee refers to existing studies and data for guidance. Unfortunately, the lack of data surrounding long-term exposure to poor air quality did not provide the NCAA with evidence to maintain or lower air quality recommendations; therefore, the committee voted to raise the air quality limits for practice and competition.

“It’s difficult because it is all long-term,” said Stovak. “We just don’t have data for [athletic exposure to poor air quality] during wildfire season. It’s just not easily observed.”

However, the NCAA guideline is just a recommendation. Individual institutions take it into consideration when determining their respective limits. As an example, UNR Athletics recommends that all athletes should limit outdoor activity (suggesting that athletes reduce activity to 50 percent) at AQI 150. Athletic competition is postponed between AQI of 121-150 until conditions improve. Boise State, in Boise, Idaho, has a policy similar to Nevada’s.

“Boise State’s policy does not differentiate between levels for practice and competition. If the AQI reaches 200 during practice or competition, everyone is required to practice indoors,” said Keita Shimada, an athletic trainer for Boise State.

On the East Coast, Zachary White, an assistant athletic trainer for Syracuse University’s football team in Syracuse, New York, was unaware of an air quality policy at his school. Upon further investigation, he found that there was no policy at all.

“The University has never had a policy set in place to address air pollution like that of you all on the West Coast,” said White. “Environmental policies that are more concerning to us are severe weather, such as heavy snow falls and low temperatures, as well as high temperature and humidity in the summers.”

This difference in priorities due to geographical locations further illustrates the need for equitable representation from across the country when it comes to making decisions regarding athletes’ safety.

Burning indictment

Poor air quality episodes expose anyone exercising outdoors to pollutants. Athletes are exposed to air pollutants at higher rates than other groups—because they perform at high levels and practice outdoors, and often for long periods of time.

“On days when the air quality is bad, I feel the short-term impact for a few days after, and on the days when the AQI is above 120 or so, I really think it could potentially lead to longer-term health impacts,” said Palladino, a student-athlete on UNR’s women’s cross country team. “For someone like me, who has exercise-induced asthma, there’s definitely a chance of that becoming worse with increased exposure on those days when the air quality is not great.”

Some believe the solution lies in learning more about the long-term effects of exposure to poor air quality and creating policies reflective of that research, both for collegiate athletes and the general public, as well.

“What it comes down to is that we know poor air quality is unhealthy, but there’s really no proof that it’s going to harm the average person long term,” said Stovak. “So, we’re not willing to cancel events at a much lower level without proof that in the long run there is going to be a lot of harm.”

However, for those on the playing field, there is often a different sentiment.

“I think the standards should be tighter than they are, and the NCAA released standards that are, at least for the sport that I know, unhealthy and a serious mistake” said Kirk Elias, women’s long-distance coach for Nevada Track and Field.

Elias has experienced times where athletes were uncomfortable due to the air quality on smoky days when the AQI was between 75 and 80. When his athletes were not comfortable running outdoors on these days, he sent them to cross train indoors, where the air had been filtered.

The current policy is informed by a 2001 study from the British Journal of Sports Medicine. The study itself states that there has been little research examining the relationship between exercise and inhaling particulate matter. But the article makes no mention of anything related to wildfire smoke, save for one mention of fires lit in the homes of those in developing countries. It makes indirect mentions to smoke and only references it in terms of smoking or smoke control.

It is unknown what studies were used in the NCAA’s previous, more conservative guidelines.

Other than the study included in the British Journal of Sports Medicine, there is little published research on the long-term effects of athletes’ exposure to poor air quality, let alone wildfire smoke specifically.

As a coach, Elias said he does not allow the lack of research to interfere with the safety and long-term health of his athletes. Instead, he bases his decisions on how athletes feel on smoky days and moves their practices indoors accordingly.

“It’s real simple. I’m not going to make athletes practice in conditions that they become uncomfortable with,” he said.

As a part of a long term plan to address the issue, UNR has proposed an indoor practice facility. The indoor fieldhouse would feature a track, football field and other amenities that would be used by collegiate and intramural athletes alike.

Details regarding the air filtration system of the new facility have not been publicly released.

Blazing ahead

The writers of this story believe the first step to solving the problem of athletes’ exposure to poor air quality is to admit a problem exists. The contributors of this story—Adria Barich and Hiley Dobbs—are students at the University of Nevada, Reno. They completed this project as a part of a medical reporting class. Barich is a senior studying journalism with a minor in communications who runs and reports on sports. Dobbs is a Canadian student-athlete who studies public health. The reporters believe when West Coast schools have nearly 20 days with poor air quality in a single year, the damage can be much worse than a month of lost practice days. With the potential to negatively affect the heart and cardiovascular system, poor air quality it is more akin to a public health crisis.

With wildfires annually blazing across much of the Western U.S., we need to prioritize awareness of the effects of exposure to poor air quality. The NCAA raising its recommendation for air quality paints the issue as not only trivial, but as an inconvenience.

The destruction of wildfires extends deeper than the ashes they leaves behind; it’s time to acknowledge that the poor air quality resulting from them could be a serious health concern and deserves to be treated as such.