Respiratory patient activity, physical exercise in normal individuals, and telehealth prediction of air pollution

Background While air pollution is associated with morbidity and mortality in patients with respiratory and cardiac disease, there are also effects in normal individuals particularly if exercising on days when pollutants are high. The accepted advice on these days is to reduce exposure by restricting activity or remaining indoors. Consequently, in the European Union, high PM10 levels in 2005 caused 625M individual restricted activity days, encouraging national telehealth programmes, which incorporate this approach. Know and Respond, introduced in Scotland in February 2012, informs individuals by text, email, or landline message of the next day’s air pollution prediction.Study Five main focus groups were contacted–COPD patients registered with our LTOT service (n=20, age 55–73), in-patient respiratory patients (n= 6 COPD and n=7 asthmatics, age 24–75), regular recreational joggers from central Glasgow (n=25, age 24–30), competitive athletes (n=15, age 21–26), and a group of occasional exercisers, who were predominately sedentary otherwise (n=15, age 25–30). Questions were asked about multimedia access, basic knowledge of air pollution and its’ influence on daily activities.Results Only 5 of the LTOT patients had internet access, and 7 had text receiving mobiles. All other subjects had internet access, and text phones. In the in-patient asthmatic group most were aware of the links between air pollution and health (6/7) and would change their exercise habits. In comparison only one COPD patient reported a link and consideration for air pollution when exercising. Some of the competitive athletes (13/15) and occasional exercisers (9/15) were aware of PM2.5 as a risk pollutant which might influence their choice of activity, but none of the joggers, who all ran regularly even during the high levels of air pollution in Glasgow during March 2012 when unseasonal weather patterns drew pollutant dusts from Europe across Scotland.Conclusion We would reasonably contend that the aim of Know and Respond is justified given the known effects of air pollution however we acknowledge that awareness of the background relevance of air pollution is extremely variable. Know and Respond patient cards have been sent to general practise surgeries nationally to encourage patients to register with this free service