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Haze haze go away, come again another day..

For most of September, it seemed like all of a sudden, our beloved KL city seemed shrouded in a blanket of mist. Sounds romantic, but this "mist" is in actual fact, haze. Though we are starting to see clear skies now, and this article may seem a little delayed in coming, but there is no harm in reading about it for future uses. Many pediatric clinics in KL saw a surge in patients seeking medical treatment from the effects of haze, and at Bright Star Baby & Child Clinic, we are no different.

Our clinic's very own Dr Wai Ko Ni recently concluded an interview with celebrity deejay Wong Chui Ling regarding the haze issue.

Here are the links:

ChuiLing YouTube channel

ChuiLing Fb (under Videos section The Wong Chui Ling Show)

And we thought, why not put it in written format too for your reading pleasure? (All the information was sourced from DOE MY and HealthHub Sg)

So, first of all, what is HAZE? Haze is an air pollutant. The key air pollutants of concern include particulate matter (PM), sulphur dioxide, ozone, nitrogen dioxide and carbon monoxide. Our Malaysian DOE (Dept of Environment) calculates the API (air pollution index) using a combination of readings from these pollutants, and our reading is in line with the calculation methods used by other developed countries. In 2018, our APIs took into account the PM2.5 particles.

What is this PM2.5 and why does it concern us? PM2.5 is a particulate matter within the air pollutants, that are 2.5 microns in size. Let's take a look at the image below for size comparison:

PM2.5 vs other fine substances
PM2.5 vs other fine substances

PM2.5 is so small that in can get into our body system easily. But again, why worry? Let's then take a look at the image below:

PM2.5 vs our airways and its effects
PM2.5 vs our airways and its effects

As you can see from the figure above, PM2.5 easily fits into our main airway branches and could cause damaging effects on our bodily systems. Below is another image regarding the effects of haze on our body, particularly PM2.5:

Our Malaysian DOE calculates the API using a combination of air pollutants, and they came up with the readings below for your reference:

Above the UNHEALTHY levels (>101), some short term effects include:

  • Irritation of the eyes, nose, and throat in healthy individuals. Such irritation resolves on its own in most cases.

  • Exposure to particulate matter and sulphur dioxide may also cause irritation of the skin.

  • Haze particles can cause worsening of heart and lungs symptoms, especially in people who already have chronic heart or lung diseases e.g. asthma, chronic obstructive pulmonary disease (COPD), or heart failure.

Other effects of haze not commonly thought about:

•Reduced visibility due to light scattering that affects road users, pilots etc, making transportation unsafe.

•Worsening of skin conditions such as eczema. Dry skin and rashes occur more often during hazy conditions, possibly due to dry and hot weather, which can trigger these conditions.

What about some long term effects of Haze? Studies have shown that continuous exposure over several years to high APIs may have a higher risk of:

•(i) cardiovascular effects, such as heart attacks,

•(ii) reduced lung development,

•(iii) the development of chronic respiratory diseases, such as asthma, COPD

•(iv) even lung cancer

Of note: PM2.5 have been shown to cause placental blood toxicity, leading to direct harm to the fetus, and may cause low weight gain in babies or IUGR (intrauterine growth retardation).

Who are most susceptible to haze effects??

•Children, elderly, and people with chronic lung disease and heart disease

•In addition, it is advised that pregnant women reduce exposure to haze for the health of their unborn baby.

What to do then?

•Best form of protection is to stay indoors, close all windows and openings, turn on the air condition, air purifier and humidifier (if available). Make sure air condition and purifiers have clean filters.

•Drink lots of water to stay hydrated.

•Eat nutritious foods like fruits and vegetables. Keep yourself well nourished so cells are in good shape.

•Moisturize your skin

•Exercise indoors to keep heart and lungs healthy

•If you are someone with chronic heart and lung problems, such as asthma, COPD, or heart failure, please stay on your medications or inhalers as directed by the doctor. Do not stop taking your long term medications.

•Seek help immediately if you have any worsening of your symptoms

•If you are healthy and have to work outdoors, minimize prolonged exertion, and wear an approved N95 mask. Normal surgical masks will not work.

•If you are part of the at risk group, avoid being outdoors. If you have to be outdoors, wear N95 masks.

A side note on N95 masks:

•N95 masks work only if there is a good fit with the face of the wearer

•Haze can contain fine particles that are 2.5 microns or smaller (PM2.5), and studies have shown that N95 masks do provide good protection against particle pollutants as they are at least 95% efficient against fine particles that are about 0.1 – 0.3 microns

•The use of N95 masks increases effort in breathing

•For some people, the use of N95 mask may cause discomfort in breathing, tiredness or headache

•This may be due to the mask causing increased resistance to breathing, and a reduction in the volume of air breathed in

•Some elderly people, people with lung or heart conditions, and women in the later stages of pregnancy may already have reduced lung volumes or breathing issues

•You should take a break from using a N95 mask if you feel uncomfortable

What to watch out for in times like these?

•Watch out for symptoms of difficulty breathing, worsening cough, fast breathing in young children. Sometimes it may show up as difficulty feeding and sleeping in very young children.

•In children with eczema or sensitive skin, do watch out for worsening rash, increased scratching or itching, and oozing lesions.

•See your pediatrician right away if any of these symptoms occur

What NOT to do?

•You do not have to wear the N95 masks at home. Prolonged wear is very uncomfortable.

•Please do not cover baby’s cot. There is no need for that, and this might even cause overheating or suffocation of the baby.

•Babies do not need masks. The best way to protect them against haze is to stay indoors, and if have to, minimize outdoor exposure. In any case, N95 masks do not fit babies, so it is not needed.

There you have it! Now that you are an expert in Haze, please feel free to share this article with your friends and family. Sharing is caring.

'With good health, our children can shine brighter"

-Dr Wai Ko Ni

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