May is Asthma Awareness Month and a report on air quality shows mixed results for Marylanders.

The American Lung Association recently released its 25th annual "State of the Air" report. Findings showed nationally, four in 10 Americans live in places with unhealthy air.

In Maryland, the Washington-Baltimore-Arlington area saw the number of unhealthy ozone days fall to 4.3 per year, which is a best-ever score for the metro, but it still received a failing grade in the report.

Dr. Panagis Galiatsatos, associate professor of pulmonary and critical care medicine at Johns Hopkins University, said there is no substitute for good air quality.

"As a lung doctor, I have good medicines, I have great medicines, great inhalers to help my patients with lung diseases," Galiatsatos noted. "The challenge is, all of those inhalers will be undone by poor air quality, I don't have a single inhaler to offset that."

The report showed more than half a million people in Maryland are living with asthma.

Maryland tracks fine particle pollution in 10 counties. Four saw worse numbers compared to the last report. Baltimore and Cecil counties both scored a 'B' for particle pollution with the remaining eight counties receiving an 'A.'

Particulate is a mixture of tiny bits of solids and liquids suspended in the air, and comes from numerous sources, including factories and combustion engines, along with wildfires and wood-burning stoves. The report spanned the years 2020 to 2022, so the effect of last summer's wildfire smoke has yet to be calculated.

Galiastatos emphasized the increasing frequency of wildfires represents a threat to vulnerable populations.

"During the bad wildfires, not only do we see an influx of hospitalizations for lung issues, but we saw the same thing for heart issues," Galiastatos observed. "This is going to have immediate effects to the lungs and to the circulation with inflammation, and likely to last not just an immediate sense, but long term if we're exposed to this constantly and chronically."

The report calls on the Environmental Protection Agency to set stronger national standards for ozone, and finalize rules limiting carbon emissions from coal and gas-fired power plants.


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If they have not already, North Dakotans are urged to become familiar with an online tool detailing air quality in their area, as environmental officials said smoky air from expanding wildfire seasons requires more awareness.

Forecasters recently warned north-central states including North Dakota would see stretches of smoke-filled air or hazy skies due to wildfires burning in Canada.

Ryan Mills, ambient air monitoring manager for the North Dakota Department of Environmental Quality, said until recently, the state would not see winds pushing smoke here until deeper in June or early July but things have changed.

"The last few years, we've been seeing this kind of tick-up right away in May," Mills observed. "It's kind of like we've had to expand our fire season, if you will."

His office does not track the root causes of longer and more destructive wildfire seasons but researchers said climate change is a factor. When conditions surface, the website and mobile app AirNow.gov provides up-to-date information on local air quality. Residents, especially those with respiratory issues, are urged to limit outdoor activities.

Mills advised when there's an air quality alert and you can start to smell the smoke, it is time to block spaces where the air can seep into your house.

"Closing your windows, things of that nature," Mills recommended. "Obviously, don't be going in and out."

Other tips include adjusting the settings on air conditioners or vehicle vents to recirculate indoor air. Online maps and other tools are often color coded to further illustrate how safe it is to be outside for long periods. When colors such as orange, red and purple come into play, it means the air quality has worsened.


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A bill to legalize cigar smoking in designated Montana barrooms has failed a third reading in the state House. Similar legislation is introduced most years, although polls show it is unpopular among Montanans.

The 2005 Montana Clean Indoor Air Act outlawed smoking in indoor public spaces and workplaces to reduce secondhand smoke and its negative health effects. Before the law passed, Helena happened to be a laboratory for those effects when a city ordinance outlawed public smoking for six months in 2002.

Richard Sargent is a retired family physician in Helena, who also volunteers with the American Heart Association. He said changes to air pollution rapidly affect health.

"We had all kinds of physiology studies showing the things that lead to heart attacks happen fairly rapidly with exposure to secondhand smoke," Sargent pointed out. "Thirty minutes is enough."

Sargent was the lead author of a study which found the rate of heart attacks in Helena decreased about 40%, from 40% to 24%, the year the ordinance went into effect.

Sargent noted the bill started with distinct buildings allowing cigar smoking outside of taverns and then changed to separate rooms in a shared building. He stressed there is no way to isolate airflow in such a setup.

"The American Society of Heating, Refrigeration and Air Conditioning Engineers has stated repeatedly that there's no ventilation system that'll handle secondhand smoke," Sargent added. "It just can't be done."

Among those surveyed, 77% of Montana voters oppose legalizing cigar smoking in bars and 89% support the Clean Indoor Air Act, according to an American Cancer Society poll.


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As Cleveland tightens its air quality standards for the first time since 1977, health officials are urging residents to take simple steps at home to reduce their exposure to harmful pollutants.

The Environmental Protection Agency reported Americans spend about 90% of their time indoors, where air pollution levels can be two to five times higher than outdoor air.

Richard Stewart, public information officer of the Department of Public Health for the City of Cleveland, said the city's push is part of its efforts to engage local residents with new monitoring tools and resources through its "CLEANinCLE" initiative.

"A lot of folks don't realize small changes inside the home can really improve your quality of life," Stewart pointed out. "For example, taking your shoes off before you come in the house, checking for lead paint dust, cracking windows. Just regular cleaning can make a big difference in improved air quality in your house."

CLEANinCLE is a community air monitoring project, including sensors in multiple neighborhoods. The health department hosts two public meetings this week, one Wednesday from 6 p.m. to 7:30 p.m. at the Frederick Douglass Recreation Center and another on Thursday at the Community of Faith Assembly. Both events include free in-home air assessments and raffles for air purifiers and electric stoves.

While many cities face water-related lead risks, Stewart noted one of Cleveland's biggest concerns is still old paint. Officials are asking residents to look out for cracking or peeling paint surfaces, especially in older housing and report issues which could expose children to lead.

"There's no amount of lead that's acceptable in a child's bloodstream," Stewart emphasized. "If you see that 'alligator paint,' where it's cracking and kind of fizzling on the house, contact your landlord. And if you're not getting any results, contact us."

The city also has a Lead Hazard Control Grant Program to help eligible property owners remove lead paint.