You ask, we answer: What are the health risks of air quality on the Nipomo Mesa?






Air quality on the Nipomo Mesa in South San Luis Obispo County regularly violates clean air standards during high wind events — and we’ve heard a lot of questions about what that means for the health of residents who live there.

We are committed to finding answers and sharing them here. The answers we provide are researched and reported by Tribune reporter Monica Vaughan or come directly from an expert in the field.

We invite you to engage in this conversation. If you have additional information to add or if you have a question that is not already answered here, please fill out the form at the bottom of this page.

High concentrations of particulate matter — tiny pieces of dust that are too small to be seen — have been measured in the area. When inhaled, that dust can travel past your upper respiratory system into your lower respiratory system, potentially causing short- or long-term health effects.

Wind storms that blow up dust in concentrations seen on the Mesa will cause respiratory issues in sensitive people like children and older adults, and those with existing conditions, according to Dr. John Balmes, an expert on the health effects of air pollution who sits on the California Air Resources Board.

For example, high concentration of dust can cause someone with pulmonary disease to end up in the emergency room.

The general population will likely experience irritation of eyes, nose and throat. However, if the dust levels are high enough, even healthy adults might experience respiratory infections such as bronchitis or pneumonia, Balmes said.

Q: How significant is the health risk of poor air quality for residents on the Nipomo Mesa?

A: According to Dr. Penny Borenstein, San Luis Obispo County Public Health officer, that’s a difficult question to answer “as the risk is not truly measurable either person to person or even within a single individual.”

“In general the more frequent, longer and higher (particulate matter measurement) the exposure is, the greater are the chances of short or long-term health impacts,” Borenstein says. “Also, persons in certain groups like infants and young children, elderly and those with underlying respiratory or cardiac illness are at greater risk of health impacts.”

A: Dr. Robert Lapidus, retired pulmonologist, says the risk for chronic obstructive pulmonary disease is “difficult to accurately assess as no studies have been done in this regard in our local area. Based upon studies done in other areas around the world, PM exposure experienced on the Mesa would likely increase the risk by somewhere between 10 and 40% compared to people who don’t have similar exposures,” Lapidus says.

Q: Can six or eight hours of bad air hurt me even if the air quality is good and meets clean air standards most of the time?

A: “Yes, it can,” pediatrician Dr. William Morgan says. “’Any bad air is bad’ is the expression. I have patients who simply go camping overnight — with dust and smoke exposure while active — and have trouble breathing the next few days.”

Q: What are the long-term risks of exposure to high levels of particulate matter?

A: Lapidus says that medical conditions that have been linked to chronic PM exposure include “asthma, COPD, lung cancer, cardiovascular disease including increased risk of heart attack and stroke, diabetes, cognitive impairment, and premature death.”

Q: Could allergy symptoms be a sign of something else?

A: “It sure could be — and most likely would be asthma, in my experience,” Morgan says. “Many people state ‘It’s just my allergies,’ when in fact it is more than that. Pay attention to the cough.”

Q: Does the PM cause asthma or asthma attacks?

A: “Yes, absolutely it does!” Morgan says. “It most certainly causes asthma attacks, and evidence exists to support it causes asthma as well.”

Q: How long does it take for symptoms to develop?

A: As Borenstein says, “There is no straightforward answer to this question. Some health impacts can be fairly immediate, such as an asthma attack or a heart attack; others like fibrosis of the lungs or worsening of bronchitis can occur over long periods of time such as years.”

Q: Should we move?

A: “That is a personal decision based upon the make-up of the household and their health status and is probably best discussed with one’s personal physician,” Borenstein says.

Q: If you have lung disease, does it do any good to move away if the damage has already been done?

A: “If you have significant lung disease, it’s important to do everything you can to minimize ongoing exposures that exacerbate the situation,” Lapidus says. “An analogy could be made to cigarette smoking and COPD. Once someone who smokes has COPD, the most important intervention is to quit smoking as this is the only intervention that has been shown to slow down disease progression.”

Q: I’m considering moving to Nipomo and have a lung condition. Is that a good idea?

A: “Any pre-existing lung condition would make you more susceptible to the adverse effects of PM pollution,” Lapidus says. “How significant this would be for you would depend upon the nature and severity of your condition. I would encourage you to talk to your physician about this before making a decision.”

Q: Is there a diagnosis for the cough that everybody gets? This so-called “Mesa cough”?

A: “Coughs are very common and brought about by a host of different reasons such as infections, limited exercise capacity, reduced lung function, cancers, toxins, allergies, and poor air quality,” Borenstein says. “There is no specific diagnosis for the so-called “Mesa cough.’ A particular cough is best diagnosed by a medical provider who will ask additional questions about the characteristics of the cough such as depth, how long, dry versus productive, associated symptoms like fever, etc. Other diagnostic tests may also be indicated.”

Q: Why isn’t air quality on the Mesa the highest priority of the county health department?

A: According to Borenstein, the county Public Health Department has worked closely with the county Air Pollution Control District and other community organizations such as the medical society and schools “to continuously educate the population at risk for high PM exposure through educational brochures, letters to health care providers, articles in journals, social media, and community meetings. There is always more that can be done. It’s a matter of balancing all of the needs and responsibilities of the department within the time and financial resources available.”

Q: What are other causes of respiratory issues on the Mesa aside from particulate matter - do eucalyptus trees or pesticides cause any respiratory irritations?

A: According to Dr. Rick Rosen, deputy health officer, “The three most common causes of chronic cough in otherwise-healthy young people are allergies, asthma, and acid reflux.”

“Allergies and asthma can be triggered by environmental irritants, which include pollution as well as factors like pollen. In Nipomo, that pollution could include PM 10 (the type of particulate we’d expect to see from the dunes) and PM 2.5 (the type of particulate generally caused by combustion, such as car exhaust or other burning, and is also seen on the dunes).

Some people may be allergic to eucalyptus and those people could experience a cough or respiratory irritation as a result; it’s also possible some people may experience a cough or respiratory irritation after exposure to pesticides. In both cases, those would be more individual reactions rather than something we’d expect to see on a large scale. It’s important to note that an ongoing cough can also be caused by less common but very serious health concerns such as heart failure, tuberculosis or Valley Fever.”

Updated Oct. 10 to add the last question, submitted by a reader.

[This article was originally published by The Tribune.]