California has done more than any other state to address and try to reverse air pollution.
But even as the American Lung Association acknowledges that effort, in its 2017 State Of The Air report, the organization lists eight California cities in the top 10 of the nation's most polluted.
San Diego ranks seventh in the nation for high ozone pollution levels. According to the lung association, inhaling ozone may affect the heart and lungs. El Centro ranks seventh in the nation for year-round particle pollution.
But pollution is not exclusive to California's air and neither are breathing problems.
Both external and internal factors are causing many people to struggle to breathe.
Dr. Kevin Glynn talks about these factors in his book, "Gasping For Air: How Breathing Is Killing Us And What We Can Do About It."
Glynn, a retired senior physician with Scripps Health in La Jolla, joined Midday Edition on Wednesday to discuss how these external and internal factors are causing respiratory issues.
This is KPBS Midday Edition I am Maureen Cavanaugh. California has done more than any other state to address and try to reverse air pollution but even as the American lung Association acknowledges that effort it lists eight out of 10 of its most polluted cities in the US right here in California. But pollution is not exclusive to California's air and neither are breathing problems. Apparently external and internal factors are making many of us struggle to breathe joining me is Dr. Kevin Glenn senior physician with Scripps health in La Jolla and author of Gasping for Air, How Breathing is Killing Us and what we can do about it. Welcome. Thank you for having me. Let's talk about asthma to the breathing problem I know have been a part of your life, how much of the rates of asthma been increasing? Asthma has only been a growth industry during the times I was in practice and roughly 10% of people suffer from asthma and that is on the rise. The causes are expected, while the really unknown, but suspected to be related to better or earlier diagnosis and maybe something in our environment or desks or chemicals or toxins. You have had asthma, two of your children have asthma and to her grandchildren, is there a genetic component? Absolutely come the Glenn family proves that in there probably 100 different genes involved because asthma is accommodated disorder. Many of the people who have the genetic tendency may not have asthma unless exposed to the right triggers. You say some people develop asthma and some do not is still a mystery? We know the genetics and we know there is an environmental factor and when they come together the person has symptoms. And we know things, for example, rural dwellers have less asthma than urban dwellers and this is led to the focus that urban dust, crowding, excretions or something like that may be responsible. That is an area of investigation. The title of your book states breathing is killing us, why? Why is it so hard for many of us to brief? Things outside of us like resins of infections, viruses, fungal or bacterial infections and then there are the things we do to ourselves every year. We introduce new toxins into the environment because of industry, we burn a lot of fossil fuels which creates dust, nitrogen dioxide particles, and of course tobacco smoke is the biggie. You talk about the many infectious diseases that target the respiratory system. They have been among the worst plagues the world is ever known aren't they? They still are and if I was talking the other night with some friends of mind, we tend not to take tuberculosis seriously middle-class America but it is the biggest killer in the world, one and a half million people will die this year from TB. And here in San Diego in fact we have more than our share of TB because of the cross-border connection, 35 or 40% of the cases of TB we see here in San Diego come because of people who live in Tijuana, work in San Diego or vice versa. You mentioned a moment ago that tobacco is a major cause of lung elements, the percentage of people who smoke in the US has gone down. Have we therefore seen a corresponding decrease in smoking-related breathing problems? I am thinking of things like COPD. We are starting to see it. The trouble is it takes 20 or 25 years of inhaling tobacco smoke for the damage to be done to the lungs. If everybody in the United States quit smoking today we would not see the COPD and lung cancer disappear for 20 years. So we are still experiencing the tale of that and of course smoking is on the increase globally because the tobacco companies are not selling as much in the way of cigarettes here in the US and so they concentrate on selling them abroad. And now they are concentrating on getting people to use nicotine in the form of vaping. And that is too early the to know the verdict on that. The pro side of it is it helps people to stop tobacco smoking and the bad side is we do not know yet what it will do. It was invented 2000 It was invented 2003. Even people who struggle not breathing during the day or do not struggle at daytime it can be having a problem at night like sleep apnea. About us like when the tongue falls back and instructs the throat or the internal diameter of the throat is small and obstructs, that does not by itself have anything to do with external factors or air pollution. But certainly any kind of inflammation and the upper airway will aggravate it. When we talk about trying to control sleep apnea the main objective is to help keep the airways open either with mechanical devices, weight loss, or in extreme cases some surgical procedure. You have seen the treatment for asthma and particular and other breathing disorders really improve over the course of your life and career. Yes. What are some of the things we can do now by the breathing challenges we face? Tobacco smoke is controllable. The second thing is the public health, trying to control the creation of air pollution but burning fossil fuels and if we could bring that under control it would reduce the rates of asthma, it would reduce the rates of COPD, we would save hundreds of thousands of lives around the globe. It must be very satisfying to you that there has been such an advancement made in the treatment specifically of asthma. I mentioned this in the book as well and in fact in the closing chapter I talk about having watched one of my grandsons play soccer. He has asthma and he takes the inhalers, neither of his parents smoke they live in Portland and I was up there watching and he was having a great time, he could dribble the ball and pass it back and forth and he scored a couple of goals, it doesn't really intrude on his life at all. That is to generation. And my children who are in their 40s and 50s lead normal lives, they run marathons and work out and do triathlons, that touch better treatment than I had in the 1940s. It leads me to be very optimistic and realize today is better than yesterday and tomorrow can be better than today. I have been speaking with Dr. Kevin Glenn senior physician with Scripps health and author of Gasping for Air, How Breathing is Killing Us and What We Can Do About It. Thanks for being here. Be sure to watch KPBS evening addition at five and again at 6:30 PM, join us again tomorrow for KPBS Midday Edition at noon and if you ever miss a show check out the midday addition podcast through KPBS.org/podcast . I am Maureen Cavanaugh , thank you for listening.
