The late-summer rise of ragweed once constituted Larry Marshall's allergy season.
Twelve years after moving to the West Coast from New York, Marshall knows his allergies and related asthma could flare up anytime, anywhere.
"I sometimes have more problems indoors than outdoors," says the 69-year-old Ashland resident. "Windows and doors are closed."
While wintertime means most plants aren't producing pollen, common microbes such as mold and dust mites remain just as active. And these pollutants are harder to avoid when cold weather keeps more people indoors.
"The winter ones sneak up on people," says Dr. Kent DeYarman, who operates a Medford allergy and asthma clinic. "They're not real obvious like the pollen.
"Christmas trees (don't) help matters."
Aromas from evergreen foliage, odors from cooking, fumes from cleaning agents — even the scents of perfume and cologne at holiday parties — can trigger "smoldering background allergies," says DeYarman. Pet dander and naturally occurring molds in potted plants add irritants to indoor air circulated through forced-air heating systems. Chronic breathing difficulties can turn dangerous in conjunction with viral and bacterial infections, which are more prevalent during cold months.
Respiratory infections are the most common cause of hospitalization for asthmatics, says Dr. Kevin Parks of the Asthma and Allergy Center of Southern Oregon. About 14 percent of Oregon asthmatics were admitted to hospitals in 2007, which cost $28 million, says Parks. About 9 percent of Oregonians — slightly higher than the national average — are believed to have asthma, says Parks, adding that asthma coincides with allergies in the majority of patients.
From 2000 to 2006, the rate of asthma-related hospitalizations in Jackson, Josephine and Klamath counties were statistically higher than the statewide average, according to data compiled by Oregon Department of Human Services. Parks and DeYarman attribute the trend largely to rural geographies and poorer economies, which create barriers to medical care.
"It's rare that we can't control asthma," says Parks, citing detailed patient plans for medication and modifying activities.
Outdoor air quality can severely compromise the health of asthmatics or sufferers of other lung diseases. Jackson County's air was deemed "unhealthy" for these "sensitive groups" on six days in 2009, according to the Environmental Protection Agency's AirNow website. Also in 2009, Josephine County recorded two unhealthy days, and Klamath County logged eight.
"Many people who have asthma may experience triggers, such as wood smoke, cold air, the inversion," says Parks.
The Biscuit Fire of 2002 heavily contributed to Jackson County's worst annual air quality within a 10-year period tracked by the government. Twenty-one days in 2002 were unhealthy for sensitive groups. Air quality over the next five years ranged from one to five unhealthy days annually. Josephine County posted its worst air-quality record of the past decade in 2008, when five days were classified unhealthy for sensitive groups.
Air in Douglas County, by contrast, was never deemed unhealthy between 2000 and 2009, according to EPA records. Yet hospitalization rates of asthmatics also exceeded the statewide average in the primarily rural county between 2000 and 2006, DHS reports.
Also rural, Klamath County's agricultural economy generates its own air-quality concerns, says Parks, who operates a clinic there. Many more patients are exposed to airborne soil particles, heavy-equipment fumes and burning material, including wood used to heat homes, compared with patients in Medford, Ashland and Grants Pass, he says.
Government data supports those observations. Klamath County averaged 13 unhealthy air days annually between 2003 and 2009 while Jackson County averaged four days during that period, Josephine just over one day.
And Klamath County's air wasn't just unhealthy for sensitive groups in 2002. Of 36 days, approximately 10 posed a health risk to the general population with at least one day dubbed "very unhealthy." The statistic also points to that year's rampant wildfires, which burned for months across much of Southern Oregon.
Summer's wildfire season, however, isn't the time of unhealthiest air locally. Jackson County's poorest air quality over the past five years was in November, Klamath's in December and January, according to the EPA. Both the Rogue Valley and Klamath Basin are known for winter inversion layers that can trap smoke and other pollutants in the air for days.
Even clean, fresh air can be problematic in winter. Because asthmatics' breathing often worsens in cold, dry conditions, doctors recommend precautions for exercising outdoors during the colder months. The simplest solution is to warm up indoors and, if the workout moves outside, wear a thin scarf over the mouth and nose. Air temperatures as mild as 50 degrees can cause airways to spasm, says Parks.
"We see the most problems when people start to exercise in that cold air."
Doctors encourage asthmatics to exercise. Escaping outside also can provide relief from indoor irritants, as Marshall attests. But anyone with breathing difficulties should check the local air-quality index, says DeYarman, and adjust plans for exercising outdoors accordingly. See www.deq.state.or.us/aqi/index.aspx.
And remember that burning in open barrels, wood stoves and fireplaces affects the air everyone breathes. Check Jackson County's wood-burning advisory, updated daily, at www.jacksoncounty.org.