As pollen season arrived here in Atlanta, it seemed as if there were more than the usual number of respiratory illnesses that I see involving those with chronic sinusitis and other chronic respiratory problems. It also seemed that the severity of the illnesses was worse and harder to treat.
Then, some two weeks ago, the answer came. According to the American Lung Association, Atlanta’s air quality is failing. Atlanta’s grade also slips from C to F for ground-level ozone pollution, recording 5.5 unhealthy days per year compared to 1.8 days in the 2024 report, according to the report.
Of course, most of my work is done in the field of chronic sinusitis, but it should be pointed out, even though I failed to mention it in my book, The Manual for the Medical Management of Chronic Sinusitis: A Holistic Approach, air pollution is a contributing factor to chronic sinusitis. Two recent studies from both Vanderbilt and Johns Hopkins have pointed out that air pollution can cause CRS. In certain populations with sensitivity to ozone and particulate matter, mucosal damage can lead to bacterial infections. With multiple recurrences over time, these infections can become polymicrobial (multiple organisms) and develop antibiotic resistance.
Many of us knew this was coming, as we’ve watched the changes occur here in the Southeast over the decades and knew this day would come. There are multiple reasons why the air quality is getting worse in Atlanta, but one reason that does not get a lot of consideration is the dome effect of the Metro-Atlanta area. Metro-Atlanta is a big concrete/asphalt island in the middle of the state with a combined statistical area (CSA) of nearly 10,500 square miles. Over half the population of the state, 6.4 million people, live in the Atlanta area, compared to the overall state population of nearly 11.2 million people. This concentration of humanity in such a condensed area causes artificially higher temperatures, sucking in particulate matter from the surrounding areas. To put it simply, Metro Atlanta is a huge heat island in the middle of nowhere, creating the dome effect.
Of course, the solution is simple – reduce emissions. Good luck with that. In the meantime, patients need to be treated.
Over the years, I have had patients who have relocated out of the Metro-Atlanta area because of their sinus issues and have done much better sinus-wise. Mostly, they move to either coastal areas or west of the Mississippi.
Unfortunately, not everyone has the luxury of picking up and moving. Thankfully, there are several regimens for these patients who cannot pick up and move. One in particular is topical medicated sinus rinses, using a combination of antimicrobials and steroids, often with a biofilm disrupter because of the polymicrobial involvement. Lately, I’ve been assisting patients and clinicians throughout the country in using this treatment for CRS sufferers.
So, if you notice your sinus symptoms worsening and you cannot pick up and move, come by and see me. Maybe I can help.
