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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. This may or may not be the final day of the Supreme Court term. We've been introducing the show like this a lot of days lately when they were official decision days for the Supreme Court, and we've been waiting for all these major rulings. Many of them have come down already. We're still waiting for their decision about the constitutionality of President Biden's student loan forgiveness program.

We're still waiting for them to pronounce on affirmative action in college admissions. We're still waiting for them to pronounce on whether businesses can deny services to gay customers because they want to. It's a decision day. We're watching the feed. We will know any minute if any of these cases come down today. Any of the rulings that don't come down today will come down tomorrow. We have Elie Mystal standing by one more time, or maybe including tomorrow, two more times. Justice correspondent for The Nation to break it down in some detail for us later in the show if we do get a major ruling today.

In the meantime, we will bring you the headlines as they break this morning if any of those Supreme Court decisions come down. Meanwhile, when I check the air quality site, AirNow.gov, at seven o'clock this morning for my New York City zip code, it was good, or the color green on the map for two of the three pollutants they track. I'll check it again momentarily for right now. Moderate bordering on what they call unhealthy for sensitive groups for the one pollutant related to wildfire smoke known as PM2.5. The map shows good air quality in green on the map, moderate pollution as a yellow area, unhealthy for sensitive groups as orange.

It goes up from there to red, purple, and maroon, as some of you know, or unhealthy, very unhealthy, and hazardous. New York City was in the maroon-colored hazardous range back on that illy, worst pollution day on June 7th. What does it all mean? How do you know if you're in a sensitive group? Is age an independent risk factor, either for children or seniors if you have no respiratory conditions? How hyper-local is the pollution? Last night, the map showed parts of Manhattan, parts of the Bronx, and parts of Queens in yellow with moderate air quality and parts in each of those three boroughs in green with good air. What? Brooklyn and Staten Island were entirely in yellow.

Are there monitors every few miles? How do you really protect yourself? At what number on the scale of 1 to 500 does say the good health habit of getting aerobic exercise become more bad for you on balance? Do air purifiers work? Does staying indoors? N95 masks if you're out? These are some of the personal health questions we're all dealing with again today. Not to lose sight of the underlying community and policy issues, global warming is making this worse and more frequent than in the past. The risks get distributed unequally, like with COVID and homelessness and everything else.

Government has a responsibility here to react as well as prevent. Dr. Dhruv Khullar is writing about this in the New Yorker. Dr. Khullar is a physician and professor of health policy and economics at Weill Cornell Medical College, as well as a contributor to The New Yorker. His latest article is called The Hazy Days of Summer. Dr. Khullar, great to have you with us again. Welcome back to WNYC.

Dr. Dhruv Khullar: Great to be with you, Brian.

Brian Lehrer: Your article is largely on personal health choices, but you also note the enormity of what we're facing now. An area of Canada has burned this year that's twice the size of New Jersey, you tell us, and 15 times as much as last year. You give us some really striking associations from studies on the effects of air pollution, everything from test scores going down to crime rates going up, to umpires making bad calls in addition to the effects on diseases. Can you give us an overview or a sampling of that?

Dr. Dhruv Khullar: That's right. This season, as you noted in Canada, is one of the worst fire seasons in the country's history. It is estimated that there's more than 15 times more Canadian land has burned this year relative to the same time last year. Just enormous amounts of land has burned in Canada this year. By their authorities' estimates up there, something like 400 or 500 fires are still burning, about half of which are considered out of control.

This situation is still evolving, and I think people can, unfortunately, expect over the course of the next few weeks and months to feel more of this as wind patterns change and some of that smoke blows down. Most New Yorkers are probably familiar with what happened a few weeks ago when we had the worst air quality in the world. Other parts of the country right now are experiencing similar levels of unhealthy air. In the Upper Midwest places like Detroit, Minneapolis, Chicago, they have had, for the past few days, unhealthy or very unhealthy air quality readings.

That affects everyone. As we've talked about, there are groups that are particularly sensitive even at lower levels of air pollution. When it gets into the levels that we've seen earlier this month in New York and currently in the Upper Midwest, that type of air pollution is dangerous for everyone.

Brian Lehrer: You wrote, "Umpires making bad calls. Good thing for the Yankees. There wasn't bad air in Oakland last night for Domingo Herman's perfect game." Why would it make umpires blow more calls?

Dr. Dhruv Khullar: This is a really important point, I think, that's sometimes overlooked. We obviously think about air pollution as dangerous for our lungs. People who have asthma, people who have emphysema, other sensitive groups, they may have a lot more trouble breathing and other health problems during these episodes. What we don't talk often about is that air pollution has actually been associated with a number of negative cognitive effects. Even in the short-term, it seems like periods during which there's very high levels of air pollution our cognitive functioning isn't quite as good as it otherwise is.

Now these are, obviously, a lot of correlational studies, so everything should be taken with a grain of salt. We do see things like violent crime going up when there's a lot of air pollution. Students' test scores seem to go down. In fact, one school district in Los Angeles installed indoor air filters in their schools, two students' test scores went up the following year. There is actually a pretty big effect of doing better air quality treatment in that way.

We also see that there's some evidence that investors who are making decisions about their money they seem to make more mistakes and have more cognitive biases when there's higher levels of air pollution. Part of that is there's a general way in which air pollution affects us, but these tiny particular matters, PM2.5, that means the particles are less than 2.5 microns in diameter. That's about 1/20th the width of a human hair. You can imagine how small that is. That can get into our lungs, but also into our bloodstreams and also into our brains. There's all sorts of respiratory, cardiovascular, but also cognitive effects that this type of pollution can have.

Brian Lehrer: The anxiety, you actually open your article with what a uniquely alarming sensation it is to believe the air around you isn't fit to breathe. Do you have any advice for listeners dealing with feelings of alarm?

Dr. Dhruv Khullar: That's right. It is something-- I note that there's nothing more basic or fundamental to life than breathing, than respiration. Feeling like you can't even breathe the air around you, that's an alarming sensation. It's something that a lot of people in the Western United States have been dealing with for the past few years, and increasingly we're dealing with it here in the Northeast as well. There are things that we can do to try to protect ourselves. There's some studies that have found that N95 masks-- I know that a lot of listeners are probably sick of masks after the past three years with the pandemic. N95s, they're tight fitting, they do filter out a lot of the pollution.

If you're going outside on a particularly hazy day, a good idea to have an N95. Obviously staying inside is better than going outside on these particularly polluted days. There's also work that suggests that indoor air quality can go down when there's this type of wildfire smoke. It's not like you're totally safe when you're sitting inside. It is important, of course, to close doors, to close windows. Newer types of construction that are better sealed off from the elements that's probably better. Increasingly, it seems that we really need to focus on indoor air quality, air purifiers, air filtration systems, they do seem to be helpful in improving that indoor air quality.

Brian Lehrer: Listeners, your call is welcome for New Yorker contributor and Cornell Weill Medicine and Health Policy physician Dr. Dhruv Khullar on how to understand and what to do in different air quality zones. 212-433-WNYC, 212-433- 9692. Listeners, with a little bit of whiplash, as another health effect from the way we may go back and forth here a little bit between air quality and the Supreme Court, we have the affirmative action ruling in from the Supreme Court.

Talk about things that may cause some of you anxiety and health effects, the Supreme Court has struck down both of the affirmative action programs that they were looking at in two separate cases that they're ruling on together, one from the University of North Carolina and one from Harvard. In both cases, the court has ruled that their affirmative action policies, meaning the way they take race into account in college admissions, violate the Equal Protection Clause of the 14th Amendment. That's all we have so far.

We'll give you more as it comes in. As I mentioned at the very top, we have Elie Mystal, justice correspondent for The Nation, standing by to read the decision in some detail before we just try to add a little bit of improv around facts we don't quite know yet to do some analysis. We do have this from Amy Howe at SCOTUSblog, which covers the Supreme Court moment to moment. "The decision is incredibly thick, so I am still reading it," she writes, "but on first blush, the court appears to hold that the Harvard and UNC programs violate the constitution." That's what we know so far, and apparently, it's specifically the 14th Amendment's Equal Protection Clause.

We are reading, my producers are reading, Ellie Mystal is reading, and we'll keep letting you know what we know when we know it. Meanwhile, let's continue to talk about the air quality with Dr. Dhruv Khullar from Cornell Weil and a contributor to the New Yorker. Can I just say one other thing about the psychological effects of this, which you brought up in the article?

Dr. Dhruv Khullar: Sure.

Brian Lehrer: For me, it's partly a feeling of being trapped. I love to get outside and exercise, usually a run, basically every day after work. My body craves it after the show and all this sedentary thinking that I have to do for my job. I'm like, "The sun is out, what do you mean I can't go for my run?" It's alarming, the word you use, but also trapping, but that's just me. Are you seeing-- do you want to say anything about that?

Dr. Dhruv Khullar: Yes. It's really one of the cruel aspects of this type of air pollution is that it is safer on these days not to do aerobic activity outside. Some of the air quality does change over the course of the day as you mentioned at the beginning. This morning, it was a little bit better than it is now. Hopefully, by the end of the day or tomorrow, it'll be better again. Part of what people might consider is thinking about just trying to find windows when the air quality seems to be better than not.

Of course, different people are more or less sensitive, so a moderate rating might not be of tremendous concern to someone who's otherwise healthy, but someone who does have underlying medical conditions might want to be a little more careful during those times.

Brian Lehrer: Yes. Are you seeing in your practice or at the hospital actual breathing problem visits or other related conditions more than usual this summer?

Dr. Dhruv Khullar: Certainly, a few weeks ago when the air quality was really pronounced and poor, there was an uptick in asthma hospitalizations and ER visits, as well as those for emphysema across the city. That was something that we saw. There's a pretty tight correlation, actually, between air quality and the level of respiratory emergency department visits and hospitalizations that's been found for years. We're still learning a lot about wildfire smoke, in particular. People may or may not know that over the past one or two decades, wildfire smoke has become an increasingly important part of air pollution in the United States and around the world and that's in part due to climate change and hotter and drier conditions.

In some states in, actually, the Western part of the country, wildfire smoke now accounts for almost as much, if not more, sometimes, of air pollution than do fossil fuels, and so it's really becoming an increasingly prominent part of the air pollution story.

Brian Lehrer: Let's take a phone call from Mike in Flatbush. Mike, you're on WNYC with Dr. Dhruv Khullar. I know you're calling about your baby, and your baby just made their radio debut. Hi, Mike.

Mike: Thank you, Brian. Hi. The walk in the park is really important to our day. I'm wondering if the doctor has any idea about what an AQI that we should maybe say it's a go or it's a no because, and then stringing days together is going to be-- yes, a couple of weeks ago was very, very tough for me and I'm sure a lot of other people, and just this one respect is babies and feeling trapped. I'm also wondering about the measure used or the study if doctor can talk a little bit more about investors making worse or better decisions, is that from an ROI perspective? That seems to be ironic because kind of the way that we got here in the first place. I'm wondering--

Brian Lehrer: What's ROI, Mike?

Mike: Return on investment.

Brian Lehrer: Right.

Mike: Is that better or worse? If you're in the fossil fuel game and you have a better investment, it's actually worse for all of us because you're accumulating capital.

Brian Lehrer: Yes. I don't think Dr. Khullar is talking about bias toward fossil fuels. I think he's just talking about your judgment goes cloudy. Dr. Khullar, he's got two really important questions there. One, don't call your broker until July 6th, or more importantly, what about his 10-month-old?

Dr. Dhruv Khullar: Yes, first of all, Mike, congratulations on the baby. I don't want people to come away from this as "don't ever go outside, don't do the things that you enjoy." It's something to be increasingly aware of. For a lot of people, being outside, taking a walk in the evening, going for a stroll with your baby, that's an important part of people's days, and that's also something that contributes to people's health and well-being.

The other thing to note is that a lot of the effects that we attribute to air pollution, many of them happen over the course of months and years and so, certainly, chronic exposure to high levels of air pollution is problematic and has been linked to all sorts of things. Even short-term exposure is linked to problems for people with certain types of conditions. It's not as if going for a stroll one day where the air pollution is high is going to have long-lasting and permanent damaging effects for people. I don't want people to come away from this thinking that they have to stay inside all day.

That being said, young babies, children, even teenagers, they are particularly at high risk for the effects of air pollution. That's true also of many older individuals as well. I would think about monitoring the air quality index in your area pretty closely when we're having these types of events. For most people, an air quality index under 100 is not particularly dangerous. I think if you have a young child, maybe when the air quality index rises above that level, certainly above 150, maybe think twice about going for that stroll, do it the next day or do it another time of the day, maybe when the air quality index has improved.

Brian Lehrer: You're saying over a hundred or so because people are looking, and if you're-- to talk about the different ages you just mentioned or age ranges, if you're a seven-year-old otherwise healthy, or a seven-month-old otherwise healthy, or a 70-year-old otherwise healthy, when should you stay indoors or not exert too much if you're out? Is there a number?

Dr. Dhruv Khullar: Again, it varies by person. I think above 100, 125 it's an important number to think about maybe cutting back. Certainly, above 150, we think about it as pretty much unhealthy for most groups. Above 100, it's considered unhealthy for sensitive groups, and so if you're a young child, certainly a baby, older adults, anyone with heart or lung disease, probably limit outdoor activities, certainly strenuous activity outdoors, and try to avoid it. I think if you're in a sensitive group, above 100 is a number to think about. If you're otherwise healthy, probably 150 is more where we start to think of some of these damaging effects.

Brian Lehrer: I know somebody who's very conservative, over 50, once it goes from good to moderate, who never paid attention to the AQI until what started to happen earlier this month. I heard on Morning Edition today that even without the wildfires, even without what's different this summer, the air quality index in New York City is usually in the moderate range, that's 50 to 100, in the summer. Why is that?

Dr. Dhruv Khullar: There's, of course, all sorts of other reasons that we have for air quality that have nothing to do with the wildfires. Just the level of traffic in a city can do that. The level of industrial activity in an area. New York does have relatively good air quality actually compared to many other large cities in the US even and around the world. If you think about a place like New Delhi, which has the worst air quality in the world, they are routinely dealing with levels of 100, 150, 200, and some cities around the world, and that really does take a toll on people's health in terms of life expectancy and premature death.

As I said, wildfire smoke is just one part of the air pollution story. There are other types of pollutants, and there's other reasons for those pollutants that also need attention, but this summer, I think, has put the idea of air pollution, both indoor air quality and outdoor air quality on a lot of people's minds.

Brian Lehrer: Here's a little more as we suffer from whiplash, again, is our condition of this morning, in addition to whatever else you may have, whiplash as we go back and forth from this air quality discussion to the news coming out of the Supreme Court. Little more on them striking down the Harvard and University of North Carolina affirmative action programs. Chief Justice Roberts writes, "However well-intentioned and implemented in good faith, they fail each of these criteria." Those are criteria centrally involving the 14th Amendment Equal Protection Clause.

Again, we're going to get you more details as we continue to read through what are being described as these very thick decisions. We do have this from sometimes guest on the show, legal scholar Steve Vladeck from the University of Texas. He writes, "Critically, it does not end all race-based affirmative action, but it severely limits how universities can consider race in admissions decisions."

Again, we have Elie Mystal, Justice Correspondent for The Nation, reading through these thick decisions as quickly as he can, and he's going to come on later in the show, but the headline is, the Supreme Court has struck down, at least as they are implemented now, the University of North Carolina and Harvard affirmative action programs for admissions. Okay, back to the air quality. Here's Dah in Manhattan, who I think picked up on Dr. Khullar the fact that you mentioned in your article, and we said it, that crime rates go up during times of high air pollution. Hi, Dah, you're on WNYC.

Dah: Great, great, thank you. Our social justice crisis is fueled by a lot of anecdotal, I'd say, myths about Giuliani time and more jails resulting in lower crime. Since the '90s, crime has collapsed almost universally. We're down to 300--

Brian Lehrer: Dah, do you have a question about air pollution?

Dah: Yes. My question is, have you done any work on the removal of leaded gasoline, and how it correlates with crime, and why it is essentially the same theory that you're proposing then?

Brian Lehrer: Interesting. Have you ever looked at that, Dr. Khullar, the removal of lead from gasoline?

Dr. Dhruv Khullar: I have not. I've not personally seen any high-quality work on that. It's not to say that it doesn't exist, but I'm not familiar with it. I do think the broader question is around the ways in which the environment and the areas in which we live, how they affect things like cognitive functioning, executive control, our ability to be the best versions of ourselves. We know that even things like higher temperatures seem to be correlated with worsening crime. Here we're seeing that things like bad air pollution increase the level of crime.

That I think has to do with the fact that our environment does affect the way that we think. It affects things like irritability, restlessness, anger. All these things are influenced by the environment around us. I think that's part of what we see here with this correlation between air pollution and higher crime.

Brian Lehrer: I did note in your article in The New Yorker, and for skeptics who think environmental laws work to protect health but at the cost of harming the economy, you cite a 2020 report on the economic effects of the Clean Air Act, which goes all the way back to the 1970s, that puts it in the plus category by trillions of dollars. Do you get why that would be?

Dr. Dhruv Khullar: That's right. This 2020 report that came out found that the Clean Air Act which was passed back in 1970, and people forget that under even a Republican administration, Nixon did a lot of work in the environmental realm. It found that that legislation because it cleaned up the air quality and other forms of pollution in the United States, it saved something like 380,000 lives in the US and still has nearly $4 trillion in economic benefits.

Part of that has to do with the productivity of workers, people who are sick, who are ailing, who are absent, obviously, who passed away, aren't able to be productive in the economy, and so a large chunk of that has to do with the productivity benefits of having people in a cleaner and healthier environment.

Brian Lehrer: We have a lot of interesting personal safety questions for air conditions like these coming in. Warren in Somerset, I see you. Debbie in Montclair. Sally in Weehawken, and others as we continue with Dr. Dhruv Khullar, physician and contributor to The New Yorker. Stay with us.

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Brian Lehrer: Brian Lehrer on WNYC, as we continue with Dr. Dhruv Khullar, Cornell Weill physician and health policy and economics professor, as well as a contributor to The New Yorker where he has written a new article called The Hazy Days of Summer. I just checked the AQI again, Dr. Khullar was talking earlier about 100 as being some kind of a cut-off point around which some people may change your behavior. That's also where the air quality index maps take it from what they call moderate to what they call dangerous for sensitive groups. Well, it was at 95 for our area when I checked it at seven o'clock this morning, now it's up to 115. Dr. Khullar, as you said before, it can vary within the course of the day.

Dr. Dhruv Khullar: That's right. It can vary the course of the day as well as in different parts of the city as well. We do see changes depending on wind patterns, the density of certain neighborhoods, elevation, how buildings are constructed, how near to one another they are. All these things can influence the microclimate over the course of the day or over the set of a city, and influence how much we are taking in to our lungs.

Brian Lehrer: By the way, here's a little more from the Supreme Court's opinion striking down affirmative action policies for admissions at the University of North Carolina and at Harvard. Here's a little nuance from the end of the court's opinion. It does say, "Nothing in this opinion should be construed as prohibiting universities from considering an applicant's discussion of how race affected his or her life, be it through discrimination, inspiration, or otherwise, but universities may not simply establish through application essays or other means the regime we hold unlawful today."

There's a little bit of nuance in there. As we go, we'll continue to pick through the decision and figure out, and Elie Mystal, justice correspondent for The Nation will come on and analyze what it actually means that UNC or Harvard or any other school can do in terms of looking for diverse freshman classes as we go along this morning. Warren in Somerset, you're on WNYC with Dr. Khullar. Hi, Warren.

Warren: Hi, and thank you. Is the breathing in of these particles a cumulative problem, or do our lungs clear them out?

Dr. Dhruv Khullar: That's a great question. Both things are partially true. It is a cumulative problem in the sense that the dose matters and the length of the exposure matters as well. Someone who has one or two days or a few weeks of bad air quality compared to someone who months and years is breathing in poor air quality, that makes a big difference. Our lungs also can recover from injuries. Even if you think about something like smoking cigarettes, there's really good research that suggests that people who stopped smoking cigarettes, their lungs start to recover and repair themselves over the course of years and decades. It is the case that cumulative exposure really matters, but also that our lungs and our bodies have the ability to repair themselves.

Brian Lehrer: Debbie in Montclair, you're on WNYC. Hi, Debbie.

Debbie: Hi, how are you? I wondered if the speaker could-- KN95s and N95s, their particulate mass. Could the speaker talk a little bit about ozone since that's a gas? Then I just wanted to point out to folks that there are a great resource across New York State network of Pediatric Environmental Health Clinics called NYSCHECK, and also on the national level, Pediatric Environmental Health Services Units. They're really a great resource that really focuses on these kinds-- a lot of different environmental health problems. To the question of what's the right respirator when you're talking about ozone?

Dr. Dhruv Khullar: It's a great question.

Brian Lehrer: Yes, respirator meaning masks. Like N95s, and is it different for ground-level ozone, which is common in the summer, but it was not the issue right now than for the particles from the fires?

Dr. Dhruv Khullar: Yes. Ozone is a different type of pollutant compared to the PM2.5 that we've been talking about. Obviously, people often think about the ozone layer around the world, but the ground-level ozone forms when nitrogen reacts with other compounds, particularly in hot temperatures and sunlight, and so it's usually worse in the summer. It has a lot of similar damaging effects to our tissue, particularly in the respiratory tract, as does PM2.5 pollution. People might experience coughing, chest tightness, worsening of asthma if they have those things.

It is important to limit exposure to the extent that you can as well. Generally, the best mask are the N95 or the KN95. It's not going to completely eliminate your exposure, of course, but that's the best that we can do when faced with high levels of air pollution, staying inside, limiting outdoor activity, wearing masks, staying away from other areas where we feel like there's-- or at least the website tells us that there is high levels of air pollution.

Brian Lehrer: I want to take a call next from Ethel in Manhattan, who I think is going to relate a health experience that she had back on June 7th, that science fiction orange sky day, when we could even feel the smoke indoors in some of our homes. Ethel in Manhattan, you're on WNYC. Hi, Ethel.

Ethel: Thank you, Brian. Hello, Dr. Khullar. Yes, I felt I couldn't-- I was panicking because I thought, "When is this going to end before I can get some help?" I noticed that my cognitive abilities were also diminishing. I couldn't remember anything, and usually, I am quite good at that. I even considered putting the shower in the bathroom, perhaps to get some more oxygen there. Anyway, I did end up in the hospital and they found everything was fine and they discharged me. At the time I--

Brian Lehrer: Do you think you were in the hospital for anxiety then or for breathing problems or something else?

Ethel: For cognitive problems and also the fact that I do have COPD. Tomorrow is my 95th birthday. I think because of my age I went. That's why I thought it'd be best to have me checked. I hope I didn't overdo their resources by having gone. Anyway, it was good that I went.

Brian Lehrer: I want every Brian Lehrer Show listener to sing happy birthday at some time tomorrow for Ethel in Manhattan when she turns 95. Dr. Khullar.

Ethel: Thank you very much.

Dr. Dhruv Khullar: Yes. Ethel, thanks for your call. Happy birthday. I'm glad that you're feeling better. It does speak to the effects that this type of air pollution can have both cognitively and on the respiratory system for people who are older and other people with chronic medical conditions. It is good if you are feeling unwell, either not thinking clearly or having difficulty breathing in any way, having chest pain, chest tightness, all those things. It is really important to get checked out if that occurs.

Brian Lehrer: By the way, a little more whiplash. Here's one line from Justice Sotomayor's dissent in the Supreme Court ruling, striking down the affirmative action and admissions programs at Harvard and UNC. Sotomayor writes, "In so holding, the court cements a superficial rule of color blindness as a constitutional principle in an endemically segregated society." Again, more on that coming up. Sally in Weehawken here on WNYC with Dr. Khullar. Hi, Sally.

Sally: Hi. I just had a quick question regarding some older buildings that are pre-war. Obviously, they won't be maybe as insulated as the newer buildings and regarding window ACs. Does a window AC, is it better to run it, not run it? What is the protection there? Does he know?

Dr. Dhruv Khullar: Yes. It's a really important point. Even newer buildings can have issues with outdoor air infiltrating them and creating hazardous quality air inside. Particularly true for older buildings, and so, in general, it is important to have an air filtration system of some sort so people can run their air conditioners, but not ones that bring air in from the outside. Increasingly, people are turning to things like indoor air sensors, which can help us understand exactly what level of air quality we're breathing when we are inside.

There's a lot of HEPA filters that actually are not that expensive. Some air filters are as cheap as $20, $30. Some are more expensive. Those types of things can help us feel a little bit more confident that the air that we're breathing when we're inside our homes is of a higher quality.

Brian Lehrer: Get an air purifier if you can?

Dr. Dhruv Khullar: Yes. Absolutely.

Brian Lehrer: For indoors. I mentioned inequality in the intro, and once again, the essential workers, and we know who they are, don't have the luxury of staying home on bad air days. You wrote that even in wealthy neighborhoods where there is newer construction, indoor air quality deteriorates considerably during fire season. For people who can get air purifiers, what do you recommend?

Dr. Dhruv Khullar: Yes, again, it's one of those things where not even-- these air filters are often not even that expensive. It's just important to have an air filter. There's many different brands that are out there. I saw that there's some that are rated. There's many services like Wirecutter and others that are rating these air filters and showing people what the pros and cons of each type are. I think the more important thing is to understand what type of air filtration system your apartment or your home currently has. Then if it doesn't have something, then investing in one of these. As I said, many of them are not terribly expensive either.

Brian Lehrer: If even the indoor air is affected, that's really unsettling. Do you have data on how that tends to run compared to outdoors? If it's 115 AQI around New York City right now, which is the last reading I saw, what's it likely to be in my apartment?

Dr. Dhruv Khullar: Yes, it's tremendously variable depending on the home, the construction, the insulation, whether doors and windows have been opened or closed, and so on. In some cases, in some people's homes, it might be half of what it is outside or a third. In some people with very high good air filtration systems, it might be a tenth. It might be much, much less than inside. As I mentioned, some of these air sensors people are starting to invest in can give you a sense of that. The level of indoor air quality might vary tremendously between two different buildings.

Brian Lehrer: By the way, did you get to answer the earlier caller's question about window air conditioners? Good for this. Only if you have the recirculate function where you're only recirculating the air from indoors, or what would you say about window air conditioners?

Dr. Dhruv Khullar: Yes, exactly. If it's bringing in air from the outside, then no. If it's only recirculating the air from the inside, then yes, it's good.

Brian Lehrer: Cars often have that option too, right?

Dr. Dhruv Khullar: Right, exactly.

Brian Lehrer: For a car air conditioner, you can usually see a button there that's for recirculating. There's a graphic, for example, that just looks like air going around in a circle. Use that one, right?

Dr. Dhruv Khullar: Right. That's exactly right.

Brian Lehrer: I know you're not a meteorologist or a weather map expert, but you know that I'm wondering why the maps sometimes show a pretty hyper-local variation, neighborhood to neighborhood even. I can't figure out how closely spaced the monitors are from looking at the main website, AirNow.gov. We have this text coming in from a listener on Long Island who writes, "I'm glad you're talking about this. I've been wondering for a long time why Nassau County doesn't have any air quality monitors listed on AirNow.gov.

Suffolk County was named the county with the worst air quality in New York, approximately five years ago. It only makes sense if you realize some counties have no monitors and therefore no data. Like I say, I know you're not a meteorologist or an expert on these maps, but any input, especially for that listener, and do you think there are really no air quality monitors feeding that system in all of Nassau County?

Dr. Dhruv Khullar: Yes, it's hard to say. It'd be hard to believe that that's the case. I was just pulling up stuff, and I wasn't able to find the air quality. I'm actually not sure. It might be good to ask your local representative why that's the case. Yes.

Brian Lehrer: Right. In fact, a listener writes, "I emailed my local representative about this early this month but he never replied." It looks to my eye like there are no air monitors in Manhattan, South of Harlem. Washington Heights, yes. Harlem, yes, but nothing Lower Down in Manhattan, if I'm even looking at it right. Listeners, maybe we have a meteorologist in the audience. John David or SallyAnn Mosey from NY1, are you out there today? Mr. G or anyone else who might answer those questions? 212-433-WNYC, 212-433-9692. We are running out of time, but let me get one more call in here for Dr. Khullar. Robin in Manhattan, you're on WNYC. Hello.

Robin: Hello. I have a question about how all of this then articulates with humidity. Also, if I can lodge a complaint, WNYC does a beautiful job giving us weather, but never humidity. If it's 80 degrees and 30% humidity, that's one thing. If it's 80 degrees and 80% humidity, that's something different, and then you add the AQI. I'm just wondering how those three factors overlap and what we can know about risks and whatnot.

Brian Lehrer: Thank you. We do tend to give the humidity when it's very high and contributes to the heat index, which is usually temperature plus humidity conglomeration, or when it suggests the chance of rain or snow. We are these days, as I think you were indicating, giving the AQI in the weather forecast a lot. The question, Dr. Khullar, from the listener is, how do all three interact with each other?

Dr. Dhruv Khullar: Yes. Humidity can actually trap some of the air pollution and prevent it from dispersing. When humidity is really high, pollutants can stick to the water droplets and make it harder for it to move out of the area. It can be particularly dangerous. It might be another time where you think a little bit more deeply about whether you're going to go outside and the extent to which you're going to be exposing yourself to pollution. It's a really important question.

For people who-- I know we're experiencing a heatwave in the southern United States right now. That combination of heat, humidity, and pollution really is a challenging combination and makes all these things that we're talking about worse, particularly, again, for people who are at higher risk, but all of us might feel like we're dragging a little bit more when those three things combine in a dangerous way.

Brian Lehrer: Dr. Dhruv Khullar, a physician and Professor of Health Policy and Economics at Weill Cornell Medical College as well as a contributor at The New Yorker. His latest article there is called The Hazy Days of Summer. Thanks for so much information and help. We appreciate it a lot.

Dr. Dhruv Khullar: Thanks very much.

 

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