Jillian Capodice, LAc discusses the importance of air quality and Traditional Oriental Medicine in relation to environmental health.

by  Jillian L. Capodice, LAc

Background

Air is a mixture of odorless gasses that surrounds the entire earth and helps to protect all living things.  The primary gasses in air include nitrogen, oxygen, argon, carbon dioxide, water vapor and trace amounts of other gasses.  Air is measured and characterized by its physical properties including pressure, density, mass and thickness.  For humans and all other living things, air is important as it protects us from harmful solar radiation, protects the surface of the earth, and allows all living things to carry out basic metabolic activities.  In short, good air quality is extremely important for health and maintenance of our daily lives and the earth’s many functions.

However, many things can negatively affect the air quality of both our environment and our indoor spaces.  With regard to the environment, the Agency for Toxic Substances and Disease Registry breaks down the most common air pollutants into six categories:

1.  Gaseous pollutants:   are mixes of vapors and air that found both outdoors and indoors.  These are frequently produced from man-made sources, volcanoes, fires and industry.  The most common gaseous pollutants are carbon dioxide, carbon monoxide, hydrocarbons, nitrogen oxides, sulfur oxides and ozone.

2.  The greenhouse effect: The greenhouse effect causes heat to be trapped on the earth’s surface, not able to rise out of the atmosphere.  This results in warming on the surface of the earth and is thought to be the general cause of global warming.

3.  Acid rain:  the interaction of gases including nitrogen oxide and sulfur dioxide with water vapor to form acid rain.

4.  Damage to the ozone layer:  Destruction of an oxygen-based layer in the upper atmosphere of the earth that acts to protect ultraviolet sun rays from reaching the earth.  Destruction to the ozone layer is thought to be caused by chlorofluorocarbons.

5. Particulate Matter:  a general term for solid and liquid particles found in the air.

6. Climactic effects: weather patterns that may impede circulation and movement of potential pollutants

Knowing that these pollutants can adversely affect our air quality the focus of this article will to briefly discuss how air quality can affect health, how Traditional Chinese Medicine characterizes respiration and lung function, and a quick synopsis of common TCM modalities and practical tips that you can use for yourself and your patients in the home, office, and outdoors to cleanse your air quality.

How air pollution can affect health

The Agency for Toxic Substances and Disease also recognizes and grades air quality according to the Air Quality Index.  This index is the tool that is used by the Environmental Protection Agency and helps to rate air quality on air pollution levels and whether it can pose a health concern.  Currently, the most common causes of poor air quality include smoke from large fires, other natural disasters and industrial pollutants.  

The level of risk to any person related to air quality is also closely related to these factors:

            a. The amount of air pollution

            b. The amount of air we breathe

            c. General health

So for example, on a poor air quality day, it would be better to spend less time outside then to go for a 3 mile jog.  Moreover, if one has preexisting lung conditions such as asthma, chronic obstructive pulmonary disease or cardiovascular conditions, when high levels of air pollution are present, it is important for these people to spend reduced time outside or even to consider wearing face protection.  Finally regardless of preexisting conditions, babies, children and the elderly are particularly susceptible to the potential negative effects of air pollution.

Sites that provide excellent information about National and Local Air Quality include:

  1.  The United States Environmental Protection Agency: www.epa.gov
  2. State Department of Health Sites:  Accessible via the Centers for Disease Control and Prevention website’s interactive Indoor Air Quality State Map:  http://www.cdc.gov/nceh/airpollution/indoor_air.htm

Health Conditions Related to Poor Air Quality

Various health conditions related to lung and cardiac function have been related to adverse air quality conditions with asthma at the top of the list.  Asthma, a syndrome characterized by airflow obstruction and inflammation in the airways can lead to reduced airflow, wheezing and dyspnea.  It currently thought that environmental factors especially those experience early in life may along with genetic predisposition, increase the likelihood of asthma. Other diseases that may be exacerbated by air pollution include cardiovascular disease, diabetes, cystic fibrosis and chronic obstructive pulmonary disease.

Traditional Chinese Medicine

 In Traditional Chinese Medicine (TCM) the importance of breathing clean air and having qi properly circulate around the body is imperative.  The five phases that categorize various organs, tissues, and senses in relation to physiologic activity, pathologic change, and medical properties distinctly relates the lung to breathing and respiration.  Of the five phases, the lung organ will be most influenced by air and air quality since the lung “thrives by purity and governs down bearing.” 

Another important aspect of lung function according to TCM is zong qi that gathers in the chest at CV 17 and ascends to the trachea to move respiration.  Finally TCM also recognizes wei qi (defensive qi) which is necessary in order to defend the body against evils.  As all factors including our general health will contribute to lung functioning and the governing of qi, the basic TCM tenet related to air quality, proper circulation and health are driven by the function and health of the lungs and circulation of qi throughout the body.

Acupuncture

Acupuncture meridian indications and point indications are commonly used with regard to treatment of disorders and regional areas.  For the lung, chest and treatment of conditions related to breathing and the lungs, regional points in the chest that will treat the chest and include CV 17 and related Foot Yang Ming points that cross the chest.  The hand tai yin channel and the other yin channels of the had can work to treat the lung, throat and general chest region disorders.

Specific point groupings have also been traditionally used to affect various conditions.  For example, yuan source points are effective in treatment of diseases in the five visceral as well as help to determine patterns in affected meridians. 

Examples of commonly used points include:

  • LU-9:  Rectifies lung qi
  • UB 11-13:  Diffuse the lunge, relieve cough, calm dyspnea
  • CV 22 and CV 17:  Diffuse the lung and transform phlegm
  • PC-4:  Loosen the chest, rectify qi

Recent related research:  Recent research demonstrated that acupuncture may help to increase expiratory lung volume in subjects with asthma. 

  • Ngai SP et al Effect of Acu-TENS on post-exercise expiratory lung volume in subjects with asthma-A randomized controlled trial. Respir Physiol Neurobiol. 2009 Jul 31;167(3):348-53. Epub 2009 Jun 18. This study demonstrated that transcutaneous electrical nerve stimulation over acupuncture points LU 7 and Ding Chuan (EX B-1) prior to a treadmill test demonstrated that those that received the therapy.


Herbal Medicine

While increasing lung capacity and function spans a broad category, there are a number of traditional formulas and single herbs that have been customarily used in the past for a variety of symptoms related to the lungs.  These include:

Single herbs

  • Huang Qi, Astragalus membranaceus: traditionally used to treat common cold and other respiratory infections.
  • Shu di huang, Rhemmania:  traditionally used to nourish the blood and yin
  • Mai men dong, Ophiopogonis japonica:  traditionally used to down bear qi, nourish yin and increase fluids

Formulas

  • Yu ping feng san (Jade Windscreen):  a classic formula that acts to nourish wei qi and build resistance to external pathogenic invasions.
  • Ding chuan san (Clear air):  a traditional formula that acts to clear heat from the lungs, resolve phlegm and calm wheezing.
  • Xie bai san (Draining the white):  A classic formula to increase lung function, reduce difficult phlegm and moisten fluids.

Cupping

Cupping therapy, the application of glass or bamboo cups to the skin that creates pressure in the cup and draws the skin and superficial connective tissue into the cup is a common and old practice in TOM.  It is commonly used for a variety of respiratory symptoms including couching, wheezing and reduction of phlegm.  Cupping is commonly done on the back and the UB meridian points are often used for the respiratory symptoms.  Commonly used acupuncture points that may be cupped on the front of the body include: CV 17, CV 22, LU 1, and LU 2.

http://www.mindbodyandspirit.com.au/services/images/cupping2.jpg

 Qi Gong

Qi gong, an ancient practice of balancing internal energy via movement and breathing is excellent for maintaining good health with particular regard to breathing and expanding the chest.  There are many studies of qi gong and internal and external forms can be utilized to strengthen the qi and improve lung function.  Examples of common types of qi gong that can help to strengthen lung function include:

  • The Ba Duan Jin (Eight Pieces of Brocade): that helps to cultivate qi and activate the inner organs
  • Meridian based qi gong:  to open specific meridians
  • Nei gong:  internal forms of qi gong aimed at strengthening the internal organs and body

Recent Related Research:   Recent research demonstrates that Tai Chi Chuan may improve the pulmonary function in asthmatic children.   Tai Chi Chuan is another internal martial art that also acts to balance internal energies of the body.

  1. A recent study published in the Journal of J Microbiology, Immunology and Infection Infect. 41(1):88-95, 2008 demonstrated that children with asthma scored better on pulmonary function tests  after completing a 12 week program of Tai Chi Chuan.

Suggestions to monitor air quality in your home or office

Assessments:

  •  Assess stuffiness in the home with regard to stale smells and the amount of time cooking odors linger
  • Check for visible mold growth
  • Assess smells of fumes, oils and gasses
  • Check family members for signs of symptoms they may experience while in the house such as:
    • Dizziness and headaches
    • Difficulty breathing
    • Itchy or watering eyes
    • Headaches and nasal/sinus congestion
  • Asses construction projects in your home or in close proximity to your home/apartment/office
  • Practical tips to improve air quality:
    Reduce obvious pollutants in your home or office
  • Household products
  • Smoke (including fireplaces, cigarette/cigar, incense)
  • Old building materials

Ventilate the home

  • Exhaust stoves and clean stoves properly
  • Open windows for fresh air when possible
  • Utilize air filters if needed

Buy some green plants:  plants absorb carbon dioxide and turn it into oxygen as well as help to absorb common pollutants.  However note that certain house plants can be toxic to dogs, cats, children and other pets so check carefully before you purchase one!

  • For TOM practitioners: while moxibustion therapy is useful for a variety of conditions,  make sure your patients are not allergic to the smoke that comes from moxibustion, use smokeless moxa and be sure to ventilate properly after using moxibustion in your office.


References

Harrison’s Principles of Internal Medicine. 17th Edition, McGraw Hill.

The Yellow Emperor’s Classic of Medicine:  A new translation of the Neijing su wen with commentary.  Ni Maoshing (Ed), 1995; Shambhala Press, Massachusetts.

The Centers for Disease Control and Prevention website viewed at:  http://www.cdc.gov/.  October 16, 2009

The United States Environmental Protection Agency website viewed at: http://www.epa.gov/. October 20, 2009


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