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Some air pollution levels have inched up in recent years, and accumulating evidence suggests that higher levels of particulates in the air are linked with increased levels of hospitalization for many serious health problems. But we can make choices to help both the environment and our health.

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Hold off before you follow new recommendations to treat mild, persistent asthma — or at least consult your doctor first. The updated guidelines from the National Institutes of Health, published online in the December 2020 issue of The Journal of Allergy and Clinical Immunology, say it's okay for people with mild, persistent asthma to stop daily use of inhaled corticosteroids and instead use them only as needed, along with short-acting beta agonists ("rescue" medications). That's considered a major shift in guidance. But that may not be a good idea for some older adults, notes Dr. Anna Wolfson, an allergist and immunologist at Harvard-affiliated Massachusetts General Hospital. "A lot of people have a harder time with the occasional use of medications than a routine practice of daily use," she says. "And you may not want to decrease your asthma regimen during the pandemic. Poorly controlled asthma could lead to a flare or an ER visit, and perhaps an increased risk for complications if you develop COVID-19." Dr. Wolfson says there are some people who might benefit from using inhaled corticosteroids only as needed, but she urges you to speak with your doctor before changing your medication regimen.

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