Thick vog hung over much of the state for a second straight day yesterday and the health impact was evident as doctors and the American Lung Association reported more people complaining of respiratory ailments.

Even many people with no history of respiratory problems are suffering.

"We're seeing probably out of every 10 patients, seven have not had symptoms before and the other three have had a history of allergies and this is just making it worse," said Dr. Irving Harper III, a Maui physician specializing in internal medicine and allergy management.

Harper said doctors he's talked with have reported a 20 percent increase in the number of patients they've seen this week. Many of the patients complain of breathing difficulties, runny noses, irritated eyes and sore throats.

The light, variable winds were unable to blow away the particles spewing from the Big Island's Kilauea Volcano. Conditions were worst on the Big Island, but residents throughout the state saw and felt the effects of the polluted air.

But as bad as skies looked, the pollutants did not approach the level at which a health advisory would be issued, said Lisa Young, environmental health specialist with the state Department of Health's Clean Air Branch.

The department has monitoring stations on the Big Island as well as on O'ahu that measure contaminants such as sulfur dioxide. The stations also monitor the particulate matter, such as dust, in the air and none came close yesterday to the levels that trigger an advisory, Young said.

The health department issued 14 advisories for parts of the Big Island in April and one on May 1 when sulfur dioxide exceeded National Ambient Air Quality Standards. None was issued for the other islands.

WITHIN STANDARDS

Although the ambient air quality has been within federal standards this week, that came as little comfort for hundreds of sufferers.

Doctors and nurses at Straub Clinic and Hospital reported a "definite increase in respiratory issues," said Claire Tong, spokeswoman for Hawai'i Pacific Health, which operates Straub, Kapi'olani Medical Center for Women & Children and Kapi'olani Medical Center at Pali Momi.

Tong said Straub's downtown emergency room and its satellite clinics have seen more respiratory cases. Some patients, she said, blamed the bad air.

But no noticeable increases in cases were reported at the two Kapi'olani hospitals, she said.

The American Lung Association Hawai'i Chapter has been taking calls on all islands from people wondering what they can do to protect themselves and their children, said Beth-Ann Kozlovich, Lung Association development director. Kozlovich, who suffers from asthma, said many callers are saying this is the worst vog they've ever seen.

"Everyone wants to know, 'What can I do? How do I cope? What are the dangers?' " she said.

She said anyone with asthma or other lung diseases should reduce their activity, stay indoors if possible, drink plenty of liquids and avoid secondhand smoke.

Kozlovich said she's lived in Hawai'i for 15 years and can't remember suffering as much as she is now.

"I grew up in Los Angeles and I had this same kind of upper respiratory thing as a youngster, where my chest hurts and my throat hurts," she said. "I just feel like this isn't the Hawai'i that I know."

HALEAKALA OBSCURED

The vog on Maui was thick yesterday, again obscuring views of Haleakala. Dr. Harper, whose office is in Kihei, is also the medical director for three Maui resorts. He said he's seen a lot more visitors with signs of vog-related ailments.

"They're saying, 'I've been on the island for 24 to 48 hours and I've developed this sore throat, my nose is running and I have a cough that won't go away and I usually don't have allergy symptoms. Do you know if there's something that's going on?' " Harper said. "I tell them what's going on with the volcano and the lack of trade winds and the content of it being a lot of sulfur."

But Harper said the vog apparently is affecting healthy people as well as allergy sufferers. He said he's treated lifeguards and others who work outdoors.

"They're younger people, outdoor people who are usually healthy and are presenting with symptoms that you usually don't see," he said. "A lot of them are saying they just don't have the energy level that they used to have and that they're a little short of breath."

The view toward the Na Pali Coast yesterday from the Pacific Missile Range Facility on Kaua'i's West side was hazy yesterday, as if it were about to rain. But it was just the smudge of vog.

"Usually it's crystal clear," said facility spokesman Tom Clements. He said the vog in recent weeks has been the worst he has seen in his four years on Kaua'i.