World Asthma Day: Medical experts on preventive care against air pollution

According to the 2022 Global Burden of Disease study, India has 34.3 million asthma patients, which is 13.09 per cent of the global burden. The study also estimates that 70 per cent of asthma patients in India are undiagnosed (also not reported) and India accounts for over 42 per cent of all global asthma deaths. World Asthma Day, observed annually, aims to spread awareness about this respiratory condition.

"Asthma is a chronic lung disease that inflames and narrows the airways. This makes it difficult to breathe, and can cause symptoms like coughing, wheezing, shortness of breath, and chest tightness. Asthma attacks can be mild or severe, and can happen at any time. Pulmonary function tests with post-bronchodilator reversibility can help diagnose asthma in patients," explains Dr Anusha C M, consultant - respiratory medicine at Manipal Hospital, Malleshwaram.

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While asthma can be managed, a significant threat comes from air pollution. She adds, "The number of reported asthma cases has doubled in the past decade. The main culprits are environmental factors like outdoor air pollutants. All these years, most of the asthma exacerbation used to be from June to December. But lately, our OPD is filled with asthma patients, even during the summer months. The worsening AQI (air quality index) makes it even more difficult to manage these exacerbations."

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Who is at risk

"Asthma can affect all age groups, right from infancy to old age. It has a genetic predisposition, meaning you are more likely to develop asthma if any of your parents or relatives have asthma. Primary triggers include pollens, house dust mites, pets, moulds over the walls, and indoor and outdoor air pollutants," says the respiratory medicine expert.

Does air pollution increase risk of developing asthma?

Research even suggests that exposure to air pollution in early life can heighten the risk of developing asthma altogether. "Yes, exposure to air pollution, particularly in children, has been associated with a higher likelihood of developing asthma. Additionally, if you already have asthma, exposure to air pollution can exacerbate your symptoms. Particulate matter (PM), which includes small airborne particles found in haze, smoke, and dust, contributes significantly to poor air quality and poses health risks, particularly in relation to asthma. Air pollutants such as PM, nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), and volatile organic compounds (VOCs) can irritate the airways and trigger inflammation, which may contribute to the development of asthma or exacerbate existing asthma symptoms," says Dr. Vasunethra Kasargod, consultant - pulmonologist at Manipal Hospital, Bengaluru.

The impact of indoor air pollution

"Indoor air pollution significantly impacts asthma patients by exacerbating symptoms and triggering respiratory issues. Tobacco smoke, home cleansers, pet dander, mould, incense smoke, mosquito repellents, biomass fuel smoke and insufficient ventilation are some of the factors that contribute to indoor air pollution," explains Kasargod.

Prevention is the best cure

The two medical experts tell us that preventive care remains paramount in managing asthma, given its multifaceted triggers and widespread prevalence. Below, they outline measures that can be adapted by asthma patients to minimise exposure to air pollution.

Eradicating house dust mites
House dust mites (HDM) stand out as a ubiquitous allergen, pervasive in household items like bedsheets, curtains, soft toys, and carpets. Regularly soaking bedsheets in hot water before washing can effectively eradicate dust mites while removing carpets and routinely cleaning soft toys can further minimise exposure. One can also try using hypoallergenic mattress covers, pillows, and bedding that can significantly reduce your exposure to dust mites and allergens they produce, promoting better sleep and potentially fewer asthma flare-ups.

Keep pollen at bay
The second most common allergen is pollen, which gets flown away by the wind from trees and plants. One easy way to prevent this is to have a shower after you reach home and have a change of clothes - this helps to get rid of them.

Groom your pets
While pets bring joy, their dander (tiny flakes of skin) can trigger allergies. Brushing your pet regularly removes loose dander before it sheds and floats around your home. Aim for daily brushing for high-shedding breeds. Also remember to wash your pet's bedding weekly in hot water to eliminate accumulated dander.

HEPA-filtered air purifiers
These purifiers trap tiny particles that can trigger asthma, like dust mites, pollen, and pet dander. By filtering the indoor air, you can significantly reduce your exposure to these irritants and potentially lessen asthma symptoms.

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Abstaining from indoor smoking
Smoke from cigarettes, cigars, and even some forms of incense can severely irritate airways and worsen asthma. Creating a smoke-free environment at home protects your lungs and those of others around you.

Preserving adequate ventilation
Fresh air is essential. Open windows regularly, especially when cooking, cleaning, or using potentially irritating products. Proper ventilation helps remove pollutants and bring in clean air, reducing asthma triggers indoors.

Monitoring humidity levels
Mould thrives in damp environments. Keeping indoor humidity levels between 30 per cent and 50 per cent discourages mould growth. Invest in a hygrometer to measure humidity and use dehumidifiers if necessary.

Keeping an eye on air quality indices
Many areas have air quality monitoring programs. Stay informed about air quality in your area and limit outdoor activities when pollution levels are high.

Consult a doctor for your Asthma treatment plan

Consulting a doctor is crucial for proper asthma diagnosis and management. They can develop a personalised asthma action plan specific to your needs and triggers. It is also imperative to know the proper inhaler technique so your asthma can be well controlled according to Dr Anusha.

Taking your medication as directed by your doctor is essential for controlling asthma symptoms and preventing flare-ups. She proposes the usage of inhalers, "An asthma treatment plan is usually initiated in the form of inhalers. As opposed to the myth, these are completely safe, not addictive, and need not be used lifelong. Since the inhalers directly reach the lungs, they are more effective than oral medications and also have fewer side effects. These inhalers help control the blood allergy levels and control the symptoms of asthma."