About Dr Aditya Agrawal:
Dr Aditya Agrawal is a leading Consultant Pulmonologist attached to several large hospitals in Mumbai. He is extensively trained in respiratory diseases both in India and the US. His special interests are in difficult-to-treat cough, asthma, bronchitis and lung fibrosis, and runs a specialised clinic for patients with chronic cough. He is a dedicated researcher and a peer influencer in the management of respiratory diseases.
In the months on Oct- Nov- Dec a lot of things change- monsoons recede, the winter is upon us, changing air temperature cross the country, a lot of air pollution increasing especially in the northern region due to stubble burning, and increased construction pollution which is at full bloom in the large metropolitan cities of the country.
With these changes in the air environment, the respiratory health takes a good beating.
Types of air pollution:
- Chemical air pollution
- Gaseous air pollution- includes air pollution due to ozone, nitrogen oxide, carbon monoxide and volatile organic compounds
- Particulate matter- particles in the air of varying sizes and their affect on the lungs in the short and long term
The elderly patients with pre existing medical conditions such as asthma, more prone to allergies, history of cardiovascular disease are more prone to respiratory illnesses due to changing weather and because of the changing air pollution.
As we age, the affect of air pollution on our lung health keeps worsening.
Sources of air pollution include:
- Exhaust from cars and motor vehicles
- Pollution from transportation
- Pollution form dust and construction
- Industrial waste
- Waste burning
- Stubble burning
- Domestic cooking especially with wood burning and cooking
- Gases coming from natural sources such as volcanos, landslides, etc.
- Stationary sources of pollution such as factories
- Secondary pollutants such as rain
Carbon monoxide is produced in poorly ventilated homes with lit fire places in the house.
With Diwali coming up, if you do not have a well ventilated home and you light diyas, you run a risk of accumulation of carbon monoxide at home. Ensure ventilation when lighting diyas or other items.
Volatile organic compounds are produced by items such as paints. They result in significant respiratory illnesses.
- Particulate matter that matter the most are fine particulate matter with the size of less than 2.5 micro meter. The ultra fine particulate matter are the ones that can reach the deepest corners of the lung and even be absorbed by the blood.
- The coarser particulate matter that are filtered by your nasal hair, upper respiratory tract and lung.
- Particulate matter of size 10 microns gets filtered in the upper respiratory tract
- Particulate matter of size 2.5 microns gets filtered in the lower respiratory tract
- Particulate matter of size less than 1 micrometer reaches the deepest corner of your lung called the alveoli
- The particulate matter that affect our heath the most are the ones of size 2.5 micrometer, they cause attacks of asthma, bronchiolitis, inflammation and swelling inside lungs. Particulate matter of size even smaller than 2.5 microns can cause pneumonias and impede your lung function and hence growth.
The short term health effects of air pollution include:
- Headache
- Coughing
- Respiratory infections such as pneumonia, sinusitis
- Inflammation, reddening and swelling of the breathing tubes (bronchi)- known as bronchitis
- Irritation of the skin- causing skin allergies
The long term health effects of air pollution include:
- Effects on the Central Nervous System
- It can worsen, aggravate your cardiovascular diseases
- Worsens your risk for asthma attacks, COPD attacks
- Worsening of long fibrosis
- It also shortens your life span
Children are the most vulnerable group apart from the elderly. Effects of air pollution on children:
- They can develop asthma
- Slowed down development of lung function and hence leading too growth retardation
- Developmental delays
- More wheezing and and cough- resulting in fewer days in school thus resulting in decreased scholastic activities
- Beginning of the process of atherosclerosis which is hardening of the blood vessels in the body
Effects of air pollution on adults:
- Exacerbation and worsening of asthma and COPD symptoms and attacks
- Heart disease such as blockage of arteries
- Vascular disease such as stroke
- Lung cancer
- Chronic Obstructive Pulmonary Disease (COPD) where there is permanent constriction of the tubes of breathing which results in air not allowed to come out of the lung easily.
- Early diabetes
- Acceleration in the decline in lung function
- Dementia
Effects of air pollution on pregnancy:
- Exposure to pollution results in prenatal and childhood neurological problems such as reduced brain development
- Slows down the process of development
- Can cause Attention Deficit and Hyperactivity Disorder (ADHD)
- Pregnancy associated with air pollution can result in lower birth rate and low brith rate is associated with slowed down/ delayed development of vital organs in the body
- Women that are exposed to particulate matter of size more than 2.5 microns may end up having twice the risk of having a child with autism.
- Women who are exposed to particulate matter of size 2.5 microns or more in the second and third trimester may see that the children may have high blood pressure when they grow up
Fluctuation the weather, temperature and humidity change can also affect your respiratory health.
When there is a climate change, there are warmer and shorter winters, high risk of exposure to viruses.
When you have longer and colder winters there is a higher risk of virus transmission.
Climate change is known to cause several thousand deaths due to respiratory illnesses.
There was a 160% increase in the incidents of death due to cancers of respiratory system viz-a- viz 1990.
There has been a 12% increase in deaths from lower respiratory tract infections such as pneumonia when compared to 1990.
There has been a 100% increase in the number of deaths due to COPD since 1990.
With increased humidity, there is increased risk of viral transmission, increased risk of respiratory infection.
Humidity and wind both play a role in transmission of viruses and viral illnesses which affect the lung.
Temperature Inversion: warm air rises up and cold air comes down towards the ground. During summers the warm air rises up and with it the pollutants rise up in the higher stratosphere in the atmosphere. Whereas with colder weather the air stays more towards the bottom/ closer to the ground thus trapping the pollutants close to the ground. This increases the risk of pollutant associated related respiratory diseases.
Signs and Symptoms:
- Chronic cough, cough lasting more than 8 weeks
- Wheezing- whistling sound in the chest
- Tightness of chest
- Shortness of breath
- Nasal allergies
- Runny nose
- Inflammatory lung disease
- Conjunctivitis and eye irritation
It is important to intervene early and consult a respiratory medicine physician
Preventive measures we can take:
- Maintain indoor air quality using air purifier
- Maintaining the indoor humidity level
- Be conscientious citizens- plant trees
- Check air quality index before leaving home
- Use masks
- Time your outdoor activities to a time when there is less pollution
- Quit smoking
- Exercise everyday- walking, yoga, deep breathing exercise
- Dietary modification which include anti oxidant rich foods
- Stay hydrated
