Asthma, although technically a reversible condition, is no trivial illness but one that demands constant vigilance. Imagine the panic if you’re a sufferer. Your chest tightens, you struggle to catch your breath and you can’t sleep. If you live in a city where air pollution is especially bad, your daily commute to and from work is a nightmare. Or, if you avoid big cities because you’re an asthma sufferer, every time you visit one of those ‘exciting capitals’, you dread inhaling all that air pollution.
Around 300 million people worldwide are affected by asthma. Perhaps it will concentrate your mind if you know that that’s the entire population of the US. And talking of the US – the biggest economy in the world loses 56 billion dollars a year as a result of asthma if you factor in hospital treatments, sick leave and reduced productivity.
Triggers for asthma attacks
Asthma sufferers are not instantly recognisable as ‘sick’ people. Unlike the lung disease emphysema – a chronic affliction usually affecting older people who have smoked heavily – asthma is often only apparent to others when an attack strikes. Asthma attacks are brought on by certain stimuli, also known as ‘triggers’, which cause the airways of the lungs to narrow or become blocked. These vary from person to person. The ‘triggers’ can be extreme exercise, respiratory infections, exposure to dust at work or . . . yes, in some cases, air pollution.
You remember those horrible minuscule air particles, known as particulate matters (PMs) that we mentioned in previous articles? These PMs contaminate the air in dirty cities. Smog and soot emanating from cars and trucks, factories and power plants, are particularly dangerous because they are full of PMs. Busy highways are also best avoided.
These PMs get into the lungs, causing bronchitis; they can also infiltrate the bloodstream and even reach vital organs, inducing heart attacks. Unfortunately, air pollution is also particularly dangerous for people with asthma because PMs contains various immunogenic substances, such as fungal spores and pollen, which can aggravate asthma.
As populations expand, air pollution worsens
Sadly, cases of asthma are likely to increase as urban areas undergo rapid population growth and, with it, worsening air pollution. Asthma sufferers, and parents of children with asthma are entitled to resent rising air pollution. Sufferers have done nothing to ‘cause’ their illness. It was never a conscious decision to inhale dirty air.
And, unfortunately, that old ‘devil’ – ozone – is another component of air pollution that harms the respiratory system and aggravates asthma. Ozone is necessary to block out harmful ultraviolet rays from the sun but when it’s low lying or hangs just above a city, it’s very harmful. Ozone forms thanks to chemical reactions between other air pollutants, such as those emitted from industrial facilities. The more ozone you breathe, the greater the likelihood of developing respiratory conditions. (Ozone is generally thought to improve during stable weather and high-pressure systems.)
Not just a trigger but also a cause
Air pollution certainly harms those who already have asthma. But can air pollution actually trigger the onset of asthma? First, consider this. The average person breathes in 21,000 times a day. That amounts to 14,400 litres of inhaled air each day.And if you’re breathing in air pollution then you can guess the consequences.
A recent survey, carried out by experts at Utrecht University in the Netherlands, followed more than 14,000 children between the ages of 14 and 16. The study included kids from Germany, Sweden and The Netherlands. It established that those born in areas of dangerously air pollution were more likely to develop asthma than other children, especially after the age of four.
‘It is probably time to doubt no more that early life air pollution exposure is a risk factor for asthma for some children,’ said Steve Georas, a researcher at the University of Rochester Medical Center, who wrote an accompanying editorial in the Lancet.
Another study, published in the European Respiratory Journal, also studied air pollution caused by road traffic in 10 European cities. The researchers estimated that high vehicle traffic is responsible for 14 percent of asthma cases in children.
What can you do if you have asthma?
You need to reduce city triggers for asthma as much as possible. But you also need to work with your doctor to stay on top of asthma management with medication. When pollens and pollution are at their worst, you should boost your preventive medications. Try to avoid pollution hotspots like junctions, bus stations and car parks when air quality is at its worst. TIf you live in the countryside and you’ve booked a city break, check out the pollution levels there beforehand. It’s also a good idea to know when air pollution levels are likely to be worse.
Afternoons and evenings are often bad times because pollution is usually higher later in the day and it’s had a chance to build up. Rush hour is also a bad time because so many vehicles are on the road. Windless, sunny days can sometimes leave a toxic smog. During humid conditions, hot, still air means pollutants are allowed to build up. Cold days trap pollution close to the ground, causing winter smog.
Limit time spent outside or go out earlier when air quality tends to be better. Stick to back streets where air pollution is not so bad. Avoid physical activities and exercise close to main roads on days when pollution levels are high. Keep your car windows closed, especially if you’re stuck in traffic. Find out about pollution levels if you’re travelling abroad. Look after your hay fever too, if pollution makes it worse.
If your children suffer from asthma, then avoid vacuuming when they are in the room. You could also wear a mask of some kind to filter the worst of the air pollution. It’s a serious matter that demands proper attention and care. But – taking the wider view – we all need to pull together to make the air we breathe fit for consumption.