World Asthma Day: Air Pollution And Asthma
Recent research shows that India is the world’s second most polluted country after Nepal. According to these findings, air pollution in India kills people nearly four years sooner than the average life expectancy.This makes air pollution the single greatest threat to human health, claiming more lives than HIV/AIDS, alcohol, and drug abuse, unsafe water consumption, and conflict and terrorism.
The main sources of air pollution in India are industrial chimney waste, automobile exhaust, and waste from domestic burning. Added to this is the waste from agricultural activities, where farmers set fire to fields to clear them for planting. Ammonia is a common byproduct released from these fires, which is one of the most hazardous and toxic gases for human health. This crop burning practice is fairly common in the North, which increases air pollution levels in Delhi and the NCR area.
Asthma cases on the rise
Outdoor air pollution has quickly added to the number of asthmatics in India and more importantly it has increased the number that suffer from severe asthma. In this kind of asthma, symptoms can be acute and hard to control. More and more patients are now complaining that the symptoms persist for the whole day and sometimes even continue into the next day. This is a new, more aggressive form of asthma on the rise, which experts call ‘severe’ asthma.
Asthma symptoms such as coughing, wheezing, chest tightness, and difficulty in breathing, vary in intensity from person to person, but can normally be controlled with oral/injectable medicines or through inhalers. People with severe asthma, however, do not respond to these interventions and continue to have symptoms without any relief. They often require emergency medical attention and
hospitalisation, which affects their quality of life, work productivity, and interpersonal relationships. In some people, severe asthma can also be life-threatening.
Effective treatment of severe asthma
research shows that India is the world’s second most polluted country after Nepal
The number of severe asthma patients who get no relief from medicines, including steroids, is only growing. In India, this number is estimated to be as high as 1.6 lakh. Doctors are aware that we need to find a more effective treatment for people suffering from severe asthma. We may have now found some new ways to do this.
Many doctors are turning to a new form of treatment called ‘anti-IgE therapy.’ Compared to inhaled steroids that work by reducing inflammation, anti-IgE therapy prevents inflammation from developing in the first place. It does this by blocking immunoglobulin E, a protein that triggers inflammation when the body comes in contact with an allergen (such as air pollutants). Anti-IgE therapy results in a 50% reduction in the number of severe exacerbations.
Another promising treatment for severe asthma is ‘Bronchial Thermoplasty.’ It is a minimally invasive procedure that uses heat energy to reopen the narrowed lung airways by reducing the swollen muscle of the lungs. As the airways widen, it becomes easier to breathe, which lessens the severity of asthma attacks. Bronchial Thermoplasty is an outpatient procedure, performed over 3 sessions, 3 weeks apart, and provides long-lasting relief from asthma symptoms.
Just as important as our search for newer treatments is, the need to encourage patients to ‘know their trigger’ is equally important. Both asthma and severe asthma can be prevented, or at the very least their severity reduced, by staying away from things that might trigger an attack. It is true that asthma triggers vary from person-to-person, but through careful observation, patients can and must learn to identify their individual triggers and avoid them to improve overall asthma management.
Dr Arup Kumar Basu is a consultant and Head of Department (Chest Medicine) at Sir Ganga Ram Hospital, Delhi. He is also a Health Council Member at Healthhunt.