Asthma And Pollution: Reducing Attacks And Improving Air Quality

Air pollution and asthma are closely linked. Asthma is a chronic respiratory disease that affects over 23 million Americans and 30 million people in India. It causes the airways to tighten and swell, making breathing difficult. Air pollution, which includes gases, chemicals, and small particles in the air, can worsen asthma symptoms and trigger asthma attacks.

People with asthma are particularly vulnerable to air pollution, and children are especially at risk. Exposure to air pollution can increase a person's risk of developing asthma, and children exposed to air pollution early in life are more likely to develop asthma.

To reduce pollution and asthma attacks, it is important to take measures to improve air quality. This includes reducing road traffic, transitioning to cleaner energy sources and vehicles, and implementing policies to reduce emissions. On a personal level, individuals can monitor air pollution levels and take precautions on days when air quality is poor, such as limiting time spent outdoors, using air conditioning, and wearing masks.

Additionally, managing asthma effectively involves avoiding triggers, taking medications, and being prepared to treat asthma episodes. This may include using inhalers, practicing breathing exercises, and maintaining a healthy lifestyle with a balanced diet and suitable exercise routines.

Wear a mask when outdoors

Wearing a mask when outdoors is a crucial preventive measure to reduce pollution-induced asthma attacks. Here are some detailed instructions and guidelines to follow:

Types of Masks:

• Cloth masks : These masks offer a lower level of protection against pollutants. They are reusable and can be washed, but their effectiveness may vary.
• Surgical/disposable masks: These masks provide a higher level of protection than cloth masks and are widely available. They are designed to be disposed of after each use.
• KN95 respirators: These are international filtering facepiece respirators that offer an even higher level of protection. They are designed to fit tightly around the face and filter out small particles.
• N95 respirators: These are the most protective masks available. They are approved by the National Institute for Occupational Safety and Health (NIOSH) and are highly effective at filtering particles and providing a secure seal.

Choosing and Wearing a Mask:

• When choosing a mask, opt for the most protective type that you can comfortably wear for extended periods. Ensure it fits well, covering your nose and mouth completely.
• Check for gaps by cupping your hands around the outside edges of the mask. A well-fitting mask will prevent air leaks, and you should feel warm air coming through the front of the mask when you breathe.
• Be mindful of facial hair, as it can interfere with the seal of respirators like the N95.
• Wear your mask consistently when outdoors, especially in crowded places or areas with high air pollution levels.

Additional Tips:

• Stay informed about air quality: Check the Air Quality Index (AQI) or use apps like EnviroFlash to receive up-to-date air quality information. This will help you plan your outdoor activities accordingly.
• Limit outdoor activities during high pollution days: On days when the AQI is above 100, it is recommended to limit outdoor activities, especially from 11 a.m. to 8 p.m.
• Practice social distancing: When outdoors, maintain a safe distance from others, especially if they are exhibiting respiratory symptoms.
• Prioritize your health: If you experience asthma symptoms, consult a doctor immediately and follow their advice. Take prescribed medications and use inhalers as directed to control asthma symptoms.

Avoid crowded places

Avoiding crowded places is a crucial step in reducing pollution-induced asthma attacks. Here are some detailed instructions to help you minimise your exposure in crowded environments:

• Workplaces: If you work in a crowded office or indoor space, ensure that the area is well-ventilated. Open windows or install air purifiers to improve air circulation and reduce the concentration of pollutants. If possible, consider working remotely or in less crowded areas to minimise your exposure to indoor air pollutants.
• Public Transport: Opt for less crowded modes of transportation, such as walking or cycling, whenever possible. If you must use public transport, try to travel during off-peak hours when the vehicles are less packed. Additionally, wear a well-fitted mask, preferably an N95/P2 mask, to protect yourself from inhaling harmful particles.
• Social Gatherings: When attending social events or gatherings, choose outdoor venues whenever possible, as they provide better ventilation. If you need to be indoors, ensure the space is adequately ventilated, with open windows or proper air filtration systems in place. If you are particularly sensitive to triggers, consider limiting your time in crowded places or wearing a mask during such events.
• Shopping Centres: Plan your shopping trips during less busy hours, such as early mornings or weekdays, to avoid peak crowds. Many shopping centres provide air quality data on their websites, so check the air quality before heading out. Wear a mask while shopping and wash your hands or use hand sanitiser after touching surfaces or handling products.
• Entertainment Venues: When visiting entertainment venues like cinemas, theatres, or concert halls, opt for less crowded showtimes or seats that are away from large crowds. If possible, choose open-air venues or those with good ventilation systems. Remember to wear your mask throughout the performance, especially when in close proximity to others.
• Schools and Educational Institutions: For students and staff, it is essential to maintain proper ventilation in classrooms and assembly areas. Open windows, use air purifiers, or install air conditioning systems to improve air quality. When possible, opt for outdoor activities or spaces with better ventilation for breaks and social interactions.

Remember, while avoiding crowded places can reduce your exposure to pollution triggers, it is also important to follow other asthma management strategies, such as using prescribed medications, practising breathing exercises, and consulting your doctor regularly.

Avoid exercising outdoors

Exercise is an important part of life, and asthma should not stop you from being active. However, exercising outdoors can sometimes trigger an episode of asthma, especially during high-pollution days. This is called exercise-induced bronchoconstriction (EIB) and is experienced by about 40% to 90% of people with asthma. It is characterized by coughing, wheezing, or shortness of breath during or after physical activity. Symptoms can be worse when the air is cold and dry, or when pollution levels and pollen counts are high.

To avoid experiencing EIB, it is recommended to limit outdoor exercise or strenuous activities when the air quality is unhealthy. You can check the air quality index online. If pollution and pollen levels are high, opt for indoor activities instead.

Additionally, warming up before exercising can help prevent EIB. Covering your nose and mouth with a scarf when exercising outdoors in cold temperatures can also help. If you have asthma, it is important to work with your healthcare provider to manage your symptoms before starting an exercise program. Follow their instructions regarding the use of inhalers and asthma medications.

If you experience asthma symptoms during physical activity, stop the activity and take your quick-relief inhaler. Consult your doctor for further advice if you regularly experience asthma symptoms triggered by exercise.

Avoid high-pollution days

If you have asthma, it's important to take precautions on high-pollution days to avoid triggering an asthma attack. Here are some detailed tips to help you avoid high-pollution days and reduce your exposure to air pollution:

Limit your time outdoors: Stay indoors as much as possible, especially during the afternoon and early evening when pollution levels tend to be higher. The hours between 11 am and 8 pm are typically the worst for air quality, so plan your activities accordingly.

Stay in well-ventilated spaces: When you are indoors, make sure the space is well-ventilated and, if possible, air-conditioned. Good ventilation helps to reduce the concentration of pollutants in the air you're breathing.

Avoid outdoor exercise: Exercise increases the amount of air you inhale, so it's best to avoid outdoor workouts on high-pollution days. Opt for indoor exercises that won't trigger your asthma.

Check the Air Quality Index (AQI): The Environmental Protection Agency's AQI report measures the levels of common air pollutants. You can access this information online or through local weather reports. When the AQI is above 100, it's considered unhealthy for people with asthma, and you may need to adjust your activities and medications.

Plan ahead: Many local weather forecasts will warn the public about upcoming high-pollution days. Use this information to plan your activities accordingly, and try to schedule any necessary outdoor activities for earlier in the day when air quality tends to be better.

Use air conditioning in your car: If you need to spend time in your car on a high-pollution day, keep the windows and vents closed, and use the air conditioning instead. This will help to reduce the amount of polluted air you breathe while driving.

By following these tips, you can help reduce your exposure to air pollution and lower the risk of triggering an asthma attack on high-pollution days.

Practice breathing exercises to increase lung capacity

Practicing breathing exercises to increase lung capacity is an effective way to reduce the impact of pollution on asthma. Lung capacity refers to the maximum amount of air your lungs can hold, and improving it can help your body use oxygen more efficiently.

Diaphragmatic/Belly Breathing

This technique is particularly helpful for people with chronic obstructive pulmonary disease (COPD). The diaphragm usually does most of the heavy lifting when it comes to breathing, but in people with COPD, it isn't as effective and could be strengthened.

Here's how to practice diaphragmatic breathing:

• Relax your shoulders and sit back or lie down.
• Place one hand on your belly and one on your chest.
• Inhale through your nose for 2 seconds, feeling the air move into your abdomen and your stomach move out. Your stomach should move more than your chest.
• Breathe out for 2 seconds through pursed lips while pressing on your abdomen.

Pursed-Lips Breathing

Pursed-lips breathing slows your breathing, reducing the work needed to keep your airways open longer. This makes it easier for the lungs to function and improves oxygen and carbon dioxide exchange.

Here's how to practice pursed-lips breathing:

• Inhale slowly through your nostrils.
• Purse your lips as if pouting or about to blow on something.
• Breathe out as slowly as possible through pursed lips. This should take at least twice as long as it did to breathe in.

Alternate Nostril Breathing

This practice comes from yoga. You inhale through one nostril while closing the other, then switch and repeat. Try to do this slowly and smoothly while staying aware of your breath.

Here's how to practice alternate nostril breathing:

• Sit comfortably and place your left hand on your knee.
• Lift your right hand to your nose, exhale, and close your right nostril with your thumb.
• Inhale through your left nostril and then close it with your fingers.
• Release the right nostril and exhale, then inhale through the right nostril and close it.
• Exhale through the left nostril.
• Repeat for up to 5 minutes and end by exhaling through the left nostril.

Additional Tips

• It takes time and practice to master these exercises. Ideally, you should practice them for about 5 to 10 minutes every day.
• Consult a doctor or respiratory therapist for guidance on using these exercises to manage asthma.
• In addition to breathing exercises, maintaining a healthy lifestyle with regular exercise and a balanced diet is important for managing asthma.

Frequently asked questions