While pollution outdoors poses a significant health risk for people, worsening indoor air quality has also become a pressing issue that needs to be addressed. Annually almost four million deaths are attributed to indoor air pollution worldwide and in India, approximately 4-6 per cent of the national burden of disease, is attributed to indoor air pollution as the major risk factor.
Present in most enclosed spaces such as work, school, malls, restaurants and even your home, indoor air pollution can be in the form of particulate matter like soot and dust mites or gases like carbon monoxide, nitrogen oxide, and sulphur dioxide that are emitted from cooking, heating, or cleaning solutions. While poor indoor air quality can affect anyone, those with lung conditions like asthma, and Chronic Obstructive Pulmonary Disease (COPD) are more vulnerable.
Indoor air pollution and asthmatics
While over and continuous exposure to air pollutants can cause irreversible lung damage and is a risk factor for chronic inflammatory lung disorders such as COPD, it is not a direct cause of asthma. However, it does irritate the airways and cause exacerbations of asthma symptoms like coughing, wheezing, chest pain, and shortness of breath. For people with asthma, the airways of the lungs are inflamed and swollen, making them a little more sensitive when exposed to allergens, pollutants, and irritants.
Therefore, when an already vulnerable respiratory tract is exposed to triggers common in indoor air pollution, it can cause the airway to swell further, increasing the production of mucus and causing the space for air to pass freely to reduce even more. This leads to further worsening of lung function. In fact, depending on the severity of your condition, the extent of exposure, and if not controlled in time, it can exacerbate into an asthma attack where the breathing tubes narrow to the point that it becomes a life-threatening emergency which could lead to hospitalisation.
Identifying potential indoor air pollutant sources
Using biomass fuels (wood, crop waste, charcoal, coal, and dung) and kerosene while cooking is a common source of indoor air pollution in India and poses significant health risks.
Additionally, there are other sources such as smoke from tobacco or e-cigarette in enclosed spaces, fumes from chemical household cleaning products, scented candles, and air fresheners. Common household products such as dhoop, incense sticks, and mosquito coils emit higher levels of respirable particulate matter, which can accumulate over time causing respiratory illnesses and can be fatal for asthmatics.
Biological pollutants such as dust mites, mould, pollen, and infectious agents produced in stagnant water, mattresses, and carpets can all contribute to an increase in asthma symptoms.
Managing indoor pollution-related asthma triggers
While awareness and avoiding triggers as well as a continuous effort to minimise pollution levels indoors is important, consulting a doctor to control and manage your condition is critical too. In fact, since asthma triggers can change over time, putting an action plan in place in consultation with the doctor is crucial to make sure that the treatment is relevant and sufficient for your existing condition.
The prescribed treatment plan may vary depending on the severity of their condition and exposure to pollutants. However, the delivery of drugs by inhalation is an integral component in combating asthma triggers and managing the condition. Patients are prescribed different types of inhalers based on their condition:
(The writer is a consultant, pulmonologist, Aysha Hospital, Narayana Hospital, Kumaran Hospital and Dr Seshiah Diabetic Centre)
Here are a few tips to keep asthma under control in an indoor environment