Rising pollution levels, rapid urban construction and a persistent tendency to manage chronic conditions like asthma at home, sometimes with the wrong tools. is putting lung health under pressure from multiple directions at once, says Dr PS Shajahan, professor and head of pulmonary medicine at Government Medical College, Kollam, in an interview with Unnikrishnan S. Edited excerpts:
Home nebulizers are becoming common. Are they necessary?
Not at all. Nebulizers are appropriate only for specific situations – patients who cannot use inhalers despite repeated training, those with severe asthma or advanced COPD, or as an emergency backup. The real danger is that a nebulizer offers temporary relief while the underlying condition quietly worsens. That false sense of security has caused patients to delay seeking care until they are critically ill. Unsupervised use is particularly dangerous in children, and has been a factor in asthma-related child deaths. There is also a hygiene risk, improperly cleaned nebulizers can harbour microbes and cause serious lung infections.
What should city residents with lung conditions know about air pollution?
Check the Air Quality Index (AQI) every day before stepping out. When it is poor, stay indoors. Cloth and surgical masks offer no real protection against fine particulate matter (PM2.5) which is the most harmful outdoor pollutant. A properly fitted N95 helps in heavily polluted environments. Indoors, avoid burning incense, candles, or mosquito coils, and use exhaust fans while cooking. One overlooked risk: exercising outdoors on high-pollution days. Deeper breathing during exercise draws more polluted air into the lungs.
Can children with asthma play sports?
Not only can they play — they should. Physical activity strengthens respiratory muscles and improves lung capacity. Many elite athletes, including Olympians, have asthma and compete at the highest level. For children prone to exercise-induced symptoms, one or two puffs of a rescue inhaler taken 15-20 minutes before activity can prevent an episode. Begin with 10-15 minutes of light movement before building intensity. Most importantly, day-to-day asthma must be well-controlled through regular medication before a child takes up any sport. During a flare-up, rest is the right call.