Dr Vikas Maurya
In the last few years, there has been a surge in respiratory issues among the elderly and children. Though many factors like allergens, smoking, family history, diet, nutrition and physical inactivity are associated with respiratory issues among these vulnerable groups, air pollution, both indoor and outdoor, is also a significant risk factor for pollution-related diseases like respiratory infections, bronchitis, asthma attacks and chronic obstructive pulmonary disease. This can result in strokes and lung cancer among the elderly, and increase medication use, doctor or emergency room visits, hospital admissions and also result in premature death.
The reason why the effect is more in children is because their immune system and lungs are underdeveloped when exposure begins, resulting in impaired response to air pollution. Also, they spend more time outdoors, so exposure is high. Their breathing rate is faster than adults, and they breathe in more air per kilogramme of their body weight than adults. So, they are more exposed to air pollutants.
As we grow older, lung function decreases, and this decline is further increased with exposure to air pollution. Moreover, pre-existing diseases may determine susceptibility. Elderly people will most likely suffer from chronic diseases, and there is evidence that co-existing chronic lung, heart or circulatory conditions may worsen following exposure to environmental pollutants.
It is important to understand that respiratory issues can also affect overall health. Anxiety, depression and post-traumatic stress disorders are common in patients suffering from chronic respiratory diseases. Sleep also gets affected, which further results in stress and affects concentration, immunity and routine work. Respiratory stress can also affect vital organs like the heart.
To reduce the effect of air pollution at home, one should ensure proper ventilation and use cleaner fuels at home. Keep the house clean. Window mesh screens can filter pollutants as well as insects. Purifiers and filters can be used, especially when someone has difficulty in controlling asthma. Air purifying plants such as aloe vera can help improve air quality at home. Avoid smoking at home. Children and the elderly should exercise to build lung capacity, and consume fruits rich in vitamin C, magnesium and food rich in omega fatty acids to improve immunity.
Before stepping out, check the pollution forecast. Pollution levels vary with time. For instance, mornings and evenings during winter are worse because of smog. Avoid exercising outside when air pollution is high. Medical grade anti-pollution masks can also be used. They vary in cost, durability and in extent of their protection against particulate matter (PM) and other pollutants. There are N95 masks, Cambridge masks, totobobo masks and N99 masks. While ‘95’ means that they can filter 95 per cent of PM, starting from 0.3 to 2.5 micron, ‘99’ means they can filter 99.9 per cent of PM, from 0.3 to 2.5+ micron. P95 and P100 masks are also available, which can filter oil-based pollutants, too. While buying a mask, look for its rating, level of protection, durability, fabric quality, nose bands and presence of exhalation valve. Extreme measures like closing the schools can be taken when pollution levels are very high.
Maurya is senior consultant and head, department of pulmonology and sleep disorders, Fortis Hospital, Shalimar Bagh, New Delhi.