Do you think you can cope with air pollution just because your test reports are healthy? Persistent exposure to toxic air can cause inflammation inside airways even when scans and routine tests look normal, says Delhi pulmonologist Dr. G. C. Khilnani.
Dr. G. C. Khilnani, Chairman of the PSRI Institute of Pulmonary, Critical Care & Sleep Medicine has seen a rise in two kinds of patients coming to him. One set includes young people without any previous history of respiratory illness, asthma or bronchitis who are increasingly complaining of persistent cough and throat irritation. Even when they do not have asthma, bronchitis or any known lung disease, their symptoms persist.
On clinical examination of many otherwise healthy patients, Dr Khilnani says the results often come normal. However, on measuring airway inflammation using fractional exhaled nitric oxide testing, levels are unusually high during pollution episodes, confirming inflammation inside the airways even when scans and routine tests look normal. Antibiotics have no benefit in pollution related cough or breathlessness. The illness is driven by toxic air causing inflammation, not bacteria, making antibiotic use ineffective and unnecessary.
The second type of patients he sees are those with asthma, chronic lung disease or heart disease who are reaching emergency rooms. They require more nebulisation, higher oxygen support and closer monitoring as polluted air sharply increases breathing difficulty and cardiac stress.
Also, younger children and elderly are the worst affected, suffering more from smog as their lungs cope poorly with polluted air. Delhi children have 30% incidence of asthma compared to 5-10% in the rest of the Indian population.
Dr Khilnani has this advice for people when it comes to taking precautions.
- His first suggestion is to encourage people to stay at home to the extent possible during high pollution days. Avoid crowded places.
- People with asthma, heart disease and the elderly should avoid early morning walks when smog is densest. That time the pollutants are at the breathable level. Walking outdoors is safer later in the day, when sunlight helps pollutants rise higher in the atmosphere.
- If stepping out is unavoidable, wearing a well-fitted N95 or N99 mask is essential. Ordinary masks won’t help in preventing harmful effects of air pollution.
- Air purifiers can help if used correctly. Dr Khilnani told ANI they must run continuously, rooms should remain closed, and filters need regular replacement. When used properly, they can significantly reduce PM2.5 levels indoors.