Asthma, a chronic respiratory disease affecting over 262 million people worldwide, remains a major public health challenge. In India, the burden is particularly significant, accounting for around 13% of global asthma cases (34.3 million), according to the 2019 Global Burden of Disease report.
While genetics can increase a person's likelihood of developing asthma, high pollution and exposure to harmful environmental triggers can worsen the condition-and prolonged exposure early in life can significantly raise the risk of developing it.
Environmental factors that exacerbate asthma
Asthma is a chronic respiratory disease that affects the airways i.e. the tubes that carry air in and out of the lungs. In people with asthma, these airways become swollen and extra sensitive. When exposed to things like smog, dust, or smoke, the airways can tighten even more, making it harder to breathe. This can cause symptoms like coughing, wheezing, or shortness of breath, and in severe cases, may lead to asthma attacks or hospital visits. Breathing in polluted air not only worsens asthma but can also increase the risk of developing asthma, COPD, lung cancer, and long-term damage to the lungs.
Pollution, indoor and outdoor: While air pollution may not directly cause asthma, it can significantly worsen symptoms in people with the condition. Asthmatics have sensitive airways, and exposure to pollutants like smog can trigger inflammation, leading to coughing, wheezing, and breathlessness. In India, where air pollution often exceeds safe limits, the threat to respiratory health is especially serious-WHO estimates that 9 in 10 people breathe polluted air. Indoors, sources like cooking smoke, incense, mold, and dust mites, along with poor ventilation in urban homes, further add to the risk.
Extreme or fluctuating weather conditions: Rapid changes in weather - such as sudden cold spells, heatwaves, or high humidity - can significantly affect the airways, especially in individuals living with chronic respiratory diseases like asthma. These shifts can irritate the lungs, trigger inflammation, and make it harder to breathe. For example, cold, dry air can cause the airways to narrow, leading to chest tightness and wheezing, while hot and humid weather can increase the amount of allergens and pollutants in the air, worsening asthma symptoms. A phenomenon known as "thunderstorm asthma" occurs when storms break pollen grains into tiny particles that are easily inhaled deep into the lungs, leading to sudden asthma attacks-even in people with no prior asthma diagnosis. ,
Lifestyle and urbanization: Rising construction dust and roadside pollution in urban areas can trigger asthma symptoms, especially in children and the elderly. Urbanisation also brings lifestyle changes-like poor diet, inactivity, and rising obesity-that may worsen asthma. India's high tobacco use (27% of the population) and increasing e-cigarette consumption further add to respiratory risks, contributing to asthma, COPD, and chronic bronchitis.
Fundamental steps to take
With worsening air quality, individuals with asthma must take proactive steps to manage their condition.
- Consulting a doctor to identify triggers and collaborating with them on a personalized action plan is essential
- Inhalers are one of the critical parts of asthma management, delivering medication directly to the lungs to relax inflamed airways and ease breathing during pollution-induced flare-ups. Doctors may prescribe daily control inhalers, and rescue inhalers for quick relief during sudden symptoms. However, proper use, training and seeking doctor's advice are key to effectiveness.
- Additional precautions include avoiding outdoor activity on high-pollution days, wearing a mask, staying hydrated, and exercising away from busy roads.
(Dr. Swami Pawar is a Mumbai based Pulmonologist)
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