If you are struggling with a persistent cough, air pollution could be affecting your lungs

Think about a cough, and you’re likely to think of a cold or allergies. And the occasional cough is usually nothing more serious than that. However, with pollution levels rising in Indian cities, experts warn that a chronic cough could be a sign of more serious respiratory conditions.

When a cough persists beyond three weeks, it’s time to see a doctor. While a persistent cough can be caused by several things, doctors warn that asthma and chronic obstructive pulmonary disease (COPD), especially chronic bronchitis, are on the rise. “Nowadays there is an increase of wheezy bronchitis, where people develop a very chronic, spasmodic cough,” says Dr Krishna Kumar, Senior ENT Specialist, Apollo Hospital.

Often, he adds, most people associate respiratory illnesses like bronchitis with wheezing or noisy indrawing of breath. However, these could also present with a chronic cough, which many people do not take seriously enough.

Air pollution is now recognised to be one of the top global killers across the world, and particularly in developing countries like India. The lion’s share of attention towards this problem has generally gone to the National Capital Region and other parts of North India, where pollution levels reach truly alarming levels during the winter. However, that doesn’t mean south India can rest easy, as several reports show that multiple cities here are also struggling with unhealthy levels of pollution.

COPD and chronic bronchitis

COPD is an umbrella term that refers to a group of conditions such as emphysema and chronic bronchitis, where exposure to irritants damages the airways and lungs, resulting in insufficient oxygen for the body.

Bronchitis usually occurs in the acute form, as a result of the cold virus, when the bronchial lining also gets infected. In such cases, there is no option but to let the illness run its course, with medications to manage the inflammation and reduce fever. In some cases, patients may also need to use an inhaler with medication to open up the bronchial passages and ease breathing difficulties.

However, with long-term exposure to irritants and pollutants, a more long-lasting form of bronchitis can occur, with a persistent cough presenting as a major symptom. This condition can have flare-ups, where the coughing increases, and the patient throws up thick, dark mucus and suffers from shortness of breath and fatigue.

While this condition is commonly known as smoker’s disease, the number of cases among non-smokers is on the rise. One of the main factors blamed for this rise is the growing levels of air pollution across India.

Asthma and air pollution

Asthma shares several common symptoms with chronic bronchitis, as it too involves chronic inflammation of the airways, resulting in a chronic cough, breathing difficulties and wheezing. However, the mechanism by which the inflammation occurs differs, meaning that the treatment process also follows different lines. One key indicator of asthma is that symptoms often get worse at night or early in the morning.

While evidence about the ways in which asthma gets worsened by air pollution has been mounting for some time, in recent years studies have also demonstrated links between air pollution and the onset of asthma in children and adults.

Dr Krishna Kumar, Senior ENT Specialist, Apollo Hospital

One of the major shifts in thinking about nasal and sinus conditions, asthma and bronchitis, says Dr Krishna Kumar, is the concept of United Airway Disease. “Earlier, the upper respiratory tract from the nose to the larynx was treated as one thing, and the lower respiratory tract till the lungs as another. But the new understanding is that it is one continuous airway from the tip of the nose to lungs.”

What this means in practical terms is that doctors now recognise the importance of treating nasal conditions at the same time as lung conditions like asthma and allergic bronchitis. Managing these treatments to avoid the side-effects of medications like steroids is also a factor to be considered.

What you can do to take care of yourself:

While air pollution is a problem of global proportions, there are a few things one can do to protect oneself from illnesses caused by pollution:

· Check pollution forecasts and avoid going outside during periods of high pollution.

· Try to avoid areas with high pollution like busy arterial roads, especially if you are exercising. Also try planning your commutes to avoid arterial roads or places with high traffic density.

· Get a quality anti-pollution mask. This doesn’t include the thin surgical-style masks most commonly seen on the streets, as these don’t filter the most hazardous particulate matter. And getting a proper fit on the mask is just as important as buying a high quality mask.  

· Go green with cleaning products. While much focus has come on outdoor air pollution, it’s also important to keep track of the kind of chemicals we’re exposed to inside the home, and avoid them as far as possible.

· Invest in a good indoor air purifier.

· Grow houseplants, as these also go a long way in helping to keep the air in your home clean and pure.

This article has been produced by TNM Marquee in association with Apollo Hospitals and not by TNM Editorial.