Outdoor air quality and childhood asthma: Connecting the dots
The smog crisis from October to December is driven by many factors including crop burning, vehicular traffic and industrial emissions. This can be especially harmful for vulnerable populations which includes young children and people suffering from respiratory conditions like asthma, COPD or other chronic lung diseases.
Children have developing lungs and hence are highly susceptible to the harmful effect of pollutants present in the air, which are not only in the acute stages when pollution increases but also in the long-term if pollution continues to increase persistently. Traffic-related air pollution (TRAP) contributes to 13% of asthma cases in India, and it is definitely one of the major concerns. In populations where there is use of biomass fuels, indoor air pollution also becomes a major risk factor. Exposure to pollutants in smog can lead to exacerbations, reduced lung function, and it can also lead to hospitalization in children if an asthma flare-up occurs. How does pollution affect children with asthma Air pollution is a significant asthma trigger in children. Common asthma triggers associated with air pollution include viral infections, pollen, particulate matter, smoke, dust, black soot, chemical, vehicular emissions. These triggers can irritate and inflame the airways, making breathing difficult for children with asthma. Polluted air often carries allergens like pollen and mold spores, intensifying allergic reactions in children with asthma. Further, ground-level ozone in smog, commonly found in polluted urban areas, acts as a potent respiratory irritant that can exacerbate asthma symptoms, including: , , • Shortness of breath, causing rapid and shallow breathing • Persistent cough or cough which is difficult to treat • Cough which often worsens at night • Wheezing, a high-pitched whistling sound during exhalation • Chest tightness especially in older children, feeling like pressure on the chest • Over exposure can lead to full-blown asthma attacks, requiring immediate medical attention • Fall in oxygen saturation i.e., when there is a lower-than-normal level of oxygen in the blood with breathlessness leading to hospitalization. Amid the heightened air pollution levels in the country, parents must remain vigilant about these triggers and implement specific precautions. This ensures that their children can enjoy the festive season without the fear of a flareup holding them back. In addition to this awareness, several essential strategies come into play during this period, such as: Early detection, diagnosis & medical intervention To ensure a proper asthma diagnosis, parents should observe their child's symptoms, consider the severity, frequency, and exacerbating factors. Family history is a very important contributory factor in those who develop asthma. While asthma is lifelong, early detection and treatment can effectively manage it. Parents should consult a doctor to determine the best treatment plan for their child and in fact the doctor should always be kept in the loop, especially when symptoms start to worsen rapidly, like breathlessness, trouble speaking, blue lips or drowsiness. Diagnostic tests may include lung function assessments like peak expiratory flow (PEF) or spirometry for children above age 6 to assess airflow obstruction. Newer techniques like impulse oscillometry can be used in children above the age of 3, while FeNO tests which are used to detect inflammation (usually for school-aged children), and allergen tests through skin prick or blood testing to identify potential triggers can be used in a few children who have allergic asthma. Proactive pediatric asthma management includes an asthma action plan. Collaborate with a healthcare provider to create this vital plan, comprising an emergency response for asthma symptoms. This personalized plan considers your child's lifestyle and environment, addressing specific triggers or challenges. Regular consultations with healthcare professionals ensure the plan remains up-to-date and aligned with your child's changing needs. Children who are known asthmatics should be on their regular inhalation therapies (as prescribed by their doctor) and should not miss their doses. Additional precautionary measures
Adapting Activity Levels and Prioritizing Indoor Play: Be flexible with your child's routine, especially on days with poor air quality. Emphasize indoor activities during peak pollution hours, typically midday to afternoon. Monitor air quality using apps or websites that provide reliable information. Creating an asthma-friendly environment: During winter, optimize indoor air quality, ensure proper ventilation, and minimize exposure to allergens and irritants. This can be achieved by using air purifiers, maintaining a clean and dust-free home environment, and avoiding tobacco smoke. Promoting a healthy lifestyle:
Encourage a nutritious diet rich in immune-boosting fruits and vegetables and ensure proper hydration. Stress management techniques like deep breathing exercises and mindfulness can help children cope with stress, a known asthma trigger. Maintaining proper hygiene: Regular handwashing, especially before meals and after outdoor activities, reduces the risk of respiratory infections, which can worsen asthma symptoms. Annual flu vaccinations: Ensure your child receives their annual flu shots to protect against influenza, which can exacerbate asthma and improve their overall quality of life during the winter season . By taking proactive steps and implementing a well-structured management plan, which ideally incorporates inhalation therapy as a fundamental aspect of asthma care, parents can adeptly navigate the challenges posed by pollution and winter conditions . This ensures their children's well-being and allows them to relish the unique experiences this season offers. By adopting these strategies, children can confidently face the winter season with resilience and good health. Disclaimer
: This information is only for general awareness and is not to promote, use, or endorse any product or encourage use of medicines in any way nor implied to be a substitute for professional medical advice nor for diagnosis or treatment/ cure of any medical condition. The views expressed are independent opinion based on studies from authentic sources. Your discretion may be exercised before using the information for consulting doctor. Please consult your doctor/ Registered Medical Practitioner before starting any treatment/medicine/ inhaler. This is being used only as a reference to create awareness and is NOT intended towards advertisement.
(Author: Dr. Indu Khosla, MD (Ped), DCH (Bom), Fellow in Ped Pulmonology (UK))
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