Asthma cases rise during winter season - Who is at higher risk and how pollution is making it worse?

Winter season has arrived and with it, multiple health issues are also appearing. Cold, flu and other respiratory illnesses dominate in the cold season, and a majority of people also struggle with asthma flare-ups.

WION spoke to experts to understand the main reason behind the rising cases of asthma during the winter season and also understand who is at higher risk.

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Dr Vikram Jaggi (MD, DNB), who is a founder and director ofAsthma Chest Allergy Centrein Delhi and Gurgaon weighed in on the same. He said that ranging from mould, dampness and dust mites to exposure to chest infections as well as cold and flu viruses, winter comes with quite a few asthma triggers, with cold air itself being a common trigger.

He said that in some cases, cold air leads to the production of histamine in the airways which can "instigate allergy-related irritations causing symptoms in asthmatics to worsen".

Dr Jaggi also mentioned that the issue, in fact, can also lead to an attack and newer cases of weather-induced asthma. He stated that cold and flu viruses run rampant during winter, and most people may just seem like a passing malady — for asthmatics it could "result in that infection developing into pneumonia".

Who is at higher risk?

Dr Jaggi noted that children and the elderly are perhaps the most vulnerable during this time of year. Children are more susceptible to common colds and infections during this time of year, while any exacerbated symptoms in older asthmatics lead to an aggravated condition. Dr Jaggi urged the two mentioned groups to be careful during the winter season and if they are asthmatics, they should pay special attention.

Dr (Brig) Ashok K Rajput (Retd), from the department of pulmonology at theCK Birla Hospital (R)in Delhi, also registered what Dr Jaggi said. Dr Rajput stated that kids and older people are more at risk, especially those having underlying obstructive airway disease of in fact any chronic respiratory illness.

"Smog and fog add fuel to the fire," said Dr Rajput, further adding that airway mucus thickens, increasing the chance of getting respiratory infections like the common cold or flu. These infections lead to exacerbations and trigger asthma symptoms.

Pointing out the air pollution, Dr Rajput said that smoking, pollution due to wood burning, campfires etc all make air quality poor and worsen asthma symptoms.

Dr Puneet Khanna, the HOD pulmonology department at the HCMCT Manipal Hospital in Dwarka highlighted how air pollution is leading to respiratory issues.

Dr Khanna said that an Air Quality Index (AQI) in the range of 50 to 100 leads to increased inflammatory response and difficulty in breathing for patients sensitive to respiratory diseases. An AQI of above 300 poses problems for healthy people as well.

Air pollution has a massive impact on the health of people. it is a known fact that the combined effects of outdoor and household air pollution cause millions of premature deaths every year resulting from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer, and acute respiratory infections. Dr Khanna stated that "from smoke inside the home to smog hanging over cities, air pollution is a major threat to health and climate".

'Avoid early morning outdoor walks'

Dr Rajput suggested that early morning outdoor walks and exercises are not good for asthmatics and should be avoided. Dr Khanna also urged that early morning walks are not advisable as pollution levels are highest in the morning, and merely walking could result in health complications due to the high concentration of particulate matter.

A word to parents

Dr Jaggi said that parents should keep a close eye on their children to understand their triggers and communicate them to their doctor. "Since asthma tends to worsen with age, the elderly should be careful and adhere to inhalation therapy as prescribed by their doctor," Dr Jaggi said.

He also said that taking the mentioned precautionary measure may help them reduce unexpected triggers and control their symptoms over time, both during and after winters.

He also noted that both groups should have an action plan in place in consultation with their doctor, an inhaler as per their doctor’s recommendation.

The current situation in New Delhi

Dr Puneet Khanna explained the current situation of the Indian national capital, New Delhi, where the air was unbreathable in the past few weeks.

Dr Khanna said that the national capital is witnessing a significant deterioration of air quality over the past few days which has coincided with the spike in asthma cases.

Every year bad air quality in Delhi accounts for more than a 20 per cent rise in asthma cases across outpatient departments (OPDs) in the city. It is also responsible for asthma-related IPD admissions across the city.

He said that environmental air pollution is one of the most important social determinants of health. The inner linings of the lungs are damaged by air pollution thereby increasing the severity of asthma infection.

While commenting on the asthma risks, he said that "low temperatures and increased air pollution lead to the suspension of particulate matter for a longer duration which increases the transmission of respiratory viruses including corona, making people more vulnerable to infections".

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