World COPD Day: Indoor air pollution is a major risk factor for COPD

COPD or chronic obstructive pulmonary disease is an often overlooked but serious global health threat. It is often underdiagnosed in India because spirometry, which can confirm the presence of COPD, is often not conducted during preliminary examination.

COPD is a gradually progressive disease characterized by airflow limitation. Cigarette smoking is the major etiologic factor; however, exposure to other chemical irritants also plays a role in the pathogenesis.

Indoor pollution is also one of the risk factors for COPD. Indoor air quality can be determined by outdoor or ambient air pollution, fuels for heating and cooking, tobacco smoke, second hand tobacco smoke, poorly ventilated and overcrowded living conditions.

When outdoor levels of pollutants are high, their levels also increase indoors. Poor ventilation and structural designs can trap volatile organic compounds, bioaerosols and particulate matter so, the indoor air quality can be up to 10 times worse than outdoor air pollution. In a country like India, it becomes increasingly important to address challenges associated with indoor cooking, especially in rural areas.

Lung is a major site of interaction with environmental particulates. Pollutants such as particulate matter can affect the lung in numerous ways causing inflammation, oxidative stress, and cell cycle death. Therefore, air pollution is strongly associated with the risk of COPD or aggravating pre-existing COPD triggering “exacerbation” episodes. Exposure to second-hand smoke may sometimes cause never-smokers to develop COPD.

Individuals, who have COPD should consult their doctors about need for increasing the dose of their medications. They must use a mask when they step out of the house.

Air quality in Delhi is “very poor” and this has been the case not only since the last few days, but also the past few years. It is becoming a recurring public health problem that needs urgent attention. However, air pollution is mainly man-made and since it harms human health, it is of immediate concern to all. It is not just the responsibility of the government, it is a collective responsibility.

We too can make a difference by adopting measures - at an individual level - to prevent or at least help control the air pollution levels and keep the environment healthy.

Here is what each one of us can do to make a difference and we can start right away.

• Walk or cycle for short distance commutes or to the neighborhood market.
•  Plan and combine all your errands (in one area or close by areas) for one trip.
• Limit driving and carpool.
• Use public transport, as much as possible, for longer distances.
• If you have to use your vehicle, keep it well-maintained for efficient functioning with regular servicing to reduce harmful exhaust emissions and get pollution check done as required. Follow speed limits. Avoid buying diesel vehicle.
• Avoid burning candles, dhoop or incense sticks at home or workplace.
•  Quitting smoking.
• Plant more trees.
•  Limit the areas of bare soil by growing grass to reduce the amount of dust.
• Sprinkle water on exposed soil or construction sites regularly to reduce generation of dust.
• Wet mopping the floors at home or workplace.
• Avoid organizing outdoor parties or any other events when AQI crosses 200.
• Be a strong advocate for measures to control emission of air pollutants. Be active participants in activities to fight air pollution such as odd/even vehicle rule.
• Follow all rules and laws as enforced by the state.

It’s “Never Too Early, Never Too Late”, as is the theme of the World COPD Day, falling on Wednesday, this year,

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA