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Dr Eccles discusses: Asthma and Pollution

 There is no evidence that air pollution can actually cause asthma. In fact some research in Europe shows more allergy and asthma in less polluted cities. Australia and New Zealand have the highest levels of asthma in the world despite having fairly good air quality. It is certainly true though that air pollutants can be the trigger for an asthma attack in some individuals. A study based in Birmingham showed a significant association between those living near main roads and asthma related hospital admissions of children under five. Some scientists believe that air pollutants may make the lungs more vulnerable to viruses and allergic triggers such as pollen. The environment may play an important role in the severity and onset of asthma. Both indoors and outdoors, certain chemicals and biological agents (such as mould) in the air increase the risk of having an asthma attack. Some of these contaminants may actually act as triggers for an asthma attack. Sulphur dioxide, produced when coal is burned, is particularly likely to cause wheezing if it is inhaled during exercise.


Environmental tobacco smoke (ETS), or second hand smoke, has a major impact on asthma symptoms and asthma development. ETS brings on asthma attacks and makes a person with asthma more sensitive to other asthma triggers. In addition, ETS may actually trigger the development of asthma in younger children. Adding to this danger is the fact that the risk of developing asthma is greatly increased in children whose mothers smoke during pregnancy. This is particularly alarming since children are unable to avoid exposure to cigarette smoke from adults smoking in their homes or in cars where they are passengers. A National Asthma Campaign survey has shown that cigarette smoke has been identified as capable of causing asthma attacks in 83% of people with asthma. The increasing discouragement of smoking in public places is good news for people with asthma. The airways of people with asthma vary in tightness from one day to the next, but in people with asthma who are smokers the tightness often becomes chronic and does not easily reverse. If you have asthma and you smoke, you are not only increasing the risk of an attack but are more likely to be permanently damaging your airways. Indoors, allergens produced by house dust mites, cockroaches, mould and pets trigger wheezing and other symptoms of asthma in those allergic to them. House dust mites also cause the development of asthma and there is some evidence that cockroaches may do the same. Some of these allergens are very common. For example, dust mites are found wherever common house dust is found, including bedding, upholstered furniture and carpeting. These allergens are often not only in homes, but schools as well, making it extremely difficult for children to avoid exposure. People with asthma can also be particularly sensitive to outdoor air pollution. Many common air pollutants, such as ozone, sulphur dioxide, and particulate matter (fine dust in air), irritate breathing passages and make asthma worse. Indeed, ozone, an air pollutant, has been associated with the development of asthma in children who participate in outdoor sports. In addition, exposure to ozone or to particulate matter from diesel exhaust multiplies the impact of allergies on asthma. The symptoms of asthma - wheezing, cough, and shortness of breath – can be greatly reduced by controlling environmental exposures. In several cases - environmental tobacco smoke, dust mites, cockroaches, and ozone exposure during exercise – steps to prevent exposure may even prevent asthma from developing. 
 Indoor exposure to allergens and pets has been linked to over 40% of the 4.6 million cases of doctor-diagnosed asthma among children and adolescents. If the cause of asthma in these cases is indeed these allergens, 2 million cases of asthma could be prevented – and £200 million annually - by eliminating exposure to cat, dust mite, cockroach and a common fungus called Alternaria. According to a 2003 report in the American Journal of Industrial Medicine Report, 23% of adult asthma can be attributed to workplace exposures, especially in the cleaning, farming and transportation industries. Dr. Thomas H. Gassert from the Harvard School of Public Health published a study of workers diagnosed with occupational asthma in 1998.  He and his team of researchers conclude that the prevalence of asthma is "...unfortunate because occupational asthma is a preventable disease that often becomes chronic and may disable millions of people worldwide at considerable personal and social cost". In addition to a focus on dust and moisture control, ventilation, and integrated pest management aimed at creating healthier indoor environments, families can make changes to further reduce exposure to dust and other indoor allergens. For example, use of special covers for pillows and mattresses and washing all bedding in hot water weekly can reduce asthma symptoms of children with mite allergen. While steps like special cleaning may be effective, the time and money involved adds a burden to families, particularly those struggling with poverty or other stresses. The challenge remains to find effective ways to remove these very common allergens in ways that are reasonable for affected families or to reduce the individual’s sensitivity to them (see section on Yamoa below). 
Outdoors, local, regional and national efforts are necessary to address the many varied and geographically diverse sources of pollutants that can worsen asthma. The small pieces of dust and particles of dirt in diesel fuel emissions have led to some concern in relation to their ability to worsen asthma. Nitrous oxide, from all exhaust emissions but also from domestic gas cookers and gas fires may irritate the airways making them more sensitive to other allergens or virus infection. Exciting News For Asthma sufferers Whilst many of the environmental triggers for asthma deserve serious political attention it is not likely that these will change with any rapidity. In my opinion and indeed from my clinical experience there is much to be gained by looking at ways that our susceptibility to asthma can be reduced by healthier lifestyle, better nutrition (including more fruits and vegetable intake as well as increase intake of the essential fatty acids as food in fatty fish or flaxseeds). More recently I have discovered Yamoa. I believe that one of the ways that this is having its positive effect in both asthma and hayfever is by an immune modulatory action leading to less allergic response and less inflammation in the airways. (See other sections on this website for more details and clinical experience with this product)


Article © 2004 Dr.Nyjon Eccles - reproduced with kind permission

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