Hetal Dhruve, Specialist Respiratory Pharmacist for City and Hackney CCG, explains the problems with air pollution for asthma suffers and the things you can do make sure it doesn’t cause an asthma attack
The UK has the highest rates of asthma compared to Europe. According to data from the Office for National Statistics (ONS), 1,320 people died from asthma in 2017 in England and Wales. This is an increase of more than 25% over a decade. There is growing concern that air pollution is impacting health – especially in children.
In London, it is estimated that almost 600,000 people are living with asthma. Asthma symptoms can be triggered by air pollution, particularly traffic fumes but can be difficult to avoid. On days that the pollution levels are high, people with asthma can be left short of breath and wheezing; increasing their risk of a life-threatening asthma attack. ONS data showed that 17 children aged 14 and under died from asthma in 2017 an increase from 13 in 2016.
Air pollution contains fine particulate matter, or PM2.5, which is a cocktail of microscopic particles. As these particular are almost weightless, they can stay in the air for long periods of time and cause harm to humans who unavoidably inhale them on a regular basis. Particulate matter has been linked to asthma and death, as they can be inhaled deep into the lungs.
London has the highest levels of nitrogen dioxide (NO2) pollution of any capital city in Europe. NO2 can inflame the airways and long term exposure can affect lung function and worsen asthma. Concentrations in London have also breached legal limits. In the city of London, NO2 concentrations are well over twice the legal limits and World Health Organisation guidelines; having a huge impact on asthmatics. The Health Effects Institute (HEI) panel have concluded there is sufficient evidence to support a causal relationship between exposure to traffic-related air pollution and exacerbation of asthma.
Living or attending schools near high traffic density roads exposes children to high levels of motor air pollutants, increasing the incidence of childhood asthma and wheeze. Currently 24% of primary schools are in areas that breach the legal limit for NO2.
The mayor of London is taking urgent action to address London’s “public health crisis” and has announced several changes to motor vehicles. To read more: https://www.london.gov.uk/what-we-do/environment/pollution-and-air-quality/your-views-how-can-we-clean-our-air and https://www.healthyair.org.uk/
Adherence to preventative inhaled corticosteroids can reduce the risk of exacerbating symptoms and/or an asthma attack. If asthma is well controlled, air pollution will have less of an effect. Children and young adults with asthma however are a slightly higher risk from the effects of pollution as they have faster breathing rates. Pollution can also make other allergies, such as pollen or house dust mite worse.
Air pollution affects people with asthma differently but it is advisable that on days that pollution levels are high, to avoid areas with lots of motor traffic, especially at rush hour. Pollution levels are usually higher in the evenings, when it’s humid, still sunny or cold days and if there are high winds or atmospheric changes. Patients with asthma should stick to the back streets, keep windows closed and avoid physical activities close to main roads.
Pollution levels can be checked on https://uk-air.defra.gov.uk/forecasting/. It is also advisable to check pollution levels if travelling to another country.
I am supporting the HLP #AskAboutAsthma campaign which is seeking to raise awareness of the impact of air pollution on asthma and to encourage patients to take preventative measures.