Air pollution: Could worsening air quality be causing more COPD flare-ups? |

Chronic obstructive pulmonary disease (COPD) refers to a long-term lung disease with symptoms such as persistent coughing, wheezing, shortness of breath, and chest tightness. COPD is associated with smoking, but also with exposure to toxic gases, dust, and even environmental pollution. COPD causes the airways to become inflamed and narrow, making it difficult to breathe over time and causing a gradual loss of lung function.
First, once a patient is diagnosed with COPD, the main treatment is to eliminate the cause of COPD. If your symptoms are caused by smoking, quitting smoking is most important. If an individual's COPD is due to environmental causes, this should be addressed through measures such as wearing protective clothing and changing the environment in which the person works or lives. However, in recent years, poor air quality has also emerged as one of the causes. We will discuss the factors that cause COPD to become more frequent and worse.

How poor air quality affects COPD

The main mode of air pollution that causes COPD flare-ups is particulate matter, PM2.5 (refers to particles smaller than 2.5 micrometers). These particles easily enter the lungs and worsen airway inflammation, stimulating more mucus production and worsening symptoms such as coughing, shortness of breath, and chest tightness. Poor air quality increases the concentration of particles, which clump in the lungs and cause underlying lung conditions. These stimuli can cause more frequent and severe flare-ups of COPD and, if left untreated, can lead to hospitalization and further damage to lung tissue.

Don't ignore the AQI index: Prolonged exposure to polluted air can increase your risk of heart attack

Poor air quality is directly linked to decreased lung function in COPD patients. Studies in various regions have consistently found that COPD patients exposed to high levels of air pollution have a faster decline in lung function than those in cleaner environments. For this reason, air quality becomes an important control factor for the disease, and patients must take active steps to reduce their exposure to pollutants.

Managing COPD flare-ups

Triggers that can cause a flare-up of the disease include respiratory infections, changes in weather, and poor air quality. Predicting these factors can aid in effective management of flare-ups. In areas with high levels of air pollution, it is critical to incorporate air quality management throughout patient care. Prompt action is important to prevent the condition from worsening and avoid life-threatening complications.
Patients should also be sure to visit their health care provider regularly to maximize their treatment plan. This means increasing or adding more medication as needed. An important aspect of COPD management includes an individualized action plan for flare-ups. This allows patients to know when to increase their medication, seek medical help, and adjust lifestyle factors to minimize triggers.

Precautions to minimize the impact of poor air quality

Apart from drug therapy, lifestyle adjustments and preventive measures can significantly minimize the impact of poor air quality on COPD patients.

• Avoid outdoor activities at dusk: Air quality is usually poor at dusk. This means that the air quality is not as good during early morning and evening hours. In this regard, patients should avoid walking or exercising outdoors during such periods to minimize exposure to air pollutants.
• Developing good indoor air quality: Ensure that your home or workplace is well ventilated to minimize the concentration of indoor pollutant particles. Staying indoors may limit your exposure to outside pollutants. However, the indoor environment must be clean and well ventilated. If you have severe COPD, investing in an air purifier can help filter harmful particulate matter inside.
• Get vaccinated: People with COPD are more susceptible to respiratory infections such as influenza and pneumonia, which can worsen symptoms and cause severe flare-ups. Influenza and pneumonia vaccinations are highly recommended for people with COPD. These vaccinations help boost immunity and reduce the chance of complications that can worsen symptoms.
• Stay informed: Informed patients can regularly monitor local air quality reports to prepare and take necessary precautions before heading out when air quality worsens. When available, apps and websites that track pollution levels can provide timely warnings about spikes in pollution.

Dr. Nimish Shah, Consultant Respiratory Medicine, Sir HN Reliance Foundation Hospitals

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