Public Health: Sharp rise of Asthma cases in India

Asthma is a chronic inflammatory disease of the airways which is triggered by allergens that cause inflammation and constricts sensitive (hyper allergic) airways making it difficult for a person to breath.

What are the reasons for asthma?

The allergens such as pollutants, dust, weather changes, pollen, mites as well as hazardous gases in indoor and outdoor air are the main reasons that make asthma a common chronic disorder in India. Asthma attack is caused when allergens or a stress factor resulting in an immune reaction that leads to inflammation (swelling) in the airways, narrowing the air passage and reducing air flow in the lungs. This results in wheezing, shortness of breath, chest tightness and coughing which may often lead to frequent hospitalisation and death.

Other triggers of asthma are overuse and misuse of antibiotics, pollen, food colour additives, obesity, smoking, poorly ventilated homes and workplaces, cold weather, exercise and stress creators like domestic violence.

What is the situation in India?

According to World Health Organisation’s ambient air pollution database, India is the home for 13 out of world’s 20 most polluted cities in India. The air present in cities like Delhi, Patna, Gwalior and Raipur are known to have tiny suspended particles (PM2.5) that are capable of causing asthma, bronchitis, heart disease, stroke and a variety of other diseases. So according to the World Health Organisation, around 15-20 million people have asthma in India.

Without any routine monitoring of air quality especially in rural areas, the effect of air pollution in rural areas is hard to be measured. It is estimated that more than 700 million especially women and children inhale smoke from the burning of wood, dung, crop residues, coal and kerosene which has carbon particles, carbon monoxide, nitrous oxides, sulphur oxides, formaldehyde and cancer-causing substances such as benzene.

What is the way forward?

Asthma being a chronic disease requires continuous medical care and appropriate treatment. Though prescriptions for asthma have been steadily increasing over the past four years, many people have frequent asthma attacks due to use of bronchodilators, inhaled corticosteroids and preventive vaccination against infections such as influenza. However, medication cannot be the only way to control asthma but it is also important to reduce air pollution in the Indian cities and rural areas. It is important to control asthma triggers that irritate and inflame the airways such as fine dust, mouldy areas, second-hand smoke etc.