Are we taking care of our lungs enough? Things to know

'Healthy Lungs. Healthy Life’ was the theme of this year’s World Lung Day. The Day (September 25) was observed under the aegis of the Forum of International Respiratory Societies (FIRS), a collective of various bodies engaged in the research of lung disease treatment. Asthma, Chronic Obstructive Pulmonary Disease (COPD), lung cancer, tuberculosis, pneumonia, and Interstitial lung disease (ILD), causing inflammation and scarring in the interstitium, have been claiming countless lives. Many more people continue to battle with these diseases. 

The significance of the lungs is being widely discussed these days, and the COVID-19 pandemic has also highlighted this aspect. Still, have we accorded the issue the due seriousness it deserves? Not at all. That is precisely where the relevance of World Lung Day lies. From hereditary factors to environmental problems and allergies to infections, the causes of lung diseases are varied. A mere glance at the lung-related health issues will reveal our criminal negligence in caring for our lungs.

Asthma
This is a major health issue affecting people of all age groups worldwide. Anyone, irrespective of race or sex, is susceptible to this disease at any time. As per statistics, around 30 million people are struggling with Asthma, which has an annual death toll of around four lakhs. Many more millions are left to live with a cough and breathlessness. The social and health hazards posed by Asthma are not small. It can be said that around three to five per cent of India’s population has Asthma. According to the World Health Organisation statistics, India accounts for 22 per cent of Asthma deaths globally. Although relatively easy to treat, the fact is that it is not properly controlled in the majority of Asthma patients.  Factors such as dust, pollen grains and climate change could make Asthma worse.

Among the safest and most effective treatments available today is the inhaler treatment, which directly delivers medicine in small quantities to the trachea. Ironically, it is also the most misinterpreted treatment method. Many people are under the impression that very heavy dose medicines are administered through the inhaler, and once started, they can never be given up, and hence, it should be used as a last resort. The complications created by such misunderstandings are severe, as they pave the way for Asthma to become even more complicated. An inhaler is not a panacea or a miracle cure. Making society aware that regular tablets for Asthma and injectable drugs are being administered through inhalers is critical in effectively managing asthma. Asthma can be controlled by adopting proper treatment at the appropriate time. 

Long-term breathlessness or OCPD
OCPD, which ranks third for causing deaths across the globe, still exists as a neglected disease. As per statistics, about 13% of deaths in India and 6% in Kerala are due to OPCD. These statistics should not be overlooked. Smoking is the primary trigger for this disease. Constant exposure to smoke in congested kitchens with limited air circulation, dust and chemical particles at workplaces, a lack of exercise, and hereditary factors also play a significant role in the disease. Quit smoking completely. Avoid passive smoking and also avoid dusty and smoky atmospheres as much as possible. Don’t ignore lung-related diseases during childhood. Give proper treatment. Intermittent cough and breathlessness could be the early signs of OPCD. Undertake treatment and resistance measures at the very outset.

Tuberculosis
The bacterium Mycobacterium tuberculosis causes tuberculosis (TB). Though the disease can affect any organs, the lungs are the primary victim. Bacteria causing TB entering the body alone does not make one a patient. The pathogen that causes TB has the capacity to remain dormant in the human body. According to studies, one-third of the world’s population has such a dormant pathogen. 

When this bacteria turn active, it marks the start of the disease. Advanced age, a lack of nutritious food, diabetes, and other diseases that weaken the immune system are among the many reasons that turn bacteria active. Intermittent fever, cough, exhaustion, weight loss, and chest pain are the main symptoms. At times, blood stain is also found in phlegm.

Even today, TB is entirely curable. Rifampin, isoniazid, pyrazinamide and ethambutol are the major drugs. A complete cure requires treatment of six to eight months. Drugs are available for free from both government and private hospitals. Usually, symptoms will subside and the patient will recover within four weeks of starting the treatment. Often, many stop treatment at this stage, and this is one of the main reasons for the failure of the treatment. Patients are given medicines under direct surveillance as part of the National Tuberculosis Elimination Programme (NTEP). 

Lung cancer
This disease ranks first among the reasons for deaths due to cancer. Lung cancer claims more lives than the total number of deaths due to cancer afflicting the breast, the large intestine and the prostate. Smoking is the main reason for lung cancer. Smoke from cigarettes and bidis contains many carcinogens that can cause cancer. In addition, it also contains quasi carcinogens and components causing damage to nucleic lysergic acid. Smoke exhaled by a smoker is also problematic. Exposure to passive smoking makes even those who have never smoked prone to cancer. In one way or another, about 80-90 per cent of lung cancer is related to smoking. Mine and quarry workers, those handling asbestos, nickel, chromium, and arsenic, are also found to be more prone to lung cancer. 

Natural radon radiation and genetic reasons can also cause cancer. Very rarely, cancer cells may form on the dried patches left by TB. Pneumonia ranks first among the causes of death due to infection. Around 25 lakh deaths are reported a year. According to statistics, one person succumbs to pneumonia every 13 seconds. A child dies due to pneumonia every 50 seconds. India accounts for about 20% of the total deaths. Yet, it required the onset of COVID to realise the risk posed by pneumonia. 

As for Interstitial lung disease (ILD), which causes inflammation and impairs the lungs, likely, society may not even be aware of it. Several factors contribute to the aforementioned lung diseases. Worsening air pollution has either caused these diseases or increased their vulnerability. Curtailing air pollution is critical for our healthy lives, especially for healthy lungs. 

(Author is a professor, respiratory wing, at the Government T D Medical College, Alapuzha).