4 min readNew DelhiNov 3, 2023 01:47 PM IST
First published on: Nov 3, 2023 at 10:43 AM IST
Rising levels of pollution over the last ten days in Delhi have kept pulmonologists busy as they are seeing an increasing number of patients in their clinics.
Dr GC Khilnani, chairman of PSRI Institute of Pulmonary, Critical Care and Sleep Medicine, is seeing an increase of 30 to 40 per cent in his case load. “And, it is likely to go up further with the kind of smog we are now experiencing and Diwali celebrations beginning soon,” says the man who is a member of the WHO Technical Advisory Group on Global Air Pollution and Health.
Dr Rajesh Chawla, senior consultant, chest medicine, critical care and sleep medicine at Indraprastha Apollo Hospital, says that he has been noting an increasing trend of such cases every year.
Who are at the highest risk of developing respiratory distress symptoms due to pollution?
Dr Khilnani says he has seen patients with well-managed respiratory conditions, such as asthma, coming in with breathlessness, cough and extreme dryness of month. “This is despite them increasing their inhaler doses. We have to sometimes nebulise them and give steroids for the symptoms to improve,” he adds.
Old people living with heart conditions are likely to experience respiratory symptoms and even heart attacks. “In the landmark study that resulted in Delhi switching to CNG, we had found an increase in heart attacks linked to increased pollution levels,” says Dr Khilnani, who was then at AIIMS and was part of the study.
What are signs and symptoms?
Dr Khilnani says his patients are reporting a stubborn sort of cough, wheezing and watering of eyes. Besides, respiratory infections in old people with co-morbidities have led to more hospitalisations. Many of Dr Chawla’s patients, who had come to Delhi to get themselves evaluated for other medical conditions, developed respiratory symptoms and needed support. “Even the apparently healthy patients needed steroids,” he says.
Why do some patients need steroids?
Steroids are known to reduce inflammation thereby improving the symptoms. Dr Khilnani says that although the X-ray and lung function test of his patients has been normal, when he performed a specialised test, called the Fractional exhaled nitric oxide (FeNO) test, they were found to have airway inflammation.
When should you go to a doctor?
Dr Khilnani says that if you are experiencing shortness of breath or tightness in chest, you should immediately consult a doctor. And seek a consultation even if symptoms like coughing and wheezing last most than a couple of days, advises Dr Chawla.
Those with existing respiratory conditions should consult their doctors as the pollution levels start going up to change their inhaler doses.
Most importantly, both doctors warn against taking any antibiotics. “These symptoms are usually caused by inflammation due to pollution or a viral infection — either way an antibiotic is of no use,” says Dr Chawla.
What can you do at home?
Dr Khilnani suggests staying at home as much as possible during high pollution days and keeping all the doors and windows shut. Avoid crowded places, roll up car windows while travelling. Stop running or other strenuous activities outdoors.
Dr Khilnani adds that using cloth masks or surgical masks are of no use. “Only an N95 or N99 mask worn properly may help,” he says.
Dr Chawla suggests that those with sensitive eyes should wear zero power glasses to protect them an keeping them hydrated. “Proper hydration helps in keeping the respiratory system moist, reducing irritation due to pollution. Having warm water or turmeric milk can help, he adds.
The elderly and old people with co-morbidities should get their pneumonia and flu shot, according to Dr Khilnani.
Do air purifiers help?
No evidence yet. “Only people over the age of 80 years with chronic heart disease or those with respiratory illnesses dependent on oxygen may use a purifier in their rooms,” says Dr Khilnani.
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Those with existing respiratory conditions should consult their doctors as the pollution levels start going up to change their inhaler doses. (Respresentational) 
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