Surviving the smog

Surviving the smog

It’s just not about asthma or cardio-vascular issues. Pollution can even cripple your digestive system, aggravate arthritis and damage your skin. Apollo doctors suggest a way out to Team Viva

Air pollution is a mixture of a number of substances including gases, such as carbon dioxide, ozone, nitric oxide, volatile organic compounds (benzene) and particulate matter (PM), with the latter being the one mostly responsible for adverse health conditions. Of note, daily ingestion of PM on a typical Western diet is estimated at 1012-1014 particles per individual. The GI tract is highly susceptible to PM (as well as smoking) and exposure to air pollution may exacerbate systemic inflammation or lead to oxidative damage of intestinal mucosa. Air pollution has dramatically increased in recent years, particularly in developing countries in Asia that are experiencing rapid industrialisation and the highest increase in IBD incidence. Exposure of the gut to air pollutants can occur via inhalation of gaseous pollutants, mucociliary clearance of particulate matter (PM) from the lungs and contamination of food and water sources .

Disturbance in normal bacterial population has been shown to be responsible in causing and increasing severity of disease. Air pollution has been shown to alter the composition of gut bacteria.

Increasing air pollution has been shown to increase the frequency of pain in patients with irritable bowel syndrome. How the air pollutants exacerbate abdominal pain has not been clarified. It has been suggested that air pollution increases inflammation and changes composition of colonic microflora and affects colonic motility.

It has been shown that air pollution may increase the risk of early-onset of inflammatory bowel disease, possibly by altering the gut microbiota and causing oxidative damage leading to more inflammation.The rate of hospitalisation has been shown to increase in patients with inflammatory bowel disease with increasing density of pollutant emission.

There is some evidence that air pollution contributes to increase in liver damage in patients with fatty liver. Fatty liver, itself is a precursor of development of diabetes and heart disease in the future.

Exposure to elevated PM2.5 after the diagnosis of liver cancer may shorten survival, with larger effects at higher concent-rations.There is suggestive evidence that ambient air pollution may increase the risk of liver cancer.

Dr Sudeep Khanna Sr Consultant (Gastroenterology )

Arthritic flares

Dirty air is bad for everyone but it affects people with rheumatoid arthritis (RA) more than others. What does smog do to sufferers? It stiffens up their joints.

A recent research noted that symptoms in patients worsened in November and December when suspended particulate matter (SPM) 2.5 increases in the atmosphere. Patients showed worsening of symptoms like joint pain and swelling.

Arthritis remains the most common cause of disability in the community. Approximately 12 to 18 per cent (18 million) of the population in India suffers from some or the other form of rheumatic disease. Despite this, it is not given its due recognition. Changing lifestyle and urbanisation is significantly contributing to the increasing prevalence of arthritis. Delay in diagnosis and treatment, which ultimately results in joint deformities, multiple-organ failure and early death. Rheumatoid arthritis has no known cure. However, symptom management techniques such as therapy and medication can lower inflammation and prevent joint damage. Keeping active lifestyle releases the happy hormones called endorphins, also known as “natural pain relievers”. Regular exercise has been known to ward off depression and keep the joints from stiffening. So devise an indoor activity pattern.

Medical experts say rheumatologic disorders are the most disabling and deforming diseases in India, where people are less aware of the disease. Delay in the treatment can lead to the joint deformity and irreversible organ damage. Swollen, tender joints and increased duration of early morning stiffness is some of the symptoms of the disease.

Dr Yash Gulati Sr Consultant (Orthopaedics, Joint Replacement and Spine)

Under your skin

The detrimental effects of air pollution are widespread. Effects on the skin alone include dryness, premature ageing, skin rashes, eczema and acne. While most people know that outdoor air pollutants can be harmful to health, not everyone realises that indoor pollutants can cause skin problems and other serious health risks as well. The Environmental Protection Agency points out that studies indicate indoor air pollutants can be two to five times higher than the levels found outside.

Unfortunately, we live in a world where it is difficult to limit exposure to air pollution. However, there are means of reducing the effects and of protecting the skin:

o             Having a diet rich in fruits and vegetables, such as tomatoes, leafy greens and berries can give your body the vitamins and nutrients to combat skin damage.

o             Drinking plenty of water every day can combat the drying effects of pollution, leaving the skin fresher.

o             Looking for skin products containing elastin and collagen is also beneficial, as these vitamins help with cellular regeneration.

o             Wash your face daily in the evening as it is one of the main tools to fight against pollution-related irritants. Use a mild, sulfate-free soap to remove these particles without damaging the skin further.

o             Using a daily moisturiser helps to replenish the oils that have been stripped from the skin.

o             Exfoliation provides an even deeper clean. This should only be done once or twice a week, as too much exfoliation can also damage the skin. Along with scrubs, some companies have introduced rotating brushes that also aid in exfoliation.

o             At-home treatments, such as masks and peels, can add a more rigorous level of skin cleaning.

Dermatologists can also recommend more in-depth options, such as procedures and procedure enhancement products. If you see changes in your skin such as new discolouration, moles, or other issues, consult a doctor.

Means of reducing the effects and of protecting your hair.

Try anti-pollution hair care

As is the case with skin care, hair companies are now creating anti-pollution products that help remove and repel all those nasty pollutants more effectively. While the exact ingredients used for this purpose vary, antioxidant-rich botanicals are common.


Choose stylers wisely

Heavy products like mousses, gels, and thickening creams can actually attract more pollution particles to the hair. If you live in a highly-polluted area, consider ditching these from your routine and swapping them for one, lightweight multi-tasking product.

Minimise how often you shampoo

It may sound counter-intuitive (after all, washing is the best way to get rid of dirt, right?), but over-sudsing can do more harm than good. Exposure to pollution (and UV rays, too) dries out the hair and excessive shampooing can only exacerbate the situation. Go as long as you can in between washes, ideally shampooing no more frequently than every other day.

Be careful when brushing and styling

If it seems like all of a sudden there’s way more hair stuck in your brush, pollution may be to blame: Smoky, polluted air weakens the shafts of the hair, making them brittle and more susceptible to breakage and split ends. The bottom line, be extra gentle when styling.

Add back hydration

When in doubt, hydrate — it’s a good rule for your health and your hair. Pollution and other environmental aggressors dry out your strands and a moisturising mask is the best way to counteract this fast.

Dr DM Mahajan, Sr Consultant (Dermatology)

Prevent the clog

Whether you live in a city where smog forecasts are routine or in a less populated place, tiny pollution particles in the air can lead to big problems for your heart. Pollution can come from traffic, factories, power generation, wildfires or even cooking with a wood stove.

One of the most common indoor sources is cooking and mosquito coils. Smoking not only harms the person who is smoking but the others also. Particles from cigarette smoke can linger for days. Smog (water vapour mixed with smoke) has the potential to affect cardiovascular system adversely. There have been many studies which link air pollution and heart diseases. In 2004, the American Heart Association issued a statement that exposure to air pollution contributes to cardiovascular illness and mortality. A 2010 update elaborated on those risks. Hence, it is advised that the heart patients or people at risk of heart diseases should take extra precautions to avoid further complications. “There are a wide variety of things in the air. Some are natural, some are manmade,” said Dr Mukesh Goel, Senior Consultant, a cardiologist at Indraprastha Apollo Hospital. “We are all exposed, to a certain degree.” Harmful air pollutants lead to cardiovascular diseases such as plaque formation in the arteries leading to blockage of the artery and heart attack.

The mechanisms by which air pollution causes cardiovascular disease are thought to be the same as those responsible for respiratory disease: Pollutants get absorbed in the bloodstream and cause inflammation and damage of the internal lining of arteries by forming toxic free radicals.

  • When the concentration of fine particulate matter (PM2.5) increases, hospital admissions also rise for heart attacks
  • Spikes in the concentration of other air pollutants
  • The combination of fine particulate matter and nitrogen oxides
  • Correlate with increased hospital admissions for potentially fatal myocardial infarction especially in vulnerable patients (patients with pre-existing heart disease though stable on medicines, diabetics, elderly)

Air pollution is a modifiable risk factor for heart disease, for some. You can reduce your risk by cutting your exposure. Follow these recommendations to protect your heart:

  • Walk, use bike or public transportation to get to your destination.
  • When you walk or bike, avoid roads and streets with high traffic, especially during rush hour
  • Avoid running or walking in early morning or late evening
  • If you must run where there is traffic, avoid peak traffic times
  • Plant indoor and outdoor plants

Dr Mukesh Goel, Sr Consultant (Cardiologist)



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