Should people with asthma, living in polluted cities, exercise?

Representational image. (Photo via Unsplash)

Diwali marks the beginning of many things — the new accounting books, muhurat trading, a new year for many, the marker of the forthcoming winter months and, for millions in India, asthma and other breathing-related health issues owing to the sharp spike in pollution that the festival of lights is almost always followed by, most prominently in Delhi and the National Capital Region.

If you happen to be an active person, who regularly plays sports and exercises, and also suffers from asthma, you might need to be a wee bit extra careful during this time but the good news is that you don’t really have to stop exercising. The World Health Organisation (WHO) statistics show that about 262 million people suffered from asthma across the world in 2019 and it is the most prevalent chronic disease among children.

Asthma affects the air passages in your lungs and they become narrow due to inflammation and tightening of the muscles around the small airways. This causes cough, wheezing, shortness of breath and chest tightness, which are the classic symptoms for asthma as anyone who suffers from the disease would reaffirm.

Thankfully, these symptoms are not a constant and those with asthma suffer the symptoms intermittently. The symptoms often get worse at night or during exercise, according to the WHO, and that though it cannot be cured, “good management with inhaled medications can control the disease and enable people with asthma to enjoy a normal, active life.” People
suffering from asthma can play high-intensity sports provided their asthma is well under control and lung function tests are normal under the supervision of a doctor, says Dr Manoj Goel, director, pulmonology, Fortis Memorial Research Institute, Gurugram. “Many International sports persons have asthma but have performed very well internationally at
the highest levels,” adds Dr Goel.

Just because one suffers from asthma, they don’t need to design a special fitness routine; asthma patients can follow the same fitness regimen and perform at the same intensities as someone who doesn’t suffer from it as long as they have their asthma under control, say health and fitness experts. “People with asthma, for that matter even those who don’t have
asthma, need to decide as to how much they can push themselves depending upon their physical capabilities. But for those who suffer from asthma, they need a lung function test under the supervision of a doctor,” adds Dr Goel.

Vaibhav Mehra, 40, a Delhi resident who has suffered from asthma since early childhood, has been able to effectively manage his asthma with age. He now not only does strength training in the gym and goes walks but has also started running and even completed a couple of half marathons and many 10km races. “To be honest, I was scared when I started but I had seen colleagues and even friends with asthma lead active lives, so I gave it a go.
But I started slow. And whenever I started going out of breath I stopped. Over a few weeks, it started getting better and understanding when I was just out of breath or when an asthma attack was about to happen,” he says, adding that he always carries his inhaler with him and whenever he goes for a run, he has his phone on him or runs with someone he knows.

He always takes it slow in the beginning and only after 10-12 minutes of warming up does he really start going 100 per cent in his exercise and runs. In fact, Mehra says all this exercise and an active lifestyle is helping him manage his asthma better. He has had fewer asthma attacks, he says.

For those who suffer from asthma and still choose to lead an active life, Goel says, they need to monitor the symptoms such as cough and difficulty in breathing and persist with the prescribed medication. “You should be regular with your medication as per the doctor’s advice and must keep inhalers with you all the time. Do not jump into very strenuous
activity right from the start. Instead, build up your endurance gradually before moving to sports and exercise at higher intensities. Asthma patients must also avoid triggers such as smoking, perfumes, smoke of any kind or any other known trigger,” suggests Goel.

The current environmental catastrophe of extremely high levels of pollution that the National Capital Region is witnessing is bad for everyone and even worse for those with asthma. Even other cities such as Bengaluru, Kolkata and Mumbai where the pollution is high make things worse for those who suffer from asthma and chronic obstructive pulmonary disease, say medical and fitness experts. “If you have a lung condition, high
pollution levels can aggravate your symptoms, such as an asthma attack or a chronic obstructive pulmonary disease flare-up. When pollution levels are high, people with asthma may find they need to use their reliever inhaler more frequently than usual. It's also critical that you use your preventer inhaler on a regular basis, so it's important to know how to take
precautions. Avoid exercising outside during peak pollution hours,” says Dr Mrinal Sircar, director and head of the department of Pulmonology and Critical Care Medicine at Fortis Hospital, Noida.

Mehra, who loves running outdoors, has felt the impact of pollution this year. Forget running, he doesn’t even want to risk stepping out of his home where air purifiers are running all day long. He has switched to home workouts and yoga. “Even healthy people should also avoid exercising outdoors when pollution levels are high, and continue with your
daily exercise routine indoors. Avoid running or jogging outside in the evenings and mornings as well as in high traffic areas,” adds Dr Sircar.

Exposure to high levels of air pollution can cause a variety of adverse health outcomes. “It raises the chances of getting respiratory infections, heart disease, and lung cancer. Short-term and long-term exposure to air pollutants has been linked to negative health effects.

The AQI between 151 and 200 could be dangerous and have serious health consequences, particularly for vulnerable groups such as the elderly, children, and people with co-morbidities. Furthermore, an AQI of 200 or higher may cause a health alert and be hazardous to anyone. People may experience difficulty breathing, a runny nose, eye rolling, skin allergies, coughing, nausea, headaches, eye itchiness, and dizziness. Long-term
exposure to pollutants can cause problems with the neurological, reproductive, and respiratory systems, as well as cancer and, in rare cases, death,” warns Dr Vivek Singh, director of Respiratory and Sleep Medicine at Medanta Hospital in Gurugram.

Owing to the increased pollution, hospitals across the National Capital Region are receiving complaints from patients who are having difficulty breathing, wheezing, coughing, nausea, and headaches. “Asthmatics are experiencing exacerbations and acute illness symptoms,” adds Dr Singh. Whenever the pollution levels are high, Dr Singh advises, people must remain indoors as much as possible. “People with asthma and other vulnerable members are advised to work indoors, where they can perform relaxation exercises, breathing exercises, stretching, running exercises, yoga, and if they have access to a treadmill,” he says, adding that wearing an N-95 mask when you step outside would be of immense help.

Precautions for asthma patients:
Dr Purodha Prasad of Pristyn Care, Gurugram, suggests the following steps to safeguard yourself when the pollution is high:

• Wear a mask to avoid the dust particles getting into your lungs

• Avoid going outdoors as much as you can

• Work out indoors and practice yoga

• Smoking should be strictly avoided

• Skip early morning walks

• Avoid using self-medication

Ways to cope with pollution for asthma patients:

• Keeping an inhaler handy for asthmatic patients

• Have a diet rich in antioxidants, fruits, and vegetables

• Drink lots of water to keep your body hydrated as that would help in removing harmful toxins from the body

• Consult a pulmonologist if symptoms persist