Mumbai: It’s that time of the year when Mumbaikars are forced to battle coughs and sniffles. The morning sky is hazy, atmospheric inversion (in which the temperature, instead of falling, increases with height above the ground) is clearly evident, and scientists furiously map the levels of pollutants in the air. But what has got Dr Rohini Chowghule worried is the number of patients walking in with bronchial hypersensitivity. “They don’t have asthma, but they need the same drugs to get well,’’ says the chest physician from Bombay Hospital, adding that this is an indicator of the pollutants in the city.
    The worse the inversion, more the pollutants trapped in the atmospheric levels, and worse the plight of people with susceptible airways. “Doctors’ clinics are overflowing with patients,’’ says allergy and asthma specialist Dr Pramod Niphadkar.
    There is no data on the number of asthmatics in Mumbai, but a study done by the National Commission on Macroecnomics in Health stated that there are 28 million asthmatics in India. It extrapolated that the numbers could rise by 25% in the next six years to 35 million.
    But if one follows the thumb rule that roughly 20% of any population suffers from respiratory allergies at any given time and a quarter of these could develop asthma in their lifetime, the numbers are huge in the city as well. A recent study from Pune, which is part of the worldwide Isaacs study on asthma, showed that one in five children in Pune suffered from the illness. “Winter pollution is difficult for normal people, so one can imagine the plight of those with sensitive airways,’’ says Dr Sanjeev Mehta from Lilavati Hospital.
    The greatest worry about asthma, says Dr Sujeet Rajan from Bombay Hospital, is poor diagnosis and poor adherence to medication. “Diagnosis of asthma is poor even among doctors. Few realise that persistent cough is a common symptom of asthma. Constricted airways in the lungs lead to cough spells,’’ he says.
    He adds that many doctors treat the symptom of the moment without addressing the underlying asthma. According to Dr Mehta, patients with mild to moderate asthma tend to ignore medication once an asthmatic attack wears off. “Despite the availability of better medication and inhalers in India, we still get asthmatic patients landing up for emergency care,’’ he says.
Breathing Difficulties
What Is Asthma?
It is a chronic disease in which the air passages get inflamed and, hence narrowed. It causes recurring periods of wheezing, tightness in chest, shortness of breath, and coughing. The coughing often occurs at night or early in the morning Growing Burden
At least 300 million people currently suffer from asthma. It’s the most common chronic disease among children. An additional 100 million will get asthma by 2025 In India, around 28 million suffer from
asthma. By 2016, the
figure is supposed to reach 35 million Most asthma-related deaths occur in low and lower-middle income countries
Causes
    The fundamental causes of asthma are not completely understood. The strongest risk factors for developing asthma are a combination of genetic predisposition along with environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways such as indoor allergens (house dust, mites in bedding, carpets, etc) and outdoor allergens (pollen and moulds)
    Tobacco smoke, chemical irritants in the workplace and air pollution also pose a risk. Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise. Even certain medication like aspirin and other non-steroid antiinflammatory drugs and beta-blockers (used to treat high blood pressure, heart conditions and migraine) can trigger an attack
Worrying Trend There has been a slight rise in the cases of allergic bronchopulmonary aspergillosis. This is hypersensitivity to aspergillus (a fungus that grows on moist surfaces) that occurs almost exclusively in patients with asthma or, less commonly, cystic fibrosis