Climate change And asthma: Rising asthma cases in children and the urgent need for intervention

Summer brings warmth, longer days, and outdoor fun, making it a pleasant season. However, the heat and rising pollution levels can trigger a range of health issues, especially respiratory infections like asthma . Not only adults but even children can also suffer from asthma. Yes, that’s right! Increased pollen, humidity, and air pollutants worsen air quality, making breathing difficult for those with respiratory conditions. While summer is enjoyable, it also demands caution to protect lung health in children. This article sheds light on the association between climate change and asthma.


Climate changing is not only becoming a matter of concern for adults but even children too. Climate change is not just an environmental crisis but a public health emergency, mainly for children aged 10-15. The sudden change in the weather as the mercury rises is taking a toll on children’s overall well-being. Not only skin problems or urinary tract infections (UTIs) but even respiratory issues are troubling everyone, especially children. One of the most concerning health impacts is the increasing prevalence of pediatric asthma.

Asthma cases are surging in children aged 10-15 age groups as they are having symptoms such as breathlessness and cough. Timely intervention is key to managing asthma and improving the quality of life of children. Rising temperatures, worsening air pollution, increased allergens, and extreme weather changes lead to a growing number of asthma cases in children across the country. This alarming trend highlights the urgent need for immediate intervention to tackle climate change and its effects on the child’s lung health.


What is asthma?


According to the World Health Organization (WHO), asthma is a major noncommunicable disease ( NCD ), affecting both children and adults, and is the most common chronic disease among children. Asthma is a chronic respiratory condition causing inflammation and narrowing of the airways, making breathing difficult and performing daily activities with ease. It leads to symptoms like wheezing, coughing, shortness of breath, and chest tightness. According to the latest Global Burden of Disease 2021 Report, India contributes to 46 per cent of global asthma deaths. This is up from 43 per cent from the 2019 report. As per The Global Asthma Report 2022, about 1,000 people per day die of asthma. This highlights the seriousness of the issue as most cases are preventable. Asthma not only goes undiagnosed in adults but even children also. Many children with asthma are suffering in silence due to the lack of timely intervention. Remember, there is no cure; asthma can be managed with medication and lifestyle adjustments.


Decoding the link between climate change and pediatric asthma


Climate change due to environmental factors contributes to asthma in children.

Air pollution: Increased emissions from vehicles and industrial activities have led to higher levels of pollutants such as particulate matter (PM2.5), nitrogen dioxide (NO2), and ground-level ozone. According to various studies, these pollutants tend to irritate the respiratory system, trigger asthma attacks, and may even lead to the development of asthma in children, which shouldn’t be ignored at all.

Rising temperatures: Higher temperatures intensify air pollution and prolong the allergy season, exposing children to harmful allergens for extended periods. Heatwaves also worsen respiratory conditions by increasing ozone levels, a known asthma trigger, and hence, parents must be cautious when it comes to their child's health. Currently, there is extreme heat in the country and many children are falling sick while others are also suffering from asthma.

Increased pollen and allergens: Climate change affects plant growth and extends pollen seasons, leading to higher concentrations of allergens in the air. Children with allergic asthma experience more frequent and severe symptoms of cough and breathlessness due to prolonged exposure to allergens such as pollen, mold, and dust mites.

Poor indoor air quality: Rising temperatures and increased humidity promote mold growth and the accumulation of indoor air pollutants, such as dust mites and volatile organic compounds (VOCs) that are also known to trigger asthma in children. Given the connection between climate change and pediatric asthma, immediate action is necessary to protect children's health. The goal should be to reduce air pollution, improve healthcare access, and effectively

The diagnosis: Of asthma in children involves a combination of medical history, symptom evaluation, and lung function tests to enhance lung function. The expert will examine the recurring symptoms like wheezing, coughing, and breathing difficulties, mainly after exercise or exposure to triggers. Spirometry, a lung function test, will help the expert to measure airflow obstruction in older children. This test will aid in the diagnosis of asthma for children. In younger children, diagnosis is often based on the symptoms, family history of asthma, other allergic symptoms accompanying and how they respond to asthma medications. Allergy tests may also be conducted for children to understand about the triggers. The expert will design the right treatment plan for the child. Initiate the treatment without any further delay.

The treatment: Treatment for asthma in children is based on controlling symptoms and preventing attacks. It includes quick-relief inhalers (bronchodilators) to ease breathing during flare-ups and long-term control medications like inhaled corticosteroids to reduce airway inflammation. Identifying and avoiding triggers such as allergens and pollution is the need of the hour. Regular check-ups help adjust treatment plans as the child tends to grow. An individualized asthma action plan ensures effective management in children. So, parents should take charge of the child’s health.


Preventive measures


Asthma is commonly seen in children. However, with appropriate precautions, it can be kept in control. Here are some essential tips to help prevent asthma attacks in children:


Reduce exposure to allergens: Various studies have proven that asthma attacks are triggered by allergens such as dust mites, pollen, pet dander, and mold. To minimize exposure, keep the child’s room clean and dust-free, use allergen-proof mattresses and pillow covers, regularly wash bed linens in hot water, avoid pet and pet dander, and opt for humidifiers at home to reduce mold growth in damp areas. Try to change the bed sheets from time to time and keep the home clean. Close the window if there is a lot of dust and allergens during the evening time.


Improve indoor air quality: Poor air quality can aggravate asthma symptoms. Steps to ensure clean air include avoiding smoking or exposure to secondhand smoke, using air purifiers to filter out allergens, ensuring proper ventilation in the home, and staying away from strong odors from perfumes, cleaning products, or smoke.


Avoiding outdoor pollution: Limit the child’s outdoor activities on high-pollution or pollen-heavy days. See to it that the child wears a mask if he/she is venturing outdoors. Don’t opt for any heavy activities such as running or high-impact exercises. Keep windows closed during heavy traffic hours to prevent outdoor pollutants from entering the home.


Adhere to a well-balanced lifestyle: Eat a nutritious diet rich in fruits and vegetables. It is the need of the hour for parents to seek help from an expert when it comes to the diet of the child. It is better to avoid giving processed, junk, canned, and sugary foods to children that induce inflammation, coughing, and lung irritation. The expert will help you to know what you should eat and delete from the diet. The child should stay healthy by maintaining an optimum weight. Encourage regular physical activity but avoid strenuous exercise in polluted environments. Ensure the child gets enough sleep and stays hydrated. The child should avoid over-exertion.


Stay in touch with the doctor: Parents, always have inhalers handy for children. The child should carry the inhaler in the bag while going to the school. Parents, try to also keep a diary to note down the triggers of asthma in the child and discuss with the doctor. This will help you to understand the child’s respiratory health status in a better way and take appropriate measures. Follow the prescribed asthma action plan provided by the doctor. Don’t skip the medication at all. Experts should educate parents regarding asthma and its ill effects on the child's health. Go for regular check-ups to monitor asthma control. The child should get vaccinated as per the expert’s advice. Parents, be alert and don’t self-medicate or follow any natural remedies as doing so can be risky. Parents, ‘Prevention Is Better Than Cure’, so be aware of the triggers and don’t neglect the child’s health

(Dr Abha Mahashur , Pulmonologist, Lilavati Hospital Mumbai )