19-25 September 2014 #725

Lung check

Dhanvantari by Buddha Basnyat, MD

In some parts of the world, 2 October is marked as the World Spirometry Day. Spirometry is a simple lung function study which assesses the health of lungs just like a blood pressure monitor measures cardiovascular health. Many western hospitals have a separate section for spirometry. The technician in this department can often be heard asking the patient to “blow hard, hard” into the spirometer. Since the test result is dependent on good effort, it is important for the technician to give clear instruction to the patient during the test.

Unfortunately, this simple and useful test is not performed in most of our hospitals or clinics even though lung diseases are rampant here. South Asia has the worst lungs in the world. Even where the tests are performed, the technician only half- heartedly instructs the patient to blow into the machine, thus compromising results. It is imperative that the lung function studies in pulmonary patients be carried out properly in order to guide therapy. The World Spirometry Day therefore helps increase awareness of this important test.

A recent study published by the McMaster University in Ontario, Canada, had some frightening data. A total of 38,517 healthy nonsmokers took part in the pulmonary (lung) function study. This group consisted of people from 17 countries including India who were matched by height, age and gender. The results revealed that the “healthy” Indians had the poorest lung functions. These findings about Indians can be extrapolated to reflect the lung functions in Nepalis.

Abnormal lung functions in healthy people were once linked to bad genes. However a 2010 study challenged this notion. Children of Indian immigrants who were born and raised in the United States had far better lung functions than those born and raised in India. What could be an important factor to account for this difference if genes are not blameworthy?

Air Pollution, which is prevalent both indoors and outdoors in South Asia, is the answer. A recent astounding finding revealed the air pollution level in New Delhi was higher than that in Beijing. (Unfortunately many of the cities and towns in Nepal are not far behind New Delhi in air pollution). Scientists measure particulate matter (PM) in the atmosphere to check how harmful the state of pollution is. PMs less than 2.5 microns are the true troublemakers because they are able to penetrate deep into the lungs, and due to their diminutive size bypass the defense mechanism of the lungs to cause abnormal lung functions and diseases.

There have been lots of reports on the alarming rate of pesticides in our food. Perhaps more anxiety-provoking should be widespread air pollution which in all likelihood kills many more people over a period of time than pesticide exposure. The World Health data has revealed that deaths due to chronic lung disease are the highest in our part of the world. It is vital that we deal successfully with air pollution prevention measures to curb not only lung diseases but a host of other diseases now scientifically linked to air pollution such as heart attacks, strokes and lung cancer, all of which are on the rise in Nepal.

Read also:

The world’s worst lungs

Kathmandu’s lungs