Air pollution, smoking, and nagging cough: When to get a lung function test?

With winter on the way and temperatures starting to drop, air quality is becoming a hot topic. It’s not just environmentalists and health experts talking about it anymore, even people are discussing it on social media and in the news. A big part of this conversation revolves around the Air Quality Index or AQI, which indicates how polluted the air is.  A higher number means worse air quality, which can lead to serious health problems. In 2024, the World Health Organization WHO reported that just seven countries were up to par with their air quality standards. Shockingly, India had 13 of the 20 most polluted cities, steering attention towards the potential respiratory illness that pollution can cause.

How does smoking affect air pollution?

Smoking, whether active or passive, poses grave dangers, especially for kids. Because they breathe more rapidly than adults, children inhale more polluted air, which can lead to long-term health issues. “It’s alarming to think that conditions like chronic obstructive pulmonary disease (COPD) might start before a baby is even born, thanks to mom being exposed to pollutants and smoking during pregnancy”, Pathologist Dr Moumita Misra, tells Health Shots.

What are the key air pollutants?

Air pollution mixes various harmful substances, and there are five main contributors to it:

• Particulate Matter (PM10 and PM2.5): Tiny particles that can penetrate deep into the lungs.
• Ground-level ozone: A harmful gas that exacerbates respiratory conditions.
• Carbon monoxide: “A colourless gas that messes with how the body gets oxygen around”, says the pathologist.
• Sulphur dioxide: Emitted from burning fossil fuels, it can lead to throat and eye irritation.
• Nitrogen dioxide, often produced from vehicle emissions, contributes to respiratory problems.

Pollutants come from a bunch of sources like cars, factories, construction sites, and even things in our homes. When we inhale them, they can irritate our airways and cause long-term inflammation. “Some of these tiny particles are really concerning because they can get into our bloodstream and impact organs that are nowhere near our lungs, and there’s even a link to cancer”, says the expert.

How to know if something is wrong with lungs?

Our lungs often let us know when something’s off before it turns into a bigger issue, but we usually write these signals off as no big deal. It’s important not to ignore the common symptoms that can indicate a problem.

• Persistent or nagging cough: A cough that lingers beyond a week.
• Irritation in the nose or throat: Feelings of discomfort that do not subside.
• Wheezing or noisy breathing: “Strange sounds during breathing can indicate airway obstruction”, says the doctor.
• Shortness of breath during routine activity: Difficulty breathing when performing tasks that should not be strenuous.
• Chest discomfort or painful breathing: Pain that can be sharp or dull, affecting the breathing process.
• Worsening of pre-existing conditions: Aggravation of asthma or other respiratory issues.

When is a lung function test required?

The rising pollution levels every year warrant getting a lung function test or pulmonary function test as part of your yearly health check. This is just as important as checking your blood sugar or cholesterol levels. “Spirometry is the test to go for; it’s quick, non-invasive, and gives you a clear picture of how your lungs are working”, shares the expert.

What is a spirometry test, and how is it done?

Spirometry is a simple yet effective test that involves blowing into a machine to assess lung function. Here’s what spirometry helps with:

• Detect early airway narrowing: Identifying issues before they escalate.
• Assess the effect of smoking on the lungs: Evaluating damage due to smoking habits.
• Monitor chronic lung conditions: “Keeping track of conditions like asthma”, says the doctor.
• Guide treatment decisions and medication use: Informing physicians about appropriate courses of action.
• Evaluate environmental exposures: Assessing potential damage from pollutants.

If spirometry shows any issues or if symptoms keep sticking around, doctors might suggest doing some extra tests to get a clearer picture of what’s going on.

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• Lung plethysmography: Measures lung volume and airway resistance using an airtight chamber.
• Gas diffusion study: “Assesses how well oxygen moves from the lungs into the bloodstream”, explains Dr Misra.
• Cardiopulmonary exercise testing (CPET) evaluates heart and lung function during physical activity, which is helpful for people experiencing unexplained breathlessness or fatigue.