Breathe easy this Diwali: Tips to protect your lungs from pollution

Diwali, the festival of lights, is celebrated with great fervour across India. However, the traditional use of firecrackers can significantly impact air quality, leading to a surge in respiratory problems. Firecrackers produce toxic fumes, which may cause chest discomfort or congestion in many individuals. This is particularly concerning for vulnerable groups such as children, the elderly, and individuals with pre-existing respiratory conditions like asthma, bronchitis, and chronic obstructive pulmonary disease (COPD).

Given these risks, it's crucial to take proactive measures to safeguard your lungs during the festive season. Additionally, it's important to be mindful of indoor air quality by keeping homes well-ventilated and using air purifiers. Dr. Salil Bendre, Director, pulmonology and chest medicine at Nanavati Max Super Speciality Hospital (Vile Parle, Mumbai) and Dr. Anusha C M, consultant, respiratory medicine at Manipal Hospital (Malleshwaram) outline the impact of air pollution during Diwali, precautions to be taken, and practical tips that will help you to protect your respiratory health.

Firecrackers and lung health: What you need to know
Firecrackers are a major contributor to air pollution during Diwali. "The smoke released contains particulate matter (PM), sulphur dioxide (SO₂), nitrogen dioxide (NO₂), and various heavy metals that can irritate the respiratory system and damage lung tissue," explains Bendre.

According to a study, ‘Effect of Fireworks Pollution on Human Health During Diwali Festival,' conducted in Ahmedabad, nearly 48 per cent of participants reported coughing, while 38 per cent experienced runny noses and eye irritation after exposure to firecracker pollution. The same study found a significant increase in symptoms like breathlessness and wheezing, underscoring the detrimental effects of pollution on respiratory health. This can hamper our respiratory health, both in the short term and long term.

Furthermore, research has demonstrated that PM2.5 concentrations - fine particulate matter that can penetrate deep into the lungs - increase significantly during and after Diwali. "This fine particulate matter is particularly harmful as it can lodge in the pulmonary region, triggering inflammation and exacerbating conditions like asthma and bronchitis," he cautions.

How does Diwali air pollution differ from other forms of air pollution? Bendre responds, "Annually, the air quality indexes highlight that PM10 and PM2.5 levels are two to three times higher during Diwali compared to non-festive periods. These pollutants can remain suspended in the air for weeks, further increasing the risk of respiratory issues for sensitive populations, including children and the elderly. Crackers that emit high levels of smoke and fumes are the most dangerous for lung health. Clinical studies from across India have shown that pollutants released during the burning of firecrackers contain a range of harmful chemicals, including aluminium, barium, strontium, and potassium perchlorate, which can lead to inflammation of the airways and severe respiratory distress."

What are the most vulnerable groups to Diwali air pollution?
Below, Anusha CM lists five categories of people who are most affected by air pollution:

Young children
Their respiratory systems are smaller and still developing. Their immune systems are also partially developed, so when exposed to air pollutants, their response is slower, and they are more easily affected.

Older population
As people age, immunity decreases, and protective mechanisms may sometimes fail, making older adults more vulnerable to air pollutants.

Stressed individuals
The third group includes people under stress, which makes them more prone to infections and exacerbations when exposed to air biotics.

Residing in high pollution areas
The fourth group consists of individuals who reside in areas with high levels of air pollution, like near industrial zones or areas with significant smoke. These people are also prone to experiencing the harmful effects of air pollution.

Residing in congested places
People from lower economic strata are at risk as well. They often stay in crowded places with inadequate ventilation and may reside close to highly polluted areas, which can adversely affect their health.

The role of exercise in lung protection
From increased lung capacity to enhanced circulation, the benefits of exercise are numerous when it comes to improving lung health and function. "While outdoor activities should be minimised during Diwali due to poor air quality, breathing exercises, yoga, and pulmonary rehabilitation play a vital role in maintaining lung health," shares Bendre.

1. Ideal exercises for lung health are mainly breathing exercises or activities that improve breathing patterns, like swimming or sports.
2. Yoga-based practices, such as pranayama, improve air intake and circulation, further strengthening the lung function.
3. Deep breathing exercises strengthen the respiratory muscles and improve lung capacity, making it more resilient to pollutants.

Dietary recommendations for better lung health
Balanced diet and nutrition play an important role in improving lung health. This is particularly important during Diwali, when air pollution levels may rise significantly. "By incorporating immunity-boosting foods into your diet, you can help your body combat the negative effects of pollution," says Bendre.

Antioxidant-rich foods
Opt for a diet rich in green leafy vegetables, which are high in antioxidants that help boost immunity and protect the lungs from oxidative damage caused by air pollutants. Citrus fruits, berries, carrots, and spinach are excellent sources of antioxidants.

Hydration
Staying hydrated by drinking plenty of water also supports lung function, as hydration helps thin mucus, making it easier for the lungs to clear toxins. Herbal teas like ginger, turmeric, and peppermint can soothe the throat and promote respiratory health.

Avoid fried food
It is also better to avoid oily, spicy, and fried foods, as they can cause acidity, which can cause coughing and exacerbate breathing difficulties.

Vaccinations: A crucial line of defence
Vaccinations are a powerful tool in the fight against respiratory diseases. In addition to taking immediate protective measures, pulmonologists recommend getting vaccinated against respiratory infections, such as influenza and pneumococcal disease. "These vaccines can reduce the severity of infections and provide an additional layer of immunity during high-pollution periods like Diwali," poses Bendre.

Anusha advises to keep track of your vaccinations during the festive period: "Stay protected by ensuring your vaccinations are up to date, and if you are using any kind of inhaler, please continue to use them as prescribed. Do not discontinue them even though you may be busy with festive chores in the house."
Precautions for individuals with pre-existing respiratory conditions

For those with conditions such as asthma, bronchitis, or COPD, it is essential to remain vigilant during Diwali. The chemicals and particulate matter (PM) released from firecrackers can trigger severe symptoms, including breathlessness, coughing, and wheezing. Below, Bendre lists key precautions advised by pulmonologists:
1. Inhaler use: Continue using prescribed inhalers regularly to manage symptoms and prevent flare-ups.
2. Mask up: Wearing a mask can help reduce the inhalation of harmful particles and gases present in the air. Choose a well-fitted mask, such as an N95 respirator, for optimal protection.
3. Indoor safety: Keep windows closed to minimise exposure to outdoor air pollution, especially when firecrackers are being used. If symptoms worsen, seek medical attention immediately.
4. Limit outdoor exposure: Try to stay indoors as much as possible, especially during the evening when firecracker use peaks.
5. Use air purifiers: Investing in a good-quality air purifier for your home can help reduce indoor pollution levels, particularly in metropolitan areas where air quality is typically worse.
6. Monitor air quality: Keep an eye on the Air Quality Index (AQI) in your area. If the AQI crosses unhealthy levels, avoid outdoor activities.
7. Stay hydrated: Drinking plenty of fluids can help thin mucus, which aids in the clearance of pollutants from the lungs.
8. Avoid firecrackers: Consider celebrating Diwali with eco-friendly alternatives to firecrackers, such as lighting diyas, using flowers, or enjoying a community feast.

Indoor air purification devices that are helpful
There are several effective indoor air purification techniques and devices that can significantly improve air quality, especially during periods of high pollution, according to Anusha. "While there are many kinds of indoor purification techniques, the most common and effective method is a HEPA filter. Although it can be quite expensive to replace the filter, HEPA filter purifies almost 99 per cent of the air. It removes most dust particles, dust mites, airborne viruses, moulds, and almost everything else. People who have allergies may need a HEPA filter for air purification."

The doctor goes on to share a few other options: "Activated charcoal is an inexpensive way to remove most volatile organic compounds (VOCs) and odours. Ultraviolet filters mainly remove bacteria, viruses, and mould. These are easy to maintain and have a longer lifespan, although they don't remove other types of pollutants. A negative ion generator removes positive ions, particularly bacteria and viruses. When combined with a HEPA filter, it becomes the most effective air purification system."

When should one seek medical attention?
Describing the most common symptom to keep an eye out for during Diwali, Anusha says, "The most common sign is an increase in cough or the persistence of a new cough in a healthy person. One may start feeling chest tightness and difficulty breathing. Phlegm or mucus production may also begin as the cough becomes persistent."

There are multiple other indicators that one can also keep in mind, she explains. "Fingertips, nails, and lip skin tone can become bluish in colour. In cases of excessive oxygen deprivation, there may be chest retractions, nasal flaring, visible muscle use in your neck, as well as an increase in respiratory rate. When these signs are observed along with a decrease in the saturation levels recorded in a pulse oximeter, it definitely warrants a visit to your healthcare provider."