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World Asthma Awareness Month: The rise of bronchial asthma in India and the role of pollution

Treatment during an asthma attack

A recent report by World Health Organization (WHO) stating that 14 out of the 20 most polluted cities are in India is really worrying. While the poor air quality is equally dangerous for all individuals, it is definitely more harmful for those suffering from breathing disorders.

One of the most common respiratory diseases around the world is bronchial asthma. As per WHO between 100 and 150 million people worldwide are suffering from this disease and the number is only rising – it has reached over 1,80,000. In India alone, over 15 million people suffer from asthma. As May is observed as World Asthma Awareness Month, we asked various experts about the presence of bronchial asthma in India and here’s what they had to say.


“Because the population has increased, the absolute number has definitely increased but if you think of percentage in the major cities, there is an evident increase in the percentage as well,” informs Chawla when asked whether he has felt that the number of asthma cases have increased over the years. With over 32 years of experience, he states that over 50 to 60 per cent of his patients are asthmatic. He further states that though the percentage has increased, there is also an increase in the suffering of people due to pollution.

“Pollution, especially indoor air pollution from dust mites, dusty carpets, incense sticks, curtains play a major role in causing bronchial asthma,” states Sudarshan. However, he agrees that there is a rise in the number of asthma patients, He also states that there is a rise in awareness among people. “Yes, the incidents are increasing but there is also an increase in research, proper treatment and awareness among the public.”

Old cars and unplanned urbanisation also play a big role in adding to pollution and hence aggravating breathing problem.

Understanding Asthma

Asthma, medically known as bronchial asthma, is a condition that occurs due to the inflammation of the air passages in the lungs. “Bronchial asthma is a variable obstruction in the airways and there are certain aggravating factors called triggers such as change of season, pollen, fungus, cold air, dust, insects, perfumes that cause the reactions,” explains Dr Rajesh Chawla, senior consultant Pulmonary and Sleep disorders at Indraprastha Apollo Hospitals, New Delhi.

However, not all people suffering from asthma experience the same trigger. Just like there are multiple triggers, there are also many types of asthma that are activated by different causes which is why no one treatment fits all.

“Asthma can be broadly put in two groups; allergic and non-allergic, but there are various other sub-categories as well,” explains Dr BP Singh, chief Pulmonology department of Midland Healthcare and Research Centre, Lucknow.

While there is not one particular cause for the disease, there are many factors such as smoking, exposure to chemical irritants, low birth weight and respiratory infection that can set off asthma. Moreover, cold weather and extreme physical exercise can also make the situation worse.


Though the causes and trigger vary, the symptoms of asthma more or less remain the same across patients.

“Wheezing, cough, breathlessness, night and early morning breathing discomfort are the common symptoms of asthma,” describes Dr Sudarshan KS, assistant consultant Pulmonology Fortis Hospitals, Bangalore. “Most people in India still confuse asthma with bronchitis. They fear to accept these symptoms as bronchial asthma. Bronchitis is an inflammation of the airway, it can be related to certain infections whereas asthma is chronic and acute,” he elaborates.

Over the years, there have been various technological advancements and treatments that have made it easier to control and prevent asthma attacks. However, the number of people suffering from the disease has continued to rise.

According to a WHO fact sheet, there are several experts who are struggling to understand why the rates worldwide are rising by 50 per cent every decade. There have been incidents where people who have never had asthma are suddenly suffering from severe asthma attacks that needs emergency treatment.


As asthma is a chronic condition, it requires continuous medical care. The patients, who suffer from moderate to severe asthma have to take long term medication such as anti-inflammatory drugs to control the underlying inflammation and prevent attacks.

“Number of patients have of course increased, but the treatment to asthma has also become simpler. It is now more understood and streamlined. So if an asthmatic takes their medicines right, they lead almost a normal life. 90 per cent of the patients, if they follow the doctor’s advice properly and take inhalers even when they are not suffering, they do fine,” states Chawla.

However, medications should not be the only way to control asthma. It is also important to avoid the trigger.

“Precaution is very important. You have to avoid triggers such as dust, flowering plants, pets, cotton pillow producing dust. Inhalers are the best treatment for bronchial asthma and there are two types of inhalers –metered-dose inhalers and dry-powder inhalers– which have to be taken,” said Singh.

When it comes to pollution, there is very little we as individuals can do to prevent the worsening quality of air. While growing trees and setting up plants around the house are some options, it is difficult to avoid it at all times. Hence, the best way to prevent oneself from an asthma attack is precaution. As advised by doctor Chawla, “Know your triggers and avoid your triggers. Keep your daily schedule regular. Don’t expose yourself to dust and understand your medicine properly,” to keep your airway healthy.