Patchy progress means many millions of people are still impacted by lung conditions and unaware of the risks that exist in their everyday lives. Dr Andy Whittamore, Clinical Lead at Asthma + Lung UK, discusses the multitude of risk factors impacting the nation’s lung health and provides health advice to mitigate those risks
The importance of good lung health is too often ignored despite lung conditions being the third biggest killer in the UK. Tackling cancer, dementia, and diabetes are all key government priorities, yet the deadly toll of lung disease on the country’s health is often overlooked. The UK has one of the worst records for deaths from lung disease in Europe, and it’s no coincidence that we also have one of the highest rates of childhood asthma here.
Over 12 million people in this country will develop a lung condition over their lifetime. While there have been improvements in respiratory research and innovation, awareness is still low about the risk factors that trigger and shorten the lives of all too many. Progress has been patchy: in the past twenty years, there has been little improvement in diagnosing and treating lung conditions. Two conditions, chronic obstructive pulmonary disease (COPD) and bronchiectasis, have seen encouraging leaps forward in treatment options. But despite the promising news that Dupilumab, a monoclonal antibody therapy currently used to treat severe asthma, is expected to be approved soon in the UK, for some people affected by severe COPD, there have been no successful new drug developments for the condition in more than 30 years.
From pollution to pets: a multitude of risks trigger lung conditions
There are many triggers. Whether indoors or outdoors, at work or at play, air pollution affects us all. We can’t see it, but this invisible killer contributes to the early deaths of up to 43,000 people in the UK. It has been linked to the development and exacerbation of lung diseases, including asthma and COPD.
Sadly, it is children who are affected the most by poor air quality because their lungs are still developing, with the damage starting even when they are in the womb. Poor air quality not only stunts lung growth but also makes children more vulnerable to developing lung conditions like asthma during childhood or later in life. The tragic death of Ella Adoo Kissi-Debrah, a nine-year-old girl who died in 2013 following an asthma attack and became the first person in the world to have air pollution listed as a cause of death, shows the deadly impact of toxic air.
Smoking has a devastating impact on lung health: recent data shows it can shorten your life by almost ten years. (1) Giving up smoking is one of the best things you can do for your health. You are around three times more likely to quit by using specialist help, such as a local stop-smoking service, and stop-smoking treatments like nicotine replacement therapy (NRT) together. While e-cigarettes are less harmful than smoking tobacco and are effective as a tool to help smokers quit, they are not risk-free, and more evidence is needed to understand the long-term risks.
Stopping smoking means you’ll likely live longer, feel better, and have more money. You’ll also protect people around you from having to breathe in your smoke. Importantly, it’s never too late to stop, no matter how long you’ve smoked for. Whatever your age, just stop! And do it now. If you smoke and have a lung condition, quitting can improve your quality of life, help you cope with your symptoms, and stop your condition from getting worse. Other significant indoor triggers include mould, dust and aerosols. Asthma + Lung UK’s 2024 ‘Life with a Lung Condition’ survey found that 48% of respondents report that their lung symptoms are triggered by dust. A further 39% of people are triggered by cleaning products, 39% by perfumes and aerosols, 30% by paint fumes, 29% by moulds and fungi, and 18% are triggered by pets.
There are significant risks in the workplace, too. Breathing in dust, gases, fumes, and vapours at work can damage the lungs and lead to lung conditions like asbestosis, mesothelioma, silicosis, COPD, and asthma. Some jobs, such as construction workers, wood workers, and bakers, increase the risk of lung problems.
It’s imperative that the company you work for does a rigorous risk assessment to understand what can harm you at work and, if necessary, how you can control these risks. It’s equally important that if you’re worried about your health and safety at work, you communicate this directly to your employer. If they can’t or don’t address your concerns, you can report the problem to the Health and Safety Executive (HSE).
Taking action and mitigating the impacts
Air pollution is an invisible public health emergency: breathing in dirty air can cause life-threatening asthma attacks. But it’s not just the nation’s lung health that is on the line. From diabetes to dementia, the list of health impacts associated with our everyday exposure to air pollution grows ever longer and will continue to do so, unless politicians take ambitious action now.
Collectively, bold government action can really help tackle high levels of air pollution in our towns and cities. Schemes such as the Ultra Low Emission Zone (ULEZ) and clean air zones have been shown to reduce pollution effectively. Asthma + Lung UK are also calling on the government to introduce stronger legal targets on air pollution that match World Health Organization (WHO) guidelines.
People with lung conditions can reduce the impact of poor air quality on their lungs by taking their medication as prescribed and seeking help from the NHS if their symptoms get worse. You can also check air pollution levels in your local area to mitigate health impacts.
Inhaler technique is very important, and Asthma + Lung UK has some excellent inhaler explainer videos to help people manage their condition and use their inhaler properly. Eighty per cent of people were found not to be using their inhalers correctly. (2) It can be tricky to get it right. If you are prescribed a preventer inhaler, make sure you use it every day. You should also ensure you have your flu jab and, if eligible, your RSV, COVID-19, and pneumococcal vaccinations.
For a bit of peer support, there are local support groups run by Asthma + Lung UK dotted around the country, which can make all the difference if you’re struggling with your condition. There are online meetings, too. Sometimes, living with a lung condition can be an isolating and lonely experience, so connecting with others who have the same condition can be a great comfort. In addition to providing community and support, these groups can improve your breathing through fun activities such as singing and even learning to play the harmonica.
There is a dizzying array of risks in our everyday lives. However, government action to prioritise lung conditions, whether in new air pollution targets or NHS prevention plans in the ten-year plan, to better prevent lung disease, combined with greater public awareness and health advice, will help us improve the nation’s lungs.
Asthma + Lung UK resources: a list of helpful links on the subjects raised in this article
• The charity has a wealth of information about what causes indoor air pollution at home, including how people can improve and manage their indoor air quality. Outdoor air pollution is also covered here.
• Asthma + Lung UK advice on how smoking and vaping affect your lungs, including support to help you stop smoking.
• Occupational health information about working with a lung condition and air pollution at work. The HSE website is also a good port of call for advice.
• Our advice on flu can be found here.
References
1. Doll R, Peto, R, Boreham & Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519
2. Making asthma inhaler checks more effective- on and offline | Feature from King’s College London
