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Perception of cold varies a great deal from person to person. Some can tolerate chilly winter night comfortably just wearing a polyester shirt while others may fall sick on exposure to transient spell of cold. It is a matter of adaptibility of the body.

 

Climatic variations have only marginal effect on a normal person. However, for asthmatic person who is prone to dust, humidity, high temperature, and dusty environment the cold weather is more dangerous.Many persons with asthma or rhinitis gets aggravation of their disease on exposure to cold. Even in resting state, a person having asthma and nasal allergy has sensitive nose. Such a person develops nasal obstruction, watering through nose  or sneezing while moving in a  cold environment. It has been shown that airway cooling is an important trigger factor causing asthma. Airway cooling enhances inflammation thereby causing narrowing of airways and an asthma attack. Breathing cold air also causes congestion of inner layer of nose (nasal mucosa) and therefore leads to nasal obstruction. Cooling of other parts of the body has also been shown to aggravate asthma.
 
Why pollutants and cold weather increase the severity of asthma?
Cold and air pollution have an added trigger effect on asthma patients. Pollutants are generated both from stationary sources (industries) and from the mobile sources (automobiles). Nitrogen dioxide, sulphur dioxide, carbon monoxide, ozone and lead are some of the pollutants emitted. These pollutants are heavier than air hence remain suspended over the surface. Winter nights specially in the walled city area makes zones of stagnant air. On a foggy night, these pollutants mixed in fog remained stationary for long duration. When an asthmatic patient passes through such an area he is affected adversely. This effect is also termed as Pollution Inversion.

TRIGGER: COLD

ASTHMATIC STYLE

Bath in cold water
  • Why harmful?
    Cooling of any part of the body is known to trigger asthma. Taking bath with cold water specially without acclimatization can aggravate asthma.
  • Should avoid and use warm water for bath.
  • Develop adaptability slowly e.g. start taking bath by tap or well water during summer and continue in winter.
  
Scooter or Two Wheeler ride in winters
  • Why harmful?
    Direct blow of air cools the face and neck. During winter cooling becomes more intense. Nose and throat are usually very sensitive to cold in asthmatic patients. During winter season woollen clothes are worn but usually neck remains uncovered thus exposing throat and windpipe to the effects of cold.
  • Full mask helmet can protect face and nose from direct blow of the air.
  • Keep a woollen neck collar in the scooter and wear it while riding. It will protect neck, throat and windpipe from the effects of cold.
  • Use a car instead of scooter during winters.
   
Head bath by ladies with long hairs
  • Why harmful?
    After hair wash residual water remains in the hairs. If hairs are long residual water will also be more. Hairs will dry with evaporation of residual water. With evaporation, skin of head (scalp) will cool. In ladies residual water is more therefore cooling will be more and it may trigger asthma.

  • Take two thick towels. Wipe excess of water with one towel and wrap second towel tightly around head to absorb the remaining water.
  • Should not sit in the wind because airblow can accelerate evaporation of water from head and thereby delivering cold in the head.
  • Use a hair dryer.
  
Direct air blow from fan, cooler or air-conditioner
  • Why harmful?
    Direct blow of air from a fan causes increased evaporation of sweat and thereby cooling of skin. Sudden cooling may trigger asthma. In addition to this air blow from a fan causes drying of nostrils which may starts itch of sneeze and rhinitis. Cooler or air- conditioner causes cooling of skin which can trigger asthma.
  • Avoid sitting in the direct stream of air.
  • Wear adequate clothing if feeling cold.
  • Adjust cooling of cooler or air conditioner to your need. You should not feel cold. Usually during sleep one feels cold therefore you must have adequate warm clothes at hand or adjust thermostat of the AC.
  • If you are traveling in an AC couch of the train try to take lower berth. Upper berths with openings of cooling ducts are likely to cool excessively.
  • Never feel hesitant in turning AC or cooler off or change the direction of blow, away from you if you feel cold.
  
Cold edibles ice-cream/cold drinks
  • Why harmful?
    Cold edibles causes cooling of throat and food pipe. If a person takes ice cream this cooling is much more pronounced. Ice at 0 degree causes more cooling than water of 0 degree because ice has latent heat of freezing. Cooling of throat triggers asthma.

  • Take half melted ice cream so as to reduce latent heat of freezing.
  • Take cold edibles slowly.
  • Avoid taking cold edibles whilst perspiring or after eating oily edibles.
  • Take some secretogogue such as sugar crystals immediately after eating cold edible.
  
Going out on a chilly day
  • Why it is harmful?
    Cold atmospheric temperature can cause cooling of skin and thereby may trigger asthma.
  • Asthmatic patient should wear extra woolen cloth while going outside on a chilly day.
  • Neck, ears and feet are usually neglected. Therefore proper woolen cloth over head, neck collar and proper woolen socks should be worn.
    
Wetting in rains
  • Why harmful?
    With rains hairs and clothing become wet. If not changed immediately then hairs and clothes dry by evaporation of water. This causes prolonged cooling of skin of the body which may trigger asthma.

  • Avoid rain wetting by not going out while raining or going in a covered vehicle.
  • Use a mask.
  • If weather is cloudy take rain coat and head cap or an umbrella with you.
  • If become wet try to change cloths as soon as possible.
  • Dry hair by wiping it immediately by a towel.
  • Never dry yourself by sitting under a fast revolving fan.
  • You may take a cup of tea or hot drink as soon as possible.
                                                             
Exercise in cold weather
  • Why harmful?
    During breathing, atmospheric air is inhaled into the lungs. In the nasal passage air gets warmed to a temperature which is equivalent to body temperature (98.4°C). If quantity of inhaled air is more than the capacity of the warming process of nose then the cold air enters into the airway and induces asthma. During physical exercise in an attempt to inhale sufficient oxygen the patient sometimes take as much as 10 times more than usual air. Nose poses greater resistance to the breathing than mouth. In resting phase a person does not feel it and continue to take breathing through nose. However, at the time of exercise a person find difficulty in taking increased amount air through nose. In this situation a patient tries to ease by opening mouth widely. During mouth breathing nasal warming is bypassed and therefore more quantity of cold air is delivered into the airways thereby inducing asthma.
  • During exercise breathing should be done through nose.
  • A scarf or thick handkerchief wrapped over nose and mouth prevents heat loss during out in cold climate and also during exercise or play.

   

   
Drying of hair with "Mehandi" under a fast revolving fan.
  • Why it is harmful?
    When hairs are dried under a fan scalp (skin of head) cools. It may trigger asthma.
  • Sit in hot sun and dry hairs.
  • Hair dryer may be used.
  • Dry hairs without sitting under a fast fan or cooler.
   
Bare feet without habit, as going to temple
  • Why it is harmful?
    Without habit of bare feet if a person walks bare feet on a cold ground it causes cooling of soles which may trigger asthma.
  • Should wear slippers/shoes as often as possible.
  •  Wear socks all the time.
   
Going to school in an autoriksha in winters
  • Cover face with sheet. 
  
Morning walk
  • During cold nights asthmatic patient should avoid visiting areas having high load of vehicular pollution or areas with pollution emitting factories. Presence of fog in such areas makes a problem worse because fog contains stagnant air with high load of pollutants.
  

HOW A FAN INDUCES ASTHMA?
Example:
Tina is an asthmatic lady having habit of sleeping without covering her face with blanket. In the month of October as usual she had problem of asthma specially during night time. In presence of Mosquitoes in the house, she used to keep fan  running. Unfortunately, the regulator of the fan was not working hence the fan swung at full-speed. Though mosquitoes were repelled yet Tina had more severe asthma this time.

Curiosity:  

  • Why Tina had more severe asthma?  
  • How problem was solved?

After through search, it was observed that the full-speed fan and habit of keeping face uncovered have caused the asthma attack problem. Tina consulted experts to suggest the measures to control both asthma and mosquitoes.

Expert Comments:
Air blow from the full speed fan cools the exposed part of the body. Therefore face of Tina was cooled more. Face cooling specially during winter days may aggravate cold and asthma.

What were the alternatives?

  • Tina could have used a mosquito net as means of protection from mosquitoes instead of running the fan on at full speed.
  • Repair the defective regulator and reducing speed of the fan.
  • Should develop habit of covering face during sleep. Face may be covered with a thin bed cover, if blanket proves suffocating.

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How playing in cold weather caused asthma?
Example:
Twelve years aged Yudi was suffering from asthma. Playing in cold weather was an important factor aggravating his asthma. Yudi's parents asked him to stop play, which frustrated him. His performance in studies was also affected and topper of the class ranked 8th this time.

Curiosity:
 
  • What should be done? 
  • How the problem was solved?

There are millions of asthmatic children like Yudi who gets asthmatic problem on playing in cold climate. Stopping play in childhood not only affects stamina of the child's body but also affects the personality and mind adversely. He should play with asthmatic style and take medicine at appropriate time.

Expert Comments:
A scarf or thick handkerchief wrapped over nose and mouth prevents heat loss during out in cold climate and also during exercise or play.

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