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Triggers
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Kitchen with poor ventilation causes more problems for an asthmatic
patient. Cooking and the kitchen have a lot to do with triggering
asthma attacks. Follow simple guidelines and kitchen rules to stop
asthma.
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Kitchen
Fumes
There are abundant clinical evidences and awareness about
precipitation of asthma by aeroallergens in the home. The
symptomatic impact of indoor air pollutants from wood fire, cow dung
fire, kerosene stoves and cooking oil fumes have not been paid much
attention.
Clinical studies
have shown that regular contact
with these type of fumes aggravate asthma in symptomatic patients.
Kitchen fumes are an important trigger factor of asthma in Indian
housewives.
How
kitchen works aggravate Asthma?
During healthy periods inner lining of
respiratory tract becomes normal and
trivial irritation of kitchen fumes does not aggravate
asthma.
During
asthmatic attack the inner layer of respiratory tract is
inflamed, ulcerated and becomes very delicate. Even slight
irritation by kitchen fumes hurts it and results into an
asthmatic attack. Combustion products of fuels, cooking oil, and
fumes generated by frying of
pepper and other spices in oil or ghee are very irritant to nasal
and bronchial mucosa. Regular exposure can prolong duration of asthma episodes to make it a chronic
disease.
Besides volatiles in the kitchen, there are few other trigger factors causing asthma such as
cleaning of cereals, straining of wheat flour "atta"
cutting of onion, etc. The causes of inducing asthma in
such kitchen work are varied. Stored grains, spices and jute bags all have storage mites
(types of dust mite). Storage mites can induce asthma in susceptible persons. Higher humidity
increases growth of storage mite. Therefore, before and after rainy season, straining
and grinding of grains and spices can induce severe asthma. Apart from mites, straining
and grinding
can generate airborne particles which can
induce irritation of nasal and bronchial mucosa, and
therefore induce asthma attack. Hot pepper powder is
most powerful irritant in this category.
Most of the
housewives get asthmatic attacks in the night after they perform these works in the day time.
Not
much literature is available on this subject even in the western text books. This is because of the
fact that western food is mostly processed and people rarely cook meals as it is done in
India. In developed nations like USA, Canada, U.K. and
Australia, the canned food, frozen food and other
eatables do not require any frying or mixing of hot spices.
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how
a Grain
grinder causes asthma?
Example:
Six year old Ritu
had asthma for last one year. She lived in a
small village with her parents. They were
living a traditional life. Her mother used
to get up early in the morning to grind
Bajra grains in the hand driven grinder
fixed beside Ritu's bed.
Curiosity:
-
What led to asthma in Ritu?
- How the
problem was solved?
When the
family realised the mistake, her bed was
shifted to another room. Then she got
relieved from this agony.
Expert
Comments:
Grain dust
when inhaled can lead to asthma.
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Risk
factors of a kitchen with
poor ventilation
- Poor ventilation increases concentration of chemical
fumes during cooking.
- Cooking
fumes stays longer in kitchen.
- Smell
of cutting onion stays longer.
- Particles of grain flour straining or cereal cleaning,
remain suspended in
air for longer.
Smoke or fume
generating works in kitchen
- "Chulha"
smoke
- Burning of coal, wood, and cow dung.
- Stove
smoke- Kerosene.
- Gas
cooking.
- Oil and Ghee cooking
- Preparing
"parantha".
- Preparing
"poory", "pakori" and other
"chat pakodi".
- Roasting
of Jeera, and Spices.
- Preparing
meat and fish.
- Other
Fumes
- Preparing
"Kadha".
- Steam
of Pressure Cooker.
Other
smokeless triggers of kitchen
- Cereals
- Taking out from
Jute nag or tank.
- Grinding garam
masala.
- Atta
- Spices
- Jeera,
Rai, Hot spices, Heeng: Straining, Grinding.
- Chillis, Turmeric:
Straining, Grinding.
- Onion
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Composition
of kitchen fumes
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Wood, cow dung and coal
combustion
- Carbon
mono-oxide.
- Carbon
dioxide.
- Nitrogen
dioxide.
- Particulate
matter.
- Polycyclic
aromatic hydrocarbon.
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Kerosene fuels
burning.
- Nitrogen
dioxide.
- Carbon
dioxide.
- Carbon
monoxide.
- Hydrocarbon.
-
Ghee or
cooking oil fumes.
- Polyclic
hydrocarbon.
- Benzopyrene.
- Dibenzo Anthracine.
- Vaporized
diglycerides.
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Fumes of
frying
- Pepper,
cumin seed and other spices in oil or ghee.
- Organic
substances and hydrocarbons.
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how
Kitchen triggers asthma?
Example:
Sapna at Dehradoon,
once had throat infection with common cold.
After 3-4 days her cold improved but cough
persisted. During this period she has
grinded chillies by "Imamdusta".
Pungent smell from chillies worsened her
cough, and later in the night she had
difficulty in breathing. Entire night she
could not sleep. Next morning she went to a
doctor who diagnosed her with an attack of
asthma.
Curiosity:
-
What caused asthma in Sapna?
- How the
problem was solved ?
She followed doctor's treatment and
got cured. Next time whenever she crushed
spices, she had difficulty in breathing.
Then she started buying ready-made 'masala'
but the quality was not up to the mark.
Expert
Comments:
Irritant
dust of spices during grinding is inhaled. It
triggers asthma.
Simple precautions may be followed:
- Wear a
mask and make central portion of the mask wet with
water.
- Use a
mixer-grinder. After grinding the spices one
should not open the lid at once but rather wait
for about 10 minutes, so that the powder is
settled.
- Avoid
exposure to trigger factors while you are having
viral infections of throat or respiratory tract.
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TRIGGER:
KITCHEN
EXPOSURE
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ASTHMA
STYLE
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| Cereals
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- Keep
cereals in tank instead of a jute bag.
- Put
a wet face mask over nose and mouth or a nasal
filter in the nose and take out wheat from
storage. Put these cereal in to a bucket half
filled with water. Wash these and dry up by
spreading on a cloth sheet under sunlight. Once
dried then clean it.
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| "Atta"
grain flour
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- Use
wet mask or nasal filter or bring food grain flour
(atta) from the container.
- STRAINING:
One should not strain "atta". If you
strain the "atta" you loose the
important fibre part "TUS" which contains
maximum useful macro-micro ingredients. It reduces
the chances of bowel cancer and saves from many
other diseases.
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| Spices
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- Try
to purchase packed spices.
- If
you want to grind it at home then use a
mixer-grinder and do not open the lid immediately
but open it after 5-10 minutes, so that powder get
settled and does not get inhaled into respiratory
tract.
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| Onion
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- Peel
off its skin and keep it in water.
- Cut
its pieces inside water.
- Cut
pieces of onions if kept in salt and water it
looses its irritating smell and then it can be
taken for eating.
- Fried
onion is devoid of its irritating properties and
therefore can be used in food.
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| Storage
of grains and spices
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- Kitchen
has high humidity levels which may help mite and
mold growth. Therefore these should preferably be
kept in separate store.
- Jute
bags attract more dust and also absorbs more
moisture therefore cereals and spices should be
kept inside a tightly packed tin or box.
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| Smoke
and fumes from fire wood, cow dung and chulha cooking or
frying
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- Proper chimney for exit of smoke from
firewood cow dung should be fixed so that smoke
does not spread in kitchen.
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Nirdhum
or smokeless chulha is a good alternative.
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Good
exhaust fan in the kitchen. The fan should be
fixed on the walls of cooking stand as shown in
the figure. It should never be placed on opposite
wall.
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Use a
wet mask or nasal filter when doing lots of oily
cooking as during festivals.
- Placements
of fume absorbing chimney. Many companies are
manufacturing such chimney. It is an efficient but
expensive alternative.
Change the style of "frying" for preparing
vegetables.
Steps
of regular preparation,
1.
Ghee/oil-heated.
2. Cumin seed
are added.
3. Hot
pepper and spices are added.
4.
Vegetable is added.
At
third step lot of irritant fumes are
generated. In order to reduce generation of fumes steps of
following asthmatic style should be adopted.
1.
Ghee/oil heated.
2. Cumin
seed are added.
3.
Vegetable is added.
4. Hot
pepper and spices are added.
5.
Container is closed and heating is
discontinued.
With
this method less fumes are generated. A useful
alternative is to mix hot pepper and spices in
water and to add in the container at the time of
third step.
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HOW
COOKING
VOLATILES CAUSE ASTHMA?
Example:
This may sound funny! A
young lady doctor, who migrated to England,
rented a single room apartment in the
Nottingham city hospital. After a couple of
days while she was cooking meals in the
kitchen a fire alarm rang loudly, and then
within five minutes police and fire brigades
were there. The doctor thought probably there
was fire in the house of some neighbor. But
fireman gave a big bang on the door of her
house. As he entered the kitchen he laughed,
Oh! Dear!
Curiosity:
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What led to fire alarm and movement of fire brigade?
- How the problem
was traced?
In England smoke detectors are fitted in large
number of houses and these are directly connected to
the fire station. Cooking
of Indian food involves lot of fumes specially during
frying and these cooking fumes activated the alarm.
Expert
comments:
The above
is not an isolated example of the UK doctor
but practically all Indian homes are prone
to this problem. Though Indian homes are not
fitted with fire alarm but every asthmatic
patient has one. Fumes of
cooking of all spicy food, triggers this
alarm which manifest in form of asthmatic
symptoms.
Though modernization in the kitchen-wares can lessen
the asthma risks but ordinarily spicy
volatiles trigger asthma specially in patients working
in the kitchen. Whether a house wife or a dear
daughter even with the remotest symptom of asthma is
cooking spicy food or using a mixer-grinder for
crushing red pepper, its aerosol particles are going
to affect the respiration. These volatiles can trigger
asthma. Viewing and assessing the patient's misery and
a
few simple precautions can lead a better environment
in the kitchen room and can facilitate working lady to
perform in congenial way.
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HOW
CLOSED
KITCHEN CAUSES ASTHMA?
Example:
Sita, 18 years, had
asthma since childhood but she never had its
acute attack while working in the kitchen.
At a new place when she complained of asthma
it was found that whenever she fried or
prepared parantha she gets an asthma attack.
Curiosity:
- What led
to asthma in Sita?
- Can Sita
cook parantha without having asthma?
- How problem was
solved?
By
using wet mask or nasal filter during
cooking Sita's problem was solved.
Expert
comments:
Fumes
emitting from parantha aggravated the
asthmatic problem of Sita. Initially it was advised her
not to do kitchen work but it was not possible for a
newly wed girl in a joint family to avoid such domestic
work. Not only that, there was no electricity in the
village, but also the exhaust fan could not be installed
in the kitchen.
Looking all the problem Sita was advised to change the
way of cooking and especially of frying techniques. She
was told to first mix Jira in the heated ghee/oil, then vegetables, and finally all the spices.
This style generates less fumes, which gave less
problem to her. She was also advised to use wet face
mask while cooking.
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Why
various types of kitchen work induces asthma?
Apart
from smoke generating works the causes of asthma
triggers in kitchen are varied. Stored grains, spices
and jute bag all have storage mites (types of dust mite)
and some may have mold. Storage mites and mold can induce
asthma in susceptible person. Higher humidity increases
growth of storage mites. Therefore, before and after
rainy season, straining and grinding of grains and
spices can induce severe asthma. Apart from mites, straining
and grinding of spices generate air-borne
particles which can cause irritation of nasal and bronchial mucosa, and therefore induce asthma attack.
Hot pepper powder is most powerful irritant in this
category.
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| What
is the effect of onion in asthma? |
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HOW
KITCHEN
FUMES INDUCE ASTHMA?
Example (True Incidence):
Mamta, 25 years, had a mild asthma
problem during change of season. But this
time Mamta had cold and cough, and later on
after 2-3 days she had asthma. Usually she
lived normally with medicines for 5-7 days,
but this time she had asthma.
Curiosity:
-
What caused asthma in Mamta?
- How the
problem was solved?
A
detailed investigation revealed that while
preparing food in her unventilated kitchen,
cooking fumes affected her respiratory
mucosa and triggered asthma. Mamta
subsequently used an exhaust fan in
the kitchen and changed the way of frying spices.
This way her asthma was minimized within a few
days.
Expert
Comments:
Mamta
had following options for having a normal asthma free
life:
- To quit
cooking of food-not practical.
- Use
face mask or nasal filter while cooking food.
- Adopt
Asthmatic
style while
frying the vegetables as shown elsewhere in this chapter.
- Use
exhaust fan in the kitchen.
- Use an
electric chimney over burner.
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