An interview with Dr Saqib Saeed Pulmonologist at Ammar Medical Complex, Lahore
1: Firstly, tell me about the role and importance of lungs?
Well, lungs are the organs which maintain the balance of oxygen and carbon dioxide in the body. Oxygen plays an important role in the breathing process and is necessary for the cells of the body. On the other hand, carbon dioxide is a poisonous waste product present in every cell that has to be exhaled out. Apart from many other functions, one of the basic functions of lungs is to bring oxygen in and expel carbon dioxide out of the body. Lungs, like any other essential organ of the body, are important in maintaining health and are vital in sustaining the life. Every function of the body would seize if lungs do not work properly. In short, one cannot live without lungs.
2: Hmm… Then what are the most common lung diseases in Pakistan?
Some of the most common lung diseases we normally come across here are pneumonia, tuberculosis, bronchitis, lung cancer, bronchial asthma, chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD).
3: Which ones are dangerous?
Well, one of the most dangerous lung diseases is lung cancer. It is on the rise because the frequency of smoking among teenagers and women is increasing rapidly in the country. Interstitial lung disease is another fatal disease common among people over 50 years. Interstitial lung disease is a term used to refer to a particular type of inflammation of the interstitium of the lungs. The interstitium is the tissue that surrounds and separates the tiny air sacs (alveolae) in the lungs.
4: What causes lung diseases?
Most of the lung diseases are caused by atmospheric pollution and smoking. Lung cancer and COPD is mainly caused by smoking be it cigarette, pipe or sheesha. COPD is uncommon in non smokers. Some interstitial lung diseases are caused by certain drugs, exposure to radiotherapy or certain other medical treatments. However certain other types of interstitial lung diseases have an unknown cause and are called idiopathic pulmonary fibrosis. Asthma is genetic and can develop at any stage in life. It is mainly caused by allergies. We have various allergens (allergy-causing substances) around us almost all the time. For example dust, fungus, pollen and animal dander. House dust is one of the major causes of asthma in children.
5: Who is at risk of having them?
Anybody can develop lung disease. Smokers obviously are at the top of the list because smoking is the cause of most of the lung diseases including lung cancer and chronic obstructive pulmonary disease. A person who on an average smokes 20 cigarettes a day for 20 years is likely to develop significant level of COPD. People living in polluted areas have a high risk of developing respiratory infections, bronchial asthma and allergic lung diseases. There are certain occupations where people are more prone to develop lung diseases for example people working in coal mines, sugar and textile mills and those who work with silica, etc.
6: Sheesha culture has become quite common now especially among the youth. Can you tell us how harmful it can be for the lungs?
It is extremely harmful for the lungs. We know that sheesha cafés have a secluded atmosphere and a lot of people are smoking in the same room. Even if you are not smoking actively you passively inhale the smoke. It is a proven fact that if you spend an hour in an enclosed sheesha café smoking sheesha you end up inhaling nearly 100 cigarettes every hour which puts a huge burden on lungs. Sheesha café culture is responsible for promoting this addiction among teenagers. The government is trying to curb such cafés. And I think the smoking areas in all the restaurants should be closed down.
7: What about children; which lung diseases are common among them?
Congenital lung diseases (present at birth) are most common among children. Children who develop this normally have defective genes. Certain children are born with soft wind pipes therefore develop a condition called Bronchomalacia that causes recurrent infections. Moreover, pneumonia and bronchial asthma are also common among children.
8: Which diseases are likely to occur in old age?
In old age most of the diseases are not a direct consequence of the aging process. They are related to various environmental factors. Smoking and atmospheric pollution play a major role. Also as you grow older your immunity reduces and you are more prone to develop lung infections.
9: Can lung diseases be prevented; how?
Lung diseases can indeed be prevented. As I mentioned earlier, lung cancer and COPD which form a major portion of lung diseases are directly related to smokers and are uncommon among non smokers. So the most important prevention of lung diseases is to avoid smoking (both active and passive).Laws should be enforced to ban smoking in public places.
10: Tell me, how important is exercise and diet in keeping lungs healthy?
Just as for other body organs, exercise is extremely important for maintaining the health of lungs. You have raised a significant issue of diet. Diet certainly has a major role in lung diseases. Bronchial asthma which affects nearly around 10 percent of the Pakistani population is believed to be a disease of urban areas. Dietary habits are to be blamed for it. Refined and fast foods play a major role in developing bronchial asthma. A proper balanced diet that has a combination of all the six essential nutrients is necessary for healthy lungs. Fiber intake is also necessary for maintaining the health of the lungs and respiratory system.
11: We hear a lot about chest infections. What actually causes them?
Chest infections are caused by various micro-organisms like bacteria, viruses and fungi present in the atmosphere. Most people develop acute chest infection over few hours or over one or two days. They may produce sputum (phlegm) that is yellow or green in color; have fever and shortness of breath.
12: How can they be treated and are there any vaccinations available?
The treatment of chest infection depends on the organism that causes the infection. Most of the infections are caused by bacteria and are treated with antibiotics. Yes, we do have vaccinations available for chronic chest problems like COPD, bronchial asthma and bronchitis etc. Vaccination however, is avoided if a person has an acute chest infection.
13: How can one avoid a chest infection?
Chest infections can be avoided by maintaining personal hygiene and observing the “clean hand” policy. Washing hands frequently with a good antiseptic soap does prevent a lot of respiratory infections. Most infections spread through coughing. I therefore advice patients not to cough openly. Those who do not suffer from respiratory infections means they follow manners of covering their mouth with a handkerchief or tissue while coughing.
14: Asthma is a common problem we see among many. Why does it occur and how can it be prevented?
As I have mentioned earlier, bronchial asthma in children is generally caused by allergens. The most common allergen is the house dust which is microscopic organism that lives in the carpets, curtains and pillow cases, etc. We can prevent asthma by removing the carpets, fabric curtains, cats, dogs and cockroaches from our houses especially from the children’s room. Modification in the home environment does help in preventing initiation of asthma but once you have developed it, the single most important factor is to take the medicines regularly. Adults can prevent asthma by avoiding active and passive smoking and by promoting and maintaining a clean atmosphere. A lot of patients think that certain foods like milk, rice, etc. cause asthma. This is not true since none of the foods are associated with development of asthma.
15: I wonder how women should deal with their asthma during pregnancy. Are medicines safe during this time?
There is an equal possibility that during pregnancy asthma might stay the same, get better or even worse. My advice to pregnant ladies who have bronchial asthma is to take their medicines regularly with their doctor’s consultation because uncontrolled asthma causes more harm to the baby than medicines. Medicines used to control asthma are safe during pregnancy.
16: Asthmatics have to use inhaler along with other medicines. And people generally fear using inhalers thinking it will cause dependency. Your take on this?
Oh well, this fear is vanishing rapidly now. There is a lot of information available on internet and people are becoming more aware about the use of inhalers and they understand it is a need.
17: Any message you would like to give to readers for keeping their lungs healthy?
To prevent lung diseases and to keep the lungs healthy stay away from smoking be it active smoking or passive smoking. And play your role in curbing down the curse of smoking.
aishamumtaz 