Diwali and Asthma

Four-year-old John Mathan is excited over the crackers piling up at home, but his mother Geetha Mathan has shopped wisely. Knowing that he
is asthmatic, she has avoided buying crackers which emit thick smoke.

Diwali, the festival of lights and sweets, is also the time when asthma patients suffer from exposure to smoke. "I see 15 to 20 patients with spasms of asthma on Diwali day, as against four or five on other days," says Dr M Manimaran, pulmonologist and allergist. According to him, the trigger for the attack is heavy smoke from crackers like chakras, sparklers and snake tablets. "Children between the ages of six and 12 are particularly susceptible to the attack during Diwali," he added.

According to environment scientists, many of the crackers preferred by children are prepared with aluminum powder, sulphur and barium nitrate which give the rainbow coloured effect to sparklers. The smoke from bursting such items hangs in the atmosphere for long, and unless there are strong winds, the exposure to pollution is more.

Due precaution can mitigate the effects on people suffering from asthma, says Manimaran. "As a precaution, children should be put on a maintenance dose (medicine already prescribed for a patient's condition) a few days before the festival, and continue the same after Diwali for two days," he adds.

"Two puffs of the inhaler in the morning, and two more at night can soothe the airways." Mathan says the advice has worked for her in the past. In severe cases of asthma attack, children should be taken to a polyclinic and put on nebuliser for 10 to 15 minutes.

Dr Ashok Mahasur, chest physician at Mumbai's Hinduja Hospital, says the Indian weather in October allows pollutants to stay in the atmosphere for long. "Due to the weather change, pollution levels rise from October. And smoke from crackers means patients with respiratory disorders getting aggravated symptoms and sometimes acute attacks. We see a 30% rise in respiratory morbidity post-Diwali.''

The biggest culprits in terms of emission are chakras, colour sparklers, fire pencils, snake tablets and hydrogen bombs. Firecrackers should be burst on the terrace or open spaces, where there is adequate ventilation. But it is preferable if asthma patients stay away from crackers completely, said Pramod Niphadkar, a chest physician at St George Hospital, Mumbai. While avoiding the smoke completely may be impossible, those who have problems during Diwali often find it difficult to get doctors, as many of them would be on holiday. So patients are advised to be well-prepared with medicines and inhalers.