ARE YOUR LUNGS FIT FOR TRAVELLING?

By Dr. W. Gifford Jones

March 3, 1991

Would you like to linger at a sidewalk cafe in Paris, Mexico City or Madrid sipping a cool drink? Few would turn down this offer. But before any of us accept this invitation it would be prudent to first test our lungs.

This year an asthmatic patient of mine landed by plane in Mexico City. A few moments later she was gasping for breath, and was rushed to an air-conditioned room at a nearby hospital. She was one of the over eight million North Americans who suffer from asthma and who encounter serious respiratory problems in any of the polluted cities around the world.

A change of geography does not always guarantee a breath of fresh air. A study of urban air pollution sponsored by the World Health Organization (WHO) attempted to rank cities such as Paris, New York, Madrid, Shenyang China, Rio deJaneiro and Milan. Many of their own residents are slowly choking to death. And unsuspecting travellers often become too breathless to partake of their pleasures.

WHO named Shenyang, Teheran and Seoul as the cities with the highest levels of sulphur dioxide in the atmosphere, a potent lung irritant produced by the burning of coal and oil.

The worst environmental disaster involving sulphur dioxide occurred in London, England in 1952. At that time 2,000 micrograms of sulphur were recorded in a single cubic meter of air. That December, 4000 Londoners died of cardiovascular complications and the city placed strict controls on the burning of coal.

High carbon monoxide levels also pose a threat to asthmatics and those with other pulmonary problems. Carbon monoxide replaces oxygen in the blood stream and can precipitate attacks of angina in those with borderline heart function. Carbon monoxide levels can reach dangerous levels particularly during urban rush hour traffic.

Air pollution carries with it other more subtle and dangerous substances. Lead accumulates in the blood, cannot be flushed out and can cause injury to kidneys and nerves. It is particularly hazardous to children. The World Health Organization sets permittable levels of lead at one microgram per cubic meter of air. Stockholm, Sydney, Paris and Mexico City all exceed this level. Nitrogen oxide and plain dust also damage the lungs.

Can travellers protect themselves from these various air pollutants? First of all, a check-up with a doctor will determine how much lung damage is already present from emphysema, bronchiectasis or asthma. And whether it's foolhardy to travel to a certain location.

Asthmatics should never take their disease lightly particularly when they travel. Even at home an increasing number of asthmatics are dying from acute attacks. For instance, in 1988, 445 Canadians died of asthma, a 50 per cent increase over a 13 year period. Other industrialized nations such as the U.S., Britain and Sweden have also witnessed a 50 per cent increase in fatality among asthmatics between 15 to 34 years of age.

Doctors say this disease should not have a fatal outcome and are hard pressed to know why this is happening. Some blame food additives and air-tight buildings that trap chemicals and fumes. Others say it's due to people taking too many puffs of their bronchodilators which gives speedy relief but a false sense of security, as it does not clear up the underlying inflammation.

Some respirologists suggest, whether you're young or elderly, it's wise to see if your lung capacity can withstand pollution in a North American city. If it can cope with the air of New York, Chicago or Toronto, you have a reasonable chance of enjoying a tequila in Mexico City.

If you have a respiratory problem, other recommendations are in order. Do your exercising at home, not in a polluted city. But if you can't resist the temptation to jog, do it early in the morning or late evening. At this time the sun isn't forming ozone in the air and there are fewer cars spewing out carbon monoxide.

You may find people staring at you, but breathing through a surgical mask or a handkerchief does help to filter out some dust. It also keeps the breath moist in dry air.

Patients with respiratory problems should also carry their medication with them. It does little good to leave asthmatic medication at your hotel when you're travelling on a dusty road in Mexico and you suffer a sudden attack miles from the nearest hospital.

Some travellers with known respiratory problems should take another tack. Pick a city where the air is clean. After all, who would complain about going to Auckland, New Zealand, Caracas, Venezuela, the British Virgin Islands or Copenhagen? Or simply exploring the rural areas of this still relatively clean continent?

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones

Canada Free Press, CFP Editor Judi McLeod