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a lung expert shares advice on how we can decrease our chances of lung disease

dr. anne hicks from the university of alberta talks about the role of heart disease, scoliosis and genetics in developing lung disease and why having a dog may promote good lung health in kids.

you breathe in and out 22,000 times each day
our lungs clean toxins, bacteria and viruses out of the air that we breathe. getty
take a deep breath.
at its most basic, it will calm you down and ease your aching neck. at its most vital, it will literally keep you alive. each time we inhale, our lungs bring life-sustaining oxygen into our body. when we exhale, they push out carbon dioxide from our blood in a kind of gas exchange agreement.

according to the canadian lung association , we breathe in and out about 22,000 times a day, yet most of us pay little attention to that vital pair of spongy organs sitting neatly on either side of our chest. until something goes wrong, that is, and then it’s all we think about.

as much as these precious life-preservers do for us, we must also do for them to keep them healthy and functioning, especially as we age, when lung capacity declines. dr. anne hicks, an assistant professor, as well as the director and clinical lead at the children’s environmental health clinic (chehc) at the university of alberta, offers advice on how to do just that.

how do our lungs protect us from the air out there?

our lungs clean toxins, bacteria and viruses out of the air that we breathe. they also act as a filter that can remove blood clots from our system.
a lot of the toxins that lungs remove are related to air pollution — black carbon, fine particulate matter from car exhaust, smoke and industrial pollution that are common components of smog, and also naturally occurring dust and wildfire smoke.

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our lungs clean themselves with a combination of mucus, hairlike structures called cilia that shift mucus from low down up into our windpipe so we can cough it out, and other mechanisms that include surfactant, a soap-like compound that collects dirt, debris, pollen and even germs, and antibodies. also, infection-fighting white blood cells attack invading bacteria and viruses.

what role do genetics play in who gets a lung disease?

a lot of lung diseases are “epigenetic” — if you have certain genetic characteristics you may be more prone to developing a lung disease. but environmental exposures also play a role.
big categories of lung disease include obstructive diseases, like asthma and chronic obstructive pulmonary disease (copd). both have genetic components and can be worsened and triggered by exposures.
another broad category of lung diseases is damage caused by infection. some conditions, such as immune deficiencies, cystic fibrosis, abnormal versions of the cilia that clear the lungs, or differences in lung structure that can increase infection risks, are inherited. some structure changes may not be genetic, but babies may be born with them. heart disease or scoliosis can also cause problems with the lungs.

besides smoking and vaping, what are some other noxious substances that can harm our lungs?

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from the natural world, dust, sand, wildfire smoke and moulds can all cause problems, as can dust storms and volcanoes. allergic responses to moulds can increase after a flood.
man-made problems include hydrocarbons from partly burnt fuels [such as] traffic-related air pollution and even byproducts from cooking with oil and using a natural gas stove. a lot of scented products are respiratory irritants. people who work with products that form dust clouds, droplets or aerosols are also at risk of harm. silica is sharp and stays in the lungs forever, causing disease years after an exposure. asbestos is also linked to lung cancer.

what are the more toxic substances some people work with? 

any fuel combustion will be incomplete, so working around gas and diesel can be an issue without good ventilation and protection, as can different types of chemicals and dusts. benzene and toluene, as well as mining coal, cause breathing problems. and, of course, health-care workers often need to use respiratory protection due to infection risk.
welders and people in similar occupations breathe in toxic compounds daily. firefighters and others who work in environments with air pollution are also at risk.

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wearing good quality respiratory protection, which may include n95 masks, can help. but also respirators that can remove chemicals more effectively, since n95s remove particles but do not control toxic gases like hydrogen sulphide.

what indoor pollutants are harmful and how do we reduce or eliminate them?

smoking — typically tobacco, but there is some evidence that cannabis and vape also have an impact — is the single-most modifiable and significant contributor to indoor air pollution.
it is important to make sure that all of your natural gas appliances work properly and vent to the outdoors. when possible, switch to appliances associated with fewer pollution problems.
anything that burns, including fireplaces, wood stoves and scented candles can contribute to indoor air pollution. lungs do not like to breathe in any kind of oil, because it consumes the surfactant that lungs use to protect themselves and make breathing easier.

common in many canadian homes is radon, a colourless, odourless gas that is a cause of lung cancer, so radon checking is important ( find out more about how to check your home for radon here)

carbon monoxide is of most concern during the winter, when people might be dependent on combustion for heat. it is odourless, invisible, and lethal, so using a carbon monoxide alarm saves lives.

how does regular exercise strengthen or improve our lung function?

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good cardiac and respiratory fitness helps us breathe more easily and can maintain heart and lung function at a higher level. that gives us a buffer against infections and irritation, both because our lungs are working well with their defense systems in good shape, and because we have “respiratory reserve,” meaning we can handle needing to work a little harder to breathe because our heart and lungs do it regularly when we exercise.
having a healthy diet can promote good health in general, and people who are in good health will have more energy to breathe and deal with infection and irritants.

what research are you working on, or are aware of, that looks promising for the prevention and treatment of lung disease?

our group is looking at the effects of indoor and outdoor lung pollution on children’s lung health. [research] shows that children who are less exposed to things like traffic-related air pollution may have healthier lungs. and it has been well-known for a long time that exposure to cigarette smoke in the home increases the risk of children needing to be hospitalized with a respiratory infection and developing asthma. there is also emerging research, including by dr. anita kozyrskyj at the university of alberta, that having a dog during the first year of life may decrease the risk of developing asthma.

anything else you’d like to add about the prevalence of lung disease and how canadians can minimize or prevent it?

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asthma is the most common chronic disease of childhood, and it is only one of many lung diseases that affects children and adults, since many lung problems develop in childhood but last a lifetime.
canadians can help prevent lung disease by minimizing exposure to irritants and infections that could cause damage, pursuing healthy exercise, and doing their best to treat their existing heart and lung diseases like asthma and copd.

on a bigger scale, preventing lung disease has a lot to do with decreasing air pollution emissions, whether that is fighting climate change at a global level or taking community actions like [implementing] anti-idling zones, or a neighbourhood “ walking school bus.

sometimes problems look really big, but small steps can help.
 
robin roberts is a vancouver-based writer.
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