8 ms·

Doctors Might Have Been Focusing on the Wrong Asthma Triggers

81 points by aliasEli 5y ago

belltaco 5y ago
I wonder how much impact the reduced pollution due to reduced traffic during the lockdowns and increased remote work later had on the study subjects, even if they were indoors.
- kurthr 5y ago
  I came to post just this. Rubber is a pretty common allergen. Wearing masks (especially N95) when out/about also probably helps a lot.
mensetmanusman 5y ago
I have had asthma my entire life, and it definitely flares up with airborne irritants. There has been awesome citizen science work going on helping people understand the direct link between anything that emits smoke and asthma attacks: https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1315 https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1315 They even found that parents waiting to pick up kids at schools with their ICE engines running increased PM2.5 inside the entire building by orders of magnitude. This data helped the kids teach their parents to stop their engines when waiting outside the school in order to help their asthmatic classmates. The transition to EV is going to have a positive impact on people’s health and make city life better.
- ADSSDA 5y ago
  Isn't most PM 2.5 pollution produced by brake pad and tire wear, which is made worse by EVs due to their weight?
  - deleted 5y ago
    [deleted]
  - oh_sigh 5y ago
    If the ev has regenerative braking, the brakes actually last much longer than in ICE cars. Not sure how tires are affected but I'd imagine they do have a shorter life, and I'm not sure how the longer brake life balances with (probably) shorter tire life from a pollution perspective
    - robbedpeter 5y ago
      Why would tires last longer in an ICE vehicle? I don't think tires care what makes them spin.
      - sargunv 5y ago
        Electric cars are heavier due to the battery.
        perl4ever 5y ago
        It depends on exactly which car you are comparing. The Tesla Model 3 is somewhere around 3500 lbs, isn't it? That's pretty average for a car these days. And there are plenty of big SUVs that have a similar weight to the heavier EVs. Besides, you can't assume that electric cars use the same tires as non-electric ones. There is a huge range of tires out there from extremely long wearing ones to sticky ones that last a fraction of the time.
      - oh_sigh 5y ago
        I believe tires last less time in an EV, because of the increased mass. But maybe that isn't the case. I just looked up a comparable ICE to a model 3, got the BMW 330i, and that has approximately the same weight (3500 lbs)
  - deeviant 5y ago
    > which is made worse by EVs due to their weight? What a ridiculous supposition. First the weight difference is not that huge, second EV's use regenerative breaking for a huge portion of their breaking spectrum bypassing break pads entirely.
    - briefcomment 5y ago
      Idk if you tried looking at any evidence when making your claim, but this clearly supports the gp and contradicts your statement [1] [2]. [1]https://www.ridef2.com/blog-del-direttore-ridef/will-electric-vehicles-contribute-less-particulate-matter-pm10-and-pm25-to-our-air-recent-analysis-and-meta-analysis-conclude-negligibly-and-policies-to-reduce-number-and-weight-of-vehicles-are-needed4720595 https://www.ridef2.com/blog-del-direttore-ridef/will-electri... [2]https://www.sciencedirect.com/science/article/abs/pii/S135223101630187X https://www.sciencedirect.com/science/article/abs/pii/S13522...
      - deeviant 5y ago
        Idk, if you bothered to read the study that you are pointing to in your coup de grace, you'd would realize your cited sources admit that EV's create no more particulate pollution than ICE engines. Your cited study actually states that EVs do reduce particulate pollution but only by a couple percent, which is opposite of "creating more" for those who prefer evidence based positions. It's almost as if regenerative breaking reduces break wear and compensates for the marginal increase weight as many other people have already pointed out?
        briefcomment 5y ago
        The original GP's post had two points: - most PM 2.5 pollution is produced by brake pad and tire wear - which [i.e. PM 2.5 pollution produced by brake pad and tire wear] is made worse by EVs due to their weight These are direct quotes from my links: - "A large fraction (50-85% and up to 90%) of traffic generated PM10 and PM2,5 is not due to the exhaust emissions by the motor, but rather to non-exhaust emissions (brake wear, road wear, tyre wear and road dust resuspension)" - "A positive relationship exists between vehicle weight and non-exhaust emissions."... "Electric vehicles are 24% heavier than their conventional counterparts."
  - Gibbon1 5y ago
    People tend to assume that gasoline engines don't produce PM2.5, but that's apparently wrong. I saw some seemingly legit report that claims tire and brakes create about 10% of the PM2.5 pollution. EV and Hybrid cars have regen braking which reduces brake pad wear. I don't know about PM2.5 but hybrids also emit much less NOx than straight gasoline cars.
  - jsharf 5y ago
    These are idle cars which are not braking, so the PM2.5 here is purely the engine pollution. City life might not be affected as much, but school buildings with cars waiting outside will be!
- bamboozled 5y ago
  I've apparently never had asthma in my life, until I moved to Sydney, Australia for a while. It's a city which _loves_ cars. I used to cycle about 20 minutes to the office, the view was beautiful but the traffic was horrendous. I used to wheeze and struggle with breathing a lot more than usual. The doctor diagnosed me with "seasonal asthma" and gave me a ventolin prescription, which I've never felt the need to refill since leaving. The doctor told me there was some phenomenon which made the air pollution worse, something about the reflection of the water from the harbor ? I wish I could remember what it was called. It's anecdotal but that was my experience.
  - 123123as1asd12 5y ago
    I cant live in sydney, I nearly died from asthma when I moved there as a child to live with my father. every time i visited he would have to rent a nebulizer, i have asthma but not that terrible, that place is horrid. I believe its the pollen as well as the cars. Coastal regions are way better for asthmatics. the dry salty air. gold coast/sunshine coast.
  - robbiep 5y ago
    Where did you live previously? Australia has one of the highest rates of asthma in the world, with higher rates in rural and regional areas than the cities. Sydney also has a high rate of moulds which can be triggers due to its often humid environment and poor building standards (cf Melbourne for example where houses are more ruggedised)
  - kortex 5y ago
    > something about the reflection of the water from the harbor Temperature inversion? https://en.m.wikipedia.org/wiki/Inversion_(meteorology) https://en.m.wikipedia.org/wiki/Inversion_(meteorology)
philjohn 5y ago
I certainly noticed this - over the last year I've gone from using reliever inhalers several times a week to not needing them for months. I did also start a new medication, Montelukast, around the time of the first lockdown, so it could conceivably be due to that in my case - but not having a chest infection at all for the last 18 months whereas I used to get one a year or so has been lovely.
- throwawayboise 5y ago
  Do you think this was largely due to wearing a mask? Whether a mask would block a virus particle is debatable but even cheap masks are effective against larger particulates such as pollen, dust, dander, etc. When I was a kid my neighbor always wore a mask while he was cutting his lawn. He had asthma that was pretty easily triggered and he said it made a big difference.
  - philjohn 5y ago
    That's a good question - I didn't actually start wearing a mask until a little later, when the mask mandate came into force in the UK. Our first lockdown was definitely pretty severe and there were much fewer cars on the road here, but that has gone away, so you could indeed be onto something.
- tejtm 5y ago
  PSA: Montelukast (Singlar) can slowly and subtlety "change your mind" [0] https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug https://www.fda.gov/drugs/drug-safety-and-availability/fda-r...
  - elric 5y ago
    Anecdata: I took Montelukast for 3 years to help with my allergies & asthma. Worked like a charm. Except for the fact that it made me really irritable. I was angry and down all the time. And I didn't really notice it until I stopped taking the tablets. That's when I started to put two and two together. I spoke to my friends about it, and they agreed that I suddenly seemed much less murdery.
MengerSponge 5y ago
https://publicintegrity.org/environment/the-invisible-hazard-afflicting-thousands-of-schools/ https://publicintegrity.org/environment/the-invisible-hazard... I imagine that keeping schoolchildren home from those schools would substantially help their respiratory health.
- deregulateMed 5y ago
  No traffic and no bullying. If kids can learn by themselves, this could change everything. But currently my kid likes unboxing videos and nothing else. School is forced variety and social skills..
  - mleonhard 5y ago
    Kids are helpless against teams of PhDs turning them into addicts. Your responsibilities as a parent include protecting them from addictive apps. Sell the iPad and buy them books & Legos.
elric 5y ago
Irceline publishes PM2.5 stats for Belgium. Here's [1] a pretty little chart with the annual mean PM2.5 concentration. If you switch between 2020 and 2019, the difference seems pretty small. Same for PM10 and Black Carbon. If the pandemic had a big impact on air quality, that effect seems to have skipped Belgium at least. It's a shame there's no similar dashboard for viruses and allergens. [1] https://www.irceline.be/en/air-quality/measurements/particulate-matter/history/pm25_anmean?set_language=en https://www.irceline.be/en/air-quality/measurements/particul...
- briefcomment 5y ago
  I wonder what the PM1 and under figures would look like. I recall seeing some analysis stating that the bulk of car related PM was smaller than PM1.
  - elric 5y ago
    That's pretty much what the black carbon component indicates.
jonnycomputer 5y ago
I come from a part of the US with fairly severe air pollution (2cd or 3rd worst in country). And asthma is a huge problem there, much so more than elsewhere. It is fairly obvious that the air pollution is the cause of the problem. Perhaps we should differentiate between the causes of the disease, and the hazards that trigger asthma attacks.
edejong 5y ago
There has been the hypothesis that it’s actually bad ventilation in schools and offices causing the asthma related problems. One thing to check before choosing a school for the kids.
aaron695 5y ago
This doesn't really suggest a wrong focus. Pollution was down. Stress was down. People staying at home means cleaner houses. Sharp temperature changes were down... probably, you'd miss the commute big ups and downs but also miss the office climate control. Peoples lives were mostly more controlled, far less variance. And viruses were down. > The ensuing months, to everyone’s surprise, turned into “this beautiful year,” Lawson told me. Scarlett hasn’t had a single asthma attack. Not a single visit to the ER. Nothing. She’s breathing so much better, This doesn't fit with viruses, wouldn't lack of viruses only account for severe ER attacks that happen during a few scattered periods, not the whole year. It will be a mix, but 80:20, it should be one big thing.
enlyth 5y ago
This year, I had my first summer without needing to take antihistamines in over a decade, I actually wonder what has caused this
snowwrestler 5y ago
Surprised not to see exercise listed. It’s a common trigger for asthma attacks, especially in cold dry air, and I bet there were pretty big changes in exercise patterns for a lot people during the pandemic.

81 points by aliasEli 5y ago

I wonder how much impact the reduced pollution due to reduced traffic during the lockdowns and increased remote work later had on the study subjects, even if they were indoors.

kurthr 5y ago
I came to post just this. Rubber is a pretty common allergen. Wearing masks (especially N95) when out/about also probably helps a lot.

mensetmanusman 5y ago

I have had asthma my entire life, and it definitely flares up with airborne irritants. There has been awesome citizen science work going on helping people understand the direct link between anything that emits smoke and asthma attacks: https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1315 https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1315 They even found that parents waiting to pick up kids at schools with their ICE engines running increased PM2.5 inside the entire building by orders of magnitude. This data helped the kids teach their parents to stop their engines when waiting outside the school in order to help their asthmatic classmates. The transition to EV is going to have a positive impact on people’s health and make city life better.

ADSSDA 5y ago
Isn't most PM 2.5 pollution produced by brake pad and tire wear, which is made worse by EVs due to their weight?
- deleted 5y ago
  [deleted]
- oh_sigh 5y ago
  If the ev has regenerative braking, the brakes actually last much longer than in ICE cars. Not sure how tires are affected but I'd imagine they do have a shorter life, and I'm not sure how the longer brake life balances with (probably) shorter tire life from a pollution perspective
  - robbedpeter 5y ago
    Why would tires last longer in an ICE vehicle? I don't think tires care what makes them spin.
    - sargunv 5y ago
      Electric cars are heavier due to the battery.
      - perl4ever 5y ago
        It depends on exactly which car you are comparing. The Tesla Model 3 is somewhere around 3500 lbs, isn't it? That's pretty average for a car these days. And there are plenty of big SUVs that have a similar weight to the heavier EVs. Besides, you can't assume that electric cars use the same tires as non-electric ones. There is a huge range of tires out there from extremely long wearing ones to sticky ones that last a fraction of the time.
    - oh_sigh 5y ago
      I believe tires last less time in an EV, because of the increased mass. But maybe that isn't the case. I just looked up a comparable ICE to a model 3, got the BMW 330i, and that has approximately the same weight (3500 lbs)
- deeviant 5y ago
  > which is made worse by EVs due to their weight? What a ridiculous supposition. First the weight difference is not that huge, second EV's use regenerative breaking for a huge portion of their breaking spectrum bypassing break pads entirely.
  - briefcomment 5y ago
    Idk if you tried looking at any evidence when making your claim, but this clearly supports the gp and contradicts your statement [1] [2]. [1]https://www.ridef2.com/blog-del-direttore-ridef/will-electric-vehicles-contribute-less-particulate-matter-pm10-and-pm25-to-our-air-recent-analysis-and-meta-analysis-conclude-negligibly-and-policies-to-reduce-number-and-weight-of-vehicles-are-needed4720595 https://www.ridef2.com/blog-del-direttore-ridef/will-electri... [2]https://www.sciencedirect.com/science/article/abs/pii/S135223101630187X https://www.sciencedirect.com/science/article/abs/pii/S13522...
    - deeviant 5y ago
      Idk, if you bothered to read the study that you are pointing to in your coup de grace, you'd would realize your cited sources admit that EV's create no more particulate pollution than ICE engines. Your cited study actually states that EVs do reduce particulate pollution but only by a couple percent, which is opposite of "creating more" for those who prefer evidence based positions. It's almost as if regenerative breaking reduces break wear and compensates for the marginal increase weight as many other people have already pointed out?
      - briefcomment 5y ago
        The original GP's post had two points: - most PM 2.5 pollution is produced by brake pad and tire wear - which [i.e. PM 2.5 pollution produced by brake pad and tire wear] is made worse by EVs due to their weight These are direct quotes from my links: - "A large fraction (50-85% and up to 90%) of traffic generated PM10 and PM2,5 is not due to the exhaust emissions by the motor, but rather to non-exhaust emissions (brake wear, road wear, tyre wear and road dust resuspension)" - "A positive relationship exists between vehicle weight and non-exhaust emissions."... "Electric vehicles are 24% heavier than their conventional counterparts."
- Gibbon1 5y ago
  People tend to assume that gasoline engines don't produce PM2.5, but that's apparently wrong. I saw some seemingly legit report that claims tire and brakes create about 10% of the PM2.5 pollution. EV and Hybrid cars have regen braking which reduces brake pad wear. I don't know about PM2.5 but hybrids also emit much less NOx than straight gasoline cars.
- jsharf 5y ago
  These are idle cars which are not braking, so the PM2.5 here is purely the engine pollution. City life might not be affected as much, but school buildings with cars waiting outside will be!
bamboozled 5y ago
I've apparently never had asthma in my life, until I moved to Sydney, Australia for a while. It's a city which _loves_ cars. I used to cycle about 20 minutes to the office, the view was beautiful but the traffic was horrendous. I used to wheeze and struggle with breathing a lot more than usual. The doctor diagnosed me with "seasonal asthma" and gave me a ventolin prescription, which I've never felt the need to refill since leaving. The doctor told me there was some phenomenon which made the air pollution worse, something about the reflection of the water from the harbor ? I wish I could remember what it was called. It's anecdotal but that was my experience.
- 123123as1asd12 5y ago
  I cant live in sydney, I nearly died from asthma when I moved there as a child to live with my father. every time i visited he would have to rent a nebulizer, i have asthma but not that terrible, that place is horrid. I believe its the pollen as well as the cars. Coastal regions are way better for asthmatics. the dry salty air. gold coast/sunshine coast.
- robbiep 5y ago
  Where did you live previously? Australia has one of the highest rates of asthma in the world, with higher rates in rural and regional areas than the cities. Sydney also has a high rate of moulds which can be triggers due to its often humid environment and poor building standards (cf Melbourne for example where houses are more ruggedised)
- kortex 5y ago
  > something about the reflection of the water from the harbor Temperature inversion? https://en.m.wikipedia.org/wiki/Inversion_(meteorology) https://en.m.wikipedia.org/wiki/Inversion_(meteorology)

philjohn 5y ago

I certainly noticed this - over the last year I've gone from using reliever inhalers several times a week to not needing them for months. I did also start a new medication, Montelukast, around the time of the first lockdown, so it could conceivably be due to that in my case - but not having a chest infection at all for the last 18 months whereas I used to get one a year or so has been lovely.

throwawayboise 5y ago
Do you think this was largely due to wearing a mask? Whether a mask would block a virus particle is debatable but even cheap masks are effective against larger particulates such as pollen, dust, dander, etc. When I was a kid my neighbor always wore a mask while he was cutting his lawn. He had asthma that was pretty easily triggered and he said it made a big difference.
- philjohn 5y ago
  That's a good question - I didn't actually start wearing a mask until a little later, when the mask mandate came into force in the UK. Our first lockdown was definitely pretty severe and there were much fewer cars on the road here, but that has gone away, so you could indeed be onto something.
tejtm 5y ago
PSA: Montelukast (Singlar) can slowly and subtlety "change your mind" [0] https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug https://www.fda.gov/drugs/drug-safety-and-availability/fda-r...
- elric 5y ago
  Anecdata: I took Montelukast for 3 years to help with my allergies & asthma. Worked like a charm. Except for the fact that it made me really irritable. I was angry and down all the time. And I didn't really notice it until I stopped taking the tablets. That's when I started to put two and two together. I spoke to my friends about it, and they agreed that I suddenly seemed much less murdery.

MengerSponge 5y ago

https://publicintegrity.org/environment/the-invisible-hazard-afflicting-thousands-of-schools/ https://publicintegrity.org/environment/the-invisible-hazard... I imagine that keeping schoolchildren home from those schools would substantially help their respiratory health.

deregulateMed 5y ago
No traffic and no bullying. If kids can learn by themselves, this could change everything. But currently my kid likes unboxing videos and nothing else. School is forced variety and social skills..
- mleonhard 5y ago
  Kids are helpless against teams of PhDs turning them into addicts. Your responsibilities as a parent include protecting them from addictive apps. Sell the iPad and buy them books & Legos.

elric 5y ago

Irceline publishes PM2.5 stats for Belgium. Here's [1] a pretty little chart with the annual mean PM2.5 concentration. If you switch between 2020 and 2019, the difference seems pretty small. Same for PM10 and Black Carbon. If the pandemic had a big impact on air quality, that effect seems to have skipped Belgium at least. It's a shame there's no similar dashboard for viruses and allergens. [1] https://www.irceline.be/en/air-quality/measurements/particulate-matter/history/pm25_anmean?set_language=en https://www.irceline.be/en/air-quality/measurements/particul...

briefcomment 5y ago
I wonder what the PM1 and under figures would look like. I recall seeing some analysis stating that the bulk of car related PM was smaller than PM1.
- elric 5y ago
  That's pretty much what the black carbon component indicates.

jonnycomputer 5y ago

I come from a part of the US with fairly severe air pollution (2cd or 3rd worst in country). And asthma is a huge problem there, much so more than elsewhere. It is fairly obvious that the air pollution is the cause of the problem. Perhaps we should differentiate between the causes of the disease, and the hazards that trigger asthma attacks.

edejong 5y ago

There has been the hypothesis that it’s actually bad ventilation in schools and offices causing the asthma related problems. One thing to check before choosing a school for the kids.

aaron695 5y ago

This doesn't really suggest a wrong focus. Pollution was down. Stress was down. People staying at home means cleaner houses. Sharp temperature changes were down... probably, you'd miss the commute big ups and downs but also miss the office climate control. Peoples lives were mostly more controlled, far less variance. And viruses were down. > The ensuing months, to everyone’s surprise, turned into “this beautiful year,” Lawson told me. Scarlett hasn’t had a single asthma attack. Not a single visit to the ER. Nothing. She’s breathing so much better, This doesn't fit with viruses, wouldn't lack of viruses only account for severe ER attacks that happen during a few scattered periods, not the whole year. It will be a mix, but 80:20, it should be one big thing.

enlyth 5y ago

This year, I had my first summer without needing to take antihistamines in over a decade, I actually wonder what has caused this

snowwrestler 5y ago

Surprised not to see exercise listed. It’s a common trigger for asthma attacks, especially in cold dry air, and I bet there were pretty big changes in exercise patterns for a lot people during the pandemic.