Asthma and COPD are both chronic lung diseases that cause airway inflammation and narrowing of the bronchial tubes, leading to breathing difficulties. Asthma typically affects younger individuals, often linked to allergic factors, causing intermittent airway constriction. It responds well to bronchodilators and inhaled corticosteroids. COPD primarily affects older adults, especially long-term smokers, and progresses silently. Both conditions are prone to exacerbations when exposed to irritants like air pollution (fine dust) and infections.

Fine particulate matter (PM) is a complex mixture containing heavy metals such as lead and cadmium, toxic organic compounds, and mineral dust. Particles larger than 10 µm are mainly filtered by the nose and throat. However, PM ≤ 10 µm can settle in larger airways, including the trachea and main bronchi (large branches from the trachea entering the two lungs). PM ≤ 2,5 µm and ultrafine particles (UFP, diameter ≤ 0,1 µm) can penetrate deep into the lungs, reaching the bronchioles and even the alveoli.

Upon entering the respiratory tract, fine dust disrupts the function of cilia, exacerbating ciliary degeneration and increasing goblet cell hyperplasia (goblet cells are crucial components that produce lubricating mucus, protecting the respiratory lining). Cilia are tiny hair-like structures covering the airways (trachea, bronchi) that act as a biological net, combining with mucus secreted by goblet cells to trap dust, bacteria, and viruses. However, if cilia are damaged, the lungs struggle to clear mucus, leading to breathing difficulties and an increased risk of respiratory infections.

In individuals with asthma and COPD, this reaction easily leads to bronchospasm, causing sudden shortness of breath, chest tightness, and wheezing. For COPD patients, fine dust exacerbates existing chronic inflammation, overactivating immune cells, destroying lung tissue structures, and increasing sputum production, which obstructs the airways. Fine dust also slows the ability of airway cilia to clear dust and bacteria, making patients more susceptible to infections.

At a cellular level, toxins in fine dust promote the formation of reactive oxygen species, leading to oxidative stress. As the number of damaged cells increases, the body signals an alarm by releasing inflammatory mediators, causing airway swelling and increased mucus secretion.

For individuals with asthma and COPD, the combination of heightened inflammatory responses damages the mucous membranes and increases the risk of infection. Patients experience symptoms such as shortness of breath, chest tightness, and wheezing, leading to a decline in lung function.

Doctors often order respiratory function tests, chest X-rays, sputum tests, and inflammatory index assessments to determine the severity of an exacerbation. For asthma patients, evaluation criteria include the frequency of shortness of breath and response to bronchodilators and inhaled corticosteroids. For COPD patients, doctors assess the degree of bronchial obstruction, blood oxygen and CO2 levels, and the risk of superinfection.

A doctor examines a patient with recurrent asthma. Photo. Tam Anh General Hospital.

To prevent asthma and COPD exacerbations, closely monitor the air quality index (AQI) and minimize outdoor activities when air quality is poor. If you must go outside, wear a PM2.5 or N95 mask. Keep doors and windows closed during periods of severe pollution, typically between 6-8h and 18-19h.

Limit activities that increase pollution risk, such as burning honeycomb charcoal, trash, or using smoky stoves in enclosed spaces. To reduce indoor dust levels, use an air purifier and regularly clean air conditioners and filter devices. Enhance nutrition with foods rich in zinc, potassium, magnesium, and vitamins A, C, E. Maintain light indoor exercise for at least 30 minutes per day, five times per week, to boost resistance. Diaphragmatic breathing exercises or hot steam inhalation can humidify the airways and help remove accumulated dirt.

Patients with asthma and COPD must strictly adhere to their treatment regimens. Patients need to continue anti-inflammatory medications and bronchodilators as directed. If signs of an exacerbation appear, such as rapidly increasing shortness of breath, frequent coughing, rapid breathing, unusual fatigue, or changes in sputum color, patients should seek medical attention immediately.

Master of Science, Doctor Dao Phuong Thuy

Department of Respiratory Medicine

Tam Anh General Hospital Hanoi