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How to Keep Your Lungs Healthy

As a society, my feeling is that we don't put enough emphasis on protecting our lungs against harmful macro and microscopic particles; this is a huge mistake, as reduced lung capacity is, in my mind, more damaging to quality of life than say, sub-optimal digestion, mild to moderate liver dysfunction, or even reduced cardiac output. If you strongly disagree with this opinion, I'm willing to bet that you'll change your mind if you spend some time in any intensive care unit and sit by a few patients who are unable to properly oxygenate their blood because of reduced lung capacity - this is a heart-wrenching scenario, one that I don't wish upon the grouchiest people I know.

Why are healthy lungs so vital to the rest of your organs and body parts? It's within the very thinnest branches of tissue that line the base of your lungs where your body accepts oxygen from your environment and expels carbon dioxide. Without this ongoing exchange of gases, you can't adequately convert nutrients from food into usable energy.

As a part of every routine physical evaluation, I look for signs of lung dysfunction with the following measures:

  1. Inspection

    I look for signs of strained breathing; sometimes, it's as subtle as seeing overuse of smaller muscles in the neck region in an effort to assist ribcage expansion during laboured inhalation. Other obvious signs of lung dysfunction are slightly purple/blue lips or fingernails, and audible distress with breathing.

  2. Palpation

    Placing my hands symmetrically on both sides of the posterior aspect of a person's ribcage, I want to see my hands move about the same amount during deep inhalation. Assymetrical movement might indicate abnormal presence of fluid or air in the space between the lungs and the chest wall.

    I also want to feel the transmission of the person's voice as vibration (called tactile fremitus) against my palms as they're pressed up against his chest wall - physicians will typically ask you to repeat a phrase like "ninety-nine" while assessing tactile fremitus. Abnormally strong vibration can indicate fluid accumulation within lung tissue, while decreased fremitus might mean that there is fluid build-up between the lungs and chest wall.

  3. Percussion

    To help confirm palpatory findings, percussion is used, whereby I use my hands to steadily percuss against the chest wall while listening to how hollow or full the chest cavity sounds along different points. This is much like tapping a wall to detect the presence of a stud - where there is a hollow sound on percussion, I know there is air; where there is a full, deadened sound on tapping, I know that there is something substantial behind the chest wall that is absorbing my percussive force, likely fluid associated with inflammation. Basically, I'm hoping for a slightly hollow sound on percussion to indicate normal presence of air in the lungs - I don't want the feedback to be too resonate, which is characteristic of chronic obstructive pulmonary disease, or too dead, which usually means that there is unwanted fluid in the area.

  4. Auscultation

    Auscultation is the process of listening to lung sounds with a stethoscope. During auscultation, I'm hoping to hear what we call "vesicular breath sounds," which is to describe a mild influx of air with inhalation, and little sound during exhalation.

    Whistling-type noises, scratchy sounds, noise that resembles what you hear when breathing through a snorkel, gurgling, and an abnormally quiet lung field all indicate some form of distress.

Here's the thing: you don't want to wait for your doctor to stumble upon an abnormal finding before becoming mindful of what you're breathing in during everyday activities. In most cases, by the time I come upon a significant finding using the screening procedures described above, chances are that dysfunction and disease have been at play for a good while.

Living in a neighbourhood with good air quality is a huge plus. But the most important priority in preventing lung disease is to minimize exposure to concentrated sources of lung irritants, and where such exposure is near impossible to avoid, it's vital to take proper precaution with optimal ventilation and protective gear.

For example, when sanding down minor repair jobs, drilling into wood, or doing any other basic chores that require being close to even a small cloud of dust, as much as it might seem going overboard, I think it's well worth the effort to wear a respirator with a decent filter, something as simple as the one found here:

3M Low-Maintenance Half-Mask Organic Vapor Respirator

This sort of protective gear is absolutely essential if you're taking on an extended project that involves steady exposure to dust, a good example being landscaping work where there is regular cutting of fresh stone, which kicks up all sorts of lung irritants like fibreglass and carborundum grit. (Crystalline silica and mica in drywall dust are probably the most common workplace lung irritants in first world nations.)

To those who tell me that they cut stone or sand drywall joints for a living and feel fine after taking a good long shower after work (all without wearing a respirator), I remind them that repeated exposure to irritants can lead to numbing of our natural feedback mechanisms, kind of like how a smoker eventually learns to inhale tobacco smoke without experiencing much of a negative physiological reaction. But if you think back to the first few times you were exposed, you're likely to remember your body's attempts to eliminate harmful particles through sneezing, coughing, tearing up, mucous production, and perhaps even an infection deep within the lungs. Bottom line: please don't neglect use of an effective respirator.

The most common lung irritants tend to harden when they come into contact with moisture. So even a few times of being exposed to concentrated stone, wood, sanded drywall mud, or other type of construction-related dust can cause acute lung tissue damage and lead to development of any number of lung problems, the more common ones being fibrosis and cancer. Just think of each particle of dust as a tiny metal-like shard, and imagine the damage that occurs when millions of these particles enter your lungs over the course of a couple of hours.

Please remember that it's not just visible dust that you should strive to avoid and protect yourself against. If chemicals that you work with give off strong smells that make you feel nauseous, you need to figure out how to avoid these substances - nausea that's triggered by stimulation of your olfactory system is a strong sign that you're in the presence of lung irritants that, over time, can create irreversible damage.

Here's a look at six substances that are highly capable of causing lung damage:

1. Crystalline silica

Crystalline silica is a component of soil, sand, and rocks (like granite and quartzite). Only quartz and cristobalite silica that can be inhaled as particles are designated known carcinogens.

Where is it found?

  • In the air during mining, cutting, and drilling.

  • Drywall mud, household cleaners, paints, glass, brick, ceramics, silicon metals in electronics, plastics, paints, and abrasives in soaps.

Occupations most at risk:

Quarry workers, plasterers, drywallers, construction workers, brick workers, miners, stonecutters (including jewellery), workers involved in drilling, polishing, and crushing, pottery makers, glassmakers, soap or detergent manufacturers, farmers, dentists, and auto workers.

2. Wood dust

Wood dust is made up of particles of wood that are created by cutting and sanding.

Where is it found?

  • Anywhere wood is chipped, turned, drilled, or sanded.

Occupations most at risk:

Those in the construction industry, and to some extent, those in the logging industry. Specific occupational settings that typically involve significant exposure include furniture/cabinetry shops, timber mills, window/door manufacturers, joinery shops, wooden boat manufacturers, and pulp and paper manufacturers.

3. Asbestos

Asbestos is a group of naturally occurring minerals that form heat-resistant fibers.

Where is it found?

  • Naturally in rock formations.

  • In some auto parts like brakes, gaskets, and friction products.

  • In some industrial textiles.

  • In some safety clothing.

Occupations most at risk:

Asbestos miners, brake repair mechanics, building demolition or maintenance workers, carpenters, cabinetmakers, construction workers, electricians, plumbers, plaster and drywall installers, auto mechanics.

4. Chromium (hexavalent)

Chromium is a naturally occurring mineral that becomes carcinogenic when it is transformed into its hexavalent form through industrial processes.

Where is it found?

  • In the manufacturing of stainless steel and other alloys.

  • In the industrial wood preservative, CCA (Chromated Copper Arsenate).

  • Used in small amounts in printer ink toners, textile dyes, and during water treatment.

Occupations most at risk:

Welders while welding stainless steel, printing machine and press operators, machinists, and pipefitters.

5. Nickel and its compounds

Metallic nickel, a possible carcinogen, is a silver-like, hard metal or grey powder. Nickel compounds, known carcinogens, tend to be green to black, but yellow when heated.

Where is it found?

Used to make stainless steel, and also found in magnets, electrical contacts, batteries, spark plugs, and surgical/dental prostheses.

Occupations most at risk:

Welders, construction millwrights, industrial mechanics, metal spraying workers, machinists, machining/tooling inspectors, nickel refinery workers, iron/steel mill workers, metal ore miners, and manufacturers in structural metals, motor vehicle parts, boilers, and shipping containers.

6. Formaldehyde

Associated cancers:

Nasopharyngeal cancer, leukemia

What is it?

A colorless, combustible gas with a pungent odour.

Where is it found?

  • Used in the manufacture of textiles, resins, wood products, and plastics.

  • As a preservative, formaldehyde is found in embalming fluid.

  • As a preservative and disinfectant, it's used in soaps, shampoos, deodorants, mouthwash, and cosmetics.

Occupations most at risk:

Embalmers, pathology lab operators, wood and paper product workers, and health care professionals (nurses, dentists) exposed during use of medicinal products that contain formaldehyde. Also at risk are painters, manual labourers, product assemblers, foundry workers, and those who teach in cadaver laboratories.

How Important Are Your Lungs?

Consider that of the total amount of waste materials that your body eliminates via urine, stools, mucous, breath, and sweat, approximately 75 percent by volume is handled by your lungs. Put another way, your lungs are at least as important to your body's ability to experience ongoing cleansing and detoxification as your digestive tract and kidneys. And to maintain healthy lungs, you have to minimize your exposure to the pollutants described above.

Beyond avoiding concentrated pollutants, here are a few tips to help ensure healthy gas exchange within your lungs:

  1. First and most obviously, you need to be around fresh air. This means being outdoors often, and when you're indoors for long stretches at a time, you should try to crack open a window or two whenever possible. Or at the very least, ensure that the ventilation system that controls the air quality in your work and living spaces is functioning properly - this includes making sure that furnace filters are replaced regularly.

    It also means that while you sleep, when the weather permits, you should crack open a window so that your lungs are exposed to a steady stream of fresh oxygen, and that the air in your room doesn't get dominated by carbon dioxide.

  2. Second, you need to be mindful of how well you're breathing. Respiratory rate - the number of cycles of inhalation and exhalation you experience per minute, is affected by a few different factors.

    Emotional stress tends to promote shallow breathing. So being mindful of your emotional state and making a habit of taking purposeful, deep breaths in and out as often as possible make for a concrete strategy to ensure optimal intake of oxygen and elimination of carbon dioxide.

  3. An oft overlooked determinant of respiratory rate is how healthy your spine and surrounding joints are. Together, your spine, ribcage, and sternum (breast bone) form a protective case that surrounds your heart and lungs. At every point of contact between your ribs and your spine and breast bone, there is some joint play - that is, built-in room to move, not a lot, but enough to allow for optimal expansion of your lungs as you inhale.

    Also, from rib to rib, you have cartilage that helps keep your ribs in place, but that also provides just enough give to allow your ribs to slightly expand and contract as your breathe.

    Over time, chronic stress, lack of exercise, and lack of mindful breathing can cause all of these moving parts to become somewhat brittle and unable to provide the flexibility that is essential to helping you breathe optimally.

    This is one reason why regular stretching of your spine, ribcage, and surrounding tissues is important to your health. By keeping all of these joints moving properly, you ensure that you have the physical capacity to fill your lungs with ample amounts of oxygen throughout the day and night.

    How can you safely and effectively stretch your spine, ribcage, and the surrounding ligaments and muscles? Feel free to view mobility exercises at our video library:

    Dr. Ben Kim @ YouTube.com

    Beyond improving your overall mobility, please remember the importance of mindfully breathing in and out throughout the day - this seemingly trivial habit can be immensely helpful to your health.

    And don't forget to wear a protective mask or respirator the next time you have some sanding or drilling to do. You can read up on an effective and inexpensive respirator here:

    3M Low-Maintenance Half-Mask Organic Vapor Respirator

    Please consider sharing this information with family and friends who may be incurring lung tissue damage without knowing it. Thank you.

 
 

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Comments

Would it be possible to add Hairdressing and Farming, to your list of dangerous jobs as I have done both. Also Anesthetics have caused problems, both after dental visits and childbirth

Hi Dr. Ben Kim, what do you think about the silica and mica found in make-up? It's inevitable that someone that uses mineral powder make-up breathes a little in when applying to their face... Do you think this is safe? I stopped using it as I was worried about the effect of breathing in little amounts every day for many years. Thank you :)

Hi Nina,

Thank you for bringing this up. I do feel that this is another significant source of lung irritation in many. Synthetic materials in cosmetics are also a potential cause of GI tract-related challenges. I have long believed that this is why more women than men tend to develop autoimmune illnesses.

Well, that is very interesting to me and I wish I had realized when I was much younger. I finally stopped coloring my hair and wearing make-up a couple of years ago at age 59 but I think it must be too late. I still have fibromyalgia and a messed up immune system. Still, I'm eating healthy and exercising most days so there's still hope I will improve over time, I guess. :)

Thank you so much for these valuable tips to help us all improve our lung health. I have found that I am extremely sensitive to air fresheners. Especially the kind that are mounted and spray intermittently in public restrooms and also the kind that plug into outlets. My mother in law has both kinds of these air fresheners in her home and I have found that after every visit I sneeze repeatedly while in her home and become sick with a cough that turns into a sinus infection, bronchitis or something that takes months for me to get over after visiting her for only two or three days. I feel sure sure the ingredients in these air fresheners are toxic as well.

I believe that crystalline silica can now be found in certain types of cat litter.

I am constantly amazed that the medical profession appears to ignore the importance of abdominal breathing for a healthy life. For the lungs, the nervous system and for energy,abdominal breathing is infinitely preferable.

Hello Dr. Kim, this is my first comment here but I have appreciated many of your posts.

Being an ex-smoker who lives in a smoggy city area, I got a refillable salt pipe. When I use it consistently it seems to help my breathing:
http://www.saltpipe.ca/order
(Feel free to delete the link if it's not suitable for your site, but I had to hunt for a good Canadian source.)

Could you perhaps comment on its efficacy in removing harmful particles from the lungs - whether it only makes one FEEL better or it could be of real value?

Thank you,
Níu

I found this newsletter on Friday when my husband was in the I/C unit after breathing fumes from our new glass shower enclosure installation. Fumes from the glue and rubber adhesive literally took his breathe away, too much for his COPD lung condition. Just ordered the breathing mask to have handy for the future. I promise to read your newsletter religiously, thank you!

Useful information

Some of the most common substances and most frequently exposed occupations don't appear on this list. Did you forget about the world's biggest problem, carbon emissions? What about the carbon/particulate matter from car and bus exhaust, and exposure to caustic chemicals associated with automotive work? Mechanics' lungs are constantly exposed to huge amounts of exhaust, petrochemicals, and other caustic chemicals. And what about many of the chemicals associated with manicurist and hair stylist professions, such as methyl methacrylate and toluene? Salon workers are exposed to and inhale these chemicals or dust for hours per day at close range.

Nothing was mentioned about nail technicians, also hair colorists. I was in this industry for over 25 years. I developed numerous lung problems, asthma, allergens. I was not a smoker & I got COPD. Toluene, I understand was outlawed in the car paint industry, BUT allowed to remain in our nail polishes.

Thanks so much for this article! I've been concerned about my lungs since so many women I know in my age group (early thirties) have been getting lung and breast cancer. It makes me wonder what's at the bottom of it.

I used to love nice, fragrant laundry soaps and fabric softeners. After I had my babies, I switched to fragrance-free products so their skin wouldn't be irritated. When I went back to the smelly stuff, I noticed that my nose itched and my throat and lungs had a sharp irritation that made me cough every time I put on a load of clothes. I decided to stick with the gentle stuff instead.

I am a former construction laborer who was once exposed to a full shift of extremely high silica concentration in a confined space without protection. It was so bad that we came out covered from head to toe with layers of refractory dust. Days later I began to go through a month of flu like symptoms, including coughing up mounds of mucous daily. These were amounts that I had never seen anyone cough up, and my chest and throat felt worse than they had ever felt(very heavy with a burning sensation). After researching acute silicosis, I was sure that this was what I was experiencing. After about 2 months the pain and mucous finally subsided, but it has now been 19 months since this occured and I have a dry cough that has never left. On top of that, I often get recurrences of mucous. Finally, I have gotten health insurance and I will have a chest X-ray soon, but I really need someone with knowledge of silicosis to inform me of what I can do to help myself. I love sports, and the feeling of my lungs burning from giving my all in a game or a few rounds of sparring, but I have refrained from any activity where heavy bbreathing is required, because I fear that it could speed up scarring in my lungs. Please let me know what I should do, regardless of what the x-ray displays. Thank you for reading.

Jerome, I'm sorry to know of your struggles.

I am by no means an expert when it comes to addressing exposure to silica as you have experienced.

My suggestion, based on what you shared, would be to engage in short sessions of deep, diaphragmatic breathing. My guess is that over time, you can facilitate improvement in lung health and restore much if not all of your lung capacity.

As your lung capacity improves, you can follow your instincts on gradually increasing your engagement with sports.

I hope that you experience improvement in the days ahead. You can always reach me directly at benkim@drbenkim.com.

 

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