Asthma is out of control

Asthma is out of control

A staggering 5.4 million people in the UK suffer from asthma. Asthma is a disease that appears to be part of modern Western society and whose prevalence has been increasing since the 1970s.

Although asthma death rates have decreased, this is only because asthma is now better treated. The various treatments are much more effective at controlling the more extreme possibilities. However, asthma remains a disease that can have a devastating impact on anyone's life.

The analysis highlights some important facets of the disease:

• Half of all cases occur in children under 10 years of age.

• In this age group, twice as many men as women are affected.

• 60% of affected adults are female.

• If a parent has asthma, their child is approximately twice as likely to develop asthma as children whose parents do not have asthma.

• Children born into households that use cleaning products more frequently are twice as likely to suffer from persistent wheezing.

There is currently no clear culprit as to the cause of asthma. Many suspects have been suggested: pollution, smoking, modern living, central heating, house dust, exercise. None of these are the root cause of asthma - they either trigger an asthma attack or create the environmental conditions that are conducive to an asthma attack. They are not the main cause of asthmatics.

However, there is a possible culprit with some suspicion hanging over it; one that has previously been indirectly implicated but has never been closely investigated. During the hearing I would like to address a number of key questions.

What is the reason for someone suffering from asthma?

A relatively new argument about the cause of asthma observes our increased use of cleaning products and argues that our increasingly sterile homes mean we are unable to develop the immunity we previously acquired through exposure to bacteria.

However, I would argue that the problem is much more direct.

In short, asthma occurs because we pour bleach (sodium hypochlorite) down the toilet; We leave it to do its work, sometimes overnight, then we use the toilet too often without flushing first.

The mixture of urine (with ammonia) and bleach reacts and releases a small dose of chloramines, which we inhale and damage our lungs.

If repeated regularly, the damage becomes significant.

Our damaged/weakened lungs become less robust and more sensitive to our environment. Triggers that we would not have reacted to before suddenly have a greater impact on us. For some, exposure to these triggers leads to an asthma attack, with the affected condition of their lungs making them more vulnerable to attack by elements in the air they breathe.

It remains questionable whether the lungs are actually damaged or whether they simply develop an increased defense system, i.e. react more quickly to a perceived threat. This could be an important finding as it would determine the path to recovery for those people who already suffer from asthma. If it is the former, the lung needs to be physically repaired; If the latter is the case, retraining or rehabilitation may be sufficient.

Why do some people suffer more than others? Why do some people suffer and others not?

There are two basic reasons why there are different levels of suffering;

First, people have different levels of exposure. Obviously, the higher the exposure, the higher the risk. Households use different amounts of cleaning products; different strengths of cleaning agents, different uses of these cleaning agents. Our exposure levels vary.

It's also worth noting that not only are we using more household cleaners, including bleach, but our attitudes toward the physical task of cleaning have also changed. We spend less time cleaning and instead believe we can clean just as effectively by throwing chemicals at the problem. We will immediately put the bleach into the toilet to clean it instead of cleaning it manually.

Second, we have different sensibilities. The varying degrees and depths to which people suffer from asthma are due to our different body mechanisms. The lung damage increases a person's risk of asthma, but they must have a predisposition to this sensitivity.

Pain, hunger, cold, tiredness - we all experience them differently. What might be a cold room for one person might be perfectly fine for another; A night of insomnia can leave one person exhausted while another can cope without feeling any different. Our lungs work similarly. The size, effectiveness and sensitivity of our lungs vary. Any lung damage effectively changes the height of the bar. It reduces their performance and can therefore also reduce exposure to a substance that we need to trigger an asthma reaction.

We should also consider that a person's diet can affect the amount of ammonia in their urine and therefore puts them at increased risk of asthma? We know that asparagus is high in ammonia. Likewise, dehydration and bacterial infections (especially in women) can increase ammonia levels.

What causes the lung damage?

Our liver converts ammonia in our body into urea, which is then excreted in our urine. This ammonia in our urine, when mixed with sodium hypochlorite (bleach), produces chloramines, which damage our lungs when inhaled.

Of course, the dose we are exposed to in our daily ablutions is tiny, but still harmful to us. Whatever we do, if we do it often enough, it will have an impact.

It's like a tanning bed: too much, too often and you risk developing skin cancer. Repeated exposure to chloramines damages the function of our lungs.

Why is asthma so common in children?

Children's lungs are much smaller and more sensitive because they are still developing. They are therefore more susceptible to damage.

We also need to consider their exposure to the chloramines.

Many households allow the bleach to soak in the toilet overnight. The first to get up in the morning is six-year-old Tommy, who dutifully goes to the toilet and gets a shot of chloramine.

Boys who are smaller and stand directly over the toilet bowl also receive a much higher dose of chloramine and therefore inhale more. This supports evidence that among children, more boys suffer from asthma than girls.

The damage is cumulative, so lung damage becomes more common with age. As boys grow, their nasal proximity to chloramine gas is reduced, while as females sit on the toilet, they remain much closer. This may explain why more women develop asthma than men as they age. It may also be important that, slightly generalized and stereotyped, since women tend to do the majority of toilet cleaning, their potential exposure is thereby higher.

Are there other sources of chloramine exposure that cause lung damage?

A similar chlorine-based cleaner is used in swimming pools. Here too, the chlorine combined with urine and sweat releases a chloramine gas, which people then inhale. In a swimming pool, any urine is significantly diluted. However, it is still there and repeated exposure can contribute to lung damage. This is why so many swimmers suffer from asthma.

How should we try to cure asthma?

We must first eliminate the cause of the problem by ensuring we are not unknowingly producing and exposing ourselves to chloramines. This prevents lung damage and makes us less susceptible to asthma.

In terms of corrective treatment and whether or not we can cure people who already have asthma, we need treatments that either aim to strengthen the lungs or treatments that alter the function of the lungs so that they are less responsive to asthma triggers. The lung's defense mechanism is designed to watch for a specific attack, but if the trigger invasion occurs via another route, it may go unnoticed. The lungs would then not go into defensive closure.

This theory of chloramine inhalation as the cause of asthma requires further investigation. Although there is clear suspicion, it is not yet a watertight case. We should do everything we can to close this case.

Inspired by Steve David Oxley