Author: Colin Michie FRCPCH, FRSPH, FLS
In the sixteenth century, Spanish colonists avidly collected pearls harvested from oysters deep off the coast of Venezuela around Cubagua. Enslaved Amerindians and later Africans were the divers. This lucrative source of treasure had significant impacts on European fashions and adornment. Freediving for pearls has been practised for centuries around Japan and in the Arabian Gulf: It requires skill, speed and practised lungs. In south-east Asia, oyster diving is traditionally carried out by women – the ama in Japan or haenyeo in Korea. Although all this breath-holding is beneficial, repeated dives of over 30 seconds can cause decompression illness and brain damage. Less extreme breath-holding on land strengthens chest muscles, but try a SCUBA course if you wish to look at a deep sea oyster!
This year, the Covid-19 virus has caused more severe infection in those with lower respiratory reserves, whether caused by age, obesity or smoking, weakening lung muscles and increasing airway inflammation. We lose our peak lung function from middle age, with “less puff” and an increasing risk of infection. After strokes and cardiovascular events, damage to the lungs is the third most common cause of death globally – we should all consider remedial strategies!
A major challenge to breathing is the breakdown of the tiny sacs in lungs, the alveoli, which in adults make up a massive surface area of between 80 and 100 square metres. With their vast nets of blood vessels, these structures are crucial to efficient oxygen collection and protection against infectious invaders. Delicate alveoli break down when exposed to toxins, such as cigarette smoke or pollutants.
Air quality is rarely optimal. On St. Maarten, for instance, there are Saharan dusts, fumes from fossil fuels and burning rubbish, together with many microbes. Air quality inside homes is often poor too, particularly if anyone smokes cigarettes, or if there is dampness. High humidity in tropical climates encourages airborne proliferation of microbes such as fungi in dusts. Alveolar irritation causes increased defensive mucus production too. Over time, this contributes to emphysema or chronic obstructive airways disease (COPD). Pollution from dusts can turn elastic lungs into stiffer, leathery organs with poor function.
Treatments for lung pathologies usually include inhaled medication to dilate airways and to reduce inflammation to make it easier to breathe. Inhalers have been engineered to deliver microscopic amounts of very fine particles of medication for asthma or COPD, when used well. Surgical approaches can be used sometimes: Nerves can be cut, emphysematous lung can be removed or small valves may be implanted. Many herbal and dietary remedies are directed at providing immune lung support, reducing mucus and easing coughing. The observation that menthol binds to a series of cell receptors makes evaluation of these traditional therapies important.
How can we improve our lung health, faced by legions of unavoidable environmental challenges? The answers are simple: For yourself – exercise; for your community – campaign to improve air quality.
Regular exercise can increase muscle power in your chest with great benefit. Enthusiasts extol swimming, cycling, rowing and endurance sports as “best workouts” for your lungs. Gym coaches have their prescribed routines. More chilled folk recommend walking. Chest exercises such as breath-holding, breathing against pursed lips, belly breathing and huffing, as well as the breathing patterns that might be part of yoga and Pilates all assist the healthy and those with lung problems too. As is evident if you meditate, breathing will affect your deep thinking and mood; but consider a musical, healing stratagem.
One of the best lung exercises is singing. When you are copying your favourite divas, singing in the shower, joining the church choir, singing for the orishas, chanting like an Argentinian in a stadium or copying a disco anthem, you use all your respiratory muscles. You will feel healthier. You do not have to sing in tune – give yourself permission, just bite out energetic chunks of music. Singing helps you cough and feel less short of breath. In a group, the benefits can be dramatic. Arias, canciones, calypsos, chants, hymns, love songs or lullabies. They all work. Exult, sing, show off your lungs! Loud singing has few side effects. It can irritate neighbours; it causes more particles to come out of your mouth. Please increase your social distancing if anyone else is nearby!
Mankind can change. This month the last coal mine in England was closed. Coal has been replaced by renewable energy sources. People can stop smoking cigarettes. The Covid-19 pandemic showed how air quality improves when vehicular traffic is reduced. We all need to act to protect our lungs and those of our infants. Singing along to this work would be a real help, too.