[HN Gopher] Doctors Might Have Been Focusing on the Wrong Asthma...
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       Doctors Might Have Been Focusing on the Wrong Asthma Triggers
        
       Author : aliasEli
       Score  : 60 points
       Date   : 2021-07-11 17:51 UTC (5 hours ago)
        
 (HTM) web link (www.theatlantic.com)
 (TXT) w3m dump (www.theatlantic.com)
        
       | belltaco wrote:
       | 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 wrote:
         | I came to post just this. Rubber is a pretty common allergen.
         | Wearing masks (especially N95) when out/about also probably
         | helps a lot.
        
       | MengerSponge wrote:
       | https://publicintegrity.org/environment/the-invisible-hazard...
       | 
       | I imagine that keeping schoolchildren home from those schools
       | would substantially help their respiratory health.
        
         | deregulateMed wrote:
         | 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..
        
       | edejong wrote:
       | 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.
        
       | mensetmanusman wrote:
       | 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
       | 
       | 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 wrote:
         | Isn't most PM 2.5 pollution produced by brake pad and tire
         | wear, which is made worse by EVs due to their weight?
        
           | deeviant wrote:
           | > 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 wrote:
             | 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-
             | electri...
             | 
             | [2]https://www.sciencedirect.com/science/article/abs/pii/S1
             | 3522...
        
               | deeviant wrote:
               | 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 wrote:
               | 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."
        
               | [deleted]
        
               | thomasmeeks wrote:
               | What's your point? That we should continue to favor gas
               | cars over EVs? That cars should be taken off the road
               | entirely? Something else?
        
               | briefcomment wrote:
               | My point was to defend ADSSDA's post against deeviant's
               | claims.
               | 
               | Personally, I would like light EVs.
        
               | TheParkShark wrote:
               | So en EV without a battery? They didn't make them weigh
               | more just because they wanted to.
        
               | hattmall wrote:
               | I think it's just that EVs will not reduce asthma caused
               | by small particle air pollution. They may in fact make it
               | worse.
        
               | askvictor wrote:
               | > "A positive relationship exists between vehicle weight
               | and non-exhaust emissions."... "Electric vehicles are 24%
               | heavier than their conventional counterparts."
               | 
               | Both are true. However, without factoring in decreased
               | friction-brake usage in EVs (due to regenerative
               | braking), this point is meaningless or deceptive.
        
               | throwawayboise wrote:
               | Brake. The word is brake.
        
               | sdflhasjd wrote:
               | Both those sources are the same paper, fyi. Found a PDF
               | here: http://www.soliftec.com/NonExhaust%20PMs.pdf
               | 
               | And the claim is a bit dubious, imo. It looks like
               | they're counting "resuspension" (kicking up existing
               | settled PM2.5 in the wake) as a source.
        
               | briefcomment wrote:
               | The first link cites multiple papers, including the one
               | in the second link. Looks like the study that mentions
               | "resuspension" is a different study[1] than the one in
               | the second link.
               | 
               | [1]https://www.sciencedirect.com/science/article/abs/pii/
               | S13522...
        
               | [deleted]
        
           | [deleted]
        
           | Gibbon1 wrote:
           | 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.
        
           | oh_sigh wrote:
           | 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
        
         | bamboozled wrote:
         | 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.
        
           | robbiep wrote:
           | 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)
        
       | elric wrote:
       | 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/particul...
        
         | briefcomment wrote:
         | 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 wrote:
           | That's pretty much what the black carbon component indicates.
        
       | philjohn wrote:
       | 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 wrote:
         | 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 wrote:
           | 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.
        
         | dillondoyle wrote:
         | * I totally read this backwards sorry. But I'll keep the
         | relevant part about different steroid and my mistake below.
         | 
         | maybe also check out a Ciclesonide inhaler (alvesco, another
         | steroid) which has helped me a lot in my cardio. I can get that
         | last 5-10% into my lungs and don't have those tiny wheezes at
         | peak respiration.
         | 
         | And I'll make a note of that drug for the future thanks!
         | 
         | -- I got on steroids last year. Had huge increase in use of
         | albuterol over the last 2 years. For like a decade i barely
         | used anything, inhaler sat in the bottom of my climbing bag.
         | 
         | I'm in Denver, really bad pollution and the fire smoke is
         | literally unlivable at its worst.
        
         | tejtm wrote:
         | PSA: Montelukast (Singlar) can slowly and subtlety "change your
         | mind"
         | 
         | [0] https://www.fda.gov/drugs/drug-safety-and-
         | availability/fda-r...
        
           | philjohn wrote:
           | That's interesting - another asthma medication I was on as a
           | child made me an absolute horror as well - wonder if there's
           | some relation in the mechanism of action.
        
           | elric wrote:
           | 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.
        
           | softwarebouwer wrote:
           | Thanks for that link, I've read something about that before
           | but haven't thought about it since I've been prescribed it
           | myself since March.
           | 
           | For me since then most of the symptoms in the list on that
           | page have actually improved. The only thing my doctor (in The
           | Netherlands) warned me about was the bad/vivid dream part,
           | before Montelukast I could hardly remember dreaming but now I
           | do almost daily (but I am also sleeping much better).
        
       | jonnycomputer wrote:
       | 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.
        
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       (page generated 2021-07-11 23:01 UTC)