Many people have breathing problems in the winter. Lung specialist Prof. Fischer give tips on how to protect your lungs from the cold, dry air and fine dust.
We put our lungs through their paces in winter, when they are exposed to cold and dry air and fine dust. People with chronic lung disease are particularly affected. They have to handle more coughing, tightness in their chest or sputum.
How can we protect our lungs from these strains and ease the symptoms? Lung specialist Prof. Fischer talks about the typical stress factors and how we can look after our mucous membranes in the winter.
It is not only people with chronic respiratory diseases that are affected by the winter. Winter sports enthusiasts should also pay more attention to looking after their airways. They are often exposed to cold air that irritates the bronchial tubes and can trigger asthma or asthma-like symptoms.
Prof. Dr Fischer: Our airways are exposed to three main stress factors in winter: Firstly, the cold air that can irritate the bronchial tubes. Secondly, there is dry air from indoor heating and also the fresh air outdoors can be drier than it is at other times of the year. Thirdly, there is more fine dust around because we heat more in winter. There is also, of course, an increased risk of catching airway infections.
Prof. Dr Fischer: Cold air is a widespread problem in winter for people with chronic airway problems or sensitive bronchial tubes, i.e. bronchial hyperreactivity. But the cold air can also be a problem for winter sports enthusiasts.
We know that, for instance, biathletes are at a significantly greater risk of asthma because they often breath in a lot of cold air and therefore are more hyperresponsive to cold, dry air. Cold air can make you cough more, make your chest feel tight or produce similar symptoms.
Prof. Dr Fischer: It is important to remember to breathe through your nose so that the air is warmed as it passes through the nose and throat and into the bronchial tubes. When you are exercising, have a blocked nose or severe lung problems it is not always possible to breathe through your nose and people then automatically switch to mouth breathing.
In these cases, it can be sensible to breathe through a scarf or a face mask if you can handle that to warm the air a little before it reaches the bronchial tubes. It is also important to remember that cold air is automatically drier and that can also put a strain on the airways.
Prof. Dr Fischer: Dry air can put a strain on the airways as it can dry the mucous membranes. Dry mucous membranes are firstly more prone to irritation than moist mucous membranes. And secondly, dry mucous membranes are less equipped to protect against infection, making them more susceptible to viruses and bacteria.
Prof. Dr Rainald Fischer: Heating in winter dries the air in our living spaces. Usually, you can increase the humidity indoors by opening the windows for a while. But on really cold winter days, the air outside is dry, as the cold weather makes the air drier.
I would still, however, advise against using a humidifier. They can be bug hubs. It is better to moisten your mucous membranes directly if you feel they are too dry or if you are exposed to a lot of cold air.
Prof. Dr Rainald Fischer:Nasal douches, seawater sprays and lozenges can help to moisturise the upper airways, i.e. the nose and throat, for example to deal with crusting or if the area feels generally dry. There are also special devices that generate a pulsating aerosol. This means that the inhalation solutions can also enter the sinuses to keep them moist and healthy.
Dissolving salt in hot water and inhaling it does not work, by the way. People often cite this as an inhalation remedy even though the salt stays behind in the pot and therefore does not get a chance to act on the mucous membranes.
Prof. Dr Rainald Fischer: Inhalation therapy with a nebuliser and saline solution can help the lower airways. It is important that you do not make the saline solution yourself. You should use products made under hygienic and sterile conditions.
When you inhale with a nebuliser, the upper airways are automatically moistened too. Professional tip: Breathe in through the mouthpiece and out through your nose.
Prof. Dr Rainald Fischer: Professional athletes and serious enthusiasts of winter sports such as biathlon, alpine skiing, cross-country skiing, figure skating, ice hockey, or ski touring and going on extended winter hikes in the mountains should support their airways with inhalation therapy to prevent them from becoming too dry and irritated by the cold air. Because too much cold air can cause lasting damage to your airways. Professional winter sports athletes therefore often inhale saline solutions with a nebuliser as a matter of routine.
Prof. Dr Rainald Fischer: In winter, there tends to be more fine dust in the air as a result of burning processes and fireplace emissions from heating our homes. Cold combustion engines emit more pollutants. Hard tires in winter are subject to more wear and there is more friction from the grit or sand. These substances are whipped up and can generate fine dust.
Finally, the cold weather, with no wind at all, can lead to temperature inversion conditions that “trap” fine dust at ground level, known as winter smog. Normally, FFP2 masks filter fine dust out of the air. But because the dust is everywhere in winter, you would have to wear one all the time, even indoors, which is not feasible in real life. I do, however, still advise that you wear a face mask in crowded spaces, to minimise the risk of catching an infection.
Prof. Dr Rainald Fischer: To avoid the risk of infection, people with chronic respiratory diseases in particular should wear a face mask in crowded places, such as public transport, in a doctor’s waiting room, in busy department stores, etc. Annual vaccination against COVID-19 and flu is also essential.
The basic rule is, of course, to stick to your prescribed respiratory treatment. In addition, or if people feel they have a build-up of secretions in their bronchial tubes, inhaling a mucolytic, hypertonic saline solution can be helpful in clearing the airways. You always have to bear in mind that thick or excessive mucus can be a breeding ground for bacteria. This is why it is important to loosen, mobilise and cough up the secretions.
Prof. Dr Rainald Fischer is a specialist for internal medicine in private practice, with a subspecialty in lung and bronchial medicine, specialty of emergency medicine, sleep medicine and allergy medicine in Munich-Pasing. Before that he worked as an internist and lung specialist, most recently as a senior physician at the Munich university hospital. Prof Dr Rainald Fischer is a founding member and president of the Deutschen Gesellschaft für Berg- und Expeditionsmedizin (German Society for Mountain and Expedition Medicine), and also a member of the Cystic Fibrosis Medical Association.
Note: The information in this blog post is not a treatment recommendation. The needs of patients vary greatly from person to person. The treatment approaches presented should be viewed only as examples. PARI recommends that patients always consult with their physician or physiotherapist first.
