By Dr Dave Ong
Haze contains air pollutants that can be harmful to one’s health, including particulate matter, sulphur dioxide, ozone, nitrogen dioxide and carbon monoxide. In Singapore, the main air pollutant in haze is particulate matter with a diameter of less than 10 micrometres. These particles tend to persist for weeks in the atmosphere. Individually, these particles are not visible to the naked eye. However, in large quantities, they become visible. Long-term exposure to fine particulate matter smaller than 2.5 micrometres (PM2.5) leads to higher risks of heart and lung problems.
Exposure to haze can affect the respiratory health of young children. Haze particles may cause irritation of the eyes, nose and throat of healthy children, resulting in an increase in red/watery eyes (conjunctivitis), runny/blocked nose (rhinitis) , throat irritation, prolonged cough and even wheezing. Haze particles can also affect the heart and lungs, especially in children who already have chronic heart or lung diseases such as asthma , causing worsening of their conditions. Long-term exposure to haze particles can potentially contribute to the development of chronic lung diseases in children.
Children with asthma need to take special care in order to minimise the impact of the haze on their health and day-to-day activities. Even a person with a history of asthma who has not experienced an attack in years may start to experience asthma symptoms again.
During periods of haze, the National Environment Agency (NEA) issues guidance on the type of physical activities that the public should carry out, depending on the air quality. This is based on Pollutant Standards Index (PSI) levels. Children should stay indoors and minimise prolonged or strenuous outdoors activities if the PSI value is above 100, and avoid outdoor activities altogether if the PSI is in the hazardous range (defined as PSI value above 300). This is the most important precaution.
Some tips on improving and maintaining air quality in the house:
Masks that offer protection against airborne particles include N95 masks and EN-149 masks, which meet a type of European standard for respiratory masks. It is important to ensure a good mask fit for optimal protection. Young children are often given normal surgical masks during the haze season as the standard N95 masks are too large to fit – these are unfortunately not helpful in reducing exposure to fine particulate matter present in haze and do not provide a good seal.
Newer N95 mask models with micro-ventilators now come in child size options which are available commercially. However these masks only have certification for adult use, and there are currently no international certification standards for their use in children. Local clinical trials to establish safety in children using these newer mask models are currently underway. If you choose to use these masks for your child, be aware that they may make breathing more difficult with prolonged use, due to increased resistance to breathing and a reduction in the volume of air breathed. You should discontinue their use immediately if your child experiences any dizziness, difficulty breathing or discomfort.
For children with known asthma, the most important step to reduce the risk of an asthma attack brought on by the haze is to ensure that your child’s asthma is well-controlled in the first place. Asthma is a chronic condition, and requires regular review by your child’s doctor to ensure that it is under control. Medications used for asthma will include quick-relief medicines (relievers, such as Salbutamol/Ventolin), which open up the airways during an asthma attack. Relievers should be readily available at all times in case of an attack, even if your child has not experienced any symptoms for some time. A large number of children with asthma also require preventer medication (e.g. Fluticasone/Flixotide or Seretide) which is used daily (even when there are no attacks) to reduce the inflammation in the airways, thereby helping to prevent future attacks. It is important to ensure that the medicines are given correctly, and that your child does not miss out on any doses prescribed by the doctor. Any known triggers for your child’s asthma (e.g. tobacco smoke, house dust mites or pets) should be avoided.
Finally, it is important that your child is kept well-hydrated by drinking plenty of water during haze periods. If your child feels unwell, you should seek medical advice promptly so that appropriate treatment can be started with minimal delay.
Exposure to the haze can irritate the eyes, nose and throat of children, causing symptoms like conjunctivitis, rhinitis, throat irritation, prolonged cough or wheezing.
Haze particles can potentially worsen conditions like asthma or contribute to chronic lung diseases in children.
Improve and maintain air quality at home by keeping doors and windows closed, cleaning air conditioning filters regularly and installing portable air cleaners to reduce particulate matter.
If your child has asthma, ensure their condition is well-controlled to reduce the incidence of an asthma attack triggered by the haze.
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