Air pollution, what actually helps, and what does not

Every winter the “lung detox” products appear, and every winter they sell. We make a respiratory product, and we are going to tell you plainly that it is not what protects your lungs.

What protects your lungs is reducing what you inhale. That is the whole intervention, and almost everything on the ranked list below is about air rather than about swallowing something.

This is information, not medical advice. Asthma and COPD are diagnosed conditions with prescribed treatment, and nothing here replaces an inhaler.

What is actually in the air, and why size matters

PM2.5, particles under 2.5 microns. These are the ones that matter most, because they are small enough to reach the small airways and the alveoli, and the finest fraction can cross into the bloodstream.

PM10, larger, mostly caught higher in the airway, causing irritation of nose and throat.

Gases, nitrogen dioxide (traffic), sulphur dioxide, ozone (which rises on hot sunny afternoons, so summer has its own problem), and carbon monoxide.

And the health effects are not limited to the lungs, which is the part people underestimate. Air pollution exposure is associated with heart attack and stroke risk, worse diabetes control, reduced lung growth in children, and effects in pregnancy, alongside the obvious asthma, COPD, infection and lung cancer risk.

So this is a cardiovascular problem as much as a respiratory one.

The ranked list

1. Indoor air, and this is the biggest miss

Most people spend the large majority of their time indoors, and most anti-pollution effort is aimed outdoors. That is the wrong way round.

Indoor sources that people do not count as pollution:

• Cooking without an exhaust, frying in particular produces substantial PM2.5
• Biomass fuel, wood, dung, coal. This is the largest single exposure for many Indian households, and it falls disproportionately on women and children
• Kerosene stoves and lamps
• Agarbatti, dhoop, and candles, incense produces significant particulate, and almost nobody counts it
• Mosquito coils, a coil burning all night in a closed bedroom is a meaningful exposure
• Smoking indoors, including at a window
• Sweeping dry dust, mop instead
• And bringing outdoor shoes in

What to do:

Use the chimney or exhaust every time you cook, and open a window while cooking.

Switch to LPG or electric where possible, this is the single biggest health gain available to a household still using biomass.

Cut incense and coils, or use them with ventilation. Use a net or plug-in vaporiser with ventilation instead of a coil in a closed room.

Mop rather than sweep.

And no smoking indoors, at all.

2. A proper mask, worn properly

And this is where most people waste their effort.

A cloth or surgical mask does not filter PM2.5 meaningfully. It is not designed to.

What works: an N95 / FFP2 respirator, and only if it seals, no gap at the nose bridge or chin, and it cannot seal over a beard.

A valved N95 is more comfortable for outdoor use in heat.

And the honest limits: it is uncomfortable, it is not for children under about two, and people with significant heart or lung disease should ask their doctor before using a tight-sealing respirator for long periods.

So: worth it for a commute, a walk, or a bad-AQI day outdoors. Not a solution for living in it.

3. Check the AQI and time your outdoor activity

Exercise is good for you. Exercise in heavy pollution is a genuine trade-off, because exertion means breathing far more air, deeper, and often through the mouth, which bypasses the nose’s filtering.

Practically:

Check the AQI before outdoor exercise. On very bad days, move it indoors.

Avoid the morning and evening traffic peaks, and avoid exercising beside a busy road, concentrations fall off substantially within a short distance from traffic.

In north Indian winter, mid-to-late morning is often better than early morning, because the overnight inversion traps pollution near the ground until the sun breaks it up. This is the opposite of the traditional advice to walk at dawn, and in a pollution season it is worth knowing.

And ozone is different, it peaks on hot sunny afternoons, so in summer the afternoon is the time to avoid.

4. An air purifier, used correctly

HEPA filters do remove PM2.5, and this is measurable.

And the conditions:

Size it to the room, and run it in the room you actually sleep in, eight hours of clean air is the best value you will get from it.

Keep doors and windows closed while it runs.

Change the filter on schedule, a saturated filter does little.

Avoid ozone-generating “ionisers”, ozone is itself a respiratory irritant.

It is expensive and it is one of the few interventions with a measurable effect on what you breathe. If a household can afford one thing, a purifier in the bedroom beats everything else on this list except fixing the kitchen.

5. Do not smoke

No pollution intervention comes close. And in a high-pollution city, smoking compounds the risk rather than adding to it.

6. Vaccination

Influenza and pneumococcal vaccines, because pollution raises the risk and severity of respiratory infection. For anyone with asthma, COPD, diabetes, heart disease, or over 60, this is specifically indicated.

7. Manage the condition you already have

If you have asthma or COPD:

Take the preventer inhaler as prescribed, daily, not only when symptomatic. This is the single most important thing in this article for you, and poor adherence to preventers is the reason most winter attacks happen.

Know your action plan, and keep the reliever accessible.

Check your inhaler technique, a large proportion of people use it wrongly, and a spacer substantially improves delivery.

And see your doctor before the season, not during an attack.

8. Saline nasal irrigation and staying hydrated

Modest, cheap, and reasonable. It clears particulate and irritants from the nose and supports mucociliary clearance.

Use boiled or distilled water, and keep the device clean, this matters, because serious infections from contaminated irrigation water have been reported.

9. Diet

A varied diet with plenty of vegetables and fruit is associated with better respiratory outcomes in observational studies. Association, not proof.

It is good advice for other reasons and it is not a shield.

What does not work

This is the section this article exists for.

“Lung detox” supplements and teas. The lungs clear particulate through the mucociliary escalator and alveolar macrophages. No swallowed product accelerates that, and nothing “flushes” the lungs. Deposited particulate is largely cleared or retained by those mechanisms regardless of what you take.

Steam inhalation as protection. Steam soothes an irritated airway. It does not remove particulate and it does not prevent anything. And it causes scald injuries, particularly in children.

Cloth and surgical masks for PM2.5.

“Oxygen bars” and canned oxygen. You are not short of oxygen. The problem is particulate, not oxygen concentration.

Jaggery (gur). The belief that jaggery clears the lungs of dust is widespread and there is no mechanism by which eating it removes inhaled particulate. It is a reasonable food; it is not a lung cleaner.

Mustard oil in the nose. Traditional, widespread, and not advisable, oily substances in the nose carry a risk of aspiration into the lungs, which can cause a chemical pneumonia. This one we would actively discourage.

High-dose antioxidant supplements as protection. The reasoning, that pollution causes oxidative stress, so antioxidants should counter it, is plausible. The outcome evidence that supplements protect against pollution’s effects is weak, and some high-dose antioxidant trials have historically produced unfavourable results. Plausible mechanism, no demonstrated protection.

Indoor plants. The effect on indoor PM2.5 is negligible at realistic plant densities. They are nice. They are not air cleaners.

And “immunity boosters” for pollution. Pollution is not an immunity problem.

The honest position on our own category

We manufacture a respiratory support product. Here is the boundary.

What a formulation in this space can honestly be: soothing for an irritated throat and airway, supportive of normal respiratory function where a nutrient has that recognised role, and built on ingredients with long traditional use in cough and breathing complaints.

What it is not: protection from air pollution, a lung cleanser, or a substitute for an inhaler.

And the specific harm we want to name: a product that makes someone feel protected is worse than no product, because it changes behaviour, the mask gets skipped, the purifier gets postponed, the preventer inhaler gets treated as optional. In this category, false reassurance is the actual injury.

So we decline “lung detox”, “pollution shield” and “lung cleanser” artwork, and we have lost enquiries over it in exactly the season when those enquiries are most profitable.

Claims

What is sayable: vitamin C’s recognised contribution to the protection of cells from oxidative stress and to normal immune function; vitamin D and zinc’s recognised contribution to normal immune function; magnesium’s recognised role in normal muscle function; and traditional-use statements for vasaka, tulsi, mulethi, pushkarmool and similar classical respiratory ingredients.

What is not sayable: detoxifies the lungs, protects against pollution, improves lung capacity, treats asthma, COPD or any respiratory disease, or prevents infection. The Drugs and Magic Remedies (Objectionable Advertisements) Act applies here regardless of licence held.

What to ask your doctor about

Worth raising before the pollution season:

Topic	Why
Spirometry	If you have a chronic cough or breathlessness, asthma and COPD are both under-diagnosed
Inhaler technique and a spacer	Most people get this wrong
A written action plan	What to do as symptoms escalate
Influenza and pneumococcal vaccines
Vitamin D	Commonly low, and winter makes it worse
Blood pressure and lipids	Pollution is a cardiovascular risk factor
Smoking cessation support	It exists, and it works better than willpower

When to see a doctor

Urgently:

• Breathlessness at rest, or difficulty completing a sentence
• Chest pain or tightness, pollution raises cardiac risk, and this is not to be assumed respiratory
• Blue lips or fingertips
• An asthma attack not responding to the reliever inhaler
• Confusion or severe drowsiness with breathlessness
• In a child: fast breathing, chest indrawing, grunting, or inability to feed

Soon:

• A cough lasting more than three weeks, tuberculosis testing in India
• Coughing up blood
• Breathlessness that is new, or worse than last year
• Waking at night with cough or wheeze, a sign of poorly controlled asthma
• Using a reliever inhaler more than a couple of times a week, the preventer needs review
• Unintentional weight loss or night sweats

The short version

1. Protection means reducing what you inhale. Nothing swallowed does that.
2. PM2.5 is the fraction that matters, small enough to reach the alveoli.
3. Air pollution is a cardiovascular risk too, not only respiratory.
4. Indoor air is the biggest miss, most effort goes outdoors, most time is spent indoors.
5. Use the kitchen exhaust every time, and open a window while cooking.
6. Switching from biomass to LPG is the single biggest household health gain.
7. Incense and mosquito coils are real indoor pollution. Almost nobody counts them.
8. Mop, do not sweep.
9. Cloth and surgical masks do not filter PM2.5. N95/FFP2, and it must seal.
10. A beard prevents a seal.
11. Check AQI before outdoor exercise, exertion means inhaling far more.
12. In north Indian winter, mid-morning often beats dawn because of the overnight inversion.
13. Ozone peaks on hot sunny afternoons, summer’s version of the problem.
14. Stay away from busy roads, concentrations drop quickly with distance.
15. A HEPA purifier in the bedroom is the best-value appliance. Avoid ozone ionisers.
16. Take the preventer inhaler daily, and check your technique and spacer.
17. Get the flu and pneumococcal vaccines.
18. Saline irrigation is reasonable, boiled water, clean device.
19. “Lung detox” does not exist. The mucociliary escalator and macrophages do the clearing.
20. Jaggery does not clear inhaled dust.
21. Do not put mustard oil in the nose, aspiration risk.
22. Canned oxygen and oxygen bars solve a problem you do not have.
23. Indoor plants are not air cleaners.
24. A product that makes you feel protected is the real harm in this category.

Composition detail: Oxivo 360 and curcumin capsule. Related: vasaka and the classical respiratory herbs, खाँसी का घरेलू इलाज, and बदलते मौसम में बीमार होने से कैसे बचें.