Are respiratory diseases only common in winter? Liu Xiaowen, director of the Occupational Disease Department of Harbin Second Hospital: Many of these diseases will continue to develop in the summer

"The lotus leaves are endless and green, and the lotus flowers are red in the sun." In late spring and early summer, life is full of vitality. It is generally believed that for people with chronic respiratory diseases, summer is a relatively mild and easy season. Since ancient times, there has been a saying that "winter diseases are treated in summer". Many common winter diseases such as upper respiratory tract infections, asthma, allergic pneumonia, chronic obstructive pulmonary disease, etc. will die down at this time. "So, is it really like this?" Professor Liu Xiaowen, a member of the Health Group of the Labor Health and Occupational Disease Branch of the Chinese Preventive Medicine Association and director of the Occupational Disease Department of Harbin Second Hospital, pointed out that in fact, many respiratory diseases are continuing to move forward with the footsteps of summer, without any signs of stopping. Such a perception is naturally a mistake and misunderstanding.

Bronchial asthma, always present After a winter of severe cold, the weather gradually warmed up. The diligent sister Li took advantage of the sunny weekend to clean up, wash bedding, and dry cotton-padded clothes and shoes... Surrounded by fine dust, sister Li kept sneezing. She thought that her old allergic rhinitis had recurred and didn't pay attention to it. But at night, she actually had chest tightness, difficulty breathing, and shortness of breath, and almost couldn't sleep all night. She rushed to the hospital the next morning. The doctor did a lung function test for her and diagnosed her with allergic asthma. After taking symptomatic medication, sister Li's symptoms were quickly relieved.

Director Liu Xiaowen explained that allergic diseases like Ms. Li's are mostly caused by the presence of allergens. Allergens can be clinically divided into the following three categories: First, inhaled allergens: the more common ones include dust mites, pollen, fungal spores, animal fur, dander, etc., which induce allergic reactions after being inhaled through the respiratory tract; second, ingested allergens: mainly fish, shrimp, crab, eggs, milk and other foods; at the same time, drugs such as penicillin, cephalosporin antibiotics, antipyretic analgesics, etc. may become allergens; third, contact allergens: such as certain metals, chemical products, rubber, plastics, etc., can cause skin contact allergies.

Knowing the above types of allergens, we should prevent them from the source. Director Liu suggested that people with allergic asthma must wear masks when cleaning, protect themselves, try not to lay carpets at home, do not use bedding made of down or animal hair, and try not to keep pets such as cats, dogs, and birds; learn to avoid eating foods that may cause allergies. Keep an "asthma diary" and seek medical attention in time if you have symptoms.

Various forms of allergic pneumonia In daily life, there are many forms of allergic pneumonia, such as "farmer's lung", "mushroom lung", "pigeon lung", "air conditioner lung" and so on.

Professor Liu Xiaowen explained that as a typical form of allergic pneumonia, "farmer's lung" is caused by villagers inhaling thermophilic actinomycete spores in moldy hay when they come into contact with moldy straw or rice. "Mushroom lung", also called "mushroom worker's lung", refers to allergic pneumonia caused by workers ingesting dust containing Micropolysporum and thermophilic actinomycetes through their mouths and noses during the mushroom cultivation process.

As for "pigeon lung", commonly known as "bird feeder's lung", it is allergic pneumonia caused by inhaling feathers containing animal protein and excrement dust; and "air conditioner lung" refers to being in an environment of air conditioning or humidifier contaminated with thermophilic actinomycetes, which inadvertently causes allergic pneumonia.

Allergic pneumonia often presents with symptoms such as cough, difficulty breathing, chest pain, etc. If the disease is not cured, it will also cause fatigue, weight loss, anemia, and later evolve into pulmonary fibrosis. In severe cases, respiratory failure is life-threatening.

Director Liu Xiaowen once again warned: The key to preventing allergic pneumonia is to avoid allergens, and to cover your mouth and nose when working outdoors; at the same time, keep the environment clean and open windows for ventilation; bird keepers should clean the birdhouse and bird droppings frequently, and it is not recommended to keep birds in the bedroom or dining room; the air conditioner should also be cleaned regularly to prevent bacteria from taking advantage. In addition, appropriate physical exercise should be performed every day to strengthen the body's immunity.

NTM lung disease that cannot be ignored NTM is an abbreviation in English, and its full name is "non-tuberculous mycobacteria". It is widely present in nature, such as soil, dust, water, poultry, fish, etc., and even in drinking water systems and heating and water supply pipes. NTM can be isolated, so it is also clinically called environmental mycobacteria. Director Liu introduced that most of these bacilli are saprophytic parasites and are usually harmless; only when people's resistance is reduced, a small number of NTM will invade the human body and cause disease, so it is called non-tuberculous mycobacterial disease. When it invades the human lungs, it is called NTM lung disease, which is generally manifested by coughing, sputum, hemoptysis, low fever, fatigue, etc.

According to the data of the previous tuberculosis epidemiological surveys in my country, the isolation rate of NTM increased from 4.3% in 1979 to 11.1% in 2000, and then to 22.9% in 2010, reflecting that the NTM disease in my country is showing a clear upward trend. In particular, people with underlying lung diseases, people with impaired immunity, and cancer patients are more likely to suffer from NTM lung diseases, such as tuberculosis, bronchiectasis, chronic obstructive pulmonary disease, cystic fibrosis, pneumoconiosis, chest deformity, chest tumors, etc., while gastroesophageal reflux, rheumatoid arthritis, vitamin D deficiency and malnutrition are all risk factors for NTM disease.

Liu Xiaowen reminds everyone that NTM may be present in aerosols formed in soil, indoor swimming pools, hot tubs, coastal marsh drainage systems, humidifiers and showers, and in dust raised by rural and urban gardens and potted soil. There are many types of NTM. For example, "hot tub lung" is caused by avian mycobacterium in NTM; "swimming pool granuloma and fish farmer granuloma" are the result of the secret mischief of mycobacterium turtle. Especially in the summer fishing and fish-eating season, many people often prick their fingers when collecting fish, turtles, shrimps and crabs. If the wound is delayed and does not heal, the possibility of NTM infection should be fully considered.

It should be emphasized that NTM infection has atypical clinical symptoms, insidious onset, often involving other organs and organs, and causing NTM skin disease, NTM osteoarthritis, disseminated NTM disease, etc. Director Liu pointed out that because NTM lung disease has a long course, many patients have gone through many detours and repeated examinations before they were finally diagnosed; and the treatment cycle of this disease is long, at least 4-6 months, and after turning negative, it is necessary to consolidate medication for a whole year, or even 24 months. Therefore, once it is confirmed to be NTM infection, it is necessary to do strain identification and drug sensitivity testing, select sensitive drugs, and use several drugs in combination to reduce the occurrence of drug resistance and adverse reactions.