The Air You Breathe: Home, Work and Habits

Most time is spent indoors

The presentation’s central idea is this: most of the air people breathe is indoors, at home and at work; people spend 90% of their time indoors. That is why tobacco, fuel, allergens and work history are treated as part of diagnosis and treatment.

The numbers show the scale. In 2019, 262 million people worldwide had asthma, with about 455,000 deaths a year. In 2021, 3.5 million deaths were due to COPD (chronic obstructive pulmonary disease), roughly 5% of all deaths. In Türkiye, daily tobacco use among those over 15 rose from 28.3% in 2022 to 30.1% in 2025. In 2024, no province had air that met the World Health Organization (WHO) guideline value.

The unseen guests at home

There is no safe level of passive smoking. Smoke from the burning tip of a cigarette contains more than 4,000 chemicals and lingers for 1.5–2 hours in an enclosed space. The residue that clings to hair, clothes and carpets is called 'thirdhand smoke'; children crawling on the floor are the most vulnerable. The advice is simple: zero smoke at home and in the car. The idea that waterpipe and e-cigarettes are 'safer' is misleading; the smoke volume inhaled in a single waterpipe session is equivalent to about 100 cigarettes.

There are also colorless and odorless but measurable gases. Radon comes from uranium in the soil and seeps through cracks in the floor; it is cited as the number one cause of lung cancer in people who have never smoked. Testing is done on the ground floor and first floor; the WHO reference level is 100 Bq/m³. In Türkiye, carbon monoxide is linked to coal stoves and water heaters; levels rise on days with southwesterly winds. A carbon monoxide detector near the bedroom is recommended.

Humidity, dust and allergens: one measure is not enough

For someone with asthma, a comprehensive approach at home is needed. For house dust mites, impermeable covers go on the mattress and pillows, sheets are washed weekly in water above 54 °C, and indoor humidity is kept below 50%. For mold and cockroaches, leaks are repaired and food and trash are kept covered. Pets stay out of the bedroom; there is no such thing as a 'hypoallergenic' dog.

Small adjustments are possible outdoors too. Pollen peaks at midday and in the afternoon, so early morning or late afternoon can be chosen for exercise. Sulfites in dried fruit, wine and pickles are on the avoidance list as well. Immunotherapy (allergen desensitization) lasts 3–5 years for a single allergen. Avoiding passive smoking is part of this too.

Workplace and occupation: history is half the diagnosis

Fifteen to twenty percent of adult asthma is work-related. Flour for bakers, isocyanates for car painters, latex and disinfectants for nurses and cleaners, and wood dust for carpenters stand out. The typical clue is that symptoms ease on weekends and holidays. That is why a physician asks, 'What do you do for a living, and where have you worked before?'

Türkiye has its own examples too. Among 145 male denim sandblasters in Erzurum, 53% had radiological silicosis (a lung disease caused by inhaling crystalline silica dust); the mean age was 23 and mean exposure only 36 months. Denim sandblasting was banned in 2009 and asbestos at the end of 2010. Erionite in Cappadocia and the white soil used as plaster in some regions are also environmental risks. For agents such as coal, beryllium and moldy hay, the basis of treatment is likewise ending the exposure.

Movement, tobacco and vaccines: small steps

Giving up exercise is not the answer in asthma; exercise-triggered airway narrowing is less common when asthma is well controlled. The presentation lists a long warm-up, slow deep breathing through the nose, and a mask or scarf in cold, dry air; swimming is usually well tolerated. In obesity, a program of 2 exercise sessions a week or weight loss is reported to improve asthma control and lung function.

Sitting for long periods is linked to the risk of blood clots (venous thromboembolism); the advice is to walk for a few minutes every hour and to rotate the ankles at the desk. In COPD, quitting smoking is cited as the only intervention that slows progression. Vaccines are part of protection too: a yearly flu vaccine is recommended for everyone older than 6 months. In Türkiye, adult flu vaccination rates in studies range between 8% and 39%; the European Union (EU) average is about 47%.

Environmental control and exercise are part of asthma treatment, but they do not replace the medication and follow-up planned by a physician; they are used alongside them. Consult a physician about preparation before exercise and about medicines. If you have symptoms, describing your job and your home conditions to the physician is an important part of reaching the right diagnosis.