Representational photo.

MUMBAI: Rising levels of air pollutants are a worry in winter, but fungus growing on the walls or air-conditioner ducts and/or pigeon droppings are a perennial cause for concern for lung health, say chest specialists.

Exposure to pigeon droppings was cited as one of the main causes for lung failure in two women — a 38-year-old from Borivli and a 68-year-old from Breach Candy — who recently underwent lung transplant at a hospital in central Mumbai.

"These women suffered from a condition called chronic hypersensitivity pneumonitis, or environment-related lung fibrosis, for years,” said pulmonologist Unmil Shah. The medical history jotted down by Shah and other pulmonologists these patients visited over the years record that both reported pigeon droppings in the common duct areas of their building.

The Borivli patient, Hemali Shah, said her breathing problems started soon after she moved into a new home in 2012. “My sister who is a doctor noticed my breathing patterns were different and a pulmonary function test showed as much,” she said. Her family got the housing society to clean up the pigeon droppings in the duct “where our air-conditioning machine was fitted” and put up special nets and spikes, but the hypersensitive reaction Hemali suffered in 2012 had brought about lung-scarring that continued to worsen despite medicines over the years. She underwent a lung transplant on September 20, 2019 at Global Hospital in Parel.

Pulmonologist Sujeet Rajan said hypersensitivity pneumonitis is emerging as the most common cause for interstitial lung disease . “It accounts for almost 47% of all ILDs, with pigeon droppings as a very common cause, besides chronically damp environments seen in homes with cracked walls and leakages, recent renovation and plastering work, and close to construction sites,” added Dr Rajan.

Delayed diagnosis is one of the main problems with lung failure (interstitial lung disease), said doctors. “Around two lakh lung failure cases are identified every year in India alone, but there is little that can be done,” said heart and lung transplant surgeon Sandeep Attawar, who operated on Shah.

While lung transplants are not as common as kidney or heart transplants even in the West, there have been only a few hundreds or fewer lung transplants conducted in India. “There is little awareness about the fact that lung transplants are performed in India,” said Dr Attawar, who has conducted 124 lung transplants in the last 34 months.

The other patient, 68 years old, is among the oldest to be operated for double lung transplant. She too had similar exposure to pigeons in her building and was diagnosed to have progressive lung fibrosis and was dependent on oxygen support.

Dr Rajan said he sees at least six patients with interstitial lung disease every day at his clinic. “Half of them have chronic hypersensitivity pneumonitis,” he added.

