Hidden Triggers of Breathing Trouble: Beyond Asthma and Smoking - Dr Nalini Nagalla

When people come to me with breathing troubles, they often assume it must be asthma, smoking, or just pollution. These are common causes, of course, but they are not the whole story. In many urban settings, the triggers can be less obvious.

Something as ordinary as pigeons nesting on balconies or windows can quietly affect lung health in ways patients rarely expect.

The weight of polluted air

City air is heavy with smoke from traffic, dust from construction, and fine particles that sink deep into the lungs. For anyone with asthma, COPD, or weakened lungs, this daily exposure fuels cough, breathlessness, and flare-ups.

Even in healthy people, long-term pollution gradually inflames the airways and reduces lung capacity. Children and older adults are especially at risk because their lungs are either still developing or already fragile.

The pigeon problem and other hidden risks

Beyond dust and fumes, there are hidden irritants. One I see more often now is linked to pigeons. Droppings and feathers release microscopic proteins that, when inhaled repeatedly, can set off a condition called hypersensitivity pneumonitis.

Patients may notice breathlessness, a dry cough, or tightness in the chest, but the symptoms often resemble asthma or infection, so diagnosis is delayed.

Sources of pigeon exposure include public feeding areas, balconies, and even AC vents.

Hypersensitivity pneumonitis, caused by pigeon droppings exposure, if neglected can progress so severely that it may eventually require lung transplantation.

It’s not only pigeons. Mold growing in damp corners, dust from old coolers, or even occupational exposure like grain dust can spark similar reactions. Because these exposures are part of daily life, people rarely think of them as culprits.

Why early attention matters

Unlike chest pain, which immediately alarms patients, a slow cough or mild breathlessness often gets brushed off. That delay can be costly. Lung inflammation and scarring build up silently, and by the time help is sought, much of the damage is already done.

What begins as a manageable issue may progress to lasting loss of lung function.

Everyday lifestyle burdens

Modern life adds more weight to the lungs. Indoor smoke from incense or poorly ventilated kitchens, cigarette smoke at home or work, and long hours outdoors during smog season all contribute. Add pigeon exposure into the mix, and the lungs are under constant strain.

Some small steps help more than people realise:

Avoid feeding pigeons and keep balconies clean with proper precautions.

Keep homes dry and ventilated to prevent mold.

Use an N95 mask when pollution levels are high, especially if exercising outside.

Stop smoking, and limit secondhand smoke exposure as much as possible.

Treatment and hope

Lung disease is not the end of the road. With correct diagnosis and early treatment, patients often regain control of their daily lives.

Inhalers, medicines that reduce inflammation, pulmonary rehabilitation, and in some cases specific therapies for hypersensitivity pneumonitis all play a role. Vaccines against flu and pneumonia further protect vulnerable lungs.

I have seen patients who once struggled to climb stairs return to normal routines after making lifestyle changes and sticking with treatment. The turnaround is possible when the problem is recognised in time.

A word from the clinic

Chronic lung disease is not only about pollution or smoking. Everyday surroundings — pigeons, mold, dust, indoor smoke — can quietly erode lung health. If breathlessness or cough lingers for weeks, it is not something to dismiss. Early consultation allows us to act before too much damage sets in.

Our lungs work silently for us, every minute of the day. To keep them safe, we must watch out not only for the obvious dangers but also for the hidden ones that slip by unnoticed. With awareness and timely medical care, many problems linked to chronic lung disease can be avoided.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.