Piotr Dąbrowiecki, MD, PhD is associate professor, specialist in internal medicine and allergology from the Department of Internal Medicine, Infectious Diseases and Allergology of the Military Institute of Medicine of the National Research Institute in Warsaw.
He is the Chairman of the Polish Federation of Asthma, Allergy and COPD Patients’ Associations, He is a member of the Main Board of the Polish Society of Allergology, the Polish Pulmonary Society and the European Respiratory Society, the advisory team on the impact of air pollution on health at the Ministry of Health, as well as a member of the Council of Patients’ Organizations at the Ministry of Health.
He is author and co-author of over 100 scientific articles IF – 60 IH-12 and textbooks for doctors and nurses in the field of diagnosis and treatment of asthma and COPD and the impact of air pollution on health.
Question: Can you tell us about the experience that led you to your current role on the LungHealth4Life project?
A: What led me to my current role in the project is my scientific interest. As a physician who cares for patients with respiratory diseases, I have seen the great impact of the environment on their health.
This impact is not only from environmental factors such as pollen or animal dander in allergic patients, but above all, from the air pollution my patients breathe, which affects the expression of diseases like allergy or asthma, and symptoms such as coughing or breathlessness. These symptoms often accompany patients living in a polluted atmosphere.
Hence my interest in the effects of air pollution, both on adult patients and on children.
Question: What inspired you to work in lung health in general?
I have allergic rhinitis, asthma, features of atopic dermatitis, and cross-reactivity to certain foods. That is what led me to choose this specialty, and it is also what led me to become the leader of a patient organisation that supports people with allergies, asthma and COPD.
Question: Why is children’s health such an important area?
I am talking about genetics, but also about the influence of the environment in which the child grows up. If young children are exposed to above-normal levels of air pollutants, it can lead to the development of asthma and allergies. It also exacerbates symptoms of both. The developing respiratory system, which grows until about the age of 7 or 8, is particularly sensitive to air pollution.
If instead of developing 300 million alveoli by the age of 7 or 8, a child develops only 250 million or 200 million, they may not notice a problem as a toddler. But this can have serious consequences for their health as a young adult or adult.
Question: What are the challenges or opportunities of implementing a pulmonary function testing project in schools?
A: This project has two main components: the educational part and the research part, which includes the spirometry tests.
Regarding the educational part, I believe school is the ideal place for such education – for the children, the teachers, and also the parents, as what the child does is largely managed by the parent. What a child learns early in life can influence their behaviour as an adult. If we teach children to take care of their health, including respiratory health, they may make better choices later in life – smoking less, choosing cleaner ways to heat their homes, being more aware of air quality and its effect on their health. That is what we aim to achieve through the educational part of this project.
As for spirometry, these tests help us understand the condition of the respiratory system in children (or adults, but in this case, children). Air pollution, frequent infections, and environmental factors often manifest as reduced lung capacity.
Vital capacity is so-called because it is an independent predictor of life expectancy. We want our children to live long lives. That’s only possible if their respiratory systems develop properly.
So, if we show a child – or more importantly, the child’s parents know – that even in the second, third or fourth year of primary school, their lung ventilation capacity is low, we can still act. We can involve the child in treatment or rehabilitation. Even if they have a chronic condition they aren’t aware of – and we often detect undiagnosed asthma during these spirometry tests – we can intervene, provide care and guidance, and advise parents so that the child can go on to live a healthy life.
Question: What would success look like for you at the end of the LungHealth4Life project?
A: I would consider it a success if, as a society, we paid more attention to respiratory health. If we start to think about whether the air we breathe has an effect on us, and if we know it does, we then make conscious lifestyle decisions: I don’t smoke, I choose a more environmentally friendly way of heating my home, I take action to improve my environment when I’m unwell.
My personal success would be that, thanks to the education in schools and the spirometry testing, children who were previously undiagnosed will be diagnosed and able to live normally with their condition. That is, earlier diagnosis of bronchial asthma in children. That would be the biggest success for me. Because untreated, undiagnosed asthma shortens adult life.
It also interferes with learning and social development. The child’s development suffers in every way. On the other hand, if a child receives a proper diagnosis – if a spirometry test reveals obstruction, and the most common cause of obstruction in children is asthma – we can change that child’s life, just as my life changed when I received my diagnosis.
