Can inhaling incense cause lung damage?

Breathing Incense Can Cause Lung Damage

Yes, breathing incense smoke can cause significant lung damage, including respiratory symptoms, impaired lung function, and increased risk of respiratory diseases.

Mechanisms of Lung Damage from Incense Smoke

Incense smoke contains multiple harmful components that can damage the respiratory system through several mechanisms:

1. Particulate Matter Exposure

   • Incense smoke contains respirable particles that deposit in the lungs 1
   • These particles induce oxidative stress, leading to cell damage and inflammatory pathway activation
   • Particulate matter can inhibit antiviral responses by causing inflammation and cytotoxicity in the lungs

2. Toxic Chemical Exposure

   • Incense smoke contains harmful chemicals similar to those in tobacco smoke, including:
     • Polyaromatic hydrocarbons that can cause immune suppression 1
     • Benzene and formaldehyde at levels exceeding WHO guidelines 2
     • Acrolein, which can suppress innate immunity or increase inflammation 1
     • Carbonyls that can damage respiratory tissues 2

3. Oxidative Stress Pathway

   • Incense smoke generates reactive oxygen species that disrupt tight junction proteins in bronchial epithelial cells 3
   • This oxidative damage compromises the epithelial barrier function of the lungs
   • N-acetyl-L-cysteine (an antioxidant) has been shown to prevent these effects, confirming the oxidative stress mechanism 3

Evidence of Respiratory Health Effects

Impaired Lung Function

• A cross-sectional study in Saudi Arabia found that exposure to incense smoke was associated with significant lung function impairments 4
• Research in Taiwan showed adolescents with daily exposure to incense had lower forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) compared to unexposed adolescents 5
• Animal studies demonstrate that incense smoke exposure causes airway hyperresponsiveness (AHR) 3

Respiratory Symptoms and Diseases

• Incense burning is associated with increased prevalence of:
  • Wheezing or whistling (35.5% in exposed vs. lower in unexposed) 4
  • Bronchitis (39% higher odds) and bronchiolitis (72% higher odds) 6
  • Pneumonia (2.79 times higher odds in boys) 6
  • Breathlessness, chest tightness, and shortness of breath 4

Vulnerable Populations

• Children appear particularly vulnerable:
  • Incense burning is associated with reduced peak expiratory flow (PEF) growth in children 6
  • Boys may be more susceptible than girls to some effects, including pneumonia and wheezing 6
  • Sharing a bedroom with incense burning further increases risk of impaired lung function 5

Recommendations for Reducing Risk

1. Avoid or minimize incense burning, especially in enclosed spaces with poor ventilation
2. Increase ventilation when incense is burned by opening windows or using exhaust fans
3. Keep children away from areas where incense is burning
4. Consider alternatives for religious or cultural practices that don't involve combustion
5. Be especially cautious with cone-type incense, which may release higher levels of pollutants than stick incense 2
6. People with pre-existing respiratory conditions (asthma, COPD) should be particularly careful to avoid incense smoke exposure

Conclusion

The evidence strongly indicates that breathing incense smoke poses significant risks to respiratory health through multiple pathways, including oxidative stress, inflammation, and direct tissue damage. The effects are similar to other forms of indoor air pollution and can lead to both acute symptoms and chronic impairment of lung function.