Is my car making me cough?

Coughing in the car can be both annoying and worrying, especially if it becomes a persistent issue. If you find yourself coughing as soon as you get in your car, you may be questioning if there is something in that environment that is triggering your cough.

Esteemed consultant respiratory physician Professor James Hull explores the possible causes and when to consider seeing a doctor.

Why do some people develop a dry cough?

Over the past few years, specialists working in the field of cough have become increasingly aware that certain chemical scents or smells or even simply changes in the temperature of the air, can trigger a feeling of irritation in the airways and throat and then coughing. Experts feel that this type of coughing starts when so-called cough ‘receptors’, which are basically nerve endings right throughout the airways, become triggered. When the cough process starts it triggers more coughing and people can get stuck in a cycle of coughing. In this setting people usual say they get a feeling of irritation or a ‘tickle’ and then have to cough as though they need to clear something but the cough is usually dry.

Could the air inside the car be the problem?

Often people who report coughing when getting in a car, report the fact that air conditioning or simply the smell of the car may trigger coughing. This isn’t an allergy process, but it is likely that this environment is triggering ‘firing’ of cough receptors that then cause coughing to occur.

Of course, other triggers may be important and include poor air quality / pollution in the car, if you are stuck in traffic or the inhalation of allergens in the spring of summer months, if the car has no pollen filter / the windows are open.   

What role do fumes and chemical irritants play?

Cars are enclosed spaces where chemical irritants like cleaning products, air fresheners, dry air-conditioned air or even petrol fumes may linger. Exposure to these substances can irritate the nerves in the lining of your respiratory system and trigger cough.

For some individuals, certain car materials or cleaning agents might release volatile organic compounds (VOCs)—chemical particles can also irritate the throat and lungs. If coughing occurs soon after entering your car, it’s worth reducing your use of heavily scented products or airing out the vehicle regularly, but also considering if you can reduce exposure to direct jets or plumes of air from an air-conditioning system. It is also worth getting a pollen filter system, but only if you are known to have seasonal allergies and generally getting other features of allergy, such as hayfever. If this is occurring in the winter months, i.e. it is unlikely to relate to seasonal allergies, that would be improved with a pollen filter system.

Could other factors be relevant?

For people with a chronic cough, often their cough is most prominent first thing in the morning, when they first become upright. Often people say – I start coughing when I first go to clean my teeth in the morning. Of course, people often tend to drive their car and notice an association with coughing, in the morning and thus the association between being in a car and coughing may be explained by the time of day, you are in the car

Stress is recognised to amplify coughing in some people and thus stressful journeys in the car may explain an increased propensity to coughing.

Should you see a doctor?

If coughing in the car is a frequent, intrusive or problematic issue then it is recommend that you do seek medical advice. The presence of a chronic or persistent cough may indicate the presence of an underlying problem in your lung and require tests such as imaging of the lungs (e.g. an x-ray or CT scan) and breathing tests.

However, for many people with this issue, the overall cause may be a conditions called a cough hypersensitivity syndrome. This can be helped by special breathing techniques and also by some medications, including novel medications such as Gefapixant.    

In the meantime, ensure your car environment is as clean and ventilated as possible, and avoid known irritants. This simple adjustment may significantly reduce your symptoms and improve your comfort on the road.

If you would like to book a consultation with Professor Hull, do not hesitate to do so by visiting his Top Doctors profile today.