CLEAN AIR FOR ASTHMA
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ASTHMA BEHIND THE SCENE ...... ASTHMA TYPES ...... SELF-CARE
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ASTHMA TRIGGERS
POLLEN ..... MOLD SPORES ..... ANIMAL DANDER & SALIVA ..... DUST MITES ..... COCKROACHES .....CHEMICALS .....
AIR POLLUTANTS ..... TOBACCO SMOKE ..... OCCUPATIONAL TRIGGERS ..... ADVERERSE FOOD REACTIONS .....
DRUG SENSITIVITES ..... HORMONES ..... EXERCISE ..... INFECTIONS .....WEATER ...... STRESS
Question: How many triggers
exist?
Answer: Thera are hundreds. In one person or
another, almost anything that is inhaled can cause the chemical
reactions in the lungs that lead to the three elements of an
asthma attack. These elements are bronchospasms, inflammation and
excessive mucus production. An asthmatic person may have several
triggers activating his asthma at any one time.
Question: Where are triggers found?
Answer: You can find triggers in the house,
school, workplace, and outdoor.
Question: Are some triggers more common than
others?
Answer: Yes. Substances range from allergens,
chemical irritants, air pollutants and tobacco smoke to food
intolerances and drug sensitivities. Exercise, infections, stress
and weather patterns can also be linked with flare-ups.
For children and adults with extrinsic, or allergic, asthma, the
most common triggers are allergens.
Question: Can you explain what an allergen is
again?
Answer: Anything to which someone is allergic.
These cause the body’s immune system to produce an antibody
called immunoglobulin E, or IgE. When IgE contacts an allergen,
strong chemicals (called mediators) are released. A mediator
called histamine produces an allergic reaction. In a person with
extrinsic asthma, the reaction displays itself in the form of
asthma symptoms.
Question: Can you give an example of these
allergens?
Answer: Many are found in household dust,
including pollen, mold, animal dander and dust mites. Because of
being so small in size, these allergens are easily stirred up,
carried in the air and then inhaled; for that reason they are
also known as aeroallergens.
POLLEN
Question: What is pollen?
Answer: This is a tiny granule produced by
trees, grasses, weeds and flowers as part of the plant
world’s reproductive process. Each plant or tree can produce
hundreds of pollen grains every year.
Question: Is one form of pollen more irritating?
Answer: Lightweight pollens pose a greater
threat to those allergic to them because it drifts easily into
the house, workplace or automobile through open doors and
windows. The pollen then becomes part of the dust.
Question: Isn’t pollen just a problem in
spring?
Answer: Is depends what region of the country
you live in. It may be present 6 to 12 months of the year, or it
could just be a problem from spring until the first killing
frost. As a rule of thumb, trees pollinate in spring, grasses in
summer and ragweed in late summer and fall.
Pollen allergies are more active on dry, windy days. Rain causes
pollen to settle to the ground, thus temporarily lowering pollen
levels out-of-doors.
MOLD SPORES
Queston: What is a mold spore?
Answer: Also called mildew or fungus, mold
spores are living organisms that reproduce by producing
microscopic spores that float through the air. These spores, not
the parent mold, cause asthma symptoms.
Mold thrives on humidity. Bathrooms, kitchens, closets and basements are area where mold flourish year-round. They can be found any place with humidity levels above 50 percent. Refrigerators, humidifiers, water vaporizers and airconditioners can harbor molds. Elsewhere in the home lurk other trouble spots: shower curtains, bathroom tiles and sweaty toilets; old mattresses, foam pillows and stuffed animals; the leaves and soil of potted plants; even old newspapers. Some foods, such as beer and many cheeses, contain mold.
Mold and fungi are found outdoors also, on compost piles, leaves,
mulches, plants and in the soil itself. They grow rapidly when
weather is warm and moist.
ANIMAL DANDER AND SALIVA
Question: What is animal dander?
Answer: Dander is tiny pieces of sloughed-off
skin (like human dandruff) from warm-blooded animals: dogs, cats,
horses, birds and rodents. People with pets will have animal
dander in their home environment. The tiny flakes easily become
airborne and become part of house dust, remaining in a room long
after the pet has left it. Zoos, farms and stables are other
places where animal dander can be found. When inhaled by a person
who is allergic to it, dander triggers asthma symptoms.
Question: Why is animal saliva a problem?
Answer: An animal will lick its fur, covering
its hair with saliva. Particles of dried saliva shed off with the
hair and eventually make their way into the dust that moves
through the air and settles on every exposed surface. The saliva
particles are inhaled and activate the cycle of asthmatic
symptoms. The cause of this reaction appears to be a particular
protein in saliva. More people are allergic to cats than any
other animal because cats lick their fur frequently.
Question: Can a person be allergic to animal
hair?
Answer: According to most experts, hair is not
the problem. It is the dander and saliva associated with animal
fur that acts as the triggers.
DUST MITES
Question: What are dust mites?
Answer: These are microscopic creatures that
feed on sloughed-off flakes of human skin. They are also called
house-dust mites. They dwell in carpets, mattresses and pillows,
upholstered furniture and other household fabrics. Mites may be
present any place where humans congregate.
According to some estimates, dust mites lay 50 eggs every 10 days
or so. The allergic reaction comes from contact with insect
debris - fecal particles and decomposed body part -which beome
part of the household dust, not from the live mite.
Question: Are dust mites found all through the U.S.?
Answer: Mites need humidity levels above 50
percent to thrive. Most parts of the U.S. have moisture levels
that high for a some of the year - summer in particular. During
humid periods, people have dust mites in their homes unless they
are kept very dry. Mites are less of a problem in cold, dry
winter months.
People who live out of the woods may inadvertently create a
breeding ground for dust mites if they use ahumidifier to bring
moisture levels above 50 percent.
Question: How can I reduce dust mites in my
home?
Answer: By regular washing, the allergens are
removed from bedding and other hiding places. However, this it
does not kill the dust mites. 30-to-60 minute prewash soaking of
blankets in a mixture of detergent and eucalyptus oil can kill
99.4 percent of dust mites.
COCKROACHES
Question: Are people allergic to roaches?
Answer: Yes. They can be allergic to cockroach
debris - fecal particles and decomposed body parts - they same
way that they can be allergic to dust-mite debris.
Question: Is it common?
Answer: It was not generally thought of as an
asthma trigger until the 1990s. Researching to explain increasing
asthma mortality in American cities, they discovered that many
city dwellers had a cockroach allergy. In one study, cockroach
allergy was found in over one-third of the asthmatic inner-city
residents surveyed. They allergy is not thought to be a large
factor in asthma in suburban America, however.
Question: Should I be aware of any similar
triggers.
Answer: Besides the aeroallergens that
we’ve just discussed for those with extrinsic asthma, there
are also a large number of nonallergic triggers referred to as
asthma irritants. These provoke the lungs of people with the
intrinsic, or nonallergic, for of asthma.
Question: What is the difference between
irritants and allergens?
Answer: Irritants provoke an asthma attack by
irritating the lungs and starting the cycle of bronchospasms,
mucus procution and airway inflammation. Allergens cause
immunoglobulin E and mast cells to release histamine and other
mediators.
CHEMICALS
Question: How do chemicals trigger asthma?
Answer: The produce aerosols and gases that
irritate the lungs known as airborne chemical irritants.
Question: Which chemicals act as airborne
irritants?
Answer: Spray disinfectants, ammonia, chlorine,
floor wax and paint; perfumes, powders, deodorants, shampoos and
hair sprays; pesticides and insecticides (especially those
containing pyrethrum). The propellants and dispersants in some
antiasthma medications can actually cause a chronic
asthma-related cough. Even cooking odors can trigger asthma
symptoms.
Airborne chemical irritantscan come in unexpected things.
Depolyment of automobile airbags can cause breathing problems for
people with asthma. This is not caused by the chemicals that fill
the airbag, but by chemicals produced whten the airbag is
deployed.
Question: What about chemicals in the
environment?
Answer: They can also cause problems, especially
in the form of air pollution.
AIR POLLUTANTS
Question: Which air pollutants cause asthma?
Answer: Sulfer dioxide, diesel-fuel exhaust, gas
from cooking stoves, automobile exhaust end emission plumes from
factories and incinerators are among the offenders. Asthma is
aggravated by irritants that are by-products of the
industrialized world in which we live. Bushfires, burning leaves
and burning garbage also release irritating particles into the
air. Smog can trigger an asthma attack. So too can fog, by
carrying air pollutants as an easily inhaled mist.
Question: Is it better for someone with asthma
to live in the countryside?
Answer: Although pollutants are found in major
metropolitan and industrial areas, the countryside is not
necessarily pollution-free. The wind can carry many pollutants to
rural communities far from the city. Also, pollen is a major
trigger, and pollen-producing plants grow more abundantly in the
countryside.
Question: What’s this I hear about
pollution and ozone?
Answer: Ozone is a major lower-atmosphere
pollutant formed by a photochemical reaction of sunlight on
already particle-laden air. While ozone can irritate the airways
of someone with asthma, its debilitating effects are multiplied
in the lungs of people with asthma.
Question: Does smoking
affect asthma?
Answer: Tobacco smoke is a major indoor
pollutant. It is an irritant that creates breathing difficulties
in the lungs of any asthmatic person who smokes. Passive smoking
- exposure to secondhand smoke - leads to more-frequent
respiratory problems among asthmatic children and more-frequent
and severe asthma episodes among asthmatic older people.
Question: Why does smoke cause problems?
Answer: It contains carbon monoxide, nicotine
and other harmful substances that damage the cilia, delicate
hairlike structures in the airways that held filter air and clear
out mucus. The cilia become more damaged the longer someone is
exposed to tobacco smoke. Because the cilia are unable to work
properly, inhaled particles begin to build up in and obstruct the
airways. This can cause asthma attacks and respiratory infections
- not to mention an increased risk of developing lung cancer and
other diseased associated with smoke inhalation.
Question: What are other kinds of smoke
problems?
Answer: The by-products of any kind of fire or
combustion can be irritants. These can be brushfires, burning
leaves, natural gas or kerosene burned in the home without
adequate ventilation, or poorly sealed wood stoves and fireplaces
used to burn wood.
OCCUPATIONAL TRIGGERS
Question: What triggers occur at work?
Answer: These irritating substances are at the
workplace and lead to what is called occupational asthma. This
asthma develops from repeated exposure to large amounts of one
particular substance found on the job. Once the person becomes
sensitized to the substance, even the slightest exposure to the
substance sets off bronchoconstriction.
For instance, bakers that are exposed to large amounts of flour
all day may develop asthmatic symptoms whenever they come in
contact with flour. Meat wrappers experience reactions from
inhaling polyvinyl chloride fumes from plastic wrap. Among the
dozens of people with documented cases of occupational asthma are
farmers, welders, carpenters, painters, plastics workers and
people in the pharmaceutical industry.
Question: How many people have occupational
asthma?
Answer: In 1997, seventeen percent of asthma
cases were work related. Although this asthma is not always an
allergic response, some physicians believe that people with
allergies are at greater risk of developing it. This kind of
asthma and its triggers are hard to detect, especially if the
person experiences a delayed response to a trigger. One sign of
occupational asthma is the absence of symptoms when away from the
job, such as during weekends or vacations.
Question: Does this mean that he’ll have to
find other work?
Answer: In some cases, yes. It differs from
other froms of asthma in one respect: It is not always
reversible. Medications may cease to prevent or contain asthma
attacks. When that happens, eliminating exposure to the trigger
is the recommended treatment, even if that means changing jobs.
ADVERSE FOOD REACTIONS
Question: Can asthma attacks be caused by what I
eat?
Answer: Some people are allergic to certain
foods or have intolerances to food additives. These adverse food
reactions can provoke severe or even life-threatening asthma
attacks.
When someone with asthma eats an offending food, the immune
system gets into action. It releases immunoglobulin E to attack
and interact with the allergen in the food. The mast cells then
release histamine and other mediators, which cause allergic and
asthmatic symptoms. Adults tend to be allergic to peanuts, tree
nuts, eggs, yeast products, shellfish and fish.
Common food allergens for children are eggs, milk, wheat, corn,
peanuts, soy, shellfish, citrus juices, artificial coloring and
some flavorings.
One advantage for children is that allergies to milk, wheat, eggs
and corn are often outgrown. However, allergies to fish,
shellfish, nuts and peanuts tend to remain for like, and the
severity of reactions to these lifelong allergens often increases
with each exposure.
Question: What are food intolerances?
Answer: These are nonallergic food reactions.
Something in the food causes the mast cells to release mediators,
but the process is not a result of an interaction between IgE
antibodies and allergens. However, the resulting symptoms are the
same.
High salt intake can make asthma symptoms worse, especially in
men, because it boosts substances that contribut to inflammation.
Alcohol can also make asthma worse. Twenty-five percent of asthma
patients in one hospital reported exacerbation by at least one
form of alcohol drink. Red wine and whiskey topped the list.
Question: What food intolerance is the most
common?
Answer: Sulfites, chemical preservatives used on
fruits and vegetables, in wine and in drugs to retard spoilage.
These cause severe episodes with even can be fatal. Sulfites are
also used as preservatives in some asthma medications, including
the bronchodilator isoetharine (Bronkosol), a corticosteroid
called SoluCortef and epinephrine (Epi E-Z Pen, EpiPen).
DRUG
SENSITIVITIES
Question: What drugs
trigger asthma?
Answer: Five to twenty percent of asthmatic
adults experience severe attacks which even can be fatal after
taking aspirin or certain other nonsteroidal anti-inflammatory
drugs. Someone with severe asthma is more prone to experience
such problems. Many people who are sensitive to aspirin also have
nasal polyps, grapelike protrusions in the lining of the nose.
Asthma experts advise that people with asthma avoid aspirin and
other nonsteroidal anti-inflammatory medications. These include
ibuprofen (Motrin, Advil, Nuprin), naproxen (Naprosyn, Anaprox)
and piroxicam. It is recommended to use acetaminophen (Tylenolj),
sodium salicylate or disalcid instead.
Tartrazine (yellow food dye #5) also causes asthma attacks on
rare occassions. Beta blockers - drugs designed to lower high
blood pressure - can trigger bronchoconstriciton. Many
medications can produce adverse reactions when taken in
combination with asthma drugs.
HORMONES
Question: Do a woman’s changin hormone
levels affect asthma?
Answer: One study reported in 1996 in the
Archives of Internal Medicine found that women with asthma are
most likely to have a severe attack immediately before and during
menstruation, mainly because of the fluctuation of estrogen
levels.
Another study reported that women who take estrogen for 10 years
or more doble their risk of developing asthma.
EXERCISE
Question: Is exercise an irritant?
Answer: Yes. It can trigger bronchospasms, which
lead to shortness of breath, chest pain or tightness, wheezing,
counging or endurance problems during vigorous exercise. This is
common in people of all ages. These many come on a few minutes
after exercise starts, peak 5 to 10 minutes after the vigorous
activity has stopped and disappear 20 to 60 minutes later. The
harder the exercise, the more severe the attack.
For some people, exercise is the only trigger for asthma. These
attacks may occur only in cold weather, although some asthmatic
people experience exercise-induced asthama year round. Sexual
intercourse can be a cause of exercise-induced asthma.
INFECTIONS
Question: What infections trigger asthma?
Answer: Viral respiratory infections, such as
the common cold and influenza, and bacterial respiratory
infections are two triggers. These can affects both children and
adults.
Question: Do colds often trigger asthma?
Answer: Yes. A 1995 Sutdy of British
schoolchildren found common cold viruses reported in 80 percent
of wheezing episodes and 85 percent of asthma episodes.
Sufferers notice that once colds develop, they tend to linger.
Doctors aren’t sure why this happens. Some say that certain
viruses irritate the lungs more, and this sets the stage for an
attack. Ohters say that the increased mucus production of a cold,
in addition ot the asthmatic lung’s already high production
of mucus, pushes the asthmatic person’s respiratory system
over the edge.
Question: What about bacterial infections?
Answer: These may follow as a complication of a
common cold and include infections such as pneumonia and strep
throat. These may develop in the area around a mucus plug that a
sufferer has been unable to get rid of. The bacterium Chlamydia
pneumoniae has been found in 58 percent of asthmatic children
ages 5 to 15. Because the bacterium can be halted with
antibiotics, researchers belive that asthma’s progress may
be similarly affected by antibiotics.
Question: Are sinus infections a problem?
Answer: Yes. These are an inflammation of the
mucous membrane of the sinuses - the open cavities in the head
behind the nose and eyes. This is known as sinusitis. The
swelling and inflammation may eventually affect the bronchial
tubes and worsen the asthma.
Sinusitis may be caused by a viral or a bacterial infection. The
symptoms include headache, sinus tenderness, nausea, post-nasal
drip, fever and a yellowish or greenish discharge from the nose.
Asthma symptoms are difficult - if not impossible - to control.
WEATHER
Question: How does the weather trigger asthma?
Answer: Sudden changes in weather fronts or
barometric pressure worsen asthma. The reasons are unclear. A
recent sutyr found that cold air masses with high pressure in the
fall are especially associated with increaed hospital admission
for asthma.
Cold winter days can cause problems because of dry, frigid air
which is a shock to the sensitive bronchial passageways. Warm,
humid days prove a problem also, because they aid in mold and
pollen growth. In 1994, 640 people with asthma (10 times more
than expected) reported to emergency rooms in London after a
thunderstorm. Other studies linked the asthmatic response to
aeroallergens kicked up during the storm.
STRESS
Question: Does stress cause asthma?
Answer: Stress and emotions do not cause athma
in someone who doesn’t already have the disease, but stress,
anxiety and anger do increase the frequency and intensity of
asthma attacks.
Strong emotions affects people in physical ways: Muscles become
tense in highly charged situations; people hyperventilate or pant
in response to stress. This doesn’t explain the full
relationship between asthma and emotions, but does point to the
usefulness of breathing and relaxation exercises and other
techniques for stress control.
Weather, infections, exercise and stress all can lead to or
intensify an asthma attack.
Question: Which medical conditions make asthma
worse?
Answer: Allergic rhinitis, (called hay fever)
makes asthma harder to control. It is an allergic response to an
inhaled substance (the allergen). In asthma, this response occurs
in the bronchial tree; in allergic rhinitis, the reaction takes
place in the eyes, nose and throat. It usually is in the form of
watery eyes, congestion, runny nose, sneezing, scratchy throat
and coughing.
Question: How does hay fever affect asthma?
Answer: The congestiona and throat irritation
may reach the lungs, which cuases bronchial inflammation and
provokes an asthma attack. Hay fever and asthma often operate in
tandem: Sufferers with asthma may develop Hay fever (especially
if they are under age 40), just as someone with hay fever may one
day develop asthma.
People with Hay fever tend to have asthma problems for an
additional reaston - they develop nasal polyps.
Question: What are nasal polyps?
Answer: The cells of the mucous membrane lining
the nose produce too much fluid, and that area of the membrane
stretches and protrudes into the nasal cavity. These protrusions
are known as nasal polyps. They are graplike and filled with
fluid. They themselves are harmless but can block nasal
passageways and make it hard to breath.
People with astma and nasal polyps tend to be extremely allergic
to aspirin. They should avoid any anspirin-containing products.
Doctors will often prescribe medicated nasal sprays to treat
nasal polyps. Sometimes surgery is recommended, although the
polyps tend to reappear, even after surgery.
Question: Are there any other conditions related
to asthma?
Answer: One is gastroesophageal reflux, which is
the regurgitation of stomach acids into the esophagus. This is
often called acid reflux; you and I know it as heartburn.
Question: What is the cause of this?
Answer: The muscle valve between the esophagus
and the stomach fails to seal tightly. Acid from the stomach
travel up into the esophagus or even into the pharynx. The
results of this are belching and the sensation of heartburn.
Someone with asthma could inhale this acid into the larynx or
bronchi, and bronchospasms and airway inflammation could develop.
Question: Is acid reflux common?
Answer: It is estimated that from 45 to 80
percent of asthma suffers have acid reflux, and one Ohio study
found the reflux to be the asthma trigger in 60 percent of those
people.
It causes more trouble when an asthmatic person is reclining.
Thus, it is more of a problem at night.
Question: How is it treated?
Answer: Your doctor may advise you to eat
smaller but more frequent meals. You also may need to avoid food
or drink between dinner and bedtime, and avoid fatty meals,
spices and alcohol.
Question: Are there any other asthma triggers?
Answer: There are hundreds of asthma triggers.
Some may still be unknown. The main thing is to realize that many
substances can cause asthma attacks and to take steps to discover
which ones affect you.
ASTHMA BEHIND THE SCENE ...... ASTHMA TYPES ...... SELF-CARE
CALL TOLL-FREE 1-800-701-1959
International Calls - Dial international code then 330-823-0691