WHAT TRIGGERS AN ASTHMA ATTACK or EPISODE?

Here are some examples and descriptions of what triggers an asthma attack or episode…

Physiological factors that may trigger or increase asthma symptoms include:

• Viral upper respiratory infections.
• Exercise.
• Untreated conditions such as rhinitis, sinusitis, and gastroesophageal reflux.
• Drugs such as aspirin and other anti-inflammatory drugs.
• Stress and strong emotions.
• Menstrual Cycle

Common indoor environmental irritants and allergens that can trigger an asthma episode include:

• Pet fur or feathers, pet urine, saliva and dander.
• House-dust mites.
• Cockroach waste and decomposing carcass.
• Mold and mildew spores. (leaking plumbing, leaking roof, etc.)
• Tobacco smoke and wood smoke.
• Perfumes, hairsprays, scented lotions, and cologne.
• Air fresheners, incense sticks and scented candles.
• Cleaning solutions, pesticides and paint fumes.

Common outdoor environmental irritants and allergens that can trigger an asthma episode include:

• Pollen from trees, grasses, and weeds.
• Mold and mildew spores. (wet rotting leaves on the ground, etc.)
• Changes in humidity.
• Exposure to cold air or very hot air.
• Industrial emissions, vehicle exhaust, and other air pollutants.

Common Environmental Allergens

The cause of the underlying airway inflammation in patients with asthma is unknown. Once a person has inflamed airways and asthma, environmental triggers can cause or increase asthma symptoms.

Exposure to chemicals or airborne pollutants at work can trigger asthma. In some cases of work-related or occupational asthma a single, high-dose exposure to ammonia, chlorine gas, hydrochloric acid, or formaldehyde (a wood preservative and additive in adhesives) can cause the onset of asthma. Work-related or aggravated asthma can also result from long-term, continuous exposures to some chemicals.

Allergy Testing

Since allergies can be an important factor in causing asthma symptoms, the diagnosis of asthma often includes testing for common environmental allergens, such as house-dust mites, molds, animal dander, cockroaches, and pollens.

Patients with persistent asthma should be tested for sensitivity to the allergens they are routinely exposed to. Testing helps diagnose allergic factors that contribute to asthma symptoms and severity. Once allergens are identified that cause asthma symptoms, exposure to those allergens can be controlled.

How to Avoid Triggers

Dust Mites - Live and breed in mattresses, bed linens, carpet, stuffed toys, fabric-covered furniture, etc and can be found in every home. They resemble a flea, but are so small that a microscope is needed to see them. To reduce asthma symptoms associated with dust mites, refer to the following.

Here are some ways to reduce exposure in the home:

• If possible, do NOT have the asthma sufferer in the room that is being cleaned to avoid aggravating symptoms.
• Wash sheets and blankets in HOT water, once a week.
• Vacuum weekly - preferably with a HEPA filtered vacuum cleaner.
• Choose stuffed toys that are washable. Wash them in hot water and dry thoroughly periodically. Stuffed toys should NOT be placed on beds or in the bedroom if possible. If the stuffed toy cannot be washed - place it in a plastic bag then place it in the refrigerator freezer for a few hours. The cold will kill the dust mites.
• Cover mattresses and pillows in dust-proof (allergen-impermeable) zipped covers. (These items can be purchased in many department stores and online).

Pets - To help avoid an asthma episode brought on by a pet, here are some suggestions:

• Consider keeping pets outdoors or even finding a new home for your pets especially if asthma episodes induced by exposure to the pet are severe. (Even by removing a pet, the allergens from that pet remain in the home for up to one year).
• Make the bedrooms and other sleeping areas of those with asthma off limits to pets at all times, and keep the door closed.
• Keep indoor pets away from fabric-covered furniture, carpets and stuffed toys. Vacuum, dust and clean often.
• Bathe and groom the dog or cat frequently to reduce allergens. (This only reduces allergens - it does not eliminate them altogether).

Molds and Mildew - Grow in damp and shady places. To help avoid an asthma episode triggered by molds and mildew try these steps:

• Wash mold off hard surfaces and dry completely. Absorbent materials, such as ceiling tiles and carpet with mold, may need to be replaced.
• Locate the source of moisture - drainage problem, leaky plumbing, poor ventilation, etc. and have the problem corrected.
• Keep drip pans in your air conditioner, refrigerator and dehumidifier clean and dry.
• Use exhaust fans or open windows in kitchens and bathrooms when showering, cooking or using the dishwasher.
• Maintain low indoor humidity, ideally between 30 to 50 percent relative humidity. Humidity levels can be measured by hygrometers, which are available at local hardware stores or home improvement centers.

Pests - Droppings or decaying body parts of pests such as cockroaches or rodents can be asthma triggers. To help avoid an asthma episode, these measures should be taken to keep them out of your home:

• Do not leave food or garbage out.
• Remove cardboard boxes - as roaches are known to lay their eggs and nest here.
• Store food in airtight containers (plastic, metal, or glass).
• Clean all food crumbs or spilled liquids right away.
• Try using poison baits, boric acid (for cockroaches) or traps first before using pesticide sprays.
• Tobacco Smoke - Asthma can be triggered by the smoke from a cigarette, pipe or cigar, as well as the secondhand smoke that is exhaled by other smokers.
• Set a "NO SMOKING" policy for your home and car.
• Avoid going into homes and businesses where tobacco smoke is present. Perfumes/Fragranced Products - Products that have strong odors such as perfumes, hairsprays, scented lotions, paints, and cleaning products can cause an asthma episode or more severe attack.
• Avoid using perfume or heavily scented products.
• Ventilate well (open windows/use fans) when using scented hairsprays or cleaning products inside the house.
• Store paints and other highly scented products in a garage can or outside storage building. Make sure containers are properly sealed. When painting, make sure the room is well ventilated.

Exercise Induced Asthma/ Exercise Induced Bronchospasm - Physical exertion can cause some people to have an asthma attack. An episode can occur during or after exercise.

• Talk to your doctor about medicines available to prevent an asthma attack during exercise. With proper medications, asthma sufferers can live healthy, active lives.
• Typically, using a fast acting beta2-agonist (bronchodilator) "Relief Inhaler" 30 minutes before exercise (such as Albuterol, Ventolin, Proventil, ProAir, or Xopenex) is recommended for individuals with asthma to help prevent symptoms.
• Choose an exercise that is less likely to trigger your asthma, like swimming, walking or leisure biking.
• Discuss any exercise plan with your physician along with a treatment plan to help you perform your best.

Cold Air or Very Hot Air- Can also trigger an asthma attack.

Take these precautions during cold weather:

• Avoid going out on extremely cold days.
• Wear a scarf around your mouth when you go outside.

Take these precautions during hot weather:

• Avoid going out during extremely hot and/or humid days if possible.
• Avoid going out during the hottest part of the day - between 10 am and 2 pm.
• Avoid going out on "HIGH POLLUTION" or bad air days. Check the local news, newspaper, or Air Quality Index websites in your area for more information.  
• WV-DEP Air Quality Index - Check your local air quality with daily updates