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What is Asthma?

Asthma is a chronic lung disease that affects many West Virginians. It is estimated that 8.5% of West Virginians had asthma in 2009. This equals approximately 126,000 adults and 32,000 children. Not all people with asthma in West Virginia are receiving treatment according to the national guidelines. Consequently, preventable symptoms and events, like hospitalizations and death, continue to occur. Since 2000, 27 West Virginians have died each year from asthma.

The disease is characterized by recurrent respiratory symptoms such as wheezing, breathlessness, chest tightness, coughing, and variable airflow obstruction that is reversible spontaneously or with treatment. Symptoms may occur or worsen at night. Sixty percent or more of those with asthma also have allergies - however by recognizing and avoiding environmental triggers asthma symptoms can be almost eliminated.

Symptoms may also occur or become worse during exercise or exposure to animals with fur or feathers, household dust mites, mold, smoke (tobacco or wood burning), pollen, changes in weather, airborne chemicals, and dusts. Viral infections, strong emotions, and menses/menstrual cycle can also trigger symptoms.

Asthma sufferers sometimes experience episodic exacerbations (attacks). During an episode, it's difficult to breath; the airways in the lungs narrow and get blocked with mucus, limiting the lungs to insufficient amounts of air. During an asthma attack, symptoms can range from intermittent and manageable to severe and life-threatening.

What Causes Asthma

It is unknown what causes asthma, but both environmental and genetic factors seem to play a roll in the development of the disease. According to research, asthma is more prevalent in industrialized countries than in underdeveloped ones, which causes some people to theorize that asthma is caused by industrial pollutants.

The majority of children diagnosed with asthma (between 50% and 90%), develop symptoms before the age of 5.

The following factors appear to be associated with the onset of asthma symptoms in children:

  • Smaller airways at birth and in early life
  • Exposure to tobacco smoke (while in utero; secondhand smoke; and thirdhand smoke)
  • Male sex
  • Low birth weight
  • A parent, especially the mother, with allergies or asthma
  • Other family members with asthma and allergy
  • Viral respiratory infections

Asthma may appear to develop at any age. When asthma symptoms appear in adulthood, it may be a recurrence of unrecognized childhood asthma or a recurrence of asthma that had gone into remission during the early adolescent years.

Asthma in patients over the age of twenty appears to be more common and more severe in women. With adult onset of asthma, work-related factors appear to be responsible in approximately 15% of reported cases.

Some cases of work-related asthma may occur because of a single, high-dose exposure to ammonia, chlorine gas, or hydrochloric acid. Work-related or aggravated asthma can also result from long term continuous exposure to some chemicals.

The onset of asthma can also be linked to obesity in both children and adults. Weight loss in obese patients with asthma has been shown to improve symptoms, lung function, morbidity, and their general health status.

Asthma symptoms, frequency, and severity are generally worse in adults aged 65 years and older, with an increase in medication requirements, hospitalizations, and mortality rates.

Presently, there is no cure for asthma. Effective management of the disease will help sufferers lead a more normal lifestyle. Having a written asthma action plan is essential to managing asthma symptoms. Talk to your doctor about developing an asthma action plan that is right for you.

There is no cure for asthma, but there is a number of treatments that can normally manage the disease. Treatment is based on two important goals:

  • Relief of symptoms, and;
  • Preventing future symptoms from developing.

Successful control of asthma can be achieved through a combination of medicines, lifestyle changes, and identifying and then avoiding potential asthma triggers.

Click here for Asthma Terms and Definitions

Asthma and Allergy Connection

Between 70% and 90% of children with asthma have positive allergy skin tests. The majority of children with asthma have positive skin test reactions to inhaled allergens such as house-dust mites, cockroaches, animal dander, and pollen. Exposures to these allergens cause increased airway irritability and asthma symptoms. Food allergens, however, do not usually trigger asthma symptoms, unless it is part of a generalized anaphylactic reaction.

Work-Aggravated Asthma is a pre-existing asthma that is made worse by dust, fumes, and other irritants found in the workplace. Work-aggravated asthma occurs in workers with a previous or concurrent history of asthma and is characterized by worsening symptoms at work in response to chemicals or physical stimuli encountered at work, such as dust or cold air.

Occupational Asthma (OA) is due to exposure to specific substances at the workplace. Often these substances are specific to certain occupations. For example, some nurses develop occupational asthma as a response to prolonged exposure to latex, and some workers in the food-processing industry develop occupational asthma as a response to prolonged exposure to flour.

Occupational asthma (OA) is a heterogeneous clinical syndrome characterized by work-related symptoms, airway inflammation (partially or completely reversible), bronchoconstriction, and hyper-responsiveness induced by workplace exposures (asthmagens). In contrast to non-occupational asthma, the differentiating feature of occupational asthma is the causal asthmagen is a substance in the occupational environment.

The symptoms of OA are similar to non-occupational asthma and include wheezing, cough, dyspnea, and impaired quality of work and non-work life. More than 250 asthmagens have been implicated and identified as causative agents in the development of OA (e.g., di-isocyanates, western red cedar, enzymes, snow crab, latex, flour, and laboratory animals). However, there are likely a variety of workplace asthmagens that have yet to be identified.

OA can occur after a single large exposure to irritant gases, fumes, or chemicals, such as nitrogen oxide, ammonia, and chlorine. This type of exposure results in reactive airways dysfunction syndrome, or RADS.

Exercise-Induced Asthma or Exercise-Induced Bronchospasm is a pre-existing asthma brought on by physical exercise. However, for most people it is an indication of poorly controlled asthma.

Managing Asthma

Every asthma sufferer should have a written Asthma Action Plan, especially those with moderate-to-severe persistent asthma or who have a history of severe exacerbations. A written action plan is essential for managing and gauging asthma symptoms. Talk to your doctor about developing an action plan specifically for you. Also talk to you doctor about the use of inhaled corticosteroids.

Have your doctor show you how to recognize early signs and symptoms of an episode - this is the first immediate step to control and lessen the chance of having an asthma episode or attack.

Your doctor can also show you how to use a peak flow meter to determine your best expiratory flow (the amount of air you can blow out of your lungs) while your asthma is under control. This will give you a basis to assess the severity of an exacerbation or asthma attack - by testing your expiratory flow during an attack and again to test your response to treatment.

See your doctor if you have a severe exacerbation or worsening of symptoms, if treatment doesn't give rapid and sustained improvement, or if symptoms become worse or more frequent.

Asthma sufferers should have the medications and equipment (e.g. spacer, nebulizer), recommended by their physician, readily available in the event of an exacerbation.

By actively assessing and participating in the management of your asthma, the disease is less likely to negatively affect your lifestyle.

Keep the following key points in mind for managing your asthma symptoms:

  • When you have asthma, it is important to take your medicine daily even if you feel good.
  • If you need to use your rescue inhaler more than twice a week, your current treatment plan is not effectively managing your asthma. Consult your doctor right away.
  • Identify and avoid your asthma triggers.
  • Talk and supply a copy of your Asthma Action Plan to your family, friends, coworkers, colleagues and teachers about how to help you during an asthma attack.

Develop an Asthma Action Plan with your doctor or other healthcare provider, give copies to your school, caretakers, family members, employer(s), and carry it with you for when you experience an attack.

Asthma Action Plan (PDF) 

Asthma Action Plan Adult

Asthma Action Plan Child

Asthma Action Plan - Condensed Wallet Size

Asthma Terms and Definitions

National Heart Lung and Blood Institute EPR 3 - (NHLBI) Guidelines for the Diagnosis and Treatment of Asthma Expert Panel Report 2007

Famous People Who Have Asthma - THIS MAY SURPRISE YOU!

Many of the medications and equipment can be expensive especially if you have to take more than one or two types. For more information on Medication Assistance Programs, please view this topic under the "LINKS" section on this website.


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