Asthma Risk Factors

Approximately 14 million adults and 6 million children in the U.S. have asthma. In fact, asthma is the most common chronic illness of childhood and a common reason for missed school days. Although anyone can have asthma, there are certain characteristics that increase the likelihood of being diagnosed with the chronic illness.

A number of factors may increase your chances of developing asthma, including:

• Living in a large urban area, especially the inner city, which may increase exposure to environmental pollutants
• After puberty, females are more at risk
• Exposure to first and secondhand smoke
• Exposure to occupational triggers, such as chemicals used in farming and hairdressing, and in the manufacturing of paint, steel, plastics and electronics
• Having one or both parents with asthma
• Respiratory infections in childhood
• Low birth weight
• Obesity
• Gastroesophageal reflux disease (GERD)
• Allergies – you can have allergies without having asthma, however, having allergies can put you at an increased risk for developing the disease
• Low income
• People with a family history of asthma
• Some minorities are impacted at very high rates by asthma

Signs and Symptoms of Asthma

Recognizing the signs and symptoms of asthma is an important part of managing the disease. Knowing when early warning signs or mild symptoms are occurring is helpful so that treatment and other interventions can begin early. Early treatment is most effective. If severe symptoms are present, it is vital to begin the appropriate treatment immediately. Accurate and timely assessment of symptoms can help determine if treatment should begin in the home, at your clinician’s office or in the emergency room. Individuals with asthma may experience some or all of these symptoms during an asthma episode. Take action to treat these symptoms before they worsen. Talk to your healthcare provider about having a written asthma action plan.

Examples of mild/moderate asthma symptoms include:

• Wheezing
• Coughing
• Shortness of breath
• Tightness in the chest
• Peak flow numbers may be in the caution or danger range (usually 50to 802f personal best)
• Disturbed sleep caused by coughing, wheezing, or shortness of breath
• Examples of severe asthma symptoms include:
• Severe coughing, wheezing, shortness of breath or tightness in the chest
• Difficulty talking or concentrating
• Shortness of breath caused by walking
• Breathing is shallow, quicker or slower than normal
• Hunched shoulders
• Nasal flaring
• Retractions – neck and area between or below the ribs moves inward with breathing
• Cyanosis – gray or bluish tint to skin, beginning around the mouth
• Peak flow numbers may be in the danger zone, usually below 500f personal best

Severe asthma symptoms can be life-threatening. If severe symptoms occur, seek emergency medical treatment right away. Have an asthma action plan ready to get emergency care quickly. Inform family members and those who are close to you about your emergency action plan.

Asthma Triggers

Although there is no known cause for asthma, there are certain things that make asthma worse. Asthma triggers are unique to every person, and are grouped into two categories, allergens and irritants.

Allergens:

Cockroaches

Cockroaches, along with their droppings, may trigger an asthma episode. To remove cockroaches in your home take away their food and water supply. They are most likely found where food is present, as they only need food and water to survive. Also, be sure to clean the areas that might attract cockroaches at least twice a week. You can also purchase cockroach traps or gels to decrease the number of cockroaches in your home.

Mold

If mold is inhaled, it may cause an asthma episode. Remove the mold in all parts of your home. It is important to keep the humidity level in your home between 35% and 50% in hot, humid climates. You may need to use an air conditioner, a dehumidifier or both to prevent mold growth. Be sure to fix any water leaks, which allow mold to grow behind walls and under floors.

Pet dander

Pets with fur may trigger an asthma episode due to the pet’s dander. When a furry pet is suspected of causing asthma episodes, the most effective solution is to find the pet another home. If that is not an option, the pet should be kept outside of the bedroom where the person with asthma sleeps.

Pets should be bathed weekly, and you should try to keep the animal outside as much as possible. Asthmatics are not allergic to their pet’s fur, so trimming the pet’s fur will not help your asthma. If you have a furry pet, vacuum often, and if your floors are not carpeted, mop them every week.

Pollen

Pollen may be a trigger for seasonal allergies, which can cause an asthma episode. Try to avoid long periods of outdoor exposure when pollen is at high levels. Take appropriate actions for controlling your seasonal allergies.

Dust

Dust and dust mites are in almost everybody’s home, but they don’t cause asthma episodes in everyone. To help prevent asthma episodes, use mattress covers and pillow case covers to create a barrier between dust mites and yourself. Do not use down-filled pillows, quilts or comforters. Remove stuffed animals and clutter from the bedroom where the person with asthma sleeps and/or plays.

Irritants

Cigarette and environmental smoke

If you have asthma and are a current smoker, it is extremely important to quit smoking. Smoking is a major asthma trigger. Environmental tobacco smoke is often called “secondhand smoke,” since it is smoke that is breathed in by those who are not smoking. Parents, friends and relatives of children with asthma should try to stop smoking completely, but especially around a person with asthma. Parents should not allow others to smoke in the home, as well as ensure that their child’s school is smoke-free.

Other triggers

Other trigger such as wood fires, charcoal grills, strong odors/perfumes, household cleaning products and paint may also trigger an asthma episode.
Some other triggers include strenuous physical exercise; some medicines; bad weather such as thunderstorms, high humidity, or freezing temperatures; and some foods and food additives which can trigger an asthma episode.
Strong emotional states can also lead to hyperventilation and an asthma episode.
Learn what triggers cause your asthma episodes so that you can prevent those triggers whenever possible and be prepared for a possible episode when the triggers cannot be avoided.
Remember, you control your asthma. Your asthma does not control you.

How is Asthma Diagnosed?

1. Personal and medical history

Your doctor asks you questions to obtain a complete understanding of your symptoms and their possible causes. Bring your notes to help jog your memory, and be ready to answer questions about your family history, the kinds of medicines you take and your lifestyle at home, school and work. This includes any current physical complaints and all previous medical conditions. Shortness of breath, wheezing, coughing and a feeling of tightness in your chest may indicate asthma. A history of allergies or eczema increases the possibility of asthma. Any past or present medical conditions experienced by your parents, siblings or children. A family history of asthma, allergies or eczema increases the likelihood of being diagnosed with asthma. All home and occupational exposure to environmental factors that can worsen asthma, such as pet dander, pollen, dust mites and tobacco smoke will be of interest to your doctor.

2. Overall physical examination

If your doctor suspects asthma, special attention will be paid to ears, eyes, nose, throat, skin, chest and lungs during the physical examination. This exam may include a pulmonary function test to detect how well you exhale air from your lungs. You may also need an X-ray of your lungs or sinuses. A physical exam allows your doctor to further evaluate your overall health.

3. Lung function tests

To confirm an asthma diagnosis, your doctor may conduct one or more breathing tests known as lung (pulmonary) function tests. These tests measure many aspects related to your breathing. Common lung function tests used to diagnose asthma include:

• Spirometry is the recommended test to confirming the diagnosis of asthma. During this test, you breathe into a mouthpiece that’s connected to a device known as a Spiro meter. You will likely be asked to take a deep breath and then exhale forcefully. A Spiro meter measures the amount of air you’re able to breathe in and out, and the rate of airflow. The number displayed is a measurement of your ability to force air out of your lungs.
• Peak Airflow is one of the simplest lung function tests. It uses a peak flow meter, a small, hand-held device that you breathe into to measure the rate at which you can force air out of your lungs. During the test you breathe in as deeply as possible, and then blow into the device as hard and quickly as possible. If you’re diagnosed with asthma, you can use a peak flow meter at home to help monitor your condition.

Lung function tests are often done before and after inhaling a medication known as a bronchodilator, which opens your airways. If your lung function improves significantly with use of a bronchodilator, it’s likely you have asthma. Your doctor may also prescribe a trial with asthma medication to see if it improves your lung function

4. Trigger tests

If your test results so far are normal, but you’ve been experiencing signs and symptoms of asthma, your doctor may use known asthma triggers to try to provoke a mild reaction. If you don’t have asthma, you won’t react. But if you do have asthma, you likely will. For example, your doctor may have you inhale a substance called methacholine.

If you have asthma, inhaling the methacholine will cause your airways to constrict. Your doctor can measure these constrictions using a lung function test. Or, if your doctor suspects you have exercise-induced asthma, he or she may have you take lung function tests before and after exercising to see if there’s a difference

Treatment Options

Even though there is no cure for asthma, it can still be controlled. Good asthma control should allow an individual to lead a full life. It also prevents permanent lung damage from happening.

Goals of asthma treatment

• Be free from symptoms day and night – including being able to sleep through the night
• Have the best possible lung function.
• Be able to participate fully in any activity
• Not missing school/work/play because of asthma symptoms
• Eliminate the need for emergency visits or stays in the hospital because of asthma
• Use asthma medicines to control the disease with as few side effects as possible

Treatment options

• Avoiding or controlling triggers
• “Controller” medicine to prevent airway inflammation and irritation
• Monitoring airways to identify and treat problems early
• “Rescue” medicine as needed for early signs of an attack
• Developing healthy habits through nutritious diet, regular exercise, plenty of sleep, timely immunizations, yearly flu shot, avoiding unnecessary stress and good hand washing techniques to prevent infection
• Regular follow-up clinic visits

Asthma Medications

Medicines used for treating asthma are either Controller or Rescue medications.

Controller Medications

• Used to prevent airway inflammation or help airway muscles stay relaxed
• Taken every day, even when felling great
• Types include anti-inflammatory, such as an inhaled steroid, anti-allergy medicines and airway relaxers, such as bronchodilators to be taken at certain times- like before exercise
• These medicines will not help with an attack, like a Rescue medicine
• Use a daily asthma management plan to list controllers

Rescue Medications

• To be used only as needed when airway problems occur
• Are usually airway relaxers called short acting bronchodilators
• Types include, inhalers or nebulizer albuterol, or similar medicines taken by mouth
• Implement an action plan to list the medications needed and when
• If the rescue medicine is used more than 2 times a week, see a physician. Asthma can be in better control

Management Plan

For people with asthma, having an management plan is the best strategy to prevent symptoms. A management plan can be developed by you and your doctor to help control your asthma, instead of your asthma controlling you. Share your asthma management plan with family, friends, teachers and caregivers.
A sample asthma management plan should include:

• Asthma triggers
• Instructions for asthma medications
• What to do if you have an asthma attack
• When to call your doctor
• Emergency telephone numbers