Asthma and your Household

Various factors inside your home can be important triggers or causes for the symptoms of asthma and asthma attacks.

House-Dust Mites

Many people with asthma are sensitive to the droppings of house-dust mites. These are tiny insects that live in the dust that builds up around the house – in carpets, bedding, soft furnishings and soft toys.

If you suspect or know that house-dust mites trigger your asthma, then you may be able to reduce some symptoms by following all the recommendations below:

    Use complete barrier covering systems on your mattress, duvet and pillows.
    Remove all carpets and replace with hard flooring.
    Vacuum all areas frequently. Use a vacuum cleaner that has good suction and a filtered exhaust that does not scatter dust. Damp dust all surfaces or use an attachment on your vacuum cleaner.
    Remove all soft toys from beds. Put them in a bag in the freezer for a minimum of six hours every one to two weeks to kill house-dust mites.
    Hot wash (at 60 degrees C) sheets, duvet covers and pillowcases once a week. Although some people are allergic to feathers there is no conclusive evidence to show that synthetic hypo-allergenic pillows are any better.

Location

Various factors in the environment and outside of your home can be important triggers or causes for the symptoms of asthma and asthma attacks.

It is often assumed that it is better for people with asthma to live in a rural area rather than in an inner city.

However, research has shown that even in the least polluted parts of the UK, such as the Scottish Highlands, the proportion of people with asthma is about the same as that elsewhere.

There is no best place to live for everyone with asthma.

Living somewhere where a person comes into contact with fewer of their triggers is the best idea, and this is why it is doubly important to identify your triggers for asthma.

Some triggers can occur in any part of the country, such as viral infections or cigarette smoke, while others may vary locally, such as air quality or pollen.

In the UK, you can easily check the local levels of air pollution by contacting the Air Pollution Information Service, run by the Department of Environment, Food & Rural Affairs (DeFRA), or on Teletext page 156.

In the U.S and Canada, the Weather Network website has air quality reports for cities in every state and province.

Asthma and Altitude

It is possible that people with asthma are more likely to be affected by altitude sickness.

However, fit, healthy people with well-controlled asthma should have no problems coping with high altitudes provided that they ascend slowly and recognise and accept their limitations, adjusting their medicine if need be.

In freezing conditions, pressurised inhalers may not work properly. They should be warmed (e.g. in the hands) before use.

In addition, the conditions are high altitudes are often dry and cold, and these conditions tend to exacerbate and trigger asthma. People whose asthma is triggered by cold conditions might find that high altitudes are a problem, as the air temperature usually decreases at higher altitudes.

Also, climbing can be a very strenuous exercise and this may trigger exercise-induced asthma in some people. However, people whose asthma is triggered by house-dust mites may find that their asthma improves, as the house-dust mite cannot survive at altitudes higher than ‘the snow line’.

People with asthma who fly directly into a place that is at high altitude will not have time to acclimatise and may experience problems. This should be discussed with a doctor so that the altitude reached by aircraft should not pose problems for people with asthma.

Living With Asthma

It is important that you work with your doctor to make an action plan that you are both happy with. As part of this, you will need to :

    Tell your doctor about all other medications and drugs you are taking, in case one of them affects your asthma.
    Follow your asthma action plan and have regular checkups.
    Learn to use your medication correctly. Ask your doctor to teach you how to use your inhaler. This is very important. If inhalers are not used correctly, less medication gets into the airways.
    If you are having problems taking your asthma medicine, seek your doctor’s advice immediately.

You also need to learn to identify and avoid the things that can worsen or trigger your asthma symptoms. These include :

If animal dander is a problem for you, keep your pet out of the house and/or at least out of your bedroom and wash your pet often, or find it a new home.

Do not smoke or allow smoking in your home.

If pollen is a problem for you, stay indoors with the air conditioner on when the pollen count is high.

To control dust mites, wash your sheets, blankets, pillows, and stuffed toys once a week in hot water. You can get special dust proof covers for your mattress and pillows.

Other Asthma Diagnostic Tests

Other tests, such as a chest x-ray or an electrocardiogram, may be needed to find out if a foreign object, or other lung diseases or heart disease could be causing asthma symptoms.

A correct diagnosis is important because asthma is treated differently from other diseases with similar symptoms.

Depending on the results of your physical exam, medical history, and lung function tests, your doctor can determine how severe your asthma is. This is important because your asthma severity will determine how your asthma should be treated, and what the options are for treatment.

A general way to classify severity is to consider how often a person has symptoms when that person is not taking any medicine or when their asthma is not well controlled.

Based on symptoms, the four levels of asthma severity classification are:

Mild Intermittent: occurs when your asthma is not well controlled, you have asthma symptoms twice a week or less, and you are bothered by symptoms at night twice a month or less.

Mild Persistent Asthma: occurs when your asthma is not well controlled, you have asthma symptoms more than twice a week, but no more than once in a single day. You are bothered by symptoms at night more than twice a month. You may have asthma attacks that affect your activity.

Asthma Diagnosis

Diagnosis is the first step in keeping asthma under control.

Early warning signs of asthma include, fatigue, coughing, even when the person does not have a cold, wheezing, difficulty breathing, tightness in the chest, runny nose or itchy throat.

Anyone regularly exhibiting any of the symptoms should see a doctor or allergist as soon as possible. The earlier it is diagnosed the earlier the condition can be controlled, and the more successful the treatment can be.

Initially, your doctor will ask about:

    Periods of coughing, wheezing, shortness of breath, or chest tightness that come on suddenly or occur often or seem to happen during certain times of year or season.
    Colds that seem to “go to the chest” or take more than 10 days to get over.
    Medicines you may have used to help your breathing.
    Your family history of asthma and allergies.
    What things (triggers) seem to cause asthma symptoms or make them worse.

Your doctor will listen to your breathing with a stethoscope and look for signs of asthma or allergies.

Also, your doctor will probably use a device called a spirometer to check your airways. This test measures how much air and how fast you can blow air out of your lungs after taking a deep breath. The results will be lower than normal if your airways are inflamed and narrowed, as in asthma, or if the muscles around your airways have tightened up. As part of the test, your doctor may give you some medication that helps open up narrowed airways to see if it changes or improves your test results. Spirometry is also used to check your asthma over time to see how you are doing.

Peak Flow Meters

A peak flow meter is a hand-held device that shows how well you are breathing.

As part of your asthma action plan, you may use a peak flow meter at home to measure lung function. To use it, you take a deep breath and blow hard into a tube to find out how fast you can blow out. This gives you a peak flow number. You will need to find out your “personal best” peak flow number by recording the peak flow number daily for a few weeks until your asthma is under control. The highest number you get during that time is your personal best peak flow. Then you can compare future peak flow measurements to your personal best peak flow, and that will show if your asthma is staying under control or not.

Your doctor will tell you how and when to use your peak flow meter and how to use your medication based on the results. You may be asked to use your peak flow meter each morning to keep track of how well you are breathing.

The peak flow meter can also help warn of a possible asthma attack even before you notice symptoms. If your peak flow meter shows that your breathing is getting worse, you should follow your action plan. Take your quick relief or other medication as your doctor directed. Then you can use the peak flow meter to see how your airways are responding to the medication.

To get a rough indication of what your peak flow should be, various charts are available, such as this Peak Flow chart :

Causes of Occupational Asthma

Oddly enough, diesel fumes and many substances with a nasty smell don’t seem to cause asthma, even though there is important evidence that they can cause allergic reactions in your nose.

If your asthma is due to your work then it should be possible to remove the cause. The fact that you have asthma from work means that others could also get it, so the discovery could help a lot of people – including your employer.

If the asthma is discovered early, then your work environment can be improved, and the asthma treated, the result of which is usually a complete cure.

But if the occupational asthma is discovered after years of working with the offending materials, then it should get better when you no longer have breathe it in all day, but you are very likely to be left with permanent asthma, and this may be mild or severe asthma.

It is important to remember that asthma is so common that most people with asthma in a workplace have it for the same reasons as everybody else, and not because of their job.

This makes it hard to determine and discover the few people who really do have occupational asthma.

If you think that you have become affected by occupational asthma, then consult an expert on ‘Occupational Asthma’, or an allergist, as soon as possible.