Health Matters by Dr.Paul: Asthma and the Indoor Environment
Up to 10% of children have asthma, most of whom will develop symptoms during the first few years of life. Although most asthmatic children get better with age, asthma can persist into adulthood. It is generally agreed that if a person has repetitive episodes of shortness of breath, and/or wheezing and/or cough, and has no other lung problem, the diagnosis of asthma can be made. In older children and adults, there are special breathing tests that can confirm the diagnosis.
Asthma symptoms may be disruptive especially if the affected person has been hospitalized or had multiple visits to the emergency room. However, the good news is that most cases of asthma can be well-controlled if one is educated about asthma, recognizes what the symptoms are, and knows what to do about them. Although there are many effective medications today that control asthma, I cannot stress enough the role of the environment on asthma. The remainder of this article will focus on this very important relationship. Although outdoor pollutants are important, I want to emphasize that the indoor allergens described below play a vital role in causing asthma symptoms, especially in children, who for the first few years of their lives spend most of their time indoors.
Asthma symptoms or “attacks” are most often triggered in children by a respiratory infection, such as the common cold. Therefore, asthma attacks tend to occur more frequently during the winter months. But the presence of other irritants - especially cigarette smoke, microscopic insects called dust mites, animal dander, especially from cats, plant pollen, deodorants or perfume - often make asthma symptoms more frequent, more severe, and more difficult to control. Other asthma triggers that can bring on an immediate asthma attack include, exercise, cold air, and in older children and adults, emotional stress.
Asthma symptoms often appear immediately after exposure to a trigger. But sometimes the constant presence of airborne irritants like dust mites or cigarette smoke can have less obvious immediate effects, though still be harmful. Sometimes symptoms appear only hours or even days after exposure. This can make it difficult to identify what a person has reacted to. For example, a child may play with a cat and seem to have no immediate symptoms. But in a so-called "late reaction," symptoms appear only later, which is an indication of inflammation.
Inflammation of the airways or breathing tubes, resulting from irritants can increase a person’s sensitivity to the asthma triggers mentioned above. In other words, a person constantly exposed to irritants such as cigarette smoke or dust mites, is more susceptible to having an asthma attack brought on by a trigger, such as a cold, as compared to a person not regularly exposed to these irritants. So, by decreasing exposure to these environmental irritants and allergens, one can reduce an asthmatic person’s need for medication and obtain better asthma control and hence better quality of life. Bottom line: maintaining a healthy indoor breathing environment is an essential part of any asthma treatment program.