Asthma Information
(from the Foundation for Better Health Care)

Asthma is a disease that affects the lungs and the airways that deliver air to the lungs. It causes periodic attacks of wheezing and difficult breathing. An asthma attack occurs when the airways become inflamed in response to a trigger, such as dust, mold, pets, exercise, or cold weather.

However, some attacks start for no apparent reason. Triggers may inflame the airways to the lungs, allowing disease-fighting cells to accumulate and causing swelling in the lungs.

In addition, the airways may become blocked or obstructed when the muscles surrounding the lungs tighten or go into spasm. This keeps air from circulating freely in the lungs. Or, mucus may clog and narrow the airways in the lungs, making breathing even more difficult.

Symptoms of Asthma

The symptoms of asthma can vary among people. Usually there is scratchy throat, or tightness in the chest, followed by a cough, wheezing, or shortness of breath.

It's time to get help if....

• Your symptoms do not get better with medicine
• Your breathing continues to get worse after treatment
• Your fingernails or lips turn grayish or blue
• It is difficult to walk or talk, or you have extreme difficulty breathing
• It feels like your neck, chest, or ribs are pulled in with each breath you take
• Your nostrils flare when you breathe

(Source: American Academy of Family Physicians)

Triggers of Asthma

Although the specific things that trigger an asthma attack can vary from person to person, some common triggers are well known.

These include the following:

Allergens (substances that people are allergic to)

Common allergens include pollen, mold, animal hair or fur, household dust/dust mites, cockroaches, and certain foods.

Infections

Both bacterial and viral infections can irritate the airways, triggering asthma attacks.

Sinusitis (inflammation of the nose and nasal airways)

During a sinus infection, mucus draining into the nose, throat, and lungs can cause asthma symptoms.

Irritants

Examples of irritants to the airways include strong odors and sprays (perfumes, household cleaners, paints, and varnishes); certain chemicals like coal, chalk dust, and talcum powder; air pollutants; tobacco smoke; changing weather conditions (for example, cold weather).

Smoke

Inhaling smoke from cigarettes or fires harms the airways and is especially hard on the airways of people with asthma. In fact, cigarette smoking is responsible for more than half of the cases of asthma in people over 40 years of age.

Exercise

Although exercise is good for people with asthma, it can trigger an asthma attack. People with asthma need to work with their doctors to prevent asthma attacks due to exercise (certain drugs can help prevent asthma symptoms from occurring after exercise). Click here for a guide to exercising for asthma patients.

Exposure to irritants on the job

Many cases of asthma are worsened or even caused by exposure to vapors, dust, gases, or fumes in the workplace. This type of asthma usually improves when the person takes a few days off from work, such as on weekends and vacations.

Sensitivity to medications and sulfites

About 5% to 20% of adults with asthma have attacks triggered by sensitivities or allergies to sulfites and to medications such as aspirin, ibuprofen, indomethacin, and naproxen. People with asthma should consult their physicians before taking any new medication, including those available without a prescription.

Sulfites are often used to preserve foods and beverages, including tuna, foods available at salad bars, dried apples and raisins, lemon juice, grape juice, and wine.

IMPORTANT NOTICE: In March, 1997, the United States Food and Drug Administration issued a warning that people with asthma or allergies as to sulfites should not eat canned white (albacore) tuna or light tuna because most canned tuna contains sulfites, even though they are not listed on the label. If you want more information about the sulfite content of specific tuna products, please call 800-283-1112, a special number set up by the tuna industry.

Emotional anxiety

Strong emotions and nervous stress can trigger asthma in some people. This may be due, in part, to the ability of emotions and stress to weaken the body's defenses.

Allergies and Asthma

Allergy is the leading cause of asthma, and about 90% of children under the age of 10 with asthma have allergies. About 70% of people under 30 with asthma and 50% of those over 30 with asthma also have allergies.

Allergy is likely to be a contributing factor to asthma if:

• You have close relatives with allergy (that is, a mother, father, sister, brother, aunt, uncle, or child)
• Asthma begins at a young age
• Symptoms occur or worsen with different seasons (usually fall or spring)
• You have allergic symptoms like runny nose, hay fever, or a skin condition called eczema
• Tests show that your blood or saliva contains a higher than normal level of eosinophils, special cells that fight infection.

Fast Facts about Asthma

If you have asthma, you're not alone.

• Asthma affects nearly 12 million people in America
• Although many people think asthma is "no big deal," about 5,000 Americans die of asthma each year.
• African-Americans are nearly three times as likely as whites to die of asthma
• Each year, asthma costs more than $4.6 billion in medical care and time lost from school or work
• Asthma is the number one reason why children miss school and the leading reason why children are admitted to the hospital
• More children than adults have asthma. This is because some children "outgrow" their asthma attacks when they grow up.

Percentage of people with asthma by age:
(Source: National Health Interview Survey, National Center for Health Statistics, 1989.)

Asthma FAQ

Will I have to limit my activities because of asthma?

Most people with asthma can live a full and active life when they are treated and are careful to avoid things they know can trigger their asthma. Your doctor can help you decide whether there are times when taking medicine may help prevent an asthma attack - for example, before exercising, on cold days, or on days when the pollution is bad or the pollen count is high.

How can I tell if my asthma is getting worse?

There are several signs that may mean that asthma is worsening. These include:

• Symptoms at night
• A drop in the readings on a peak flow meter of 20% or more
• The need to use a bronchodilator more often

If you feel that your asthma is getting worse, it is important to talk to your doctor right away. Your therapy may need to be changed (that is, you may need to change the amount of medicine, the type of medicine, or the way you take your medicine).

How can I tell if my treatment is working well?

The goals of treatment for asthma include:

• No symptoms or minor symptoms
• Sleeping through the night without waking because of symptoms
• No lost time from school or work because of asthma
• Full participation in physical activities
• No emergency room visits or stays in the hospital
• Few or no side effects from asthma medication

For more information, check out the following websites:

Allergy, Asthma and Immunology Online (American College of Allergy, Asthma & Immunology)

American Academy of Allergy, Asthma & Immunology

American Academy of Pediatrics

American College of Chest Physicians

American Lung Association

National Heart, Lung, and Blood Institute

National Institute of Allergy and Infectious Diseases

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