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May 1 is World Asthma Day – the perfect time to review allergens that may trigger your asthma symptoms and to discuss steps you can take to breathe easier. Here Dr. Peter B. Terry, professor of medicine in the division of Pulmonary Medicine at Johns Hopkins, offers advice that can help – even if you suffer from chronic, long-term asthma.
Even people whose asthma is well controlled with medication can experience symptoms if they are exposed to allergens—substances that can cause airway inflammation in susceptible people. Pollen, dust mites, animal dander, and mold are examples of allergens; they may trigger asthma in people allergic to these substances. Irritants, however, can worsen symptoms in all asthma sufferers. They include smoke, air pollution, strong odors, and cold air. It's not possible to completely eliminate allergens and irritants, but you can take the following steps to minimize your exposure to them.
Allergies, allergens, and asthma. If you have asthma and are allergic to pollen, dust mites, animal dander, or mold, exposure to these substances can cause asthma symptoms.
- Pollen and asthma. Pollen, the microscopic male cells of flowering plants, travels through the air to fertilize other plants. People with pollen allergy—often referred to as hay fever—can experience sneezing, congestion, runny nose, and itchy nose, mouth, throat, eyes, and ears. The pollen season generally lasts from February or March through October. To reduce your exposure to pollen, keep your house and car windows closed and use air conditioning as needed. Don't hang sheets or clothing outside to dry, as pollen may collect on them and be brought inside the house. Avoid mowing lawns and being around freshly cut grass. In addition, limit your outside activities during the early morning (5 a.m. to 10 a.m.), when pollen levels are highest.
- Dust mites and asthma. These microscopic creatures that live in house dust can cause a stuffy or runny nose, sneezing, itchy or watery eyes, coughing, or wheezing in people allergic to them. Dust mites thrive on warm, moist air, so keep the humidity in your home below 50%, using a dehumidifier or air conditioner if necessary. (You can use an instrument called a hygrometer, available at hardware stores, to measure the humidity level.)
Also, dust often with a damp cloth, have carpets and upholstered furniture vacuumed weekly (if you have asthma and need to vacuum, wear a mask that can filter out small particles—most drugstore masks do not help), and wash sheets and blankets once a week in hot water.
Allergists have long recommended encasing mattresses and pillows in plastic or allergen-impermeable covers. Although this practice has recently been called into question, people with asthma should continue to use such covers unless further studies confirm that they are not helpful.
- Animal dander and asthma. Many people are allergic to a protein in the saliva, dander, or urine of animals with fur or feathers. Animal allergies can cause sneezing, wheezing, itchy or runny nose, or itchy or swollen eyes and throat.
The most effective way to reduce pet allergies is not to have a pet with fur or feathers. If you have a pet that you cannot keep outside or give away, minimize your contact with the animal. Do not allow the pet into your bedroom or other areas where you spend a lot of time. Keep all mattresses and cushions in plastic covers, and use hardwood, tile, or linoleum floors whenever possible (vacuuming doesn't remove pet dander from the lower levels of carpeting).
Ask your veterinarian if it is safe for your pet to be bathed weekly; this practice will reduce the amount of allergens released into the air by your pet but may also dry the animal's skin.
- Mold and asthma. Mold spores can grow on wet surfaces in your home, and they thrive in moisture-rich environments. Symptoms of mold allergies are similar to those of hay fever and include sneezing, runny nose, red eyes, and skin rash. Mold also can cause wheezing in people with asthma. (Mold also can irritate the eyes, skin, nose, throat, and lungs of people without mold allergies.)
To lessen the chance that mold spores will grow, reduce the amount of moisture in your home. Use bathroom and kitchen fans when showering and cooking, respectively, fix any leaking pipes or faucets, keep humidity between 30% and 50%, and make sure the drainage system outside the house is working properly. Also, frequently clean areas where mold is likely to grow, such as bathrooms, kitchens, basements, shower curtains, and pans under refrigerators.
Irritants Can Cause Asthma Symptoms
Some substances in the air have the potential to cause breathing difficulties in everyone, but especially in people with asthma.
- Smoke and asthma. Any form of tobacco smoke can exacerbate asthma. Ask others not to smoke around you, and don't allow anyone to smoke in your home, even with the windows open. If you are a smoker, talk to your doctor about ways to quit. In addition, avoid using wood-burning stoves, kerosene heaters, and fireplaces.
- Air pollution and asthma. In the upper atmosphere, ozone (a type of oxygen) filters out some of the sun's ultraviolet rays. However, ozone can harm the lungs when it is in the air we breathe. Ground-level ozone is mostly a problem in large urban and suburban centers, where pollution levels from cars and industrial plants are high. Sunlight and heat play a role in ozone formation, so levels tend to be highest in the hotter months.
People with asthma or other chronic lung diseases may find that their symptoms worsen on days when ozone levels are high. If you have a lung disease and ozone levels are predicted to exceed 100 for the day, or an ozone alert is declared, you should avoid spending long periods of time outdoors and severely limit any outdoor physical exertion. If your local news does not provide ozone information, go to www.epa.gov/airnow for detailed information on ozone and other pollutants in your area. You can also visit www.weather.com and, under "Health," click on "Air Quality." Select your state to find the ozone levels for cities in your area.
- Strong odors and asthma. Anything with a powerful scent can exacerbate your asthma. Limit your exposure to perfume, talcum powder, hair spray, and oil-based paints.
- Cold air and asthma. Exposure of the lungs to very cold air can trigger the release of histamine, which can cause wheezing in people with asthma. Always inhale through your nose and cover your nose and mouth with a scarf on cold or windy days to warm the air before it enters your lungs.
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