Asthma

An Unexplained Epidemic

For information about Hartford's asthma problem, click here.

What are asthma triggers?

Asthma triggers are things that can cause or worsen asthma attacks. Every person with asthma has different asthma triggers. What triggers an attack in one person may not trigger it in someone else. However, everyone, especially people with asthma, should avoid irritants (like tobacco smoke), but only those who are sensitive to specific allergens need to avoid those allergens.

Asthma triggers include:

Allergens, which set off allergic reactions in individuals who are sensitive to those substances.

Allergens include indoor substances (such as dust mites, molds, and pet dander) and outdoor ones (pollens and mold spores)

Irritants, which provoke or worsen asthma attacks in all people with asthma.

Irritants include indoor substances (tobacco smoke, aerosol sprays, and perfunes) and outdoor ones (automobile exhaust and gasoline).

In children under 5 years old, viral respiratory infections are the number one asthma trigger.

Adults may be exposed to industrial fumes, chemicals, dust, and gases that can lead to occupational asthma.

What substances in indoor air can trigger asthma?

Many substances in the indoor environment can cause or worsen asthma attacks:

Triggers	Ways to Avoid in Your Home
Drugs Aspirin Heart medicines	Talk to your doctor about alternative medications
Dust and particles in the air	Clean as frequently as possible, to keep down the amount of dust and other asthma triggers If one person in the family has asthma, dust and clean when that person is not at home If possible, don't vacuum; instead, damp mop If you have to vacuum (for carpet and fabric-covered furniture), use a high efficiency filter to trap dust and allergens in the exhaust Dust with a damp cloth to avoid putting dust into the air Use washable curtains and window shades that won't collect dust or can be wiped down
Dust mites (very tiny creatures that live in pillows, mattresses, bedding, clothes, stuffed toys, carpets, and fabric-covered furniture)	If possible, remove carpeting, which can shelter more dust mites than a bare wooden or linoleum floor Put dust-proof covers (allergen-impermeable) on mattresses and pillows Wash sheets and blankets once a week in hot water Wash stuffed toys often in hot water, and keep them off beds
Household products Cleaners and sprays (furniture polish, starch) Liquid chlorine bleach Paint Perfumes Talcum powder	Avoid as much as possible Use alternative products when necessary
Molds and fungi	Fix sources of water problems, such as leaky plumbing Clean surfaces often: wash off mold and dry surfaces Try to keep down moisture, especially in kitchens and bathrooms, by opening windows or turning on exhaust fans Replace moldy shower curtains, or remove them, scrub well with household cleaner, and rinse thoroughly before rehanging them If possible, use a dehumidifier. Empty it daily and clean often
Pests Cockroaches Rats and mice	Don't leave food or garbage out, where it may attract pests Store food in airtight containers Clean up spilled food and crumbs immediately Use poison bait or traps. Always follow label instructions carefully.
Pets with fur or feathers: dander (tiny flakes of skin, hair, or feathers), urine, and saliva Dogs Cats Birds Rodents (such as mice, gerbils, and rabbits)	If possible, wash pets frequently to reduce dander and pollen in their coats Keep pets out of the bedrooms, and keep bedroom doors closed Keep pets away from upholstered furniture, carpets, and stuffed toys Consider keeping pets outside, away from the person with asthma If a pet still causes severe asthma attacks, you may need to find a new home for it
Some foods Nuts and peanut butter Chocolate Eggs Shellfish Sulfites (a preservative in some foods)	Avoid foods that trigger asthma attacks Read ingredients list of packaged foods carefully
Tobacco smoke Cigarettes Cigars Pipes	Do not smoke or allow smoking in the house If someone in the house continues to smoke, open windows and use fans to blow smoke outside. Do not allow smoking in child's bedroom.

Outside your home, how can you try to prevent asthma attacks?

In your workplace:

Talk to your employers about getting rid of any triggers (for example, dust or chemicals).

In school:

Talk to your children's teachers about getting rid of any triggers in the classroom, such as
- Pets
- Chalk dust
See whether your school has implemented the Tools for Schools Program, a national program to improve indoor air quality in schools.

How does smoking affect asthma?

Both smoking itself and breathing secondhand smoke (sometimes called environmental tobacco smoke, or ETS) are especially dangerous. Tobacco smoke contains particles and gases that can cause many respiratory problems-including asthma. More than 4,000 substances, many of which are strongly irritating to the lungs, have been identified in tobacco smoke.

Children are more susceptible than adults to the harmful effects of tobacco smoke.

Children of smokers are twice as likely to develop asthma as are children of nonsmokers.
Children whose mothers smoke heavily have more severe asthma symptoms.
When pregnant women smoke, the cigarette chemicals block the unborn baby's airways and may result in premature birth.
After the baby is born, breathing smoke can make their small airways become even smaller. These babies may be more susceptible to respiratory problems later in life.

How can you prevent exposure to smoke in public places?

Avoid smoke-filled rooms.
Ask to be seated in the nonsmoking section in restaurants.

What substances in outdoor air can trigger asthma?

Many substances in the outdoor environment can cause or worsen asthma attacks:

Triggers	Ways to Avoid in Your Home
Allergens Molds Pollens	If possible, stay indoors when pollen counts are especially high (usually 6 AM to 10 AM and 5 PM to 7 PM) Keep windows closed and use air conditioning, if it is available If you are driving when there is a lot of mold or pollen outside, keep the car windows shut and use air conditioning, if it is available If you do go outside, take a shower and change your clothes when you come inside again
Gases or particles in the air Auto or bus exhaust Ozone Sulfur dioxide	If possible, stay indoors when there is a lot of air pollution outside.
Changes in weather Cold air	Try to avoid outdoor exercise, especially if it involves a sudden drop in temperature Talk to your doctor about alternative forms of exercise

Are there other asthma triggers?

For some people, asthma triggers can also include illnesses and factors that are not environmental.

Triggers	Ways to Avoid
Respiratory illnesses Common cold Flu Influenza	Wash hands often Talk with your doctor about getting flu shots
Hard exercise	Avoid outdoor exercise in cold weather Talk to your doctor about alternative forms of exercise, such as yoga
Emotional stress or excitement	Learn stress management techniques, such as deep breathing, meditation, and other relaxation techniques Pay attention to your feelings

How do changes in time and season affect asthma?

Asthma symptoms are often worse at night, and they can also become worse in particular seasons throughout the year. In Connecticut, the number of patients who go to the hospital for asthma increases during the fall and decreases during the summer. This pattern may have to do with an increase in allergens such as molds and spores in the fall, as well as with an increase in indoor pollution from wood-burning stoves, fireplaces, and gas and oil furnaces.