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Asthma Asthma One study
concluded that the majority of the 400,000 annual emergencies related to
severe asthma attacks are brought on by poor indoor air quality. Doctors know
that irritation of the lungs by chemicals can trigger asthma attacks.
Long-term exposure to chemicals can contribute to the development of asthma.
This is especially true with children. A child’s immune system is not fully
developed until he or she is twelve years old. A one-year-old has practically
no detox system at all. Out of
well-intentioned germ-phobia, some parents constantly spray disinfectant into
the air and on all surfaces in their baby’s nursery. What they may not
realise is they are exposing their children to formaldehyde, cresol, phenol,
ammonia, ethanol, and chlorine. It takes much less of these chemicals to harm
a baby than an adult. Babies’ bodies are much smaller and they breathe at ten
times the rate of adults. The average child visits the doctor twenty-three
times in the first four years of life, with the most common complaint being
respiratory ailment. When babies get sick, the last thing they need is to
have irritating chemicals filling their lungs. What is Asthma? Asthma is
a term used to describe a specific type of breathing problem that arises due
to narrowing of the airways (breathing tubes) within the lungs. How do I recognise Asthma? If the
breathing tubes are narrow it is more difficult to get air in and out of the
lungs. This causes the sensation of breathlessness and tightness in the chest
i.e. uncomfortable, difficult breathing. With the narrowed airways there may
be a wheeze that can be heard and there may be a cough. The cough is usually
a dry irritating cough that is triggered for example when you breathe in,
laugh or do exercise. It can sometimes be associated with some phlegm and
sometimes just occur at night, disturbing sleep. When do these symptoms arise? One of
the characteristics of asthma is that the symptoms can be variable i.e. some
days are good and others are not. This will relate both to the treatment that
is being given (to increase number of good days) and environmental exposure
to triggers such as exposure to allergens and other chemicals that may worsen
asthma (increase number of bad days). In addition to this, symptoms may vary
spontaneously throughout the day. For
everyone, in general the airways are narrowest in the small hours of the
morning so this will be worse in asthma. If the asthma is not well controlled
with treatment and the avoidance of allergens which trigger attacks, waking
at night due to breathlessness, wheeze, chest tightness or cough often
occurs. What triggers make asthma worse? Specific
things can induce or worsen asthma and when the asthma is inadequately
controlled the airways are irritable and respond to a range of environmental
stimuli. Specific factors include allergens, such as house dust mite
droppings in dust, pets, (such as cats and dogs), pollens, (such as tree and
grass). In some
individuals exposure to chemicals in their home or work environment can also
lead to the development of asthma (see “Who Gets Asthma’). Triggers are
numerous and these include exposure to cigarette smoke, car exhaust fumes,
perfumes, aerosol sprays, such as hair lacquer or furniture polish, change in
temperature, especially going from a warm to a cold environment, paint or
cooking odours and exercise. This list is not exclusive and there may be
other factors relevant to different individuals with asthma. Some of
these may often be referred to colloquially as an allergy e.g. "I am
allergic to cigarette smoke”, although technically this is wrong because this
acts as an irritant rather than causing allergic reaction, although the
consequence, more difficult breathing, is the same. Who gets Asthma? Asthma
can arise at any age, so it can affect anyone. Asthma tends to run in
families so if there is a family history of asthma or of allergy, such as hay
fever or eczema, an individual may be more likely to develop asthma. Asthma
is commonly induced by allergies, particularly by indoor allergens such as
those related to house dust mites, pets, artificial musk-based scents or
aerosol sprays, so sensitisation to these allergens increases the likelihood
of developing asthma. Why Does Asthma Arise? Asthma
arises because of inflammation of the lining of the airways. This can be
induced by allergies and worsened by infection. In general infection worsens,
but doesn’t initiate, the type of inflammation associated with allergy. This
allergic inflammation makes the lining of the airways “raw” and accounts for
the irritability of the airways so that they react to non-specific triggers
such as chemical aerosols and cigarette smoke. The chemicals released into
the airways, as part of the inflammation, stimulate nerves and the muscle
such that cough and constriction (narrowing) of the airways arises. How is Asthma diagnosed? The
diagnosis of asthma is based on two main features. Firstly on the presence of
symptoms compatible with asthma (see “How do I recognise asthma”) and secondly
on the variability in the airway narrowing and symptoms. The variability in
the airway narrowing is usually measured by home monitoring of lung function
with a peak flow meter. A peak flow meter is a simple device to measure the
flow of air out of the lungs. The measure is made by blowing into the hand
held device. If over a period of time the morning and evening values vary by
more than 15% or treatment for asthma improves the readings by more than this
value this is indicative of asthma. How should asthma be treated? The
treatment of asthma, once the correct diagnosis has been made, is based on
(a) allergen avoidance where relevant and possible and (b) drug treatment. The
drug treatment is directed towards the two main components of asthma, the airway
inflammation and the muscle narrowing around the airways. For very
mild asthma in which symptoms arise only occasionally, a reliever inhaler to
relax the airway smooth muscle to be used when needed is all that is
required. If this is needed once a day then a regular prophylactic inhaler to
suppress the airway inflammation should be used to control the asthma. If it
is not possible to use inhalers then a tablet may be available but inhalers
are the preferred way to deliver drug to the airways and are a more effective
form of treatment. However,
avoiding the allergens (triggers) which bring on asthma symptoms in the first
place is also highly desirable, since removing the root cause of the problem
is a better way of dealing with asthma rather than simply relying on
alleviating drugs. Removing the source of irritants contained in many
household products is an excellent place to start. How do I know my asthma is well controlled? The aim
of treatment is to prevent symptoms, improve lung function and to enable a
person with asthma to lead a normal life style without limitations. So if
symptoms persist, especially night time symptoms, or day time symptoms
requiring additional reliever medication then extra regular preventer treatment is required to control the asthma. However,
asthma preventer treatment does not cure asthma, it only suppresses the asthma tendency, so needs
to be taken on a daily basis. If such preventer
treatment is stopped, unless the asthma is only evident for short periods
after infection, then the asthma will return. It is therefore important to
try to remove as many of the asthma triggers as possible from the home
environment. Is there a cure for asthma? At
present none of the treatments for asthma will cure the condition. Studies
which are on-going to assess the impact of allergen avoidance in prospective
mothers after their infants are born suggest that this may decrease the
allergic tendency. These studies have, however, not yet been followed for
long enough to make recommendations. Studies with immune stimulators and pro-biotics are also ongoing to see if they can deviate the immune system away from allergy, but again
these studies are still in the early stages. Immunotherapy
is another way of deviating the immune system and
whilst it is effective for hay fever, it does not appear as effective for
asthma and so is not recommended within the Once
again, avoiding the irritating chemicals contained in many household cleaners
is one of the best ways of ensuring that the risks of triggering asthma
symptoms are reduced to a minimum. Here is
what the ‘Information involving 7,019 families from the “Children
of the 90s Project” at the And here is
a quote from Medical News Today: ‘There is a connection between exposure of domestic
cleaning products and wheezing in toddlers, which is an early sign of asthma,
according to new research. The study of 14,000 children up to the age of
three and a half, published in the journal Thorax found that exposure to
household products such as bleach, aerosols, carpet and window cleaners
increased the risk of wheezing.’ |