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Health & Nutrition
Asthma
Tobacco Smoke
• Dust Mites
• Things That Will Help
• Animal Dander
• Cockroach
• Vacuum Cleaning
• Indoor Mold
• Pollen and Outdoor Mold
• Smoke, Strong Odors, and Sprays
• Exercise, Sports, Work, or Play
• Other Things That Can Make Asthma Worse
• References
May 3, 2000, Donna Shalala, Secretary of Health and Human Services declared
that "we are confronting an epidemic of asthma". According to the
Centers for Disease Control (C-D-C), asthma affects almost 15 million people in
America of which almost 5 million are children. Between 1980 and 1993, the death
rate for children 19 years and younger increased by 78 percent. The number of Americans
afflicted with asthma almost doubled from 1980 to 1996 with children under the
age of 5 five years old experiencing the highest rate of increase. The disease
results in over 5,000 deaths per year. Other consequences of asthma are nearly
500,000 hospitalizations, 9 million visits to health care providers and over 1.8
million emergency room visits each year. Asthma is also the leading work-related
lung disease. In 1998, the National Heart, Lung and Blood Institute (N-H-L-B-I)
estimated that the annual costs of asthma were $11.3 billion per year.
Asthma affects all ages, races, ethnic and socioeconomic populations, but
low-income and minority groups experience substantially higher rates of
fatalities, hospital admissions, and emergency room visits due to asthma.
Although African Americans were only slightly more likely to have asthma than
whites, the death rate among African Americans was over twice the rate of white
Americans from 1993 through 1995. The disparity among children was even greater
with African American children being four times as likely to die from asthma as
were white American children. The disparity is similar when comparing
hospitalizations and emergency room visits among different racial and ethnic
groups. African Americans are hospitalized nearly four times more than whites
and are five times more likely than whites to seek medical care at a emergency
room for asthma. Studies also have shown the greatest incidence of the disease
among low income populations.
Asthma is defined as a chronic inflammatory disorder of the airways in which
many cells and cellular elements play a role, in particular, mast cells,
eosinophils, T- lymphocytes, neutrophils and epithelial cells. In susceptible
individuals, this inflammation can cause recurrent episodes of wheezing,
breathlessness, chest tightness, and cough particularly at night and in the
early morning. These episodes are usually associated with widespread but
variable airflow obstruction that is often reversible spontaneously or with
treatment. The inflammation also causes an associated increase in the existing
bronchial hyperresponsiveness to a variety of stimuli.
This chronic disease of the lungs is characterized by episodes, or attacks,
in which the airways overreact to certain factors, called triggers. During an
asthma attack, the branches of the windpipe, called bronchi, react in three
ways: Their linings swell; their surrounding muscles tighten; and mucus glands
in the walls produce excess mucus. All of which blocks the flow of air.
Symptoms can be mild or severe and can include one or more of the following:
- Coughing - the
lung's attempt to dislodge mucus. People with asthma feel that their symptoms
would subside if they could cough up enough mucus, but this is rarely
possible.
- Wheezing - a
whistling noise when breathing caused by air moving through the narrowed
airway.
- Chest tightness -
the feeling that the chest is being squeezed or that a weight is sitting on
it.
- Shortness of
breath - the result of too many swollen, plugged airways.
- Other symptoms can include:
- Excess mucus - restricted breathing caused by thick mucus clogging airways
- Fatigue - easily tired, which can be caused directly by symptoms, or indirectly because other symptoms are interfering with sleep
- Inability to speak loudly or in full sentences
- Signs of asthma in infants and small children can include:
- Rapid, noisy breathing
- Chest congestion, tightness
- Wheezing during a respiratory illness
- Coughing after running or crying, and especially at night
- Sucked-in looking chest (between ribs, and at front of neck)
- Frequent respiratory infections such as pneumonia and bronchitis
- Shortness of breath
See your doctor if you or your child has any of these symptoms. Most primary
care physicians have experience diagnosing and treating asthma, but in some
cases a referral may be made to a specialist-either an allergist or a
pulmonologist, depending on the nature of the problem
During the normal breathing process, the body takes in air through the mouth
and nose. The fresh air, which is rich in oxygen, flows through the windpipe
into all of the airways until it reaches the tiny air sacs in the lungs, where
the oxygen is exchanged for carbon dioxide. The air that's breathed out is
stale, meaning it's high in carbon dioxide, the waste gas of the body.
During an asthma attack, the individual feels as though they can't get enough
air into their lungs. But contrary to this feeling, is that the airways are too
constricted to let stale air out of their lungs. This fresh air blocks fresh air
from entering the lungs. Blood tests are used during a severe asthma attack to
monitor blood oxygen and carbon dioxide levels.
Asthma attacks can strike without warning and last from minutes to days.
Approximately 50 percent of adults with asthma exhibit allergic responses. Avoidance or
control of triggers that lead to asthma attacks is as much of a priority as
treatment of the disease. Because there are so many substances that can trigger
allergic responses, identifying and avoiding the allergens can be very
difficult. Some simple actions can be taken to avoid the most obvious and common
problems. The N-H-L-B-I suggests the following:
Tobacco Smoke
- If you smoke, ask your doctor for ways to help you quit. Ask family members to quit smoking, too.
- Do not allow smoking in your home or around you
- Be sure no one smokes at a child's day care center
Dust Mites
Many people with asthma are allergic to dust mites. Dust mites are tiny
"bugs" you cannot see that live in cloth or carpet.
Things that will help the most:
- Encase your
mattress in a special dust-proof cover
- Encase your pillow
in a special dust-proof cover or wash the pillow each week in hot water. Water
must be hotter than 130 degrees F to kill the mites.
- Wash the sheets
and blankets on your bed each week in hot water.
Other things that can help:
- Reduce indoor
humidity to less than 50 percent. Dehumidifiers or central air conditioners
can do this.
- Try not to sleep
or lie on cloth-covered cushions or furniture.
- Remove carpets
from your bedroom and those laid on concrete, if you can.
- Keep stuffed toys
out of the bed or wash the toys weekly in hot water.
Animal Dander
Some people are allergic to the flakes of skin or dried saliva from animals
with fur or feathers.
The best thing to do:
- Keep furred or
feathered pets out of your home.
If you can't keep the pet outdoors, then:
- Keep the pet
out of the bedroom and keep the bedroom door closed.
- Cover the air
vents in your bedroom with heavy material to filter the air
- Remove carpets and
furniture covered with cloth from your home. If that is not possible, keep the
pet out of the rooms where these are.
Cockroach
Many people with asthma are allergic to the dried droppings and remains of
cockroaches.
- Keep all food
out of your bedroom.
- Keep food and
garbage in closed containers (never leave food out).
- Use poison baits,
powders, gels, or paste (boric acid, for example). You can also use
traps. If a spray is used to kill roaches, stay out of the room until
the odor goes away.
Vacuum Cleaning
- Try to get
someone else to vacuum for you once or twice a week. Stay out of the rooms
while they are being vacuumed and for a short while afterward.
- If you vacuum, use
a dust mask, a double layered or microfilter vacuum cleaner bag or a vacuum
cleaner with a HEPA filter.
Indoor Mold
- Fix leaky
faucets, pipes, or other sources of water.
- Clean moldy
surfaces with a cleaner that has bleach in it.
Pollen and Outdoor Mold
What to do during your allergy season (when pollen or mold spore counts are
high):
- Try to keep
windows closed.
- Stay indoors with
windows closed during the midday and afternoon, if you can. Pollen and some
mold spore counts are highest at that time.
- Ask your doctor
whether you need to take or increase anti-inflammatory medicine before your
allergy season starts.
Smoke, Strong Odors, and Sprays
- If possible, do
not use a wood-burning stove, kerosene heater, or fireplace.
- Try to stay away
from strong odors and sprays such as perfume, talcum powder, hair spray, and
paints.
Exercise, Sports, Work, or Play
- You should be
able to be active without symptoms. See your doctor if you have asthma
symptoms when you are active - like when you exercise, do sports, play, or
work hard.
- Ask your doctor
about taking medicine before you exercise to prevent to prevent symptoms.
- Warm up for about
6 to 10 minutes before you exercise.
- Try not to work or
play outside when the air pollution levels are high.
Other Things That Can
Make Asthma Worse
- Flu: Get a flu
shot.
- Sulfites in foods:
Do not drink beer or wine or eat shrimp, dried fruit, or processed potatoes if
they cause asthma symptoms.
- Cold air: Cover
your nose and mouth with a scarf on cold or windy days.
- Other medicines:
Tell your doctor about all the medicines you make take. Include cold
medicines, aspirin, and even eye drops.
References
Clark, N.M.; et al. Childhood Asthma. Environmental Health Perspectives. Vol. 107 (suppl 3): 421-429; 1999.
Guidelines for the Diagnosis and Management of Asthma. National Asthma Education Program Expert Panel Report 2 (Final Version). NIH Publ 97-4051. Bethesda, MD:National Heart, Lung and Blood Institute, 1997.
Morbidity and Mortality Weekly Report, Vol. 47/No. SS-1, April 24, 1998, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA 30333
U.S. Department of Health and Human Services, National Institutes of Health,
National Heart, Lung, and Blood Institute, Bethesda, MD 2082
Also see our fact sheet on Asthma
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