Asthma Cases Among Adults: Asthma Cases Among Adults

An in-depth report on how asthma is diagnosed, treated, and managed in adults.

Managing Asthma

Avoidance or control of the triggers that lead to asthma attacks is as much a priority as treatment of the disease. Of some concern are studies reporting no change in asthmatic symptoms after controlling cat or dust mite allergens. More research is needed to identify the reasons for this.

Indoor Protection

The following are some recommendations for avoiding allergens inside:

Controlling Pets. Patients who already have pets and are not allergic to them probably have a low risk for developing allergies. If pets trigger asthma, however, they should be kept outside. If this isn't possible, they should at least be confined to carpet-free areas outside the bedroom. Cats harbor significant allergens, which can even be carried on clothing; dogs usually present fewer problems. Washing animals once a week can reduce allergens. Dry shampoos, such as Allerpet, are now available for both cats and dogs that remove allergens from skin and fur and are easier to administer than wet shampoos.
Controlling for Dust. A 2002 study reported that simply using a spray furniture polish is very effective for reducing both dust and allergens. Air cleaners, filters for air conditioners, and vacuum cleaners with HEPA filters can help remove particles and small allergens found indoors. Neither vacuuming nor the use of anti-mite carpet shampoo, however, is effective in removing mites in house dust. In fact, vacuuming stirs up both mites and cat allergens. Carpets and rugs should be avoided, if possible.

A HEPA (High Efficiency Particle Arresting) filter can remove the majority of harmful particles, including mold spores, dust, dust mites, pet dander and other irritating allergens from the air. Along with other methods to reduce allergens, such as frequent dusting, the use of a HEPA filtration system can be a helpful aid in controlling the amount of allergens circulating in the air. HEPA filters can be found in most air purifiers, which are usually small and portable.

Bedding and Curtains. Using semipermeable coverings to fully encase mattresses and pillows is the most proven effective step in reducing dust mite levels. (Vinyl mattress covers limit airflow and may also exacerbate, or even cause, asthma in children. Synthetic pillows may pose a significantly higher risk for severe asthma attacks in children than feather or no pillows.) Curtains should be replaced with shades or blinds and bedding washed using the highest temperature setting.
Reducing Humidity in the House. Although warm, moist air from vaporizers can greatly ease and moderate asthma attacks, living in a damp house is counter productive. Dust mites thrive in humidity and damp houses increase the risk for mold. On-going humidifiers, then, can be counterproductive. If they are used, humidity levels should not exceed 40% and they should be cleaned daily with a vinegar solution.
Gas Stoves, Kerosene, and Cooking. People with asthma who cook should choose electric ovens rather than gas, which release nitrogen dioxide, a substance that can aggravate asthma symptoms. (Children do not appear to be affected by gas cooking.)Kerosene (used in space heaters and lamps) may also produce allergic reactions. And, just smoky cooking can worsen asthma.

Exterminating Pests (Cockroaches and Mice). Cockroaches should be eliminated by professional exterminators. (One study reported that ridding a home of cockroaches and cleaning the house using standard housecleaning techniques failed to eliminate the cockroach allergens themselves.) Mice should be eliminated, and attempts should be made to remove all dust, which might contain mouse urine and dander.
Avoiding Smoking and Cigarette Smoke. Cigarette smoke can accelerate the decline in lung function related to asthma. Even exposure to secondhand smoke can double the risk of asthma-related emergency room visits. In one study, it was the most frequently cited trigger of asthma symptoms.

Outdoor Protection

The following are some recommendations for avoiding allergens outside:

Camping and hiking trips should not be scheduled during times of high pollen count (in the Northern states, May and June for grass pollen and mid-August to October for ragweed).
Patients should avoid strenuous activity when ozone levels are highest, which usually occur in early afternoon, particularly on hot hazy summer days. Levels are lowest in early morning and at dusk.
Asthma attacks are often higher during thunderstorms. It is not clear why. Some evidence points to a build-up of ozone that accompanies such storms. One study suggested that changing airflow patterns bring a sudden downdraft of air containing concentrations of pollens, small particles and allergens.
Patients who are allergic to mold should avoid barns, hay, raking leaves, and mowing grass. Exposure to automobile fumes may worsen asthma. Fungi in car air conditioners can also be a problem.

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Thursday, July 7, 2011