By learning what sets off your allergic asthma symptoms, you can reduce exposure to those triggers and reduce your risk for an attack.
By Beth W. Orenstein
Every day, some 44,000 Americans have an asthma attack. More than half of the nation’s 25 million asthma suffers — approximately 60 percent — have allergic asthma, which is triggered by inhaled allergens. Not everyone has the same allergic asthma triggers, but for many they include dust mites, pet dander, pollen, mold, and cigarette smoke. Exposure to your triggers can set off a cascade of allergic asthma symptoms such as coughing, wheezing, and difficulty catching your breath. You can’t always prevent an allergic asthma attack, but you can take steps to reduce your risk. Here’s how.
Know Your Triggers
To avoid your allergic asthma triggers, you first have to know what they are. “Allergy testing — blood and skin — can help identify your triggers,” says Albert Rizzo, MD, section chief of pulmonary/critical care medicine for the Christiana Care Health System in Newark, Del., and immediate past chairman of the National Board of Directors of the American Lung Association (ALA). Keeping a journal of where you were and what you were doing when your allergic asthma symptoms kicked in can also help you identify triggers. Once you know your triggers, you can take steps to avoid exposure. “Prevention is key,” Dr. Rizzo says.
Kick Out the Mites
Dust mites are a common allergic asthma trigger. To minimize dust mites in your bedroom, buy dust-proof, zippered covers for your mattress and pillows. Avoid down comforters or pillows. Wash all of your bedding, not just your sheets, at least once a week. Be sure to use hot water and set your dryer on high. Hardwood or tiled floors are better for people with allergic asthma than carpets, which can attract dust mites. And no matter how much your children adore them, don’t let them sleep with stuffed animals, which also invite dust mites.
The Truth About Cats and Dogs
Many people with allergic asthma are triggered by the dander from cats and dogs. All breeds — even those without fur or hair — can trigger an attack. Although not everyone who has allergies or asthma is affected by pets, you shouldn’t have one in your home if you are. Typically, locking pets out of your bedroom won’t be enough. The protein in the pet dander, saliva, or urine that triggers your allergic asthma can get on your clothes and go where you go. It also can spread through the air. If you can’t bear to part with your pet, at least reduce the number of places where your animal’s allergens can hide. Use blinds rather than drapes, and furnishings not covered in fabric for easier and more thorough cleaning. Also, vacuum regularly with a HEPA filter.
Use HEPA Filters
A 2010 report by the Indoor Allergen Committee of the American Academy of Allergy, Asthma & Immunology, published in the Journal of Allergy and Clinical Immunology concluded that many people with allergic asthma can benefit from using HEPA room air filters, especially if they’re in the room where you sleep. HEPA stands for “high-efficiency particulate air” filter. Another tip from the report: If people in your home have allergic asthma, make sure you do regular maintenance on your heating and cooling systems — and keep the filters clean so they can do their job.
Check Air Quality Reports
Make it a morning ritual to listen to your local air quality index report. The ALA has a “State of the Air” app you can download on your smartphone to do just that. Don’t have a smartphone? You can sign up for e-mail alerts, find air quality forecasts in newspapers, on morning news programs, and on the Web from sites such as AirNow.gov. When the air quality is poor, adjust your activities accordingly to better manage your allergic asthma. “If the air quality is going to be unhealthy, you should plan to go out early and get back indoors as soon as possible,” Rizzo says. “Don’t plan a lot of outdoor activities the rest of the day.” If you must go out, be sure to take your rescue inhaler with you and consider wearing a scarf or facemask.
Clear the Smoke
Even if you don’t smoke, friends and family members who do could pose a real problem for you. Secondhand smoke can be as harmful to people with allergic asthma as being the actual smoker. To better manage your allergic asthma, you can’t let anyone smoke near you. That may mean having to avoid bars and other places where smoking is still permitted. Similarly, perfumes and other odors can flare your allergic asthma symptoms. Stay out of candle shops and away from perfume counters at department stores. Be aware of all lung irritants and avoid them as much as possible.
Follow Doctor’s Orders
Your doctor may have given you two medications to manage allergic asthma: quick-relief and long-term drugs. If you feel allergic asthma symptoms coming on, that’s when you need to take your quick-relief medicine. “Keep your rescue inhaler with you in case you’re exposed to allergic asthma triggers,” Rizzo says. “Hopefully, you can prevent an attack.” You also need to take your long-term medicine according to your doctor’s directions, which could be every day, even if you’re feeling fine. By taking your long-term meds as prescribed, you’ll be less likely to need your inhaler.
Have an Allergic Asthma Action Plan
You and your doctor should outline how to manage your allergic asthma day to day and what to do if you have an attack. Write down your allergic asthma action plan so you’re sure to remember it. Review your plan each time you see your doctor. You may find that you’re feeling well and your allergic asthma symptoms are under control. However, if your allergic asthma is interfering with your daily activities, you’ll want to talk to your doctor about adjusting your action plan, Rizzo says. Knowing what to do every day and in emergencies will help you better manage your allergic asthma.
Exercise With Caution
Some people with allergic asthma are also affected by exercise-induced asthma, which may be triggered by heavy breathing during physical activity. In particular, outdoor exercise can be a trigger if you have allergic asthma. Exposure to environmental triggers while running or biking outside can bring on an allergic asthma attack. If outdoor exercise is one of your triggers, talk to your doctor about taking your medications before you go for a run or a ride. Some forms of exercise are better suited for someone with allergic asthma, like indoor cycling or a dance class. No matter what your sport, keep equipment free of dust and mold and avoid exercising outdoors entirely on bad air quality days. If you think you’re also affected by exercise-induced asthma, avoid exercising in cold weather because the cold, dry air of winter can trigger or worsen symptoms.
Adjust the Dry Air Indoors
During the cold weather season when the air becomes dry, you may find that your lips chap and your skin gets rough and raw. Dry air can also irritate your sinuses, making it harder to breathe, especially if you have allergic asthma. A humidifier can ease the discomfort, but there’s just one problem: Dust mites like humidity as much as you do, and dust mites are the number one indoor allergic asthma allergen. If you’re going to use a humidifier, keep the moisture in your house between 30 and 45 percent, no higher. Use a hygrometer — an instrument that measures moisture — to monitor the level. Mold, another common allergic asthma trigger, thrives in humidifiers. Be sure to keep your unit clean. Carefully follow the manufacturer’s instructions on how to clean your humidifier.
Subscribe to Dr. Gupta’s Newsletter
Health Matters With Dr. Sanjay Gupta delivers real-life perspective and advice on health and condition news that matters to you.
Sign up for Dr. Gupta’s newsletter for health info and advice, delivered each weekday to your e-mail inbox.