Understanding Asthma Triggers

Asthma triggers are those things that make the airways tighten and become inflamed which leads to coughing, wheezing, and difficulty breathing. Sometimes a trigger brings on a reaction right away, but other times it may take several hours or days before symptoms begin. Here is information on several triggers.

Infections

Any infection a cold, virus, the flu, or sinus infections can trigger an asthma episode. The following tips will help you stay well and hopefully avoid asthma symptoms.

• Get a flu shot every year
• Ask your doctor or healthcare provider if you should get a pneumonia shot
• Wash your hands often with warm soap and running water. It is important to lather well and wash for 15 seconds. Rinse well under running water and dry with a paper towel. Use the paper towel to turn off the faucet handle
• If soap and water is not available, use an alcohol-based hand sanitizer and rub it on all areas of your hands until dry
• Sneeze or cough into your sleeve, not into your hands. This will prevent germs from spreading. Make sure to wash your hands after using a tissue to clear your nose
• Call your doctor or healthcare provider if you are sick. Follow your asthma action plan when you have symptoms

Weather

Many people notice that when the weather changes, asthma symptoms occur or increase. Cold air, increased heat, and humidity, as well as changes in seasons, can all trigger asthma.

• If cold air is a problem for you, limit your time outdoors when air is cold and dry. If you do go outdoors, cover your nose and mouth with a scarf
• If heat and/or humidity are your triggers, stay inside and use an air conditioner if possible

Allergens

Allergic reactions can cause asthma symptoms to begin or worsen. Allergens are present both indoors and outdoors and are identified by seeing an allergist for skin testing. Common outdoor allergens are tree, grass, and weed pollens, and mold spores. They spread in the breeze and are difficult to avoid. Indoor pollens include dust mites, pet dander, indoor mold, and pests (cockroaches, rodents). The following information will help you avoid/control these allergens.

Pollens/Mold Spores (Outdoor)

• Pollen counts are highest in the early morning until mid-day. Avoid outdoor activities during these times if possible
• Keep windows closed during pollen season
• Use air conditioning, which filters pollen out of the air and also dehumidifies the air
• Shower and change clothes after outdoor activities to remove pollens from hair and clothing
• Wear a mask while doing outside yard work

Dust mites (Indoor)

Dust mites are very tiny bugs you cannot see. They can be found in carpets, mattresses, pillows, cloth furniture, curtains and drapes, stuffed animals, and dust. Increased humidity in the home, as well as the presence of pets, can also increase dust mites.

• Cover your pillows and mattress with a dust mite allergy proof cover
• Wash bedding in hot water once per week
• Avoid heavy curtains/drapes and use washable window coverings. Plain window shades are better than mini-blinds.
• Dust with a damp cloth
• Vacuum at least once per week. Use a multi-layer allergen-proof vacuum bag or a vacuum with a HEPA (high-efficiency particulate air) filter
• Wear a mask while vacuuming and dusting. If a family member has asthma vacuum when they are out of the room.
• Remove carpeting if possible. If not, vacuum frequently
• Keep indoor humidity low (25% to 50%). Remember dust mites live best in high humidity. Use a dehumidifier if possible

Molds (Indoor)

Molds grow indoors where leaks have happened in roofs, pipes and walls, as well as in damp basements, crawl spaces or where there has been flooding.

• When showering use a bathroom fan or open a window. Do the same in the kitchen when cooking
• Use a dehumidifier. Use an air conditioner when it is hot and humid
• Keep indoor plants out of bedrooms or eliminate indoor plants completely
• Clean moldy surfaces with soap and water
• Do not use a fan if mold is present. It will spread the mold spores throughout the house
• Fix leaky pipes

Pet dander (Indoor)

• If you or someone in your family has asthma triggered by pets it is best not to have a pet in the home
• If you have a pet, keep them out of the bedroom and keep the bedroom door closed
• Keep pets off of furniture and carpeting. Pet dander will remain even after the pet is gone from the home
• Washing the pet once a week may help decrease the amount of dander that is present

Cockroaches (Indoor)

Cockroach droppings and remains (along with other pests like mice) are a common asthma trigger if you are allergic to them. The following ideas will help control this allergen in your home.

• Keep food in closed containers. Never take food in the bedroom
• Keep garbage in closed containers, and take trash out of the home daily
• Clean up any food crumbs and cooking spills
• Fix leaky plumbing to avoid moisture from building
• Use roach baits or traps
• If your home must be sprayed with insecticides, you should not be present. Do not return until all odor is gone

Tobacco smoke

Smoke from cigars, cigarettes and pipes is a powerful asthma trigger. The smoker inhales tar, carbon monoxide, nicotine and other harmful substances that irritate and inflame the airway as well as those that can cause cancer. These same substances are also present in second-hand smoke which is made up of both the smoke that comes from the burning end of the cigarette, cigar or pipe as well as what the smoker exhales. Smoking directly or second-hand smoke can lead to more frequent and worsening asthma symptoms.

• If you smoke, QUIT. Discuss this with your doctor or care provider to obtain information on Quit Smoking programs
• Even if you do not smoke yourself, if you live with a smoker, help them learn about the dangers of smoking and encourage them to quit
• Do not allow smoking in your home or car
• Ask the smoker to only smoke outside and to remove their jacket or shirt when they come indoors. The smell of cigarette smoke on clothing can also trigger asthma symptoms
• If you have children, tell their caregivers/babysitters not to smoke when caring for the child
• Avoid places where smoking is allowed

Irritant triggers

Strong odors from perfumes, cleaning agents as well as wood smoke and air pollution are irritants that can trigger asthma.

Strong odors/sprays

• Avoid using scented body lotions, shower gels, hand soaps etc. and heavily scented perfumes
• Avoid using heavily scented cleaning products, paints and aerosol sprays. Use low odor paints indoors. Make sure the work area is well ventilated. Wear a mask while working with these products

Smoke

Avoid wood smoke and the use of kerosene heaters, unvented fireplaces, gas stoves or gas heaters.

Air pollution

• If you live where air pollution (including exhaust from cars/trucks/buses) is a problem, avoid being outdoors when the pollution counts are high
• Check your local TV weather or newspaper for local air quality reports

Strong emotions

Laughing hard, crying, being upset or stressed can trigger asthma in some people. You cannot always avoid or control these but you can develop ways to deal with this better.

• Make sure your asthma is well controlled so these triggers may be less of a problem. For example, always coughing and wheezing when you laugh hard is a signal that asthma may not be under control
• Try to reduce stress in your life. Ask for support from your family members and friends
• Relaxation exercises can be helpful in reducing stress. There are many audiotapes available that teach you these techniques
• Get enough sleep. Lack of sleep leads to being overtired with less energy to deal with daily stressors
• Exercise. Being active is a great way to deal with stress and clear your mind

Medicines

Your doctor/provider should be told about all the medicines you take, including over-the-counter medicines (cold medicines, aspirin, etc.) and other prescription medicines such as blood pressure medications or eye drops. You should also tell your provider about any herbs, vitamins, or other supplements. Some of these may make asthma worse, and it is important that your provider knows about these.

Foods

Food allergy resulting in asthma symptoms is more common in infants and young children. If you think food allergy may be a cause of increasing asthma symptoms in you or your child, an allergist can be helpful in determining what you are allergic to. Sulfites in foods can be an asthma trigger for some people. They are a preservative that is sometimes added to food or medicines.

• Sulfites can be found in beer and wine as well as shrimp, dried fruit, processed foods, wine vinegar and maraschino cherries to name a few. Avoid these if they cause asthma symptoms
• Read labels of all packaged foods to see if they contain sulfites
• Read labels of all medicines as well

Of note: Food allergy results more commonly in anaphylaxis which includes wheezing and breathing difficulty as well as hives, vomiting, diarrhea, abdominal cramping and rashes around the mouth or other parts of the body. Anaphylaxis is an emergency and treatment is needed right away.

Exercise

Exercise is important to staying healthy both physically and mentally and may improve lung health. Exercise is anything from taking a walk to playing team sports. It is important that you get at least 30 minutes of moderate activity four to five days per week. Asthma should not stop you from doing anything you may want to enjoy. Many asthmatics have asthma symptoms during or after physical activities. For some people, the only time they experience symptoms is with activity; this is called exercise-induced asthma.

Sports that are generally well tolerated by people with asthma are those with short bursts of exertion such as volleyball, gymnastics, baseball, and wrestling. Swimming is a strong endurance sport that is generally well-tolerated as it is performed where the air is warm and moist. Biking, aerobics, walking, or running on a treadmill are also good activities. Activities with more constant periods of exertion (basketball, soccer, distance running) or those performed in cold weather (ice hockey, ice skating, and skiing) might not be tolerated as well. However, many asthmatics can fully participate in any activity they like.

Following are some tips to avoiding/managing symptoms with exercise.

• Always use your pre-exercise inhaler as prescribed
• Perform warm-up exercises before beginning and cool down after exercise
• If weather is cold, exercise indoors if you can. If you must go out, wear a mask or scarf over your nose and mouth
• If allergic to pollen, avoid exercising outdoors when pollen counts are high. Pollen counts are usually highest in early morning to mid-day
• Avoid outdoor activities if there are high levels of air pollution
• Exercise at a level that is right for you

Asthma should never stop you from doing the things you want to do. It is important to work with your doctor/provider and follow your care plan so you can enjoy the benefits of exercise without asthma symptoms.