Step 11: Avoid asthma triggers

Mastering your asthma means understanding your medications, using them correctly, and monitoring your signs and peak flow on an ongoing basis. But it's important to try to avoid the things that trigger your asthma in the first place.

Many of the same culprits that trigger allergies also trigger asthma -- and if you reduce your exposure to them, it will mean less inflammation, fewer symptoms, and a potentially lower dose of medication. Consider the following important allergens:

• Animal dander -- Do you have a pet? If so, you might feel nasal, eye, or chest symptoms after a carpet has been vacuumed. Do your symptoms improve if you have been gone from home for a week or more? Do your symptoms get worse within 24 hours of returning home?
• Dust mites -- Do you feel nasal, eye, or chest symptoms after a carpet has been vacuumed? Do you get these symptoms after making a bed?
• Pollen -- from grass, weeds, and trees, and outdoor molds: Does your asthma get worse during any particular part of the year?
• Indoor fungi (molds) -- Do you feel nasal, eye, or chest symptoms in basements or other damp, moldy rooms?
• Other asthma triggers -- include irritants like smoke, pollution, fumes, cleaning chemicals, and sprays. Food allergies are not a common trigger of asthma.

Anyone who has persistent asthma and is using daily medications should probably get tested for allergies, if they haven't already done so. Skin or in vitro allergy tests determine whether you are allergic to certain allergens (like animal dander, dust mites, mold, or cockroaches). Once you have a better idea of what's triggering your asthma, you can focus on taking specific steps, like keeping pets out of the bedroom or removing carpeting.

Many studies have proven that reducing indoor allergens in your home reduces asthma symptoms, so these steps should be seriously considered.

Finally, keep in mind that allergies can either increase or decrease with age. Allergy testing, therefore, is like a snapshot of a moving picture. Even though you or your child has been tested once, testing again may be appropriate, especially if your living environment has changed.

Immunotherapy

Immunotherapy, also called allergy shots, has been shown to reduce asthma symptoms. This strategy should be considered when you know that certain allergens are causing your asthma, you can't avoid these allergens and they cause symptoms year-round, and drug therapy is not working well. However, keep in mind that people with asthma are more likely to have bad reactions to allergy shots than people who take them just for allergies, and that asthma experts are not in agreement about what role this strategy should take.

Occupational asthma

Some people are exposed to irritants in their place of work -- such as chemicals, dusts, gases, smoke, and fumes. These irritants can trigger pre-existing asthma, but in other cases they can actually cause asthma that wouldn't otherwise occur. Therefore, it is important to deal with these irritants as soon as possible -- the longer you wait, the more likely it becomes that your symptoms will remain after you are no longer exposed to them in that workplace. An allergist can help you evaluate the impact that your work environment may be having on your breathing.

Reference

Williams SG, Schmidt DK, Redd SC, Storms W. Key clinical activities for quality asthma care: recommendations of the National Asthma Education and Prevention Program. MMWR Recomm Rep . 2003 Mar 28;52(RR-6):1-8.

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