Asthma - reducing your exposure to triggers

Written by Dr Angela Simpson, specialist registrar respiratory medicine

Viruses
Viruses cannot generally be avoided and many patients with asthma will experience an exacerbation of their symptoms when they get a cold, which may last for a few weeks.

Asthma patients should take particular care to check their peak flow when they get a cold and use this information to follow their asthma management plan. This will often involve a doubling in the dose of the inhaled steroid (preventer inhaler) for several weeks, as the symptoms often take a while to settle down.

The Chief Medical Officer, who advises the government on issues of public health, recommends that those with chronic respiratory illness, including asthma, should have the flu vaccine each year.

Aspirin
In some patients with asthma (particularly in those with nasal polyps) taking aspirin or related medicines called non-steroidal anti-inflammatory drugs or diclofenac) could make their asthma worse, sometimes causing a very severe attack.

The component of aspirin that can cause asthma in some people is also found in many processed foods as well as fruits and vegetables. In a minority of patients who are very sensitive to aspirin a strict diet may need to be followed to improve asthma symptoms. If the doctor diagnoses aspirin-sensitive asthma, the help of a qualified dietitian may be required to plan your diet.

Cigarette smoking
There are many reasons why people with asthma should not smoke.

Cigarette smoke contains many chemicals that irritate the airways, making all smokers more susceptible to chest infections than non-smokers.

Cigarette smoking causes cancer and other lung diseases such as chronic bronchitis or emphysema (now known as COPD - chronic obstructive pulmonary disease).

COPD is more likely to develop in asthmatics who smoke than in non-asthmatics.

In addition, children with asthma who are exposed to cigarette smoke at home have worse lung function and require more asthma medication than asthmatic children who live with non-smokers.

Outdoor air pollution
Air pollution comes mainly from motor vehicle exhausts, power stations and industrial plants and factories. It is composed of ozone and oxides of nitrogen and sulphur.

Although there is little evidence that air pollution causes asthma, exposure to air pollution does make asthma symptoms worse for many sufferers. Pollution, however, is difficult to avoid.

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