WHAT TRIGGERS ASTHMA SYMPTOMS OR AN ASTHMA ATTACK?
Here are some examples and descriptions of what can trigger asthma symptoms that can lead to an asthma attack.
Every asthma attack is different and no two people with asthma react the same way to the same allergen exposure.
There are many allergens and irritants that can cause an asthma sufferer to have an asthma attack or flare-up. Symptoms of an asthma attack can at first be very mild and then become suddently very severe. It can quickly become deadly if the person cannot remove themselves from the trigger or if they do not have their asthma medication. Frequent exposure to the same trigger may lead to a strong sensitivity to that trigger which may cause a more severe reaction or asthma attack the next time the person is around the same trigger. Each person with asthma is not the same, and each person does not react the same to a specific trigger. Often, by reducing contact or exposure to a known asthma trigger – either from the home, school, and work – you can reduce asthma symptoms and reduce the severity of the asthma attack.
Step One: Identify your asthma triggers – what triggers your asthma symptoms – it may be a common everyday item, or exercise, or you may need to see a specialist, such as an allergist, to perform testing to figure out what is causing the asthma symptoms.
Read through the following to learn about what may trigger asthma symptoms or attacks.
Physiological factors that may trigger or increase asthma symptoms include:
- Viral upper respiratory infections.
- Untreated conditions such as rhinitis, sinusitis, and gastroesophageal reflux (GERD).
- Drugs – NSAIDS such as aspirin, Ibuprofen (motrin), acetaminophen (tylenol), naproxen sodium, and ketoprophen; statin drugs (cholesterol reducing medications); and other anti-inflammatory drugs.
- Stress and strong emotions.
- Menstrual cycle/hormone changes.
Common indoor environmental irritants and allergens that can trigger asthma symptoms or an asthma attack include:
- Pet fur or feathers, pet urine, saliva and dander.
- House-dust mites.
- Cockroach waste and decomposing carcass.
- Mold and mildew spores. (leaking plumbing, leaking roof, etc.)
- Tobacco smoke and wood smoke.
- Perfumes, hairsprays, scented lotions, and cologne.
- Air fresheners, incense sticks and scented candles.
- Cleaning solutions, pesticides and paint fumes.
Common outdoor environmental irritants and allergens that can trigger asthma symptoms or an asthma attack include:
- Pollen from trees, grasses, and weeds.
- Mold and mildew spores. (wet rotting leaves on the ground)
- Changes in humidity. (high humidity)
- Exposure to cold air or hot humid air.
- Industrial emissions, vehicle or truck exhaust, and other air pollutants such as Coal Dust.
- Ozone. (avoid being out in the hottest part of the day during the summer months)
Food allergies involve the body’s immune system reacting to proteins found in food. The body treats these proteins the same way as it would a disease. Different people react to different types of food although some types have a greater chance of becoming a trigger. Between 2% to 10% of people are affected by food allergies, with a greater percentage occurring in children. Reactions can occur within a few minutes or over a period of several hours. Undiagnosed and untreated, severe attacks can be fatal.
The diagnosis of a food allergy mainly is making sure it is not something else such as food intolerance, which can occur in a variety of other illnesses. If a patient says to the doctor, “I think I have a food allergy,” the doctor has to consider a number of diagnoses. The possibilities include not only food allergy, but also any other diseases that have symptoms brought on by food. The diagnosis includes reactions to certain chemicals in food for example, histamine or food additives, food poisoning, several other gastrointestinal diseases, and psychological symptoms.
American Academy of Allergy Asthma & Immunology
Common Environmental Allergens
The cause of the underlying airway swelling (inflammation) in patients with asthma is unknown. Once a person has swollen airways and asthma, environmental triggers can cause or increase asthma symptoms.
Exposure to chemicals and pollutants in the air at work can trigger asthma. In some cases of work-related or occupational asthma a single, high-dose exposure to ammonia, chlorine gas, hydrochloric acid, or formaldehyde (a wood preservative and additive in adhesives) can cause asthma. Work-related Asthma (aggravated asthma) can also result from long-term, continuous exposures to some chemicals.
Allergies and Allergy Testing
Since allergies play a role in causing asthma symptoms, the diagnosis of asthma often includes testing for common allergens, such as house-dust mites, molds, animal dander, cockroaches, and pollens. At least 60 percent or more of those with asthma also have allergies that cause their symptoms.
Individuals with persistent asthma should be tested for how sensitive they are to allergens they are often exposed to. There are several types of allergy tests. One type of test looks for immunoglobulin E (IgE) mediated responses – this chemical in the blood turns on the mast cells in a person’s skin to release histamine which causes swelling, redness and itching (similar to being stung by a bee). Allergy testing can include: allergy skin tests (prick, intradermal, patch tests), allergy blood tests (RAST, PRIST, etc.), and other lab tests to see if allergic disease is there. These allergy tests can also tell if you have an infection or other problem. After having an allergy test, your doctor may know what is triggering your asthma and allergy symptoms, and be able to treat those symptoms better. For more information on types of testing click here.
Food Allergies – Foods can occasionally trigger asthma. Usually there is a skin reaction, such as eczema (scaly itchy skin) or hives, as well as, having asthma symptoms or an episode. If you think a food is a trigger discuss it with your doctor.
Medication Issues – Beta Blockers (most of these medications end in -lol such as metoprolol, etc.) are a frequently prescribed medication used to treat high blood pressure, heart failure, heart attack, migraines and glaucoma. They can make asthma worse by interfering with the effectiveness of your quick-relief inhaler (quick relief inhalers are beta-based drugs). If you think you may be on a beta blocker, and you are having difficulty managing your asthma symptoms contact your doctor for other treatment options.
If you have asthma, you need to be very careful with over-the-counter pain medicines. Remember: No drug is risk-free. There are some tips from the experts for using these medicines safely. Tip Sheet WebMD
Asthma & Aspirin Sensitivity
For some people with asthma, taking aspirin has no effect on their asthma, either good or bad. However, a small number of poeple with asthma, about 3-5%, aspirin can cause asthma symptoms to begin or to worsen. Often these asthma symptoms can be very bad and cause a sudden asthma attack. For people sensitive to aspirin, it can also cause a stuffy nose (nasal congestion) and stomach type pain (abdominal pains). Most often, this sensitivity to aspirin begins as an adult. It found often with people who have nasal polyps (growths of extra nasal tissue that plug the nasal passageways).
Many people with asthma will be told by their physicians to avoid aspirin because of their asthma. The only way that you can tell if you are sensitive to aspirin (and related medications) is to have a bad reaction with your asthma after taking one of these medications. Most over the counter pain relievers – NSAIDS contain aspirin as well as several prescription medications. Please talk to your doctor if you think you may be sensitive to aspirin.
Avoid Asthma Triggers
Avoiding triggers is the easiest and best way to improve your asthma! Do a home, a school, and a work checklist to see if you find what triggers your or your family member’s asthma.
- Indoor AIRepair – asthma trigger checklist and newsletter for home, school, and at play
- Home Environment Asthma Checklist – Is your home “asthma friendly”? Here is an easy to follow list and suggestions to improve the air quality of your home.
Dust Mites – Live and breed in mattresses, bed linens, carpet, stuffed toys, fabric-covered furniture, etc and can be found in every home. They resemble a flea, but are so small that a microscope is needed to see them. Here are some ways to reduce exposure to Dust Mites in the home:
- If possible, do NOT have the asthma sufferer in the room that is being cleaned to avoid aggravating symptoms.
- Wash sheets and blankets in HOT water, once a week.
- Vacuum weekly – preferably with a HEPA filtered vacuum cleaner.
- Choose stuffed toys that are washable. Wash them in hot water and dry thoroughly periodically. Stuffed toys should NOT be placed on beds or in the bedroom if possible. If the stuffed toy cannot be washed – place it in a plastic bag then place it in the refrigerator freezer for a few hours. The cold will kill the dust mites.
- Cover mattresses and pillows in dust-proof (allergen-impermeable) zipped covers that are specific for dust mites. (These items can be purchased in many department stores and online).
Pets – To help avoid asthma symptoms brought on by a pet, here are some suggestions:
- Consider keeping pets outdoors or even finding a new home for your pets especially if asthma symptoms brought on by exposure to the pet are severe. (Note: Even by removing a pet, the allergens from that pet may remain in the home for up to one year).
- Make the bedrooms and other sleeping areas of those with asthma off limits to pets at all times, and keep the door closed.
- Keep indoor pets away from fabric-covered furniture, carpets and stuffed toys. Vacuum, dust and clean often – at least weekly.
- Bathe and groom the dog or cat frequently to reduce allergens. (This only reduces allergens – it does not completely remove them).
Molds and Mildew – Grow in damp and shady places. Caused by collection of water such as leaky pipes or roof. To help avoid asthma symptoms try these steps:
- Wash mold off hard surfaces and let dry completely. Absorbent materials, such as ceiling tiles and carpet with mold, may need to be completely removed and replaced.
- Locate the source of moisture – drainage problem, leaky plumbing, poor ventilation, etc. and have the problem corrected.
- Keep drip pans in your air conditioner, refrigerator and dehumidifier clean and dry.
- Use exhaust fans or open windows in kitchens and bathrooms when showering, cooking or using the dishwasher.
- Keep low indoor humidity, ideally between 30 to 50 percent relative humidity. Humidity levels can be measured by hygrometers. Hygrometers are available at local hardware stores or home improvement centers.
- How to lower humidity levels – Use a portable dehumidifier in your home or office. These products can be purchased at most home improvement centers and hardware stores. The newer models of dehumidifiers have digital readouts where you can set the percent of relative humidity that you want your room to be. Preferrably 30-50 percent. Lower humidity levels reduces the number of dust mites. Dust mites have difficulty living and reproducing in lower humidity
Pests – Droppings or decaying body parts of pests such as cockroaches or rodents are known asthma triggers. To help avoid asthma symptoms, these measures should be taken to keep them out of your home:
- Do not leave food or garbage out.
- Remove cardboard boxes – as roaches like to lay their eggs and nest here.
- Store food in airtight containers (plastic, metal, or glass).
- Clean up all food crumbs or spilled liquids right away.
- Try using poison baits, boric acid (for cockroaches) or traps. Avoid using pesticide sprays since these chemicals irritate the lungs.
Indoor Air Pollution
Tobacco Smoke –
- Asthma can be triggered by the smoke from a cigarette, pipe or cigar, as well as the secondhand smoke that is exhaled by other smokers.
- Third-hand smoke is now a known trigger of asthma symptoms and may also contribute to developing asthma in infants. Third-hand smoke is the smoke residue that remains on a person’s body, clothing, furniture, carpet, and other fabric items. Small children and infants will inhale these particules off of a family members clothing and while crawling on the carpet.
- Set a “NO SMOKING” policy for your home and car.
- Avoid going into homes and businesses where tobacco smoke is present. Perfumes/Fragranced Products – Products that have strong odors such as perfumes, hairsprays, scented lotions, paints, and cleaning products can cause an asthma episode or more severe attack.
Scented Products – many people with allergies and asthma are very sensitive to scented or perfumed products.
- Avoid using or wearing perfume or scented products such as body lotion, hairspray, cologne, etc.
- Avoid using potpouri, air fresheners, incense, or scented candles – these items may seemingly smell good to you, but the chemicals used can irritate the lungs of people with asthma and other lung diseases.
- Ventilate well (open windows and use fans) when using scented cleaning products inside the house or at work.
- Store paints and other highly scented products in a garbage can or outside storage building. Make sure containers are properly sealed. When painting, make sure the room is well ventilated by opening windows, doors, and using fans.
- Read the labels of cleaning products prior to buying or using. Products labeled “GREEN” are not necessarily safe to use around people with asthma or allergies.
Outdoor Air Pollution
Coal dust and coal soot, emissions from coal-fired power plants, factories, toxin and chemical emissions from industrial manufacturers, vehicle and truck exhaust, and ozone are known “asthma triggers” and can cause severe damage to the lungs.
If you have asthma, your doctor can help you design a plan to control and prevent asthma attacks. Limiting your exposure to air pollution can be an important part of that plan. The US Environmental Protection Agency keeps tabs on local air quality across the country through its daily Air Quality Index, which measures levels of five major air pollutants.
These five pollutants include:
Ground Level Ozone – A toxic component of smog, ozone triggers asthma attacks and makes existing asthma worse. It may also lead to the development of asthma in children. Ozone is produced at ground level when tailpipe pollution from cars and trucks reacts with oxygen and sunlight.
Sulfur Dioxide (SO2) – A respiratory irritant associated with the onset of asthma attacks, sulfur dioxide is produced when coal and crude oil are burned. Coal-fired power plants, particularly older plants that burn coal without SO2 pollution controls, are the worst SO2 polluters.
Particulate Matter – refers to a wide range of pollutants — dust, soot, fly ash, diesel exhaust particles, wood smoke and sulfate aerosols — which are suspended as tiny particles in the air. Some of these fine particles can become lodged in the lungs and could trigger asthma attacks. Studies have shown that the number of hospitalizations for asthma increases when levels of particulate matter in the air rise. Coal-fired power plants, factories and diesel vehicles are major sources of particulate pollution.
Nitrogen oxide (NOx) – A gas emitted from tailpipes and power plants, nitrogen oxide contributes to the formation of ground-level ozone and smog. It also reacts with other air pollutants to form small particles that can cause breathing difficulties, especially in people with asthma.
- Avoid or limit the exposure to these known pollutants
- Avoid going out on “HIGH POLLUTION” or bad air days. Check the local news, newspaper, or Air Quality Index websites in your area for more information.
- WV-DEP Air Quality Index – Check your local air quality with daily updates
Additional information and resources can be found at the following:
Exercise Induced Asthma or Exercise Induced Bronchospasm (EIA)
Physical activity can cause some people to have an asthma symptoms or an asthma attack. An asthma attack can occur during or after the exercise activity.
- Talk to your doctor about medicines available to prevent an asthma attack during exercise. With proper medications, asthma sufferers can live healthy, active lives.
- Make sure the coach, physical education teacher, and teammates are aware that you have asthma. Educate them on what they can do to help you if you have an asthma attack. See the Asthma Guidance for Coaches on this site.
- For many with EIA, typically by using a bronchodilator or “Quick-Relief Rescue Inhaler” 30 minutes before exercise (such medications are: Albuterol, Ventolin, Proventil, ProAir, or Xopenex) will reduce or relieve asthma symptoms.
- Spend extra time “warming up” before exercise, play time, or exerting yourself.
- Stay Hydrated! Drink more water before, during, and after exercise. The lungs as well as your body needs water.
- You may need to choose an exercise that is less likely to trigger your asthma, like swimming, walking or leisure biking. Discuss options with your doctor.
- Discuss any exercise plan with your physician along with a treatment plan to help you perform your best.
Avoid Extreme Temperature Changes
Severe weather conditions can trigger a asthma symptoms or an attack.
Take these precautions during cold weather:
- Avoid going out on extremely cold days if possible.
- Wear a scarf or mask that covers your mouth and nose when you go outside.
Take these precautions during hot weather:
- Avoid going out during extremely hot or humid days if possible.
- Avoid going out during the hottest part of the day – between 10 am and 2 pm.
- Avoid being outside on extremely windy days – allergens are in the air.