Asthma: disarming the triggers

Asthma attacks can disrupt sleep, work, school, sports, and so much more. Most families will do almost anything to their environment to cut down on these incidents. That well-meaning concern could lead people off in the wrong direction, aggressively cleaning up mold when the actual triggers for an individual’s asthma could be dust mites, other allergies, cold weather, or even the common cold. As Dr. James Krieger, chief of epidemiology at Public Health, Seattle & King County, says, there are several asthma triggers, some of which you can do something about and others that can’t be controlled.

“The most common asthma trigger, especially in children, is getting colds and other viral infections in the respiratory tract. Those can set off asthma attacks in susceptible children and some adults,” says Krieger, who is also a clinical associate professor of medicine and health services at the University of Washington. “Some children just have asthma in the winter when these infections are common and they’re fine the rest of the time. They tend to outgrow that kind of asthma. Other children have a genetic predisposition to develop allergies and they tend to be more responsive to allergic triggers as well.”

The first step in asthma-proofing your home is determining which triggers apply in your particular case.

“If someone has frequent asthma symptoms, more than a couple of times a week, it’s good to get an allergy test administered by your primary care physician or an allergist,” Krieger states. “The best one is the skin test, where small amounts of allergens are scratched into the skin. Then you can remove from the home the allergens that are the main problems in your particular case.”

Tobacco smoke is one of the biggest allergic triggers for asthma attacks. The solution is making sure that the person who has asthma is not exposed to any smoke at home.

Dust mites are a frequent asthma trigger, especially in wet climates.

“These mites don’t have mouths, so the only way they get moisture is from damp air, through their skin. They thrive if the relative humidity is above 60 percent. You can pretty much eliminate dust mites from the home if you can reduce the humidity below 50 or even 40 percent,” Krieger adds.

The pesky mites like living in warm moist places and hate sunlight. Their favorite real estate is in mattresses, although they can also live in upholstered furniture, drapes, and even stuffed animals. The best way to get rid of them is to wash bedding in hot water, followed by about a half hour in a hot dryer. Dust mites can be killed in stuffed animals by either the hot-water-and-dryer treatment or by putting them in the freezer for 24 hours.

Pet dander, the dried saliva they leave on their fur and feathers, can also be a trigger. While the obvious answer may be to make pets outdoor animals, some families can’t accept that.

“At the very least, keep the pet out of the bedroom of anyone with asthma,” Krieger says. “There was a move a few years ago to bathe the pets of asthma patients once a week. That can temporarily lower allergen levels, but it’s never been proven to have a clinical benefit. Especially with a cat, it’s not the most pleasant thing to do,” he notes. “Some experts believe using a HEPA air filter can reduce the levels of animal allergens and tobacco smoke, but more evidence of that is needed.”

The main tool in asthma control is to know the specific triggers and then act to control those that can be managed.

“It is possible that some people have a single allergy to which they can be desensitized.”