Improve Asthma Control by Knowing Your Triggers
 The management of asthma and allergy triggers is one that continues to be of major importance to patients with asthma who are susceptible to them. Interestingly, it is in our own homes that we encounter many of the triggers that can initiate or worsen an asthma condition Knowledge of these triggers and methods to reduce them can help you avoid exposures and better control your asthma.
The five most common triggers are secondhand smoke, animal danders, molds and mildew, dust mites, and cockroaches. Some patients may be sensitive to more than one of these. Your health care provider can help you discover a likely cause and effect, devise an intervention, learn all about what you need to know. If you are experiencing persistent symptoms when exposed to allergens, ask your doctor if you can take an allergen skin test. Here are some other triggers you should be aware of and try to avoid.
Common trigger No. 1
Secondhand smoke can exacerbate the asthmatic condition. Being exposed to the airborne particulates can initiate this, and so can exposure to particles that have settled onto a smoker’s clothing. Of course, the most important message here is not to smoke. Also, do not get close to anyone smoking because they will put you at increased risk for an asthma attack. Today there are numerous patches, gums, and pills that offer a nicotine replacement option that will help the smoker quit. Smoking-cessation programs are readily available in most communities.
Common trigger No. 2
We love our dogs and cats in this country, but it is these domestic animals that can actually trigger an asthma episode in a sensitized and allergic patient. Options here are to remove the pet from the home or to relegate the animal to a particular area of the home—preferably one that is away from anyone prone to asthma episodes. The most important strategy with controlling this trigger is never to allow the dog or cat into the bedroom. The door should remain closed at all times. Other options include washing the dog or cat once or twice a month.
Common trigger No. 3
Mold spores are invisible to the eye, but the damage they cause can be picked up by the other senses. Mold contamination can be seen as it forms on objects and, in many instances, can be smelled as well. The cardinal rule with mold is to immediately clean it up, dry the area, and correct the cause of the water leak. It is often found in humid areas of the home such as the shower, kitchen, and basements, but can also be found outdoors. Use of a dehumidifier and/or an air conditioning unit can also help to lower the humidity levels, which in turn will decrease mold growth. Another strategy is to open a window or operate an exhaust fan in the bathroom or kitchen when showering or cooking.
Common trigger No. 4
Dust mites are invisible to the naked eye but can be a significant trigger for a sensitive asthmatic. Dust mites are in all areas of the Unites States in large numbers but are less dense in upper levels of the Rocky Mountains and in the desert Southwest. The dust mite requires a warm humid environment; therefore, it is important to control humidity levels by lowering them to less then 50% relative humidity. Again, this can be achieved with dehumidifiers and air conditioning units.
Another successful intervention is to wash the bedding once a week in hot water (over 120° F). Children should not be allowed to keep stuffed animals exposed to the air but rather to keep them isolated in a container so that they will not collect dust when not in use. Do not lie directly on carpeting or upholstered furniture as those areas potentially house large numbers of dust mites. Instead, lay down a protective barrier (such as a blanket) to reduce direct exposure.
Common trigger No. 5
Cockroaches are a significant trigger usually seen in the inner city and southern portions of the United States, but certainly can be found anywhere. Children under the age of two are most at risk because it is at this age that a child may develop a life-long sensitivity. The best way to control roaches is to practice keeping an environment that will be inhospitable to roaches. This means not allowing food to be kept out or within easy access of a roach. Garbage should be taken outside and not kept in the home. There are also effective chemical agents that can help control the infestation. Boric acid is deadly to the roach and can be purchased inexpensively. Poison baits are also effective in attracting the roach and then creating a route into the nest where the roach that consumed the poison will actually contaminate and kill the other roaches.
About the Author
Thomas J. Kallstrom, BS, RRT, AE-C, FAARC, is associate executive director and chief operating officer of the American Association for Respiratory Care in Irving, TX. He is also a member of the NAEPP Coordinating Committee and is a certified asthma educator.
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