Allegry and Asthma Health - New Asthma Assessment Guidelines Released by ATS/ERS

Going to Extremes: Two Environmental Conditions That Can Affect Your Asthma

by Thomas J. Kallstrom, MBA, RRT, FAARC

If you have asthma, exposure to extreme environments can certainly impact your ability to maintain a symptom-free life. These exposures exist around the world, and most folks are likely to come upon many of them regardless of where they live or travel. Two of these extremes that often give people trouble are exposure to dust and cold air.

Dusty days

For people living in or visiting an arid desert environment, there is the risk of exposure to dust that contains levels of quartz and other substances and microorganisms that could irritate sensitive airways. Quartz dust has a tendency to irritant the lungs because it does not exit the lungs easily and can become embedded in the airways and tiny air passages.

A recent study in the American Journal of Respiratory and Critical Care Medicine found children living in areas impacted by desert-dust storms had a higher incidence of asthma, and the heavier the levels of dust, the higher the likelihood that the child would be hospitalized. This was especially true with the combination of desert dust and higher levels of pollen and air pollutants.

But dust does not have to come from the desert to impact people with respiratory disease. The attack on the World Trade Center in 2001 produced a massive cloud caused by the collapse of the buildings and burning rubble, and many people who were exposed to this cloud continue to have respiratory problems today.

People in the area who already had asthma were especially hard hit. Another study in Allergy and Asthma Proceedings found that in Chinatown, which is within walking distance of the site, childhood asthma rates increased after the attack and those with preexisting asthma had a worsening of their disease. This, in combination with higher levels of air pollution in the area, intensified the effect of subsequent exposure to air pollution.

Cold environments

Cold air is yet another extreme that can cause people with asthma to exhibit symptoms. Breathing in cold air irritates the lungs of people with asthma, which causes airway obstruction. This can be even more difficult for a person who is exerting him or herself and, therefore, has an exercise-induced bronchospasm. Sometimes this reaction will present as coughing. This is a particular concern for folks with asthma who participate in outdoor sports activities in the winter months.

Managing the extremes

So what can you do to manage these extreme environmental exposures? The answer is essentially avoidance at all costs. The evening weathercast does not forecast quartz levels in daily dust, but it does put out advisories that specify levels of particulate matter. Usually this is translated as air quality that is good, moderate, or unhealthy. Pay attention to these warnings, and when the levels are high limit outdoor activity or simply stay indoors with the windows closed. If this happens during the summer months, running the air conditioner will help reduce dust exposure as well as reduce the humidity levels in the home.

When exposed to cold air, the prevailing recommendation is to cover your mouth with a scarf or a mask and breathe through your nose, which will act to humidify the air that is inhaled. If exercising, do a pre-exercise warm up as well as an albuterol treatment, as advised by your physician.

Exposure to the elements is going to happen; but if you make an effort to avoid those elements whenever possible, you'll be less likely to suffer their ill effects.

Tom Kallstrom is associate executive director and chief operating officer of the American Association for Respiratory Care.