How Do You Care For A Child With Asthma?

By Scot McDougall of The Independent Pharmacy

A study by The Independent Pharmacy has unveiled the everyday asthma triggers impacting the 300 million people worldwide, who have asthma. 

Asthma is a common, but hidden, chronic illness that has a grip over the nation. The prevalence of asthma increases by 50% every decade and one million children in the UK are currently receiving asthma treatment, making it the nation's most common long-term medical condition in young people (1 in 11). 

Nearly half of these patients have experienced an asthma attack in the past year, and just 25% have a personalised action plan to control their symptoms. 

But, does the nation truly understand the everyday triggers and asthma danger points in our day-to-day lives? To help promote asthma trigger awareness, The Independent Pharmacy have generated research and interactive imagery to increase our understanding of asthma flare-ups, as well as awareness of the surprising scenarios that can trigger asthma attacks. 

The research analysed six common living conditions to reveal the potential hot spots that may exacerbate the symptoms of asthma and trigger an asthma attack. 

Think you know what triggers asthma? Test your knowledge below. 

Asthma has many burdening symptoms, all of which can vary from mild to severe: wheezing, breathlessness, chest tightness and coughing. All of which can contribute to an asthma attack, wherein the asthma patient’s symptoms become more severe and breathing is restricted.

Many people learn to live with their asthma and, in some cases, the condition can greatly improve in later life. Asthma becomes easier to manage and control once the sufferer has an understanding of the triggers that exacerbate their symptoms. 

Typical asthma triggers include infections like colds and flu, as well as common allergies such as hay fever. Though there are many other major triggers you might find surprising: 

- Air pollution: including vehicle fumes and tobacco smoke
- Emotional reactions: including laughter, stress, and anxiety
- Medication: including NSAIDs and Beta-Blockers
- Food allergies: and foods containing sulphates 
- Weather conditions: including sudden temperature changes
- Mould and damp: particularly when exposed for long periods
- Excercise: strenuous exercise

So, how does this impact asthma patients’ everyday lives? 

Asthma triggers at school

Asthma is a worry for many parents when their children go to school. Children returning to school are more sensitive to new asthma triggers, with more children being rushed to hospital for asthma in September than any other time of year. 

Infections such as colds and flu are among the most common asthma triggers (75% of asthma patients say getting a cold or flu makes their symptoms worse). With hundreds, if not thousands, of students attending the same school, the spread of infection is common. 

Stress and anxiety are asthma triggers too: these strong emotions make asthma patients more likely to react to their triggers. Too much stress can also lead to a panic attack, causing people’s breathing patterns to change and flare up asthma symptoms. 

That is why exam season can often exacerbate, with the pressure of exams inducing stress. The pollen count is also high during the summer (when many children take exams), which causes hay fever and triggers asthma. 

Exercise-induced asthma is another factor to consider when at school. While exercise can help relieve asthma symptoms, some people find overexerting themselves through exercise can trigger asthma symptoms, making physical education lessons a risk factor. 

Asthma triggers at the playground

Outdoor play areas and parks expose asthma patients to a myriad of potential triggers all year round. 

Pollen allergies are among the key outdoor asthma triggers: this is because pollen from trees, plants (particularly weeds) and grass blow into your eyes and nose, causing an allergic reaction for many and exacerbating asthma symptoms. 

Tree pollen occurs typically from March to mid-May, weeds from April to August, and grass has two peaks lasting from mid-May through to July. 

Air pollution and vehicle fumes from nearby roads are also a factor to consider (particularly in urban areas). In fact, vehicle pollution causes 4 million new asthma cases every year. Pollution is quick to irritate airways, with some pollution particles being small enough to get into your lungs. 

Are you surprised by the number of everyday asthma triggers? With a high number of dangers for asthma patients, it’s not uncommon for these triggers to take effect and cause an asthma flare-up. 

Asthma triggers in the living room 

Being the most communal area of the home, the living room is a hotspot for asthma triggers. 

Take your sofa, for example, a UNICEF study found the average sofa could be harbouring 12 times the amount of bacteria as a toilet seat: it also collects lots of dust, both in the cushions and the area underneath. 

Carpets and rugs are another hidden dust trap. Invisible allergens and dust particles stay hidden deep into the fibres of a carpet, making your living room a thriving environment for dust mites – a tiny creature that can trigger asthma symptoms. The same can be said for television screens, as well as ceilings and walls (dust is hiding everywhere). 

Animal dander can be found across the home too, so your beloved family pet might be triggering an allergic reaction that exacerbates your asthma symptoms. 

House plants can also be an asthma trigger, both for being a hiding spot for dust, as well as a place where mould can develop if overwatered. Some plants, however, can help your asthma by filtering toxins from the air (peace lilies are a great example). 

Asthma triggers in the kitchen

Gas stoves are a likely culprit for worsening asthma symptoms. Nitrogen dioxide is an irritant that can affect your eyes, nose, and throat. 

Many common cleaning products can also exacerbate asthma symptoms, including bleach, detergents and air fresheners. Cleaning products typically contain strong scents and chemicals that reduce indoor air quality. 

The medication box can trigger your asthma symptoms too. Some medicines, over the counter or prescribed, can cause asthma symptoms to flare up: this includes aspirin ibuprofen and beta-blockers. It’s thought somewhere between 10% to 20% of adults with asthma are sensitive to aspirin and NSAIDs. 

Dust is also rife in your kitchen, with the tops of kitchen cabinets, fridges, and light fixtures being key areas where dust can gather. 

Asthma triggers in the bedroom 

We spend most of our life in bed, but did you know it could be exacerbating your asthma? 

Dust mites thrive in mattresses and pillows as they feed on dead skin cells and enjoy warm, humid conditions. Many asthmatics are allergic to dust mites, making mattresses (especially old or second-hand ones) a major asthma trigger. 

Lampshades, under the bed, and any decorative items in your bedroom also collect dust that could affect asthma. 

Scented candles are a popular bedroom accessory, but the perfumes typically included in these products are known to make asthma worse. Tea lights are a good alternative that can illuminate your room without reducing indoor air quality. 

Asthma triggers on an aeroplane 

If your asthma is well managed, flying is generally safe: this is especially true because most modern planes have fantastic filtering systems to remove particles from the cabin. 

However, when taking asthmatic children on holiday, there are a few things to be mindful of. There are surprising parts of an aeroplane that may carry lots of dust or bacteria. According to a CBC watchdog series report, headrests and seat pockets are some of the dirtiest parts of a plane – and yeast and mould were detected on a majority of flights. 

You can avoid getting sick on a plane by taking precautions such as regularly washing your hands, as well as avoiding touching your eyes, nose and mouth. 

Changing air pressure is another potential asthma trigger. Why? Because at high altitudes the amount of oxygen decreases, which puts pressure on the lungs. Some recommend onboard oxygen for severe asthmatics and those who suffer chronic obstructive pulmonary disease (COPD). 

Plus, with stress being a key asthma trigger, a fear of flying can also cause asthma symptoms to become more severe. Constant communication with someone you’re flying with may help calm feelings of anxiety. Also, ensure all asthma medications and treatments are up-to-date before travelling. 

So, what should you do if you see someone having an asthma attack? 

Keep calm when you see someone having an asthma attack, you should reassure the person and look to not cause any additional stress or anxiety (this will make breathing even more difficult). Instead, you should do the following: 

• Sit the individual in an upright position: to help free airways. 
• Remove the trigger: this may be tobacco smoke, pet allergies, dust or a myriad of other possible triggers.
• Understand their treatment: communicate with the individual (or someone with them) and follow their asthma plan. The plan will inform whether you help them use a rescue inhaler or immediately contact emergency services when symptoms worsen. 

While following these steps, you also need to evaluate the severity of the attack. Blueish lips and tight skin that looks sucked in between the ribs are classic signs of a severe asthma attack – this means the individual is struggling to get any air into the lungs. You should also pick up on whether the person is having trouble speaking or isn’t responding to medication. 

If you feel someone is having a severe asthma attack, call the emergency services.

For asthma patients, the best way to prevent asthma flareups is to keep their condition well under control. You can do this by ensuring you have an up to date asthma action plan: this is a tailored guide to treating your asthma, typically filled in alongside a GP. 

An asthma action plan outlines the medication the patient can take (preventers and relievers), how to act when symptoms get worse, and what to do if emergency action is required. For people looking to support friends, family or colleagues with asthma, ask if the person has an asthma plan and if there are any triggers they particularly struggle with.  

By Scot McDougall of The Independent Pharmacy

Commenting on the research, Scott McDougall (MPharm) Co-Founder and Manager of The Independent Pharmacy: 

“We felt it was important to visualise the hidden triggers asthma suffers navigate every day to boost awareness of the reality of living with asthma. 

“As many asthma patients will know all too well, living with asthma means an action plan always needs to be in place and symptoms and triggers need to be closely monitored. This means that many everyday activities and scenarios will involve an added layer of pre-planning to ensure asthma treatments are always on hand and to try and avoid the most impactful trigger points for each individual. 

“This research will hopefully help to open other people’s eyes to the otherwise hidden trigger points affecting people with asthma, and hopefully encourage an open and supportive conversation about how we can all help people with asthma. 

“This is also particularly important in the spring and summer months when natural triggers, like pollen and hay fever, are more prevalent. But, this doesn't mean asthma patients should hide away from the outdoors! Instead, we should all be looking to support with knowledge of their asthma action plan. 

“Asthma triggers and responses are often exacerbated by hay fever, which many people may be experiencing now as the pollen count is high. 

“If you’re suffering from hay fever you might also experience itching in the throat, mouth, nose and ears. And in cases where a person also suffers from a chronic breathing condition like asthma, symptoms of the conditions are likely to be triggered or even exacerbated. 

“Typically, hay fever can be treated by a pharmacist, who will provide advice on suitable treatments like antihistamine tablets and nasal sprays to help with watery eyes and a blocked nose. If symptoms persist or get worse after taking antihistamines, you may need to see a GP: they’ll likely prescribe a stronger steroid treatment or refer you for immunotherapy in some cases.”