There are only a few months to go before HFA inhalers are the only type of inhalers available for people with asthma. Starting in 2009, CFC inhalers will no longer be made.

But many people are complaining that the HFA inhalers don't work as well, asthma control is slipping, or they are allergic to some of the ingredients. Oh yes, the new inhalers also cost a lot more – so much so that some of us are having trouble affording them. There also are no over-the-counter HFA albuterol inhalers.

In the face of so many problems, why does the United States continue to move forward with this initiative anyway?

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There's been much in the news this past year or so about black box warnings for asthma medicines. One type of warning was applied to combination asthma medicines, such as Symbicort and Advair. These are inhalers used to treat people with asthma who haven't achieved asthma control with an inhaled steroid alone.

As such, they've been quite useful in asthma treatment. But once the black box warnings were issued, people who took these combo medicines started to worry that they might be too risky to keep taking. But it's important to note that the black box warnings were applied to the combination medicines only because one of the medicines they include is a long-acting bronchodilator (LABA) and LABAs have been implicated in a study as linked to an increased risk of asthma death. Combination medicines also include an inhaled steroid and steroids have been proved as quite safe to take.

Subsequent studies have been unable to document any serious risk of asthma death because of taking Advair. In fact, they suggested that the reason that people taking LABAs alone faced serious risk of death is because LABAs alone are not an effective treatment for controlling asthma. Now a new 52-week study also shows that Symbicort has a similar safety profile to its inhaled steroid, Pulmicort (generic name budesonide). This is good news for Symbicort users!

Should you be concerned if your medicine has a black box warning?

Asthma and allergy management in schools has been a hot topic for some time. You need to know your kids' health is protected when they're out of your sight, but with such varying (or nonexistent) policies, it's been hard to feel secure. Over the past year or so, though, many states have worked hard to pass laws that will protect your children with allergies and asthma when they're at school, including the "right to carry" laws.

Now, the Asthma and Allergy Foundation of America (AAFA for short) has just released a report that "identifies states with the most comprehensive and preferred state-wide public policies supporting people with asthma, food allergies and related allergic diseases in U.S. elementary, middle and high schools." They go on to state that the goal of creating this report is "to provide a blueprint for asthma and allergy advocates in all states to help recognize and develop better school-based policies and practices."

In fact, the AAFA created an "honor roll" of states that excel in asthma / allergy policies. To do this, they looked at 18 different policy standards in 3 categories:

• Medication & Treatment
• Awareness
• School Environment

Six states were named to the honor roll for 2008:

• Connecticut
• Massachusetts
• New Jersey
• Rhode Island
• Vermont
• Washington

If you're fortunate enough to live in one of these 6 states, then your children are well-protected. If not, it might be time to become more of an advocate for your child!

Exercise-induced asthma (EIA for short) is common in competitive athletes, even at the elite Olympic level. So, obviously, having it doesn't mean you can't participate in sports. In fact, as many as 20% of summer athletes suffer from allergic diseases like nasal allergies and asthma.

In addition, the prevalence of allergic disease is greater in athletes, while treatment is often lacking because of the anti-doping regulations that govern elite athletes. So, at the request of the National Olympic Committee, the Global Allergy and Asthma European Network has initiated a study of Olympic athletes. Scientists have designed the study to assess the affect that environmental pollution has on asthma symptoms and lung function, and also to help identify athletes who may develop asthma and allergy symptoms while in Beijing.

Regular exams throughout the Olympics will measure lung function and symptoms in more than 2,000 athletes. Skin prick tests will measure for allergies. It is hoped that the study will lead to a better understanding of allergic disease in top athletes, as well as better care. And that should lead to a better approach for everyday athletes and active kids as well!