Asthma Blog

It seems that asthma medicines have been in the news a lot the past few years. You might be wondering just how safe it really is to take your asthma medicine? Wondering if the risks outweigh the benefits of Advair, Singlulair or others?

Believe me, I don't blame you. The United States' system of approving medicines via the FDA before they go on the market is one of the most restrictive in the world. Indeed, many medications yet to gain approval here have been used successfully for years in Europe.

It's surprising, then, that so many problems crop up after drugs get on to the market here, isn't it?

So what IS the truth about your asthma drugs? What do black box warnings really mean? The answers to those questions can be found in a new article here on Black Box Warnings for Asthma Medications.

If your child has any type of allergies or asthma, then anaphylaxis at school is a possiblity, even if it has never happened before. Unfortunately, anaphylaxis is often mistaken for asthma in its early stages. The truth may not be recognized until it is too late. So, sending your allergic or asthmatic child off to school can be worrisome, at best.

The good news is that schools and their staff are becoming more aware of anaphylaxis, how to recognize it and how to respond quickly. But, as a parent, there is much that you can do too.

1. First, work to make school a safer, more child-friendly place by minimizing allergic triggers in the environment.
2. Second, get the facts about managing anaphylaxis at school.
3. Finally, know your child's rights to carry allergy and asthma medicine that may save his or her life.

It's time once again for global asthma education and awareness, on World Asthma Day 2008.

World Asthma Day is a partnership between health care groups and asthma educators to raise awareness about asthma and improve asthma care throughout the world. Sponsored by the Global Initiative for Asthma (GINA), the message is that even people with asthma can live a life without limits. The theme this year is "You Can Control Your Asthma."

Asthma control is the main goal of asthma treatment. When asthma is under control, you can:

• Have a productive, physically active life. You can work and go to school. You can exercise and participate in normal physical activities.

• Avoid troublesome asthma symptoms day and night. Your day is not interrupted by breathing problems. You do not wake up at night or lose sleep because of asthma symptoms.

• Avoid most asthma attacks. Asthma attacks are very rare when asthma is under control.

• Use little or no fast-acting reliever or "rescue" medication.

• Have normal or near-normal lung function. Lung function can be monitored with an easy to use peak expiratory flow (PEF) meter.

• Avoid most side effects from treatment. Many options are available for asthma treatment. Your doctor can help you find the one that works best for you.

GINA goes on to outline 4 main strategies for achieving asthma control:

1. Develop patient/doctor partnership
2. Identify and reduce exposure to risk factors
3. Assess, treat, and monitor asthma
4. Manage asthma flares

A "step-wise" approach to asthma medicine enables the best approach to achieving control with the minimum amount of medicine needed.

Learn More:

• Explore World Asthma Day activities in your country
• About World Asthma Day
• About GINA

Asthma is one of the most common chronic illnesses today, in both adults and children. The numbers of people with asthma are growing at a steady rate. However, there are still many people who have breathing problems or symptoms who don't know whether they have asthma or not.

No worries – the American College of Asthma Allergy & Immunology (ACAAI for short) is here to help. According to their asthma screening page on their website, the annual Nationwide Asthma Screening "can help you find out if your breathing problems might be symptoms of asthma. If you already know you have asthma, the screening can help you find out if your disease is under control."

The program is in its 12th year and offers free screenings at over 250 sites across the United States. As part of National Asthma & Allergy Awareness Month, most of the screenings take place this May. Check out the ACAAI website for more info on what a screening consists of and where to find one near you. You can even watch a video to see what a screening is like. And, if there is no screening location near you (as there isn't near me!), then you can take an online screening test.

Learn More:

• How Asthma Is Diagnosed
• Common Symptoms of Asthma

It's spring and that means tree pollen is in the air – big time. And THAT means that seasonal allergy symptoms and asthma symptoms could be on the rise as well. If you're allergic to trees as I am, then you know what I mean – the wheezing, the sneezing, the itchy, watery eyes. The fun never stops. So that's the bad news about trees and asthma.

But here's a piece of good news. A new study finds that young kids (4 to 5 years old) who live on tree-lined streets have lower rates of asthma. The study will soon be published in the Journal of Epidemiology and Community Health. Here are the highlights:

• Data was from New York City, where asthma is the leading cause of admission to hospitals among children under 15
• Medical data was compared to city data, including number of trees in each area, sources of pollution, racial and ethnic make-up, and population density
• NYC had an average of 613 street trees per square kilometer
• 9% of young children had asthma
• Asthma rates fell by almost a quarter for every standard deviation increase in tree density

These patterns were true despite factors such as sources of pollution, levels of affluence, and population density, all things deemed likely to affect the results.

Experts caution that there may be no direct relationship between number of trees in an area and the rates for asthma. And they're not sure how to explain the findings above. It could be that trees improve air quality or encourage children to play outdoors away from often potent indoor asthma triggers.

So, I'm not sure what to make of this research. But I do know I like looking at the trees, and it sure makes me notice my asthma symptoms less – even if their pollen is not the best thing for me. How about you?

May is Asthma & Allergy Awareness Month in the United States. Since it's peak allergy season, it's a great time to increase public understanding of asthma and allergies, as well as how to manage them, according to the originators, the Asthma & Allergy Foundation of America (AAFA for short).

You can do your part to educate your family and friends about asthma & allergies. If you're a parent of a child with one of these conditions, then this is also a perfect time to become an asthma-friendly / allergy-friendly school advocate for your child. The AAFA has a great downloadable "planning kit" that can help.

Learn More:

• Allergic Asthma Facts
• Nasal Allergies & Asthma - What's the Connection?
• Your Asthma Action Plan

Air pollution is both a known risk factor for asthma AND an everyday irritant for kids and adults who have asthma already. Now a new study, supported by the U.S. National Institutes of Health and Environmental Protection Agency, suggests that even when air pollution levels fall within what are considered acceptable air quality standards, inner-city kids who have asthma continue to suffer.

The Inner City Asthma Study Group monitored the asthma symptoms of kids who lived in low-income, inner-city sections of Boston, New York City, Chicago, Dallas, Seattle and Tucson for more than 2 years. Here are the highlights of the study:

• Study looked at 861 children, ages 5 to 12, with persistent asthma
• Kids had significantly decreased lung function after being exposed to common air pollutants such as sulfur dioxide, airborne fine particles, and nitrogen dioxide
• Higher nitrogen dioxide levels and higher levels of fine particles were associated with asthma-related school absences
• Motor vehicle exhaust is the main source of nitrogen dioxide

The researchers suggest that asthma management plans for inner-city kids need to focus on reducing exposure to air pollutants. They also questioned whether their findings raise questions about current air quality standards in the United States. Air quality is an important factor in most respiratory illnesses, including asthma.

The Olympic games are coming this summer and will be hosted in Beijing, China, a densely populated, air polluted urban environment. As a result, many elite athletes are worried about exercise-induced asthma's possible effect on their performance.

Exercise-induced asthma is is a condition where your lungs and airways overreact to exercise, resulting in airway inflammation. Pollen and other airborne allergens and irritants can make the reaction even worse.

In light of recent studies showing that college athletes often suffer from asthma without realizing it, many Olympic teams this year are taking extra precautions and testing their athletes for asthma. One such Olympic team is the Australian team. The Sydney Morning Herald reports that a 20-minute test in a Melbourne medical laboratory reproduces the lung stress of high-intensity exercise. The Australian Olympic team doctors are using this test to pinpoint athletes who may be at risk because of China's poor air quality.

Early detection gives doctors and athletes time to prepare and get asthma under control, so that the stresses in China can be weathered more easily.

I've talked periodically in this blog about the new HFA inhalers, and I have an article on them in my regular content on this site too:

• A New Look, Feel, & Taste for Your Rescue Inhaler On the Way
• Revisiting CFC vs. HFA Inhalers
• Switching From a CFC to an HFA Asthma Inhaler - What Should I Expect?

I've gotten quite a few comments about the new inhalers, and I'd have to say my impression is that people just don't like them. But I thought I'd run a poll so I can get a better, more objective perspective... so c'mon, tell me how you feel. Answer this poll, won't you?

A retrospective review by the Cochrane Group was published this week in Copenhagen. This type of review looks at the data for many similar past studies and attempts to draw a conclusions about specific issues. In this case, researchers looked at whether getting rid of dust mites would improve asthma and allergies.

They examined 54 different studies that involved more than 3000 patients. In the course of their review, they concluded that getting rid of dust mites had little to no effect on controlling asthma and allergy symptoms. In response, they recommended against physical and chemical means of eliminating dust mites, including expensive vacuum cleaners with HEPA filters.

This obviously goes against traditional teaching about how to control asthma and allergies. In fact, Mike Tringale, the director of external affairs for the Asthma and Allergy Foundation of America, spoke out against the Cochrane Center's conclusions, pointing out that the review was incomplete. Also, Tringale said, “There’s not one cause of the problem and there’s not one solution.”

So, who do you believe? At this point, I'm just not sure. But one thing I do know: getting rid of 1 trigger is probably not enough anyway to get rid of your asthma symptoms. You'll also need to take your medicine regularly as prescribed, avoid smoking, and avoid other triggers as well.