Only through understanding the cause of asthma can we hope to cure
You are probably familiar with what can trigger or worsen your asthma, sinus or allergies. I have described many of these agents below, and perhaps some of the information will be useful to help you avoid them in your environment. Many of these agents are harmful to our health in other ways.
Modern medicine, as it stands at the moment, has either stopped looking for the causes of asthma or it has false impressions of the causes. Through dealing with "trigger factors" we can only hope to treat the symptoms of the problem. Only through understanding the cause of the disease (Read the Naturally Free From Asthma Report), can we hope to cure.
Some reported, well-known and not so well-known triggers for asthma or bronchospasm include:
Allergens (particles that cause allergies) such as dust mites, cockroaches, pollen, molds and animal dander (which are tiny scales or particles that fall off hair, feathers or skin) from any pets
Aspirin
Peanuts
Particulates (air-born pollution)
Cold air or hot stuffy environments, or sudden changes in temperature Tobacco smoke and wood smoke
Perfume, paint, hair spray, or any strong odors or fumes
Common cold, influenza, and other respiratory illnesses
Food chemicals that may trigger asthma include: Sulphites (sulphur dioxide and sodium metabisulphite)
Food colours (tartrazine) Monosodium glutamate (MSG) Alcoholic drinks (Sulfite additives have been associated with triggering asthmatic responses. They are present in significant levels in most wines, but other ingredients in wine can also trigger an asthmatic response.)
Obesity
The dramatic increase in the number of asthmatics may be linked to an increase in levels of obesity, scientists have said. Researchers have found that the fatter the adult, the greater the likelihood of asthma.
Your Occupation
Plastics
Exercise (Exercise, especially in cold air, is a frequent asthma trigger)
Overeating, or laughing excessively
Some controversial triggers under discussion include:
Organophosphates – the widespread use of organophosphate insecticides to address pest infestations in lower socio-economic areas, may contribute to the very disproportionate high rates of asthma in disadvantaged black and minority communities in the US.
Toluene
72% of asthma patients in a study showed adverse reactions to perfumes; i.e., pulmonary function tests dropping anywhere between 18% and 58% below baseline (from "Affects of Odors in Asthma,"
Chang Shim, MD and M. Henry Williams, MD, American Journal of Medicine, January, 1986 Vol. 80)
Toluene-laced fragrance industry chemical products have become increasingly pervasive in the last ten years - used not only in perfumes, but also in furniture wax, tires, plastic garbage bags, inks, hair gel, hairspray, and kitty litter. A Danish toxicological journal, "Ugeskr Laegar", Vol. 153, ISS 13, 1991, p. 939-40, found perfume in kitty litter to be a cause of asthma in humans.
The only safe assumption about scented products is that they contain numerous toxic chemicals which constantly vaporize into the air and attach themselves to the hair, clothing, carpets and and surroundings of anyone who wears them. These chemicals go directly into the bloodstream when applied to our skin and are also absorbed into the skin from our clothing. We also inhale the chemical fumes, which then go straight to our brains where they can do major harm. These chemicals are skin irritants, suffocants, eye and respiratory tract irritants, and neurotoxins.
Household cleaning products and synthetic fragrances - One theory for the rise in asthma cases says that it isn't being caused by more pollutants - it's caused by the world being too clean. According to this theory, children raised without enough exposure to dirt, dust, and disease may not build up a resistance to some allergens -- causing problems later in life. My personal belief is that it is the fragrance and other toxic ingredients in our household cleaning products, air fresheners, dishwasher powder etc that is contributing to the rise.
Here are some ways to help control the worst asthma, sinus and allergy triggers.
Dust Mites & Dust
Put your mattresses in airtight covers. Tape over the length of the zipper. Rubber mattresses are best as the mites cannot penetrate.
Put pillows in airtight covers. Tape over the length of the zipper. Or wash your pillows every week. Polyester filling is best for pillows and duvets – avoid feathers or down.
Wash all bedding every week in water that is at least 130 degrees F. Removing the bedspread at night may help if it is one that is not regularly washed.
Don't sleep or lie down on upholstered (stuffed) furniture. I had always found this particularly 'lethal' myself.
Remove carpeting in the bedroom, indeed the whole house if possible.
Clean up surface dust as often as possible. Use a damp mop or damp cloth when you clean rather than a feather duster that just distributes the dust throughout the room.
Don't use aerosols or spray cleaners if they can be avoided. Don't clean or vacuum the room when someone with asthma or allergies is present.
Children's stuffed toys are rich environments for dust mite populations. Limit the number of toys and clean them regularly - freezing them every couple of weeks keeps the mite populations down.
Window coverings attract dust. Use window shades or curtains made of plastic or other washable material for easy cleaning.
Remove stuffed furniture and anything under the bed. Vacuum under the bed.
Closets need extra care. They should hold only needed clothing. Putting clothes in a plastic garment bag may help. (Do not use the plastic bag that covers dry cleaning).
Particularly clean on top of closets where dust collects. (Creepy fact of the week - most of that dust is our own dead skin!)
Dust mites like moisture and high humidity. Cutting down the humidity in your home can cut down the number of mites. A dehumidifier may help. Adequate ventilation is now considered to be extremely important.
Use a High Efficiency Particulate Arresting (HEPA) vacuum cleaner or one with a power head, which picks up three to six times as much dust as one without power brushes. A dirt-finder vacuum (which has a light that turns from red to green when the carpet is clean) is even better.
Cockroaches
Cockroaches are one of the most common and allergenic of indoor pests. Recent studies have found a strong association between the presence of cockroaches and increases in the severity of asthma symptoms in individuals who are sensitive to cockroach allergens.
These pests are common even in the cleanest of crowded urban areas and older dwellings. They are found in all types of neighborhoods.
The proteins found in cockroach saliva are particularly allergenic but the cockroach allergen also comes from dead roaches and roach droppings. It collects in house dust and may persist in the home for some months even after the cockroaches are eradicated.
It is thought that the reason some people are supposedly allergic to chocolate is by virtue of included cockroach protein. Apparently, when the dried cacao beans are gathered up, they are typically covered in cockroaches and some beasties and droppings come along for the ride. ‘Cockroach chocolate’!!!
Preventative strategies include: Limit the spread of food around the house and especially keep food out of bedrooms.
Keep food and garbage in closed containers. Never leave food out in the kitchen.
Mop the kitchen floor and wash countertops at least once a week.
Eliminate water sources that attract these pests, such as leaky faucets and drain pipes.
Plug up crevices around the house through which cockroaches can enter.
Use bait stations and other environmentally safe pesticides to reduce cockroach infestation.
Mouse urine and faeces could be an important cause of childhood asthma in inner cities, says an American team.
"Although cockroach allergen is the most important factor in terms of asthma severity, we have found that mouse allergen is much more important than dust mites or allergies to cats or dogs," says Robert Wood of Johns Hopkins University in Baltimore, US, who led the research.
The team took samples from the homes of over 600 asthmatic children in eight US cities. Traces of mouse urine or faeces were found in at least one room in 95 per cent of the homes. Tests showed nearly one in five of the children was allergic to the mouse traces and these children tended to have more severe asthma.
"We were surprised. This is not an allergen that has been looked at carefully," said Robert Wood.
Martyn Partridge of the British National Asthma Campaign agrees: "To date, we haven't thought that mice are a problem as a trigger for asthma."
Wood's team analysed dust samples from the homes of 608 children. The percentage of homes with mouse allergen in each of the eight cities varied from 74 per cent in Cleveland to 100 per cent in Baltimore.
Like cockroaches, mice are more common in inner cities and research suggests asthma is twice as common here. Woods thinks mouse allergen is unlikely to be a significant cause of asthma in suburban or rural areas.
He believes doctors should now start routinely testing asthmatic children for mouse allergy. A positive test would mean a mouse eradication programme could be implemented in the child's home.
Ideally, says Woods, general mouse eradication programmes should be carried out: "Most of our asthma patients lived in flats. Even if you keep your own area clean, mice will still get in from other homes."
Journal of Allergy and Clinical Immunology (vol 106, p1070)
Indoor Mold
When humidity is high, molds can be a problem in bathrooms, kitchens, and basements. Make sure these areas have good air circulation and are cleaned often. The basement in particular may need a dehumidifier. And remember, the water in the dehumidifier must be emptied and the container cleaned often to prevent forming mildew.
The smell of ‘damp’ can be a powerful trigger for an asthmatic.
Molds may form on foam pillows when you perspire. To prevent mold, put the pillow in an airtight cover and tape the cover shut. Wash the pillow every week, and make sure to change it every year.
Molds also form in house plants, so check them often. You may have to keep all plants outdoors.
Particulates
Stay indoors, close the windows and turn on the air-conditioning, or cover bedroom air vents with several layers of cheesecloth to lower the number of large-size allergen particles coming into the bedroom.
"Dirty Delhi air makes you breathless"
There is conclusive evidence that the polluted air in large cities like Delhi is responsible for over 40 per cent of the emergency hospital admissions of patients with breathing and heart problems.
A study conducted over a two-year period at the emergency room of the All-India Institute of Medical Sciences has shown that a distinct correlation exists between air pollution and emergency room admissions of asthma, bronchitis and heart patients.
Here is a newspaper article about the typical impact these substances can have.
"Particulates, microscopic bits of soot and dust, burrow deep in the lungs, swelling airways and constricting already narrow breathing passages. Ozone sets off similar attacks.
On days with average particulate pollution in 1999, Valley asthma deaths jumped 10 percent compared to clear days, according to an Arizona Department of Health Services study. Asthma attacks increased 9 percent.
On the worst pollution day that year, when particulates inched toward unsafe levels, asthma deaths jumped 40 percent and asthma attacks increased 36 percent."”
The Arizona Republic Feb. 28, 2001
Covering bedding cuts kids' need for asthma drugs
Encasing mattresses and pillows in special covers may help asthmatic children cut down on their use of powerful anti-inflammatory drugs, new study findings from Denmark suggest.
After 1 year, about 73% of youngsters given the polyurethane covers cut their dose of inhaled steroids by at least half, compared with 24% of children given cotton covers, according to the report published in the January issue of the Journal of Allergy and Clinical Immunology.
Such polyurethane covers have long been recommended as a way to cut down dust-mite allergen, the most common cause of allergic asthma, although how effective they are has been unclear. The proteins associated with dust mites, the ubiquitous microscopic creatures that live in and on many household surfaces, can collect in pillows and mattresses.
In the current study, Dr. Susanne Halken of the Sonderborg Hospital and colleagues had 26 asthmatic children aged 5 to 15 use pillows and mattresses completely encased in semi-permeable polyurethane. A second group of 21 children were given mattress and pillow covers made of good quality cotton.
All of the children has asthma, were allergic to dust mites and had never used such covers before. Youngsters allergic to cats or pollen were excluded from the study.
Before and during the study, the researchers tapered the children's inhaled steroids to the lowest effective dose. Corticosteroids are medications used to treat inflammatory conditions such as asthma and chronic lung disease. They are usually used in combination with bronchodilators, which are drugs that widen the airways and make it easier to breathe.
"We found a significant effect of the coated polyurethane mattress and pillow encasings on the need for inhaled steroids," the researchers report.
They found that the dose of inhaled steroids was cut by about 50% in those children without causing their symptoms to get worse or requiring an increase in other medications.
Asthma is the most common chronic disease in children, and for reasons that are unknown, the number of asthma cases has been on the rise in the US and other developed countries.
Journal of Allergy and Clinical Immunology 2003;111:169-176
Occupational Asthma
Occupational asthma is a respiratory disorder directly related to inhaling fumes, gases, vapors or dust while "on the job." Due to this exposure, asthma may develop for the first time in a previously healthy worker, or pre-existing asthma may be aggravated.
Occupational asthma has become the most prevalent work-related lung disease in developed countries.
Causes
Occupational asthma may be caused by direct irritants, allergic triggers or pharmacologic factors. Irritants that provoke occupational asthma include exposure to hydrochloric acid, sulfur dioxide or ammonia found in the petroleum or chemical industries. These asthmatic episodes frequently occur immediately after exposure to the substance, and allergic sensitization is not involved. Workers who already have asthma or some other respiratory disorder are particularly affected by this type of exposure.
Allergic factors play a role in many cases of occupational asthma. This type of asthma frequently requires long term exposure to a work-related substance before allergic sensitization occurs.
Examples of this allergic-type of occupational asthma include exposure to the enzymes of the bacteria bacillus subtilis in the washing powder industry, and exposure to castor beans, green coffee beans and papain in the food processing industry. Other allergic forms of occupational asthma can occur in workers in the plastic,. rubber or resin industries following exposure to small chemical molecules in the air.
Furthermore, veterinarians, fishermen and animal handlers in laboratories can develop allergic reactions to animal proteins. Health care workers can develop asthma from aerosolized proteins from latex gloves or from the mixing of powdered medications.
Pharmacologic factors include the inhalation of dust or liquid. These substances do not lead to allergic sensitization, but instead directly lead to the release of naturally occurring substances such as histamine within the lung, which then in turn lead to asthma.
Prevention
Once the cause is identified, exposure levels should be reduced (a worker could be moved to another job within the plant, for example).
Work areas should be closely monitored so that exposure to asthma-causing substances is kept at the lowest possible levels.
Common Agents That Cause Occupational Asthma - Agent Workers At Risk
Acylate
Adhesives handlers
Amines
Anhydrides
Animal-derived allergens
Animal handlers
Bakers, millers
Cabinetmakers
Carpenters
Carpet makers
Cereals
Chloramine-T
Detergent users, pharmaceutical
workers, bakers
Drugs
Dyes
Electronics workers
Enzymes
Epoxy resins
Fluxes
Forest workers
Formaldehyde
Glutaradehyde
Gums
Hairdressers
Health professionals
Hospital staff
Insulation installers
Isocyanates
Janitors, cleaning staff
Latex
Manufacturers of plastics, rubber & foam
Metals
Persulfate
Pharmaceutical workers
Refiners
Seafood
Seafood processors
Shellac and lacquer handlers
Solderers
Spray painters
Textile workers
Users of plastics
Wood dusts
Indoor plastics linked to respiratory problems in kids
Inexpensive, easy-to-clean plastic materials used to cover walls and floors may put young children at increased risk of developing respiratory tract problems, results of a recent study suggest.
Researchers found that children who lived in homes in which the walls were covered with plastic materials were more likely to suffer from problems of the lower respiratory tract such as persistent wheezing, a prolonged cough and phlegm.
These children were also more likely to be diagnosed with asthma or pneumonia, the report indicates. However, the study could not conclusively prove that the wall coverings were the cause of the respiratory ailments. It is possible that parents installed such coverings because the children had respiratory problems.
"Emissions from plastic materials indoors may have adverse effects on the lower respiratory tracts of small children," write Dr. Jouni Jaakkola and colleagues in the May issue of the American Journal of Public Health, the Journal of the American Public Health Association. Such materials can emit chemicals, such as plasticizer agents used in the production of polyvinyl chloride.
"These chemicals may cause airway inflammation and thus increase the risk of bronchial obstruction, asthma, and perhaps susceptibility to respiratory infections," the authors add.
Jaakkola, of the Nordic School of Public Health in Goteborg, and colleagues at the University of Helsinki, Sweden, and Oxford University in the UK surveyed the parents of more than 2,500 Finnish children aged 1 to 7 years. The investigators found that plastic wall materials were present in less than 3% of homes and that about 2% of all the children had asthma. The researchers did not actually measure the amounts of chemicals in the homes of the children.
"Given the vast number of chemicals present in plastics and other building materials, it is not feasible to measure all of the relevant compounds in indoor air," Jaakkola's team notes.
Their findings "provide additional evidence that indoor plastic materials may emit chemicals that have adverse effects on the lower respiratory tracts of small children," according to the report. The results "warrant further attention to the types of plastic materials used in interior decoration.
American Journal of Public Health 2000;90:797-799.
Swiffer cloths pick up dust, dust mites, pet dander, and other particulates commonly found in the home very effectively. A study showed that they reduced 97% of cat and dog allergens.
There are now online stores that specifically support asthma, sinus and allergy sufferers. For further reading and to obtain products that can help in the home environment such as HEPA air purifiers, HEPA vacuum cleaners, dust mite encasings, hypoallergenic bedding and dehumidifiers, visit Allergy Resources International which has listings for every country.
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