Are You Worried About Environmental Asthma Triggers?

If You're Not Observant You May Not Notice Poor Asthma Control

Is the Environment Impacting Your Asthma?.

A number of parents tell me that they were slow to identify environmental asthma triggers compared to other triggers that may worsen their kids' asthma.

This was certainly the case for Tonya Winders, president and CEO of Allergy & Asthma Network. She told me that she was “slow on the uptake” related to environmental asthma triggers as compared to other asthma and allergy triggers. The mom of 5 kids, 4 with allergies and two with concomitant asthma, describes a scenario that is not that uncommon from what I see in my clinical practice.

Her older kids had seasonal allergies, early childhood wheeze, and some component of atopic dermatitis, but she and her pediatrician were reluctant to label or diagnose her children.

While her 3rd child had more respiratory symptoms than her other kids, it was not until her fourth child that she really took serious notice. Her child had year round allergies and several episodes of recurrent wheeze, but then one day she was forced to “face the music” of her families allergy and asthma problem. She said that they had not really paid attention to environmental concerns because they had never seen it as a problem.

The family went to a friends house that had cats, but they had been put away and her daughter had never had problems in the past. Her daughter complained of some minor allergy symptoms that later in the night got much worse. Eventually, her daughter ended up in the emergency room with a full blown asthma attack.

She forever became more diligent and no longer overlooks environmental asthma control as an integral part of her kids' asthma action plan.

Advocates For Allergy Testing

Tonya now believes environmental allergy testing should be preformed on patients with asthma when clinically indicated. The Allergy & Asthma Network encourages allergy testing and states on their webpage that the network:

Supports the role of physicians in the diagnosis and treatment of allergies and asthma, including the use of blood tests to identify potential triggers. Skin prick testing, however, requires specialized training to administer and interpret the tests and determine appropriate treatment.

When indicated, Winder believes in vitro specific IgE or skin prick testing to be most appropriate. Additionally, the network specifically warns against some dubious allergy testing and therapy practices that parents should watch out for. The network recommends that allergy testing and treatment be done in conjunction with a board certified allergist.

You Can’t Live In A Bubble

Winder also points out that letting asthma and allergies limit your kids is bad for their development and stated that “you can’t live in a bubble.”

She recommends several environmental strategies designed to limit exposure while not limiting your life. Strategies will depend on the particular allergen and the time of year. For someone with pollen and grass triggers she recommends that you try to create a “safe sleep zone.”

This could include specific strategies such as watching pollen counts and limiting time outdoors during bad pollen times, but not eliminating outdoors altogether. Additionally, showering before going to bed can help create a safe sleep zone by trying to keep the area we spend the greatest amount of time in free of triggers.

If dust mites cause problems for your asthma, removing books from the bedroom is one strategy Winder finds helpful to cut down on dust. If your child is a stuffed animal lover, limiting the number and then washing or freezing weekly are strategies that can decrease trigger exposure.

Trigger control is an essential part of your asthma action plan.

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  1. Interview with Tonya Winders, president and CEO of Allergy & Asthma Network Mothers of Asthmatics. March 2015
  2. National Heart, Lung, and Blood Institute. Accessed. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma Accessed on March 28, 2015.

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