Asthma affects more than 22 million children and adults in the United States. It is the most common chronic childhood disease and the cause of frequent hospitalizations for US children.¹

The Centers for Disease Control and Prevention estimate that each year in the United States, asthma is responsible for approximately:

• 2 million emergency department visits
• 500,000 hospitalizations
• 4000 deaths²

Although people of all races can develop asthma, it affects more African Americans than whites. It occurs most often in male children until puberty, but by late adolescence boys tend to have fewer symptoms than girls. After puberty, more girls than boys have asthma, and in people age 40 or more, asthma is most often diagnosed in women.¹

Asthma and Its Symptoms

During an episode of asthma, muscles in the airways tighten—a process known as bronchospasm. The airways also become irritated and inflamed.

Symptoms include:

• Wheezing
• Tightness in the chest
• Coughing
• Shortness of breath

In some people, asthma symptoms are more pronounced early in the morning or at night.

Asthma Types

• Exercise-induced asthma is caused by physical activity, and is sometimes worse in cold weather. It can be overlooked in people who do not have symptoms except when they exercise or engage in vigorous physical activity. For this reason, it is important to tell your doctor if you wheeze, cough, feel short of breath, or experience tightness in your chest when you are active
• Allergic asthma is caused by allergens, including pollen, cigarette smoke, pet dander, dust, and mold. People with this type of asthma generally have allergies or a family history of hay fever, allergic skin conditions such as eczema, allergic rhinitis, or other problems
• Seasonal asthma is caused by pollen from flowers and trees, grass, and other plants
• Nonallergic asthma is not caused by allergens; however, it can worsen with exposure to irritants such as tobacco or wood smoke; hair, deodorant, perfume, or room sprays; odors or fumes from paint, cleaning products, certain foods, and air pollution; sinus and respiratory infections such as the cold or flu; cold air and sudden temperature changes; heartburn; and exercise
• Nocturnal asthma can affect people with all types of asthma. The symptoms typically occur between 2 AM and 4 AM often as a result of a sinus infection, cold, flu, or allergens that activate the mucous membranes and cause postnasal drip. Some researchers believe that certain substances in the body such as adrenaline and corticosteroids that protect against asthma reach their lowest levels between midnight and 4 AM, prompting asthma symptoms
• Occupational asthma is caused by irritants such as fumes, chemicals, and other substances that people encounter at work¹

Asthma Triggers

Although genetic factors can determine a person’s chances of developing asthma, environmental factors also have a significant role. For example, air pollution, first- and second-hand smoke, and environmental allergens are believed to contribute to the increasing numbers of people who experience asthma symptoms.¹

Asthma triggers include but are not limited to:¹

• Exercise and vigorous physical activity
• First- and second-hand tobacco smoke
• Dust mites
• Pets
• Cockroaches
• Mold (indoor and outdoor)
• Smoke
• Strong odors
• Sprays (hairspray, perfume, bug spray, aerosol deodorants)
• Pollen
• Colds
• Infections
• Changes in weather
• Certain foods or food additives such as sulfites found in beer, wine, shrimp, dried fruit, processed potatoes, and processed meats
• Certain over-the-counter and prescribed medications, including aspirin, cold medicines, ibuprofen, and eye drops

Treatment

In addition to improving the quality of life for asthma sufferers, treatment can help prevent long-term damage to the lungs. Many patients with asthma experience relief with the use of an oral inhaler such as albuterol. An inhaler works by quickly delivering medication to the airways and opening them within the lungs, which makes it easier for the asthma sufferer to breathe. Because it can be used to relieve sudden asthma symptoms, inhaler medication is often referred to as rescue medicine.

Inhalers can be used in patients who:

• Experience daytime symptoms more than twice weekly
• Have nighttime symptoms that wake them more than twice a month
• Visit urgent care or emergency departments as a result of asthma symptoms
• Are hospitalized for asthma-related symptoms
• Need oral steroids such as prednisone to relieve their symptoms

Although there is no cure for asthma, there are effective treatments that can help you manage the condition and maintain an active, normal life. If you are experiencing asthma symptoms, see your Summit Medical Group allergist and immunologist or your Summit Medical Group pulmonologist. He or she can identify the type of asthma you have and develop a treatment plan to help control your symptoms.

References

1. National Heart Lung and Blood Institute Diseases and Conditions Index.

www. nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html. Accessed October 7, 2009.

2. Centers for Disease Control and Prevention. FastStats Homepage. Asthma.

www.cdc.gov/nchs/fastats/asthma.htm. Accessed October 6, 2009.