Bronchial asthma is the most common chronic disease of childhood. Worldwide, three hundred million people have it, and in the United States there are 16 million adults and 7 million children with the condition. Every country in the world has people with bronchial asthma. No one knows the cause of the disease, and there is no available cure. Medication and lifestyle change, however, enable these patients to have productive and enjoyable lives.
There seems to be a genetic predisposition to asthma. More than 80 percent of deaths from the disease occur in low and lower-middle income countries. It is, without doubt, a life threatening medical condition, and severe exacerbations of asthma require prompt hospital treatment and aggressive clinical management. In the United States, students miss more than 14 million school days per year because of bronchial asthma.
Health disparities
Asthma disproportionately affects African-Americans who have higher rates of occurrence, hospitalization, and death from it than Caucasians. There is also a gender health disparity as young boys are more likely to have asthma than are young girls, but the occurrence rates tend to equalize as children become older. Obese children are at risk for the condition as well.
When someone has an asthma attack, there is swelling of the lining of bronchial tubes, and this narrows the airways and accounts for chest tightness and wheezing. These attacks will occur if something irritates the patient’s respiratory system, and people with asthma will vary as to what will irritate their airways and precipitate an attack. Hence, each person who has the disease must learn to avoid the things that will trigger it.
Asthma triggers
The most common trigger for an asthma attack is viral respiratory infection. Exposure to house dust mites in carpets, bedding, and stuffed furniture may also trigger it. Secondhand smoke is another respiratory irritant, and family members and friends should not smoke in the home where these patients live. Cockroaches and their droppings are well known irritants, and families should make an effort to remove them from the home.
Patients should follow air quality forecasts because automobile exhaust and industrial emissions can irritate their breathing. Furry pets or animal dander can trigger an attack, and parents should keep the pet out the child’s bedroom and vacuum and damp mop the house regularly. Another approach is to find a new home for the pet.
Mold is another possible trigger, and one should keep the humidity in the house between 35 and 50 percent. In hot or humid climates, this may necessitate an air conditioner or dehumidifier or both. Water leaks will enable mold to grow under floors and behind walls, and they require repair to prevent that.
Inhalation of chemicals, particularly in the workplace, will irritate the respiratory system. Bad weather and cold, dry air may also trigger attacks. Smoke from burning wood, grass, or other vegetation may pose a problem for these patients as well. Certain medications such as aspirin and other nonsteroidal anti-inflammatory agents and beta blockers can precipitate an asthma attack. Beta blockers are useful for the treatment of heart disease, migraine, and other medical conditions.
Nasal and sinus allergies, emotional stress, certain foods and food additives such as sulfite, and strenuous exercise can cause an asthma attack. Patients with gastroesophageal reflux disease may encounter problems with their asthma too. Finally, perfume, paint, and gasoline fumes may be irritants for these patients.
There are many resources available for anyone who would like to learn about bronchial asthma.
References
American College of Allergy, Asthma, and Immunology. (2010). Asthma resources. Retrieved January 19, 2011.
Centers for Disease Control. (2010). Asthma—Basic Information. Retrieved January 19, 2011.
Michael Koger - Dr. Koger obtained his medical education at Meharry Medical College and specialized in Internal Medicine.
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