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Commentary: Eliminating Asthma Triggers—How Far is Too Far?

Commentary
6/27/2019 Emily J. Pennington, MD, Wake Forest School of Medicine;

Asthma is already one of the most common chronic diseases in children, and it’s becoming more prevalent in the United States. Given this increase, people are doing everything they can to decrease the risk of asthma for their families.

Asthma is a condition in which the airways of the lungs narrow in response to certain triggers, causing coughing, wheezing, chest tightness and shortness of breath. Common asthma triggers include   

  • Inhaled allergens (such as dust mites, animal dander, particles from feathers, and pollen)
  • Respiratory tract infections
  • Irritants (such as cigarette smoke, perfume, or air pollution)
  • Exercise
  • Stress and anxiety
  • Aspirin

There are a few theories as to why asthma develops. One theory is the hygiene hypothesis. This idea proposes that childhood exposure to germs and viral infections help the immune system develop. It teaches our immune system the difference between a harmful and harmless substance and tells our immune system not to overreact. But, this hypothesis cannot fully explain why children develop asthma. We know that exposure to certain infections, like respiratory syncytial virus (RSV), may make children more likely to develop asthma rather than prevent it. There is also evidence that the severity of infection and when the infection occurs during childhood affects the development of asthma.   

Take a real-world approach

So how can parents reduce asthma triggers from the home without overdoing it and creating an environment that’s too clean?

The answer, as with so many things, is moderation and adjusting to the specific situation.

If someone in your household has asthma that is triggered by environmental allergens, there are some basic things you can take to manage the environment around you. Take steps like changing air filters frequently, checking your house for water leaks or mold, and dusting regularly. If you have carpet in your house, vacuum your house on a regular basis to remove pet dander and dust mites.  

Target the Right Triggers

You don’t necessarily have to give away the family pets, tear out all your carpets, and throw away your pillows and drapes. You can be much more deliberate about identifying and removing the specific triggers.

Many patients often have an idea of what’s causing their asthma—they experience symptoms when they exercise, with seasonal allergies, around house pets, etc. But if not, a good way to identify potential asthma triggers is to keep an asthma diary. Jotting down exactly when and where you experience symptoms can reveal less obvious causes such as stress or medications like aspirin, or specific triggers in the house such as pets or contents of a certain room.

Your family doctor or lung specialist will use this diary and breathing test results to help recognize your triggers. If something clearly is a trigger, you really should make every effort to eliminate it from your house. But if something does not seem to be a trigger, particularly a cherished pet or stuffed toy, you don’t have to get rid of it.

If asthma attacks still occur frequently after removing known triggers, it’s time to talk to your doctor about what else may be triggering symptoms. Sometimes these triggers are out of a person’s control, including pollen, heavy rain, thunderstorms, or extreme temperatures. While you can’t control the weather, you can close the windows, limit outdoor time when pollen counts are high, or cover your nose and mouth in cold weather. Stress and anxiety can also be a contributing factor to asthma, and doctors can help to develop a stress-reduction strategy. In other cases, allergy shots can help curb reactions to asthma triggers. It’s important to make sure you’re talking to your doctor about all potential triggers and treatments for asthma.

To learn more about minimizing asthma triggers and preparing for a conversation about asthma with your doctor, check out the Manuals page on asthma and the Manuals Quick Facts on asthma. For more on asthma in children, visit the Manuals page and the Quick Facts page

Emily J Pennington, MD