Avoiding asthma triggers

Asthma symptoms can be triggered by a broad range of things in the air that we breathe. Allergy triggers include dust mites, pollen, animal dander and mould. Non-allergy triggers include smoke, exercise, cold air and viruses. Other triggers include stress, hormonal changes, and some medications.

Unfortunately, it is very difficult to completely avoid triggers in our everyday lives. However, you can take some precautions to reduce exposure to some substances that may trigger your asthma.

Tip for asthma carers

If you live with or take care of someone with asthma, there are some actions you may take to improve the home environment and avoid possible asthma triggers. Many asthma patients react to multiple factors that are everywhere in the environment, and it is almost impossible (and not necessary) to try to avoid them completely. Nevertheless, some small actions may help the person you are caring for to live a better life.

Lifestyle hacks reduce exposure to asthma triggers

Quit smoking and vaping to breathe better

Each cigarette you smoke or vape may worsen asthma symptoms because cigarette smoke irritates the lungs. Smoking also greatly increases the risk of developing COPD such as emphysema, and lung cancer. Quitting smoking and vaping can reduce the risk of severe asthma attacks and improve the overall health of asthma patients. Patients should also avoid exposure to environmental tobacco and vaping smoke because it irritates the airways. Quitting smoking may be a difficult process, it may take many attempts before you successfully quit! Start by taking notes in your asthma journal about how many cigarettes you smoke daily and in what circumstances you feel the urge to smoke. This may give you a picture of your habit and what type of quitting strategy may be best for you.

Second-hand smoking is a source of indoor pollution that sensitises the lungs. Smoking should never be allowed at home or in the car!

Quit smoking

  • Ask your healthcare provider how you can get support to quit smoking and vaping.
  • Many national healthcare systems offer support programmes and other resources free of charge to help people stop smoking and vaping.
  • Check the websites of patients’ associations to see if they offer peer support programmes to quit smoking.
  • Check EFA’s Members associations for more resources.

Inform your healthcare provider before taking new medicines

Always inform healthcare providers about your asthma before taking a new medication. If your symptoms worsen while taking a concomitant drug, immediately inform your doctor.

Take notes between asthma consultations

  • Write in your daily asthma journal when you start and stop taking a new medicine.
  • Report any signs or symptoms to your healthcare providers.

Eat healthy

Unless you have been diagnosed with an allergy or food chemical sensitivity, it is not necessary to avoid any specific food. But remember that a healthy diet is good for your general health and helps to prevent obesity which may worsen your asthma.

Healthy diet

  • Try to eat a healthy diet containing vegetables and fresh fruits as this will improve your general health. Avoid ultra-transformed foods for general health reasons, and because they are likely to contain additives, flavours, and substances that may trigger your asthma and that you are not aware of.
  • If you have a food allergy, avoid the foods you are allergic to, have an anaphylaxis plan and always keep your epinephrine (adrenaline) pen with you .

Exercise your lungs

Breathing exercises do not reduce risk of severe asthma attacks or have consistent effects on lung function, but they may help you tone down your symptoms and improve your quality of life.

Listen to your breath

  • Find a moment of the day to dedicate to breathing and relaxation exercises .
  • Sing along! Programmed singing as part of pulmonary rehabilitation can improve pulmonary symptoms and has a positive impact on psychosocial wellbeing.

Be active!

Regular physical activity, 30 minutes a day for at least five days per week, will improve your general health. If your healthcare provider prescribed it, you should take your reliever (SABA or ICS-formoterol) before exercising!

Safe exercising

  • Warm-up before exercising, and use your reliever (SABA or ICS-formoterol) if it you have been prescribed to do so.
  • Use a step counter or a smartwatch to track physical activity.
  • Taking a long walk every day is good exercise .

Avoid stress

Emotional stress may lead to severe asthma attacks in children and adults. Hyperventilation associated with excessive laughing, crying, anger or fear can cause airway narrowing, increasing asthma symptoms. This usually means you need a review of your asthma treatment and inhaler technique, to improve your asthma control.

Try to relax

  • Take some time to think about what causes you to feel stressed.
  • Once you know what’s causing your stress, consider how you can eliminate or reduce it.
  • Try to clear your space, clear your mind, and relax.

Healthy environment at home for asthma

Clean it up!

A clean home can reduce the irritants and allergens you are exposed to. Allergen avoidance strategies may be beneficial for individuals with allergies, but they may be complicated, and the burden may outweigh the benefits. Nevertheless, simple strategies can sometimes reduce irritants and allergens without too much effort.

Take care of your home environment

  • Air your home daily.
  • Clean your home regularly.
  • When using cleaning sprays, make sure the room is well ventilated.
  • If you are allergic to house dust mites, encasing your bedding in impermeable covers may reduce exposure to dust mites but won’t necessarily help your asthma.
  • Make sure the room is well ventilated when you are vacuuming.
  • Clean curtains and cushions and other textiles as they tend to accumulate dust and small particles
  • If you are allergic to house dust mite, replacing carpets with hard flooring may reduce your exposure, but this may not be feasible; it is often costly and it may not improve asthma control.
  • Try to minimise pet dander, especially if there are children in the house.
  • If dirt and dust irritate your lungs, wear a face mask to protect your airways when cleaning.
  • Remember to change the filters of air conditioners regularly to reduce the amount of airborne pollen you might inhale during sleep.
  • Use vacuum cleaners with an integral HEPA filter and double thickness bags.
  • Get rid of pests with baits.

Avoid moisture!

Humidity in homes can contribute to the growth of mould, fungi and other micro-organisms. It also creates a favourable environment for allergens such as cockroaches and dust mites.

Prevent moisture

  • Ventilate rooms to reduce the chances of humidity leading to mould
  • If you cannot ventilate the room, equip it with an extractor
  • Fix any leaks in the roof, walls, or plumbing so that mould does not have humidity to grow
  • Remove or replace carpets and furniture that cannot be dried properly or that are in places that may have a lot of moisture (like bathrooms or basements)
  • Use bath extractors during showering, to prevent moisture
  • If mould is growing in the home, you must clean it up and fix the moisture problem. Mould can be removed from hard surfaces with household products, soap and water, or a bleach solution (one cup of household laundry bleach in 3.75 litres of water).
  • If using bleach solution or household sprays, be extremely careful to do this only in a well ventilated area, as inhaling the fumes can cause damage to your airways and lungs.

Use eco-friendly heating

Wood and coal burning should not be used to heat the home. Non-polluting, more effective heating sources (heat pump, wood pellet burner, flued gas) are recommended.

Indoor heating

  • Look for non-polluting heating sources that can be effective and eco-friendly.
  • Don’t forget to ventilate the rooms every few hours.

Cook without fumes

Gas stoves produce high levels of indoor nitrogen dioxide that may trigger asthma. If it is not possible to replace them with electric stoves, extraction hoods may be beneficial

Cooking with asthma

  • Ensure that cooking fumes are collected and filtered by the device or vented outdoors.
  • If the kitchen doesn’t have a window use an extractor.

Air pollution and asthma

Air pollution is everywhere and people with respiratory diseases are particularly reactive to air quality . The burden of disease due to air pollution is estimated to be the same as that of tobacco, and air pollution is now recognised to be the single biggest environmental threat to human health.

The only way to significantly reduce air pollution is through national or local policy changes, nevertheless being aware of pollutants may empower you to take care of your asthma.

If you have asthma, some outdoor air pollutants may worsen your symptoms or trigger an asthma attack. In particular:

  • Ozone: Ozone is one of the most common air pollutants. It is a component of smog and is very frequent in urban areas, in proximity to main roads and when the winds are low.
  • Nitrogen dioxide: A brown toxic airborne gas. It can be found on busy roads, and it is particularly emitted by old cars, around industrial and building sites and where fossil fuels are burned.
  • Acidic aerosol: A substance made of acidic particles that is common in summer smog and in proximity to industrial sites and main roads.
  • Particulate matter: Small particles, such as dust, dirt, soot, smoke or drops of liquid in the air that can pass through your nose or mouth, enter your lungs and make asthma worse. These particles can be found close to manufacturing industrial and building sites, in wildfire smoke and in proximity to main roads.

If your asthma is well-controlled, there is no need to change your lifestyle, but if pollutants in the air are very high or if you feel that your asthma is getting worse you can take some measures to limit your exposure to unfavourable environmental conditions:

  • Look for air quality bulletins on the internet, radio and television
  • Plan your outdoor activities when air pollution levels are low
  • If air quality is poor, choose lighter outdoor activities (like walking instead of running) to limit the amount of air you breathe in
  • If the air quality is very poor, and your asthma is worsening, e.g., you have had a recent attack, prefer indoor activities

References

  1. WHO global air quality guidelines: Particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide [Internet]. Geneva: World Health Organization; 2021. PMID: 34662007.
  2. https://www.cdc.gov/air/pollutants.htm

Healthy asthma environment outdoors

Avoid outdoor asthma triggers

Pollens, moulds and air pollutants (e.g., ozone, nitrogen oxides, acidic aerosols) can worsen your symptoms and increase your risk of severe asthma attacks. There is no need to change your lifestyle to avoid them, but it may be helpful to check the air quality in your area to identify unfavourable environmental conditions. If you are allergic to pollen, check local resources to see when pollen levels are high in your area.

Watch out for asthma triggers

  • When mould or pollution (or pollen counts, if you are allergic to pollen) is high or air quality is poor, try to avoid strenuous outdoor physical activity.
  • Keep windows closed during very cold weather, in case of low humidity or high air pollution.
  • Check the air quality bulletin in your area to identify unfavourable environmental conditions.
  • If possible, try to avoid exercising in peak traffic hours and industrial production times .

Prevent viral infections

Viral infections can affect your lungs. They can trigger asthma symptoms or asthma attacks. At the first sign of viral infection, follow the steps of your action plan and talk to your healthcare provider if you feel unwell or if your symptoms worsen.

Protect yourself

  • Get a flu vaccination every year, or at least when vaccination of the general population is advised .
  • Wear a face mask to protect yourself in the flu season.
  • Try to stay away from crowded indoor environments during viral infections.

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