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[Oct. 9,
2003]
Q.
What, if any are acceptable levels of mold on asthmatics ?
A.
There is NO acceptable level of indoor mold infestation
for an asthmatic or other persons with other serious
respiratory health problems or depressed immune systems.
The problem with living or working in a mold infested
place is that the cumulative effect of breathing in
airborne mold spores minute after minute results in a
large cumulative mold exposure dosage that is especially
dangerous to persons with asthma or other serious health
problems. Your first step is to mold test the air of where
you live or work to determine what molds and in what
concentrations these molds are in, especially in
comparison to an outdoor mold control test. You should
visit the mold health sections of
Mold Types and
Toxic Mold Advice as well as our mold test
kit section of
Mold Mart.
What is asthma?
Asthma is a condition that affects the airways – the
small tubes that carry air in and out of the lungs. People
with asthma have airways that are almost always red and
sensitive (inflamed). Their airways can react badly when
they have a cold or other viral infection, or when they
come into contact with an asthma trigger (something that
sets off their symptoms). When this happens the muscles
around the walls of the airways tighten and they become
narrower. The lining of the airways swell and often
produce a sticky mucus. As the airways narrow, the air has
to squeeze in and out, and this is what causes the person
with asthma to find it difficult to breathe. Asthma
symptoms can include coughing, wheezing, shortness of
breath or a tight feeling in the chest.
Asthma affects more than 5.1 million people in the UK,
including one in eight school children and one in 13
adults. With the correct treatment, support and advice,
most people with asthma can lead full and active lives.
Top
What are the things that can set off (or trigger)
asthma symptoms?
A trigger is anything that irritates the airways and
sets off the symptoms of asthma. Common triggers include
colds or 'flu, cigarette smoke, exercise and allergies to
things like pollen, furry or feathery animals or
house-dust mite. Everyone's asthma is different and you
will probably have several triggers.
Top
What causes asthma?
Asthma, like its related allergic conditions eczema and
hay fever, often runs in the family and may be inherited.
There are probably a number of other, environmental,
factors that contribute to someone developing asthma –
many aspects of modern lifestyles, such as housing and
diet, might be responsible. We also know that smoking
during pregnancy increases the chance of a child
developing asthma. There is currently no evidence that
traffic pollution causes asthma, although poor air quality
can make your asthma worse.
Top
How can I tell if I have asthma?
There is no hard and fast way of telling if you have
asthma or not. This is partly because the symptoms can
vary and may be similar to other respiratory conditions
that are not asthma. Asthma symptoms include shortness of
breath, wheezing (a whistling noise in the chest), cough
and chest tightness. Not everybody will have all these
symptoms. A history of asthma, eczema or hay fever in the
family may mean that your chances of developing asthma are
slightly higher than those without.
If you suspect that you may have asthma, it is
important to see your doctor. Your doctor will discuss
your medical history and your current symptoms. S/he may
want to measure your peak flow using a peak flow meter. A
peak flow meter is a small hand-held device with a marker
that slides up and down as you blow into it. The marker
stops at the point when you blow hardest. Each time you
use the meter (usually morning and evening) the result is
marked on a chart. It can help along with keeping a record
of your symptoms to give the doctor a better picture of
how well controlled your asthma is. The doctor may decide
to give you your own peak flow meter on prescription and
ask you to keep a diary of readings before seeing him or
her again.
Top
Is there a cure for asthma?
Unfortunately, there isn't. However, a lot of extremely
important asthma research is being carried out at the
moment – much of it funded by the National Asthma
Campaign. Researchers are tackling asthma from many
directions: indoor and outdoor pollution, allergies, gene
therapy, cell biology and chemical structures to name but
a few. The results of their work will help us understand
much more about how and why this common condition
develops. It might also lead to even more effective asthma
treatments – and an even better quality of life for
everyone who has asthma.
Current research is suggesting that taking certain
preventative measures in the home can lessen your chances
of developing asthma, or reduce your symptoms. These steps
include reducing the amount of dust in your home and can
be achieved using simple measures like damp dusting and
opening windows.
Top
How is asthma treated?
Medication can come in the form of inhalers and
tablets, although currently inhalers are more common. An
inhaler ensures that very small amounts of medication are
delivered directly into the lungs. There are a variety of
inhalers available. It is important that you use a device
that you are comfortable with and can use properly. Your
doctor or nurse will advise you on the most appropriate
device and should demonstrate how to use it correctly.
There are two main types of asthma medication –
relievers and preventers.
• Reliever inhalers are usually blue. They act by opening
up the airways causing the muscles to relax and therefore
allowing you to breathe more easily. The reliever should
only be used when the symptoms of asthma appear or, if
recommended, before exercise. They do not reduce the
inflammation in the airways. If you need to use your
reliever more than once a day or 3-4 times per week this
suggests that there is a degree of inflammation in your
airways that requires preventer treatment.
• Preventers usually come in brown, red or orange
inhalers. They work over a period of time to calm
inflammation in the airways and make them less likely to
react badly when you come across an asthma trigger. They
need to be taken regularly. Most preventers are inhaled
corticosteroids. It is important to understand that
corticosteroids are not the same as anabolic steroids used
by athletes to improve their performance.
There are other types of medication that can be added
to your reliever and preventer treatment if needed, such
as preventer tablets and long-acting relievers.
Top
How can I avoid so many visits to the doctor?
Besides taking your preventer medicine regularly, you
can help yourself by getting to know the things that
trigger (or set off) your asthma and avoiding them where
possible. Don't ignore your symptoms, by taking action
fast you can stop your asthma deteriorating.
The National Asthma Campaign's
Be in
control scheme will help you to take control of your
asthma by working with your doctor, ask about the scheme
next time you have a review, or find out more on this
website.
Top
What do I do if I have an attack?
• Take your reliever inhaler immediately
• If the reliever has no effect after five to ten
minutes, call your doctor or an ambulance
• Continue to take reliever medication every few minutes
until help arrives.
Top
Are steroids safe for me to take?
Many people with asthma use a preventer that contains a
low dose of inhaled steroid. There are very few side
effects from inhaled steroids, especially if used with a
spacer. You may experience local side effects such as a
hoarse voice or sore throat. It is possible that at higher
doses of inhaled steroid (more than 1000mcg of budesonide
or beclomethasone) some steroid may be absorbed. This is
still a much smaller dose than from a steroid tablet.
Occasionally if asthma symptoms are severe your doctor may
prescribe a short course of steroid tablets. These should
not cause any long-term side effects.
However, if you have very severe asthma and need to
take steroid tablets for a long period of time there may
be some side effects such as thinning of the bones or
weight gain. It is important to discuss your concerns with
your doctor.
Top
Where is the best place to live?
There is no evidence that moving house will improve
your asthma symptoms. Many people associate asthma with
bad air quality and presume that somewhere with better air
quality will improve their asthma.
Pollution can be a trigger for some people but it is
only one of many things that can affect asthma. Even in
the least polluted parts of the UK, such as the far north
of Scotland, the percentage of people with asthma is about
the same as that elsewhere (including cities).
Nowhere in the UK has a significantly lower level of
asthma and, so, there is nowhere that is likely to be good
for all people with asthma. Asthma varies from one person
to another. A place that agrees with one person may not be
so good for another. Your own personal experience will
give you clues as to what triggers your asthma. Some
triggers will be found indoors, where we spend most of our
time. House-dust mite, for example, is a common trigger
which will be found wherever you live. Most people with
asthma have more than one trigger – it is possible that by
moving house you may be exchanging one trigger for
another. Sometimes people feel better in a new area for a
short while and then become sensitive to triggers they
find there. Except in a few circumstances, such as living
in damp housing, there seems little to be gained from
moving house.
Top
Will products like vacuum cleaners or air purifiers
make my asthma better?
No single product is likely to improve your symptoms on
its own. However, there are several simple measures that
you can take to reduce dust or improve the air quality in
your home and these might help to reduce your symptoms. In
fact, recent research funded by the National Asthma
Campaign is suggesting that by removing the common things
that set off asthma in the home, you may lessen the
chances of a child developing asthma.
You might like to try damp dusting, having fewer
carpets and soft furnishings (where house-dust mites like
to live), avoiding smoking in the house and keeping the
house well ventilated to reduce humidity. Special bedding
covers, which usually cover the whole mattress and protect
against house dust mites, have been shown to have some
benefit for people with asthma.
Regular vacuuming with an efficient vacuum cleaner that
has strong suction power and does not blow dust out of the
exhaust will help to reduce dust in your house. An
efficient vacuum cleaner does not need to be an expensive
one. There are some products, such as specialised vacuum
cleaners, that are advertised as being especially good for
people with asthma. These products may be efficient in
removing levels of dust mite allergen from the home. Good
ventilation is also essential for reducing humidity – and
therefore allergen levels – in the home. But that doesn't
mean you have to go out and buy an expensive air
conditioning unit. Simply keeping a window open should do
the trick.
Although air purifiers will help to filter out fine
dust particles and revitalise stale air, there is no clear
evidence to suggest they reduce asthma symptoms.
Top
Will having asthma stop me getting the job that I
want?
As long as your asthma is well controlled, you will be
able to apply for most jobs, in fact, legislation is in
place, in the Disability Discrimination Act (DDA), to
ensure that discrimination does not occur because of a
long-term health problem. However, a few jobs; in the
armed services, the fire brigade, the police, and the
prison service, are not covered by the DDA and do have
restrictions for people with asthma.
The army, police force, navy and prison service all
require applicants to be physically fit and will assess
your application on an individual basis. The fire and
ambulance services will not accept applications from
people with asthma as workers commonly come in to contact
with smoke and toxic fumes, which can commonly set off
asthma symptoms. You will not be able to join the air
force as a pilot if you have ever had asthma, although you
can work as part of the ground crew. You can find out more
from your local careers service, or from the organisation
concerned.
Some other jobs involve working closely with things
that set your asthma off, for example chemicals in
engineering, photocopier toner in the office, dust from
flour in a bakery. If you feel that your job is
aggravating your asthma it is important to discuss it with
your doctor or nurse. Further advice can be obtained from
your union (if you are a member of one), the health and
safety representative at work or the Health and Safety
Executive (your local office will be listed in the phone
book). You can find out more in our
Asthma
News article.
Top
Will smoking make my asthma worse?
Smoking can make your asthma worse. If you smoke you
will be increasing your chances of developing many health
problems and your asthma symptoms will be worse and harder
to control. You may also cause long-term damage to your
airways. Many people are also affected by breathing other
people's cigarette smoke (passive smoking). Smoking while
pregnant also increases the risk that your baby will have
asthma, and may cause other health problems.
Top
Can I still have pets even though I have asthma?
Unfortunately, animals are one of the things that
commonly set off, or trigger, asthma symptoms. In
particular many people with asthma will have their
symptoms set off by cats and dogs. There are minute
particles called allergens found in the animal's fur,
saliva and urine, which get into the air and are breathed
in. This does not affect most people, but people with
asthma have sensitive airways and breathing in allergens
can cause an increase in symptoms. You can become
sensitive to a pet even if you have had the pet for a long
period of time.
There are measures you can take to help. Firstly, if
you have a furry or feathery pet then keep the pet
outdoors wherever possible. It is especially important to
keep pets out of your bedroom. Always wash your hands
after handling the pet. Also find out whether your vet can
advise about products you could use to wash the animal
once a week, in order to reduce the amount of allergens
you are exposed to.
Top
Can I still play football with the lads?
As long as your asthma is well controlled you should be
able to take part in most exercise. Some forms of exercise
that people with asthma can find particularly beneficial
are yoga as it teaches proper breathing techniques and
swimming, where the damp atmosphere can be of benefit,
though chlorine can set some people's asthma symptoms off.
Team sports that allow you to have a rest can also be
good.
If you find that exercise makes your asthma worse,
warming up properly for a minimum of five minutes and
taking a couple of puffs of your reliever inhaler before
you begin will mean there's no reason why you can't join
in. If your symptoms continue, talk to your doctor or
practice nurse as this could be a sign that your
medication needs to be reviewed.
There are a few sports such as diving, parachuting and
mountaineering where restrictions may be imposed if you
have asthma. If your asthma is well controlled you should
be able to take part in these sports. Talk to your doctor
or asthma nurse beforehand. You can find out more in our
Fact Sheets,
Exercise and asthma and
Asthma and
Altitude.
Top
Where can I go to get more information?
If you have more questions or worries about your
asthma, you can phone the National Asthma Campaign's
Asthma Helpline and talk to our asthma nurses for the
cost of a local call (UK only). The Asthma Helpline: 0845
7 01 02 03 – advice that's right for you, Monday to Friday
9 am to 5pm.
You can also find out more about asthma by exploring
this website. Your local GP and pharmacist will also have
more information about asthma.
Parental Concerns About Asthma
Here
you'll find the answers to frequently asked questions, including the
risks associated with asthma during pregnancy and childhood, and the
possible link between high dosage steroids and learning disability.
Q. What happens if my child stops breathing? What are the odds
he/she will suffocate?
A. Any parent who has seen a child in this situation—gasping for
breath, the skin around his lips turning blue and purple, his face
pale and clammy—understands that sense of mounting panic. You may be
familiar with the asthma triggers involved and the course of action
required, but it's still hard to cope in this type of emergency.
Despite the alarming nature of an attack in children, always remind
yourself that, in the vast majority of cases, it is controllable and
manageable. Extreme cases require further medical attention but can be
reversed quickly under hospital supervision.
Q. Could the steroid medications my child has been prescribed
result in learning disabilities or psychiatric problems?
A. Although cognitive deficits have been recorded in rare cases
when high doses of dexamethasone and prednisone have been
administered, in the vast majority of cases of low oral steroid
intake, no symptoms of learning disability have been reported.
According to the Allergy Asthma Immunology Report (1999;
83:495-504), any symptoms that do exist are largely dose dependent and
in extreme cases can include "mania, depression, mood liability, and
psychosis."
Q. Does childhood asthma persist into adulthood?
A. Despite the high diagnosis rate during childhood, research
indicates that most cases do not persist into adulthood. It also
suggests that asthma triggers that affect infants and young children
often lose their impact in adulthood. This is particularly evident in
mild cases.
The British Medical Journal (July 9, 1994) had good news about
childhood triggers. A major study concluded that of all those children
with asthma at age 7, only 25 percent continued to suffer into
adulthood.
Q. I'm concerned about asthma and pregnancy. Is pregnancy safe for
me and the fetus? Can I safely continue with my medication during
pregnancy?
A. The medical community agrees on most aspects of asthma and
pregnancy. Most doctors agree that it is generally safe for asthmatics
to become pregnant, and that most asthma medication can be taken
during pregnancy. Evidence of damage to either mother or baby due to
the condition itself is negligible. However, situations in which
asthma is not controlled during pregnancy can result in intrauterine
growth retardation, low birth weight, and in extreme cases, fetal
death. The greatest risk to the fetus occurs when the condition
remains untreated. Asthmatics who are considering becoming pregnant
should consult their physician for specific advice.
SOURCE
AQMD head announces asthma, cancer initiatives
By Associated Press
The head of the agency overseeing air pollution control in most of
Southern California announced new initiatives Friday to increase the
number of low-pollution buses, create an asthma and air pollution
research center, and examine the links between smog and brain cancer.
Dr.
William A. Burke, chairman of the South Coast Air Quality Management
District, proposed at an agency board meeting that the AQMD earmark 90
percent of its air pollution penalty fees for the new programs.
He
called for 70 percent of penalty fees to be spent on the agency's
continuing effort to buy low-emission school buses. Ten percent would be
set aside to establish an independent Southern California Consortium on
Asthma and Outdoor Air Quality, and 10 percent would be spent on
research into the possible link between higher brain cancer rates in
some metropolitan areas and air pollution.
The
remaining 10 percent of penalty funds would be held in reserve for other
projects.
The
AQMD is the air pollution control agency for Orange County and major
portions of Los Angeles, San Bernardino and Riverside counties.
Burke
also asked the agency's staff to develop a plan for carrying out the
initiatives that will be presented Feb. 7 at the next board meeting.
"We've
made great strides during the last three years by cleaning up dirty,
smoke-belching diesel school buses," Burke said. "We must
press on with this effort until we have eradicated this threat to our
children's health from school buses."
Since
1999 the AQMD has approved more than $43.5 million to clean up and
replace diesel-powered school buses in Southern California. The
projects, which are partly funded by the state, include the purchase of
206 compressed natural gas-powered school buses; 87 low-pollution diesel
buses; and the retrofitting of 1,482 diesel buses with particulate
emission traps.
The
new asthma center would rely on University of California researchers to
help develop a firmer scientific foundation for public policy on asthma
prevention. About one in 12 children in Southern California suffer from
asthma and as many as 13 percent of children under 17 in San Bernardino
County are asthmatic, Burke said.
The
third initiative would further explore previous studies, including one
by the American Lung Association, that have linked air pollution to
increased rates of brain cancer in urban areas.
"We
need to increase public awareness of the link between pollution
prevention and cancer prevention," Burke said.
Los
Angeles Daily news
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