Friend or Foe?

A trigger is anything that sets off your asthma symptoms or brings on an attack. Triggers vary from person to person, and it is common to have more than one trigger that prompts an asthma attack.

It is important to recognise your asthma triggers so you can reduce or avoid your exposure to them, making your asthma more manageable.

The following are some of the more common triggers: 

Tobacco smoking

Various products are used for tobacco smoking (e.g. vape, e-cigarettes, cigars and shisha). Smoke contains more than 4000 particles that can cause diseases such as cancer.

It irritates the surface of the airways and can trigger asthma, both as a direct consequence or when patients are exposed to secondhand smoke. The latter is also a risk factor for the development of asthma in young children. Children’s bodies are still developing and they breathe more quickly than adults. Both these factors make them even more at risk to the effects of tobacco smoke.

What can be done?
If you are not able to give up smoking just yet, you should
  • Avoid smoking in an enclosed environment(restaurants, cars, etc.)
  • Avoid smoking near individuals with asthma
  • Avoid smoking near children
Pets

Asthma is usually associated with cats, but it can be triggered by any pet such as dogs and hamsters. Triggers are not limited to the pet’s fur - its skin flakes, saliva, urine and droppings also play a role.

What can be done?
  • Avoid allowing pets indoors
  • Clean your home thoroughly if you decide to put your pets outdoors
  • Isolation is an option for those who find it difficult to part with their pets. During isolation, you should keep your pets outdoors, outside the bedroom and regularly clean the house (best done when the patient  with asthma is away)
Cockroaches

The droppings, saliva and body parts of cockroaches can trigger both allergic reactions and asthma in some patients. These can be present even if cockroaches are not visible - they are known to be sneaky little creatures!

What can be done?
  • Routine hygiene (regularly clean floors, tables)
  • Clear foodstuff immediately
  • Store food in airtight containers or in the refrigerator as soon as possible
  • Insecticides may play a role, but they too can trigger asthma
Dust Mites

The droppings and body parts of dust mites can trigger asthma. These insects are very small and are present in every home. As they feed on skin flakes, they tend to be found in mattresses, pillows, stuffed toys, bedcovers and furniture.

What can be done?
  • Wash bedding and covers regularly at 60°C
  • Vacuum carpets and furniture regularly
  • Buy stuffed toys that are washable (allow to dry completely)
Mould

Moulds are created from fungi. These thrive in the presence of moisture. Both the moulds themselves and their spores can trigger asthma. The spores spread by floating through the air.

What can be done?
  • Clean up all mould and eliminate the water source
  • Conduct regular checks for mould on the shower and air conditioning
Chemicals

Chemicals used indoors may contain irritants that trigger asthma. These include strong-smelling perfumes, pesticides, air fresheners, paint and generally anything that can come out of an aerosol can.

What can be done?
  • witch products (especially to those that are fragrance-free)
  • Use products when asthma patient is away.
  • Use the product in a well-ventilated area (e.g.outdoors, in a room with open windows)
Air pollution/haze

There are many components that make up air pollution. These can trigger asthma both as individual factors or in combination with others.

Outdoor air pollution is usually caused by small particles that come from open burning, barbecues, dust, vehicle exhaust, factories and power-plants.
Pollution can be highest near busy roads or during the regular haze occurrence.

What can be done?
  • Monitor the degree of air pollution outdoors (via online air quality index sites)
  • Avoid outdoor activities when air pollution is particularly bad
  • Go outdoors when the air is likely to be less polluted (e.g. avoid peak hours)
Weather

Walking from a cold to a warm room (and vice versa) can trigger asthma. Other factors include exposure to windy and stormy weather and high humidity.

What can be done?
  • Avoid alternating between cold and warm areas
Chest Infections

Asthma can be triggered by a cold, the flu or an ear, nose, and throat (ENT) infection. Most are viral in nature and do not require an antibiotic, but may require additional treatment for your asthma.

What can be done?
  • Wash your hands frequently
  • Avoid individuals with a chest infection
  • Get the flu and pneumococcal vaccination
At work

Some people have asthma symptoms related to their workplace. This includes people who get asthma because of the nature of their profession (known as occupational asthma) and people who already have asthma but it is worsened by the work they do (known as work-aggravated asthma).

What can be done?
  • Avoid contact with substances that triggers your asthma symptoms
  • Take your asthma medication as necessary
  • Use a written Asthma Action Plan to help you manage your asthma
Emotion

Stress, depression and even laughter can trigger asthma.

What can be done?
  • Control your asthma by taking your medication
  • Manage your asthma with the aid of a written Asthma Action Plan
  • Try to find other ways to manage your stress (e.g. yoga, swimming, and cycling among others.)
Hormones

Women may notice changes to their asthma when levels of the female hormones (oestrogen and progesterone) change. These happen around puberty, during menstruation, pregnancy and menopause. During these times, women may experience greater sensitivity to triggers or may find that an asthma attack occurs more easily.

What can be done?
  • Use a peak flow diary to help you identify changes around the time of menstruation
  • Use a written Asthma Action Plan to track your symptoms and adjust medication accordingly
Exercise

Some people with asthma find that exercise triggers their asthma. In theory, any form of physical activity - from a walk or climbing the stairs to a game of football or badminton - can trigger asthma symptoms or an asthma attack.

What can be done?
  • Take your medication as prescribed by your doctor
  • Check with your doctor that you are using your inhaler correctly
  • Go for regular asthma reviews
  • Warm up adequately before exercise
  • Use your inhaler before exercise (you will need to discuss with your doctor)
  • If playing sports in a cold environment, wear a mask
  • Use Montelukast to achieve better control of your asthma; it is also good for exercise-induced asthma (you will need to discuss with your doctor)
Food and Drug Allergies

Food allergies induce mild to severe life-threatening reactions. Asthma symptoms caused by food allergies are often accompanied by rash, hives, nausea, diarrhoea and vomiting. If food allergies are not addressed promptly, anaphylaxis may occur, this leads to airway swelling and narrowing, and eventually, gets cut off.

The most common foods associated with allergic symptoms are eggs, milk, peanuts, soy, wheat, fish, shrimp and other shellfish, salads, fresh fruits, among others.

What can be done?
  • Identify and avoid your food trigger (your doctor can carry out allergy tests)
  • Read food labels and find out how foods are prepared when you dine out
  • In extreme cases, you might need to carry an Adrenaline EpiPen (consult your doctor if this is necessary)

In an ideal world, we will be able to avoid exposure to all triggers. However, some triggers such as air pollution, dust mites, air-conditioning and cold weather are part and parcel of life. It is therefore essential for necessary remedial steps to be taken such as:

  • Take your preventer inhaler daily
  • Use a written Asthma Action Plan
  • To have annual checkups