Asthma and Respiratory

Causes and triggers of asthma

Asthma is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow. It may happen randomly or after exposure to a trigger.

Common asthma triggers include:

• allergies (to house dust mites, animal fur or pollen, for example)
• smoke, pollution and cold air
• exercise
• infections like colds or flu

Identifying and avoiding your asthma triggers can help you keep your symptoms under control.

Asthma Symptoms

Asthma symptoms are individual to each person and can come and go, it is possible to have one or more of the symptoms below:

• Shortness of breath / breathing
• Cough (day or night)
• Wheezing
• Chest tightness

These symptoms can also be caused by other conditions, so if you suspect you may have asthma you should see your GP.

What happens in an asthma attack?

In an asthma attack the muscles around your airways can become swollen and inflamed with increased mucus production resulting in one or more of the following symptoms: difficulty breathing, difficulty speaking, experiencing a wheeze, blue colour to the lips and feeling distressed.

Signs that you may be having an asthma attack include:

• your symptoms are getting worse (cough, breathlessness, wheezing or tight chest)
• your reliever inhaler (usually blue) is not helping
• you’re too breathless to speak, eat or sleep
• your breathing is getting faster and it feels like you cannot catch your breath
• your peak flow score is lower than normal
• children may also complain of a tummy or chest ache

The symptoms will not necessarily occur suddenly. In fact, they often come on slowly over a few hours or days.

Managing an asthma attack

1. Immediately take 1 puff of your asthma inhaler, repeating 1 puff, if required, every 30-60 seconds, up to a maximum of 10 puffs
2. Try to remain calm and sit upright (this allows you to breathe easier)
3. If you feel worse, or do not feel any better after 10 puffs call an ambulance (this ensures medical help is on its way)
4. If the ambulance takes longer than 15 minutes to arrive then repeat step 1.

For advice and information on how to manage your asthma and asthma treatment, please download one of our useful factsheets.

Never be frightened of calling for help in an emergency and try to take the details of your medicines (or your personal asthma action plan) with you to hospital if possible.

If your symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP or asthma nurse.

Diagnosing asthma

What is thunderstorm asthma?

Thunderstorm Asthma is caused by high winds drawing higher levels of pollens and pollution particles into the air. When the  pollen granules come into contact with water the pollen breaks down into smaller particles that  are released into the air,  these particles  are so small  that when they are breathed in  through  the nose and mouth  they can  get deeper down into the smaller airways in the lungs and trigger asthma symptoms. Some airborne allergens involved in thunderstorm asthma are grass and tree pollens and mould spores.

Most people with hay fever will feel their normal symptoms, like sneezing, runny nose and itchy eyes. However, hay fever can cause asthma symptoms to worsen and these weather conditions can cause even mild symptoms to become severe (such as difficulty breathing and chest tightening). So it is important to be prepared and take your allergy treatments and medications to control symptoms.

Complications of asthma

Although asthma can normally be kept under control, it’s still a serious condition that can cause a number of problems. This is why it’s important to follow your treatment plan and not ignore your symptoms if they’re getting worse.

Badly controlled asthma can cause problems such as:

• feeling tired all the time
• underperformance at, or absence from, work or school
• stress, anxiety or depression
• disruption of your work and leisure because of unplanned visits to a GP or hospital
• lung infections (pneumonia)
• delays in growth or puberty in children

There’s also a risk of severe asthma attacks, which can be life threatening.

Indoor air quality & why it matters

Many of the allergens that cause an allergic reaction can be found in our own homes (and even our place of work). House dust mites, for example, are tiny creatures, just a quarter of a millimetre long. House dust mite allergy is very common and associated with asthma, eczema and perennial allergic rhinitis. Mites are found in carpets, soft furnishing and clothing but a significant amount of exposure to house dust mite allergens happens in bed.  You can take measures to avoid house dust mite, which will help, but will not entirely remove dust mite allergens.

Mould is another culprit.  It is the spores from the mould that can trigger allergic symptoms such as runny/itchy nose, itchy eyes, eczema and, most importantly, asthma. There are ways to avoid moulds – ventilation is key to help stop moulds flourishing in a damp environment.

Outdoor air quality & why it matters

Air pollution is the top environmental risk to human health in the UK, and the fourth greatest threat to public health after cancer, heart disease and obesity.

It makes people more susceptible to respiratory infections and other illnesses and it can have a significant impact on those living with allergies. There is a proven link between the quality of the air we breathe and the health of people living with allergic disease. Sensitivity to the adverse effects of air pollutants will vary in individuals and air pollution levels will also vary seasonally, from day to day, as well as by the time of day.