2022-09-16

Asthma is one of the most common chronic illnesses, affecting over 300 million people worldwide. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, talks about the causes of asthma, preventative steps to reduce the chances of an attack and treatment.

What is asthma?

Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation, production of extra mucus and tightening of the muscles around the small airways. This causes asthma symptoms such as coughing, wheezing, shortness of breath and chest tightness. These symptoms can be intermittent, are often worse at night and can be triggered by exercise.

It affects approximately one in 10 children (10%) and one in 20 adults (5%) and can occur for the first time at any age, even in adulthood. Although asthma usually begins before the age of five, a few children affected will 'outgrow' it during their teenage years but it usually persists if contracted in adulthood. Asthma tends to run in families, as do related allergic conditions like hay fever and eczema.

Signs and symptoms

Asthma is often under-diagnosed and under-treated and this can lead to disturbed sleep, tiredness during the day and poor concentration. If you fail to recognise and avoid triggers that lead to your tightened airways, you may have an asthma attack, feel respiratory distress or experience a life-threatening situation. So, it's important that you know how to avoid the triggers and recognise the signs of this condition to enjoy a better quality of life.

What causes asthma?

There are various types of asthma including allergy-induced asthma. Research shows that the risk factors include a combination of genetic predisposition and environmental exposure, to inhaled substances and particles that may cause allergic reactions or irritate the airways. These include indoor allergens - such as dust mites, particles of cockroach waste and pet dander (allergens from cats and dogs found in skin cells as well as in their saliva and urine) and outdoor allergens - such as pollen which is seasonal, mould as well as tobacco smoke and air pollution. Smoke and strong soaps and perfume can also be triggers.

Other triggers for asthma can include cold air, physical activity - especially in cold, dry air, stress, certain medications, such as aspirin and other non-steroid anti-inflammatory drugs and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine) viral infections like cold and occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust.
Factors associated with asthma prevalence or disease severity in South African children include the adoption of an urban lifestyle, atopy (a genetic predisposition to having allergies), obesity, respiratory infection or exposure to industrial pollution or tobacco smoke.

Treating asthma

Asthma can be life threatening when left untreated and cannot be cured but, with the right treatment most asthmatics will lead completely normal, active lives. The aim of treatment should be to make the lungs and breathing tubes as normal as possible so that there are minimal symptoms and as little disruption to ordinary life as possible.

People with asthma may need an inhaler. Their treatment will depend on the frequency and severity of symptoms and the different types of inhalers available. There are two main types of inhalers:

• Bronchodilators that open the air passages and relieve symptoms
• Steroids that reduce inflammation in the air passages. This improves asthma symptoms and reduces the risk of severe asthma attacks and death

It can sometimes be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. Using a spacer device makes it easier and helps the medicine to reach the lungs more effectively. A spacer is a plastic container with a mouthpiece or mask at one end and a hole for the inhaler in the other. A homemade spacer, made from a 500ml plastic bottle, can be as effective as a commercially manufactured inhaler.

Reduce your exposure to allergy triggers

The best way to reduce your exposure to seasonal allergy triggers is to avoid them. Here are ways to mitigate your risk of exposure in and around the house.

• Try to avoid activity in the early morning when pollen levels are at their highest
• Stay indoors on dry, windy days as the pollen counts surge in these conditions
• The best time to go outside is after a good rain, as rain washes pollen away, but beware, pollen counts can also soar after rainfall
• Try to delegate gardening chores like mowing the lawn to others as it will stir up allergens
• Wear a pollen-filtering mask if you must do chores outside
• Once you go inside, take a shower to rinse pollen from your skin and hair, then put on a clean set of clothes
• Keep windows shut and try to use an air conditioner, especially if you know that pollen counts are going to be high
• Clean floors often with a vacuum cleaner
• Wash your bedding in hot water at least once a week
• Don't hang laundry outside during this time as pollen can stick to sheets and towels
• Cover your bedding and pillows with allergen-proof covers
• Remove stuffed toys from your children's bedrooms

Dr Mkhatshwa says, 'If you are experiencing asthma symptoms or think you might have asthma, it is important for you to talk to your GP. This will help you establish if your symptoms are linked to asthma or whether something else is causing them