Ways to Avoid Common Asthma Triggers
A Guide for Parents

Respiratory Infections

• Teach children to wash their hands frequently, especially after being in contact with someone with a cold or the flu. Colds are usually spread by hand-to-hand contact and less frequently, by airborne droplets from sneezes or coughs.

• Maintain good general health habits: adequate sleep, proper diet, regular exercise.

• Drink adequate fluids.

• Annual flu shots are generally recommended for children with asthma.

• Start early treatment for asthma if your child develops a respiratory illness.

Exercise
It is very important for all children to have active exercise. Children living with asthma can participate in sports just like other children with appropriate medical treatment and when appropriate precautions are followed. In fact many sports stars have asthma. They have achieved a balance between their medical needs and their sports activities. Next to viral inflections, exercise can be the most frequent trigger of asthma in children. Almost all children can enjoy a satisfying, active childhood if they are encouraged to explore alternatives until they find something that works for them. Here are some tips for an effective regular exercise program for children with exercise induced asthma.

• If recommended by your child's health care provider, use an oral or albuterol bronchodilator or a cromone a sufficient time before the children starts playing to give the medication time to work.

• Select type, location, and level of activity so as not to trigger asthma. Avoid allergenic environments such as grass fields. Short bursts of activity followed by short rest periods are better than one continuous period of exertion.

• Have your child avoid playing hard in cold, dry conditions, or try having the child wear a cold-weather mask covered by a scarf.

• Swimming is a great activity for children with asthma. All children should be taught to swim and encouraged to pursue it if they enjoy it.

• Children with asthma can pursue any sport they like if these precautions are followed.

• Children should slow down if they start to have symptoms and use albuterol as needed.

Environmental Control
Environmental control is important in avoiding allergic and irritant triggers of asthma such as the following:

Allergic Triggers and irritant Triggers

• Dust
• Dust mites
• Animal dander
• Mold spores
• Pollens
• Air Quality including Ozone (Smog) and Particulate Matter
• Smoke
• Fumes
• Strong odors
• Dust
• Sulfur dioxide
• Temperature and barometric pressure changes
• Humidity
• Winds

The following are ways to avoid such agents if they are problems.

Allergic House Dust Control

• House dust mites are the most important causes of allergy in the home. The house dust mite is a bug that is only visible under a microscope. It feeds on dry skin shed by animals and people in the home.

• Do not confuse allergic house dust with ordinary dirt. It is possible to have a very clean house and yet have high levels of allergic house dust, depending on how many house dust mites are present and how you clean.

• Allergic house dust is the material you see floating in the air when a bright beam of light shines through the room. To control this type of dust, never use a broom or dust mop in the house. Always use a vacuum cleaner with filters that trap dust or damp mop.

• Hard finished floors and smooth upholstery are best, especially in the child's bedroom. Avoid heavy rugs and plush draperies or upholstery. Small objects such as knick-knacks, books and records should be placed in drawers or closed cabinets. Stuffed animals and dolls should be removed from the child's bedroom if possible or replaced with washable toys.

• In homes with forced-air heating or air conditioning take care that the air intakes and their surroundings are clean and free of dust. Change the filters monthly. The addition of a high-efficiency air filtering systems is expensive but may be helpful.

• It is especially important to dustproof the child's bedroom because so much of the child's time is spent there. Blankets, comforters, and bedspreads should be machine washable and dryable. They should be washed in hot water every week or two to remove dust and destroy house dust mites. Items that are hung outside to dry may become contaminated with pollen.

• Place dust mite coverings on all pillows, mattresses, and box springs. These casings should be zippered and airtight. Do not store things under the bed.

• Avoid cleaning when the children are present. However, as they get older and need to learn to help with cleaning, the children may need to use a face mask.

Animal Dander

• Next to house dust, the most important asthma triggers in the home are animals. Animal dander comes from tiny flakes of animal skin, as well as from animal urine and saliva. Many kinds of animals have dander. Any allergic individual should completely avoid contact with animal dander. Pets should be kept out of the house. Ideally, they should never be obtained or they should be relocated.

• Replace down, feather, and kapok pillows and comforters with synthetics.

• Very small amounts of animal dander can cause symptoms. These materials can travel through heating and cooling vents from one room to another. They can stay in the house for months, even if a pet comes in only once in a while. They can even be in the house for months after occupants have moved. If you have a sensitive child be sure an check about previous pets in the home prior to renting or buying.

Strong Odors

• Avoid wearing perfumes.

• Avoid using strong chemical spays or solutions—such as cleaning products, paint, bug spray, gasoline, turpentine, room fresheners—around the child.

Molds and Mildew
If mold or mildew is a problem:

• Molds and mildew live in damp cool places such as shower stalls, bathtubs, bathrooms, cabinets under sinks, refrigerators, air conditioners, basements, windows, and eaves of houses. Check for musty odors. Clean thoroughly and spray repeatedly with Lysol or some other mildew control spray, or wipe areas frequently with pre-moistened mildew control cloths.

• Dehumidifiers may help control mold. Avoid moldy firewood, hay, and dried plants, and keep jute and straw accessories dry.

• Automobile air conditioners must be kept clean to avoid molds.

Pollens and Smog
If pollen sensitivity is a problem:

• During the pollen seasons, all windows in the home should be kept tightly closed 24 hours a day. Air conditioning may be used, but remember to clean filters frequently.

• Pollens are most concentrated in the early morning and late evening hours and when the weather is dry and windy. At these times, try to keep your child indoors as much as possible.

• Automobile windows and vents should be kept tightly closed during pollen seasons or when exhaust fumes are heavily concentrated (e.g., in traffic jams or parking garages).

• Your child's health care provider may be able to prescribe additional medications to get your child through a vacation in which he or she will be exposed to high concentrations of allergens or irritants.

• During high pollution days, stay indoors and minimize activity. Filtered air may be helpful.

Weather

• Cold air causes the lungs to be more reactive. When the child goes outside in cold weather, cover the mouth and nose with a scarf or mask to create a source of warm air, which can be rebreathed.

• Encourage your child to play indoors on very cold days. The combination of cold air and exercise can trigger asthma symptoms.

• Weather changes can also indirectly trigger asthma symptoms. They may bring in cold air or winds containing irritants or pollens. Avoid having your child play outside on a windy day or when there is a lot of air pollution.

Smoke

• The Surgeon General has clearly stated that second hand smoke is a serious health hazard.

• Children exposed to secondhand smoke are also at an increased risk, acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.

• The impact on the health and development of children is more severe than previously thought. “Children are especially vulnerable to the poisons in second hand smoke.”

• Discuss your child's need to avoid respiratory infections and smoke sensitivity with family and close friends. You may be surprised by how cooperative they will be.

• Make your home a no-smoking zone. Be sure to keep your child's bedroom smoke-free.

• Research shows that ventilation systems are ineffective in removing second hand smoke in public buildings. Take your child only to public buildings that are non-smoking. Many hotels and restaurants are now smoke free as are most other public buildings.

• Remember that smoke from fireplaces, wood stoves, or burning leaves may also aggravate your child's asthma.

Foods and Medicines
Food allergies are an uncommon cause of asthma. Severe food-induced asthma is much more common in young children with eczema. If your child's asthma seems to be triggered by certain foods, the only way of treating it is to avoid those foods. Check the contents of prepared foods—packaged and restaurant foods, as well as foods prepared by others. The following foods may trigger allergic symptoms in some children: nuts, peanuts, candy, chocolate, food with mint flavor or strong artificial flavoring such as Kool-Aid type drinks, gelatin desserts, ketchup, chewing gums, and carbonated drinks, especially the "diet" type.

Other Recommendations:

• Alert the teacher to the child's triggers. Keep the child away from chalk dust, plants, and furry animals if possible.

• Encourage the teacher to keep the room as dust-free as possible.

• If certain felt-tip markers are a problem for your child, purchase non-allergenic markers for your child to use at school.

• Some individuals with chronic asthma are sensitive to aspirin. Avoid aspirin and aspirin containing medications. Use acetaminophen (Children's Tylenol) instead. It is especially important to avoid giving aspirin to children who have the flu or chicken pox. Giving aspirin to children with these diseases may increase their risk of developing Reye’s syndrome, a neurologic disease.