• Animal dander – Flakes of skin from animals
• Pollen – Tiny dust-like spores sent into air by plants, grass, trees and weeds
• Dust mites – Spider-like creatures that are too small to see and present in beds, furniture, rugs and house dust. People with asthma are allergic to their bodies and waste.
• Cockroaches – Insects that live inside buildings. People with asthma are allergic to their bodies and waste, which can be present in house dust.
• Mold, mildew – Grows in damp places and sends tiny spores into the air

• Diagnosis made using lung or pulmonary function tests to measure reduced lung function caused by obstructed airways that prevent air from being exhaled at normal rate of speed
• Measured using medical equipment that determines lung capacity and exhalation speed
• Classified using National Heart, Lung and Blood Institute guidelines:

• Vacuum and dust with a wet rag weekly.
• Use dust-proof covers on mattresses and pillows. Ask your doctor where to get these.
• Don’t introduce pets into your home if you don’t already have them.
• Use dehumidifiers to take dampness out of air. Mold, mildew and dust mites all need dampness to live.
• Keep windows closed when pollen levels are high. Pollen seasons are spring and fall, with levels highest in morning.
• Don’t let your child play in leaves and freshly cut grass.
• Get rid of things that collect dust, especially in children’s rooms, including rugs, curtains, shelves and objects stored under the bed.

• Colds and flu viruses can trigger asthma, so practice good prevention measures:
  • Wash hands often.
  • Avoid touching eyes, nose and mouth.
  • Get flu vaccine.

Tobacco smoke

• Children who live with smokers are more likely to get this diseaseasthma, and their asthma tends to be worse.
• After an asthma flare, they may take longer to get well.
• Adults with asthma should avoid smoking.

• Dry, cold winter air can trigger asthma.
• In winter, put a scarf over your or your child’s nose and mouth. This warms air before it gets to lungs. Warm air is less likely to trigger this diseasease

• Although it can trigger asthma, exercise is important and we encourage patients to be active.
• If exercise triggers asthma, tell your doctor.
• Certain medicines can be taken before exercise to keep asthma flares from starting.
• Many star athletes have this condition.
• The best sports are those with rest periods, such as baseball and football.

• Written  management program including instructions on how and when to watch for triggers, monitor peak flow rates and increase medications for flares
• Call your doctor if unresponsive to action plan or exhibiting any of these signs:
  • Cough, shortness of breath, rapid breathing
  • Chest pain, inability to lie flat
  • Difficulty talking
  • Ribs and neck muscles show when breathing
  • Facial appearance that’s pale or dusky in color
  • Mood changes
  • Extreme fatigue
  • Rescue medications not working

• Identify and control environmental triggers, such as pollen, mold, dust mites, pet dander, and cockroaches.
• Allergy skin testing is used to identify triggers. (Read more about allergy skin testing)

• Inhaled corticosteroids, combination of inhaled corticosteroids and long-acting bronchodilator and leukotriene modifiers
• Typically taken every day to prevent the lungs from becoming inflamed

• Short-acting bronchodilators
  • Used for treatment of acute episodes or flares, every 4-6 hours as needed
  • Open inflamed lung airways quickly
  • Treatment intensity depends on severity of flare
  • Include short-acting beta2-agonists such as albuterol that relax the muscles lining the small airways and anticholinergics that do the same for the large airways
  • Daily or increasing use may indicate need for additional long-term controller medication or adjustment in therapy

• Short courses are often used for more severe flares

• Shortness of breath
• Cough
• Chest tightness
• Wheezing (whistling sound when breathing in or out)
• Poor stamina

Exposure to cold air, low humidity

Nasal blockage, viral respiratory tract infections

Air pollutants, high pollen counts

Certain sports like jogging or biking in cold months/locations

• Involves formal exercise challenges and lung function testing
• Is important to diagnose early since young children with EIA may have trouble keeping up with peers and avoid strenuous activity – both of which can negatively affect their physical and social well-being
• Is key to help adults with EIA understand why they see no improvement in stamina or performance despite regular exercise
• Allergist testing for EIA includes:
  • Pre-visit preparation, which may include prescription for inhaler medication to use before exercise and request to wear comfortable clothes and shoes for running tests
  • Thorough medical history and physical exam
  • Pulmonary function (breathing) tests at rest and after exercise if needed

• Choose physical activities carefully:
  • Walking, light jogging, leisure biking and hiking may be better than more strenuous sports.
  • Indoor swimming is ideal due to warm, humid atmosphere, year-round availability and horizontal position that may help move mucus from bottom of lungs.
  • Sports such as baseball, football, wrestling, short-distance track and field events, golfing, gymnastics and surfboarding that require short bursts of energy are better than endurance or cold-weather sports such as basketball, soccer, field hockey, skiing, ice hockey or long-distance running – though asthmatics can participate in most any sport with proper training and medical care.
• Take pre-exercise medication such as albuterol, metaproterenol, terbutaline, cromolyn sodium, nedocromil or theophylline if prescribed.
• Warm up gradually to avoid the symptoms that often occur within 15 minutes
• Restrict exercising during viral infection, when pollen or air pollutions levels are high or when temperatures are extremely low.
• Adopt breathing techniques such as pursed (narrowed) lip breathing to reduce airway obstruction and breathing through nose or facemask while exercising in cold weather to reduce heat and moisture loss.