The third week of September each year in the U.S. is known as Asthma Peak Week, the week that typically has the highest concentration of asthma flare ups and hospitalizations all year.1 While Peak Week is a challenging time for people with respiratory conditions, like severe asthma, there are things people or their loved ones can do to help mitigate potential triggers this week and throughout the year. And, while you can’t always control what you’re exposed to outside, there are ways to manage items in your home to create a space that is more asthma and allergy friendly. So, for this Q&A we sat down with two experts who live with asthma themselves: Dr. Payel Gupta, a physician and asthma and allergy specialist, and Andrea J., a Certified Asthma Educator (AE-C), who works in public health, has asthma – and raised three children living with asthma.
Why is indoor air pollution a problem? What are some of the most common household allergens and triggers for asthma? Do they cause indoor air pollution?
Dr. Gupta: Most people spend the majority of their day indoors, and while we might be aware of, or be able to see, the visible signs of poor air quality outside, our indoor air quality is often overlooked and can be worse than the air outdoors if we’re not careful. While specific asthma triggers vary person to person, dust, dust mites, mold, cockroaches, mice, pets, viruses and VOCs (Volatile Organic Compounds, which come from things like burning candles, perfumes, cleaning products and cooking) are some of the most common triggers in a home for someone living with asthma. Outdoor pollutants can also enter the home, especially if you live near a busy roadway. If you feel there’s something in your environment triggering your asthma but aren’t sure what it is, you should ask your doctor about allergy testing to help pinpoint.
The third week of September each year in the U.S. is known as Asthma Peak Week. Why is this time of year challenging for people living with asthma, and how can they prepare for it?
Dr. Gupta: I often refer to Peak Week as “the perfect storm” because the reason this time of year can be so challenging is largely due to two separate factors. First, it’s peak ragweed season, which is not only a very common allergy but can trigger allergic asthma. Second is the Back-to-School timeframe. Kids are exposed to a lot of viruses and asthma triggers this time of year and are often bringing them home with them. Given the uptick in exposure, this is an opportune time to check-in on your or your child’s level of asthma control and see if any changes to either of your asthma management plans need to be made. A good rule of thumb to gauge if your asthma may be uncontrolled is the “Rules of Two”: having asthma symptoms or using a rescue inhaler more than two times per week, waking up at night with asthma symptoms two or more times per month, or refilling your rescue inhaler more than two times per year. If you’re experiencing any of the above, your asthma may not be well controlled, and you should discuss additional management options with an asthma specialist, such as an allergist or pulmonologist.2,3
Andrea J.: In terms of preparation, it’s important to make sure you and your kids are up to date on your asthma management plans and have a non-expired rescue inhaler ahead of the school year. Kids can legally carry their inhaler in all states in the U.S. However, parents may need to have a “Self Administration Form” signed by them, their child’s doctor and the school nurse; so it’s important to contact your school ahead of time to confirm their policy. It’s also important to practice good hygiene. Make sure that you and your family are diligent with handwashing, and that you are blowing your nose when returning home from school or being outside of the house to clear out any allergens.
What can patients or caregivers do to keep their homes asthma friendly?
Andrea J.: Beyond regularly washing your bedding in hot water and using protective coverings — including on pillows! – to minimize dust mite reactions, air purifiers with HEPA filters are an incredibly important management tool in the home. Just like air conditioning units, it’s important to make sure that your air purifier is fit for the size of the space it’s in. For example, a large living room may require something different than a bedroom. An air purifier will help trap unwanted particles like dust, dander, pollen, mold and other common allergens that may trigger asthma. Another common source of indoor air pollution is what we track inside. During peak pollen seasons, even small changes like removing your shoes at the front door, changing your clothes and showering before bed can help prevent pollen and other allergens you picked up outside from sticking around. And if you’re traveling to visit friends or family, remember that it’s important to communicate your allergy and cleanliness needs ahead of time so they can help prepare your space. Your loved ones want you to feel well and might not be aware of the special precautions you need to take!
Dr. Gupta: Two things that are often the hardest for people to adapt to lifestyle-wise are pets and candles. We all love our pets and love our homes to smell nice, but both can be huge triggers for asthma flare-ups. With pets, you may be allergic to the pet themselves or allergic to the dust and allergens that get trapped in their fur. For either scenario, I recommend keeping pets out of bedrooms as much as possible and bathing them regularly, ideally once a week to minimize dander. For candles, I advise no candles or any product that puts scent into the air. To address household smells, proper air flow and air purifiers can help remove any unwanted scent from cooking you may want to cover up.
Any other surprising household triggers you’ve encountered?
Andrea J.: The kitchen and the bathroom are two spaces people often don’t think about. In both spaces, you often need to use more heavy-duty cleaning products to ensure surfaces are sanitized. Products that have strong fumes can trigger asthma, so wearing a mask can help minimize fume intake. In the bathroom, you also want to make sure you’re letting the space air out after showers that produce steam, as any trapped moisture can cause mold to grow. A dehumidifier can also be helpful for high humidity climates to prevent mold growth.
To close, what is your biggest piece of advice for anyone living with asthma or who may have a child with asthma?
Dr. Gupta: Make sure to check in with your doctor before your problems impact your day-to-day life. People often only seek treatment for their asthma when it becomes a problem and ignore symptoms that can be an indication of underlying inflammation. Addressing your asthma in a preventative way can help reduce exacerbations, visits to urgent care and the ER in the future.4,5
Andrea J.: If you’re a parent to a child with asthma, trust your gut. If you sense something is off, don’t be afraid to advocate for your own and your families’ specific needs, and continue to seek the advice of a doctor or an asthma specialist. It’s also important to keep track of how often your child is using a rescue inhaler and the frequency of their symptoms. Knowing this will help you become an active participant in their care and help you to identify the signs that something isn’t normal for your child.
To learn more about how you can better understand and manage your asthma, sign up for live virtual events through LUMA (Learn to Understand and Manage Severe Asthma) by visiting https://luma-edu.com/. There will be two sessions dedicated to Peak Week on September 28, 2022 at 8pm PST and 8pm EST.
- Services, AAFA Community. “Brace Yourselves: The Biggest Week for Asthma Attacks Is Coming.” Asthma and Allergy Foundation of America, https://community.aafa.org/blog/September-Asthma-Peak-brace-yourselves-the-biggest-week-for-asthma-attacks-is-coming. Accessed August 2022
- “Severe Asthma.” American Lung Association, https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/severe-asthma. Accessed August 2022
- “Assess and Monitor Your Asthma Control.” American Lung Association, https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/assess-and-monitor-your. Accessed August 2022
- “Asthma Facts and Figures.” Asthma and Allergy Foundation of America, https://www.aafa.org/asthma-facts/#:~:text=On%20average%2C%2011%20people%20in,the%20right%20treatment%20and%20care.&text=In%202020%2C%20deaths%20due%20to,first%20time%20in%2020%20years. Accessed August 2022
- “FastStats - Asthma.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Feb. 2022, https://www.cdc.gov/nchs/fastats/asthma.htm. Accessed August 2022