What is Asthma
Asthma is a chronic lung disease affecting the airways that carry air into and out of the lungs. It’s characterized by an inflammation and/or obstruction of the airways. Symptoms vary from person to person, but may include coughing, wheezing, shortness of breath, chest tightness, or producing a lot of mucus.
People with asthma have inflamed airways which are super-sensitive to things which do not bother other people. These things are called “aggravators.”
Although asthma aggravators vary from person to person, some of the most common include:
- Substances that cause allergies (allergens) – dust mites, pollens, food…
- Irritants in the air – smoke, strong fumes…
- Respiratory infections – flu, colds, possible mastitis infection…
- Strong emotions-anger, fear…
Presently, there is no known cure for asthma. However, medical researchers worldwide are making tremendous progress in learning what causes asthma, and how to prevent episodes (attack). Some things you should know about asthma:
- Asthma causes nearly 5,500 U.S. deaths each year.
- Asthma affects more African-Americans and Hispanics than whites.
- They are three times more likely to be hospitalized from asthma.
- About $11.3 Billion a year is spent on health care related to asthma.
- What is an Allergy?
- An estimated 40 million to 50 million Americans are afflicted with allergies, but according to doctors, the vast majority of sufferers never seek medical help.
An allergy is an abnormal sensitiveness to certain foods or substances. What distinguishes allergy from other reactions is that it always involves the immune system springing into action to defend us from substances which are normally harmless. An allergen is the substances that one is sensitive too.
- Pollens – grasses, trees, weeds…
- Molds – indoor and outdoor spores in the atmosphere.
- Dust mites – tiny creatures that share our home.
- Stings – bee, wasp…
- Other aggravators – medicines, chemicals, plants, metal jewelry…
- Mold Spore Allergy
What is Mold?
Molds are microscopic fungi which, unlike plants, are unable to produce their own food from sunlight and air. They are made up of clusters of filaments, and live on plant or animal matter, which they decompose for their nourishment. Molds are among the most widespread living organisms, with tens of thousands of different varieties. The common bread mold is a well known example.
Some molds produce penicillin or other antibiotics, or are necessary for agriculture and food production; others produce potent toxins or are major sources of plant disease. Many molds reproduce by releasing spores into the air, which then settle on organic matter and grow into the air, which then settle on organic matter and grow into new mold clusters. These airborne mold spores are far more numerous than pollen grains, and when inhaled can produce allergic symptoms.
Where are molds found?
Molds can be found in most environments, and unlike pollens do not have a strictly limited season. Their growth is encouraged by warmth and high humidity, however, so they are most prevalent during the humid seasons of the year. Molds are found out of doors and in the home.
They are present in outside air unless there is a cover of snow on the ground, and are especially prevalent in shady, damp areas and on decaying leaves or other vegetation. Mold spores produced outside become widely dispersed through the air, and can enter the home. Other molds are produced in the home, especially in areas of high humidity such as showers and basements.
What can be done to decrease mold exposure?
Mold sensitive individuals should avoid exposure to areas of high mold growth, such as basements, compost piles, fallen leaves, cut grass, barns and wooded areas. A face mask should be worn when such exposures are unavoidable. In the home, it is important to prevent high levels of humidity. A gauge measuring relative humidity should be obtained, and the level in the house kept below 35 percent.
This can be accomplished by the use of air conditioners and dehumidifiers in the summer, and by preventing over-humidification in the winter. Excess humidity produced by showering or cooking should be removed with an exhaust fan. Mold growing in the home can be killed with various products.
Mold Control in the Home
- Throughout the house:
Keep humidity low, 30 percent if possible, but in no case over 50 percent. Obtain a gauge to measure relative humidity. Use an air conditioner or dehumidifier in the summer, with the windows closed. Dehumidifiers must be emptied of water regularly. Air conditioners should be sprayed at the air intake with a mold killing spray if they develop a musty odor.
If using a humidifier in the winter, avoid over-humidification. Wash the humidifier and change the water frequently to prevent mold growth in the unit, occasionally cleaning the interior with a dilute bleach solution. Central humidifiers are common sources of mold growth, and must be checked and cleaned frequently. Very tightly insulated houses prevent the escape of moisture and thus encourage mold growth. Allow adequate ventilation.
- In the kitchen:
Use an exhaust fan to remove water vapor when cooking. Mold can grow in refrigerators, particularly around the door gaskets. Empty water pans below self-defrosting refrigerators frequently. Be careful with stored foods, removing spoiling foods immediately. Molds grow in garbage containers, which should be emptied frequently and kept clean.
- In the bathroom:
Use an exhaust fan or window to remove humidity after showering. Wash shower curtain, bathroom tiles, shower stall or tub, toilet tank and ceiling with mold-killing and mold-preventing solutions (see Products to kill molds). Repair any damaged caulking or grout. Replace shower curtain when mold growth is noted. Do not carpet bathroom.
- In the basement:
Use a dehumidifier. Correct seepage or flooding problems, and remove any previously flooded carpet. If a dirt floor is present, cover with a plastic vapor barrier.
Keep the basement free of dust, and remove moldy stored items. Avoid storage of any unnecessary items likely to harbor molds. Use a paint with a mold inhibitor, especially on brick or cinderblock walls. Allergic individuals should avoid living in basement apartments or dormitories.
- In the bedroom
Follow steps to decrease dust exposure. Ideally, carpeting should be removed and mattresses encased in zippered, air-tight covers. Foam rubber pillows and mattresses are particularly likely to become moldy.
Window condensation can lead to moisture and mold growth on the window frame. Books, leather products, stuffed toys, wood paneling and wallpaper paste also support mold growth, and should be avoided if possible or cleaned with appropriate mold-killing solutions.
Mold grows well in closets, which are damp and dark. Dry shoes and boots thoroughly before storing. A low watt light bulb, or a chemical moisture remover, can prevent mold growth in closets.
Although indoor plants are not a major source of indoor mold spores, it is prudent to limit the number of houseplants. Spores can become airborne when plants are watered, repotted, or otherwise disturbed, and plants increase the indoor humidity. Mold is present on the bark of wood. If using a fireplace or wood burning stove, do not store firewood inside. Live Christmas trees are best avoided.
Good quality HEPA air cleaners can remove mold spores from the air. Inexpensive table top air cleaners are not effective.
- Out of doors:
Avoid cutting grass and raking leaves, or use a face mask if these chores must be done by the allergic individual. Avoid exposure to soil, compost piles, sandboxes, hay, fertilizers and barns. Prune or cut trees to avoid shading of the home. Eliminate vines.
Correct drainage problems near the house, as pooled water greatly increases mold formation.
Avoid camping or walking in the woods, where mold growth on rotted logs and other vegetation is high. Some mold spores are spread on dry and windy days, others at times of rainfall. Limit outdoor exposure at these times.
- Work and Miscellaneous Environments:
Greenhouses, antique shops, saunas, sleeping bags, summer cottages and hotel rooms are sources of increased mold exposure. Automobile air conditioners may harbor mold.
Occupational exposure to mold occurs in farmers, gardeners, bakers, brewers, florists, carpenters, mill workers, upholsterers and paper hangers. Your allergist can offer specific recommendations.
- Products to kill molds:
A solution of equal parts of household bleach and water will kill mold. Commercially available products such as X-14® contain a similar solution combined with cleaning agents in a spray dispenser. Mold growth can be prevented by a solution of 1 oz. of 17% Zephiran® (available in pharmacies) in 1 gallon of water, or by commercially available Mildew Stop® spray.
A Guide to Managing Asthma
The Stages of Asthma – Classification of Asthma Severity
The classification of asthma severity according to clinical symptoms and objective measurements is a useful guide in optimizing asthma therapy. Based on a stepwise approach, the level of treatment should increase as severity increases.
The chart below outlines asthma severity according to clinical symptoms and objective measurements. (Mild, Moderate and Severe. PEF*: peak expiratory flow / Lung Function.)
Brief symptoms less than one to two times per week
Nocturnal asthma less than twice per month
Asymptomatic between exacerbations
PEF* greater than 80% predicted at baseline
PEF normal after bronchodilator
PEF variability less than 20%
Exacerbations greater than one to two times per week
Nocturnal asthma greater than twice per month
Beta-antagonist required almost daily
PEF* 60%-80% predicted at baseline
PEF normal after bronchiodilator
PEF variability 20%-30%
Frequent exacerbations and nocturnal asthma
Limited physical activity
Hospitalization in previous year or previous life-threatening exacerbation
PEF* less than 60% predicted at baseline
PEF below normal despite optimal therapy
PEF variability greater than 30%